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J del Rey Calero

Publications and source records attributed to J del Rey Calero.

At least 19 recordsLinked to original sources

[Smoking and subjective health in Spain].

BACKGROUND: To examine the relationship between smoking and subjective health in Spain. MATERIAL AND METHOD: Datacome from the 1993 National Health Survey. Analyses were performed with logistic regression, adjusting for the main confounding factors. RESULTS: Among those less than 25 years, there is a dose-response relationship (p = 0.0001)between cigarette consumption and suboptimal health (fair, pooror very poor health). CONCLUSIONS: Smoking controlactivities should inform on the worse subjective health of youngsmokers, for whom other effects of tobacco smoking are less relevant because they appear to happen in the distant future.

Adolescent↗

[The transition from acute to chronic ischemic heart disease in Spain, 1980-1994].

BACKGROUND AND OBJECTIVES: The remarkable increase in hospital admissions from heart failure in Spain in the last few years may result paradoxical because it coincides with a decrease in ischemic heart disease mortality, the leading cause of heart failure. A plausible explanation is the increase in ischemic heart disease survival, derived from the recent therapeutic advances, which will translate into an increase in the chronic forms of disease. Thus, an analysis was made of mortality and hospital admission trends due to acute and chronic ischemic heart diseases in the 1980-1994 period in Spain. METHODS: Population-based study of temporal trends with data of primary diagnosis of acute (CIE-9: 410-411) and chronic (CIE-9: 412-414) ischemic heart disease obtained from the National Vital Statistics and the National Survey of Hospital Morbidity. RESULTS: The number of deaths due to acute ischemic heart disease has increased by 8.3%, from 18,559 in 1980 to 20,101 in 1994. Deaths due to chronic ischemic heart disease increased by 49.3%, from 4,703 in 1980 to 7,020 in 1994. As a result, chronic forms accounted for 20.2% of all deaths attributable to ischemic heart disease in 1980 and 25.8% in 1994. The age-adjusted acute ischemic heart disease mortality rates decreased by 20.1%, whereas those due to chronic increased by 14.6%. The number and rate of age-adjusted hospital admissions increased remarkably for both acute and chronic ischemic heart disease. Nevertheless, the increase observed with chronic form was higher, from 39.4% of all hospital admissions due to ischemic heart disease in 1980 to 58.4% in 1994. This classification of ischemic heart disease was more notorious among males and younger patients. CONCLUSION: Currently, we are witnessing a transition from acute to chronic ischemic heart disease. That partly explains the increase in hospital care for heart diseases, particularly ischemic heart disease and heart failure.

Adult↗

[Profiles of youths in modern society and health risks].

The youngsters are clearly conditioned by the society where they live, though they may feel apart. These youngsters have benefited from more educative and material resources than generations before, and their vital and social itinerary will depend, in great part, from the behaviours and attitudes acquired during adolescence and youth. They have not been formed in austerity and determination. They mainly value the near and the present. Courses of action more determined by the emotional than by the rational. While tolerant, they have selfish traits with self-contradictions between end- and instrumental values (effort, dedication, compromise), and certain indifference for the religion. Finally, they are demonstrate solidarity in specific situations.

Adolescent↗

The association of tobacco and alcohol consumption with the use of health care services in Spain.

BACKGROUND: Information on the impact of tobacco and alcohol consumption on the use of health services is scant and partially inconsistent. This paper examines the relationship between tobacco and alcohol consumption and the use of health care services in Spain. METHODS: Data were drawn from the 1993 Spanish National Health Survey, covering a random 21,120-person representative sample of Spain's noninstitutionalized population ages 16 years and older. Information was obtained through home-based interviews. RESULTS: Compared with never smokers, male smokers of more than 20 cigarettes/day tend to be hospitalized more frequently (odds ratio (OR) 1.31; 95% confidence limits (CL) 0.89-1.93) and make greater use of hospital emergencies (OR 1.51; 95%CL 1.13-2.01; P < 0.01). Among female smokers of more than 20 cigarettes/day, hospitalizations (OR 1.62; 95%CL 0.80-3.26) and medical visits (OR 1. 35; 95%CL 0.79-2.30) are also higher than among never smokers, although the associations do not reach statistical significance. Compared with never smokers, ex-smokers of both sexes make greater use of health care services (P < 0.01 for most services). There is a negative dose-response relationship (P < 0.001) between alcohol consumption and utilization of hospital and ambulatory services, for both sexes. Results are reasonably consistent across all age groups and are observed after adjustment for the principal confounding factors. We have found no evidence of a tobacco-alcohol interaction with the use of health care services. CONCLUSIONS: Smokers and ex-smokers make greater use of health care services. Control of smoking might reduce the use of such services and the ensuing human and economic costs. However, as alcohol consumption increases, the use of health care services decreases. This finding should not be used to promote even the moderate consumption of alcoholic drinks.

