José Ramón Serrano

Bio: José Ramón Serrano is an academic researcher from Polytechnic University of Valencia. The author has contributed to research in topics: Turbocharger & Diesel engine. The author has an hindex of 36, co-authored 179 publications receiving 3635 citations. Previous affiliations of José Ramón Serrano include University of Seville & University of Los Andes.

Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma.

Abstract: The onset of fatal and near-fatal asthma attacks can be rapid. The objective of this study was to determine the frequency and clinical characteristics of rapid-onset asthma (ROA) in patients suffering fatal and near-fatal crises. Two-hundred and twenty patients with fatal or near-fatal attacks were enrolled in a multicentre, prospective study. ROA was defined as a crisis developing in ≤2 h. Data on patient and clinical characteristics were collected, and spirometric and allergy studies were performed when the patients were in a stable condition. Forty-five attacks (20%) were ROA and 175 (80%) were slow-onset asthma (SOA). The triggers for SOA and ROA attacks were different, with the ROA group having a significantly lower rate of suspected respiratory infection (7% versus 38%), higher rates of fume/irritant inhalation (9% versus 1%) and a higher intake of nonsteroidal anti-inflammatory drugs (14% versus 3%). The ROA group exhibited significantly higher rates of impaired consciousness (63% versus 44%), absence of lung sounds upon admission (68% versus 42%), fewer hours of mechanical ventilation (13 h versus 28 h) and fewer days of hospitalization (8 days versus 9.5 days) than the SOA group. The 20% frequency of rapid-onset fatal and near-fatal attacks in this study suggests that rapidly developing attacks may not be rare. These findings also support a distinct clinical profile for rapid-onset asthma marked by differences in triggers, severity of exacerbation and clinical course.

An official American Thoracic Society/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice.

Abstract: Background: The assessment of asthma control is pivotal to the evaluation of treatment response in individuals and in clinical trials. Previously, asthma control, severity, and exacerbations were defined and assessed in many different ways.Purpose: The Task Force was established to provide recommendations about standardization of outcomes relating to asthma control, severity, and exacerbations in clinical trials and clinical practice, for adults and children aged 6 years or older.Methods: A narrative literature review was conducted to evaluate the measurement properties and strengths/weaknesses of outcome measures relevant to asthma control and exacerbations. The review focused on diary variables, physiologic measurements, composite scores, biomarkers, quality of life questionnaires, and indirect measures.Results: The Task Force developed new definitions for asthma control, severity, and exacerbations, based on current treatment principles and clinical and research relevance. In view of current knowledge ...

Idiosyncratic drug hepatotoxicity

Abstract: The occurrence of idiosyncratic drug hepatotoxicity is a major problem in all phases of clinical drug development and the most frequent cause of post-marketing warnings and withdrawals This review examines the clinical signatures of this problem, signals predictive of its occurrence (particularly of more frequent, reversible, low-grade injury) and the role of monitoring in prevention by examining several recent examples (for example, troglitazone) In addition, the failure of preclinical toxicology to predict idiosyncratic reactions, and what can be done to improve this problem, is discussed Finally, our current understanding of the pathophysiology of experimental drug hepatotoxicity is examined, focusing on acetaminophen, particularly with respect to the role of the innate immune system and control of cell-death pathways, which might provide targets for exploration and identification of risk factors and mechanisms in humans

Advanced Calculus I

Abstract: WITH the ever-widening scope of modern mathematical analysis and its many ramifications, it is quite impossible to include, in a single volume of reasonable size, an adequate and exhaustive discussion of the calculus in its more advanced stages. It therefore becomes necessary, in planning a thoroughly sound course in the subject, to consider several important aspects of the vast field confronting a modern writer. The limitation of space renders the selection of subject-matter fundamentally dependent upon the aim of the course, which may or may not be related to the content of specific examination syllabuses. Logical development, too, may lead to the inclusion of many topics which, at present, may only be of academic interest, while others, of greater practical value, may have to be omitted. The experience and training of the writer may also have, more or less, a bearing on both these considerations.Advanced CalculusBy Dr. C. A. Stewart. Pp. xviii + 523. (London: Methuen and Co., Ltd., 1940.) 25s.

The Mechanics of Aerosols

Abstract: a time as one year after leaving the Rehabilitation Unit, and about one quarter were not in competitive jobs but were in sheltered employment. Only just over one quarter were still working in ordinary jobs. Their average wage was £8 I is. 6d. Furthermore if one compares the type of work these patients were able to perform there was a definite decline from their premorbid position. The social class grouping before and after rehabilitation was Class II, i-i, Class III, 9-3, Class IV, 4-6, and Class V, IO-I4. Indeed the authors report that 'even the least handicapped of these patients presented continuous problems . . .' and it is noted that such a programme requires special personnel and a great deal of work. Comparing these results with the extra cost in personnel, time, and effort (which could be directed elsewhere) a Doctor Beeching of the psychiatric services would probably scrap such a rehabilitation service before it even started. But is this the right way of looking at it? The authors point out that such a programme, if applied throughout the country, would affect about 6,ooo patients. If the failure rate were the same as in this experiment, about I,500 would be rescued from a disabled life in a mental hospital and once more returned to an at least partially useful and, one assumes, more satisfying life. Obviously more is involved here than mere economics. We were interested to read that as regards behaviour at the Rehabilitation Centre and during the follow-up year 'There were no outstanding differences' between the schizophrenic and the non-schizophrenic rehabilitees. It appears that the group of schizophrenics had difficulties in social adjustment which were even greater than those of work adjustment. '. . . the men concerned had greater difficulty in living outside hospital, than in working outside hospital. If, however, adequate arrangements are made to cater for these various needs, there seems to be every reason to expect that a small selected group of long stay schizophrenic patients can be successfully resettled in work.' The experiment and the report show the high standards we have come so confidently to expect from Dr. Wing and his colleagues, and the publication will be read with interest, not only by psychiatrists, but by all those concemed with rehabilitation problems of chronically disabled patients. J. HOENIG