Biomedical subjects

M A Vila

Publications and source records attributed to M A Vila.

5 recordsLinked to original sources

PubMed2001

[Control of blood pressure in a population of patients with hypertension and in a subgroup with hypertension and diabetes: relationship with characteristics of the health care center and the community].

AIMS: To evaluate how well blood pressure (BP) is controlled in the population of persons with hypertension alone and with diabetes, and to evaluate the influence of characteristics of the health care center on the degree of control of BP. Design. Descriptive, cross-sectional, multicenter, retrospective study. SETTING: 31 health centers in Catalonia (Northeastern Spain). Participants. Random sample of 2240 clinical records of patients with hypertension who were seen at 31 different primary care centers in Catalonia between January and December 1996. MAIN OUTCOME MEASURES: Audit of clinical records. We recorded the two most recent BP measurements, and annotations regarding screening for and diagnosis of other cardiovascular risk factors. We also recorded health center and physician characteristics. RESULTS: 495 patients (22.1%) had diabetes in addition to hypertension. 61.2% were women. Mean age was 64.9 years (95% CI, 64.4-65.4 years). In 25.7% of the patients, BP was below 140/90 mmHg (95% CI, 23.9-27.5%), but among patients with diabetes only 6.7% had BP below 130/85 mmHg (95% CI, 4.5-8.9%). Mean systolic and diastolic BP at the end of the study period were higher at teaching centers. Diastolic BP was significantly higher at urban centers and in patients younger than 65 years. Diastolic BP was also higher in patients with at least one associated cardiovascular risk factor, and at centers less than 6 years old, although these differences were not statistically significant. We found no differences according to physician characteristics. CONCLUSIONS: Blood pressure was adequately controlled in few patients with hypertension and diabetes in Catalonia. Associated cardiovascular risk factors, age less than 65 years, and being a patient at a teaching center or an urban center, were associated with a worse degree of BP control.

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PubMed1996

[Self perception of health and complete evaluation of the elderly patient at a primary care center].

OBJECTIVES: 1) To make an integrated evaluation of the cognitive status, functional capacity, chronic disorders and social situation of the over-75 age group. 2) To find this group's self-perception of their health. DESIGN: A descriptive crossover study. SETTING: The Gòtic Health District in Barcelona. PARTICIPANTS: 316 people were included in the study. They were chosen by simple randomised sampling from the over-75s seen at the centre (n = 1,625). MEASUREMENTS AND MAIN RESULTS: To assess cognitive status, the Pfeiffer Short Portable Mental Status Questionnaire was used; for functional capacity, the Katz Index; and for chronic disorders, the medical records were reviewed. A questionnaire was used to find patients' social situation and assessed social relationships, social resources used and architectonic barriers. Self-perception of health status was evaluated using the Nottingham Health Profile. Prevalence of cognitive deterioration was 29.7%. 39.4% of patients were dependent in one or more basic activities of their daily life. 90.8% had a chronic disorder, the most frequent being AHT, arthrosis, obesity and dyslipemias. 28.3% lived alone and 26.7% used social services. CONCLUSIONS: We think this kind of assessment is useful in primary care. It would provide an integrated diagnosis (clinical, functional, medical and social) of elderly patients.

Activities of Daily Living↗

PubMed1995

[Left ventricular hypertrophy in a general hypertensive population in Barcelona].

BACKGROUND: Left ventricular hypertrophy (LVH) is a well known cardiac risk factor. There are no data available as to the epidemiology of this disease in the general hypertensive population in Spain. METHODS: A randomized sample (n = 267) of a general hypertensive population under the age of 80 years was followed in a Basic Health Care Area located in the center of Barcelona, Spain. A Doppler-echocardiographic study of the patients was carried out. The patients were considered to have LVH when they demonstrated an index > 134 g/m2 of left ventricular mass in males and > 110 g/m2 in females. The odds ratio (OR) was estimated on presentation of LVH associated with exposure to different factors. RESULTS: A prevalence of LVH diagnosed by echocardiogram was observed in 64% (confidence interval 95% from 58.3 to 69.8%). The independent risk factors associated with the presence of LVH were female sex, age and systolic blood pressure. CONCLUSIONS: Left ventricular hypertrophy is a frequent cardiovascular risk factor in the general hypertensive population in Spain. A systematic search by echocardiography cannot be recommended in primary health care until cost-effectiveness studies have been performed.

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PubMed1993

[Reflex sympathetic dystrophy].

OBJECTIVE: The description of three cases of reflex sympathetic dystrophy. DESIGN: Retrospective clinical observations. SETTING: Gòtic basic Health Area, Barcelona. PATIENTS AND OTHER PARTICIPANTS: Two women and a man (aged 75, 65 and 56) with mechanical pain and inflammation in the extremities. Two of the cases had a case history of trauma. Radiological signs of mottled osteoporosis were observed in the affected extremities of all the patients. In one there was gammagraphic pick-up. They were diagnosed as suffering reflex sympathetic dystrophy. INTERVENTIONS: Rehabilitation, non-steroid anti-inflammatories and treatment with Calcitonin. MEASUREMENTS AND MAIN RESULTS: Clinical and complementary diagnostic trials. CONCLUSIONS: Describing the clinical presentation and the necessary complementary trials to be able to reach an early diagnosis of this illness, which provides a better prognosis.

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PubMedDate not supplied

Mining association rules with improved semantics in medical databases.

The discovery of new knowledge by mining medical databases is crucial in order to make an effective use of stored data, enhancing patient management tasks. One of the main objectives of data mining methods is to provide a clear and understandable description of patterns held in data. We introduce a new approach to find association rules among quantitative values in relational databases. The semantics of such rules are improved by introducing imprecise terms in both the antecedent and the consequent, as these terms are the most commonly used in human conversation and reasoning. The terms are modeled by means of fuzzy sets defined in the appropriate domains. However, the mining task is performed on the precise data. These "fuzzy association rules" are more informative than rules relating precise values. We also introduce a new measure of accuracy, based on Shortliffe and Buchanan's certainty factors [Shortliffe E, Buchanan B. Math Biosci 1975;23:351-79]. Also, the semantics of the usual measure of usefulness of an association rule, called support are discussed and some new criteria are introduced. Our new measures have been shown to be more understandable and appropriate than ordinary ones. Several experiments on large medical databases show that our new approach can provide useful knowledge with better semantics in this field.

Databases, Factual↗