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Biomedical subjects

X Bonfill

Publications and source records attributed to X Bonfill.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Prospective assessment of clinical outcomes in patients with lung cancer].

BACKGROUND: The aim of this study was to assess the outcome in patients with lung cancer. PATIENTS AND METHODS: Prospective study in 93 patients with lung cancer in 3 community hospitals. In each evaluation (4-6 weeks) the following results were obtained: a) questionnaire on the quality of life or performance status (QoL/PS), based on different instruments (Karnofsky Performance Scale [KPS], ECOG, QLQ-C30, and the Nottingham Health Profile [NHP], and b) a clinical questionnaire. Active follow-up was for 18 months and survival tracking was to five years. A descriptive analysis of the outcome variables and a survival analysis (Kaplan-Meier) were done. The prognostic value of each instrument (Cox) and the correlation between the instruments (Spearman) were also evaluated. RESULTS: The mean values recorded at the time of diagnosis between 60% and 70% of the maximum value possible. Mean survival was 12.4 months; accumulated survival was 30% to one year and 4% to 55 months. Only 17% of patients presented any disease-free period. Toxicity of treatment was almost always irrelevant. The correlation between the KPS, the QLQ-30 and the NHP was acceptable and their initial values were important prognostic factors. The QoL/PS scores for the survivors were similar to their initial values, but the global values were 11%. CONCLUSIONS: The outcomes measures used in this study provide very useful information, although registration and analysis of the necessary data should be systematic. The KPS was comparable to the other QoL/PS indicators used, but it is shorter, more acceptable and easier to use. Better QoL/PS measurement instruments are needed to evaluate outcomes in the practice of clinical oncology.

Adult↗
PubMed1999

[Systematic reviews on infectious diseases. The Cochrane Collaboration].

BACKGROUND: Theoretically, doctors update their knowledge from the scientific literature, and bibliographic databases have made it possible to overcome many of the limitations with this information, but not all of them. When faced with a therapeutic issue, the practice of evidence based medicine requires the efficient access to information derived from controlled clinical trials (CCT). Reviews of the scientific literature are of increasing importance. The Cochrane Collaboration is dedicated to preparing, maintaining and disseminating updated, systematic reviews of CCTs of health care interventions, which are published in the Cochrane Library. OBJECTIVE: To describe the Cochrane Collaboration and to locate, with the greatest exhaustiveness possible, CCTs published in the journals "Enfermedades Infecciosas y Microbiología Clínica", describe their characteristics and include them in a global database of clinical trials maintained by the Cochrane Collaboration. METHODS: The CCTs were identified by systematic manual searches of all issues of the journal. A descriptive analysis of the CCTs located was made. RESULTS: A total of 24 CCTs were published in 15 years (1.6 per year), 10 were original articles and 14 were communications at congresses. All were done in Spain and the majority were done in hospitals. The most frequently researched question was antibiotic prophylaxis and all evaluated pharmaceutical interventions. The majority of the CCTs published had important information missing (phase of study, randomization, blinding, etc.). CONCLUSIONS: The identification of CCTs is a prerequisite for the development of systematic reviews. There were few clinical trials published in the 15 years of publication of this journal, and the most common characteristic is, clearly, the absence of basic data. The most common is a lack of on the phase of the clinical trial, the follow-up period, and funding sources. The idea of what experimental clinical investigation in infectious diseases is in our country needs to include the identification of CCTs published in other Spanish and international journals.

Bibliometrics↗
PubMed1999

[The identification and description of clinical trials published in Spanish journals of general and internal medicine during the period of 1971-1995].

BACKGROUND: When faced with a therapeutic issue, the practice of evidence-based medicine requires efficient access to information derived from controlled clinical trials. The objectives of the study were to locate, with the greatest possible exhaustivity, all controlled clinical trials published in Spanish journals of general medicine, between 1971 and 1995 (25 years), to characterize them, and to incorporate them into the worldwide database of clinical trials maintained by the Cochrane Collaboration. METHODS: The controlled clinical trials have been identified by a systematic, manual review of all the Spanish journals of general and internal medicine. The results obtained have been compared with an exclusive electronic search in MEDLINE. A descriptive analysis of the characteristics of the localized controlled clinical trials was done. RESULTS: 68 journals of general and internal medicine have been identified, only 6 being indexed in MEDLINE. A search carried out exclusively using MEDLINE would imply the loss of one third of all controlled clinical trials. About 16 controlled clinical trials per year have been published in Spain in the area of general and internal medicine, most of them with important missing information. CONCLUSIONS: The limitations of searching only in MEDLINE have been shown once again. There are few controlled clinical trials published in Spain in the area of general and internal medicine, and in order to improve their quality and their diffusion is recommended that authors and editors adhered to the international consensus initiatives that are under way.

