Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 21
Filter
3.
Eur J Intern Med ; 17(6): 402-7, 2006 Oct.
Article in English | MEDLINE | ID: mdl-16962946

ABSTRACT

BACKGROUND: The issue of "hospital at home" (HAH) for acute respiratory patients is one that is still being debated, partly because economic, cultural and health service differences between locations imply that HAH schemes need to be tailored to local situations. The aim of the present study was to analyze the feasibility and effectiveness of HAH for patients with acute respiratory disease at our institution. METHODS: Of all the patients admitted to our institution via the emergency department during a 34-day subject enrollment period, 25 with diagnoses of respiratory infection, pneumonia, pulmonary insufficiency or exacerbated chronic obstructive pulmonary disease who were living within 25 km of our center and who were willing to receive HAH care were assigned to HAH. Fifty sex-matched controls with the same diagnoses were given conventional hospital care (CHC) as inpatients. The dependent variables evaluated included time to discharge, readmissions within 3 months and deaths within 3 months. RESULTS: There were no significant differences between the HAH and CHC groups with regard to age, diagnoses, physical and analytical findings, or co-morbidity, or with regard to deaths (HAH 16%, CHC 10%) or readmissions (HAH 17%, CHC 24%). Time to final discharge was significantly shorter for HAH patients (7 days) than for CHC patients (12 days). Some 95% of the HAH patients were satisfied and would choose HAH again. CONCLUSIONS: HAH seems feasible for appropriately selected acute respiratory disease patients presenting in our emergency department. It frees hospital beds for other patients, its readmission and mortality rates are no higher than for conventional hospitalization, and, in general, it is favorably evaluated by patients.

5.
J Diabetes Complications ; 13(5-6): 325-31, 1999.
Article in English | MEDLINE | ID: mdl-10765011

ABSTRACT

The prevalence of stroke is increased in diabetic patients. The vasoconstrictor peptide endothelin-1 (ET-1) has been implicated in the development of cerebral vasospasm after stroke but its role in the physiological regulation of cerebral blood flow (CBF) is not well known. Our aim was to assess the relationship between CBF and plasma ET-1 levels in type I diabetic patients. Regional CBF was assessed semi-quantitatively by 99Tc(m)-hexamethylpropylene-amine-oxime (99Tc(m)-HMPAO) single photon emission computed tomography (SPECT) in 50 cerebral "regions of interest" (ROIs) of 19 type I diabetic patients without clinical evidence of cerebral disease, and 10 healthy control subjects. In both groups, plasma ET-1 levels were measured. Results showed that type I diabetic patients had significantly more hypoperfusion ROIs than control subjects. While up to 68.4% of the type I diabetic patients showed 3 or more hypoperfusion ROIs, only 10% of the control subjects did. Plasma ET-1 levels were lower in the type I diabetes subgroup with 3 or more hypoperfusion ROIs than in the type I diabetes subgroup with less than 3 hypoperfusion ROIs and in the control group. Moreover, an inverse correlation between the number of hypoperfusion ROIs and plasma ET-1 levels (r = 0.47, p = 0.04) was found in the type I diabetes group. It is concluded that plasma ET-1 is decreased in type I diabetic patients with subclinical abnormalities of regional CBF assessed by cerebral SPECT. This fact may reflect a compensatory response to the reduction of the brain perfusion in order to prevent ischemic events in these patients.


Subject(s)
Brain Ischemia/diagnostic imaging , Brain Ischemia/physiopathology , Brain/blood supply , Brain/diagnostic imaging , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/physiopathology , Diabetic Angiopathies/physiopathology , Endothelin-1/blood , Adult , Blood Pressure , Brain Ischemia/blood , Cerebrovascular Circulation , Cholesterol/blood , Diabetic Angiopathies/blood , Diabetic Angiopathies/diagnostic imaging , Diabetic Nephropathies/physiopathology , Diabetic Neuropathies/physiopathology , Diabetic Retinopathy/physiopathology , Female , Humans , Male , Reference Values , Regional Blood Flow , Regression Analysis , Smoking , Tomography, Emission-Computed, Single-Photon
6.
P R Health Sci J ; 12(2): 109-13, 1993 Jun.
Article in English | MEDLINE | ID: mdl-8210281

ABSTRACT

We report the therapeutic outcome of 14 eyes of 11 patients with chronic clinically significant pseudophakic cystoid macular edema refractory to medical management who underwent argon laser photocoagulation of the perifoveal area. Inclusion criteria included chronic cystoid macular edema of more than six months duration of decreased visual acuity (20/100 or less), positive fluorescein angiogram and contact lens examination, pseudophakos with posterior chamber intraocular lens and intact posterior capsule, normal fasting blood sugar, failed medical treatment and minimal follow up of six months. Fifty per cent of the eyes improved after laser treatment (p = .0345, relative to unchanged plus worsened cases). Further prospective, randomized, clinical trials are recommended to define the effectiveness of this treatment protocol.


Subject(s)
Laser Coagulation , Macular Edema/surgery , Aged , Aged, 80 and over , Argon , Chronic Disease , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies
7.
P R Health Sci J ; 12(2): 123-8, 1993 Jun.
Article in English | MEDLINE | ID: mdl-8210283

ABSTRACT

Levels of serum antibodies against lens alpha, beta H and beta L crystallins were determined in 15 patients before and after endocapsular cataract extraction. The most abundant antibody at the time of surgery was anti-beta L, followed by anti-beta H and anti-alpha. An increase in the basal levels of these antibodies was seen after surgery in 93 percent of the cases. Relative increase was highest for anti-alpha, followed by anti-beta H and anti-beta L. There were individual variations both in the shape of the time-dependent antibody response after surgery and in the relative intensity of the response to the different antigens. The endocapsular technique therefore leads to the release of crystallins into the anterior chamber in sufficient amounts to provoke in many patients a humoral immune response.


