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Biomedical subjects

A Cueto Espinar

Publications and source records attributed to A Cueto Espinar.

At least 19 recordsLinked to original sources
PubMed2002

[Diagnostic protocol for unknown primary cancers. Review of 157 cases].

OBJECTIVE: Decision-making to diagnose an Unknown Primary Cancer (UPC) is subject to great variability. It is possible to design a standard procedure using the scientífic literature, which seems to be able to avoid this variability. We describe the characteristics of the UPC in Asturias and measure the degree of adaptation of the diagnostic decisions to the theoretic standard procedure. METHOD: Descriptive retrospective study (1992-96) RESULTS: A pilot study included 157 cases: mean age 67 years and 59% male. The presentation form most frequent was hepatomegaly (29%) and histology: adenocarcinoma (51%). The diagnosis of the primary was possible in 22%: lung (31%). Median survival: 13 weeks, higher for squamous carcinoma, but independent of the diagnosis of the primary tumour. Comparing with the recommended protocol, the average of unnecessary diagnostic techniques per patient was: 8 analyses, 3 image studies and 0.6 unnecessary aggressive techniques. CONCLUSIONS: The great variability in decision-making for diagnosing advises the application in of a diagnostic protocol that would avoid unnecessary damage for the patient and sanitary costs.

Adenocarcinoma↗
PubMed2001

[Quality of life and neurologic diseases].

BACKGROUND: The development reached by many countries of our planet has allowed that in them most of the infectious diseases have diminished and that the life expectancy is over the 75 years of life. As a result of this, degenerative and chronic diseases are every day more prevalent and their treatments are longer and complex. To value quality of life in these patients and the effect of the therapy on health is at the moment a main goal of public health. OBJECTIVES: To know the origin, the evolution, and the theoretical foundation of the concept of the quality of life, as well as their measurement methods. On the other hand, to describe the characteristics of the different available questionnaires in Spain to measure the quality of life, either of generic or specific for neurologic illness. MATERIAL AND METHODS: The most important questionnaires which have been adapted and validated into Spanish have been revised. An exhaustive revision of the bibliography related with quality of life and neurology was carried out, and all the questionnaires described in these processes were revised. RESULTS: We describe the philosophy and concepts of health, quality of life (QOL) and health related quality of life (HRQL). The following generic questionnaires are described: the Nottingham Health Profile (NHP), the Sickness Impact Profile (SIP), the Medical Outcomes Study Short Form (SF-36), the European Profile of Quality of Life (EuroQoL), the Questionnaire of Quality of Life (CCV) and the Profile of Life quality in the Chronically ill (PLC). In an exhaustive bibliographical revision on quality of life and neurology, 52 indexed papers appeared, of those which only twelve were related with those subject. The following specific questionnaires are described: Qualité de Vie et Migraine (QVM), the Parkinson's Disease Questionnaire (PDQ-39), the Functional Status Questionnaire (FSQ), the Quality of Life in Epilepsy Inventory (QOLIE-89) and their variant of 31 items. Finally two questionnaires ad hoc are described to study migraine and epilepsy. CONCLUSIONS: The incorporation of HRQL measures in patients with neurological illnesses is an increasing and valued practice by its specialists. We observe that the availability of generic tools to measure the HRQL in Spanish is wider every day, although most of these come from other cultures. The process continued in their transcultural adaptation and validation allows us to have some tools of great reliability and effectiveness that facilitate its use. In relation to the specific questionnaires on neurologic process, the supply is considerably smaller due to the recent appearance of these methods in this clinic area.

Health↗
PubMed1998

[Use of elements from the ISO 90000 system in Spanish hemotherapy].

PURPOSE: To evaluate the prevalence of all twenty elements of ISO 9000 in the practice of the Blood Banks of Spain independently of being certified or not to ISO system. MATERIALS AND METHODS: By a survey sent in november 1996 to the Hospital-Based Blood Bank and Transfusional Services of 225 hospitals with more than 100 beds, and to 25 Community Blood Centers. The survey had 38 questions on the all elements of the ISO system and on other aspects of quality no directly related with it, as to be accredited by transfusional accreditation Committee, to have an hospital transfusion committee, informed consent of the transfusion and guidelines for using hemoderivatives. RESULTS: The survey was answered by 53 (21%) of hospitals and Community Blood Centers. None of the participant were certified to ISO system. The elements more used were the documentation of adverse reactions, procedures manual, validation of blood components, control of nonconforming products, and product identification and traceability, all of them used for more than 80% of participants. On the contrary, the elements less used were to have a quality unit, equipment manual, to validate the computer system, internal quality audits, criteria on purchasing, training and quality manual, all of them used by less than 30% of the participants. CONCLUSIONS: Generally speaking the elements of the ISO system more commonly used are those related to the basic ones of daily work and the least used are those related to the organisation aspects of quality. The Community Blood Centers score higher than hospital blood banks and among these, the best results are in the blood banks of hospitals more than 500 beds and the hospital accredited for teaching.

