Teresa Feixas

Hospital de la Santa Creu i Sant Pau, Barcino, Catalonia, Spain

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Publications (22)23.09 Total impact

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    Respiratory Medicine. 04/2012; 106(4):599.
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    ABSTRACT: IntroductionPrimary hyperhidrosis is characterized by excessive sweating of the palms, soles, and axillae due to overactivity of the sympathetic nervous system at the level of the second and third sympathetic thoracic ganglia. The treatment of choice is bilateral dorsal sympathectomy performed using video-assisted thoracic surgery (VATS). The objective of our study was to determine whether lung function changes observed in a group of patients prior to bilateral dorsal sympathectomy performed using VATS were still evident 3 years after surgery.
    Archivos De Bronconeumologia - ARCH BRONCONEUMOL. 01/2010; 46(1):3-6.
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    ABSTRACT: The measurement of breathing pattern in patients with chronic obstructive pulmonary disease (COPD) by electrical impedance tomography (EIT) requires the use of a mathematical calibration model incorporating not only anthropometric characteristics (previously evaluated in healthy individuals) but probably functional alterations associated with COPD as well. The aim of this study was to analyze the association between EIT measurements and spirometry parameters, static lung volumes, and carbon monoxide diffusing capacity (DLCO) in a group of male patients to develop a calibration equation for converting EIT signals into volume signals. We measured forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), FEV(1)/FVC, residual volume, total lung capacity, DLCO, carbon monoxide transfer coefficient (KCO) and standard anthropometric parameters in 28 patients with a FEV(1)/FVC ratio of <70%. We then compared tidal volume measurements from a previously validated EIT unit and a standard pneumotachometer. The mean (SD) lung function results were FVC, 72 (16%); FEV(1), 43% (14%); FEV(1)/FVC, 42% (9%); residual volume, 161% (44%); total lung capacity, 112% (17%); DLCO, 58% (17%); and KCO, 75% (25%). Mean (SD) tidal volumes measured by the pneumotachometer and the EIT unit were 0.697 (0.181)L and 0.515 (0.223)L, respectively (P<.001). Significant associations were found between EIT measurements and CO transfer parameters. The mathematical model developed to adjust for the differences between the 2 measurements (R(2)=0.568; P<.001) was compensation factor=1.81# - 0.82# height (m)# -0.004 x KCO (%). The measurement of breathing pattern by EIT in patients with COPD requires the use of a previously calculated calibration equation that incorporates not only individual anthropometric characteristics but gas exchange parameters as well.
    Archivos de Bronconeumología 07/2009; 45(7):320-4. · 2.17 Impact Factor
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    ABSTRACT: Primary hyperhidrosis is characterized by excessive sweating of the palms, soles, and axillae due to overactivity of the sympathetic nervous system at the level of the second and third sympathetic thoracic ganglia. The treatment of choice is bilateral dorsal sympathectomy performed using video-assisted thoracic surgery (VATS). The objective of our study was to determine whether lung function changes observed in a group of patients prior to bilateral dorsal sympathectomy performed using VATS were still evident 3 years after surgery. Of the 20 patients studied at baseline, we were able to obtain data for 18 (3 men and 15 women; mean age, 35 y). They underwent spirometry and a bronchial challenge test with methacholine, and the fraction of exhaled nitric oxide (FE(NO)) was measured. The results were compared with those of the tests performed before surgery. At 3 years from baseline, we detected a statistically significant increase in forced vital capacity from a mean (SD) of 96% (10%) to 101% (11%) (P=.008), and a statistically significant decrease in midexpiratory flow rate from 3.8 (0.9)L/s to 3.5 (0.9)L/s (P=.01). The results of the bronchial challenge test with methacholine and the FE(NO) remained unchanged. The lung function changes detected point toward minimal, clinically insignificant small airway alterations due to sympathetic denervation following bilateral dorsal sympathectomy performed 3 years earlier.
    Archivos de Bronconeumología 06/2009; 46(1):3-6. · 2.17 Impact Factor
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    ABSTRACT: Nitric oxide (NO) production has been described using a 2-compartment model for the synthesis and movement of NO in both the alveoli and the airways. The alveolar concentration of NO (Ca(NO)), an indirect marker of the inflammatory state of the distal portions of the lung, can be deduced through exhalation at multiple flow rates. Our objective was to determine reference values for Ca(NO). The fraction of exhaled NO (Fe(NO)) was measured in 33 healthy individuals at a rate of 50mL/s; the subjects then exhaled at 10, 30, 100, and 200mL/s to calculate Ca(NO). A chemiluminescence analyzer (NIOX Aerocrine) was used to perform the measurements. The mean (SD) Fe(NO) was 15 (6)ppb. The mean Ca(NO) was 3.04 (1.30)ppb. These values of Ca(NO) measured in healthy individuals will allow us to analyze alveolar inflammatory behavior in respiratory and systemic processes.