Subject(s)
Antibodies/blood , Cataract Extraction/methods , Crystallins/immunology , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Period , Time Factors
8.
P R Health Sci J ; 12(2): 157-8, 1993 Jun.
Article in Spanish | MEDLINE | ID: mdl-8210289

ABSTRACT

The smallport system is a new technology that brings to surgeons who begin in phacoemulsification more advantages and control in surgery, more security and less time required for learning. The authors show the differences (advantages and disadvantages) between standard systems and the endocapsular "smallport". In nuclei up to grade 3 hardness we have good results with low phaco power (5-10%) and higher linear aspiration (200 mmHg) causing minimal loss of endothelial cells and quick visual rehabilitation.


Subject(s)
Cataract Extraction/methods , Cataract/therapy , Ultrasonic Therapy , Cataract Extraction/instrumentation , Humans
9.
P R Health Sci J ; 12(2): 99-103, 1993 Jun.
Article in English | MEDLINE | ID: mdl-8210293

ABSTRACT

A single center, single surgeon, nonrandomized, prospective clinical trial was performed comparing the keratometric induced astigmatism by different types of incisions and closures, one day, one week, one month and three months after 255 cataract surgeries. After phacoemulsification, or in rare cases after extracapsular cataract extraction, through a scleral pocket or limbal incision, patients received either a 5 x 6 mm, 5.5 mm, or 6 mm diameter polymethylmethacrylate optic posterior chamber intraocular lens. Incision was closed with either none, one horizontal or radial, or running 10-0 nylon suture. Vector analysis calculations of prism diopters of mean postoperative-induced keratometric astigmatism showed a trend to lesser values at each interval in scleral pocket incisions but statistically significant difference only at 1 day and 1 week between 9-mm and 6-mm limbal, and 5-mm and 6-mm scleral pocket incisions. Other subgroup analyses, including incision shape and distance from limbus, and type of suture, did not reach statistical significance. Horizontal, 5-mm, sutureless scleral tunnel incision showed less induced astigmatism with more rapid stable refraction.


Subject(s)
Astigmatism/etiology , Cataract Extraction/methods , Adult , Aged , Aged, 80 and over , Astigmatism/epidemiology , Cataract Extraction/adverse effects , Female , Humans , Male , Middle Aged , Prospective Studies
10.
An Med Interna ; 7(4): 186-8, 1990 Apr.
Article in Spanish | MEDLINE | ID: mdl-2103784

ABSTRACT

The selective deficit of IgA is characterised by its clinical variability. This disease can be detected in non-symptomatic patients or associated to multiple diseases of different features. The allergic reactions, recurrent infections, gastrointestinal alterations, autoimmune diseases, and some neoplasias are the most frequent features of this deficit. We present 3 cases with different pathology associated to the common deficit of IgA, giving a view of the wide clinical spectrum of this process.


Subject(s)
Dysgammaglobulinemia/diagnosis , IgA Deficiency , Adolescent , Adult , Humans , Male , Middle Aged
11.
An Med Interna ; 7(4): 198-202, 1990 Apr.
Article in Spanish | MEDLINE | ID: mdl-2103788

ABSTRACT

The selective deficit of IgA is the most frequently acquired immunodeficiency. It is important because of this and the variability of the clinical presentation, which might be non-symptomatic or simply show several clinical features. The prognosis depends on the associated clinical affliction. There is no substitute treatment for this immunodeficiency, in which the immunoglobulins administration produces a paradoxical antibody formation against this, and adverse immunological reactions. We reviewed the immunodeficiency in this paper, highlighting the frequency, pathogenia, clinical diversity and therapy.


Subject(s)
Dysgammaglobulinemia , IgA Deficiency , Dysgammaglobulinemia/diagnosis , Dysgammaglobulinemia/epidemiology , Dysgammaglobulinemia/therapy , Humans
12.
An Med Interna ; 6(8): 424-7, 1989 Aug.
Article in Spanish | MEDLINE | ID: mdl-2491086

ABSTRACT

A patient admitted into hospital suffering from quadriparesis, secondary to distal symmetric sensitive and motor polyneuropathy, is presented. Diffuse osteosclerotic bone changes associated to neurological symptoms were detected and histologically confirmed as non-secreting plasmacytoma, on noting the non-production of paraprotein. Also, there were endocrine, skin and systemic alterations. We comment on the association of these changes as POEMS syndrome, discussing the pathogenesis and giving details of the treatment, emphasizing the excellent response.


Subject(s)
Bone Neoplasms/diagnosis , Endocrine System Diseases/diagnosis , Osteosclerosis/diagnosis , Paraproteinemias/diagnosis , Plasmacytoma/diagnosis , Polyneuropathies/diagnosis , Skin Diseases/diagnosis , Adult , Bone Neoplasms/complications , Endocrine System Diseases/etiology , Humans , Male , Osteosclerosis/complications , Paraproteinemias/etiology , Plasmacytoma/complications , Polyneuropathies/etiology , Quadriplegia/diagnosis , Quadriplegia/etiology , Skin Diseases/etiology , Syndrome
SELECTION OF CITATIONS
SEARCH DETAIL
...