Blood Banks↗
PubMed1996

[Thematic and methodological analysis of investigation in primary care (1988-1992)].

OBJECTIVE: To describe Spanish scientific output in primary care with regard to subjects, design and statistical methods employed and also its appropriateness, importance and funding. DESIGN: Descriptive, longitudinal and retrospective study. SETTING: Spanish scientific output in primary care published in medical journals and listed in the Indice Medico Español during the five year period 1988-1992. MATERIAL: 446 original articles published in thirty-four journals. MEASUREMENTS AND MAIN RESULTS: The greatest percentage of articles came under the heading "policy and health" (23.6%), next was "health services" (14.8%). There was a predominance of observational designs (79.9%) and within this category, descriptive studies (67.1%). The most common statistical methods used were contingency tables (35,9%). The majority of articles (94.8%) do not indicate the source of their funding. The appropriateness was around 50% and the importance around 4%. CONCLUSIONS: According to our study, research into primary care centres on the evaluation and organization of the health services. The majority of the designs have little inferential power and simple statistical methods. There is hardly any funding available, and only a half of the articles comply with appropriateness criteria.

Longitudinal Studies↗
PubMed1996

[Bibliometric indicators of research in primary care (1988-1992)].

AIM: To describe Spanish scientific production in primary care by means of using bibliometric indexes. SETTING: Spanish scientific production which was published in medical periodicals and indexed in the Indice Médico Español during the years 1988-1992. MATERIAL: 446 articles published in thirty-four different medical journals. DESIGN: Descriptive, longitudinal and retrospective study. MEASUREMENTS AND MAIN RESULTS: The number of articles slightly increases over the complete time of the study, principally in 1992. 98.4% were written in Spanish language. The average number of signatures per article is about five. Most of the authors are family doctors or interns of the medical specialty. In 76.46% of the cases, the articles were signed by only one institution. The majority of them (38.56%), were done in teaching units of family medicine. Barcelona is the most important producer of articles (20.2%) and 78% were published in the Atención Primaria periodical. The average number of references slightly increases during the whole period and is about 17 references in the five years studied. CONCLUSIONS: The scientific production on primary care seems to have an exponential increase according to Price's Law and it is concentrated in the Atención Primaria periodical. Most of authors are family doctors or interns of such specialty, who work in units of family medicine. Collaborative studies among institutions are uncommon. The number of signatures and the use of references were found to be similar to other medical specialties.

Bibliometrics↗
PubMed1996

Disappearance of DNA HPV in sequential specimens of occult cervical infection in a "normal" population.

OBJECTIVE: The behaviour of occult infection in the uterine cervix was studied over one year in 175 women randomly selected, to determine if the infection persisted, disappeared or if the viral genotype became modified. STUDY DESIGN: An earlier study of the prevalence of HPV cervical infection detected 11 (6.2%) occult infections. Of these the infectious genotype could only be identified in five. One year later the infected women were subjected to further colposcopical examination and molecular hybridization testing. RESULTS: In seven of the 11 cases with cervical occult infection, the DNA HPV genome was found to be completely absent at year-end. Colposcopic and cytological studies remained negative in all women. CONCLUSIONS: The loss of DNA HPV in seven of the 11 previously positive women is probably due to variability in the number of cells that became infected in a situation where small numbers of copies are made. The high proportion of occult infection with uncharacterized viruses supports the view that this type of infection is often due to new genotypes, presently non-classifiable.

Adolescent↗
PubMed1995

[School acceptance of the theater as a method of health education].

OBJECTIVE: To find how theatre was evaluated as an instrument of Health Education by the pupil-actors of a school where a play on the European Code against Cancer was put on. DESIGN: An observational study (descriptive and crossover). SETTING: Community level. Primary Education. PARTICIPANTS: 100 pupil-actors of the 220 at a primary school in a rural area. They were selected by means of a free, voluntary and spontaneous practical theatre test. INTERVENTIONS: A theatrical show with 14 scenes was created. 8 performances, open to the public, were held in the village's Cultural Centre. MEASUREMENTS AND MAIN RESULTS: Evaluation was with a self-administered questionnaire composed for the occasion and consisting of closed multiple-choice questions. An anonymous group survey, done in class and covering each year separately, included 77 of the 100 actors. A prior pilot survey had evaluated intelligibility. The results were that 97.4% classed the experience as positive and 87% of them considered it very good. 81% had no problem at the moment of acting. 83% were helped by teachers and 81% by parents. 98% would like to do theatre again. CONCLUSIONS: Theatre is highly rated and widely accepted by children, making it a useful

Child↗
PubMed1995

[Prevalence of localized pain of the locomotor system in the general population].