    Archivos de Bronconeumología 04/2009; 45(3):145-9. · 1.37 Impact Factor
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    ABSTRACT: Background and Objective The measurement of breathing pattern in patients with chronic obstructive pulmonary disease (COPD) by electrical impedance tomography (EIT) requires the use of a mathematical calibration model incorporating not only anthropometric characteristics (previously evaluated in healthy individuals) but probably functional alterations associated with COPD as well. The aim of this study was to analyze the association between EIT measurements and spirometry parameters, static lung volumes, and carbon monoxide diffusing capacity (DLCO) in a group of male patients to develop a calibration equation for converting EIT signals into volume signals.
    Archivos De Bronconeumologia - ARCH BRONCONEUMOL. 01/2009; 45(7):320-324.
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    ABSTRACT: Nitric oxide (NO) production has been described using a 2-compartment model for the synthesis and movement of NO in both the alveoli and the airways. The alveolar concentration of NO (CaNO), an indirect marker of the inflammatory state of the distal portions of the lung, can be deduced through exhalation at multiple flow rates. Our objective was to determine reference values for CaNO. The fraction of exhaled NO (FeNO) was measured in 33 healthy individuals at a rate of 50mL/s; the subjects then exhaled at 10, 30, 100, and 200mL/s to calculate CaNO. A chemiluminescence analyzer (NIOX Aerocrine) was used to perform the measurements. The mean (SD) FeNO was 15 (6)ppb. The mean CaNO was 3.04 (1.30)ppb. These values of CaNO measured in healthy individuals will allow us to analyze alveolar inflammatory behavior in respiratory and systemic processes.
    Archivos De Bronconeumologia - ARCH BRONCONEUMOL. 01/2009; 45(3):145-149.
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    ABSTRACT: To address the minimum duration of pulmonary rehabilitation necessary for patients with chronic obstructive pulmonary disease (COPD) to achieve a plateau in Health-Related Quality of Life (HRQL) and exercise tolerance. COPD patients with a dyspnea rating of at least 2 on the Medical Research Council scale participated in an outpatient rehabilitation program of 3 weekly sessions for 12 weeks. Measurements included HRQL and exercise tolerance 2 weeks before the program started and every 2 weeks thereafter. Patients were considered to have reached a plateau if they showed no improvement beyond 20% of the minimal important difference between 2 consecutive evaluations on HRQL score or walk tests. Twenty-eight patients participated. The number of patients achieving stability after 8 weeks, showing continued improvement after 8 weeks, and demonstrating an erratic pattern of change was as follows: for physical function 16 (56%), 10 (37%) and 2 (7%) patients; for emotional function 22 (79%), 5 (18%) and 1 (4%); and for 6-min walk test 21 (75%), 5 (18%) and 2 (7%). More severe patients demonstrated a greater likelihood (76%) of achieving stability in physical function at 12 weeks than did less severe patients (27%; p on difference=0.003). The likelihood of stability at 12 weeks in emotional function and the 6-min walk test did not differ by severity. A program of 3 weekly 3-h sessions of outpatient pulmonary rehabilitation program should last at least 8 weeks in order to achieve optimal HRQL and exercise tolerance for most patients.
    Respiratory medicine 01/2009; 103(5):722-8. · 2.33 Impact Factor
  • Ana María Fortuna, Teresa Feixas, Pere Casan
    Archivos de Bronconeumología 11/2008; 44(10):580. · 1.37 Impact Factor
  • Ana María Fortuna, Teresa Feixas, Pere Casan
    Archivos de Bronconeumología. 10/2008; 44(10):580.
