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Biomedical subjects

B Costa

Publications and source records attributed to B Costa.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Diagnosis of the health of a diabetic population in the county of Priorato in Tarragona province].

A health diagnosis made over a two-year period in the basic health area of Falset is described (17 municipalities with populations between 39 and 2,603 inhabitants, making-up a total reference population of 7,283 habitants) in relation to the diabetic population of the Priorato county in Catalunya. This county is geographically heterogeneous, with semi-arid hilly landscape, with poor communications, a farming population and a notoriously hostile climate. The population pyramid, inclined towards progressive aging of the population, is evidence of a major migration from the country. By means of continuous education of health personnel, updating of information sources, improvement of registration systems, and final evaluation, the outlines of an action plan is worked out with a view to the organisation of diabetic care in this rural context. A total of 226 diabetics were counted: 15 type 1 (6.2%), and 211 type II (93.8%). The incidence of diagnosed diabetes in the basic health area is 3.1% (1.4% to 10.33%). The average age of the patients was 65.6 years with a preponderance of women (146 = 64.6%). In 92 patients (40.2%) the evolution time was less than 5 years. The insulinisation rate was calculated at 26.1%. The typical diabetic patient is a retired person or a housewife (87.8), with primary of elementary education (82.7%), supported by the family.

Diabetes Mellitus↗
PubMed1991

[Multicenter evaluation of a diabetes program in primary care in Tarragona].

To evaluate a provincial diabetes program for primary care in Tarragona 14 months after its implementation, the data provided by all centers were evaluated. The participants were 8 CAPS and the professionals of a rural area, with a reference population of 170,159. A total of 1,766 diabetic patients were sensed. 131 were type I (7.4%) and 1,635 type II (90.6%). The health care variables of 1,197 patients (67.7%) and the rate of complications of 654 (54.6%) were assessed. A high prevalence of hypertension (50.0%) and dyslipemia (40.5%) were found associated with diabetes. Overall 868 individuals (72.5%) received individualized education in the clinic; 112 of these (12.9%) were included in collective education programs for groups. At the time of this evaluation, the proportion of patients treated with insulin (174/545) was significantly higher than that found before the program (79/402, p less than 0.0001). The practice of glycemic self assessment at home was also significantly increased (82/691 versus 440/1, 124; p less than 0.0001). The initial impact on the professional and diabetic patients of our area has been remarkable. Although the planning of multicentric evaluation systems in complex, it is possible to implement it if the data and recording system are coordinated.

Diabetes Mellitus↗
PubMed1990

[Percutaneous endoscopic gastrostomy. 174 cases].

Nutritional assistance was given by percutaneous endoscopic gastrostomy to 174 patients with neurological diseases (80 cases), tumours of the ear, nose and throat (ENT) region (70 cases) or malnutrition (24 elderly people). These patients had either deglutition disorders with inhalation or severe malnutrition, or could not tolerate a nasogastric tube. The endoscopic catheter (Bioser) was installed by the pull technique under general anaesthesia (26 percent), neuroleptanalgesia (16 percent), premedication (14 percent) or without sedation (44 percent). Installation was possible in 98 percent of the cases. Twenty-nine percent of the patients were treated in an outpatient clinic. The problems encountered (21 percent) were mainly due to blockade of the flange and rupture of the thread. Transoperative accidents, such as dyspnoea, bleeding or cardiac arrest, all without sequelae, were noted in 5 percent of the cases. The catheter remained in situ for a mean period of 3.9 +/- 0.3 months (range: 0.1 to 20 months). The following complications were observed: short-term (15 percent), hyperthermia (5), local infection (6), abscess of the abdominal wall (3), meteorism (9), pneumoperitoneum (1), subocclusion (2); long-term (25 percent), inflammatory reactions (13), leakage (19), catheter displacement (8) and catheter rupture (3). Local infections were more frequent in patients with ENT tumours than in the others. Percutaneous endoscopic gastrostomy is a fast and reliable technique preferable to surgical gastrostomy. Complications are frequent (46 percent) but usually minor (42 percent). Contra-indications must be respected, and the catheter must be introduced with the utmost care.

Administration, Cutaneous↗
PubMed1989

Segmental myoclonus in a young man who had had localized encephalitis in childhood.

A man who had had an episode of localized encephalitis, diagnosed as viral cerebellitis in childhood came to observation at the age of 23 for attacks of segmental myoclonus of the cervical axial musculature. BAEP changes at brainstem level in this case point to involvement of the Guillain-Mollaret triangle in the pathogenesis of this syndrome.