Adolescent↗

[Geographic variation in hospitalizations and mortality related to congestive heart failure in Spain, 1980-1993].

BACKGROUND AND OBJECTIVES: Geographical differences in hospitalizations and mortality for heart failure serve to estimate the potential for reducing the associated hospital and demographic burden on the population. Accordingly, the objective of this paper is to analyze the geographic variation in heart failure hospitalizations and mortality in Spain during the period of 1980-1993, and to examine their potential determinants. METHODS: Data on the primary diagnosis of heart failure were taken from the National Hospital Morbidity Survey and National Vital Statistics. Information on determinants of heart failure were obtained from large-scale nationally representative surveys conducted by the National Statistics Office. RESULTS: The period of 1980-1993 witnessed a decrease in geographical differences in heart failure hospitalizations and mortality. Theoretically, however, heart failure hospitalizations and mortality among persons aged > or = 45 years could still be further reduced by 60% and 30% respectively. In the period of 1989-1993 heart failure hospitalizations were correlated (p < 0.05) with ischaemic heart disease hospitalizations and the number of beds/1,000 inhabitants. Heart failure mortality showed a statistically significant correlation (p < 0.05) with ischaemic heart disease mortality, illiteracy and unemployed status. CONCLUSIONS: There is a great potential for a reduction in the hospital and demographic burden of heart failure in Spain. Control of ischaemic heart disease and a reduction in the geographical differences in socio-economic status would probably contribute to lessening the healthcare burden of heart failure in Spain.

Aged↗

The association between mortality from ischaemic heart disease and mortality from leading chronic diseases.

AIMS: Coronary risk factors raise the risk of other chronic disorders. We therefore tested the hypothesis that the geographic distribution of ischaemic heart disease mortality is associated with that of other chronic diseases with which it shares risk factors. METHODS AND RESULTS: For the 50 provinces of Spain, we collected mortality data for the period 1980-1995 from the national vital statistics. We calculated age-adjusted mortality rates for the leading causes of death in quintiles of provincial distribution of ischaemic heart disease mortality, and correlation coefficients with respect to provincial ischaemic heart disease mortality. As expected, because they share risk factors with ischaemic heart disease, mortality from cerebrovascular disease, malignant tumours, lung cancer, respiratory diseases, chronic obstructive pulmonary disease, diseases of the digestive system, cirrhosis of the liver and all causes, increase with the rise from lower to higher quintiles of ischaemic heart disease mortality. Ischaemic heart disease mortality registered correlations over 0.5 (P<0.001) with mortality from many of the above diseases in the periods 1980-1984 and 1991-1995. Expectations were similarly borne out for disorders not sharing risk factors with ischaemic heart disease, in that mortality from prostate and breast cancer, injury and poisoning, traffic accidents and ill-defined causes in most cases did not show a provincial association with ischaemic heart disease mortality. In general, these results were observed for both sexes and across all age groups. CONCLUSION: Ischaemic heart disease mortality is associated with mortality from chronic diseases which share coronary risk factors, across provinces of Spain over the period 1980-1995. This suggests that the geographic variation in such chronic diseases is due to common factors, potentially susceptible to similar preventive interventions.

Adult↗

[Current interest of antipneumococcal vaccination].

Pneumonia acquired in Community (CAP) may be a primary disease occurring in healthy individuals or secondary to predisposing factors or comorbidity. Prevalence of CAP is 2.6 to 5% for all ages, in USA 12%, for over 65 years 30%. Streptococcus pneumoniae is the commonest pathogen 30-50%, H. influenzae in COPD, the atypical pneumonia Mycoplasma pn., M. catharralis, Legionella pn., Enterobacteria, anaerobics often in hospital survey. In children is different RSV, Parainfluenzae type 3, Rhinovirus in the first 2 years old. Others are S. pneumoniae, H. influenzae, Chlamydia sp., etc. Appropriate empiric antibiotic therapy choices are based in guidelines. The most common pathogen is S. pneumoniae, isolates raised resistance rates to Penicillin to 20-50%, 40% in our country and also to Macrolides, with potential clinical failure (21-40%). Specially in elderly people and with the comorbidity are recommended the 23 valent polysaccharide vaccine, effective in bacteremic pneumonia 70-80%. Is not effective in children under 2 years, for that is important conjugated vaccine Hib (toxoids T, D, CRM197, OMP Nm) to prevent carriers, otitis media and reduce exacerbation of these respiratory infections.

Adult↗

[Environmental factors during early life and socioeconomic status in the present: which is more important for cardiovascular mortality in Spain?].

