Biomedical subjects
J Espinàs
Publications and source records attributed to J Espinàs.
[Therapeutic guide to primary care based on the evidence, 2nd edition: an honest and practical work].
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[CUIDA'L: a clinical trial evaluating the effectiveness of an intervention in care givers].
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[A reasoned approach to the pharmacologic treatment of Alzheimer's disease].
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[Quality indicators in diabetes mellitus].
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[A re-evaluation of the program for diabetes mellitus type 2. A proposal for quality indices].
OBJECTIVE: To find out how accurate our records are and the state of health of the patients with diabetes mellitus type II (DM) in our Base Health Area (BHA) in Osona county (Barcelona), both before and after introducing a new procedure. DESIGN: Quality control study based on the medical records (PCMR) of DM patients. The evaluation took place between 1.1.90 and 31.12.90; and the re-evaluation between 1.1.91 and 31.12.91, after the DM procedure had been put in place as a corrective measure. PATIENTS: 198 patients: all of those suffering from DM type II. MAIN MEASUREMENTS AND RESULTS: 110 women and 88 men, with an average age of 65.4 +/- 11.9, were under study. We observed from the records of attendance that 94.4% were or had been smokers, whereas the question of the eye fundus was only mentioned in 36.8%. The introduction of a procedure has improved the records in almost every parameter. In 1991, 36.8% of the patients had normal-weight criteria, 33.3% had good biochemical control and 15.6% fulfilled both these criteria. CONCLUSIONS: Those tests which could be performed with few instruments were carried out much better than those which needed more complex technology or specialist support. Arising from this study, the authors propose four indicators of quality control: 1) Weight normality. 2) Annual plasmatic fructosamine. 3) Annual eye fundus check. 4) Annual proteinuria check.
[Full moon: more work at the delivery rooms?].
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[Expenses generated by 4 patients with tetanus in the Tarragona province and economic possibilities in regard to prevention].
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[Cost analysis and degree of hypercholesterolemia control in type 2 diabetic patients according to different groups and scientific societies].
OBJECTIVES: To analyse the cost and describe the degree of control of the hypercholesterolaemia of type-2 diabetic (DM2) patients according to different groups and scientific societies. DESIGN: Retrospective cross-sectional study. SETTING: Rural health area. PATIENTS: All DM2 patients monitored in the health area (n = 338). MEASUREMENTS AND MAIN RESULTS: Gathering of data on clinical histories, determination of cardiovascular risk, LDL-C concentration and total/HDL cholesterol index. DM2 prevalence was 3.08%; annual incidence, 2.55/1000; 45.2% presented hypercholesterolaemia; 16.9% received lipid-lowering treatment; and 20.1% (n = 68) had DM2 with cardiovascular disease. According to the criteria of the GEDAPS-99, European Consensus-98 (Framingham table), Sheffield Group (objectives of the European Consensus-98) and PAPPS-99 for primary prevention, 59.3%, 58.4%, 24.5% and 17.7%, respectively, of hypercholesterolaemic patients were poorly controlled. The percentages of hypercholesterolaemic patients who in each case should receive treatment were: 64.9%, 66.1%, 36.4% and 29.6%. Expenditure in thousands of pesetas every 28 days to achieve proper control of these patients was 282, 423, 274 and 117. The criteria on secondary prevention of the GEDAPS-99 and European Consensus-98 gave figures of 81% and 72.4%, respectively, of poor control of Hypercholesterolaemia. 82.7% and 77.5% of these patients should receive treatment. Expenditure in thousands of pesetas every 28 days to achieve proper control of these patients was 342 and 210. CONCLUSIONS: The degree of control and the costs of hypercholesterolaemia in both primary and secondary prevention vary enormously, depending on the criterion used by the group or scientific society.
[A study of the prevalence of alcohol consumption in the Baix Ebre region (Tarragona)].
A cross-sectional study was carried out in the Baix Ebre region about the prevalence of alcohol use, within a wider study of hypertension and other risk factors. The following characteristics were considered for the elaboration of the present study: non drinker, moderate drinker and heavy drinker, as well as the amount of alcohol intake related with demographic, socioeconomical and cultural variables such as: age, sex, urban or rural medium, marital status, place of origin, working status, social and professional level, and educational status. 64.2% of the whole population greater than or equal to 20 years were usual alcohol users, and so were 79.4% of males and 48.2% of females. According to the definition of heavy or excessive drinker, such were 21.8% of males and 2.6% of females. Males drank a higher alcohol amount, with a mean and standard deviation of 47.1 +/- 35.5. In females, these figures were 19.4 +/- 12.4 g per day. The rate of alcohol drinkers was higher in young individuals, in those with active working status, in those with medium social and professional level, and in those with medium and high educational status.