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    ABSTRACT: To compare unilateral lung function estimated by 2 methods: electrical impedance tomography (EIT) and ventilation-perfusion lung scintigraphy. This prospective clinical study was carried out in the pulmonary function laboratory of a general hospital. Twenty patients diagnosed with lung cancer (17 men and 3 women, ranging in age from 25 to 77 years) who were candidates for lung resection underwent ventilation-perfusion lung scanning breathing a radioactive gas. Differential lung function was estimated based on images taken at 2 intercostal spaces in which ventilation and perfusion were represented by changes in bioelectrical impedance. Each lung's contribution to overall respiratory function was also calculated based on scintigraphy. The right lung contributed a mean (SD) of 54% (9%) of ventilation (range, 32%-71%) according to EIT. Scintigraphy similarly estimated the right lung's contribution to be 52% (10%) of total ventilation (range, 31%-80%) and 50% (9%) of perfusion (range, 37%-71%). The difference between the 2 estimates was not significant (t test), and the correlation coefficients between them were r=0.90 for ventilation and r=0.72 for perfusion (P< .05 in both cases). The analysis of agreement showed that the mean difference between the methods was 1.9% (95% confidence interval [CI], 10.5% to -6.8%) for ventilation and 3.4% (95% CI, 17.1% to -10.3%) for perfusion. EIT is able to estimate differential lung function as accurately as ventilation-perfusion scintigraphy.
    Archivos de Bronconeumología 08/2008; 44(8):408-12. · 1.37 Impact Factor
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    ABSTRACT: Objective TO compare unilateral lung function estimated by 2 methods: electrical impedance tomography (EIT) and ventilation-perfusion lung scintigraphy. Patients and methods This prospective clinical study was carried out in the pulmonary function laboratory of a general hospital. Twenty patients diagnosed with lung cancer (17 men and 3 women, ranging in age from 25 to 77 years) who were candidates for lung resection underwent ventilation-perfusion lung scanning breathing a radioactive gas. Differential lung function was estimated based on images taken at 2 intercostal spaces in which ventilation and perfusion were represented by changes in bioelectrical impedance. Each lung’s contribution to overall respiratory function was also calculated based on scintigraphy. Results The right lung contributed a mean (SD) of 54% (9%) of ventilation (range, 32%−71%) according to EIT. Scintigraphy similarly estimated the right lung’s contribution to be 52% (10%) of total ventilation (range, 31%−80%) and 50% (9%) of perfusion (range, 37%−71%). The difference between the 2 estimates was not significant (t test), and the correlation coefficients between them were r=0.90 for ventilation and r=0.72 for perfusion (P<.05 in both cases). The analysis of agreement showed that the mean difference between the methods was 1.9% (95% confidence interval [CI], 10.5% to −6.8%) for ventilation and 3.4% (95% CI, 17.1% to −10.3%) for perfusion. Conclusions EIT is able to estimate differential lung function as accurately as ventilation-perfusion scintigraphy.
    Archivos de Bronconeumología 08/2008; 44(8):408-412. · 1.37 Impact Factor
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    ABSTRACT: Even though an inflammatory process is known to be the underlying cause of asthma, diagnosis is based on clinical history, reversible airway obstruction and bronchial hyperresponsiveness according to international guidelines. The fraction of exhaled nitric oxide (FE(NO)) and induced sputum eosinophil count (Eos%) have been used as non-invasive inflammatory biomarkers. The aim of this study was to compare the sensitivity and specificity of FE(NO), Eos% and spirometry and to assess whether their combined use in clinical practice would improve diagnostic yield. In 50 patients with asthma symptoms we performed spirometry, a methacholine challenge test, FE(NO) measurement and assessment of Eos% in induced sputum. The standard diagnosis of asthma followed the guidelines of the Global Initiative for Asthma. Twenty-two of the 50 patients were diagnosed with asthma. The sensitivity and diagnostic accuracy were higher for FE(NO) measurement (77%; area under the receiver operating curve [AUC], 0.8) than for spirometry (22%; AUC, 0.63). The sensitivity and specificity of Eos% in induced sputum were 40% and 82%, respectively, and the diagnostic accuracy of Eos% was lower (AUC, 0.58). When both inflammatory biomarkers were used together specificity increased to 76%. The diagnostic accuracy of FE(NO) measurement was superior to that of the standard diagnostic spirometry in patients with symptoms suggestive of asthma. The use of FE(NO) measurement and induced sputum Eos% together to diagnose asthma in clinical practice is more accurate than spirometry or FE(NO) assessment alone and easier to perform.