BACKGROUND: To examine whether provincial mortality from ischaemic heart disease and cerebrovascular disease in Spain in 1991-1995 is associated with infant mortality in 1930-1934, independently of illiteracy (an estimator of socioeconomic status) in 1991. MATERIAL AND METHODS: Population-correlation study. RESULTS: Infant mortality is correlated with mortality from ischaemic heart disease (r = 0.38; p < 0.01) and cerebrovascular disease (r = 0.41; p < 0.01). When adjusting for illiteracy rate in 1991, the correlation of infant mortality with ischaemic heart disease mortality is r = 0.01 (p = 0.93), and with cerebrovascular disease mortality is r = 0.25 (p = 0.08). CONCLUSIONS: Ischaemic heart disease and cerebrovascular disease mortality are moderately associated with infant mortality during the 1930s. This association might be explained by present socioeconomic status.

Adult↗

[The decline in moderate alcohol consumption has been associated with a decrease in heavy drinkers in Spain in the 1987-1993 period].

BACKGROUND: To examine whether the decline in alcohol consumption among moderate drinkers, which has occurred in Spain in the period 1987-1993, has been associated with changes in the proportion of heavy drinkers and abstainers. SUBJECTS AND METHODS: The units of analysis have been the 17 administrative regions of Spain. Alcohol consumption data have been taken from the 1987 and 1993 National Health Interview Surveys. RESULTS: A decrease of 10 g/week in mean alcohol consumption among male moderate drinkers has been associated with a decrease of 1.2% (95% CI: 0.7-1.7%) in the proportion of heavy drinkers. The association was also observed among women, those over and below 45 years of age, and was stronger for wine than for other alcoholic beverages. CONCLUSION: The decrease in moderate consumption of alcohol has probably had a beneficial effect on the health of the Spanish population.

Adult↗

[Hypertension-related mortality and arterial pressure in Spain].

BACKGROUND: Given the high figures of cardiovascular disease and hypertension in Spain, and the continuity of cardiovascular and total mortality risks at any level of blood pressure, mortality related to hypertension and blood pressure is estimated. SUBJECTS AND METHODS: Blood pressure distribution from a representative sample of the 35 to 64 years old Spanish population and the relative risks for death coming from valid and reasonably generalizable international studies (MRFIT, Framingham and Chicago Project) were used. The proportions and absolute numbers of cardiovascular and total deaths related to blood pressure and hypertension (categories of the US Joint National Committee VI [JNC VI]) have been calculated in middle-aged men and women. RESULTS: As many as 42% of the coronary deaths, 46.4% of the stroke deaths and 25.5% of the total deaths are related to hypertension (> or = 140/90 mmHg), most of them in stages 1 and 2. It follows high-normal plus normal blood pressure group (8.3, 10.2 and 6.2% of these deaths, respectively). All together, 17,266 total deaths and 4,502 cardiovascular deaths related to blood pressure took place annually, three-quarters of them in males. Over the last ones, 65.5% are coronary and 34.5% cerebrovascular, prevailing the first ones in both sexes. Eight out of 10 deaths, cardiovascular or total, related to blood pressure are concentrated in the hypertension categories, and two out of 10 in the high-normal or normal blood pressure groups. CONCLUSIONS: One out of 3 total deaths and one out of 2 cardiovascular deaths are related to blood pressure. One out of 4 total deaths and one out of 2.5 cardiovascular deaths are related to hypertension. A substantial part of these deaths come from stages 1 and 2 hypertension and from high-normal and normal blood pressure group.

Adult↗

Determinants of geographical variations in body mass index (BMI) and obesity in Spain.

OBJECTIVE: To identify the factors associated with geographic variations in Body Mass Index (BMI) and obesity in Spain. DESIGN: Cross-sectional, ecological analysis using data on illiteracy rate (per 1000 population), energy intake (kcal/person/d), sedentary population (%), smoking population (%), alcohol consumption (g/person/d), and percentage of population aged 65 y or over, for Spain's 50 provinces. SUBJECTS: Non-institutionalized population aged 16y or over. MEASUREMENTS: Median BMI and percentage of population with obesity, defined as BMI > 30 kg/m2. RESULTS: There was a clear geographical pattern, with some areas in the south and north-west of the country registering the highest BMI and prevalence of obesity and a north-south pattern on illiteracy per 1000 population. Multivariate regression analysis showed that illiteracy, sedentary lifestyle and energy intake explain 35% and 14% of the variation in BMI and obesity, respectively. Illiteracy proved to be the variable most associated with both BMI (regression coefficient (beta = 0.01; P = 0.005) and obesity (beta = 0.05; P = 0.013). Sedentary lifestyle showed a statistically significant relationship with BMI (beta = 0.01; P = 0.03), but not with obesity (beta = 0.03; P = 0.581). Energy intake exhibited a relationship with BMI (beta < 0.01 P = 0.03) that lost statistical significance when adjusted for age. CONCLUSION: Geographical variations in BMI in Spain are partly explained by illiteracy, sedentary lifestyle and, to a lesser extent, energy intake, whereas regional variations in obesity are related only to the educational level of the population.