OBJECTIVE: To find the prevalence of "Generalised Pain of the Locomotive System" (GPLS) in the Principality of Asturias. DESIGN: A crossover study, consisting of an interview and a medical examination. SETTING: Urban and rural population throughout the Autonomous Community of the Principality of Asturias. PARTICIPANTS: The population group under study was chosen at random by multi-stage and proportional sampling. Criteria validated for the diagnosis of GPLS were applied. RESULTS: The response was 75.6% (702 people), in whom 9.2% prevalence of GPLS was found, with a significant preponderance of women. A statistical association of GPLS both with limitations in daily activities and with the presence of anxiety or depression was found. CONCLUSIONS: GPLS shares many features with Fibromyalgia syndrome. Its high prevalence and its association with functional and psychological disturbances indicate the important social repercussions of this disorder.

Adolescent↗
PubMed1994

[Submandibular fold. An alternative for the assessment of subcutaneous fat].

BACKGROUND: Folds are a useful method of measuring subcutaneous fat. This study reports the feasibility of the use of the submandibular fold to evaluate the subcutaneous fat. METHODS: A transversal descriptive study was designed by a poly-staged stratified randomized sample (n = 572). A series of anthropometric measurements (weight, height, different folds and surrounding areas) were performed in addition to the measurement of the submandibular fold. In addition blood pressure was determined as well as oral glucose tolerance test. RESULTS: After correction of the effect of age, the submandibular fold was found to be related with both the Quetelet's index (BMI) (males r = 0.50; females r = 0.61, both p < 0.0001) and the Benn's index (males r = 0.53; females r = 0.60, both p < 0.0001). Their correlations with those of other folds and with the measurements of centralization place the submandibular fold in a median position with respect to central and peripheral fat deposits. Furthermore, the percentage of fat which the increase in BMI carries is practically constant. Likewise, it was associated with the presence of high blood pressure in both sexes (males F = 9.7, p < 0.025; females F = 6.1, p < 0.025), diabetes mellitus (F = 6.1, p < 0.005) and inguinal hernias (F = 10.8, p < 0.0025) in males and in females, as well as to the presence of abdominal striae in females (F = 12.2, p < 0.001). CONCLUSIONS: The submandibular fold may be used by investigators who wish to evaluate subcutaneous fat through one sole fold, which is accessible and easy to measure. This measure is intermediate between the central and peripheral zones. In addition, it may reflect the fat deposit which is produced with both an increase in the body mass index and age.

Adult↗
PubMed1994

Epidemiology of musculoskeletal complaints and use of health services in Asturias, Spain.

To determine the prevalence of musculoskeletal symptoms in the general population and the use of health services of rural and urban population of Asturias, Spain, questionnaires and clinical exploration of 702 subjects were applied. The response rate was 75.6%; 44.9% had presented symptoms related to the locomotor system in the preceding 12 months. The lumbar spine was the most prevalent localisation. The presence of symptoms was related to age, sex, and a lower educational level. The use of health services for rheumatic symptoms was 22.5% of the total sample. The degree of pain was the variable which had greatest influence on the use of health services, whereas the existence of anxiety, depression or difficulties in carrying out daily activities, were not influential in the use of health services. The symptoms referred to the locomotor system in a 12 month period, are present in almost 50% of the general population, and are associated with certain demographic variables. The use of health services for rheumatic symptoms depends fundamentally on the degree of pain of the patients.

Adolescent↗
PubMed1993

[The epidemiology of rheumatic diseases in the Principality of Asturias].

OBJECTIVE: To determine the prevalence of rheumatic illnesses in the Principality of Asturias. DESIGN: Crossover study, consisting of an interview and a medical examination, administered to 702 people selected in a random fashion, in line with multi-stage and proportional sampling. Validated criteria for the diagnosis of rheumatic pathology were applied. SETTING: Urban and rural population throughout the Autonomous Community of the Principality of Asturias. RESULTS: There was a 75.6% response (702 people). In these a 23.8% prevalence of arthrosis was found, with a significantly higher proportion among older people and women. The second most common condition was rheumatism in soft parts; and then lumbalgia, which predominates in middle age. Inflammatory arthropathies are much less common (2.5%) in the general population. 6.1% of the sample presented a rheumatic pathology that could not be adequately defined. CONCLUSIONS: Rheumatic illnesses are extremely common among the general population. Arthrosis, rheumatism of the soft parts and lumbalgia are the most customary conditions. Their prevalence is much greater than that of inflammatory rheumatism.

