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Biomedical subjects

J Altimiras

Publications and source records attributed to J Altimiras.

28 records · Page 2Linked to original sources

[Influence of sex, age, and profession on transient work disability at a health center].

OBJECTIVE: To analyse whether the variables of gender, age and type of job of those in full-time work affect short-term unfitness for work (SUW) in a study undertaken within our health area. DESIGN: A prospective and retrospective study of all the SUW. SETTING: Primary Care. An urban Health Centre. PARTICIPANTS: Those people with full-time jobs registered at the Centre. MAIN MEASUREMENTS AND RESULTS: The entire 1098 certificates of SUW issued in 1990 were processed. The population pyramid and job distribution among those in full-time work was obtained by a random sample of 5% of the active population. When time off for maternity (TOM) was excluded, women accounted for 44.8% of SUW and men 55.2%. There were no significant differences with the percentages these figures represent for the active population as a whole. The number of SUW per 100 people in work was 15.9 for men and 21.5 and 17.4 for women (including and excluding TOM, respectively). The average length of SUW, excluding maternity, was 27.06 days for men and 26.8 for women. On the question of age, those under 19 and over 40 contributed least to the SUW percentage. Additionally, those under 19 and over 60 were the proportions of the population least prone to SUW. On the question of type of job, we found a higher contribution to absenteeism than expected within Groups 3 and 4 and less in Groups 0/1, 5 and 7/8/9. The longest average length of time for SUW was in Group X (84.2 days/SUW). CONCLUSIONS: Excluding TOM, gender does not appear to be a variable that affects SUW. Age group and type of job are variables affecting SUW. It will be necessary to undertake research into whether there are additional social or labour factors which might explain.

Absenteeism↗

Knowledge of medication in hospitalized chronic respiratory patients.

Object of the study was to assess educative needs in the field of drug therapy among 99 chronic patients with advanced chronic lung disease admitted to the Respiratory Service of the Hospital Sta. Creu i Sant Pau (Barcelona, Spain). The knowledge of the patients about their previous drug treatment, sources of information as well as patients' conception of side-effects, was gathered from medical records and by means of a questionnaire. The majority of patients studied were male (63%), aged over 60 years (average 63 +/- 12), illiterate or with basic education (88%), had a chronic obstructive, pulmonary disease (76%) and with an important degree of chronicity. They had been treated for their condition during a mean of 8.4 years and took an average of 4.6 drugs. 31% Of patients did not answer any question about their medication properly and only 17% gave a correct answer to all the questions. The lower the age and the higher the educational level, the higher the proportion of correct answers to knowledge questions. 35% Of the patients stated not to have been informed about their medication and 55% stated that they had read the patient package inserts.

Age Factors↗

[An analysis of the interruptions in general medicine consultations].

AIM: To find out the number and nature of the interruptions which occur in general medical consultations. DESIGN: Prospective study lasting two months. SITE. Two representative primary care consulting rooms in an urban health centre (a family and community medicine teaching centre). PATIENTS AND OTHER PARTICIPANTS: All the interruptions which occurred on the days chosen within the period of study were analysed. MEASUREMENTS AND MAIN RESULTS: The two consulting rooms had an average of 10 and 6.8 interruptions a day: which suggests that, in 91% and 54% respectively of the consultations that took place, some type of interruption occurred. The average length of the interruptions was 35 and 16 seconds, which represented 3.2% and 1.1% of the total time of the consultations. The members of staff who caused most interruptions were janitors (30.6% and 37%), followed by clerks (24.1% and 22.5%). However those who took the most time in their interruptions were clerks (25.4% of the total time in one consulting room) and nurses (30.3% of the total time in the other consulting room). The majority of the interruptions (63% and 53%) were considered unjustified. The handling over of analyses and further tests (15.8% and 21.4%); the bringing-in of certificates stating inability to work (16.5% and 18.1%); and the bringing-in or taking-out of clinical notes (15.1% and 11.2%) accounted for the most common causes of interruption. CONCLUSIONS: There is a need to organise the health centre's infrastructure so that as few interruptions as possible take piece actually during a consultation, given the bad effect they have on the doctor-patient relationship.

Age Factors↗

Prevention of aortocoronary vein-graft attrition with low-dose aspirin and triflusal, both associated with dipyridamole: a randomized, double-blind, placebo-controlled trial.

