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Biomedical subjects

J M Martín Moreno

Publications and source records attributed to J M Martín Moreno.

At least 19 recordsLinked to original sources
PubMed1999

[The 4 Provinces Study: its principal objectives and design. The Researchers of the 4 Provinces Study].

INTRODUCTION AND OBJECTIVES: Spain shows an important variation in the geographical distribution of ischaemic heart disease and cerebrovascular disease mortality. In this article, the primary objectives and design of the Four Provinces study are described. In this study we analyzed the contribution of environmental factors (diet, lipid profile and plasma antioxidants), acting in childhood, to explain differences in cardiovascular mortality rates between different provinces in Spain. METHODS: An ecological design was projected in which the units to study were four Spanish provinces with a wide variation in cardiovascular mortality in adulthood. The design compares diet, anthropometric variables and biological markers (particularly plasma lipids and antioxidant levels) in 6-7-year-old children, between the two provinces with the highest cardiovascular mortality rates and the two provinces with the lowest. The information for each province is collected in a cross-sectional manner in a representative sample of children from each province. DISCUSSION: Evidence from the literature concerning Northern European countries suggest the contribution of environmental factors during early age in the development of cardiovascular disease in adulthood. The "Four Provinces" study will provide, for the first time, information about the influence of factors in early childhood of cardiovascular risk in a Mediterranean country. The study will also offer interesting data about food intake during school age in four provinces and it will allow us to estimate values of population of the variables of interest in those provinces.

Antioxidants↗
PubMed1999

[Towards evidence-based public health?].

Evidence-based public health can be viewed as a way of facing community health problems by which the decisions are taken accordingly to the available evidence. A complete multidisciplinary approach should be introduced, with the goal of identifying and articulating the different dimensions which are present when trying to respond to the challenges or problems for the people's health. In addition to clinical medicine, disciplines such as epidemiology, biostatistics, health services research, economics, behavioural sciences, demography, nutrition, gerontology or computing sciences, among others, may contribute to health promotion and disease prevention. This open approach should not be exempt of a captious attitude toward the obtainable information, while it is essential to have a comprehensive spirit to combine this information with the previous experience and the peculiarities of each situation. Searching for evidence begins with a clear operational statement of the problem. This helps to select and obtain the key pieces of information. The information obtained must be judged critically, and related to the specifics of the problem. Lastly, it should be accepted that search for evidence does not mean finding certitude. Idolizing evidence can end up being as inappropriate as the implementation of a health program ignoring the previous information about its potential effectiveness, if such information were available. Many decisions in public health have to be taken conscious that scientific evidence does not rule out uncertainty, as other elements such as the cultural context, the individual preferences and other social factors may have a decisive influence in the success or failure of public health interventions.

Bacterial Vaccines↗
PubMed1997

[Trends in the mortality attributable to tobacco use in Spain, 1978-1992: 600,000 deaths in 15 years].

BACKGROUND: The main objective is to describe time trends and evolution of mortality attributable to tobacco use in Spain in the period 1978-1992. MATERIAL AND METHODS: Spanish pevalences for never smokers, current smokers and former smokers estimated from national health surveys, and relative risks for death attributed to tobacco use from the Cancer Prevention Study II were used. The proportion and number of deaths attributed to tobacco use in the Spanish population of 35 years and over have been calculated by cause of death, sex and age. The trend in mortality attributable to tobacco use over the period 1978-1992 has also been calculated, expressed as the mean percentage change per year in the standardised mortality rates, estimated by a log-lineal model. RESULTS: Tobacco consumption caused 46,226 deaths in Spain in 1992. Most of them occurred in males (93.4%). One of every 4 deaths in males, and one of every 50 in females were attributable to tobacco consumption. One third of the deaths attributed to tobacco use were premature deaths (under 65 years). Lung cancer, chronic obstructive pulmonary disease, ischemic heart disease and cerebrovascular disease caused 75% of deaths attributed to tobacco use. Lung cancer was the first specific cause in males, and chronic obstructive pulmonary disease was the main cause in females. A total of 621,678 deaths attributed to tobacco consumption were produced in the period (1978-1992). The main percentage change per year in the mortality rates shows a moderate increment of 0.1% (-0.2% in males +6.7% in females). CONCLUSIONS: Mortality attributable to tobacco use in Spain represents a high cost in terms of avoidable deaths and shows the limited impact of the interventions directed to tobacco control in Spain. One of every 4 deaths in males and a disturbing and rapidly increasing proportion in females are attributable to smoking.

Adult↗
PubMed1994

[Cultural and linguistic validation, in Spanish, of the International Prostatic Symptoms Scale (I-PSS)].

