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1.
Jesús Bellido-Casado Vicente Plaza Miguel Perpiñá César Picado Santiago Bardagí Cecilia Martínez-Brú Montserrat Torrejón 《Archivos de bronconeumología》2010
The association between onset of asthma exacerbation and the inflammatory response has not been sufficiently studied. 相似文献
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María Isabel Velasco-García Raquel Recuero María Jesús Cruz Rafael Panades Gabriel Martí Jaume Ferrer 《Archivos de bronconeumología》2010
Introduction
The purpose of the present study is to analyse the prevalence and distribution of asbestos lung residue in the Barcelona urban population.Material and methods
Lung autopsy samples were obtained from 35 individuals who had lived in Barcelona. The close family were interviewed in order to rule out asbestos exposure. Samples were obtained from three areas of the right lung during the autopsy: upper lobe apex, lower lobe apex, and lower lobe base. The samples were treated to remove organic material. The inorganic residue was analysed using a light microscope. The results were expressed as asbestos bodies (AB) per gram of dry tissue. Levels greater than 1000 AB/g of dry tissue were considered as potentially causing disease.Results
AB were detected in 29(83%) of the subjects, of which 86% had levels less than 300 AB/g. Only one individual (3%) had values greater than 1000 AB/g dry tissue. The asbestos residue was higher in the lower lung lobe in 17 individuals (48%) than in the rest, although no significant differences were seen as regards AB residue in the three lung areas studied.Conclusions
The results of this study show that the urban population of Barcelona have asbestos levels in the lung that vary between 0 and 300 AB/g dry tissue. No differences in the asbestos residues were detected in the lung areas studied in this population. 相似文献3.
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Barrett's esophagus (BE) is the main recognized risk factor for the development of esophageal adenocarcinoma (EAC). The incidence of this cancer and its associated mortality has increased in developed countries during the last few years. Detection of EAC at earlier stages could potentially improve survival dramatically in these patients, which is especially important as mortality from EAC remains high despite the available treatments. Therefore, endoscopic surveillance is an attractive option for patients with Barrett's esophagus. Consequently, periodic endoscopic surveillance is recommended by all the International Gastroenterology Societies in an attempt to detect EAC at an early and potentially curable stage. Currently, the frequency of endoscopic surveillance and its need in Barrett's esophagus with low-grade dysplasia or without dysplasia are under discussion. This review presents the available evidence in order to assist clinicians in the decision-making process. 相似文献
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Carmen Ezpeleta-Baquedano Jose Luis Barrios-Andrés Alberto Delgado-Iribarren García-Campero 《Enfermedades infecciosas y microbiología clínica》2013
The inanimate hospital environment is rarely implicated in infection transmission, except among vulnerable patients. Some authors argue against the use of environmental surveillance cultures because the tests can be expensive and time consuming, and because they should not be used instead of quality control and good practices in disinfection and maintenance procedures. 相似文献
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Maciej Wójcik Alexander Berkowitsch Sergey Zaltsberg Christian W. Hamm Heinz F. Pitschner Thomas Neumann Malte Kuniss 《Revista espa?ola de cardiología》2014
Introduction and objectives
Long-term efficacy following cryoballoon ablation of lone paroxysmal atrial fibrillation remains unknown. We describe long-term follow-up results of the single cryoballoon ablation procedure.Methods
Pulmonary vein isolation was performed in 103 patients (72 male; median age 52 years) with symptomatic lone paroxysmal atrial fibrillation. The end-point of this observational cohort study was first electrocardiogram-documented recurrence of arrhythmia (atrial fibrillation, atrial tachycardia, or atrial flutter) during the 5-year follow-up, in the absence of anti-arrhythmic treatment.Results
Acute complete pulmonary vein isolation was achieved in 86% of the patients with a single cryoballoon. The 6-month, 1-year, and 5-year success rate after a single procedure was 94%, 91%, and 77%, respectively. Arrhythmia recurrence was observed in 24 cases at a median of 14.8 months [range, 8.0-16.8 months]. Thirteen symptomatic patients were well controlled on beta-blockers only. Seven symptomatic patients had anti-arrhythmic treatment (class IC in 5 patients; dronedarone in 2 patients) introduced during the blanking period. Two of them had early arrhythmia recurrence within the blanking period only; they were arrhythmia-free in further follow-up on dronedarone. The rate of complications was relatively low and included a 4.8% incidence of transient phrenic nerve palsy.Conclusions
A single cryoballoon ablation procedure for lone paroxysmal atrial fibrillation resulted in high rates of acute, medium-term, and long-term efficacy. The rate of complications is relatively low and includes a 4.8% incidence of transient phrenic nerve palsy.Full English text available from:www.revespcardiol.org/en 相似文献9.
