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Biomedical subjects

C Fernández Olano

Publications and source records attributed to C Fernández Olano.

7 recordsLinked to original sources

[Quality of life of patients after radical surgery of bladder cancer].

OBJECTIVE: To analyze the impact of surgery for bladder cancer on the patient's quality of life. METHODS: The SF-36 questionnaire was utilized to assess the quality of life of 53 cystectomized patients. Sociodemographic data, associated and surgery-related morbidity, type of urinary diversion, anatomopathological stage and current oncological status were analyzed. RESULTS: Patient mean age was 64.3 years. There were 46 males (86.8%), 33 (62.3%) had no schooling, 32 (68.1%) were social class IV and 35 (66.0%) had chronic associated conditions. External urinary diversion had been performed in 28 (52.8%) and bladder substitution in 21 (39.6%) patients. The early complication rate was 37.7% (n = 20) and the late complication rate was 86.8% (n = 46). Tumor stage was < or = pT2 in 28 cases (52.8%). Age correlated inversely with Physical Performance (r = -0.324; p = 0.018). Patients with chronic conditions had a lower score for Physical Performance, Vitality and SFI. Patients with tumor stage < or = pT2 scored higher for Physical Performance (p = 0.034), Vitality (p = 0.046), Mental Health (p = 0.036), Emotional Role (p < 0.05) and MSI (p < 0.05). Those with postoperative complications had a worse score for Physical Performance (p = 0.031), Vitality (p = 0.027), Emotional Role (p = 0.014), Mental Health (p = 0.012) and MSI (p = 0.015). The SF-36 showed no differences between the types of urinary diversion except that patients that had undergone orthotopic bladder substitution had a higher score for Physical Performance (p = 0.014) and FSI (p = 0.045). CONCLUSIONS: Although the quality of life of cystectomized patients is worse than that of the general population, it is better in younger patients without chronic associated conditions, no postoperative complications, lower tumor stage and those submitted to orthotopic bladder substitution.

Aged↗

[Factors associated with chronic drug consumption in the elderly].

BACKGROUND: To determine chronic drug intake in the non-institutionalised elderly population and identify factors associated with polypharmacy. PATIENTS AND METHODS: Cross-sectional study by means of home interview. 1,015 elderly individuals were selected systematically from the 1991 municipal electoral list of Albacete, Spain (level of confidence 95%, precision 3%, response rate 93.8%). The questionnaire included, disability scales (Minimental test, index of Katz and Lawton-Brody, Yesavage scale and DUKE-UNC questionnaire), a self-preceivement of health, demographic data and qualitative and quantitative information about drug intake. We employed the anatomic classification of drugs to obtain a profile of consumption. RESULTS: 75% of those interviewed admitted to taking medication chronically (CI 95%: 72.6-78.6). The mean number of drugs was 3.17 +/- 1.94 SD. Intake was significantly higher in women (p = 0.01), widows (p = 0.04), those of lower social status (p = 0.01), greater age (p < 0.02), and a greater number of illnesses (p < 0.001), more frequent users of health resources (p < 0.001), those physically dependent (p < 0.001) and those suffering from depression or cognitive impairment (p = 0.001). The most commonly taken drugs were: cardioactive drugs (22.1%), diuretics (19.4%) and vasodilators (14.2%). Using logistic regression analysis we found that the factors associated with higher drug intake were: three or more ilnesses (OR = 2.24), poor self-assessed status of health (OR = 1.45), physical dependence (OR = 1.59), age greater than 74 years (OR = 1.63), depression (OR = 1.68), > or = 4 contacts with health providers over a three-month period (OR = 2.73) and previous hospital admissions (OR = 2.67). CONCLUSIONS: The high intake of drugs by the elderly is determined, among other factors, by sociodemographic considerations, the subject's perceived status of health and different forms of disability. These factors should be taken into account by health professionals when planning a rational use of drugs. There is a high consumption of peripheral vasodilators despite their scanty therapeutic value.

Aged↗

[Depression in older persons. Associated factors].