    Respiratory Medicine 12/2007; 101(11):2416-21. · 2.59 Impact Factor
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    ABSTRACT: Electrical impedance tomography (EIT) involves the application of a small alternating current to produce a series of chest images that can be used to monitor breathing pattern. The relation between chest images and tidal volume has not been sufficiently validated. The aim of the present study was to analyze the correlation between EIT images and the volume-time signal measured with a pneumotachometer in 13 healthy volunteers. The following measurement devices were used: a) MedGraphics preVent Pneumotach, with special software for recording the volume-time signal (reference test), and b) EIT-4, a fourth-generation prototype unit designed by the Department of Electronic Engineering at the Universidad Politécnica de Cataluña, Spain that records the volume-time signal and produces a graphic depiction of a cross section of the thorax at the sixth intercostal space. The mean (SD) tidal volume measured by the pneumotachometer and the EIT-4 was 0.523 (0.102) L and 0.527 (0.106) L, respectively (P value not significant). The linear correlation coefficient between the 2 measurements was 0.923 (P=.001), and the mean of the differences between the 2 procedures was -0.003 L (95% confidence interval, -0.045 to 0.038). The greatest differences were associated with female gender, body mass index, and chest circumference. In view of these differences, a different equation based on these variables was needed for calibration of the EIT-4. The EIT-4 provides an alternative means of monitoring breathing pattern, although a number of issues related to the circumference of the rib cage need to be resolved.
    Archivos de Bronconeumología 07/2007; 43(6):300-3. · 1.37 Impact Factor
  • Ana María Fortuna, Teresa Feixas, Pere Casan
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    ABSTRACT: Measurement of the fraction of exhaled nitric oxide (FENO) provides a noninvasive way to monitor asthma treatment in clinical practice. The aim of this study was to determine FENO reference values for measurements recorded with the portable NIOX MINO monitor in a group of healthy volunteers. We also assessed the association between values recorded by the portable monitor and the N-6008 chemiluminescence analyzer used in our pulmonary function laboratory. The FENO values obtained with the portable monitor were consistently higher than those recorded by the N-6008 analyzer; the cutoff value for the portable monitor was 34 ppb (mean + 2 SD). We detected a direct correlation (r=0.92) between the FENO measurements recorded by the 2 monitors (P=.001). The following equation expresses the relationship between measurements from the 2 devices: FENO(NIOX MINO) = 10 + [1.5 FENO(N-6008)]. We did not observe statistically significant correlations between FENO measurements and age, sex, body mass index, or spirometry.
    Archivos de Bronconeumología 04/2007; 43(3):176-9. · 1.37 Impact Factor
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    ABSTRACT: La determinación de óxido nítrico en aire espirado (FENO) es una técnica no invasiva que se utiliza en la evaluación clínica y el tratamiento del asma. El objetivo de este estudio ha sido determinar los valores de referencia de FENO en un grupo de voluntarios sanos mediante la utilización de un nuevo equipo portátil (NIOX-MINO® Aerocrine), así como determinar el grado de relación que presenta con el equipo de determinación habitual en nuestro laboratorio de función pulmonar (sensor de quimioluminiscencia N-6008® SIR). Según los resultados obtenidos, los valores de FENO que da el equipo portátil son siempre superiores a los que ofrece el sensor habitual, con un valor de corte de 34 ppb (media + 2 desviación estándar). Existe un relación directa y significativa de la determinación de FENO entre ambos equipos (r = 0,92; p = 0,001) con un factor de corrección de: FENO (NIOX-MINO®) = 10 + 1,5 FENO (N-6008®). La relación entre los valores de FENO y la edad, el sexo, el índice de masa corporal y los valores espirométricos no fue estadísticamente significativa.
