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Biomedical subjects

J Casas Rodríguez

Publications and source records attributed to J Casas Rodríguez.

8 recordsLinked to original sources
PubMed2001

[Evidence based medical treatment of heart failure].

INTRODUCTION AND OBJECTIVES: Recommendations for the treatment of heart failure were carried out by a systematic review of the available evidence of the different pharmacologic treatments. MATERIAL AND METHODS: The review focused on the treatment of chronic and systolic heart failure. All the studies published in english about the pharmacologic treatment of heart failure where identified. The evidence of every pharmacologic treatment was classified according to: a) efficacy variables (reduction of mortality and hospitalizations, improvement of functional class, ejection fraction and exercise tolerance), and b) the level of quality of the evidence according to an evaluation scale. The evidence was also reviewed for the comparisons and the combinations of the pharmacologic treatments, as well as for the toxicity and costs of treatments. RESULTS: The recommendations were defined according to the NYHA functional class and were classified in the A, B and C categories according to the level of quality of the available evidence. The evidence on mortality was considered the most important. First line drugs, the alternatives and other possible treatments were take into account. CONCLUSIONS: There is enough evidence based on information about some variables such as reduction of mortality or hospitalizations to carry out treatment recommendations in all stages of heart failure. This point out the interest ant the priority of used them in the evaluation and improvement of the results of heart failure.

Adrenergic beta-Antagonists↗
PubMed1996

[Proposal for a new classification of long-term treatment in primary health care].

OBJECTIVE: To evaluate the suitability of medication for an automatised dispensing system (ADS) for prescriptions by means of an indicator specially designed for this study. DESIGN: A descriptive, crossover study of the medicines contained in our ADS. SETTING: Raval-Sud Basic Health District, Barcelona. MEASUREMENTS AND MAIN RESULTS: The indicator was designed and its categories determined through the interaction of the following variables for each medicine: its most usual indication, length of treatment, intrinsic value and the theoretical source of prescription. Then all the medicines included in the ADS were codified and analysed with a computer program. The 728 analysed were classified in 8 different categories: those for acute pathology (32%), for subacute or acute pathology requiring long-term treatment (potentially chronic indication) (9%), for chronic pathology controlled at the primary care level (22%), for chronic pathology controlled in the hospital context (12%), for mental pathology (8%), for chronic pathology well controlled but with a low intrinsic value (3%), medicines of low intrinsic value for chronic pathology (degenerative pathology) without recognised pharmacological alternatives which the family doctor or specialist can prescribe (14%). CONCLUSIONS: If medicines were better defined and codified, the proposed indicator would facilitate rapid discrimination of different groups of drugs' suitability or otherwise for ADS.

Acute Disease↗
PubMed1991

[Intervention to improve the quality of continuing drug prescription at a primary care center].

An evaluation study has been done on the quality of long-term drugs prescription. The aim was to check the effectiveness of certain corrective measures agreed by the professionals working in a primary care centre. Using the results of a first evaluation made in 1989, a series of recommendations were made to reduce the prescription of drugs with a low intrinsic value (LIV). A further evaluation took place 9 months later. A relative reduction of 20.2% in LIV drugs was obtained. This represented a reduction from 25% to 20.8% of the total number of prescriptions. In the relevant pharmacological subgroups a reduction of 77.9% in the prescription of nitrites linked to barbiturites was obtained; of 60% in LIV antacids; of 50.3% in antivaricose drugs; of 36.1% in LIV laxatives; and of 30.1% in Dipiridamol. There was no improvement in the prescription of external LIVs nor cerebral vasodilators. It is concluded that the intervention has proved its usefulness in the improvement of long-term drugs prescription.

Ambulatory Care Facilities↗
PubMed1990

[Thyrotropic hormone in an adult population seeking care at a primary health care center].

In a study of the need for detecting subclinical hypothyroidism in a population aged 60-80 years, the measurement of thyrotropin with the immunofluorometric technique in 446 individuals seeking attention identified 58 with high TSH (greater than 4 microU/ml); only 33 of these were evaluated in a specialized endocrinological unit. The abnormality was confirmed by radioimmunometric technique in 19 patients (4%), and in the remaining 14 individuals disease was ruled out. The prevalence in this group of individuals is comparable to that found in other studies which recommend screening for subclinical hypothyroidism, but the requirement for the implementation of such a screening program in our area should be carefully evaluated before it could be recommended.

Aged↗
PubMed1990

[The indicators of the quality of the prescription for chronic pathologies].

To assess the qualitative characteristics of the prescription for chronic diseases and to select the most appropriate quality indicator, we evaluated 1588 drugs recorded in 549 forms for chronic prescription. 64.9% of the drugs were included in the Index Farmacològic, and the same rate in the Essential Drugs list of the WHO, 73.4% had a high intrinsic value (IV) and 80.7% were monocomponents. The male patients received more drugs included in the WHO list and with high IV, while patients older than age 65 years received more drugs with absent or unacceptable IV. A higher quality in the four indicators was found in the prescriptions from the CAP physicians than in those from specialists. The drug preparations with a not high IV more commonly prescribed belonged to the categories of cerebral and peripheral vascular therapy (16.2%), antacids and antiflatulents (9.3%), oral antidiabetics (8.4%), and antivaricose and antihemorrhoidal drugs (8.4%). It is concluded that the intrinsic value in the most adequate quality indicator for the prescription studies in primary care.

Age Factors↗
PubMed1990

[Multiple sclerosis. A primary care approach].

We report five cases of multiple sclerosis (MS), diagnosed in the population cared for in a primary care center. We assess the different forms of presentation and outcome, making practical suggestions for the diagnosis and follow up in a primary care setting.

Adolescent↗
PubMed1990

[Amoxicillin/clavulanic acid and trimethoprim in the treatment of urinary infection in primary care].

The effectiveness of amoxicillin/clavulanic acid (A/Cl) and trimetoprim (TMP) were compared in two different schedules: 10 days treatment and monodose, in 80 patients with, urinary tract infection (UTI) demonstrated by urine culture. The patients over 65 years, the males and those with underlying risk conditions randomly received A/Cl or TMP during 10 days. The rates of cure were 76.9% for A/Cl and 73.9% for TMP. The difference was not significant. Thirty-one patients without those features randomly received a short A/Cl course or a single dose of TMP. The rates of cure were 92.8% for A/Cl and 58.8% for TMP. The difference was statistically significant. It was concluded that, in our patients, complicated lower UTI have a similar response rate to a ten days course of A/Cl or TMP, whereas A/Cl for three days is more effective than a single TMP dose to treat noncomplicated lower UTI.

Amoxicillin↗