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Biomedical subjects

A Cayuela

Publications and source records attributed to A Cayuela.

10 recordsLinked to original sources
PubMed2001

Age and gender differences in basal and isoprenaline protocols for head-up tilt table testing.

AIMS: Syncope is a common occurrence, the prevalence of which increases with age, and among the multiple causes of syncope, neurally mediated syncope is thought to be a frequent cause in the young and in the elderly. Head-up tilt table testing (HUT) has become the diagnostic test of choice for neurally mediated syncope, the response to which varies clearly with age. The purpose of this study is to report the differences among patients suffering syncope referred for HUT, and the influence of age and gender on HUT results (percentage of positive responses and response patterns) in two study protocols (basal and isoprenaline). METHODS AND RESULTS: One thousand, two hundred and nineteen patients with syncope were referred to the authors' Cardiology Department for HUT from September 1990 to April 2000; 1061 undergoing basal HUT (Group A) and 158 undergoing isoprenaline tilt table testing (Group B). Complications were noted in neither protocol. Females were more frequent among young people, and males in the elderly (P<0.05). Head-up tilt table testing was abnormal in 259 (24.4%) patients in Group A and in 85 (53.7%) patients in Group B (P<0.05), and no gender differences were observed. The positive rate of tests in men and women significantly declined with age in Group A (P<0.05), but not in Group B (P=ns). There were no differences in the patterns of haemodynamic collapse in both groups. CONCLUSIONS: In the study of syncope, basal HUT has a high positive rate in young people; a decrease in positive rate with age suggests, however, the need for using another protocol with a similar diagnostic accuracy in the elderly.

Adult↗
PubMed2001

Use of venous thromboembolism prophylaxis for surgical patients: a multicentre analysis of practice in Spain.

OBJECTIVE: To assess the use of venous thromboembolism prophylaxis in surgical patients. DESIGN: Retrospective multicentre study. SETTING: Eight acute-care teaching hospitals with more than 400 beds, Spain. PATIENTS: Medical records of all consecutive patients undergoing operations in the general surgical and trauma and orthopaedic services during the month of April, 1997, were randomly selected. INTERVENTION: The sample size for each type of operation (general, trauma-orthopaedic) was calculated from the number of operations done at each hospital (with an absolute precision of 5%, and an alpha error of 5%) and the prevalence of the use of venous thromboembolism prophylaxis obtained from a random sample of 50 records (25 from patients in general surgery and 25 from patients in orthopaedic surgery) from each centre. MAIN OUTCOME MEASURES: Appropriate and inappropriate pharmacological prophylaxis defined according to a combination of risk categories for venous thromboembolism, doses of antithrombotic agents given, time of starting prophylaxis, and its duration. RESULTS: A total of 1848 medical records (general surgery, n = 1025; trauma-orthopaedic surgery, n = 823) were included. Physical methods (elastic stockings, intermittent pneumatic compression) were used in only 0.3% of patients. Pharmacological prophylaxis consisted of low molecular weight heparin in 99% of cases. The percentage given heparin-based prophylaxis was 54%. Overall, appropriate prophylaxis was given in 1175 patients (64%). Use of thromboprophylaxis ranged from 27% to 70% among the participating hospitals. Prophylaxis was more likely to be appropriate in orthopaedic patients (577, 70%) than in general surgical patients (598, 58%) in both the high and moderate risk categories. CONCLUSIONS: Given the large variability between the participating hospitals, more specific protocols and recommendations about prophylaxis of thromboembolism in surgical patients are needed.

Adolescent↗
PubMed1997

[The white coat effect in primary care. Analysis of patients with newly diagnosed arterial hypertension].

BACKGROUND: In a non-selected group of hypertensive patients with a new diagnosis at primary care, blood pressures obtained in the office (oBP) are compared to ambulatory ones (aBP). White coat hypertension (WCH) and white coat phenomenon (WCP) are estimated to evaluate a white coat effect on such population. PATIENTS AND METHODS: An ambulatory blood pressure monitoring (ABPM) was performed to 91 hypertensive patients (55 females) from 21 to 70 years-old, with consecutive diagnosis in 4 office rooms in an health center (oBP mean > or = 140 mmHg for systolic blood pressure and/or 90 mmHg for diastolic blood pressure during three measures at least). WCH was defined by systolic aBP < or = 135 mmHg and diastolic < or = 85 mmHg, simultaneously, and WCP by oBP-aBP differences > or = 20 and/or 10 mmHg (for respective systolic and diastolic blood pressure). RESULTS: oBP systematically exceeded aBP with wide variations for each subject (difference mean +/- SD: 15 +/- 13/7 +/- 9 mmHg for systolic/diastolic), sex (female: 19 +/- 12/11 +/- 9, male 8 +/- 11/2 +/- 9) and depending on the observer who made the measure. WCH was detected in 27 patients (22 females), and WCP in 47 (37 females), so 30% (confidence interval [CI]: 21-40%) and 52% (CI: 41-62%) respective prevalences are supposed. CONCLUSIONS: Within primary care, white coat effect causes a substantial hypertension sobrediagnosis as quantitative as qualitatively. Confirming measures made by nurses and additionally, ABPM for women, seem to lessen this effect.

Adult↗
PubMed1996

[Utilization of a post-anesthetic recovery index].

