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Biomedical subjects

J Alonso

Publications and source records attributed to J Alonso.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Evaluating quality-of-life and health status instruments: development of scientific review criteria.

The Medical Outcomes Trust is a depository and distributor of high-quality, standardized, health outcomes measurement instruments to national and international health communities. Every instrument in the Trust library is reviewed by the Scientific Advisory Committee against a rigorous set of eight attributes. These attributes consist of the following: (1) conceptual and measurement model; (2) reliability; (3) validity; (4) responsiveness; (5) interpretability; (6) respondent and administrative burden; (7) alternative forms; and (8) cultural and language adaptations. In addition to a full description of each attribute, we discuss uses of these criteria beyond evaluation of existing instruments and lessons learned in the first few rounds of instrument review against these criteria.

Health Status↗
PubMedDate not supplied

[Social self-positioning as indicator of socioeconomic status].

OBJECTIVE: Self-perceived class results from directly questioning subjects about his or her social class. The aim of this investigation was to analyse self-perceived class in relation to other indicator variables of socioeconomic level. METHODS: Data from the 1994 Catalan Health Interview Survey, a cross-sectional survey of a representative sample of the non-institutionalised population of Catalonia was used. We conducted a discriminant analysis to compute the degree of right classification when different socioeconomic variables potentially related to self-perceived class were considered. All subjects who directly answered the questionnaire were included (N = 12,245). With the aim of obtaining the discriminant functions in a group of subjects and to validate it in another one, the subjects were divided into two random samples, containing approximately 75% and 25% of subjects (analysis sample, n = 9,248; and validation sample, n = 2,997). RESULTS: The final function for men and women included level of education, social class (based in occupation) and equivalent income. This function correctly classified 40.9% of the subjects in the analysis sample and 39.2% in the validation sample. Two other functions were selected for men and women separately. In men, the function included level of education, professional category, and family income (39.2% of classification in analysis sample and 37.2% in validation sample). In women, the function (level of education, working status, and equivalent income) correctly classified 40.3% of women in analysis sample whereas the percentage was 38.9% in validation sample. The percentages of right classification were higher for the highest and lowest classes. CONCLUSION: These results show the utility of a simple variable to self-position within the social scale. Self-perceived class is related to education, income, and working determinants.

Adolescent↗
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[Reference population values for the Spanish Child Health and Illness Profile-Adolescent Edition (CHIP-AE) using a representative school-based sample].

AIM: The Child Health and Illness Profile (CHIP-AE) is a generic health status instrument for adolescents aged 12-19 years adapted for use in Spain. The aim of this study was to obtain reference population values of the Spanish version of the CHIP-AE. METHODS: The CHIP-AE was administered to a representative sample of adolescents from schools in Barcelona. The sample was selected by using cluster-sampling, stratified by type of school (public or private) and an ecological socioeconomic index (Indice de Capacidad Familiar: low, middle, and high). The CHIP-AE scores were standardized to a mean of 20 and a standard deviation (SD) of 5. Means and percentiles were computed. Means were compared by age, gender, and socioeconomic status using analysis of variance. RESULTS: The response rate was 81% (n = 902). The distribution of the CHIP-AE scores presented a wide range with scores generally skewed toward positive health status. Nevertheless, the results suggest that the sample selected from a general population was not free of health problems. Twenty-five percent of adolescents presented scores below 17.2 in the domain of discomfort, indicating an effect size of 0.56 standardized SD units. The distribution of scores in the reference samples from Barcelona was similar to the original results in Baltimore (USA), with some marginal differences in individual risks. CONCLUSIONS: The CHIP-AE systematically gathers information on health domains in adolescents. The results from this reference sample will allow comparisons with adolescents from other regions, and/or with different health problems, as well as description of inequalities in health during adolescence.

Adolescent↗
PubMedDate not supplied

[Perceived health and functional capacity of a non-institutionalized elderly population in Barcelona].

