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R Tresserras

Publications and source records attributed to R Tresserras.

At least 19 recordsLinked to original sources
PubMed1999

Age at starting smoking and number of cigarettes smoked in Catalonia, Spain.

BACKGROUND: Few studies have investigated the association between age at starting smoking and the average number of cigarettes smoked per day in adulthood. To provide further evidence on this issue, we analyzed data from the Catalan Health Interview Survey (CHIS). METHODS: The CHIS was conducted in 1994 on a randomly selected sample (N = 15,000) of the population of Catalonia, Spain. A total of 4,897 current or exsmokers (3,276 males and 1,621 females) were included for analysis. Age-standardized proportions of subjects smoking <15, 15-24, and >/=25 cigarettes/day, age-standardized mean number of cigarettes smoked per day, and multivariate odds ratios (OR) of being a heavy smoker (>/=25 cigarettes/day) according to age at starting smoking (<15, 15-17, 18-19, >/=20 years) were computed. RESULTS: Men who started smoking before the age of 15 smoked on average 5.5 cigarettes more than those who started at age 19 or over. Women who started smoking early in life smoked, on average, 6.8 cigarettes/day more than women who started later. The proportion of smokers of <15 cigarettes/day was higher among subjects who started smoking later. Both for males and for females, the OR of being a heavy smoker significantly increased with decreasing age at starting smoking (OR = 2.4 for males and 4.5 for females who started at age <15 versus >/=20 years). The level of education did not modify the relationship in males, whereas the association with age at starting was only apparent for more educated women. CONCLUSIONS: This study confirms that age at starting smoking is inversely and strongly associated to the number of cigarettes smoked per day. Thus, actions aimed at the prevention or delay of smoking onset among adolescents would have an important beneficial effect.

Adolescent↗
PubMed1999

Prevalence of diabetes in Catalonia (Spain): an oral glucose tolerance test-based population study.

The goal of this study was to investigate the prevalence of diabetes mellitus and impaired glucose tolerance in the adult population of Catalonia and study their association with obesity, central obesity, hypertension and smoking habit. A random sample of 3839 subjects aged 30-89 years participated in this cross-sectional study: 2214 subjects underwent a health examination with oral glucose tolerance test (OGTT) and 1625 were interviewed by phone. Diabetes prevalence (known and unknown) in the 30-89-year-old population was 10.3%, (95% CI: 9.1-11.6). In this age group, the prevalence rates of known diabetes, unknown diabetes and impaired glucose tolerance were 6.4, 3.9 and 11.9% in men and 6.9, 3.4 and 11.9% in women. The age adjusted prevalence to the world population for the 30-64-year-old age group was 6.1% (7.1% in men and 5.2% in women).The factors significantly associated with diabetes were age, obesity, hypertension and family history of diabetes. The high ratio of previously known diabetic cases to newly discovered ones, specially in the oldest age group, suggests good levels of awareness and medical services. The prevalence in Catalonia is similar to that observed in other Mediterranean countries.

Adult↗
PubMed1999

[Renal failure secondary to diabetic nephropathy. A review of the characteristics of the diabetic patients who started dialysis in Catalonia in 1994].

The appearance of diabetic nephropathy and its progression towards renal failure can be prevented if an early treatment is instituted. However, diabetes is currently one of the main causes of entry into a dialysis program. Therefore, the diagnostic characteristics of renal disease in 105 patients who started dialysis in Catalonia in 1994 were reviewed; the presence of other changes associated with diabetes were assessed. The results showed that 81.7% of patients had proteinuria higher than 0.5 g/24 h, and 40.5% had plasma creatinine higher than 5 mg/dl at the first nephrological control. As a result, the period between diagnosis of nephropathy and the inclusion in the dialysis program was very short (3.7 years) and considerably shorter than that reflected in literature for other countries, whereas the incidence of other micro and macrovascular complications was similar. Remarkably, a high number of smokers and treatment with oral antidiabetic drugs (33%) at the end stage of renal failure was observed. These results suggest that follow-up of diabetics should be more exhaustive and serial tests be performed to detect nephropathy early. An appropriate control during renal failure stage can also postpone the disease progression and avoid the appearance of complications which at present have a high morbid-mortality and high cost.

Adult↗
PubMed1998

[Prevalence of nephropathy in type I diabetes].

