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C Alvarez-Dardet

Publications and source records attributed to C Alvarez-Dardet.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Age as a prognostic factor in intensive care].

In order to define the prognostic impact of the age of critical patients as well as its association with the initial severity of illness (SAPS index) and therapeutic effort (TISS index), we studied 1.102 patients older than 14 years admitted consecutively to 3 general intensive care units. The oldest patients (more than 65 years) showed a higher mean SAPS (11.00 versus 8.58, p less than 0.0001) and mortality (odds ratio = 1.99, p less than 0.0001) than the younger ones. The association between age and mortality showed a "dose-response" pattern, even after controlling for the effect of initial severity (p less than 0.0001). The effect of age was stronger in the groups of patients with low SAPS (odds ratio = 2.94, p = 0.0007) or admitted for acute myocardial infarction (odds ratio = 3.28, p less than 0.0001). The oldest group showed a lower TISS/SAPS ratio and a shorter stay in the intensive care unit than younger patients, suggesting a low relative therapeutic effort in the latter. The differential therapeutic effort did not explain, however, the mortality excess in the oldest group, because the gradient of mortality increased after adjusting for TISS/SAPS ratio (adjusted odds ratio = 2.42, p less than 0.0001).

Adolescent↗
PubMed1990

[Evaluation of the variability of rapid diagnosis of infection by Chlamydia trachomatis using direct immunofluorescence].

The interobserver and intraobserver agreement between two microscopists was independently assessed in a blind fashion to evaluate the reproducibility of the results of the quick diagnosis of Chlamydia trachomatis infection with direct immunofluorescence. The study was carried out in two phases, and 604 samples of cervical and urethral exudate from patients seen at a center for the prevention and therapy of sexually transmitted diseases were evaluated. The two observers had a kappa index of agreement between them of 0.41, with 95% confidence intervals (95% Cl) of 0.31-0.51, while their agreement within themselves was 0.78 (95% Cl: 0.65-0.91) for the first observer and 0.61 (95% Cl: 0.47-0.75) for the second one. After discussion of the data and analysis of the reasons of disagreement, the evaluation was repeated. In this second phase, both interobserver and intraobserver agreement were substantially improved. The kappa index was 0.71 (95% Cl: 0.61-0.80) for the former, whereas regarding the latter the first observer had a kappa index of 1 (95% Cl: 0.86-1.13) and the second observer an index of 0.82 (95% Cl: 0.61-0.80). It was concluded that the test may have problems in its practical performance if the microscopists are not previously trained with systematic programs for the evaluation of results.

Cervix Uteri↗
PubMed1990

Predictors of death following ICU discharge.

In order to study possible predictors of early after-discharge mortality (EADM), 700 consecutive patients discharged alive from three intensive care units (ICUs) were followed up 2 months after their admission. The observed mortality was 7.3%. Univariate analysis indicated a strong statistically significant association of the following variables with mortality: initial simplified acute physiological score (SAPS) greater than 10, therapeutic intervention score in the first 24 h of admission greater than 20, age greater than or equal to 65, length of stay in the ICU greater than 10 days, and low educational level. The multiple logistic regression analysis included as predictive independent variables the SAPS, organs or systems failure, age, and length of stay. The model built upon these four variables was able to identify a group of patients at high risk (21-46%) of EADM. We conclude that some simple variables can be used as useful markers of patients groups at high risk of EADM.

Adult↗
PubMed1990

Anaemia during pregnancy as a risk factor for infant iron deficiency: report from the Valencia Infant Anaemia Cohort (VIAC) study.

A prospective cohort study with a 1-year follow-up of 156 neonates was carried out specifically designed to test the hypothesis that there is a positive relationship between iron deficiency during pregnancy and the development of the same disease in newborn infants. Exposure was defined as being born of a mother with ferropenic anaemia at delivery, and cases as the infants who developed iron deficiency during their first year of life. A statistically significant positive association was detected with an odds ratio of 6.57 (95% confidence limits 1.81-25.97). A stratified analysis was also performed to control the effect of potential confounders such as socio-economic variables, feeding practices and other factors linked with the iron status of infants. This second analytical procedure showed no alteration in the association detected in the simple analysis but that there was a statistically significant strong interaction between the quantity of cow's milk intake and the ferropenic status of the mother. These results show a relationship between iron deficiency of the mother at delivery and the development of iron deficiency in the infants. These new findings could be important in the development of new prevention programmes applied to pregnant women.

Anemia, Hypochromic↗
PubMed1989

[Predictive value of obligatory reporting of sexually transmitted diseases].

Sexually transmitted diseases (STD) were recently included in the Spanish reporting system, or Compulsory Reporting of Diseases (EDO). In the present study, the validity of this system is evaluated with the estimation of the positive predictive values of the EDO. A preestablished questionnaire was administered by phone to the reporting physicians of the 478 cases of STD that had been reported to the EDO system from August 1987 to May 1988 in the Alicante and Valencia provinces. In this survey, in addition to data related to the reporting physician (specialty and place of work) and to the patient (sex, clinical symptoms and signs), information permitting to classify each diagnosis as certain, likely and unlikely was collected (incubation time, laboratory tests). Considered as a whole, the results suggested an acceptable accuracy (positive predictive value 79.09%, confidence limits 76.7%-81.5%) for both diseases. This permits to consider STD statistics as fairly accurate. Among the factors influencing the diagnostic precision are the disease itself, the patient's sex, the qualification of the reporting physician and his place of work. The predictive value of the cases reported from centers of diagnosis of STD was higher. We think that, although these results are acceptable for the epidemiological survey, the quality of care could be enhanced by a better organization of services and an improved undergraduate and postgraduate education.

Attitude of Health Personnel↗
PubMed1989

[Healthy carriers of enteropathogenic micro-organisms among the child population of Seville].

We have studied for 1-year period a group of 144 children (31 newborn infants, 62 aged 1 year and 51 aged 2 years) who were randomly selected from the registrar's office of Sevilla with the purpose of determining the incidence of diarrhoea and the prevalence of enteropathogenic microorganisms. Two samples of faeces (one at the beginning and the second by the second semester of the 1-year period) were obtained from all children which were processed for culture and parasite and rotavirus examination. We found a prevalence rate of enteropathogenic Escherichia coli carriers (EPEC) of 7%, of Giardia lamblia of 4% and of rotavirus of 14%. The state of EPEC was more frequent among children from high social-economic status. The state of G. lamblia carrier was six-fold higher in children with body weight alterations and in non-vaccinated or incompletely vaccinated children.

Animals↗
PubMed1987

[Types of study].

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Data Collection↗