Biomedical subjects

M M Suárez-Varela

Publications and source records attributed to M M Suárez-Varela.

7 recordsLinked to original sources

PubMed2000

Occupation and small bowel adenocarcinoma: a European case-control study.

OBJECTIVES: Because of the rarity of small bowel adenocarcinoma (SBA), little is known about the aetiology of this disease. This study aimed to identify occupational clustering of cases SBA as a systematic approach to new hypotheses on the aetiology of this disease. METHODS: A European multicentre case-control study was conducted in 1995-7, inclusive. Incident cases aged 35-69 years with SBA (n=168) were recruited before acceptance by a pathologist. Altogether 107 cases and 3915 controls were accepted, of which 79 cases, 579 colon cancer controls, and 2070 population controls were interviewed. RESULTS: The strongest industrial risk factors for SBA taking account of 10 years' exposure lag were dry cleaning, manufacture of workwear, mixed farming (women), and manufacture of motor vehicles (men). A significantly increased risk of SBA (odds ratio (OR) and 95% confidence interval (95% CI)) was found among men employed as building caretakers, OR 6.7 (1.7 to 26.0) and women employed as housekeepers, OR 2.2 (1.1 to 4.9); general farm labourers, OR 4.7 (1.8 to 12.2); dockers, OR 2.9 (1.0 to 8.2); dry cleaners or launderers, OR 4.1 (1.2 to 13.6); and textile workers (sewers or embroiderers), OR 2.6 (1.0 to 6.8). For the last four groups, together with welders OR 2.7 (1.1 to 6.6) (men) an exposure-response pattern was found when calculating the ORs for jobs held 1-5 years and >5 years, with never having held the job as reference. The ORs (95% CIs) for 1-5 years and >5 years were 4.3 (0.4 to 44.0) and 3.5 (0.9 to 13.7), 3.0 (0.3 to 26.2) and 4.3 (0.9 to 21.2), 4.6 (0.4 to 48.1) and 11.0 (2.0 to 60.4), 1.3 (0.2 to 11.0) and 5.8 (2.0 to 17.2), and 2.8 (0.3 to 23.8) and 4.6 (1.3 to 16.6), respectively, for each of these occupations. Among welders, people performing semiautomatic arc welding (MIG/MAG) were identified as a high risk group (OR 5.0 (1.3 to 19.6)). CONCLUSIONS: This explorative study suggests an increased occurrence of SBA in certain occupations, which needs further evaluation.

Adenocarcinoma↗

PubMed1999

Socioeconomic risk factors in the prevalence of asthma and other atopic diseases in children 6 to 7 years old in Valencia Spain.

A cross-sectional survey of a cohort study was carried out between June and December 1994 in Valencia, Spain (population in 1994: 764,293 inhabitants). Two hundred sixty public and private schools randomly selected from the total of schools in Valencia were invited to participate; 3948 children aged 6-7 years cooperated in our study after informed consent was obtained from parents and school director. The survey in Valencia is part of the International Study of Asthma and Allergy in Childhood (ISAAC). Prevalences for asthma, rhinitis and atopic dermatitis were determined and contrasted with socioeconomic status (SES) among children. No statistically significant associations were established between the prevalences of asthma, rhinitis and atopic dermatitis, and SES. However, atopic dermatitis was found to be common among upper class children (21.5 per 100 children). Likewise, significant associations were observed between the severity of atopy (2 or 3 atopic manifestations) and SES (p = 0.000), being greater for lower strata (4.5 per 100 children); for the three SES level significant differences were established (p = 0.008) regarding passive exposure to tobacco smoke in the home.

Asthma↗

PubMed1999

Evidence based general practice.

OBJECTIVES: To estimate the proportion of interventions in general practice that are based on evidence. DESIGN: A one-year cross-sectional study involving all consultations by patients over age 15 years seen in 34 national primary health care centers. SETTING: The rural Castellon provincial district within the Valencian Community in eastern Spain, with a total population of 21,155 inhabitants. SUBJECTS: of 1990 case histories registered in the course of one year, 4800 consultations were identified; of these, 2341 (49%) distinct diagnosis-intervention pairs were identified and coded. MAIN RESULTS: The evidence basis for the diagnosis-intervention pairs in the study was derived from a computerized search of the scientific literature published in 1992-1996. The quality of the evidence was classified according to the method of Ellis et al. Within the 2341 diagnosis-intervention pairs, there was positive evidence in support of the intervention used in 55%. The evidence basis was sound for 42%, with 38% being based on Type I (clinical trials) evidence and 4% on Type II evidence. The most frequently presenting diseases involved the circulatory (18.7%), respiratory (14.9%), nervous (14.2%), musculo-skeletal (12.5%) and nutrition and metabolism and digestive systems, with 12.1% each. CONCLUSIONS: Clinical practice was clearly supported by positive evidence of all Types (I-III) in a total of 55% of interventions, and by good positive evidence of Type I or II in 42% of interventions. The percentage of evidence-based interventions in general practice serving a substantial population in rural Spain was lower than had been reported by some authors.

