Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services.

BACKGROUND: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. METHODS: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. RESULTS: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. CONCLUSIONS: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.

[Do COPD patients lie about their smoking habit?] / ¿Mienten los pacientes con EPOC sobre su hábito tabáquico?

OBJECTIVE: To determine the deception rate or concordance between the interview on smoking and cooximetry in COPD patients from a monographic consultation. DESIGN: Prospective observational study to evaluate the concordance between the values of cooximetry and the response to a clinical interview on smoking. SETTING: COPD monographic consultation, Pneumology, Seville. PARTICIPANTS: Patients with a confirmed diagnosis of COPD in any degree. INTERVENTIONS: Clinical interview and measurement of carbon monoxide by cooximetry. MAIN MEASUREMENTS: Cooximetry values, responses on smoking, sociodemographic variables. RESULTS: n: 169. 107 patients presented values less than or equal to 6 ppm compared to 62 with values greater than 6 ppm, determining a prevalence of active smoking of 36.7%. The deception rate was 19.5% of the total sample (24.3% of all those who claimed not to smoke), with a Cohen kappa of 0.48 and p < 0.000. 40% of patients confessed not having told the truth. No relationship of this data was found with age, accumulated tobacco consumption or FEV1. A significant relationship with sex was found (deception rate: 31.8% in women vs. 15.2% in men, p 0.017). CONCLUSIONS: In spite of our attempts to make patients stop smoking, a considerable deception rate was found in our consultation; higher among women, recent ex-smokers or in the process of abandonment, so it would be essential to incorporate objective measures such as the cooximeter in the approach of this type of patient.

Anxiety, depression and tobacco abstinence. / Ansiedad, depresión y deshabituación tabáquica.

There is evidence of the relationship between mental illness and smoking and increased risk of depressive episodes after quitting smoking, even with specific treatments for abstinence. OBJECTIVE: To assess the influence of a cessation program on the emotional state of patients by measuring levels of anxiety / depression and differences depending on the presence of psychiatric history. METHOD: A prospective observational study of patients taking part in a combined program (pharmacological and cognitive-behavioral) for giving up smoking. Anxiety (A) and depression (D) were measured using the HADS questionnaire at baseline, first and third month of abstinence. RESULTS: Anxiety and depression showed significant and progressive improvement during treatment (A: baseline 9.2 ± 4.5, 5.9 ± 3.6 1 month, 3 months 4.5 ± 3.1, p.

Existe evidencia de la relación entre patología mental y tabaquismo y del mayor riesgo de sufrir un episodio depresivo al dejar de fumar, incluso con tratamientos específicos para la abstinencia. Objetivo: valorar la influencia de un programa de abandono del tabaco en el estado emocional de los pacientes mediante la medición de los niveles de ansiedad/depresión y las posibles diferencias en función de la presencia de antecedentes psiquiátricos. Método: estudio de cohortes observacional y prospectivo de pacientes que acudieron a dejar de fumar mediante programa combinado (farmacológico y cognitivo-conductual). Se midió ansiedad (A) y depresión (D) utilizando el cuestionario HADS al inicio, primer y tercer mes de abstinencia. Resultados: la ansiedad y la depresión presentaron mejoría significativa y progresiva a lo largo del tratamiento (A: basal 9,2±4,6; 1 mes 5,9±3,6; 3 meses 4,5±3,1; p.

[Blood uric acid levels in patients with sleep-disordered breathing]. / Valores de ácido úrico en sangre en pacientes con trastornos respiratorios del sueño.

OBJECTIVE: Recurrent hypoxia associated with sleep apnea-hypopnea syndrome (SAHS) leads to an increase in the degradation of adenosine triphosphatase to xanthine and, secondarily, to an increase in uric acid concentrations. The aim of the present study was to determine whether there is a correlation between uric acid levels in peripheral blood and sleep-disordered breathing, independently of known confounding factors. PATIENTS AND METHODS: We carried out a retrospective cross-sectional study of 1135 patients evaluated for suspected SAHS. For all patients, a medical history was taken using a standardized protocol. In addition, biochemical analysis of venous blood and an overnight sleep study (with either conventional polysomnography or home monitoring) were carried out. RESULTS: The mean (SD) concentration of uric acid was 6.31 (1.5) mg/dL, and 36% of patients had concentrations above established normal values for their sex. We found a significant correlation between uric acid levels and some sleep study parameters (number of respiratory events, number of desaturations, or the cumulative percentage of time with oxygen saturation less than 90%). Those patients with more respiratory events (apnea-hypopnea index or respiratory event index >or= 30) had higher uric acid levels than those with mild or no SAHS. However, this difference was not apparent in the univariate analysis of variance, in which body mass index and cholesterol and triglyceride levels were considered confounding factors. CONCLUSIONS: Uric acid levels are positively correlated with the number of obstructive respiratory episodes and oxygen desaturations during sleep, but this correlation seems to be influenced by other factors, such as obesity.