    Archivos de Bronconeumología 03/2007; · 1.37 Impact Factor
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    ABSTRACT: OBJECTIVEElectrical impedance tomography (EIT) involves the application of a small alternating current to produce a series of chest images that can be used to monitor breathing pattern. The relation between chest images and tidal volume has not been sufficiently validated. The aim of the present study was to analyze the correlation between EIT images and the volume–time signal measured with a pneumotachometer in 13 healthy volunteers.MATERIAL AND METHODSThe following measurement devices were used: a) MedGraphics preVent™ Pneumotach, with special software for recording the volume–time signal (reference test), and b) EIT-4, a fourth-generation prototype unit designed by the Department of Electronic Engineering at the Universidad Politécnica de Cataluña, Spain that records the volume–time signal and produces a graphic depiction of a cross section of the thorax at the sixth intercostal space.RESULTSThe mean (SD) tidal volume measured by the pneumotachometer and the EIT-4 was 0.523 (0.102) L and 0.527 (0.106) L, respectively (P value not significant). The linear correlation coefficient between the 2 measurements was 0.923 (P =.001), and the mean of the differences between the 2 procedures was –0.003 L (95% confidence interval, –0.045 to 0.038). The greatest differences were associated with female gender, body mass index, and chest circumference. In view of these differences, a different equation based on these variables was needed for calibration of the EIT-4.CONCLUSIONSThe EIT-4 provides an alternative means of monitoring breathing pattern, although a number of issues related to the circumference of the rib cage need to be resolved.OBJETIVOLa tomografía por impedancia eléctrica (TIE) permite realizar un seguimiento del patrón ventilatorio a partir de una secuencia de imágenes torácicas obtenidas por la captación de una corriente alterna de baja intensidad. La relación entre las imágenes torácicas y el volumen circulante no está suficientemente validada. El propósito del presente estudio ha sido comparar, en un grupo de 13 voluntarios sanos, la correspondencia entre las imágenes de la TIE y la señal volumen/tiempo obtenida mediante un neumotacómetro.MATERIAL Y MÉTODOSLos equipos que se utilizaron para las mediciones fueron: a) MedGraphics prevent TM™ Pneumotach, implementando el software adecuado para registrar las señales volumen/tiempo (prueba de referencia), y b) TIE-4, cuarta versión de un equipo diseñado por el Departamento de Ingeniería Electrónica de la Universidad Politécnica de Cataluña, que permite tanto el registro de la señal volumen/tiempo como una representación gráfica de la sección transversal situada en el sexto espacio intercostal.RESULTADOSLa media ± desviación estándar de volumen circulante obtenida mediante el neumotacómetro fue de 0,523 ± 0,102 l, y con la TIE-4, de 0,527 ± 0,106 l (p no significativa). El coeficiente de correlación lineal entre ambas determinaciones fue de 0,923 (p = 0,001). La media de las diferencias entre ambos procedimientos fue de –0,003 l (intervalo de confianza del 95%, –0,045 a 0,038). Las mayores diferencias estaban relacionadas con el sexo femenino, el índice de masa corporal y el contorno torácico, lo que obligó a una ecuación diferente para calibrar la TIE-4 en función de estas variables.CONCLUSIONESLa TIE-4 se presenta como un método alternativo para realizar el seguimiento del patrón ventilatorio, aunque deben resolverse aspectos relacionados con la conformación de la caja torácica.
    Archivos de Bronconeumología ((English Edition)). 01/2007;
  • Archivos De Bronconeumologia - ARCH BRONCONEUMOL. 01/2007; 43(6).
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    ABSTRACT: EIT has been proposed and used in the past to monitor ventilation. However, image calibration in terms of volume is not standardized, making it difficult to be used in routine clinics. We have measured two groups of healthy volunteers. First group consisted on 12 males and 15 females (age: 35±13, height: 1.69±0.12 m, weight: 69±13 kg). EIT was performed at a rate of 17 frames/s (TIE4_sys, Barcelona System, 16 electrodes) and ventilation simultaneously measured with a pneumotach (MedGraphics preVent™ Pneumotach). Tidal Volume was recorded for 30 s (between 5 and 8 respiratory cycles) with 3 min of resting until 25 to 30 cycles were obtained for each volunteer. After a statistical identification of the most relevant parameters, two equations were obtained (males, females) relating ventilation (ΔV) to the change in impedance (ΔIC) calculated from EIT dynamic images, and some anthropometrical parameters. A second group of volunteers consisting on 10 males and 9 females (age:29±7, height: 1.71±0.1 m, weight: 69±12 kg) was used to validate the above equations. A mean tidal volume of 0.535±0.12 L was found with the pneumotach while a mean value of 0.504±0.18 L was found by EIT and the above equations.
    12/2006: pages 572-575;
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    ABSTRACT: Most inaccuracies in the analysis of gases and electrolytes in arterial blood samples are due to preanalytic factors, among which is the type of equipment used for blood collection. Our objective was to compare arterial blood gas sample kits used under clinical conditions and to evaluate the impact of delay in estimation on variability in results. In 2 types of study we compared 5 kits (Radiometer's Pico 70, Becton Dickinson's Preset, SIMS Portex's Pro-Vent, SIMS-Concord's Pulsator, and Marquest's Quick ABG). In the first study kitsyringe assignment was randomized for collecting arterial blood samples from 160 consecutive patients to evaluate practical aspects of using them and the presence of bubbles in the samples taken. The second study evaluated the effects of delays of 30 and 60 minutes in estimation and of the type of heparin used in 54 blood samples. The kits which produced the fewest bubbles, gave samples with the greatest stability, and had the least impact on ion concentration were Radiometer's Pico 70 and SIMS-Portex's Pro-vent.
    Archivos de Bronconeumología 09/2004; 40(8):378-80. · 1.37 Impact Factor