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Biomedical subjects

J M Rodríguez Vallejo

Publications and source records attributed to J M Rodríguez Vallejo.

8 recordsLinked to original sources
PubMed2002

[Interpretation of results of clinical trials in benign prostatic hyperplasia].

The random clinical trial (RCT) is the most suitable study to evaluate the treatment effectiveness in the benign prostatic hyperplasia (BPH). Although most of the urologists will not collaborate in a RCT development, they will treat BPH patients, so it is very important to know if a CRT in BPH is well designed and their conclusions are correct. The aim of this article is to give the basic elements of analysis that urologists need in order to evaluate the quality and the level of evidence of a RCT in BPH. This article emphasizes the three main elements of a RCT: to check if the study has been correctly performed (internal validity), to evaluate if the treatment achieves an important clinical improvement (relevance of the results) and the applicability of the results in our patients (external validity). The article shows that to analyse these elements common sense and clinical judgment are needed rather than statistical knowledge.

Data Interpretation, Statistical↗
PubMed2001

[Prevalence of prostatic intraepithelial neoplasia in Spain].

OBJECTIVE: To study the prevalence of high grade prostatic intraepithelial neoplasia in a Spanish population and to compare it with the prevalence in Caucasians of other countries and Afro-Americans. METHODS: 162 prostates obtained at autopsy from Spanish men aged 20-80 years, were fixed in 10% formalin and slices perpendicular to the posterior margin were made every 3-4 mm along its entire length. All blocks were embedded in paraffin and examined microscopically. Mapping of focality and site of the high grade prostatic intraepithelial neoplasia was done for each case. The Wayne University autopsy study was used for comparison of the prevalence in other countries and races. RESULTS: 146 prostates from men with a mean age of 48.5 years were considered valid for histological analysis. There were 42 high grade prostatic intraepithelial neoplasia; 20 were focal and 22 multifocal. By age group, the prevalence of high grade prostatic intraepithelial neoplasia were 7.1%, 14.7%, 28.5%, 33.3%, 45.4% and 51.8% for the 3rd, 4th, 5th, 6th, 7th, and 8th decades. CONCLUSIONS: High grade prostatic intraepithelial neoplasia begins to manifest in the Spanish population after the 3rd decade. It is usually focal and peripheral, and significantly increases with age and becomes multifocal. Its prevalence in the Spanish population is moderately lower than in American Caucasians and significantly lower than in Afro-Americans.

Adult↗
PubMed2000

[Benign prostatic hyperplasia and evidence based medicine: its approach in clinical practice].

The contribution of evidence based medicine (EBM) methodology to the clinical practice of symptomatic benign prostatic hyperplasia (BPH) patients may be very helpful. Otherwise its development is incipient. BPH is still a high prevalent and far-reaching clinicopathologic entity. In the last few years, new drug and surgical therapies have emerged that have significantly changed BPH clinical management. In this article, the elements that make feasible the application of EBM to the clinical management of BPH patients are reviewed, with the aim of making this relation part of the vast extension of EBM in the different medical specialties. This objective is an answer to the double interest, on one hand, in defining the importance of this new concept of medical practice and, on the other hand, in making clinical practice suitable for solving the queries of a disease with such a variable influence in patient's welfare and quality of life. We therefore conclude that application of EBM methodology to BPH management is relevant and necessary.

Aged↗
PubMed2000

[Quality of life and symptomatology in benign prostate hyperplasia in active Spanish population].

BACKGROUND: Due to the lack of existing data regarding urinary symptoms and quality of life secondary to benign prostate hyperplasia (BPH) in the active Spanish population, and with the objective to evaluate the QoL in patients with lower urinary tract symptoms suggestive of BPH, we decided to conduct a national study which included 2,312 men employed by the National Railway Association (RENFE). SUBJECTS AND METHODS: 14 cities were selected and clinical histories, physical examinations, IPSS-L questionnaires and prostate echographies were conducted following the diagnostic guidelines of the Third International Committee by the WHO. RESULTS: Almost 20% of the men participating in the study had moderate or severe symptoms according to the IPSS and almost 15% were unsatisfied with their urinary situation. 3 out of every 4 men between the age of 50-65 years with moderate-severe symptoms have their urinary quality of life affected. The most prevalent symptoms were: filling, nicturia in almost 60% of the subjects, and emptying, the force and flow of the urinary stream diminishing in one out of every 3 participants. CONCLUSIONS: With an increase in age there is a higher prevalence of symptoms as dimmed by the IPSS, a poorer urinary quality of life, and a larger prostate volume as measured by echography.

Aged↗
PubMed1999

[Comparative population-based survey as evaluation method of prostate disease changes].

A survey-based comparative study was conducted to evaluate the changes on the prostate pathology in two male populations separated by a time interval of two years (1st and 3rd Week of Prostate Health). A total of 2056 respondents in the 1st Week, and 2126 in the 3rd Week were evaluated. The questionnaire included questions relative to prostate awareness, impact of urinary complaints on daily like activities, Spanish validated IPSS and selective questions for prostate patients. The comparison between both surveys disclosed visits to the urologist at earlier age and longer-standing symptoms. The most prevalent symptoms continue to be decreased calibre of the urinary stream, pollakiuria and urgency. IPSS/L and IPSS/age ratios remained unchanged. There was increased number of visits by mildly symptomatic patients (IPSS < 8), increased periodical revisions, and in the number of patients seen and treated by the urologist. A significant approximation to the diagnostic testing criteria established by the WHO for BPH was demonstrated. The number of patients who received treatment raised and there was also a significant improvement in the outcome. Comparative populational studies could allow to assess changes in the awareness status of the prostate, changes in symptomatic levels and quality of life of the population requesting health care, as well as changes in the diagnostic and therapeutical schemes in patients suspected of having BPH.

Health Surveys↗
PubMedDate not supplied

[Primary care physicians and prostatic disease. National survey. Members of the Spanish Council of Prostatic Health].

The paper presents the results of a survey distributed to 15,000 primary care physicians (PCP) asking about their management of prostate conditions. From the 3.265 surveys completed, the following information was obtained. The number of visits for "prostatism" is low, 3.92 + 3.99 per week. Most PCPs inquired for symptoms related to prostate conditions regardless the initial reason for the visit. 95% refer the patient directly to the urologist, either with no further investigation or after a diagnostic evaluation or initial therapy. Vegetable extracts are the pharmacological group most commonly used by PCPs. They would accept to monitor the patient's evolution, after diagnosis and treatment by the urologist, and always with the specialist's regular supervision. Most show little sensitivity toward prostatic conditions and are aware of slight of null urological education received during their graduation. They are by a majority also ready for a retraining in urology permitting them one active participation in this pathology.

Family Practice↗
PubMedDate not supplied

[The urologist and prostatic disease. National survey. Members of the Spanish Council of Prostatic Health].

Analysis of the results of a survey answered by 290 urologists on their relationship with primary care physicians (PCP), as well as the diagnostic and therapeutical approach to "prostatism". According to urologists, the PCPs attitude towards these patients shows a low profile, and they lack the necessary urological training to undertake diagnosis and treatment. With regard to the urological diagnostic approach, it is surprising that 73% of urologists who work outside the hospital milieu, usually do not perform digital examination. Likewise, urography is initially requested by 47.9% of the respondents. The symptoms questionnaire are used by only part of the hospital urologist and is never used by those who have no direct relation with hospital. These tendencies are in conflict with the recommendations established by the WHO for diagnosis of the condition.

Health Care Surveys↗