Biomedical subjects

J Giaconi

Publications and source records attributed to J Giaconi.

11 recordsLinked to original sources

PubMed2003

[Community perception on the quality of public health services delivery in the Norte and Ichilo districts of Bolivia].

The current study identifies the people perception on the quality of public health services in Norte and Ichilo health districts (Bolivia), with a particular emphasis on the relationship between heath workers and patients. Both qualitative and quantitative methods were utilised such as: survey, focus groups, participatory observation, unstructured interviews to Key informants and open discussions with the community. Results show that the public health services reputation is affected by elements as discriminatory attitude towards people belonging to a low socio-economic strata, lack of communication between health workers and patients, perceived insufficient technical skills and recognition of a low therapeutic efficacy. The people who are coming from highlands (collas) appear as the most disappointed by the health service provision structured on the western predominant pattern with a top-bottom approach ignoring its potential users' expectations and needs. A low capability of the public health services to accept and recognise the inter-cultural features of the region, makes that the challenge to be undertaken by the district health personnel should focus on the establishment of intercultural bridges between the public health service providers and the potential patients, as well as among the different co-existing medical systems.

English Abstract↗

PubMed1996

International comparison of hip fracture rates in 1988-89.

A comparison of hip fracture rates among nine countries (Canada, Chile, Finland, Hong Kong, Scotland, Sweden, Switzerland, the United States and Venezuela) was made using national hospital discharge data for the same time interval. The rates increased by age and were higher for females than males in all nine countries. When based on overall discharge rates, the incidence of hip fracture appeared high in three European countries (Finland, Scotland and Sweden) relative to the other countries. However, when transfer cases were removed and adjustments made for differences in case definition, the risk of hip fracture for both men and women was much similar among the four European and two North American countries, but higher than in Hong Kong. Rates of fracture were lowest in Venezuela and Chile, varying from three to 11 times less than for residents of the other seven countries. Although there are limitations in using hospital discharge data as a measure of incidence, the wide variation in the risk of hip fracture across the nine countries appears real but differences between North American and north European countries may not be as great as previously reported. Such cross-national comparisons may help clarify different etiologic hypotheses.

Age Factors↗

PubMed1996

[Hip fracture: a case-control study in the metropolitan region I].

BACKGROUND: Hip fracture is a preventable cause of disability among elderly people AIM: To study factors associated to hip fractures in Chile. PATIENTS AND METHODS: Patients admitted to seven public hospitals in Chile, with hip fracture not due to major accidents, were considered as cases. To each, at least one age and sex matched hospitalized control, without or neoplastic diseases, was assigned. All patients were subjected to an inquiry, using an instrument devised by the WHO. RESULTS: Two hundred sixty eight cases and 501 controls were studied. Cases and controls has similar educational and labor histories. The right hip was fractures in 47% of cases and the left in the rest. Compared with controls, cases had a higher body mass index, loss of height during life, rate of hysterectomy, incidence of smoking and a lower consumption of diary products. Cases had higher risk of falls inside their homes and controls outside. CONCLUSIONS: The obtained information may contribute to the development of preventive measures and reduce the public health impact of hip fracture.

Aged↗

PubMed1994

Time course of direct cardiotoxic effects of high cocaine concentration in isolated rabbit heart.

Studies of acute cocaine cardiotoxicity are often confounded by the effects of cocaine on peripheral hemodynamics and an intact sympathetic nervous system. To study the direct effects of an acute dose of cocaine on heart, we used Langendorff-perfused isolated rabbit hearts. The hearts were attached to a Langendorff perfusion system through the aorta and were perfused with Krebs-Henseleit buffer. In nonpaced hearts, cocaine in concentrations of 10, 25, and 50 microM (reported to be in the range of drug concentrations lethal for humans) caused dose-dependent deterioration in heart contractility (decrease in +dP/dt, -dP/dt, and developed pressure) and coronary flow, when measured at 10, 20, and 30 min of the protocol. Cocaine 25 and 50 microM also caused a decrease in heart rate (HR). In paced hearts treated with cocaine 50 microM, early events included a progressive decrease in +dP/dt (by 15% vs. baseline at 20 s of perfusion and by 26% vs. baseline and 19% vs. control group at 30 s of perfusion; p < 0.05) and in -dP/dt (by 20% vs. baseline at 30 s of perfusion and by 25% vs. baseline and 15% vs. control group at 40 s of perfusion, p < 0.05). Decrease in HR (failure to pace) was observed only at 60 s of perfusion and averaged 20% versus both baseline and control group (p < 0.05). No changes in coronary flow were observed during the first 60 s after onset of cocaine administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

[Ideas contributing to the reform of the health sector in Chile].

General criteria are proposed for the organization of chilean health system. The fundamental ideas emphasize administrative decentralization, an effective and expedite intercommunication between different attention levels and a rationalization of the use of diagnostic procedures and treatments. The "basic health plan" features are outlined. The need for patient and family education and the access to tertiary medicine only through referrals is highlighted. The second part of article proposes changes in Medical Education. The need to reorient undergraduate medical formation towards solving outpatient problems and to extend specialization possibilities to all graduates, including Adult and Children general medicine training programs, is emphasized. The incorporation of basic economical concepts to the curriculum and group work training is considered beneficial. Finally, self-teaching behaviors and resolutive capacities in legal and ethical aspects should be encouraged in students. The potential teaching roles of future health reference, diagnostic and therapeutic centers is insinuated.

Adolescent↗

PubMed1993

The association of height, weight, menstrual and reproductive events with breast cancer: results from two prospective studies on the island of Guernsey (United Kingdom).

The association with breast cancer of menstrual and reproductive events, family history of breast cancer, and body size have been studied on two cohorts of 6,706 volunteers on the island of Guernsey (United Kingdom), 168 of whom had breast cancer detected during follow-up. The median follow-up time of the non-cases was 21 years in the first study and 10 years in the second. A time-dependent Cox regression model was fitted to the data with age as the time-dependent variable in order to represent the effect of changing menopausal status. Other variables examined in the model were age at menarche, parity, age at first birth, family history of breast cancer, height, weight (both directly measured), relative weight (weight [kg]/height[m]), and Quetelet's body mass index (weight[kg]/height[m]2). Interactions between age and all other covariates also were examined. Family history was found to be the most important risk factor for women aged less than 51 years (relative risk [RR] = 3.5, 95 percent confidence interval [CI] = 2.0-6.0), and intervals between menarche and first birth longer than 14 years were found to increase significantly the risk of breast cancer in women older than 61 years (RR = 2.4, CI = 1.3-4.4). Height was the only indicator of body size which was associated significantly with risk of breast cancer, the estimated regression coefficient indicating an increase in risk of about 70 percent for women on the 90th centile of height relative to those on the 10th centile. A survey of the literature showed that the association between risk of breast cancer and height was found in those studies which used direct measurements of height but not in others which used self-reported values.

Age Factors↗

PubMed1974