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Biomedical subjects

M Rué

Publications and source records attributed to M Rué.

44 records · Page 3Linked to original sources
PubMedDate not supplied

[Variability in preventive activities among primary care teams in Catalonia. Application of a multilevel analysis].

OBJECTIVES: To determine whether variability exists among primary care teams (PCTs) in Catalonia in opportunistic screening activities (screening for smoking, drinking, hypertension and tetanus vaccination) and to analyze the explanatory factors in the individual characteristics of the population treated and the characteristics of the PCT. METHODS: A multilevel analysis with individual and PCT explanatory variables was performed. The data were draw from a sample of 3,000 clinical histories from the adult population treated in 1995 in 30 PCTs from the restructured primary care network in Catalonia and from PCT characteristics. RESULTS: The recording of preventive activities in the clinical histories increased with the number of risk factors and/or diseases diagnosed, the number of other preventive activities recorded, and age. Recording of arterial pressure was more frequent in women while the remaining preventive activities were more frequent in men. Workload impeded opportunistic detection. Greater recording of antitetanus vaccination was associated with the number of years that the PCT had been functioning and with wider geographical area. Recording of smoking was higher in urban areas. CONCLUSIONS: Variability in opportunistic detection exists among PCTs in Catalonia. The characteristics of the PCT and the population treated that explain part of this variability are identified. Lower workload favors preventive activities in primary care.

Alcoholism↗
PubMedDate not supplied

[Health self-perception in men and women among the elderly].

OBJECTIVES: To analyze the differences in health self-perception between men and women in the later stages of life and to assess their association with sociodemographic and health variables. METHODS: Data on 1,459 men and 1,993 women aged 60 or older from the 1994 Catalan Health Survey, were collected and an analysis of health self-perception according to age, gender, social class, reporting of chronic disease and handicaps was performed. Multivariate logistic regression analysis was used, taking into account the survey design. RESULTS: Of the women aged 60 and older, 57.3% reported poor health compared with 43.6% of men of the same age. The proportion of women with one or more handicaps was also greater (41.2%) than that of the men (28.7%), as was the case with chronic disease (92.2% in women and 85.6% in men). The multivariate model also revealed that health self-perception was poorer among women than among men. Other explanatory factors were the number of chronic diseases, having handicaps, and being a member of a lower social class. Age interacted with the number of chronic diseases to mitigate the effect of chronic diseases on perceived health status. CONCLUSIONS: In the elderly population, poor health self-perception was greater among women, even when other significant explanatory variable (social class, age, handicaps and chronic disease) were adjusted for. The most important explanatory factors in health self-perception were having chronic disease and/or handicaps. The impact of chronic disease on poor health self-perception decreased in older age groups.

Age Factors↗
PubMedDate not supplied

[Years of potential life lost: comparison of 3 calculation methods].

Two methods of assessing Years of Potential Life Lost (YPLL): 0 to 65 years and 1 to 70 years are compared to a third, 0 to life expectancy which is considered a priori the most appropriate. In addition we would like to corroborate that YPLL is a complementary indicator of the crude rate of mortality. The results show that the first cause of YPLL remains tumors in all the methods. However, differences appear in the second and following causes. Disparities are also found in crude rates as YPLL reflect causes of death of the youngest age groups of the community. The method 0 to life expectancy is considered the least arbitrary and consequently it is recommended to calculate YPLL.

Adolescent↗
PubMedDate not supplied

[The effectiveness of breast cancer screening in our country].

The aim of this paper is to review the current state of breast cancer screening in our country, as well as to discuss the most appropriate approaches for its development. Firstly, the impact of breast cancer in Spain is presented, as well as the current evidence about the efficacy of the screening. The major programs and initiatives addressed to promote screening are described. Finally, a few recommendations are given in order to achieve that breast cancer screening be, not only efficacious, but also effective. It is concluded that it is necessary that health and professional authorities coordinate and monitor breast cancer screening programs.

Adult↗
PubMedDate not supplied

[Cancer mortality in the counties of Catalonia (1983-1989)].

