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Biomedical subjects

J M Antó

Publications and source records attributed to J M Antó.

17 recordsLinked to original sources
PubMed1992

Epidemiology of prostatic disorders in the city of Barcelona.

Although disorders of the prostate are among the most prevalent problems in elderly males, little is known about their epidemiological characteristics. The 1986 Barcelona Health Interview Survey (BHIS), a cross-sectional study of a random sample of the noninstitutionalized population of the city, was used to estimate the prevalence of prostatic disorders (PD) and to analyse sociodemographic characteristics, self-perceived health, and use of health services among males reporting PD. Ninety-eight out of 1218 males over 45 years old (8%) reported having PD, the prevalence increasing substantially with age. A pattern of increasing prevalence with decreasing occupational class was found. As compared to subjects not reporting PD, individuals reporting PD reported slightly more restricted activity days (prevalence odds ratio [POR] = 1.28; 95% confidence interval [CI]: 0.52-2.80), more chronic disorders (POR = 4.75; 95% CI: 2.04-13.53), and worse self-perceived health (POR = 1.55; 95% CI: 0.92-2.58). Medical visits and hospitalizations were also higher in the prostatic group (P < 0.05). Men reporting PD appear to constitute a subgroup with increased morbidity and health services use.

Age Factors↗
PubMed1992

Measurement of general health status of non-oxygen-dependent chronic obstructive pulmonary disease patients.

Chronic obstructive pulmonary disease is a prevalent condition causing a high level of disability, and it is one of the leading causes of death. To assess the general health status of moderate to severe Chronic obstructive pulmonary disease patients, we studied 76 male patients attending an outpatient hospital clinic who were not dependent on oxygen and who did not present bronchial obstruction reversibility. We assessed clinical status (dyspnea, six-minute walking distance) and functional respiratory impairment (spirometry, and blood gas analysis) of the patients and also asked them to respond to the Spanish version of the Nottingham Health Profile, a multi-dimensional generic health status measure. Patients scored especially higher than the general population (denoting more level of distress) in energy, physical mobility and sleep Nottingham Health Profile dimensions. The former two dimensions scores had a high correlation with dyspnea (respectively Spearman Rs = 0.60, and Rs = 0.64; P less than 0.01). High levels of sleep disturbances were found for patients reporting low or very low dyspnea level. Health status measurement (Nottingham Health Profile dimension scores) and functional respiratory impairment were not correlated. Results underscore the importance of measuring symptoms carefully when assessing these patients, whose health status is substantially affected by the Chronic obstructive pulmonary disease. They also suggest that it is relevant to assess sleep disturbances in these patients.

Activities of Daily Living↗
PubMed1992

Risk factors of soybean epidemic asthma. The role of smoking and atopy.

Epidemics of emergency room admissions for asthma occurring in Barcelona during the period 1981 to 1987 were caused by inhalation of soybean dust. To investigate the risk factors that determined why some asthma patients became reactive to soybean and were consequently affected by the asthma epidemics of Barcelona but others did not do so, a case-control study was conducted during 1989, 2 yr after the cessation of asthma epidemics. Patients with asthma admitted in emergency room services during epidemic asthma days (n = 169) were compared with asthma patients admitted in the same services during nonepidemic days and who were never admitted during the epidemics (n = 147). Risk factors other than soybean exposure, namely skin reactivity against at least one common allergen (odds ratio [OR] 3.0, 1.7 to 5.3), age over 64 yr (OR 2.8, 1.4 to 6.0), cigarette smoking at the time of the epidemics (OR 2.3, 1.2 to 2.4), past smoking (OR 1.8, 0.9 to 3.7), and total immunoglobulin E (IgE) higher than 100 IU/ml (OR 1.7, 1.0 to 3.0), were found independently related to epidemic asthma. The role of smoking was especially important for those who had a positive skin reaction and were exposed to soybean dust (OR 7.9, 1.8 to 36.0). In this group, a dose-response pattern with pack-years was observed (p less than 0.01). The present findings suggest a multifactorial process for epidemic asthma, in which atopy and cigarette smoking played an important synergistic role. This has a preventive potential for IgE-related asthma.

Asthma↗
PubMed1991

Effects of urban air pollution on emergency room admissions for chronic obstructive pulmonary disease.