Alcohol Drinking↗

Association of moderate consumption of alcohol with rates of heavy drinking and abstinence in Spain.

BACKGROUND: Moderate consumption of alcohol reduces general mortality among middle-aged and elderly persons through a reduction in cardiovascular risk. Furthermore, higher consumption of wine is associated with lower cardiovascular mortality in northern Spain. This information may be used to promote moderate consumption of alcoholic beverages in Spain. However, alcohol consumption is influenced by the drinking habits of the individual's social environment. Therefore, we examine the relation between average consumption of alcohol and the prevalence of heavy drinkers, who most often have adverse effects from alcohol, and the prevalence of abstainers, who do not benefit from alcohol, in Spain. METHODS: Spain's 17 administrative regions are the units of analysis. Alcohol consumption data were taken from the 1993 National Health Survey. Data were analyzed using weighted correlation coefficients and linear regression. RESULTS AND CONCLUSIONS: Mean alcohol consumption among moderate drinkers showed a positive correlation with the proportions of men (r = 0.63; p = 0.007) and women (r = 0.58; p = 0.015) whose alcohol intake was above the 90th percentile of consumption distribution. Similar results were yielded when median rather than mean consumption was used, and when heavy drinking was defined as the consumption of 210 g and 140 g of alcohol per week, in men and women, respectively. The association also was observed across all ages and all types of beverages. However, no statistically significant association was seen between mean and median alcohol consumption and the proportion of abstainers. SIGNIFICANCE: Moderate consumption of alcohol is associated with the prevalence of heavy drinkers in all regions of Spain. Therefore, promotion of moderate consumption of alcohol in Spain might be associated with a rise in the prevalence of heavy drinkers, those who most frequently suffer the harmful effects of alcohol.

Adult↗

[Infectious disease trends].

Infectious disease mortality has increased during the last decades: from a rate of 38.10(5) inhabitants in 1980-95 to 41, 5.10(5) in 1998. Demographic changes have modified susceptibility to infections, due to the increment of elderly people--who have less immunity--, and the increase in drug-abusers and HIV-infected subjects. Social and technological environmental factors have had some influence on emergent and re-emergent diseases. Key issues to be considered are problems with antimicrobial resistance, infectious related- to chronic diseases, infections in immunodeficient subjects, and new vaccines to use. Among the challenges to public health is the need for incorporating new and rapidly technologies as microarrays, strategies of planning, multisectorial approaches to detecting preventing and controlling emerging and re-emerging infectious diseases.

Acquired Immunodeficiency Syndrome↗

[Wine consumption and ischemic heart disease mortality in Spain].

BACKGROUND: To identify the determinants of the geographic distribution of ischaemic heart disease (IHD) mortality in Spain. POPULATION AND METHODS: Ecological study at the provincial level. Data are obtained from the 1976-1980 vital statistics, the 1964-1965 Household Budget Survey and the 1970 Population Census. RESULTS: Consumption of wine, chicken, fish, and vegetables, as well as illiteracy, explain 47% of IHD mortality. Consumption of wine alone exhibits a statistically significant relationship (p < 0.05) with IHD mortality. Moderate consumption of wine is negatively associated with IHD mortality, whereas higher consumption reveals a positive association. CONCLUSION: Results are consistent with those from an earlier study in Spain for the 1983-1987 period.

Alcohol Drinking↗

[Cardiovascular mortality in Spain and its autonomous communities (1975-1992)].

BACKGROUND: Given the great relevancy of the cardiovascular diseases, were analyzed the cardiovascular mortality in the Spanish autonomous communities and its trend during the period 1975-1992, to identify communities with a high death risk by these diseases and to as certain the underlying factors. MATERIAL AND METHODS: The mortality rates standardized by age are calculated for the diseases of the circulatory system (DCS), ischaemic heart disease (IHD) and cerebrovascular disease (CVD). The mortality trend has been quantified through the percentual change annual means, using a log-lineal model. RESULTS: The Communities of Valencia, Extremadura, Andalusia and Murcia show the highest cardiovascular diseases mortality rates while the Communities of Madrid, Navarra, Castilla and Leon and Aragon present the most decreases. In all the communities a decrease of the mortality by DCS has occurred, that ranges from a percentual decrease annual means higher than 3% in Navarre (-3.7%) and Madrid (-3.4%) to values that they do not reach to the 2% of decrease in Murcia (-1.8%) and Balearic Islands (-1.9%). In males as well as in females, the mortality by IHD and CVD falls in all the communities in the period 1975-1992, though the decrease is much greater for CVD. CONCLUSIONS: This study demonstrates a consistent fall of the cardiovascular mortality in all the Spanish autonomous communities and some considerable differences in the level and in the trends of the magnitude mortality among these communities during all the studied period.

Aged↗