In order to explore the perceived health and functional capacity in the elderly, a cross-sectional study was undertaken in a representative sample of the non-institutionalized population aged 65 and over, resident in Barcelona (N = 1,288), and included in the 2nd Health Interview Survey. Sociodemographic information was collected, as well as perceived morbidity, sensorial problems and functional capacity (measured by the activities of daily living [ADL]). Some 60.3% of the elderly reported having "good" or "very good" health, and 56% reported being able to do all ADL without difficulties. Women in general reported a worse perceived health and a higher chronic limitation in each age group (p = 0.001). Age was not significantly associated with perceived health, but was...associated with disability (ADL) (p = 0.001). Variables with a stronger association with "poor", "bad" o "very bad" perceived health were: comorbidity (OR = 3.69 IC 95% = 2.60-5.25), restricted activity (OR = 3.25 IC 95% = 1.86-5.66) and incapacity in any of the basic ADL (OR = 2.15 IC 95% = 1.38-3.36). The elderly who were dependent in any of the basic ADL were more frequently female, 75 or more years old, and in 10.5% of the cases did not receive any personal help. The present study gives a general description of the health status and functional capacity of the elderly and identifies a group of old people with unmet basic care needs.

Activities of Daily Living↗
PubMedDate not supplied

[The Oregon state health plan for access to health services: the context, elaboration and characteristics].

The Oregon Health Plan is the first explicit and public attempt to establish the priority of health services by a systematic assessment of their cost-effectiveness. The need to solve major health problems such as increasing costs or the effectiveness and equity of health services as well as the debate developed around the plan, deserves a detailed review. This article describes the health care context where the plan took place, reviews the most important elements of its elaboration, analyzes methods used and summarizes the main reactions to the plan.

Cost-Benefit Analysis↗
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[Validity of the occupation as an indicator of social class, according to the British Registrar General classification].

OBJECTIVE: Measuring social class is important for evaluating its influence on health status and on the access to health services. This paper is aimed to assess the construct validity of the classification of social class based on the individual's occupation. METHODS: Data come from the Barcelona Health Interview Survey of 1986. In the survey, 2,205 households and 6,894 individuals participated (82% of the eligible households and 84% of the eligible individuals). Information was gathered on, among other issues, the following socioeconomic variables: annual family income, lack of some household services, property of the household, education level and occupation of the individuals, as well as their occupational situation and labor relationship. Data about the value of the household was collected from the City Council census (catastro). Social class was assigned using the individual's occupation or, if none, the head of the household's occupation in the following groups: I, II, III, IVa, IVb, V, and "Not Classified". The association between social class and socioeconomic variables was analyzed using: ANOVA for the comparisons of continuous variables, Chi-squared test for categorical variables, Spearman correlation coefficients and discriminant analysis. RESULTS: A total of 3,357 individuals reported an occupation. "Employed in administrative services" was the most common (14.3%). Social class was "Not classified" in 6.4% of the individuals. All socio-economic variables showed statistically significant differences, following a predicted pattern: better indicators for more favoured social classes. Social class showed a moderate to high correlation with education level (r = 0.57) and somewhat lower with the other variables. Variance in socioeconomic variables explained by social class was higher than the 95% (p < 0.001). CONCLUSIONS: The pattern of relationships between socio-economics variables was intense, monotone and consistent, suggesting that the occupation is a valid and feasible of social class. Routinely including occupation in health information systems should allow to monitor inequalities in health in Spain.

Health Surveys↗
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Optimal design of an enzymatic reactor for flow injection analysis.

A simulation procedure for the optimization of enzymatic reactors used in sandwich flow injection systems is evaluated. The system is modeled as a plug-flow reactor with axial dispersion. To calibrate it, dispersion coefficients can be evaluated using residence time distribution techniques; meanwhile, enzymatic kinetics must be determined for the system considered, according to the values of the substrate conversion attained. The model has been linked to an optimization routine based on the Powell algorithm. The proposed approach has been evaluated in a system performing simultaneous determinations of glucose and glycerol, considered the common carbon sources in a fermentation process.

Biotechnology↗
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Evidence that an endothelial cytosolic protein binds to the 3'-untranslated region of endothelial nitric oxide synthase mRNA.

