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C Ochoa-Sangrador

Publications and source records attributed to C Ochoa-Sangrador.

7 recordsLinked to original sources

[Epidemiological study of colorectal cancer in Zamora (Spain): a comparison between the years 1996 and 2003].

INTRODUCTION: Colorectal cancer (CRC) is one of the most frequent tumors in Western countries. In Spain, widely different rates have been reported for distinct regions. AIM: To determine the epidemiological characteristics of CRC in the province of Zamora in 1996 and 2003 and to identify possible variations in these characteristics in each of these two years. MATERIAL AND METHODS: We performed a descriptive, retrospective study of all cases of CRC diagnosed in the Complejo Asistencial de Zamora in 1996 and 2003. RESULTS: In 1996, 146 patients were diagnosed with CRC, representing an unadjusted and adjusted incidence of 70.85 and 49.40 cases per 10(5) inhabitants. In 2003, 173 patients were diagnosed, representing an unadjusted and adjusted incidence of 86.89 and 58.12 cases per 105 inhabitants. The mean age at diagnosis was 72.08 years in 1996 and 71.15 years in 2003. The mean time to diagnosis was 3.37 months in 1996 and 4.11 in 2003. The mean time to diagnosis in 1996 was 4.35 months in rectal tumors and 2.87 months in colon tumors (p = 0.013). In 2003, the mean time to diagnosis was 4.70 months in rectal tumors and 3.84 months in colon tumors (p = 0.0749). The mean time to diagnosis was 3.56 and 3.83 months in patients living in urban areas and was 3.24 and 4.35 months in those living in rural areas in 1996 and 2003, respectively. More than 65% of the neoplasms were located in the rectum and sigmoid colon, with no differences between the two years. In 1996, 46.1% of the tumors were stage III or IV at diagnosis while in 2003, this percentage increased to 50.9%. In both years, the four basic health areas with the highest rates within the province were Aliste, Carbajales, Carballeda and Corrales. CONCLUSION: CRC is a highly frequent disease in the province of Zamora, especially in some of the western regions. The incidence of CRC was higher in 2003 than in 1996. Most of the tumors were located in the rectum and sigmoid colon. The time from symptom onset to diagnosis was prolonged. A high percentage of tumors were diagnosed in advanced stages.

Adult↗

Predictive model of functional independence in stroke patients admitted to a rehabilitation programme.

OBJECTIVE: To develop a prognostic model to estimate the probability of patients being independent in ambulation and in activities of daily living (ADL) after six months of stroke. DESIGN: Cohort analytical study. SETTING: Rehabilitation departments of two district general hospitals. SUBJECTS: Ninety-two consecutive stroke patients admitted to a rehabilitation programme. MAIN OUTCOME MEASURES: Independent ambulation was defined as a Functional Ambulation Classification (FAC) > or =4, and the independence in ADL as a Barthel Index (BI) > or =285. All patients were assessed on admission to rehabilitation, and in the first, second, third, fourth and six months after stroke. RESULTS: Prognostic factors were identified by means of a multivariate survival analysis using Cox regression. Three variables were predictors for a FAC > or =4: (1) The patients in the motor (M), motor-sensitive (MS) and motor-sensitive with hemianopsia (MSH) groups (relative risk (RR) 5.43 of M with respect to MSH, and 2.41 of MS to MSH). (2) A Motricity Index >25 (RR 3.19). (3) An age <70 years old (RR 1.99). For a BI > or =85 three predictors were selected: (1) The classification M-MS-MSH (RR 6.02 M to MSH, and 1.52 MS to MSH). (2) An initial BI >20 (RR 3.45); the highest contribution in the achievement of an initial BI >20 was bowel and bladder continence. (3) The antecedent of previous independence (RR 2.68). The predictive models, constructed by means of multiple logistic regression correctly classified 77% and 79% of the patients who obtained FAC > or =4 and a BI > or =85 respectively. CONCLUSIONS: The syndromic classification M, MS and MSH, together with other routinely available data, such as the Motricity Index, BI, the age and the previous functionality, can be used to obtain a patient prognosis level with regard to ambulation and ADL independence.

