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Biomedical subjects

E Rivero

Publications and source records attributed to E Rivero.

17 recordsLinked to original sources
PubMed1998

Epidemiology of peptic ulcer disease in cirrhotic patients: role of Helicobacter pylori infection.

OBJECTIVE: The aim of this study was to investigate the clinical and epidemiological factors associated with the appearance of peptic ulcer in patients with cirrhosis and, in particular, the role of Helicobacter pylori infection. METHODS: A total of 201 of 220 consecutive patients included in a prospective study that aimed to evaluate the effect of dietary intervention on cirrhotic complications and survival underwent upper gastrointestinal endoscopy. At entry, an epidemiological and clinical questionnaire was completed and the presence of peptic ulcer disease or esophageal varices at endoscopy was prospectively collected. Sera were obtained and stored at -70 degrees C until analyzed, being tested afterward for Helicobacter pylori antibodies using a commercial ELISA kit. RESULTS: Eleven of 201 patients had borderline anti-Helicobacter pylori IgG titers and were excluded from further analysis. In the remaining 190 patients, point prevalence of peptic ulcer was 10.5% and lifetime prevalence 24.7%. Multivariate analysis selected male sex (OR 2.3; 95%CI 1.09-4.89) and Helicobacter pylori seropositivity (OR: 1.7, 95%CI 1.02-2.81) as the variables independently related to peptic ulcer disease. CONCLUSIONS: Male sex and seropositivity for Helicobacter pylori are the major risk factors for peptic ulcer in cirrhosis.

Female↗
PubMed1997

Seroprevalence and epidemiology of Helicobacter pylori infection in patients with cirrhosis.

BACKGROUND: Helicobacter pylori infection is the major pathogenic factor for peptic ulcer disease. Its epidemiology is not fully known; few data are available in patients with chronic liver disease. AIMS: To investigate the seroprevalence and factors associated with Helicobacter pylori infection in a series of liver cirrhosis patients. METHODS: Two hundred and twenty consecutive patients were prospectively included in a study aimed to evaluate the effect of dietary intervention on cirrhosis complications and survival. At inclusion, an epidemiological and clinical questionnaire was completed. Sera were obtained and stored at -70 degrees C until analyzed. They were tested for Helicobacter pylori antibodies using a commercial ELISA kit. RESULTS: Eleven out of 220 patients had borderline anti-Helicobacter pylori IgG titers. Of the remaining 209 patients, 105 (50.2%) showed positive titers of Helicobacter pylori IgG. Univariate analysis showed that Helicobacter pylori infection was more frequent in older patients, those born outside Catalonia, and in patients with a low educational level. Past ethanol consumption and current smoking correlated negatively with Helicobacter pylori infection. Multivariate analysis selected age (OR 3.1. 95% CI 1.46-6.45), educational level (OR 2.2. 95% CI 1.18-4.2) and alcohol consumption (OR 0.7. 95% CI 0.45-0.99) as the variables independently related to Helicobacter pylori infection. CONCLUSIONS: Helicobacter pylori infection in cirrhosis has the same epidemiological pattern as in the general population. Suggestions that the etiology or the severity of the liver disease could be related to Helicobacter pylori infection were not confirmed by our study.

Adult↗
PubMed1996

Lung cancer mortality among males of Catalonia and Spain compared with other European countries between 1975-1977 and 1987-1989.

This study compares the lung cancer mortality rates among males in the years 1975-1977 and 1987-1989 in Catalonia and Spain with other European countries selected for their geographical proximity. Adjusted calculations using the direct method have been made for male lung cancer mortality. Adjusted truncated rates for the age groups 0-44, 45-64 and more than 65 years were also calculated, as well as percent differences between the mortality rates of each period studied. Lung cancer mortality rates for males in Catalonia and Spain show relative increments of 46.58% and 52.41%, respectively. In contrast, lung cancer mortality in countries such as England-Wales and Switzerland have decreased. Moreover, the 0-44 year age group in Catalonia and Spain shows the absolute highest rates in the 1987-1989 period among all the countries analyzed. The marked contrast of the lung cancer mortality rate evolution in Catalonia and Spain compared with some other European countries and the considerable increase of the mortality in younger age groups indicate the need to intensify lung cancer control measures.