Changes in the endothelial nitric oxide synthase (eNOS) expression could be involved in the endothelium-dependent vasorelaxing dysfunction associated with cardiovascular diseases. We have recently demonstrated the existence of endothelial cytosolic proteins that bind to the 3'-untranslated region (3'-UTR) of eNOS mRNA and could be involved in eNOS mRNA stabilization. In the present work, we have characterized the cytosolic proteins that bind to 3'-UTR eNOS mRNA. An endothelial cytosolic protein (MW 60-kD) specifically bound to 3'-UTR eNOS mRNA as determined by a cross-linking assay followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The endothelial cytosolic protein recognized a cytidine (C)-rich region within 3'-UTR eNOS mRNA. Furthermore, tumor necrosis factor-alpha (TNF-alpha) increased the level of the 60-kD endothelial cytosolic protein. In addition, TNF-alpha reduced eNOS mRNA levels and this was prevented by coincubation with cycloheximide. Cycloheximide also prevented the binding activity of the endothelial cytosolic protein to 3'-UTR eNOS mRNA. In summary, these data suggest that a 60-kD endothelial cytosolic protein binds to 3'-UTR eNOS mRNA. TNF-alpha increased the 60-kD protein levels. Cycloheximide prevented the binding activity of the cytosolic protein to 3'-UTR eNOS mRNA related to TNF-alpha; this effect was associated with greater eNOS mRNA levels. Further specific studies are needed to determine the involvement of this 60-kD endothelial cytosolic protein in the regulation of eNOS mRNA stabilization and in the endothelial dysfunction associated with cardiovascular diseases.

3' Untranslated Regions↗
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Study of the ability of proton nuclear magnetic resonance spectroscopy of human plasma to differentiate between controls and breast cancer patients.

Water-suppressed proton nuclear magnetic resonance spectroscopy of plasma had been proposed as a technique for detecting malignant tumors although its general diagnostic value is widely contested. To assess its diagnostic value in screening for breast cancer, we collected and analyzed 108 plasma samples from healthy women and women with breast disorders, mainly adenocarcinomas. No significant differences were found between controls and patients when average methylene-methyl linewidths were compared. Significant differences, however, were observed when methylene linewidths were compared. Unfortunately, the marked overlapping of both groups greatly reduced the possible diagnostic value of the technique. Among the various biochemical parameters analyzed for each plasma sample--triglyceride, total cholesterol and HDL cholesterol concentration, altered levels of carcinoembryonic antigen, phosphohexose isomerase, 5'-nucleotidase and phosphatase alkaline in patient samples, and estrogen and progesterone receptors of tumors--only triglyceride concentrations presented a clear inverse linear correlation with methylene linewidths.

Adenocarcinoma↗
PubMedDate not supplied

Willingness to pay to shorten waiting time for cataract surgery.

We interviewed persons who had recently been placed on a public waiting list for cataract surgery in Manitoba, Canada; Barcelona, Spain; and Denmark. The majority of the respondents were unwilling to pay higher taxes to reduce the length of the waiting list or to pay more out of pocket to have the surgery performed earlier in the private sector. Less than 2 percent actually had the surgery done in the private sector. We conclude that in spite of expressed public dissatisfaction with waiting lists in all three sites, a majority of the respondents did not support the actions that could have reduced their own wait.

Aged↗
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Histoplasmin and paracoccidioidin skin reactivity in infantile population of northern Argentina (1).

In order to estimate ages at which etiological agents of systemic mycoses initiate infection, histoplasmin and paracoccidioidin skin tests were performed in 344 children of both sexes, between 2 and 15 years old. They were selected from a statistically significant population sample Gral. San Martín city (Northeast Argentina). Tests were read 48 h after injection and considered positive if a 5 mm on larger induration was present. Circulating antibodies were also evaluated by agar gel immunodiffusion. The overall infection rate for H. capsulatum was 9.2%, belonging to children from 4 to 14 years old, without significant differences among sexes. Five children from 2 to 14 years old were positive to paracoccidioidin (1.6%). None of the children had specific antibodies neither signs of active mycosis. Results show H. capsulatum infection can be found from age 4, while for P. brasiliensis the lower limit was two years old. These findings may contribute to better knowledge on infantile fungal infection in a geographical region where no previous references can be found.

