Intoxicación subclínica por monóxido de carbono en nuestra área sanitaria / Subclinical carbon monoxide poisoning in our health area

Presentamos un estudio observacional sobre la relación entre niveles elevados de carboxihemoglobina (COHB) e intoxicación subclínica por monóxido de carbono (CO) en nuestra área sanitaria, realizado en febrero y marzo de 2000, en 228 pacientes de ambos sexos, mayores de 18 años, que acudieron a Urgencias por diversos motivos. Previo consentimiento informado, obtuvimos una muestra de sangre venosa para determinar COHB y recogimos datos antropométricos, consumo de tabaco y tipo de calefacción domiciliaria. Los valores límite de COHB obtenidos fueron: en no fumadores, 1,9 por ciento; en fumadores de 1-10 cigarrillos/día, 5,1 por ciento; de 11-20, 6,9 por ciento y de > 20, 9,6 por ciento. El 25 por ciento de los pacientes presentaban una COHB elevada independientemente del hábito tabáquico, siendo el brasero de cisco la fuente de exposición más frecuente a CO (AU)

[Subclinical carbon monoxide poisoning in our health area]. / Intoxicación subclínica por monóxido de carbono en nuestra área sanitaria.

We present an observation study on the relatioship between high levels of carboxyhemoglobin (COHB) and subclinical poisoning by carbon monoxide (CO) in our health area. The study was carried out in February and March 2000 in 228 over 18-year-old patients of both sexes who went to the Emergency Room for various reasons. After an informed consent was conceded, a venous blood sample was obtained in order to determine the level of COHB; later, we collected the anthropometric data, the data relative to the tobacco use, and the data of the type of heating at home. The values limit of the COHB obtained were the following: in non smokers, 1.9%; in 1-10 cigarettes/day smokers, 5.2%; in 11-20 cigarettes/day smokers, 6.9%; in >20 cigarettes/day smokers, 9.6%. A COHB high level was observed in 25% of the patients regardless of the smoking habits, being the coal-dust slack brazier the source of most frequent exposure to CO.

[Efficacy of demand of positive airway pressure therapy for treating obstructive sleep apnea syndrome]. / Eficacia de la presión positiva a demanda en el tratamiento del síndrome de apnea obstructiva del sueño.

UNLABELLED: The treatment of choice for obstructive sleep apnea syndrome (OSAS) is nasal continuous positive airway pressure (nCPAP). The precise level of pressure is adjusted by polysomnography. Devices to deliver pressure on demand have recently been designed to adapt the level of pressure to each respiratory cycle according to flow modification. OBJECTIVE: To compare the manual titering nCPAP system with that of demand continuous positive airway pressure (nDPAP) in patients diagnosed of OSAS. PATIENTS AND METHODS: Eighteen consecutive patients whose OSAS was diagnosed by conventional polysomnography were enrolled with apnea-hypopnea indexes over 10/hour (AHI > 10) and clinical symptoms of daytime drowsiness and/or cardiovascular risk factors. Titering polysomnographs were performed for all patients with nCPAP and with nDPAP and analyzed blindly. RESULTS: No significant differences between nCPAP and nDPAP were found in neurophysiological variables analyzed (sleep architecture, arousals, sleep efficiency) or in respiratory variables (AHI, oxygen saturation) with the exception of minimum SatO2 during REM sleep, which was significantly better with nCPAP (p < 0.03). Mean end pressure with nCPAP and mean pressure with nDPAP were similar; it is also worth noting that mean pressure was lower with nDPAP than with titered nCPAP pressure a mean 65.7 +/- 22% of the time. CONCLUSION: Automatic nDPAP is as effective as titered nCPAP for treating patients with OSAS.

[Level of compliance in the treatment of sleep obstructive apnea syndrome with nasal continuous positive pressure]. / Nivel de cumplimiento en el tratamiento del síndrome de apnea obstructiva del sueño con presión positiva continua nasal.

The therapy of the obstructive sleep apnea syndrome (OSAS) with nasal continuous positive airway pressure (CPAP) eliminates symptoms of OSAS and is currently the non-surgical therapy of choice. The present study was undertaken to evaluate the compliance with such therapy in our setting, the factors associated with it, and the secondary effects. A sample of 88 patients diagnosed with OSAS and undergoing CPAP followed for a period of 29 +/- 11 months was studied. The results showed that compliance among our patients, as measured by time counter, was 70% and was associated with drowsiness degree, apnea/hypopnea index, and mean pressure of CPAP. The subjective evaluation of compliance by patients overestimates the actual use of the CPAP device. There was a high satisfaction degree with therapy, and secondary effects were not a limiting factor for compliance. The therapeutical approach of the patient must be on an individual basis if a good acceptance level is to be achieved.

[Varicella pneumonia in healthy adults. Apropos of 6 cases]. / Neumonía varicelosa en adultos sanos. A propósito de 6 casos.

Varicella is a self-limited, benign disease in childhood. When it affects adults, however, serious complications can develop, the most frequent and most dangerous being pneumonia. Adults who develop varicella should be followed closely, with careful attention given to respiratory symptoms in particular, from the first week the rash is evident until it begins to fade. Should pneumonia appear, early start of intravenous acyclovir therapy is indicated in immunodepressed or pregnant patients, or in immunocompetent patients with respiratory problems.

[Interstitial pneumopathy as extradigestive manifestation of ulcerative colitis]. / Neumopatía intersticial como manifestación extradigestiva de la colitis ulcerosa.

We report two cases of interstitial pulmonary disease in ulcerative colitis unrelated to sulfasalazine or 5-Aminosalicylate therapy. It is concluded that these two cases represent an extracolonic manifestation of ulcerative colitis.