BACKGROUND: Diabetic nephropathy is a serious complication of diabetes, of which there are few epidemiological data in Spain. The aim of this study is to determine diabetic nephropathy prevalence in a group of patients with type I diabetes mellitus, representative of the population of Barcelona, Spain, evaluating several risk factors related with its development. PATIENTS AND METHODS: 639 patients (296 males and 343 women), from 6 hospitals, selected according with the diabetes duration (194 between 5 and 9 years [group I], 227 between 10 and 19 years [group II] and 218 with 20 years or more [group III]) were studied. In all patients urinary albumin excretion and plasma levels of creatinine, HbA1c, cholesterol and triglycerides were determined. The presence of retinopathy, neuropathy, vasculopathy and tobacco consumption were also evaluated. RESULTS: The prevalence of diabetic nephropathy increased with longer diabetes duration (8.1% [CI: 4.3-11.9] in group I, 24.7% [CI: 19.1-30.3] in group II and 44.7% [CI: 38.1-51.3] in group III), as well as that of hypertension, diabetes complications, cholesterol and triglycerides plasma levels. Related to people with normal renal function, after logistic regression, microalbuminuria was associated with hypertension and longer diabetes duration. Clinical nephropathy (macroalbuminuria + renal failure) to hypertension, longer duration, hypertriglyceridemia, male sex and tobacco consumption. CONCLUSIONS: The prevalence of diabetic nephropathy in Barcelona area is high and similar to that observed in other european regions. Its existence is associated with other diabetic complications. In addition to the classic risk factors, tobacco consumption must also be considered as a factor for diabetic nephropathy.

Adult↗
PubMed1998

Actions implemented to improve hypertension control in Spain.

Hypertension prevalence is estimated at approximately 30% of the adult population in Spain, using the 140/90 mm Hg cutoff. This represents a heavy public health burden when compared with other European countries, although the direct cost per person is one of the lowest in Europe. The programs implemented regionally since 1985 are presented here. As a result of them, a decade later the number of hypertensives with controlled blood pressure has increased from 10% in 1986 to 13% in 1995, and cerebrovascular mortality has steadily decreased.

Adolescent↗
PubMed1998

Management of the hypertensive patient who smokes.

Smoking and arterial hypertension are highly prevalent at the community level. While the coexistence of both risk factors is less frequent, the potentiation of cardiovascular risk when both are present makes the association highly relevant in terms of a preventive approach. There are many interrelationships between smoking and high blood pressure at the clinical, epidemiological and pathophysiological levels. Those demonstrable links compel us to review the usual explanation of the influence of smoking on blood pressure. Pharmacological treatment of the hypertensive patient who smokes must be adapted to the patient's risk profile, using the most efficacious antihypertensive agents. With the exception of nonselective beta-blockers, all the available antihypertensive drugs can be prescribed. Minimal intervention and nicotine replacement constitute the most well tested interventions in helping smokers to quit their habit. Nicotine replacement is currently a well tolerated intervention, even in patients with cardiovascular disease.

Adolescent↗
PubMed1997

[Differentiated thyroid carcinoma, 1972-1992. Follow-up, detection of recurrences and prognostic factors].

BACKGROUND: There is no consensus about the treatment and the follow-up of differentiated thyroid carcinoma (DTC), because in some patients, currently known prognostic factors cannot predict the course of the disease. The aim of this work has been to review the results of the treatment of our patients with DTC and to assess the prognostic factors. PATIENTS AND METHODS: We include, retrospectively, 204 patients with DTC (54 males and 150 women) with a men (SD) age of 38 (23) years, attending to a terciary university hospital. The follow-up is 9.2 (6) years (range, 2-22 years). They all underwent near total thyroidectomy, ablative doses of radioactive iodine (131INa) and L-thyroxine to suppress thyroid stimulating hormone (TSH) levels. At least once a year, a clinical examination, a whole-body scan (WBS) with 131INa and serum thyroglobulin (Tg) measurements were performed in hypothyroid state. In the statistics, chi 2 test, univariate analysis, Student's t test, Kaplan-Meier method, Mantel-Cox test and multiple regression analysis were employed. RESULTS: The survival rate was 89.05%. Twenty patients died of DTC (9.8%) (papillary 8 [6%], follicular 12[17%]). Surgical complications (recurrent nerve palsy or permanent hypoparathyroidism) were seen in 5% of the patients. The sensitivity of WBS to detect distant metastases or local (neck) involvement was 71% (initial 100%, late 71%). Tg sensitivity was 85% (initial 95%, late 73%). Factors associated to a poor prognosis were age > 40 years (p < 0.0001), follicular carcinoma (p < 0.02) and initial stages III and IV (p < 0.0001). CONCLUSIONS: The mortality and complications rates in our patients with differentiated thyroid carcinoma validate our management schedule. Tg measurements are more sensitive than WBS to detect distant or local metastases; however, sensitivity of both techniques was lower in the detection of late metastases. Age below 40 years, papillary carcinoma and initial stages I and II are factors of better prognosis.

