Search results for "228"
showing 10 items of 834 documents
COVID-19 y tabaquismo: revisión sistemática y metaanálisis de la evidencia
2021
RESUMEN Objetivo: el objetivo del estudio ha sido responder a las siguientes preguntas: ¿Se asocia el consumo de tabaco en pacientes con Covid-19 con una progresión negativa y desenlace adverso de la enfermedad? y, ¿se asocia el consumo de tabaco, actual y pasado, a una mayor posibilidad de desarrollar COVID-19? Material y Métodos: Se realizó una revisión sistemática (RS) y metaanálisis (MA) de trabajos publicados previamente. La estrategia de búsqueda incluyó todos los descriptores conocidos sobre Covid-19 y tabaco y se realizó en diferentes bases de datos. Se utilizaron modelos estadísticos adecuados para abordar el tamaño del efecto en un metaanálisis: modelo de efectos aleatorios y de e…
Les réadmissions après résection pulmonaire en France : la base de données du PMSI
2021
BACKGROUND Readmission within 30 days is an indicator of the quality of care, because it often reflects post-discharge care that is not optimal. The objective of this work is to measure over time on the one hand the readmission rate and on the other hand the number of hospitals with a standardized readmission rate beyond the national average. METHOD All patients with major pulmonary resection for lung cancer in France were extracted from the PMSI national database. Readmission within 30 days was defined as any new hospitalization either in the same hospital or in another establishment. RESULTS From January 1, 2005 to December 31, 2018, 110,603 patients were included. The 30-day all-cause re…
Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions
2020
Mechanical ventilation is a supportive treatment commonly applied in critically ill patients. Whenever the patient is spontaneously breathing, the pressure applied to the respiratory system depends on the sum of the pressure generated by the respiratory muscles and the pressure generated by the ventilator. Patient-ventilator interaction is of utmost importance in spontaneously breathing patients, and thus the ventilator should be able to adapt to patient's changes in ventilatory demand and respiratory mechanics. Nevertheless, a lack of coordination between patient and ventilator due to a mismatch between neural and ventilator timing throughout the respiratory cycle may make weaning difficul…
The effect of tiotropium/olodaterol versus fluticasone propionate/salmeterol on left ventricular filling and lung hyperinflation in patients with COPD
2020
This exploratory, randomised, double-blind, double-dummy, multicentre, cross-over study explored the effect of 6 weeks of treatment with tiotropium/olodaterol (T/O) versus fluticasone propionate/salmeterol (F/S) on left ventricular filling in patients with chronic obstructive pulmonary disease with functional residual capacity (FRC) >120% predicted and postbronchodilator improvement of FRC ≥7.5%. Overall, 76 patients were randomised across nine sites. Treatment with T/O or F/S increased left ventricular end-diastolic volume index from baseline (adjusted mean change: T/O: 2.317 mL/m2, F/S: 2.855 mL/m2), with no statistically significant difference between treatments. However, T/O resulted…
<p>Switch from IL-5 to IL-5-Receptor α Antibody Treatment in Severe Eosinophilic Asthma</p>
2020
Background Anti-IL-5 antibodies represent an established therapy for severe eosinophilic asthma (SEA), but some patients show inadequate response. The objective of this study was to assess the effects of a switch to anti-IL-5Rα therapy in patients with inadequate response to anti-IL-5 therapy. Methods In this retrospective multi-centre, real-life study, we analysed all SEA patients switched from anti-IL-5 to anti-IL-5Rα therapy due to inadequate response or intolerability. Pulmonary function tests, blood gas analyses, asthma control tests (ACT) and oral corticosteroid (OCS) usage were analysed and compared at three timepoints: baseline (BL, before anti-IL-5 therapy), timepoint 1 (T1, under …
Withdrawal of inhaled corticosteroids in COPD: A meta-analysis
2017
Background Conflicting findings exist on the benefit of withdrawal of inhaled corticosteroid (ICS) in chronic obstructive pulmonary disease (COPD). We performed a quantitative synthesis in order to assess real impact of ICS discontinuation in COPD patients. Methods We carried out a meta-analysis via random-effects model on the available clinical evidence to evaluate the effect of ICS discontinuation in COPD. Randomized clinical trials and observational real-life studies investigating the effects of ICS withdrawal on the risk of COPD exacerbation, lung function (forced expiratory volume in 1 s [FEV1]) and quality of life (St. George's Respiratory Questionnaire [SGRQ]) were identified by sear…
Development and Validation of the OSA-CPAP Perceived Competence Evaluation Interview
2021
Continuous positive airway pressure (CPAP) is one of the most common therapies for Obstructive Sleep Apnea (OSA). We present a brief, patient-reported outcome measure used to assess patients' levels of adherence with CPAP treatment.A questionnaire was developed based on academic literature. We qualitatively tested a pool of 18 items. It was tested in a sample of 174 patients from the Hospital La Princesa. Next, 1021 patients from Catalonia were evaluated.5 items were removed. Nominal groups referred to three areas: general knowledge about OSA and its risks; CPAP treatment information and expectations; CPAP use, monitoring, and confidence with its use. The 13 retained items maintained the sa…
Uniportal thoracoscopy combined with laparoscopy as minimally invasive treatment of esophageal cancer
2018
A 67-year-old man was referred to our attention for management of esophageal adenocarcinoma, localized at the level of the esophagogastric junction and obstructed the 1/3 of the esophageal lumen. Due to the extension of the disease (T3N1M0-Stage IIIA), the patient underwent neo-adjuvant chemo-radiation therapy and he was then scheduled for a minimally invasive surgical procedure including laparoscopic gastroplasty, uniportal thoracoscopic esophageal dissection and intrathoracic end-to-end esophago-gastric anastomosis. No intraoperative and post-operative complications were seen. The patient was discharged in post-operative day 9. Pathological study confirmed the diagnosis of adenocarcinoma …
Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment
2017
In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients. This review summarises the available studies on the physiological phenotypes of upper airway response to obstruction durin…
The puzzle of metabolic effects of obstructive sleep apnoea in children.
2016
In adults, obstructive sleep apnoea (OSA) is often associated with metabolic alterations. Although obesity is a major culprit [1], large epidemiological studies have reported a metabolic risk associated with OSA that is independent of obesity. In particular, meta-analyses have shown that effective treatment of OSA by continuous positive airway pressure (CPAP) improves glycaemic control in both diabetic [2] and nondiabetic patients [3]. In obese children with obstructive sleep apnoea insulin resistance is common while lipids do not show a clear pattern