Adolescent↗
PubMed1992

[Epidemiology of diabetes mellitus in the province of Leon].

BACKGROUND: Diabetes mellitus (DM) is a very important health problem because of its high morbidity and mortality. The aim of the present study was to investigate the prevalence of diabetes in the adult population of the León province and its possible association with the most common risk factors and markers. METHODS: A cross-sectional descriptive study was designed with a multistage stratified sampling (572 individuals). A questionnaire about several sociodemographic variables, an alimentary survey, measurements of height and weight, capillary baseline glycemia, and oral glucose tolerance test with 75 g glucose were carried out. RESULTS: The observed prevalence of diabetes mellitus was 5,6% and that of glucose intolerance 10,3%. The known/unknown DM ratio was 2,2/1. The prevalence of treated DM was 1,9%. The leading variables associated with DM were age, a positive family history of diabetes and obesity. A higher incidence of DM was found in females, in urban media, and in high social classes. BACKGROUND: Diabetes had been previously underrated in the León province. The observed prevalence values are close to those from other methodologically similar studies. In addition, an association was found between DM and some non-modifiable risk factors (age, sex or family history); by contrast, there is a very important risk factor (obesity) which may be modified by intervention.

Adult↗
PubMed1992

[Obesity in the province of León. Differing criteria, different prevalences].

OBJECTIVE: To assess the prevalence of obesity among the adult population of our province. DESIGN: Cross-sectional. SITE. León Province. PATIENTS OR OTHERS PARTICIPANTS: This was a random sample with 572 individuals over 17. They were picked from the electoral register. The confidence level was 95%, with a 3.5% length of interval. They were selected by means of proportional, multi-stage stratified sampling. The Hansen method was used for a subsequent survey of the cases missed. MAIN MEASUREMENTS AND RESULTS: Socio-demographic data were collected, and weight and size measured, using standard procedures. Those who had a Quetelet index > or = 30 kg/m2 or with a relative weight > or = 120%, in line with different weight tables, were considered to be obese. Under the first criterion there was a 23.25% prevalence of obesity (CI: 19.79-26.71). The second showed long variations, running from 59.92% (CI: 55.64-64.20) to 16.17% (CI: 13.06-19.28). CONCLUSIONS: The prevalence of obesity among adults in our province is above that in other zones of Spain and other countries. The calculation of relative weight is not possible in an important number of cases because age or size are not properly included in the reference table. The criteria for defining someone as obese need to be unified in order to be able to make comparisons between different surveys.

Adult↗
PubMed1992

[What is the normal threshold of glycemia in our elderly?].

The aim of this paper is to study the evolution of basal glucemia and TTOG with age, as well as the prevalence of diabetes in different age groups. A cross-sectional descriptive study was designed, with a polystratified random sampling method among the whole adult population of Leon. In addition to fill in a questionnaire, basal glucemia was measured with a capillary reflectometer and a TTOG with 75 g. The effect of age on the average values of basal glucemia and on TTOG glucemia was no demonstrated. A significant correlation between the prevalence of the disease and the age of subjects was also observed, being maximum in the age group 60-69 (14.50%). After discussing the results, we conclude that only prospective studies will be able to establish the threshold of glucose tolerance-intolerance, beyond which the risk increases.

Adult↗
PubMed1991

[The diagnosis of diabetes mellitus in epidemiological studies].

The aim of the present study was to evaluate the relative usefulness of some of the diagnostic methods used to estimate the prevalence of diabetes mellitus in epidemiological studies. A cross-sectional descriptive study with multistage stratified sampling was designed. A personal interview, a capillary baseline glycemia and a OGTT were carried out. The medical records and the use of antidiabetic drugs and self-control products were also evaluated. The prevalences obtained with these methods were: Medical records = 1.31%, personal interview = 7.91%, use of drugs = 1.93%, self-control products = 1.05%, capillary baseline glycemia greater than or equal to 120 mg/dl = 4.04%, OGTT with WHO criteria = 5.62%. Using OGTT as a reference, the diagnostic test with the greatest overall value was capillary baseline glycemia equal to or higher than 120 mg/dl. We think that, as a whole, the election of one method or another will depend on both the precise aim of the study and the type of design and the cost that can be sustained.

Cross-Sectional Studies↗