Adenocarcinoma, Follicular↗
PubMed1997

[Smoking prevalence trends in Catalonia, Spain, 1982-1994].

BACKGROUND: Smoking prevalence trends from 1982 to 1994 of adult population in Catalonia (Spain) are described. SUBJECTS AND METHODS: Four population surveys have been carried out periodically using the same questionnaires and definitions for smoking status. Surveys in 1982, 1986 and 1990 have been implemented taking samples of Catalonia population through a multistage sampling with random stratified selection by province and habitat. Individuals were chosen through a random route process. In 1994, a survey with a complex probabilistic sample design with 8 geographical areas (health regions) and 2 basic units (towns and individuals) was implemented. RESULTS: Among the 15-64 years old adults, a decrease of 6.9% in smoking prevalence has been observed. The initial prevalence in 1982 was 37.9% (CI 95%: 35.4; 40.3); in 1994 this prevalence was 35.3% (CI 95%: 34.4; 36.2). In 1994, the prevalence of current smokers in population over 14 years old was 30.6% (CI 95%: 29.8; 31.4). We have observed a significant decrease in smoking prevalence in all age groups among male population (-20.6% for the 12-year period) whereas prevalence has increased among female (+28.0%) mainly among those between 25 and 54 years old. The main percentual decrease in smoking prevalence has been observed among young people aged 15-24 years old for both genders. The proportion of former smokers has remained stable (11.4% in 1982, 12.9% in 1994) during the period studied. The proportion of former smokers increases with age among man over 25 years. CONCLUSIONS: Smoking habit is still very prevalent in Catalonia, even higher than in other Western European countries. In spite of the increase among women, the significant dectines of smoking prevalence among men and youngsters (of both genders) could represent encouraging findings in order to pursue the efforts aimed at reducing the morbi-mortality burden of smoking in our society.

Adolescent↗
PubMed1996

Mortality trends and past and current dietary factors of breast cancer in Spain.

Spain had one of the lowest breast cancer mortality (BCM) rates in Europe a decade ago but this is no longer the case. A study of the trends of breast cancer mortality in Spain during the last 30 years, and an analysis, at the ecological level, of the current and past dietary patterns associated with breast cancer mortality have been conducted. Age standardized rates and standardized mortality rates (SMR) for this period were calculated. Dietary information about 20 different groups of foods for the 50 Spanish provinces was obtained from two National Household Budget and Expenditure Surveys, conducted in 1964-1965 and 1980-1981. Simple correlation coefficients were calculated, and multiple regression (dependent variables: BCM and breast cancer SMR) with a stepwise procedure was performed. Trends of breast cancer mortality in Spain for the last 35 years indicated a 100% increase in the 35-64 years group. Results indicate important changes in food consumption patterns in Spain, departure from the traditional Spanish diet, and the association of breast cancer mortality with past (15 years period) consumption of beef and total meat and the current consumption of vegetable oils, among other features of interest. Past consumption of meat and particularly beef meat seems to be associated with current breast cancer mortality rates in Spain. However, results at ecological level need to be confirmed in individuals.

Adult↗
PubMed1996

Epidemiology of renal involvement in type II diabetics (NIDDM) in Catalonia. The Catalan Diabetic Nephropathy Study Group.

The aim of this cross-sectional study was to establish the prevalence of renal involvement and to identify associations with its most important possible risk factors in a group of patients with Type II diabetes mellitus, representative of the population living in Catalonia. One thousand two hundred and three patients (47% males, mean age: 61 +/- 6 years, diabetes duration 9 +/- 6 years) were studied. Overnight urine samples were collected to determine urinary albumin excretion (UAE). If UAE was > 15 micrograms/min, a new 24-h urine collection for UAE measurement to establish the existence of microalbuminuria (20-200 micrograms/min) or macroalbuminuria (> 200 micrograms/min) was obtained. Clinic and metabolic evaluations were also performed. The prevalence (%) of microalbuminuria, macroalbuminuria and hypertension were, respectively, 23. 1, 5.4 and 42. In comparison with normoalbuminurics, patients with microalbuminuria were predominately male (P < 0.03), with a significantly higher systolic (P < 0.001) and diastolic (P < 0.001) blood pressure and body mass index (P < 0.001). The prevalence of smokers (former + current) was higher in patients with microalbuminuria (43 vs 32%, P < 0.025). Moreover, patients with nephropathy had more prevalence of retinopathy (P < 0.001), neuropathy (P < 0.001), peripheral angiopathy (P < 0.001) and coronary disease (P < 0.001). The prevalence of microalbuminuria in Type II diabetes in Catalonia is similar to that observed in other european countries. The existence of microalbuminuria is associated with several diabetic complications, as well as tobacco consumption and obesity.