Activities of Daily Living↗

Pediatric parenteral nutrition mixtures design program: validity and stability study.

The formulation and elaboration of a correct parenteral nutrition (PN) in infancy requires the use of many parameters, the realization of complicated mathematical calculations, and repeated and individualized adjustments of the final constituents. The use of computer programs in the confection of PN has simplified the whole process, but, to our understanding, the programs being used at the moment lack the flexibility needed to generalize its use in the pediatric age. The aim of this work is to present a new computer program able to make up complete pediatric units of PN by itself, which follow the nutritional requirements and the marketed preparations established for each clinical situation. The program provides, automatically, standard amounts for each nutrient, according to age, water needs, and route of administration. The program turns these amounts, which can be modified before or after knowing the final composition, into milliliters of each commercial product and provides a complete analysis of the PN solution. It is also possible to adapt the basic configuration of the program to the needs of each patient, modifying the nutritional requirements and the products that the program will use. In order to assess the validity of the program, we made up a series of PN solutions, for a simulated sample of patients, which represented different clinical situations and age groups. We analyzed the composition of the mixtures and its physical-chemical stability. No problems in the PN solutions generated by the program when using our standard configuration were found. A study of reproducibility was carried out and no difficulties of execution, errors, or differences in the composition of the PN solutions designed by the different physicians were found. Average time needed for the design of a PN was less than 5 min. The use of computer programs in the design of mixtures of PN reduces errors and time, allowing a better use of this technique of nutritional support.

Adolescent↗

[Generic drugs in the treatment of epilepsy].

AIM: We discuss some controversial aspects with prescription of generic drugs (GD) and the problems concerning bioequivalence, mainly in the case of drugs with non-linear pharmacokinetics and/or narrow therapeutic rank, like the antiepileptic drugs (AED). DEVELOPMENT: There is considerable debate about GD in the treatment of epilepsy, with clearly advantages (cost saving) and disadvantages (loss of seizure control or drug toxicity) in prescribing generics anticonvulsants. We make a systematic review of the literature in primary (PubMed) and secondary (Tripdatabase and Cochrane Library) bibliographic databases in relation to GD and AED. The main information is about classical AED (phenytoin, carbamazepine, valproic acid and primidone) and we don't found studies in this area about the new AED. The level of evidence is, generally, weak, based on case-series and expert opinion without explicit critical appraisal (except in phenytoin with level of evidence moderate, based on some analytical studies). In Spain, at this moment, there are only two generic AED, one-classical (carbamazepine) and one-new (gabapentin). CONCLUSION: The American Academy of Neurology and Epilepsy Foundation maintains that the individual and physician should be notified and give their consent before a switch in antiepileptic medications is made, whether it involves generic substitution for brand name products, or generic to generic substitutions.

Anticonvulsants↗

[Consistency of clinical practice with the scientific evidence in the management of febrile seizures].

INTRODUCTION: An important inconsistency exists between the evidence available about the management of febrile seizures (FC) and its application in real practice. AIM. To value the degree of appropriateness of current management of FC. MATERIALS AND METHODS: Structured review of the articles on appropriateness published in biomedical literature. Methodological analysis and qualitative synthesis. RESULTS: The evidence available on the diagnosis and treatment of the FC is little. Except for the related to the preventive treatment of recurrences of FC, the rest of the evaluation criteria is based on the opinion of experts or methods of consensus. Eight articles have been identified that reflect the following problems: insufficient or excessive use of antiepileptic drugs during the seizures, unnecessary accomplishment of lumbar puncture, sanguineous analysis, neuroimage studies or electroencephalograms, and prescription of preventive treatments in simple FC. The methodological quality of the reviewed papers is little and its heterogeneity prevents the quantitative synthesis. CONCLUSIONS: The management of FC must be reviewed since an important part of the decisions of the clinical practice is not always sustained in a valid scientific evidence. We only have sufficient evidence on the effectiveness and security of the anticonvulsant treatments to the prevention of the recurrences.

Anticonvulsants↗