A randomized, double-blind, placebo-controlled trial was performed in 209 patients to evaluate the efficacy of a low dose of aspirin plus dipyridamole or that of a new antiplatelet agent (triflusal) plus dipyridamole in the prevention of aortocoronary vein-graft occlusion. An angiographic control performed in 161 patients 9 days after surgery showed no significant differences between groups, but a new control on 138 of those patients 6 months later did show significant linear trends towards fewer distal anastomosis occlusions (P = 0.027) from the placebo (24%, 22/91) to the aspirin (16%, 17/106) and to the trifusal groups (12%, 10/86), and towards fewer new occlusions (P = 0.056) from 12% (9/78) to 10% (10/99) and to 2.6% (2/78), respectively, in the same groups. A multivariate logistic regression model, used to determine the effect of 33 variables on distal anastomosis occlusion at 6 months control, demonstrated that diameter of distal bed (P = 0.006), moderately to severely atherosclerotic distal bed (P = 0.003) and the interactions between poor distal bed and triflusal (P = 0.005) were independent predictors of occlusion. Thus, triflusal plus dipyridamole appeared superior to low-dose aspirin plus dipyridamole in the prevention of vein-graft occlusion, independently of coronary and vein-graft determinants of occlusion.

Adult↗

Delivering pharmaceutical services from a decentralized pharmacy--health care system in Spain.

This article presents a practical demonstration of a decentralized pharmacy system improving the quality of pharmaceutical services. The authors explain the working system of a satellite pharmacy in one of the pavilions of the Hospital de la Santa Creu i Sant Pau in Barcelona, Spain. Clinical pharmacists working in this satellite become deeply involved in drug information, quality control programs, pharmacokinetics, patient education, research, and teaching activities.

Delivery of Health Care↗

[Usefulness of information leaflets about drugs for hospitalized patients with chronic diseases].

To know how patients perceive the information leaflets about medicines, it has been carried out a study in a sample of 65 patients admitted to a hospital for chronic respiratory or cardiac diseases. A 47.7% of patients expressed that the main information provided by the leaflet was such concerning to the purpose of the drug, whereas a 18.5% pointed out such concerning to side effects and management of unexpected circumstances. Sixty three percent of patients expressed that leaflets did not provide them new information. A relevant percentage of patients did not know the meaning of some terms frequently used in leaflets and package-inserts (80% of mistakes in the interpretation of "take the drug on an empty stomach"). It is concluded that the information leaflets can be useful in the framework of a good physician-patient relationship, as a reminder, and to reinforce the knowledge that the patient already has. It is considered that the most appropriate time for the education of chronic patients about drugs is when the treatment is prescribed for the first time.

Aged↗

[The temporary work incapacities of professional administrative workers and nurses].

We show the results of a retrospective study designed to assess the features of transient job disability (TJD) episodes of workers from two groups (clerks and nurses) from an urban health basic zone with 24,536 inhabitants, out of which 6,009 were active workers registered in social security databases. Population pyramid and job distribution in active workers were obtained from a random sample including 5% of the active population, out of which 17% were clerks and 5.54% nurses. There were 1098 TJD episodes in 1990; 32.4% of them involved clerks and 8.3% nurses. The mean length of episodes was 28.2 days in nurses and 27.8 days among clerks, compared to 32.4 days in the active population. These differences remained (p < 0.001) even after excluding TJD episodes of pregnant women, in whose case the mean length of episodes involving male or female workers was the same. The percentage of TJD episodes was higher among female nurses and clerks, than among the whole female population. Influenza was responsible for 20.5% of TJD in clerks against 14.3% among nurses and 14.8% in the whole active population. We conclude that, in the groups studied, the rate of job absenteeism was higher than in the whole population, and higher in female than in males. However, in the whole population, there were no differences in TJD rates between males and females. We discuss that several factors other than illness may explain the differences among groups.

Absenteeism↗

Is the short-term modulation of heart rate in teleost fish physiologically significant? Assessment by spectral analysis techniques.

Heart rate is an important physiological variable in the control of cardiac output, even in fishes, where the importance of stroke volume has been overemphasized. Except for the myxinoids, the fish heart is innervated by cranial nerve X and the nature of this innervation is mainly inhibitory by parasympathetic fibers, although a sympathetic contribution has also been demonstrated. In mammals, cardiac innervation is not only responsible for the control of mean heart rate but it also modulates the beat-to-beat heart rate changes. These beat-to-beat changes are known as heart rate variability (HRV) and appear to be related to fluctuations in respiration and blood pressure. In this paper we demonstrate the link between cardiac innervation and HRV in several species of teleosts because HRV is greatly decreased after vagotomy or atropinization. In contrast, after abolishing the sympathetic influence with propranolol, only slight changes in total HRV are observed, indicating the restricted importance of the adrenergic innervation in determining phasic changes in HRV despite the significant tonic effect which has been demonstrated. Thus, it appears unlikely that the sympathetic influence will be present in any measured spectral component as suggested previously. Furthermore, clear spectral patterns do not always exist and this may be due to the erratic influence of respiration which is clearly faster than heart rate in all fish species studied. This differs from the slow ventilation frequency displayed by many mammalian species that exerts an influence on a beat-to-beat basis (respiratory sinus arrhythmia). Spectral patterns could also be affected by changing levels of circulating catecholamines, although this is still unproved.

Animals↗