Formal presentation of the cultural and linguistic validation, in Spanish, of the International Prostatic Symptoms Scale (I-PSS). The process for the official translation into Spanish of the questionnaire on prostatic symptomatology and quality of live derived from urinary symptoms, has followed a methodology common to several countries (UK, Italy, Norway, The Netherlands and Spain) which consisted in: translation into Spanish of the original American-English version published by the WHO in 1992, by two independent bilingual urologists; re-translation into English, checking any conceptual and semantic changes that had caused difficulties in the process of translation/re-translation; final choice of the text by an International Committee based both on the data provided by the above process and the experience of the Central Committee accrued over their relationships with the various National Committees. The resulting text was applied to 33 patients with prostate disease and 12 controls, individually recording any difficulty of interpretation and choice of answer observed for each of the questions. The final text herewith presented constitutes the official reference for the Spanish translation of the International Prostatic Symptoms Scale (I-PSS) which should be used for future symptomatic evaluations. The purpose of this cultural and linguistic validation is to secure that the application of these scales provides comparable and consistent numerical results in those countries where the translation has not been officially validated.

Cultural Characteristics↗
PubMed1993

[Eat less fat to prevent ischemic cardiopathy. The potential impact of population and individual strategies for controlling cholesterolemia in Spain].

BACKGROUND: The aim of the application of population and individual strategies for the control of cholesterolemia recommended by several commissions of experts in Spain is to obtain marked decreases in mortality by ischemic heart disease. This study is the first to estimate the potential benefits obtained by the application of both strategies in males from 35 to 64 years of age in Spain. METHODS: Upon fixing the population dietetic aims for the ingestion of fats and cholesterol, the foreseen decrease in mean serum cholesterol was estimated by predictive equations. For individuals at risk, more ambitious objectives were made in regard to decrease in cholesterolemia. The consequent reduction of coronary death risk was obtained for each strategy comparing the foreseen coronary risks by logistic functions for previous serum cholesterol values and those posterior to the health intervention. RESULTS: The population decrease of saturated fat to 7-10% of total calories of the diet and of the consumption of cholesterol to 300 mg/day would produce a reduction of serum cholesterol of between 6.5 and 21.4 mg/dl (0.2-0.6 mmol/l) which would represent nearly 200 mg/dl (5.2 mmol/l). This would then produce a decrease in coronary deaths of 5.5 to 17.1%. This population strategy must reach 934 to 2,857 people per death avoided. With the individual strategy, the reduction of 55 mg/dl (1.4 mmol/l) in mean cholesterolemia of subjects with more than 250 mg/dl (mean 7.1 mmol/l) or of 36 mg/dl (0.9 mmol/l) in those with more than 200 mg/dl (mean 6.2 mmol/l) would produce a decrease of population coronary death between 3.3 and 12.5% in the first group, and 5.2 to 20% in the second requiring 237 or 454 subjects in each group, respectively per death avoided. The joint application of both strategies would reduce the risk from 8.4 to 24.5%. This would delay the appearance of 570 to 1,640 coronary deaths each year. CONCLUSIONS: The population strategy for cholesterolemia control provides greater health benefits, within a short term, than those of individual strategy although it must be applied to more subjects per unit of benefit. The joint application of both strategies may produce a modest but appreciable reduction, within a medium term, of coronary death in Spain.

Adult↗
PubMed1992

[The relevance of mortality due to circulatory system diseases in Spain].

Cardiovascular diseases is the first cause of death in Spain, as it occurs in most western countries, with a crude death rate of 306 per 100,000 inhabitants in the male population and 351 in the female population in 1987. While this represented a 44.9% of all death causes in 1976, it represented a 42.6% in 1987. Death due to cardiovascular diseases, once corrected for the aging population, has decreased at a yearly rate of 1.26% in males and 1.6% in females from 1968 to 1987 (last year with available date). Most part of the decrease is due to a mean annual decrease of 3% in cerebrovascular mortality since the mid 70s, followed by a reduction in coronary deaths, slightly above 1% annually, since approximately the same time. The changes in life style that have taken place, together with medical and surgical advances and the influence of other factors which have not been so widely studied could be responsible for the potential saving of over 12,000 deaths due to cardiovascular diseases, which would have been added to those occurred in 1987 if mortality rate due to cardiovascular diseases had been the same as in 1976. The difficulty to assign a quantified degree of responsibility changes constitutes a research challenge, not discrediting the preventive action on this facts which are already known.

Age Factors↗
PubMed1989

[Mortality caused by cardiovascular diseases in Spain: where are we going?].

Spain is one of the european countries with a lowest mortality rate by cardiovascular diseases (although they are the leading cause of mortality) and, specifically, by ischemic heart disease. The trends in the last 16 years for which data are available point to a reduction of the former in 1.07% in males and 1.53% in females for the complete study period (1968-1984) and a trend towards the stabilization of the latter (a reduction of 0.45% in males and 1.88% in females from 1978 to 1984). The apparently unfavorable evolution of the classical risk factors of coronary artery disease, however, makes that its future outcome is uncertain. Therefore, their control is a basic aim of the policy for the control of this disease.

Adolescent↗