The authors assessed the relation between sulfur dioxide and other air pollutants (black smoke, carbon monoxide, nitrogen dioxide, and ozone) and daily emergency room admissions for chronic obstructive pulmonary disease in Barcelona, Spain, during 1985-1986. Barcelona is a Mediterranean city of 1.7 million inhabitants that has air pollution levels lower than standard values. A weak but statistically significant association between emergency room admissions and levels of sulfur dioxide, black smoke, and carbon monoxide was observed. Daily emergency room admissions for chronic obstructive pulmonary disease increased by 0.02 and 0.01 for each microgram of sulfur dioxide and black smoke per cubic meter, respectively, and 0.11 for each milligram of carbon monoxide per cubic meter, after adjusting for meteorologic and temporal variables. Similar estimations were obtained after controlling for the autocorrelation effect by means of time series analysis. In addition, when the data were stratified by season, the effects remained in summer. This strengthened the conclusion that the relation observed in winter, spring, and throughout the study period was indeed real. After truncating the data according to sulfur dioxide or black smoke levels, the authors still found effects for these pollutants at levels below the air quality guideline of 100 micrograms/m3 established by the World Health Organization. The consistency of these results with other recent toxicologic and epidemiologic observations suggest that current air pollution standards do not totally protect public health with a margin of safety in specific places.

Air Pollutants↗
PubMed1991

Comparison of perceived health status and conventional functional evaluation in stable patients with coronary artery disease.

A cross-sectional study of stable coronary hospital patients was carried out to compare perceived health assessment with conventional clinical measures; 93 consecutive patients were studied, 45 of whom had undergone bypass surgery. Exercise tests and clinical functional classification were obtained together with blind concurrent self-responses to the Nottingham Health Profile (NHP), a measure of distress. Coronary arteriography was available for all patients. Patients with negative exercise tests had lower NHP scores (lower levels of distress) than those with positive or inconclusive tests, especially in the energy, pain and physical mobility NHP dimensions (p less than 0.01). High Spearman correlation coefficients were found between exercise performance and energy (rs = -0.51) and pain (rs = -0.36) scores. This correlation was closer than that found with clinical functional class. In these patients, exercise performance closely correlated with perceived distress. Self-perceived health status measures may improve the evaluation of coronary patients based on clinical assessment alone.

Adult↗
PubMed1991

Epidemiological surveillance of opioid-related episodes in an emergency room of Barcelona, Spain (1979-1989)

In the early 80's opioid addiction was a low prevalence problem in Spain, grew enormously during that decade and became the most important risk factor for AIDS in recent years. The limitations of assessing the prevalence of illegal drug use by means of standard epidemiological methods lead, worldwide, to the use of indirect indicators. A Register of Toxicological Emergencies, developed for research purposes and containing data from 1979 to 1989 at the Hospital del Mar (Barcelona) is described. Results for opioid-related emergencies are presented, showing an epidemic increase in the number of such emergencies after 1981. The total number of opioid-related emergencies was 18,042 with a mean of 2.23 opioid-related emergency admissions per client throughout the whole period, implying that some 8000 persons were seen. In episodes from non-arrestees, mean age increased slightly over time, the male/female ratio being 2.5; withdrawal was the more frequent reason for attendance (53%), overdose accounting for 9% of admissions, and other medical conditions for 33%. Non-arrested women were more likely to attend for other medical conditions and overdoses than men. The importance of this kind of register as well as its limitations for assessing the trend of opioid use prevalence is discussed.

Adolescent↗
PubMed1990

Characteristics of patients with soybean dust-induced acute severe asthma requiring mechanical ventilation.

Patients presenting with acute severe asthma during the Barcelona's outbreaks caused by soybean dust inhalation from August, 1981, through September, 1987, characteristically showed an abrupt severe onset of each attack followed by a rapid relief of symptoms after treatment. To throw further light on clinical findings, pathophysiology and outcome in the most life-threatening episodes, we reviewed records of acute severe asthma patients treated by mechanical ventilation in one of the four main hospitals of the city. Twelve such patients (15 episodes) were compared to 24 non-epidemic asthmatic patients (25 episodes) also treated by mechanical ventilation in the same institution during the same period of time. There was a male predominance during outbreaks (p less than 0.03) and epidemic patients were ventilated fewer hours (12 +/- 8 h) (mean +/- SD), admitted fewer days to intensive care (1.6 +/- 0.7 days), and hospitalized fewer days (7.1 +/- 4.4 days) than non-epidemic patients (65 +/- 84 h, 4.6 +/- 3.8 days (p less than 0.001, each), and 16.0 +/- 13.2 days (p less than 0.004), respectively). These differences together with both the fulminant presentation of the episodes of epidemic asthma and the point-source origin of the asthma outbreaks previously shown are consistent with the unusual nature of the aetiologic agent, soybean dust.

