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Biomedical subjects

A Llopis González

Publications and source records attributed to A Llopis González.

At least 19 recordsLinked to original sources
PubMed2002

[Spontaneous pneumothorax and atmospheric pressure].

In order to assess factors associated with spontaneous pneumothorax (SP), mainly climatic changes, a prospective study was undertaken of 62 SP episodes among patients admitted to our hospital during a two-year period, from January 1994 to January 1996. Atmospheric pressure (AP) changes were analyzed, with daily recording of the number of unusual changes in AP (increases above 95th percentile and decreases below 5th percentile) and how many of these changes were followed by some episode of spontaneous pneumothorax during the following five days. To measure the degree of this association between the emergence of pneumothorax and exposure to unusual changes I AP, the relative risk (RR) was calculated. A total of 77 unusual AP changes were observed, 17 of which concurred with the emergence of 8 episodes of SP during the following five days, with a RR of 2.7 (1.6-4.4). Although the etiology of SP is unknown and probably of multifactorial origin, these data suggest that unusual changes in AP may play a relevant role in triggering this condition.

Adolescent↗
PubMed2001

[Home hospitalization: background, current situation, and future prospects].

OBJECTIVE: To establish the different forms that the concept of home care has taken over time as a modality for providing health care, so as to contribute to the debate on the circumstances affecting health care management in the face of future challenges. METHODS: The literature is reviewed on home care as a method for delivering health care, by researching publications indexed during the period of 1995-2000 in three medical bibliographical databases: MEDLINE, LILACS (Latin American and Caribean Health Sciences) and the Indice Médico Español (Spanish Medical Index). RESULTS: Home hospitalization has developed differently over time in various countries, with an assortment of models for this type of care, each with its respective advantages and disadvantages. CONCLUSIONS: There are some criteria and proposals that could provide a framework for home care that is innovative, effective, and of high quality. Home care could help in the design and creation of a consensus on an organizational and financing model that fits in harmoniously between primary care and care in a hospital.

Delivery of Health Care↗
PubMed2000

Mycosis fungoides: review of epidemiological observations.

BACKGROUND: Mycosis fungoides (MF) is a chronic cutaneous T-cell lymphoma characterized by small cells with cerebriform nuclei that usually express a mature peripheral T-helper cell (CD4+) immunophenotype. Its evolution is typically quite slow, with years between the first manifestations and development of advanced stages of disease. OBJECTIVE: The purpose of the present paper is to contribute to the material about MF already present in the literature. The review articles that have appeared to date fundamentally address the morphological characteristics, diagnostic criteria and treatment of the disease; in contrast, the present study centers on the evolution of the incidence of MF and on the knowledge of the possible risk factors implicated in its development. METHODS: Review of published papers about MF epidemiology. RESULTS: The evidence suggests that the incidence is increasing, but this may be artifactual due to improved diagnostic techniques. The risk of MF is limited to gender and race, being higher in males and in blacks. Survival is highly stage dependent, but 90% of patients survive 15 years with only 10% of cutaneous involvement. Few risk factors have been identified, but several studies have found an association with industrial exposure, particularly to oils. CONCLUSION: MF is a rare disease and its risk factors have not been studied in any great detail. A European case-control study in progress will substantially increase the evidence available and progress towards identifying a prevention strategy.

Adult↗
PubMed2000

[The clinical history and physical examination in patients with chronic lumbar pain. Patient classification by a decision tree].

AIM: To analyze the correlation between clinical symptoms and physical examination signs in diagnostic groups of low back pain patients; making a spanning tree. MATERIAL AND METHOD: A prospective longitudinal study of 485 low back pain patients was carried. We assess the type of pain and its irradiation, evolution in time, duration of the episodes, timetable, intensity and morning stiffness. A complete physical examination with specific tests for sacroiliac joints and neurologic examination was carried. We carried out a study of absolute and relative frequencies; calculating the rates with the chi 2 Pearson test and having a confidence of 95%. RESULTS: We found a significant relation (p < 0.0001) between the type of pain and the diagnosis groups. Proximal irradiation with functional disorders (p < 0.01) and metabolic bone diseases (p < 0.0001); the radicular irradiation and the disorders by physical agents (p < 0.001). The flare-up back pain with disorders by physical agents and metabolic bone diseases (p < 0.001). The morning stiffness was exclusive in the inflammatory diseases. In the physical examination, was found a significant relation (p < 0.0001) between the different tests with the diagnostic groups. CONCLUSION: The history and the physical examination provide us symptoms and signs which let us direct towards the above diagnostic. The type of pain with its characteristics and the referred pain as a main symptoms, give us some information, which complemented with the physical examination tests, providing the base on which we support our diagnostic hypothesis, allow us the first classification of the patients; at the same time we understand as a low back pain patients suffer its problem.