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Carlos A. Jimenez Ruiz Segismundo Solano ReinaJose Ignacio de Granda Orive Jaime Signes-Costa MinayaEva de Higes Martinez Juan Antonio Riesco MirandaNeus Altet Gómez Jose Javier Lorza BlascoMiguel Barrueco Ferrero Pilar de Lucas Ramos 《Archivos de bronconeumología》2014
The electronic cigarette (EC) is a device formed by three basic elements: battery, atomizer and cartridge. When assembled, it looks like a cigarette. The cartridge contains different substances: propylene glycol, glycerine and, sometimes, nicotine. When the user “vapes”, the battery is activated, the atomizer is heated and the liquid is drawn in and vaporized. The smoker inhales the mist produced. Various substances have been detected in this mist: formaldehyde, acetaldehyde and acrolein and some heavy metals. Although these are found in lower concentrations than in cigarettes, they may still be harmful for the human body. Several surveys show that 3-10% of smokers regularly use e-cigarettes. A randomized study has shown that the efficacy of e-cigarettes for helping smokers to quit is similar to nicotine patches. Nevertheless, the study has relevant methodological limitations and reliable conclusions cannot be deduced. This report sets down the Position Statement of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on the efficacy and safety of e-cigarettes. This statement declares that e-cigarettes should be regulated as medicinal products. 相似文献
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Joan Gavaldà Yolanda MeijeÓscar Len Albert Pahissa 《Enfermedades infecciosas y microbiología clínica》2012
Invasive fungal infections (IFI) represent a serious threat for patients undergoing solid organ transplantation (SOT). IFI in SOT has a significant incidence and mortality not due to negligence. The management of IFI in SOT involves specific recommendations and has been individualized to the type of transplant and patient. The current review presents an overview of epidemiology, diagnosis, treatment and prevention of IFI in TOS. Depending on risk factors for different IFIs and transplant type, this paper includes the main recommendations based on previous publications and on the opinion of the authors on the prophylaxis and treatment of these patients. These recommendations highlight epidemiology changes and the emergence of new antifungals. The current document has focused mainly on Candida spp. and Aspergillus spp., with a special mention to the rest of yeasts and moulds that are common in SOT. 相似文献
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José Antonio Blázquez Pilar Escribano Enrique Pérez María Jesús López Miguel Ángel Gómez José María Cortina 《Archivos de bronconeumología》2009
Background and objectives
Pulmonary thromboendarterectomy (PTE) is considered the potential curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We analysed the results of the PTE application in our institution.Patients and methods
From February 1996 to December 2007, 30 patients with CTEPH underwent video-assisted PTE. Preoperative hemodynamic data were: systolic pulmonary artery pressure (SPAP) 87±17 mmHg, mean pulmonary artery pressure (MPAP) 51±11 mmHg, pulmonary total resistance 1067±485 dynes·s·cm–5, pulmonary vascular resistance 873±389 dynes·s·cm–5 and cardiac index 2.2±0.5 l/min/m2. We analysed the influence of several factors on hospital mortality and survival, and we performed partial analysis of mortality since 2004.Results
PTE resulted in significant improvements in SPAP (P<0.001), MPAP (P=0.001) and cardiac index (P<0.001). Hospital mortality was 17% (5/30) (95% confidence interval, 6%-35%). From 2004, it dropped to 5% (1/20) (95% confidence interval, 0%-25%). Hospital mortality was influenced by preoperative pulmonary total resistance, preoperative pulmonary vascular resistance, postoperative SPAP, reduction of SPAP, reduction of MPAP, reperfusion pulmonary oedema and residual postoperative pulmonary hypertension (P=0.036; P=0.018;P=0.013; P=0.050; P=0.050; P=0.030; P=0.045). Survival after PTE, including hospital mortality, was 76±9% at 10 years. Through long-term follow-up, functional status (P=0.001), 6 min walking distance (P=0.001), end-diastolic right ventricle size (P<0.001), and tricuspid regurgitation (P<0.001) significantly improved.Conclusions
PTE effectively reduces pulmonary hypertension and offers CTEPH patients a substantial improvement in survival and quality of life. 相似文献13.
Laura Rubio-Cirilo M. Dolores Martín-RíosGonzalo de las Casas-Cámara M. José Andrés-PradoGil Rodríguez-Caravaca 《Enfermedades infecciosas y microbiología clínica》2013
Introduction
Notifiable infectious diseases represent a public health hazard, which is why they are under surveillance and must be reported. We tried to assess hospital physicians’ knowledge of hospital physicians on notifiable infectious diseases and their self-reported attitudes to notification.Methods
An observational study was conducted using a questionnaire with 11 multiple choice questions, two yes/no questions and one short-answer question. It was distributed to all senior doctors and residents in 19 medical and surgical departments.Results
A total of 248 questionnaires were sent out, with a response rate of 79.84%. More than three-quarters (76.3%) of the respondents were senior doctors. As regards specific knowledge about whether a particular disease is a notifiable disease, 29.5% identified correctly 100% of the named diseases, 3.2% could not identify any of them. All urgent named notifiable infectious diseases were correctly identified by 25.3% of physicians. Statistically significant differences were found in the knowledge of notifiable diseases knowledge in medical and surgical departments, as well as for senior doctors (P = .047) and residents (P = .035). A high percentage of medical services (40%) and surgical (70%) department reported never failing to notify. When asked about the causes of under-reporting, 72% did not know whether notification was mandatory or not, and 88% did not know what diseases must be notified.Conclusions
Although many respondents are aware that diseases notification is part of their daily activity, many of them admit under-reporting. There is insufficient knowledge about what diseases are considered notifiable infectious diseases and how to notify them. 相似文献14.