OBJECTIVE: To determine the proportion of elderly people with depressive disorders and study the possible association with sociodemographic factors, self-perception of health, cognitive function, diseases suffered, drug consumption, sleep disorders and use of services. DESIGN: An observational crossover study using a home interview. SETTING: Community-based. PARTICIPANTS: 787 elderly people aged 65 and over, not institutionalised and living in the city of Albacete. MEASUREMENTS AND MAIN RESULTS: A questionnaire designed for the study was used to gather data on the sociodemographic variables, self-perception of health, diseases suffered, drug consumption, cognitive function, sleep disorders and contacts with the health service. The variables found by logistic regression to be associated independently to the presence of depressive disorders were: being female (OR = 2.75), habitually suffering sleep disorders (OR = 2.75), having self-perception of poor health (OR = 17.61) and cognitive deterioration (OR = 2.45). CONCLUSIONS: It would be advisable to apply a screening test to detect depressive disorders in elderly people with associated factors (being female, having sleep disorders, self-perception of poor health and cognitive deterioration), so that they could benefit from early diagnosis and adequate treatment.

Aged↗

[Visual and auditory difficulties expressed by the aged].

OBJECTIVE: To determine the proportion of the elderly who have difficulties in their perceptive functions (seeing and hearing) and associated factors in the area of health self-perception and functional capacity. DESIGN: Observational and crossover, using an interview. SETTING: Community. PARTICIPANTS: 787 elderly people not in institutions; 93.8% reply rate. MEASUREMENTS AND MAIN RESULTS: Using a questionnaire, data were obtained on deficiencies in their sense organs and self-perceived health. Validated scales to determine functional capacity (physical, psychic and social) were used: Katz, Lawton and Brody indexes, Cognitive mini-test, DUKE-UNC questionnaire and Geriatric Depression scale. A serious difficulty or inability to read or watch television was expressed in 17.3% of cases (CI 95%; 14.8-20.0) and to follow a normal conversation in 10.5% (CI 95%; 8.4-12.6). The proportion of the elderly dependent on others to carry out their normal daily activities was 2.2 times greater among those who displayed severe visual problems (CI 95%; 1.7-2.9) and 1.8 times greater if they had hearing difficulties (C.I. 95%; 1.4-2.3). There was a linear tendency between greater visual or auditory problems and less social support (p = 0.01), greater dependency on others for basic daily activities (p < 0.001) and worse perceived health (p < 0.001). CONCLUSIONS: The elderly, especially the oldest among them, frequently display hearing and visual problems, which are related to low self-perception of health and greater functional incapacity.

Age Factors↗

[Clinical and epidemiological features of hepatic cirrhosis. Analysis of 200 patients].

We have evaluated the clinical and epidemiological features of hepatic cirrhosis in a retrospective study of 200 patients admitted to our Area Hospital from 1984 to 1987. 77% of patients were 40-69 years old and 74% were males, with a M/F ratio of 2.84. 56% were caused by high alcohol intake, 25% were cryptogenic and 13% post-hepatitis. 29.2% were diagnosed in a compensated stage of the disease. 52.2% presented with ascites, and 30.5% with upper gastrointestinal hemorrhage. We found superimposed hepatocellular carcinoma in 4.5% of patients, all of them males, with a mean age of 63.5 years. 18% died during their hospital admission, 50% from hepatic coma, 19.4% from hypovolemic shock and 16.6% from hepatorenal syndrome. Survival from the time of diagnosis in the patients who died was shorter than one year in 41.5%.

Adult↗

[Epidemiologic study of complicated urinary calculi: an analysis of 164 cases].

We report a clinical and epidemiological study of 164 cases of complex urinary calculi which were seen in our hospital between 1984 and 1988. The highest incidence was found in patients aged between 40 and 50 years, with a female:male ratio of 1.27/1. In 37% of patients there were first degree relatives with calculi. The most common type were calculi with a calcium component, with a remarkably high proportion of struvite calculi and a low one of uric acid. Housewives had a high rate of struvite calculi associated with infections during pregnancy. Qualified professions have been associated with calcium oxalate and phosphate calculi. 13% has congenital renoureteral malformations, 4% had hyperuricemia and 1.2% had hyperparathyroidism. Pain was the most consistent symptom, followed by fever and urinary tract infection. 50% of patients had previously passed stones. 90% of calculi were visible in the plain abdomen X-ray film. 65% of patients required aggressive therapy.

Adolescent↗

[Benign unilateral hematuria causing anemia by mesangial deposit of IgM].

We present a case of benign unilateral persistent hematuria, due to nephrectomy due to important anemia and requiring several blood transfusions. The only pathological finding obtained during the study of the kidney was the presence of mesangial deposits of IgM. This process is very rare due to its unilateral feature, relevance of the hematuria and from the paradoxical finding that a percutaneous biopsy revealed a normal kidney during a study prior to nephrectomy.

Adolescent↗