Adolescent↗
PubMed1996

Factors related to the failure of endoscopic injection therapy for bleeding gastric ulcer.

BACKGROUND: Although endoscopic injection therapy is effective in controlling initial haemorrhage from peptic ulcer, between 10% to 30% of patients suffer rebleeding. AIM: To assess the factors that may predict the failure of endoscopic injection in patients bleeding from high risk gastric ulcer. SUBJECTS: One hundred and seventy eight patients admitted for a gastric ulcer with a bleeding or a non-bleeding visible vessel were included. METHODS: Patients received endoscopic therapy by injection for adrenaline and polidocanol. Twelve clinical and endoscopic variables were entered into a multivariate logistic regression model to ascertain their significance as predictive factor of therapeutic failure. RESULTS: Eighty seven per cent (155 of 178) of patients had no further bleeding after endoscopic therapy. Endoscopic injection failed in 23 (13%) patients: 20 (12%) continued to bleed or rebleed, and three (1%) patients could not be treated because of inaccessibility of the lesion. Logistic regression analysis showed that therapeutic failure was significantly related to: (1) the presence of hypovolaemic shock (p = 0.09, OR 2.38, 95% CI: 0.86, 6.56), (2) the presence of active bleeding at endoscopy (p = 0.02, OR 2.98, 95% CI: 1.12, 7.91), (3) ulcer location high on the lesser curvature (p = 0.04, OR 2.79, 95% CI: 1.01, 7.69), and (4) ulcer size larger than 2 cm (p = 0.01, OR 3.64, 95% CI: 1.34, 9.89). CONCLUSION: These variables may enable identification of those patients bleeding from gastric ulcer who would not benefit from injection therapy.

Aged↗
PubMed1995

Topical pharyngeal anesthesia improves tolerance of upper gastrointestinal endoscopy: a randomized double-blind study.

BACKGROUND AND STUDY AIMS: The usefulness of topical pharyngeal anesthesia is not well established. The aim of the present study was to determine its benefits in relation to patient tolerance and facilitation of the procedure in unsedated patients undergoing upper gastrointestinal endoscopy. PATIENTS AND METHODS: A randomized double-blind study comparing Topicaina spray - a mixture of benzocaine butyl aminobenzoate (butoforme), amethocaine, and butacaine - and a placebo was carried out on 256 outpatients referred for diagnostic endoscopy. No additional premedication was used. After the examination, both the tolerance to and difficulty of the intubation and examination were evaluated by patients and endoscopists respectively, using visual analogue scales and a questionnaire. RESULTS: Three patients (1.2%) did not tolerate the endoscopy. One patient was excluded for unexpected therapeutic endoscopy. One hundred twenty-five patients received the active spray and 127 received the placebo. The two groups were similar with respect to patient characteristics. Both intubation and examination, assessed with visual analogue scales, were better tolerated (both p = 0.0001) and more easily performed (p = 0.02 and p = 0.0001 respectively) in the active treatment group. Patients receiving the active spray had a better tolerance for the procedure, according to questionnaire replies. CONCLUSIONS: Topical pharyngeal anesthesia in unsedated patients undergoing diagnostic upper gastrointestinal endoscopy improves tolerance and makes examination easier.

4-Aminobenzoic Acid↗
PubMed1995

Changes in cancer mortality in Catalonia and Spain (1975-77 and 1987-89). A comparison with other European countries.