Chi-Square Distribution↗
PubMed1998

[Prevalence and depression degree in patients with rheumatoid arthritis].

BACKGROUND: Study goals were: a) to know the existence and depressive level among a series of rheumatoid arthritis (RA) patients; b) to assess differences in depression levels of individuals with and without RA, and c) to identify the association of depression level with socioepidemiological, clinical, and prognostic characteristics in these patients. MATERIAL AND METHODS: Cross-sectional study that undertakes a 3 years period (July 1992-March 1995) and includes 221 patients diagnosed of RA according to the 1988 criteria of the American College of Rheumatology (ACR). Association of depression levels, assessed with the Self-Rating Depression Scale of Zung-Conde, with each one of the variables was evaluated using chi 2 tests (p < 0.05). A multivariate analysis type Automatic Interaction Detection (AID), based on the statistic r2, was applied to determine patient's profile with RA and depression. RESULTS: Depressive level was identified in 33.48% of patients. Odds ratio (OR) between "not depressive" and "depressive" levels was from 20.35 with 95% CI: 8.87-47.88 (p < 0.00001). Association was found with the variables sex (p < 0.0001), profession (p = 0.02), weight and height (p < 0.0001 in both variables), Ritchie index (p < 0.004), number of painful joints (p = 0.002), morning stiffness (p = 0.049) and secondary effects of the treatment (p = 0.034). Sex was the variable that most influenced in depressive level (p < 0.00001). In females group, the factor mainly related with depression was the number of painful joints (p < 0.0002) while in males, it was the self-rating pain valuation with a Likert scale (p < 0.0001). CONCLUSIONS: RA could causes depression in the patients. The factor with highest influence in the depression of these patients was the sex. The most influential factor in the females was the number of painful joints, while in the males was the self-rating of pain.

Adolescent↗
PubMed1998

[Social health evolution in Vall d'Uixó. Application of multivariate analysis as a new health status indicator method].

OBJECTIVES: This study evaluated the relative position of Vall d'Uixó within the province of Castellón, the Valencian Community and Spain. DESIGN: The study covers the period from 1981 to 1993. A multivariate analysis of the main components was performed. This compared the interrelationship of these indicators in the different zones analysed. PATIENTS AND OTHER PARTICIPANTS: Our study focused on an area of 27,387 population, geographically within the province of Castellón in the south-west of La Plana county. RESULTS: The analysis showed that Vall d'Uixó had a low level of development and little economic activity. It had a relatively young population. CONCLUSIONS: The health problems were linked to the social and economic situation. Apart from the re-creation of industrial jobs, it would be desirable to improve programmes to monitor TB and cardiovascular diseases.

Cause of Death↗
PubMed1996

The evolution of breast cancer mortality and morbidity in Spain (1977-1988).

A study of breast cancer mortality and cancer morbidity has been carried out in Spain recently for the period 1977-1988, covering the population of the 17 Autonomous Communities and 50 provinces of the country. Data was obtained from INE, Instituto Nacional de Estadística (National Institute of Statistics), with age standardization using the indirect method. The different Autonomous Communities and provinces were compared in order to establish possible significant differences. The crude mean mortality rate was 21 cases per 100,000 inhabitants/year; Las Palmas, Gerona, Barcelona, the Balearic Islands, Navarra and Zaragoza have the highest mortality rates, with a proportional increment of 54% in that period. The crude national mean morbidity rate for the considered period was 64.0 cases per 100,000 inhabitants, and the proportional increment 180%. According to provincial figures, Alava had the highest fitted mean morbidity rate, 135 cases per 100,000 inhabitants, whilst the highest fitted mean rate was Las Palmas (28 cases/100,000 inhabitants), and the highest proportional increment was the rate for the province of Huesca (169%). When using the ANOVA test on the mean rate of the period, for mortality as well as morbidity, we observed significant differences among provinces and among Autonomous Communities (p < or = 0.05).

Breast Neoplasms↗
PubMed1996

[Risk factors associated with etiopathogenesis of non-melanoma skin cancer in Valencia].