Acute Disease↗
PubMed1989

Community outbreaks of asthma associated with inhalation of soybean dust. Toxicoepidemiological Committee.

Since 1981, 26 outbreaks of asthma have been detected in the city of Barcelona. The geographic clustering of cases close to the harbor led us to consider the harbor as the probable source of the outbreaks. We therefore studied the association between the unloading of 26 products from ships in the harbor and outbreaks of asthma in 1985 and 1986. All 13 asthma-epidemic days in these two years coincided with the unloading of soybeans (lower 95 percent confidence limit of the risk ratio, 7.2). Of the remaining 25 products, only the unloading of wheat was related to the epidemics of asthma, although when adjusted for the unloading of soybeans the relation was not statistically significant. High-pressure areas and mild southeasterly to southwesterly winds, which favored the movement of air from the harbor to the city, were registered on all epidemic days. Particles of starch and episperm cells that were recovered from air samplers placed in the city had morphologic characteristics identical to those of soybean particles. Furthermore, the lack of bag filters at the top of one of the harbor silos into which soybeans were unloaded allowed the release of soybean dust into the air. We conclude that these outbreaks of asthma in Barcelona were caused by the inhalation of soybean dust released during the unloading of soybeans at the city harbor.

Asthma↗
PubMed1989

Case-control study of serum immunoglobulin-E antibodies reactive with soybean in epidemic asthma.

Since 1981, twenty-six asthma outbreaks have been identified in Barcelona, all coinciding with the unloading of soybean in the harbour. Serum from patients with epidemic asthma and individually matched controls with non-epidemic asthma was assayed for immunoglobulin-E (IgE) antibodies against soybean antigens by means of a radioallergosorbent test. In 64 of 86 cases (74.4%) there was a reaction with commercial soybean antigen extracts, compared with only 4 of the 86 controls (4.6%) (odds ratio = 61; lower 95% confidence limit = 8.1). The statistical significance was greater for reactions with extracts of soybean dust taken from Barcelona harbour (odds ratio, unquantifiably high; lower 95% confidence limit = 11.7). No other serological covariate (total serum IgE levels or specific IgE levels against the commonest airborne allergens or legumes) confounded the association between serum anti-soybean IgE antibodies and epidemic asthma. These results support a causal relation between the release of dust during unloading of soybean at the harbour and the occurrence of asthma outbreaks, suggesting an underlying allergic mechanism.

Antibodies↗
PubMed1986

A point-source asthma outbreak.

Epidemiological data for the eighth asthma epidemic in Barcelona were available from the whole city. They reveal a striking space clustering, an hour-time clustering, and simultaneous time and space clustering, which indicate that the outbreak was a point-source epidemic. Air pollution by smoke and oxides of sulphur and nitrogen was unlikely to have been the cause of the epidemic, as was an unusual level of pollen or fungal spores. The industrial area adjacent to the neighbourhood in which the epidemic occurred was a probable source of the cause of the outbreak.

Acute Disease↗
PubMedDate not supplied

[Perceived health and functional capacity of a non-institutionalized elderly population in Barcelona].

In order to explore the perceived health and functional capacity in the elderly, a cross-sectional study was undertaken in a representative sample of the non-institutionalized population aged 65 and over, resident in Barcelona (N = 1,288), and included in the 2nd Health Interview Survey. Sociodemographic information was collected, as well as perceived morbidity, sensorial problems and functional capacity (measured by the activities of daily living [ADL]). Some 60.3% of the elderly reported having "good" or "very good" health, and 56% reported being able to do all ADL without difficulties. Women in general reported a worse perceived health and a higher chronic limitation in each age group (p = 0.001). Age was not significantly associated with perceived health, but was...associated with disability (ADL) (p = 0.001). Variables with a stronger association with "poor", "bad" o "very bad" perceived health were: comorbidity (OR = 3.69 IC 95% = 2.60-5.25), restricted activity (OR = 3.25 IC 95% = 1.86-5.66) and incapacity in any of the basic ADL (OR = 2.15 IC 95% = 1.38-3.36). The elderly who were dependent in any of the basic ADL were more frequently female, 75 or more years old, and in 10.5% of the cases did not receive any personal help. The present study gives a general description of the health status and functional capacity of the elderly and identifies a group of old people with unmet basic care needs.

Activities of Daily Living↗