Aged↗
PubMed1996

[Smoking cessation program using nicotine patch among physicians and pharmacists of Catalonia: results after 3-12 months].

Smoking abstinence rates of a group of 300 physicians and pharmacists of Catalonia (Spain) who participated in an open non-controlled follow-up design study with nicotine patch, are presented. Were eligible all the individuals who regularly smoke more than 15 cigarettes/day and get Fagerström Test score of 5 or more. Those who smoke more than 20 cig/day were offered a 3-month 24-hour transdermal nicotine treatment (30-20-10 schedule) and those smoking between 15 and 20 cig/day, received the 20-20-10 schedule. A follow up of participants was carried out at 3, 6, 9 and 12 months. After one year, 12 participants (4%) were dropped out. The overall abstinence rates at 3, 6, 9 and 12 months were respectively 55.9% (IC95%: 50.2-61.6), 42.7% (IC95%: 37.0-48.4), 35.4% (IC95% 29.9-40.9), 33.7% (IC95%: 28.2-39.2). Among predictive cessation variables, only those who had mad 1 to 3 previous attempts and those with only "cold turkey" (or slow reduction) quit experience, obtained statistically better results at 3 months. These results seem to be as good as or even better than those obtained in other similar studies with nicotine patch.

Administration, Cutaneous↗
PubMed1995

How could changes in diet explain changes in coronary heart disease mortality in Spain? The Spanish paradox.

We review and compare trends in coronary heart disease (CHD) and stroke mortality in Spain from 1966 to 1990 and changes in food consumption at national and regional levels. Since 1976, a decrease in cardiovascular disease (CVD) mortality in males and females has been observed, and standardized CHD mortality rates have fallen. Stroke mortality decreased during the same period. Trends in food consumption show increases in intakes of meat, dairy products, fish, and fruit, but decreases in consumption of olive oil, sugar, and all foods rich in carbohydrates. Although fat and saturated fat intakes increased, these changes were not accompanied by an increase in CHD mortality rates. This paradoxical situation can be explained by expanded access to clinical care, increased consumption of fruit and fish, improved control of hypertension, and a reduction in cigarette smoking. Diet appears to have an important role in this paradox, but it may not be as critical as other factors. Nevertheless, we suggest dietary guidelines for prevention of CHD in Spain.

Cerebrovascular Disorders↗
PubMed1993

[Analysis of the geographic distribution of the incidence of diabetes mellitus type I in Catalonia].

BACKGROUND: The aim of the present study was to evaluate the geographic distribution of the incidence of diabetes mellitus type I (DMI) in Catalonia from 1987-1990. METHODS: The base of the study is the Catalonian registry of incidence of DMI in the period from 1987-1990. The definition criteria were: diagnostic criteria of diabetes (WHO norms 1985), age of diagnosis under 30 years, residence in Catalonia in the period of diagnosis and exclusion of other types of diabetes. The population at risk was estimated according to the general census of the population of 1986. The total incidence of Catalonia was calculated by provinces and counties according to the Poisson distribution. RESULTS: The incidence of DMI observed in Catalonia was of 11.5/100,000 inhabitants per year (CI 95%, 10.6-12.4) in the age group from 0-14 years and 10.7/100,000 inhabitants per year (CI 95% 10.1-11.3) in the age group from 0-29 years. The exhaustivity in the detection of the cases was of 90.3%. No differences were found in interprovincial incidence in the 0-14 age group: Barcelona 11.6 (10.6-12.7), Girona 10.2 (7.2-13.4), Lleida 11.7 (7.7-15.8), Tarragona 10.5 (7.6-13.5). In the 15-29 age group a lower incidence was observed in Tarragona. The incidence by counties varied between 2.9 and 15.0/100,000 inhabitants per year with those of greatest incidence being observed in the Vallés Oriental (15.0/100,000 inhabitants/years), Alt Penedés (14.5/100,000 inhabitants/year), Segrià (15.0/100,000 inhabitants/year) and the Priorat (13.7/100,000 inhabitants/year). CONCLUSIONS: No differences were found in the incidence of diabetes mellitus type I in the four Catalonian provinces. Distribution by counties was more heterogeneous without defining zones with a much higher incidence to that observed in the whole of Catalonia.

Adolescent↗