Bibliometrics↗
PubMed1998

[Epidemiological study on the incidence of inflammatory bowel disease in 4 Spanish areas. Spanish Group on the Epidemiological Study of Inflammatory Bowel Disease].

BACKGROUND: The incidence of inflammatory bowel disease (IBD) shows marked geographical variations. The aim of this study was to determine and compare the incidence of IBD in four Spanish areas: Sabadell (Northeast), Vigo (Northwest), Mallorca island and Motril (South). PATIENTS AND METHODS: Prospective survey based on inception cohorts over a two-years period (1 October 1991 to September 1993). Subjects were the patients resident in these areas and diagnosed of IBD according to a standard protocol for case ascertainment and definition. RESULTS: Altogether 328 cases were identified, of whom 191 were diagnosed as ulcerative colitis (UC), 135 as Crohn's disease (CD) and 2 as indeterminate colitis. The overall adjusted incidence rate per 100,000 persons between ages 15-64 years of UC and CD were respectively 9.8 and 5.2 in Sabadell, 7.7 and 5.0 in Vigo, 7.8 and 5.8 in Mallorca and 4.3 and 6.5 in Motril. The Incidence rate ratio showed no significant differences for either conditions among these areas. The global adjusted incidence rate of UC in Spanish areas (8.0; IC 95%: 6.3-9.7) was significantly lower to that of Northern European countries while that of CD (5.5; IC 95%: 4.1-6.9) was between that of Northern and Southern Europe with no significant differences. CONCLUSIONS: The incidence of IBD did not show differences among the Spanish areas, and rates are between 2 and 6 times higher than those previously reported. The incidence of UC is significantly lower than that observed in the North of Europe, while for CD the incidence is between that of Northern and Southern Europe.

Adolescent↗
PubMed1997

[Evidence-based medicine].

This paper presents the origins and the concepts in which the paradigm of a new line of clinical reasoning "Evidence Based Medicine", is based. We describe its basic components such as: problem-oriented clinical policy formulation; information retrieval distillation and synthesis of the medical literature; critical appraisal of the evidence and clinical application. Additionally, we describe them already well established, for promoting and Evidence Based Clinical Practice. We particularly focus on the so called "Cochrane Collaboration", an international initiative whose mission is to prepare, maintain and disseminate systematic and updated reviews of the effects of health care.

Controlled Clinical Trials as Topic↗
PubMed1997

Employee and public responses to simulated violations of no-smoking regulations in Spain.

OBJECTIVES: This study evaluated compliance with regulations prohibiting smoking in public places by using a new method of smoking simulation. METHODS: Sites in Sabadell, Spain, were visited by observers who lit a cigarette, simulating the act of smoking, and noted the placement and content of signs indicating smoking restrictions. RESULTS: A warning was given in only 17% of sites. A significant association was observed between the presence of signs banning smoking and the elicitation of a warning from people present. CONCLUSIONS: Simulating the violation of smoking restrictions may be used as an efficient method of assessing enforcement of the prohibition of public smoking.

Humans↗
PubMed1996

Lung cancer mortality among males of Catalonia and Spain compared with other European countries between 1975-1977 and 1987-1989.

This study compares the lung cancer mortality rates among males in the years 1975-1977 and 1987-1989 in Catalonia and Spain with other European countries selected for their geographical proximity. Adjusted calculations using the direct method have been made for male lung cancer mortality. Adjusted truncated rates for the age groups 0-44, 45-64 and more than 65 years were also calculated, as well as percent differences between the mortality rates of each period studied. Lung cancer mortality rates for males in Catalonia and Spain show relative increments of 46.58% and 52.41%, respectively. In contrast, lung cancer mortality in countries such as England-Wales and Switzerland have decreased. Moreover, the 0-44 year age group in Catalonia and Spain shows the absolute highest rates in the 1987-1989 period among all the countries analyzed. The marked contrast of the lung cancer mortality rate evolution in Catalonia and Spain compared with some other European countries and the considerable increase of the mortality in younger age groups indicate the need to intensify lung cancer control measures.

Adolescent↗
PubMed1995

[Winter epidemic of carbon monoxide poisoning in Badia].