Comparisons of cancer mortality in Catalonia and Spain have shown an intermediate position of these areas in relation to the rest of Europe. This study compares the overall cancer mortality in Catalonia and Spain in the periods 1975-77 and 1987-89 in relation to other European countries selected on the basis of geographical proximity and availability of information. Adjusted and truncated cancer mortality rates and relative changes in these rates have been assessed for both sexes. The mortality rate for males in Catalonia, Spain, Italy, Portugal and France has increased from 1975-77 to 1987-89 with relative increments of 13.5%, 13.7%, 10.1%, 9.6% and 4.3% respectively, whereas in Switzerland and England and Wales this rate has decreased. The mortality rate for females showed a slight drop between the two periods in all the studied countries except England and Wales and Portugal. By age groups, in males, the 0-44 year interval in Catalonia, Spain, France and Portugal, in descending order, showed the highest rates. The marked contrast of the evolution of the cancer mortality rate in Catalonia, Spain, Italy, France and Portugal, compared with Switzerland and England and Wales, and especially the considerable increase of the mortality in young people in Catalonia, indicates the extremely urgent need for all countries to adopt the measures to control cancer that have already shown themselves to be effective elsewhere.

Adult↗
PubMed1993

[Evaluation of the design and reliability of a questionnaire to identify elderly individuals in need for social and health services].

BACKGROUND: To assess the construction of a short screening questionnaire designed for the detection of elderly people living in the community and in need of social and health care, and to test the reliability of the scores obtained on the scales of Activities of Daily Living (ADL) and mobility through its application. METHODS: A short screening questionnaire of 11 items was designed to score elderly community dwellings on the scales of ADL and mobility of the International Classification of Impairments, Disabilities and Handicaps of the WHO (ICIDH). A random sample of 1,000 people aged 65 and over from the community of a geographical area of Catalonia (Spain) were interviewed in 1989, either by telephone or in-home personal interview, by non-professional trained interviewers on the basis of the mentioned schedule, and scored on the ICIDH ADL and Mobility scales. The design of the screening questionnaire was evaluated on the construction, content and wording through a 16 opinion statements questionnaire upon which 12 professionals, familiarized with questionnaire construction, expressed agreement or disagreement. To test reliability, each interviewer re-scored, one month apart, 20 subjects based on the information they had registered on the questionnaires, and following the same procedure, a gold standard observer re-scored all 1,000 interviews. In addition, a number of interviews were tape recorded, with previous consent of the subjects, and re-scored by 9 different observers. Interobserver and intraobserver reliability was measured with Cohen's weighted kappa coefficient. RESULTS: The average time of questionnaire administration was approximately 10 +/- 5 min. Although the instrument was said to be a good tool for the interviewer to score the subjects on the scales, wording of some items of the questionnaire need to be reviewed. Both intraobserver and interobserver reliability were high: kappa coefficients of 0.79-0.97 and > 0.75 respectively. CONCLUSIONS: The use of a simple and reliable ADL and mobility questionnaire is a practical way to obtain information on the functional status of elderly people living at home, and to select elderly people for a further comprehensive assessment of their social and health care needs for planning the appropriate services in the community.

Activities of Daily Living↗
PubMed1993

[Tendencies of mortality from cardiovascular diseases in Catalonia: 1975-1992].

BACKGROUND: There is an uncertainty of which is going to be the trend of cardiovascular disease in Spain. In the present study cardiovascular disease mortality is described from 1975 to 1992 in Catalonia, and a prediction until 1997 is made, assuming the same trend. Possible causes of this trend are analyzed. METHODS: Deaths from cardiovascular disease, ischaemic heart disease and stroke have been identified from 1975 to 1992. It has been used the direct method for standardization by age and sex, using the European population as the standard population. Logarithmic transformations of the standardized rates were used for each cause of death and for both sexes. Linear regression analysis was used to adjust the evolution of the rates in the time period. RESULTS: There is a reduction of 2.6% and 2.7% by year in rates for cardiovascular diseases mortality for both males and females respectively, a reduction of 1.2% by year in rates for ischaemic heart disease in males and a reduction of 1.8% in females, and a reduction of 4.0% and 4.2% for stroke in males and females respectively. CONCLUSIONS: Trends in cardiovascular disease mortality reveal a decline for both males and females, mostly due to a reduction in stroke mortality; ischaemic heart disease mortality slightly decreased specifically during the period 1983-1992.