A series of personal, occupational and sociocultural characteristics have been described in patients with non-melanoma skin cancer (NMSC). A case-control retrospective study was undertaken to determine these characteristics in patients with NMSC treated in the La Fe University Hospital (Valencia, Spain) between October 1992 and June 1993. NMSC is seen in elderly individuals, the risk being greater among males than in females. A light complexion clearly increased risk, as did a tendency to sunburn easily. Open-air occupational activities were in turn related to an increased risk of developing NMSC. A significant rise in risk was also observed as age-adjusted occupational exposure to sunlight increased.

Adolescent↗
PubMed1995

Mortality, morbidity and drug consumption in a rural area (Spain).

A descriptive study was made of the health indicators in 5 rural municipalities of the province of Castellón (Spain), with a total of 1428 inhabitants. This population is characterized by its aging, 36.9% of all individuals being older than 65 years. A retrospective evaluation was made of the annual mortality rates between 1940 and 1990, and of morbidity and medications consumption for the period between June 1991 and May 1992. An increase in general mortality was observed during the study period, though the rates also diminished in relation to age groups, sex and cause of death. In addition, 59.45% of the study population made use of health-care services in the course of one year, an average of 2.59 drugs being prescribed per inhabitant in that same period. Morbidity in decreasing order of importance was attributed to acute respiratory disease, osteomuscular disorders, hypertension, depression and gastric pathology. Medications for the common cold and coughing were the most frequently used drugs, along with pain-killers, cardioactive agents, psycholeptics and non-sterioidal anti-inflammatory drugs (NSAIDs). Aging causes the mortality variations recorded, despite the socio-sanitary improvements observed in the zone during the study period. Aging may also be related to the important use of healthcare services and of drugs noted in the study. The highest morbidity rates and drug consumption levels corresponded to chronic diseases that deteriorate patient quality of life without actually increasing mortality.

Adolescent↗
PubMed1994

[A comparative study of cancer mortality according to the work activities of the population].

In industrialized countries the three main contaminant factors of the environment are: energy production, industrial activities and agricultural activities. A large number of epidemiologic proofs shows the great importance of the environmental factors on inducing different kinds of cancer. The purpose of this paper is studying the possible repercussions of human activities on the population health, specially focused on cancer. Four areas of the Valencian Community (two agricultural areas and two industrialized areas) has been selected. A cancer mortality study has been carried out in the different kinds of areas (CIE-IX revision) over the 1976-1989 period, calculating mortality rates per 100.000 inhabitants and standardizing them by direct method. A statistical significance test (chi square) has been applied with a reliability level for 95%. Finally, the prevailing tendency all over the studied period has been evaluated, applying a linear regression analysis to the gross rates. In industrial areas a statistically significant increase (p < 0.05) of GI system tumours, respiratory tract tumours, blood and hemopoietic tumours and benign tumours of unspecified nature has been observed. In agricultural areas the studied pathologies sustain a steady tendency, except for benign tumours and tumours of unspecified nature, showing significant increase in one of both agricultural areas. We can conclude that mortality patterns with regard to cancer are different in agricultural areas from regard to cancer are different in agricultural areas from those found in industrial areas--and this could be related to the distinct environmental and labour features in each population.

Agricultural Workers' Diseases↗
PubMed1993

AIDS and tuberculosis.

Between 1985-1989 were diagnosed 376 cases of TBC in "La Fe" hospital in Valencia. 36 of this cases also had AIDS. We have carried out a compared study among the 340 cases of TBC and the 36 cases of AIDS+TBC. In this way we have described the social and work conditions of both groups, the hospitalization, the associated pathologies, the different risk factors, the different characteristics of the disease in each group of TBC, the diagnoses methods and the treatment of each case.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Mortality due to respiratory diseases in Spain (1977-1985)].

A descriptive and comparative epidemiological is made of mortality due to respiratory disease by provinces in Spain. The study period covers 1977 to 1985, this being the last year reported by the Natural Movement of the Spanish Population (Movimiento Natural de la Población Española). In particular, 5 causes of death were analyzed in accordance to the International Classification of Disease (IX Revision): respiratory tuberculosis, influenza, chronic pulmonary disease, pneumonia and other pathologies of the respiratory apparatus. The results reveal an annual increase in these diseases. Standardized mortality ratio in turn reflects the provinces with increased mortality, the distribution of which varies for each pathology studied as a result of the different factors involved. Variation is also seen in terms of sex. Thus, influenza predominates among women, whereas males are more frequent as regards the remaining pathologies. Mortality due to pneumonia is similar in both sexes, this being the disease exhibiting the greatest increase during the study period. The results obtained may be of use in protocolizing resources for better control and prevention of respiratory disease in this country.