OBJECTIVE: To find the incidence, morbidity and possible causes of the acute carbon monoxide poisonings (ACMP) which occurred in Badia between january 1992 and june 1993. DESIGN: A longitudinal, retrospective study. PATIENTS: Every Badia resident discharged from the Hospital Consortium of Parc Taulí, Sabadell with a diagnosis of ACMP and/or from Barcelona's Red Cross Hospital (RCH) after hyperbaric treatment was considered. MEASUREMENTS AND RESULTS: Cases were identified using the hospital discharge records from Parc Taulí and the RCH. A systematic review of the primary care clinical records was undertaken. The causes of the poisoning were investigated by a technical committee and through the gas company carrying out inspections of dwellings in 1993. The incidence of ACMP was 76.5 per 100,000 inhabitants in 1992 and 109.4 per 100,000 in the first half of 1993. 94% of the 34 cases occurred in December, January, February and March. 50% of those affected were under 17. The number of cases per household varied between 2 and 5 people. The most common underlying cause was the existence of defects in the conduits taking fumes away from gas heaters. The gas review detected defects in installation in 54% of dwellings. CONCLUSIONS: ACMP is a common and serious problem in our environment. The underlying causes and the high number of dwellings at risk have suggested a need for information campaigns in the community.

Adolescent↗
PubMed1995

Changes in cancer mortality in Catalonia and Spain (1975-77 and 1987-89). A comparison with other European countries.

Comparisons of cancer mortality in Catalonia and Spain have shown an intermediate position of these areas in relation to the rest of Europe. This study compares the overall cancer mortality in Catalonia and Spain in the periods 1975-77 and 1987-89 in relation to other European countries selected on the basis of geographical proximity and availability of information. Adjusted and truncated cancer mortality rates and relative changes in these rates have been assessed for both sexes. The mortality rate for males in Catalonia, Spain, Italy, Portugal and France has increased from 1975-77 to 1987-89 with relative increments of 13.5%, 13.7%, 10.1%, 9.6% and 4.3% respectively, whereas in Switzerland and England and Wales this rate has decreased. The mortality rate for females showed a slight drop between the two periods in all the studied countries except England and Wales and Portugal. By age groups, in males, the 0-44 year interval in Catalonia, Spain, France and Portugal, in descending order, showed the highest rates. The marked contrast of the evolution of the cancer mortality rate in Catalonia, Spain, Italy, France and Portugal, compared with Switzerland and England and Wales, and especially the considerable increase of the mortality in young people in Catalonia, indicates the extremely urgent need for all countries to adopt the measures to control cancer that have already shown themselves to be effective elsewhere.

Adult↗
PubMed1993

[Surveillance of nosocomial infection at a regional++ hospital. Results of incidence and prevalence studies in a 2 years' experience].

BACKGROUND: The most appropriate methods for surveillance of nosocomial infection (NI) in hospitals with less than 250 beds remain to be elucidated. The aims of this study were to investigate the differences between the results found in a study in incidence (IS) and in another concerning prevalence (PS) carried out in a county hospital and study the experience in the application of a collection method of incidental cases through a survey. METHODS: For 2 years IS trimestrally accumulated and simultaneously PS trimestrally were applied for global surveillance and for type of NI as well as for knowing the etiology of the same. In both types of study all the hospital patients were included. RESULTS: The accumulated incidence of patients with NI over the 2 years was 3.9% (3.6 in the first 12 months and 4.1 in the 12 remaining months) and the global prevalence was 7.5%. The global trend of NI was that of an increase in both studies. The most frequent NI in both studies were surgical wound and urinary infection. PS did not detect the least frequent NI. The etiologic agents of NI were similar in both studies. The survey undertaken for the detection of NI demonstrated 61% sensitivity, 98% specificity and a positive prediction value of 94%. CONCLUSIONS: In small hospitals global prevalence studies may be useful for surveillance of the most frequent nosocomial infections. The results obtained by incidence studies were less variable and better reflect the trend of nosocomial infection. A survey used as a study method of incidence for the collection of cases of nosocomial infection loses sensitivity over time.

Cohort Studies↗
PubMed1992

Intraoperative colonoscopy in patients with colorectal cancer.

Sixty-seven patients underwent intraoperative colonoscopy during elective surgery for colorectal cancer. Complete examination of the colon was achieved in 65 patients (97 per cent), albeit with insertion through a colotomy in three (4 per cent). A synchronous carcinoma was found in six patients (9 per cent), which necessitated a change of planned surgical procedure. Synchronous polyps were detected and removed in 24 patients (36 per cent); two had polyps with carcinoma in situ. The mean age of patients with synchronous carcinoma was significantly higher than that of those without (74.1 versus 61.2 years, P = 0.02). Intraoperative colonoscopy took a mean of 15 min surgical time and only two minor complications (serosal lacerations) were encountered. In patients with colorectal cancer, intraoperative colonoscopy allows complete assessment of the colon and identifies synchronous lesions.

Aged↗