Cross-Sectional Studies↗

PubMed1998

[Social health evolution in Vall d'Uixó. Application of multivariate analysis as a new health status indicator method].

OBJECTIVES: This study evaluated the relative position of Vall d'Uixó within the province of Castellón, the Valencian Community and Spain. DESIGN: The study covers the period from 1981 to 1993. A multivariate analysis of the main components was performed. This compared the interrelationship of these indicators in the different zones analysed. PATIENTS AND OTHER PARTICIPANTS: Our study focused on an area of 27,387 population, geographically within the province of Castellón in the south-west of La Plana county. RESULTS: The analysis showed that Vall d'Uixó had a low level of development and little economic activity. It had a relatively young population. CONCLUSIONS: The health problems were linked to the social and economic situation. Apart from the re-creation of industrial jobs, it would be desirable to improve programmes to monitor TB and cardiovascular diseases.

Cause of Death↗

PubMed1996

Variations in avoidable mortality in relation to health care resources and urbanization level.

"Avoidable" mortality may be defined as causes of death whose occurrence is closely related to medical intervention. Areas with particular health care delivery problems can be identified through a geographical comparison of these "avoidable deaths." Mortality data for Valencia from 1982 to 1990 were examined to determine whether or not the availability of medical care resources in the area influenced the occurrence of avoidable deaths. We identified variations in mortality from avoidable causes, grouped according to the differences in levels of urbanization and health care resources, in the 537 municipalities of the Valencian community. (In Spain, the municipality is the lowest administrative division.) Linear regression analysis was performed to predict or estimate this relationship. Only in a small number of avoidable causes did the mortality trend for males differ significantly from 0 (p < 0.005) in relation to different levels of urbanization and health care resources. A direct association between these two variables was observed in males with regards to pneumonia, tuberculosis, chronic rheumatic heart disease, and bacterial infection. In females, a relationship between "avoidable" mortality rates and the differences in urbanization and health care resources was found in cervical cancer, pneumonia, abdominal hernias, and cholecystitis. Mortality from asthma and cardiovascular disease (in both males and females) declined faster in urbanized, high income areas than in rural areas. The results clearly demonstrate the considerable mortality risk associated with living in urban areas. On the contrary, we found very little correlation between health service access and mortality.

Adolescent↗

PubMed1996

Non-melanoma skin cancer: a case-control study on risk factors and protective measures.

There is considerable evidence that exposure to ultraviolet radiation increases the risk of many dermatological conditions, such as non-melanoma skin cancer (NMSC). In order to better understand this relationship, we examined the connection between quantitative measures of individual sun exposure and the risk of NMSC, and the benefits of some protective measures against sunlight, analyzing the differences by sex. A case-control study was conducted in Valencia, Spain during 1990 to 1992 that included 276 cases of histologically confirmed NMSC and 552 control subjects matched by age, sex, and area of residence. Quantitative ultraviolet exposure, phenotypic features, and protective measures from sunlight were estimated by means of a history questionnaire administered by interview. Logistic regression analysis was carried out for each variable and level of quantitative measures. We observed a statistically significant increase in the risk of NMSC proportional to an increase in the hours of occupational exposure to the sun (OR = 1.2, 2.5, and 5.3, respectively). An increased risk of NMSC was observed in men with high nonoccupational exposure (OR = 1.7; p < 0.05 in open-air activities in the sun, OR = 2.1; p < 0.05 in the sun while on vacation). In women, we found instances of OR > 1, but without significance (p > 0.05). Wearing a hat at work appeared to be an important protective measure for men. Light phenotypic features predominated in our study, especially in women, and seems to be the major risk factor involved. It seems reasonable to presume that differences between the sexes are basically sociocultural, (i.e., different work activities and different use of leisure time.

Aged↗

PubMedDate not supplied

[Application of DRGs at a regional hospital].

BACKGROUND: Of among the different measures systems of hospital production, we adopted the Diagnosis Related Groups (DRG) approach for the management of the cases series of the "Arnau de Vilanova" Hospital (Valencia, Spain). The use of hospital services makes it possible to establish the number of patients attended and in which services, while pathology distribution reflects the types of patients who makes us of the hospital. METHODS: A transverse study was made, reviewing the clinical histories of the hospitalized patients and applying an autoexcluding medical or surgical DRG designation. Patient inspection and comments with the healthcare staff afforded greater specifications. We included all patients hospitalized between May 11 and 24, 1992, i.e., 263 in total, corresponding to 2.53% of the annual hospitalizations in 1992. RESULTS: The most frequently employed services were Internal Medicine and General and Digestive Surgery. Hospital activity was defined by 90 DRGs, the GDRGs most associated to hospital (nosocomial) infection being HIV-positive individuals, those operated on for inguinal hernia, and oncological patients with laryngeal cancer. CONCLUSIONS: Hospital activity was found to be concentrated in high volume DRGs--one of them being the Medical Type "non-groupable diseases due to clinical incompleteness of the management parameters, as a result of which this information remained undetermined.

Cross Infection↗