Adolescent↗
PubMedDate not supplied

Evolution of multiple sclerosis lesions on serial contrast-enhanced T1-weighted and magnetization-transfer MR images.

BACKGROUND AND PURPOSE: Magnetization-transfer imaging is a technique that could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions. The purpose of this work was to study the evolution of MS lesions on T1-weighted MR images over time and to investigate changes in magnetization-transfer ratio (MTR) values of MS lesions with different initial appearances on contrast-enhanced T1-weighted images. METHODS: Eleven patients with relapsing-remitting MS were studied with MR imaging. The MTRs were calculated for 47 lesions that had been classified according to their appearance on contrast-enhanced T1-weighted images. Each patient was examined at four time points over a 1-year period. The MTR changes observed in the selected lesions were compared with their initial T1-weighted appearance. RESULTS: The lowest MTR values were initially found in hypointense nonenhancing lesions and in ring-enhancing lesions, with both types showing a hypointense center. Changes in MTR values were more dynamic and reversible in ring-enhancing than in hypointense nonenhancing plaques. Nodular-enhancing lesions had slightly lower initial MTRs than did isointense non-enhancing lesions. CONCLUSION: The absence or presence of contrast uptake may indicate a different pathologic basis for hypointense MS lesions on T1-weighted MR images. These differences should be kept in mind when considering T1 lesion load as a surrogate marker of disability in MS.

Adult↗
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[Determination of verotoxins in strains of Escherichia coli O157:H7].

We performed an study to find out the main virulence factor in verotoxigenic Escherichia coli: the production of verotoxins in 50 non sorbitol-fermenting Escherichia coli strains (possible enterohemorrhage) which were isolated from children with acute diarrheas in the City of Havana and referred to the National Reference Laboratory for acute diarrheal diseases in "Pedro Kourí" Institute. By using the agglutination technique with latex particles of E. coli O157:H7, we determined whether the verotoxins belonged to this serotype, we also researched the production of verotoxins in Vero cell culture. Ninety-six percent of the total number of strains were positive in the qualitative determination of this factor which was more frequently observed after 24 hours.

Bacterial Toxins↗
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Magnetization transfer ratio values and proton MR spectroscopy of normal-appearing cerebral white matter in patients with liver cirrhosis.

BACKGROUND AND PURPOSE: Hepatic encephalopathy in cirrhotic patients may be the clinical manifestation of disturbed cerebral cell volume homeostasis. The aim of this study was to investigate the presence of significant changes in magnetization transfer ratio (MTR) values, which could reflect an increase in free water within the brain of patients with liver cirrhosis, and to correlate these findings with minimal hepatic encephalopathy and proton MR spectroscopy ((1)H-MRS) abnormalities. METHODS: Twenty-four patients with liver cirrhosis and eight healthy control volunteers were included in the study. MR imaging studies included conventional T1- and T2-weighted imaging, (1)H-MRS, and magnetization transfer imaging. MTR and (1)H-MRS values were obtained from normal-appearing white matter and were correlated with each other and with the presence of minimal hepatic encephalopathy. RESULTS: (1)H-MRS showed a decrease in choline and myo-inositol and an increase in glutamine + glutamate with respect to creatine + phosphocreatine. MTR values were significantly decreased in cirrhotic patients when compared with healthy control volunteers, although this decrease was not significantly higher in the patients with minimal hepatic encephalopathy. The decreases in MTR values correlated with increases in glutamine + glutamate. CONCLUSION: The MTR decrease in patients with liver cirrhosis may be caused by low-grade astrocytic swelling produced as a response to the osmotic stress occurring in these patients. However, in this cross-sectional study, we did not find a correlation between MTR decrease and the presence of minimal hepatic encephalopathy, probably because of limitations in MTR quantification techniques.

Adult↗