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Biomedical subjects

A Llopis-González

Publications and source records attributed to A Llopis-González.

9 recordsLinked to original sources
PubMed1999

Evidence based general practice.

OBJECTIVES: To estimate the proportion of interventions in general practice that are based on evidence. DESIGN: A one-year cross-sectional study involving all consultations by patients over age 15 years seen in 34 national primary health care centers. SETTING: The rural Castellon provincial district within the Valencian Community in eastern Spain, with a total population of 21,155 inhabitants. SUBJECTS: of 1990 case histories registered in the course of one year, 4800 consultations were identified; of these, 2341 (49%) distinct diagnosis-intervention pairs were identified and coded. MAIN RESULTS: The evidence basis for the diagnosis-intervention pairs in the study was derived from a computerized search of the scientific literature published in 1992-1996. The quality of the evidence was classified according to the method of Ellis et al. Within the 2341 diagnosis-intervention pairs, there was positive evidence in support of the intervention used in 55%. The evidence basis was sound for 42%, with 38% being based on Type I (clinical trials) evidence and 4% on Type II evidence. The most frequently presenting diseases involved the circulatory (18.7%), respiratory (14.9%), nervous (14.2%), musculo-skeletal (12.5%) and nutrition and metabolism and digestive systems, with 12.1% each. CONCLUSIONS: Clinical practice was clearly supported by positive evidence of all Types (I-III) in a total of 55% of interventions, and by good positive evidence of Type I or II in 42% of interventions. The percentage of evidence-based interventions in general practice serving a substantial population in rural Spain was lower than had been reported by some authors.

Cross-Sectional Studies↗
PubMed1998

Antacid (A02A) and antiulcer (A02B) drug prescription patterns: predicting factors, dosage and treatment duration.

BACKGROUND: A study is made of the pharmaco-epidemiology of antacid (ATC class A02A) and antiulcer (A02B) drug prescriptions during the year 1992. METHODS: Prescription data were extracted from 1941 case histories of patients over 15 years old from four health care centers in the Valencian Community (Spain). Dosage and treatment duration were evaluated, along with the way in which morbidity, self-evaluated health, the demographic pattern and life-style characteristics influence drug prescription. RESULTS: The proportion of drug prescriptions increased with age in both sexes (p < 0.01). Drug use depended mainly on chronic diseases. In prescribing antacids, the most influential diagnosis was gastritis (ICD 534, OR: 157), followed by duodenal ulcer (ICD 532, OR: 152) and gastric ulcer (ICD 531, OR: 122), other gastrointestinal disorders (ICD 66, OR: 54) and undefined diagnoses (OR: 15). In the prescription of antiulcer drugs, the most influential diagnoses were gastric and duodenal ulcer (OR: 380 and 342, respectively), and a significant relation was observed with the diagnosis of osteomuscular diseases (OR: 6). Lifestyle and demographic pattern were of marginal importance. The estimated duration of treatment was 85 days. No significant differences were observed in either treatment duration or administered doses of almagate, ranitidine and omeprazole with respect to sex, age or diagnosis. CONCLUSIONS: Prolonged treatment is common for acid suppression. The widespread use of peptic ulcer drugs is mostly due to excessive prescription for non-ulcer dyspepsia. At the same time, many patients consume these drugs on a long-term basis in the absence of a clear diagnosis. This observation supports the need for appropriate diagnostic and prescription protocols to secure increased economical savings and management results.

Adolescent↗
PubMed1997

A Study of the Health of Seafaring Workers of Valencia, Spain.