Female↗
PubMed1993

[Cutaneous melanoma: a review of risk factors].

In Europe, mortality due to cutaneous malignant melanoma represents 5,000 deaths a year, during this period about 17,000 people develop this disease. The highest incidence rates are those of Northern Europe, where this neoplasm has always been a public health problem, nevertheless countries of southern Europe (Spain, Portugal, Greece, Italy ...) are showing important increments in their rates, during the last years. Because of all of this, it is becoming a public health problem in every white race populations. This increment in its incidence is mainly attributed to changes in lifestyle, with an increase of solar radiation exposure during holidays and leisure activities, increase of tobacco and alcohol consumption, exposure to different chemical substances, use of ultraviolet lamps, etc.

Humans↗
PubMed1992

[Mortality from acute respiratory infections and influenza (1976-1980)].

Acute respiratory infections (ARI) and influenza (flu) are extremely common illnesses, which make up the main causes of medical consultation and absence from work. OBJECTIVE. To discover the level of mortality because of ARI and flu in the Health Areas within the Community of Valencia; to analyse their possible relationship with socio-economic factors and also to identify higher-risk groups according to age and sex. DESIGN. Retrospective study. SITE. The Community of Valencia. PATIENTS OR OTHER PARTICIPANTS. Mortality data across the Community were obtained from the mortality statistics published by the Generalitat (Government) of Valencia during the five-year period of 1976 to 1980. MAIN MEASUREMENTS AND RESULTS. The results establish that Health Areas 4, 6, 7, 9-12 and 18 present less mortality because of ARI and flu. These are the better areas, socio-economically speaking, although the data are without statistical significance. A spectacular increase in mortality in the age-group of those over 70 was observed, with no great differences found between the sexes. CONCLUSIONS. Given that the main interventions to prevent these diseases are based on vaccination, it would be useful to carry out vaccination programmes with greater thoroughness in those areas identified as of high risk.

Acute Disease↗
PubMed1992

Non-melanoma skin cancer: an evaluation of risk in terms of ultraviolet exposure.

A retrospective study of 143 patients histologically diagnosed with non-melanoma skin cancer (NMSC) was carried out in order to evaluate the influence of ultraviolet (UV) radiation on the appearance of more than one NMSC in the same person. Descriptive statistical and logistic regression analyses were carried out for each variable and its possible interaction, in order to determine the potential appearance of multiple NMSC. The results obtained were in agreement with those of earlier studies. A significant relationship was observed between occupational UV exposure and individuals with more than one NMSC. Those patients tended to be blue-eyed and were chronically exposed to UV radiation as a result of occupational activities (although not always in leisure activities); most did not take protective measures such as the use of hats or creams.

Aged↗
PubMed1992

[Delay in childhood tuberculosis detection as a negative factor in the anti-tuberculosis struggle].

Childhood morbidity due to tuberculosis infection in Spain is not diminishing at the expected rate in relation with available knowledge and facilities. An important factor is the delay in diagnosis, which evaluation constitutes the objective of this publication. Said delay is due to several causes, patient does not consult on time (mean value between onset of symptoms and consult is 34.3 days), or physician does not think in tuberculosis as first diagnosis, which meant an added mean delay of 7.6 days more. These delays mean an important detriment for the patient, and one of the objectives in the anti-tuberculosis struggle is to shorten delays through information to the lay public and health professionals on the highly important current issue of tuberculosis.

Adolescent↗
PubMed1992

[An epidemiological study of the distinct histological types of cutaneous melanoma in relation to other variables of the disease].

A retrospective descriptive study is carried out from the whole of malignant cutaneous melanomas diagnosed at the Dermatology Service of the General University Hospital of Valencia (HGUV), during the period 1977-1987, in which the 80% of the whole of the cases in the province of Valencia are diagnosed, specifically 247 patients are studied. The ones located on the leg stand out 21%, followed by posterior thorax 14% and face 12%. Likewise, differences statistically significant p less than 0.001 are observed among the distinct histological types of cutaneous malignant melanoma (CMM) with regard to the depth of the tumours invasion (measured in Clark levels and millimetres of depth), mitosis/area, mitosis index and prognosis index. Being the lentigo of malignant melanoma (LMM) the histological type diagnosed in earlier phases, hence it is the most capable variant of curative treatment, just the opposite that happens to the nodular malignant melanoma (NMM), that is normally diagnosed in more advanced phases of the illness.

Humans↗