Adult↗
PubMed1989

Evaluation of the conjunctival provocation test in allergy diagnosis.

Conjunctival provocation tests (CPT) were performed in 65 respiratory allergic patients, 24 of them with a clinical history of allergic conjunctivitis and 41 who had never complained of allergic conjunctivitis, to assess the role of the conjunctiva as a target organ. The usefulness of CPT and RAST to identify symptom-related and symptom-unrelated allergen in 51 patients sensitized to two allergens but only symptomatic to one of them was also studied. Conjunctiva was found to react in a similar way to skin in patients with and without clinical conjunctivitis. CPT was positive for both symptom-related and symptom-unrelated allergens in 33 of the 51 pluri-sensitized patients. Nevertheless, in the 18 patients showing positive CPT to only one allergen, agreement with clinical data was generally found. Thus CPT appears to be a useful test in the evaluation of atopic sensitization in patients reactive to a single allergen, but not in the identification of clinically relevant allergens in individuals who are skin or RAST positive to multiple agents.

Adolescent↗
PubMed1989

Concentrations of lipids and apolipoproteins in patients with clinically well-controlled insulin-dependent and non-insulin-dependent diabetes.

The triglyceride and cholesterol content of total, very-low-, intermediate-, low-, and high-density lipoproteins, and of apolipoproteins (apo) Al, All, B, Cll, Clll, and E were determined in plasma from 107 patients with clinically well-controlled diabetes and from 66 age- and weight-matched healthy normal subjects. The diabetic patients were separated into two groups: those with insulin-dependent diabetes mellitus (IDDM, type 1, n = 24) and those with non-insulin-dependent diabetes mellitus (NIDDM, type 2, n = 83). The latter group contained two subgroups: those treated by diet (type 2d, n = 42) or by insulin (type 2i, n = 41). High-density lipoprotein cholesterol was increased in IDDM patients, and decreased in NIDDM patients relative to control subjects. Mean apo Al values in IDDM patients were higher than in their respective controls and in NIDDM patients. Concentrations of apo B, Clll, and E were higher in all diabetic patients than in the healthy controls, but those of apo Cll did not differ statistically between diabetics and nondiabetics. Although total plasma cholesterol and triglyceride concentrations were apparently near normal values in patients with good glycemic control, we found a persistent increase of intermediate-density lipoproteins (remnants) in all the diabetic groups studied. This factor may be related to the perceived increased cardiovascular risk in these individuals.

Adult↗
PubMed1989

[Diabetologic education at a general hospital in Cataluna: methodology and short-term indicators of effectiveness].

In order to carry out an initial evaluation of an intrahospital diabetes education programme after its first year, the methods used are described and some previously established short term effectiveness indicators are analyzed: 1) knowledge of the theory, 2) insulinization, 3) blood glucose self testing at home, 4) metabolic control, 5) readmission in hospital, and 6) detection of chronic complications. An analysis of the previous situation was carried out resulting in a mean hospital stay of 10.8 days/patient/year during 1985, being the mean hospital stay for the general population of 8.1 days. 222 diabetic patients (63 type I and 159 type II) were included in the programme during the first year, and their cultural background, diabetes education, place of origin and participation were evaluated. 358 written tests were examined. The scores obtained after the educational sessions (75.6 +/- 17.5) were significantly higher than the initial scores (47.4 +/- 23.1; p less than 0.001). Prior the programme, 93 patients (41.9%) were on insulin. At the time of the evaluation 156 (70.2%) were on insulin treatment, of which 86 (38.7%) were on rapid insulin. Furthermore, 141 patients (66.1%) were carrying out periodic (over 10 tests/week) blood glucose determinations at home. In a 96 patient follow up group (36 type I and 60 type II) a significant improvement in baseline glucose levels (8.6 +/- 2.7 vs 12.6 +/- 4.2 mmol/l; p less than 0.001) as well as glycosylated hemoglobin levels (9.3 + 1.2% vs 11.0 + 2.0%; p greater than 0.001) was confirmed; this improvement was maintained throughout the time period considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Cerebral toxoplasmosis in AIDS. Case report.

In a patient with AIDS presenting partial epilepsy cerebral toxoplasmosis was diagnosed on the serological and CT evidence. The diagnosis was confirmed by the immediate response to sulfonamide therapy.

Acquired Immunodeficiency Syndrome↗