Under the auspices of the Service of Maritime Health of the Marine Social Institute of Valencia, Spain, the health status of seafaring workers from Valencia was evaluated. An epidemiologic study was carried out based on 707 pre-embarkation health examinations, collecting information about the health problems of these workers and their associated risk factors. The data were analyzed to estimate population frequencies and the corresponding 95% confidence intervals. Significance among groups was calculated by the chi-square test (p < 0.05). Relative risks were calculated in comparisons of the seafaring workers with the general population of Valencia. High incidences of ophthalmologic disorders were found in workers over 50 years of age (15.9%) and in alcohol consumers (29.3%). Digestive problems were observed among alcohol-consuming (21.7%) workers 31-40 years old (8.5%). Risk factors for circulatory disorders increased steadily among those over age 50 (9.0%), non-smokers (10.3%), and those weighing more than 75 kg (8.2%). Finally, respiratory diseases were more frequent among individuals whose work involved fishing (12.7%). Risks increased with alcohol and tobacco consumption (16.6% and 17.5%, respectively). The risks of developing circulatory and ophthalmologic disorders were 10.5 and 10.3 times greater, respectively, among the seafaring workers than in the general population, while the risks of infections and genitourinary disorders were 10.2 and 9.7 times greater. Workers at high risk for health problems were typically more than 51 years old, with body weights of more than 75 kg, family histories of health problems, and heavy use of tobacco and alcohol. Compared with the general population of Valencia and the national population of Spain, the prevalences of ophthalmologic, digestive, respiratory, and circulatory disorders were higher in the seafaring workers.

Journal Article↗
PubMedDate not supplied

Atmospheric contamination in the city of Valencia: relation to noise and climate.

A qualitative and quantitative study is made of the polycyclic aromatic hydrocarbons (PAH), nitrogen oxide, and sulfur dioxide in the atmosphere of the city of Valencia for the period 1988-1989; an analysis is made of their concentrations during the year in terms of season and noise levels. Eleven sampling points in the city were used to determine PAH composition by reverse-phase, high-resolution liquid chromatography with fluorimetric detection, employing an acetonitrile-water gradient; nitrogen oxides and sulfur dioxide were determined by the Valencia city government. Environmental noise levels were determined using a BK 2221 integrated precision sonometer, and temperature values were obtained from the city Meteorological Institute. Daily PAH values varied between 0.1769 and 2.0916 micrograms/m3, whereas the figures for nitrogen oxide were between 91.5 and 100.67 micrograms/m3 during 1982-1989 (only one value, 58.01 micrograms/m3, is available for 1988-1989, corresponding to the Mercadona sampling point), and between 17.33 and 129.36 micrograms/m3 for sulfur dioxide for a total of 9 sampling points; the highest concentrations were recorded in the winter and spring months, the association between PAH and temperature being statistically significant (p less than or equal to .05). The relation to noise was also significant (p less than or equal to .005), Fluoranthene was the predominant PAH in all samples analyzed.

Air Pollutants↗
PubMedDate not supplied

Cancer of the rectum in relation to components of the Spanish diet.

Cancer of the rectum is common in most industrialized countries. It is considered to be the result of a combination of environmental (diet, tobacco, alcohol, etc.) and genetic factors. We studied the evolution of morbidity and mortality due to cancer of the rectum and sigmoid in Spanish provinces and its relationship to different Spanish diet components. Our study covered the period 1977-1985. We used the indirect method to determine morbidity and mortality rates per 100,000 population, grouped according to age and sex. The consumption of different diet components was obtained from National Statistics Institute publications on the subject. These components were total lipids, animal fats, vegetable fats, butter and pork lard, margarine, fiber, and alcohol (all in g/person/day). For the study period, the mean national standardized mortality was 5.26 per 100,000 population and morbidity was 171.57 per 100,000. Provinces having rates above and below the national average were noted. The study revealed that, overall, alcohol consumption presents a 0.42 (p less than .001) positive correlation with standardized mortality, as does total lipid consumption.

Colorectal Neoplasms↗
PubMedDate not supplied

Trends in malignant skin melanoma and other skin cancers in Spain, 1975-1983, and their relation to solar radiation intensity.

Epidemiological studies have shown solar exposure to play an important role in the appearance of skin cancer. We investigated the association between mortality standardized by the indirect method for malignant skin melanoma and other skin cancers and the mean intensity of solar radiation during July and August for the different provinces in Spain. A statistically significant relation was observed (p less than .05) for these two months but not upon considering mean annual solar radiation. We thus suggest that intermittent, intense exposure to sunlight constitutes an important risk factor for skin cancer. We observed an 8.5% and 15.72% increase in mortality due to malignant skin melanoma and other skin cancers, respectively, during the period 1975-1983. Mortality was slightly higher among males than females.

Dose-Response Relationship, Radiation↗