PubMed Health⌕ Search

Biomedical subjects

J Díez Manglano

Publications and source records attributed to J Díez Manglano.

11 recordsLinked to original sources
PubMed2005

[Congestive heart failure in Spain: cost-effectiveness and cost-benefit analyses of treatment with beta-blockers].

OBJECTIVE: Beta-blockers (BB) have proven to be effective in the treatment of congestive heart failure (CHF). This study is an economic analysis for the addition of BB to standard treatment of CHF. PATIENTS AND METHOD: Randomized, double-blinded controlled studies are included, with 1,647 patients treated with bisoprolol, 3,034 treated with carvedilol, 2,432 treated with metoprolol, and 6,807 treated with placebo. Direct costs of BB treatment and of every hospitalization episode are assessed. Cost-effectiveness is assessed as cost in euros by prevented death, and cost-benefit as the difference between hospitalization costs and BB costs. The study is conducted from the perspective of a third-party payer. RESULTS: Two studies with bisoprolol, six with carvedilol, and five with metoprolol are included, with an average follow-up of 13.5 months. Carvedilol prevents 5.07% of deaths per year of treatment and is more effective than bisoprolol (3.82% of avoided deaths) and metoprolol (3.03%). Cost-effectiveness ratio (cost for every prevented death and year) was 10,832 euros for bisoprolol, 17,516 euros for carvedilol and 16,664 euros for metoprolol. Incremental cost-effectiveness ratio for carvedilol ranges between 12,631 euros and 86,610 euros for life saved. All BB generate costs saving for hospitalization but only bisoprolol provides a net profit. Benefit-cost index is 1.13 for bisoprolol, 0.26 for carvedilol and 0.59 for metoprolol. CONCLUSIONS: Use of BB in the treatment of CHF is an effective and cost-effective alternative. Carvedilol is the most effective alternative, and bisoprolol the most cost-effective alternative and the drug with greater benefit-cost index.

Adrenergic beta-Antagonists↗
PubMed1994

[Preferences in the use of antihypertensives among resident physicians].

OBJECTIVE: To find the preference of interns working in our area for different anti-hypertension drugs. DESIGN: Crossover study. SETTING: A tertiary hospital in Zaragoza's Health Area III. PARTICIPANTS: 60 interns selected by stratified random sampling. INTERVENTIONS: A written questionnaire administered individually during the second term of 1991. RESULTS: The anti-hypertension drugs favored by the interns for elderly people were: the IECA group (21 interns, 35%; CI: 24-47%), the ACa (21 interns, 35%; CI: 24-47%) and diuretics (17 interns, 28%; CI: 18-40%). In pregnancy, hydrallazine (25 interns, 41%; CI: 30-54%) and alphamethyldopa (9 interns, 15%; IC: 8-26%) were favored; for diabetics, the IECA (25 interns, 58%; IC: 45-70%); for hyperlipaemics, the IECA (24 interns, 40%; IC: 28-52%) and the ACa (18 interns, 30%; CI: 19-42%); for patients with LCFA, the IECA (21 interns, 35%; CI: 24-47%); and for those with ischaemic cardiopathy, the ACa (31 interns, 51%; CI: 39-64%). CONCLUSIONS: Interns use anti-hypertension drugs in line with what is described in the literature. With the exceptions of AHT associated with pregnancy and ischaemic cardiopathy, they follow the recommendations of the Accord for the Control of AHT in Spain.

Adult↗
PubMed1992

[Medulloblastoma in the adult: presentation of a new case].

A case of hemispheric medulloblastoma of cerebellum in a 22 male patient is presented. The patient complained of headache and an intracranial hypertension syndrome progressively appeared. Diagnosis was established by CT scan. Treatment consisted of radical surgery associated to radiotherapy and chemotherapy. Present survival with this treatment is 4 years being the patient asymptomatic and without signs of relapse.

Adult↗
PubMed1991

[Myocardial sarcoidosis treated with implantable defibrillator].

We describe the case of a 33 year old diabetic patient with systemic sarcoidosis who, prior to this, had episodes of myocardiac alterations such as ventricular tachycardia, which partially improved with steroid therapy. She eventually needed a defibrillator-pacemaker implant which serves to reduce the high risk of sudden death in this type of patient. The myocardiac biopsy did not show granuloma. The diagnosis, prognosis and treatment of cardiac sarcoidosis are commented on, as well as its association to diabetes mellitus, such as in this case.

Adult↗
PubMed1991

[Primary lymphoma of the central nervous system].

Primary lymphoma of the central nervous system (PL-CNS) is a tumor the incidence of which has increased in the last ten years and is frequently associated to immunosuppressed states. It is a non-Hodgkin lymphoma, usually diffuse and of type B. The clinical presentation form is nonspecific and for its diagnosis CT scan data are usefull although it is necessary to confirm this diagnosis with a biopsy. Treatment consists on holocranial radiotherapy associated to chemotherapy. Prognosis is obscure since local relapses are very frequent although its extension to other sites outside the CNS is rare.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Mixed cryoglobulinemia secondary to Mediterranean boutonneuse fever].

A clinical case of Mediterranean Boutonneuse Fever (MBF) with circulating cryoglobulins during the acute phase, with no clinical symptoms is described and considered an epiphenomenon of the infection. The possible relationship between the infection and the cryoglobulinemia are discussed. The patient is also added to the increasing list of patients reported of Boutonneuse Fever in the Mediterranean area during the observation period.

Aged↗
PubMedDate not supplied

[Medical residents' attitudes to the diagnosis and treatment of arterial hypertension].

OBJECTIVE: To find the attitude of Residential Interns (RI) to the diagnosis and initiation of treatment for Arterial Hypertension (AH). DESIGN: Crossover study. SETTING: Tertiary hospital in Zaragoza's Health Area III. PARTICIPANTS: 60 RIs selected by means of stratified random sampling. An open-reply questionnaire administered in writing on an individual basis during the second term of 1991. RESULTS: 28% of RIs (17 RIs) used the figures 140/90 mmHg to diagnosis AHT. 70% (42 RIs) made three measurements before making a diagnosis. 13% (8 RIs) took therapeutic measures when systolic pressure (SP) was above 140 mmHg and 30% (18 RIs) when the figures were above 160 mmHg. Diastolic pressure (DP) above 90 mmHg was a signal that treatment was needed for 43% (26 RIs); and figures above 95 mmHg for 31% (19 RIs). There were no differences for the doctor's age, gender, specialty, year of graduation or year of residency. CONCLUSIONS: The RIs used figures recommended by bodies such as the WHO or the Spanish Society for the Fight against AHT, to diagnose AHT. They made the diagnosis after three measurements. They started treatment, which is usually hygiene-dietetic measures to begin with, according to the DP.

Humans↗