OBJECTIVES: To compare mortality among counties (comarques) in Catalonia, Spain for the most frequent malignant tumors. METHODS: Overall mortality data and for five specific tumor sites were analyzed for a five-year period (1983-1989). Crude and site-specific mortality rates were computed. The comparison between counties was adjusted for the 1986 population of Catalonia using the direct method. Comparative mortality ratios (CMR) were obtained for each county with respect to Catalonia. RESULTS: Overall cancer mortality was higher in the Barcelonès for men and in Osona form women. The CMR for men in the Barcelonès was the highest for cancer of the trachea, bronchi and lungs; the CMR in Solsonès was the highest for stomach cancer, while in Cerdanya it was the highest for colorectal cancer. Among women, the highest CMR for cancer of the trachea, bronchi and lungs was in Montsià, whereas for breast cancer it was Baix Empordà, and Alt Urgell for stomach cancer. CONCLUSIONS: Comparative analyses of cancer mortality by county in Catalonia and sex underscores differences in its distribution, allowing the orientation of cancer control policies and research to be developed in each geographical area.

Breast Neoplasms↗
PubMedDate not supplied

Comparison of in-phase and opposed-phase GRE and conventional SE MR pulse sequences in T1-weighted imaging of liver lesions.

PURPOSE: Our goal was to compare in-phase (IP) and opposed-phase (OP) GRE and conventional SE sequences in T1-weighted (T1-W) imaging of the liver and to evaluate chemical shift GRE imaging in characterizing liver/lesions for fat content. METHOD: IP and OP T1-W GRE with fast low angle shot (FLASH) technique and T1-W SE sequences were compared in 162 patients at 1.0 T. Chemical shift GRE imaging was used to characterize lesions with fat content. Two hundred sixteen lesions were analyzed in three groups of liver: (a) "normal" liver (n = 74 with 110 lesions); (b) cirrhotic liver (n = 76 with 85 lesions); and (c) fatty liver (n = 12 with 21 lesions). Liver/lesion contrast and liver/lesion contrast-to-noise ratio were assessed for lesion detectability. The percentage of signal intensity variation (SIV) between IP and OP images was used to characterize lesions for fat content. RESULTS: The OP GRE sequence had significantly higher contrast for normal and cirrhotic livers (p < 0.001), and the IP GRE sequence had significantly higher contrast and contrast-to-noise ratio for fatty liver (p < 0.001). There were no significant differences between OP, IP, and T1-W SE imaging in cirrhotic cases for contrast-to-noise ratio (p < 0.28). Chemical shift imaging detected fat in 21 lesions (9.7%, mean SIV, 191.1%) (sensitivity and specificity 100% when compared with fine needle aspiration cytology). CONCLUSION: OP GRE sequences could replace conventional SE sequences in T1-W imaging in nonfatty livers, whereas in fatty livers, T1-W SE sequences could be obviated, but both OP and IP sequences are necessary. Chemical shift imaging (OP and IP) can be used to accurately characterize lesions for fat content.

Analysis of Variance↗
PubMedDate not supplied

[Patients with end-stage chronic renal insufficiency on programmed withdrawal from dialysis].

UNLABELLED: The voluntary discontinuation of dialysis by patients is a common mode of death in dialysis programmes. Unfortunately the Spanish experience has not been related in the nephrological literature. Initiation of, and withdrawal from, dialysis pose ethical questions for medicine in the 21st century. The dialysis population is aging and they have multiple medical problems. The choice may be between prolongation of quantity or quality of life. We evaluated a protocol for initiation of dialysis in patients with end stage renal failure and their subsequent withdrawal. We determined the factors predicting withdrawal of dialysis and revised the protocol to take account of these. We carried out an opinion poll of doctors and nurses about the effectiveness of the protocol. We studied prospectively the reasons for death of patients in the last seven years. RESULTS: Thirty patients were withdrawn from dialysis out of 116 who died during treatment by hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) in the last seven years. Vascular nephropathy is the principal disease predicting withdrawal from dialysis; the main precipitating cause is mental incapacity. The availability of a protocol for withdrawal of dialysis is well received by doctors and nurses and it engenders moral and legal calm when facing difficult decisions. Twenty-six per cent of deaths on regular dialysis are the result of withdrawal of treatment.

Adult↗