Adult↗
PubMed1987

Endoscopic cholangiopancreatography in the infant: evaluation of a new prototype pediatric duodenoscope.

The usefulness of a new pediatric duodenoscope PJF in the diagnosis of neonatal cholestasis was studied in 23 infants with ages ranging from 19 to 150 days. In 22 of 23 infants the papilla was cannulated. In 13 of 14 neonates (93%) with neonatal hepatitis, the common bile duct was opacified and biliary atresia was excluded. In one of two neonates with choledochal cyst, the common bile duct was demonstrated. In six of seven neonates (86%) with biliary atresia, only the pancreatic duct was demonstrated and the diagnosis was suspected. Although absence of a common bile duct opacification does not rule out biliary atresia, ERCP with the new duodenoscope proved to be most useful in the diagnosis of normal biliary tree and served to avoid unnecessary surgery in most infants with neonatal cholestasis.

Biliary Atresia↗
PubMedDate not supplied

[Cancer mortality in the counties of Catalonia (1983-1989)].

OBJECTIVES: To compare mortality among counties (comarques) in Catalonia, Spain for the most frequent malignant tumors. METHODS: Overall mortality data and for five specific tumor sites were analyzed for a five-year period (1983-1989). Crude and site-specific mortality rates were computed. The comparison between counties was adjusted for the 1986 population of Catalonia using the direct method. Comparative mortality ratios (CMR) were obtained for each county with respect to Catalonia. RESULTS: Overall cancer mortality was higher in the Barcelonès for men and in Osona form women. The CMR for men in the Barcelonès was the highest for cancer of the trachea, bronchi and lungs; the CMR in Solsonès was the highest for stomach cancer, while in Cerdanya it was the highest for colorectal cancer. Among women, the highest CMR for cancer of the trachea, bronchi and lungs was in Montsià, whereas for breast cancer it was Baix Empordà, and Alt Urgell for stomach cancer. CONCLUSIONS: Comparative analyses of cancer mortality by county in Catalonia and sex underscores differences in its distribution, allowing the orientation of cancer control policies and research to be developed in each geographical area.

Breast Neoplasms↗
PubMedDate not supplied

[Usefulness of dilatation in esophageal stricture in children].

During 8 years, 140 children aged from 23 days old to 12 years old with the diagnosis of esophageal narrowness of different etiologies were studied. They had been treated through periodic dilatations according to their needs; the number of dilatations varied in relation to the clinic entity, age and time passed since the beginning of treatment standing out that the precocious dilatations had a greater success as less of them were required, specially in children with esophageal narrowness post ingestion of caustic and those with post surgical narrowness from correction of esophageal atresia. Among the patients who finished the treatment with dilatations, 81.4% were success fully resolved including 14.2% who needed surgical treatment, that is, resection of stenosis in 7.15%, transposition of colon in 4.28%, and required Nissen operation in 2.85% of patients.

Age Factors↗
PubMedDate not supplied

[Accessory spleen: compensating hypertrophy after of splenectomy. A case report].

The prevalence of accessory spleens has been reported to be about 7.1% in infants. When these patients undergo splenectomy without removal of the accessory spleen, the latter develop hypertrophy later in life and can reach the size of a normal spleen, with clinical manifestations similar to the ones before surgery. We report the case, of fourteen-old boy, who had splenectomy 7 year ago, for refractory and recurrent thrombocytopenia, who had splenectomy at age 7 years because of persistent thrombocytopaenia, resistant to non-surgical treatment, and who was found by conventional ultrasound study, doppler duplex color and selective angiography to have a hypertrophied spleen with sings of portal thrombosis and portal hypertension.

Adolescent↗