28 research outputs found
Clinical Audits in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Workflow
Objectives:
Previous clinical audits for chronic obstructive pulmonary disease (COPD) have provided valuable information on the clinical care delivered to patients admitted to medical wards because of COPD exacerbations. However, clinical audits of COPD in an outpatient setting are scarce and no methodological guidelines are currently available. Based on our previous experience, herein we describe a clinical audit for COPD patients in specialized outpatient clinics with the overall goal of establishing a potential methodological workflow.Methods:
A pilot clinical audit of COPD patients referred to respiratory outpatient clinics in the region of Andalusia, Spain (over 8 million inhabitants), was performed. The audit took place between October 2013 and September 2014, and 10 centers (20% of all public hospitals) were invited to participate. Cases with an established diagnosis of COPD based on risk factors, clinical symptoms, and a post-bronchodilator FEV1/FVC ratio of less than 0.70 were deemed eligible. The usefulness of formally scheduled regular follow-up visits was assessed. Two different databases (resources and clinical database) were constructed. Assessments were planned over a year divided by 4 three-month periods, with the goal of determining seasonal-related changes. Exacerbations and survival served as the main endpoints.Conclusions:
This paper describes a methodological framework for conducting a clinical audit of COPD patients in an outpatient setting. Results from such audits can guide health information systems development and implementation in real-world settings.This study was financially supported by an unrestricted grant from Laboratorios Menarini, SA (Barcelona, Spain)
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Hypophysectomized Rhesus Monkeys (Macaca mulatta)
Three female rhesus monkeys that were completely hypophysectomized at least 9 months before, were induced to ovulate twice with human menopausal gonadotropins (hMG) and human chorionic gonadotropin (hCG). During the first treatment cycle, D-Trp-6-LH-RH was administered i.m. at a dose of 10 �g (dose previously shown to induce luteolysis in intact rhesus monkeys) on Days 3 and 5 postovulatory. Serum progesterone concentrations and length of the luteal phases were not altered by the administration of agonistic analogue of LHRH. During the second treatment cycle, I mg of D-Trp-6-LH-RH was infused into the ovarian circulation over a period of 1 h, and blood was collected from the main ovarian vein prior, during, and after the infusion. No decreases of progesterone concentrations were observed in the ovarian vein blood during the period of this study. Peripheral serum progesterone levels and luteal phase lengths were not different from those of untreated animals from our colony. These results show that the administration of D-Trp-6-LH-RH to hypophysectomized rhesus monkeys did not result in luteolysis nor decreases of progesterone secretion by the corpus luteum. These findings cast doubt upon the theory of possible direct effects of LHRH and analogues at the gonadal level in primates as the mechanism by which they induced paradoxical antifertility processes
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Luteolytic Effect of D-Trp6-Luteinizing Hormone-Releasing Hormone in the Rhesus Monkey (Macaca mulatto)
Concentrations of immunoreactive inhibin in seminal plasma and serum from normospermic, oligospermic, vasectomized, Klinefelter's syndrome, and Sertoli-cell-only syndrome subjects
Semen samples and blood were collected from 57 men: 23 normospermic, 20
oligospermic, 10 vasectomized, two with Klinefelter's syndrome, and two with Sertoli-cell - only
syndrome. Inhibin was measured by radioimmunoassay techniques as reported previously.
Immunoreactive inhibin concentrations in seminal plasma were found to be 8000 to 10,000 times
higher than in blood. A significant correlation (P < 0.005) was observed between the serum
and seminal plasma concentrations in all groups. No direct correlation was observed between
immunoreactive inhibin concentrations in serum or semen with number of sperm in the ejaculate or
with sperm motility. Seminal plasma and serum immunoreactive inhibin levels in normospermic
subjects were significantly higher than in oligospermic, vasectomized, and Klinefelter's syndrome
subjects (P < 0.001 and < 0.01, respectively)