OBJECTIVES: 1. To introduce use of the postanesthesia recovery score (assessing consciousness, mobility, ventilation, hemodynamics and blood analysis) as a good method for evaluating and classifying recovery from anesthesia in the postoperative care unit. 2. To determine overall patient progress and assess the influence of various patient, anesthetic and surgical factors. PATIENTS AND METHODS: This was a multicenter study of 1,227 patients. We excluded all patients who were to be transferred to intensive care units after surgery. A score of 10 or more, with no single item score equal to 0, was considered optimal for discharge from the postanesthesia care unit. RESULTS: The lowest score upon admission to the unit was among patients who had undergone high abdominal surgery (16.4%). Scores over 9 belonged to patients who had undergone lower abdominal and perineal surgery (87.5 and 95.3%, respectively). Scores were < or = 9 in patients who received inhaled anesthetics (42%). Intravenous anesthesia patients (84.4%) had scores over 9. The local-regional anesthetic procedures with the best scores were axilar blocks and local infiltrations. Patients staying longer in the recovery unit were those classified as ASA III, those whose procedures lasted longer than 120 minutes, those undergoing surgery on the upper abdomen or on extremities, those receiving isoflurane and pancuronium, and those suffering adverse events during and after the procedure. Factors influencing perioperative events were age, duration of procedure and history of intraoperative events.

Adolescent↗
PubMed1991

Changing mortality patterns for major cancers in Spain, 1951-1985.

Mortality trends for main cancer sites in Spain from 1951-1985 are presented. Age-standardized mortality rates per 100,000 were computed using the direct method. The Spanish population of 1970 was used as the standard. Age-standardized mortality rates for total cancer showed a marked increase among men throughout the period of study. This can be attributed mainly to the increase in lung cancer mortality (from 8.63 person-years to 44.74 between 1951 and 1985), which was only partially balanced by a reduction in the stomach cancer mortality (from 36.18 to 18.31). Among women the increase in total cancer is lower overall. It occurred mainly during the 1950s and thereafter the trend has remained stable and even declined in recent years. Lung cancer mortality rates among women have remained fairly stable and stomach cancer followed the same pattern as for men. Breast cancer mortality increased constantly during the period (from 7.21 to 19.38) but it was not until 1978 that it became the leading cause of cancer mortality among women.

Female↗
PubMed1991

Oesophageal cancer mortality: relationship with alcohol intake and cigarette smoking in Spain.

STUDY OBJECTIVE: The aim of the study was to explore temporal changes in mortality from oesophageal cancer that could be related to tobacco and alcohol consumption. DESIGN: The study used mortality trends from oesophageal cancer over the period 1951-1985. In addition, available trends on per capita consumption of alcohol and cigarettes are also presented. SETTING: Data for this study were derived from Spain's National Institute for Statistics. MAIN RESULTS: Age standardised mortality rates from oesophageal cancer have increased significantly among men in Spain from 1951 to 1985 (p less than 0.01). Mortality rates in women have not changed significantly during the same period, although there is evidence of a certain decrease in recent years. Trends of per capita cigarette consumption from 1957 to 1982 related positively with oesophageal cancer mortality among men, whereas no significant relationship was observed in women. Trends of beer, spirits, and total alcohol consumption were also positively correlated with oesophageal cancer mortality in men. Among women, a weaker relationship was found. Wine consumption showed no relationship with oesophageal cancer mortality either in men or women. CONCLUSIONS: These results are similar to those found in other studies, supporting a role of alcohol (spirits and beer) and cigarette consumption in causation of oesophageal cancer. No relationship was observed with wine consumption.

Adult↗
PubMed1989

Analysis of cohort mortality from prostatic cancer in Spain, 1951-1983.

Prostatic cancer mortality rates in Spain were analysed for the period 1951-1983 by age groups. Five year interval age cohort trends were also studied. A rising trend was seen over this period of time, although there has been some stabilisation during the recent past. Age cohort analysis shows a generation effect in those cohorts born before 1896, consistent with an increased exposure to environmental and/or occupational factors.

Age Factors↗
PubMedDate not supplied

[Avoidable years of life lost ratio: an indicator to identify excess mortality in health areas. Mortality workshop of the Valencia region].

Avoidable mortality has been proposed as an outcome indicator of health services. Until now the Standardized Mortality Ratio (SMR) has been the effect measure most used to detect excesses in avoidable mortality. We propose the use, as a complementary measure, of the Avoidable Years of Life Lost Ratio (AYLLR). We show that for tuberculosis, hypertension and for all avoidable deaths both measures provide complementary information, since in some areas where observed deaths are below the expected number (SMR less than 100) we detect an observed number of years of life lost higher than expected (AYLLR greater than 100), due to the occurrence of these deaths at younger ages. The AYLLR is a standardized effect measure that puts a higher weight to premature deaths.

Catchment Area, Health↗
PubMedDate not supplied

[Geographic differences in mortality from digestive tumors in Spain, 1980-1984].

The purpose of this study is to analyze the geographical distribution of eight gastrointestinal (GI) cancer sites in Spain, during the 1980-1984 period. Data for deaths attributed to each cancer site were obtained from Spain's National Institute for Statistics (INE). Standardized Mortality Ratios (SMR) were calculated for each GI cancer site, using the International Classification of Diseases (ICD) 9th revision. Statistical tests were performed to determine whether SMR's were statistically significant. The mortality distribution for cancers of the oropharynx and oesophagus showed a similar pattern, which might suggest some common risk factor in their etiology. Stomach cancer presented high SMR's in the northern central areas (Meseta). Colon, rectum and pancreas cancer sites emerged with irregular patterns though high SMR's were more often observed in developed areas within the country.

Cluster Analysis↗