José Manuel Benítez Cantero José Manuel Ángel ReyManuel Rodríguez Perálvarez María Dolores Ayllón TeránJuan Jurado García Pilar Soto EscribanoAntonio José Hervás Molina Antonio Poyato GonzálezÁngel González Galilea 《Gastroenterologia y hepatologia》2011,34(7):460
Eosinophilic esophagitis is an underdiagnosed disease that should be suspected in all patients with dysphagia and food impaction. Although these are the leading symptoms, the clinical and endoscopic spectrum is highly varied. Clinicians should be aware of the risk of endoscopy-related complications in this disorder. Precautions should be maximized in endoscopic examinations to avoid iatrogenic damage. We describe the case of a young patient with esophageal stricture and dysphagia who suffered a perforation following a biopsy. 相似文献
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Alicia Gutiérrez-Misis María T. Sánchez-Santos José R. Banegas María V. Zunzunegui Mercedes Sánchez-Martínez María V. Castell Ángel Otero 《Revista espa?ola de cardiología》2013
Introduction and objectives
Few studies have used time-dependent correction to analyze the relationship between blood pressure and all-cause mortality, and to our knowledge none has been performed in older people from the Mediterranean area. This study aimed to estimate the relationship between baseline blood pressure and blood pressure as a time-dependent covariate with the risk of all-cause mortality in a population cohort of persons aged 65 or older in Spain.Methods
Data were taken from the population-based study «Aging in Leganés» with 17 years of follow-up, launched in 1993 in a random sample (n=1560) of persons aged ≥65 years. Mortality was assessed in 2010. Cox proportional hazards models were fitted to examine the effects on mortality of blood pressure at baseline and of blood pressure as a time-dependent covariate.Results
The lowest mortality was observed at baseline systolic blood pressure of 136 mmHg and time-dependent covariate value of 147 mmHg. The highest risk of mortality for time-dependent covariates occurred with systolic blood pressure<115 mmHg and >93 mmHg and diastolic blood pressure<80 mmHg. Diastolic blood pressure over 85 mmHg did not increase the risk of death.Conclusions
Based on the dynamic association between blood pressure and mortality, a U-shaped relationship was found for systolic blood pressure and a negative relationship for diastolic blood pressure and all-cause mortality. The lowest mortality corresponded to a systolic blood pressure level slightly over the diagnostic hypertension value and suggests that a value of 140 mmHg is not adequate as a diagnostic and therapeutic threshold in an elderly population.Full English text available from:www.revespcardiol.org/en. 相似文献18.
Carolina Fernández David Jiménez Javier De Miguel David Martí Gema Díaz Antonio Sueiro 《Archivos de bronconeumología》2009
Background
The diagnosis of pulmonary embolism (PE) is often complicated by the presence of chronic obstructive pulmonary disease (COPD). Some studies have suggested that patients with PE and concomitant COPD have a worse prognosis than patients without COPD.Patients and methods
Outpatients diagnosed with acute symptomatic PE at a university tertiary care hospital were prospectively included in the study. Clinical characteristics, time between onset of symptoms and diagnosis, and outcome were analyzed according to presence or absence of COPD. The primary endpoint was all-cause deaths at 3 months.Results
Of 882 patients with a confirmed diagnosis of acute symptomatic PE, 8% (95% confidence interval [CI], 6%–9%) had COPD. Patients with COPD were significantly more likely to have a delay in diagnosis of more than 3 days and to have a low pretest probability of pulmonary embolism according to a standardized clinical score. The total number of deaths during 3 months of follow-up was 128 (14%; 95% CI, 12%–17%). Factors significantly associated with mortality from all causes were a history of cancer or immobilization, systolic blood pressure less than 100 mm Hg, and arterial oxyhemoglobin saturation less than 90%. COPD was significantly associated with PE-related death in the logistic regression analysis (relative risk, 2.2; 95% CI, 1.0–5.1).Conclusions
Patients with COPD and PE more often have a lower pretest probability and a longer delay in diagnosis of PE. COPD is significantly associated with PE-related death in the 3 months following diagnosis. 相似文献19.
Josep Montserrat-Capdevila Pere Godoy Josep-Ramon Marsal Inés Cruz Mònica Solanes 《Enfermedades infecciosas y microbiología clínica》2014