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Biomedical subjects

P Gayoso Diz

Publications and source records attributed to P Gayoso Diz.

16 recordsLinked to original sources
PubMed2006

[The tuberculin skin test in a healthy child program: should we change our practice].

BACKGROUND: The Healthy Child Program and the Preventive Activities and Health Promotion Program involve systematic tuberculin skin testing at distinct ages according to different programs, with variable evaluation of its effectiveness. OBJECTIVE: To evaluate the tuberculin skin test performed in healthy children within the ongoing basic health program in order to determine whether our activity is effective in detecting latent tuberculin infection. MATERIAL AND METHODS: A prospective observational study was performed. POPULATION: Mantoux test performed in children aged 15 months to 14 years during regular health examinations in 22 primary care pediatric clinics over a 12-month period in southern Pontevedra in Spain (catchment population 300,613 inhabitants according to the official census data in January 2003, with 472,444 health cards). Descriptive study and univariate analysis were carried out. RESULTS: We studied 2,530 children with a mean age of 51.25 months (95 % CI: 49.38-53.13). Eight positive Mantoux tests were registered (0.36 %). There were three positive results in children aged less than 3 years, two positive results in children aged between 4 and 9 years old (all were immigrants) and the remaining positive results were registered in children between 10 and 14 years of age. CONCLUSIONS: Given that the tuberculin skin test is a good screening test despite its limitations in the control of latent tuberculin infection in children, its indications should be adjusted to ever-changing epidemiological characteristics. According to the results obtained in this study and considering the prevalence of tuberculosis in our environment, we propose that the systematic application of the Mantoux test be discontinued except in children from countries with a high incidence of this disease or risk factors. However, we also recommend that systematic Mantoux testing in adolescence (12-14 years of age) be maintained, when vaccination and various medical examinations are carried out. Epidemiological studies in this age group should simultaneously be performed.

Adolescent↗
PubMed2006

Prevalence of Helicobacter pylori infection in the general adult population of the province of Ourense.

OBJECTIVES: to determine the prevalence of Helicobacter pylori infection in the general adult population of the province of Ourense. MATERIAL AND METHODS: a cross-sectional study was carried out with a randomly selected populational sample. The diagnosis of Helicobacter pylori infection was reached using the 13C-urea breath test. RESULTS: three hundred and eighty-three subjects were studied, with a prevalence rate of 69.1% (95% CI: 61.7-75.1%); 69.8% (95% CI: 63.2-76.6%) in males and 68.4% (95% CI: 61.5-75.4%) in females (difference not statistically significant). Prevalence increases with age up to a maximum of 88.4% in the 45-54 years age group, and decreases thereafter to a rate of 57.1% in individuals over the age of 84 years. CONCLUSION: this study reveals that the prevalence rate of Helicobacter pylori infection is high in the general adult population of the province of Ourense. It increases with age until it peaks in the group of middle-aged individuals and is similar in both sexes.

Adolescent↗
PubMed2006

Risk factors associated with Helicobacter pylori infection. A population-based study conducted in the province of Ourense.

OBJECTIVES: to identify the relationship between Helicobacter pylori infection and various factors that have been described in other studies in the general adult population in the province of Ourense. MATERIAL AND METHODS: three hundred and eighty-three participants were enrolled in a study on the prevalence of Helicobacter pylori infection. All participants filled in a questionnaire under supervision, and the data obtained were examined by means of a univariate analysis. The odds ratio corresponding to each variable studied was calculated with their corresponding 95% confidence intervals. Furthermore, a multivariate analysis was performed. RESULTS: the univariate analysis revealed an association between infection and: age, place of residence during childhood, current social status based on the head of the family s profession, current blue collar/white collar profession of the head of the family, sharing a bedroom during childhood, type of drinking water, and contact with animals during childhood. No association was found with respect to the presence of dyspeptic symptoms. The multivariate analysis disclosed that only age is an independent risk factor associated with infection. CONCLUSION: age has been identified as the only independent risk factor associated with Helicobacter pylori infection in this population-based study. The univariate analysis has detected other factors. No association has been identified with respect to dyspeptic symptoms.

Adolescent↗
PubMed2005

[Auricular fibrillation as a risk factor of cerebrovascular events in the over-65s. Is clinical practice in anticoagulant prophylaxis adequate?].

AIM: To describe the clinical practice in antithrombotic therapy to prevent stroke in older patients with atrial fibrillation (AF). DESIGN: Cross-sectional study. SETTING: Ourense's area with 95,840 inhabitants over 65 years. PARTICIPANTS: Patients over 65 with non rheumatic AF, chronic or paroxistic; 411 cases, 69.6% older than 75 year. MAIN MEASUREMENTS: Demographic characteristics, personal history, stroke risk, diagnostic characteristics of AF, antithrombotic treatment, and its adequacy. RESULTS: Only 33% high risk patients received oral anticoagulation (OCA) with warfarin at diagnosis. Some features were found to be significant independent risk factors for OCA: age (older than 75 vs 65-74 years; odds ratio =0.32; 95% confidence interval, 0.18-0.59), and prior stroke (odds ratio =2.02; 95% confidence interval, 1.16-3.55). CONCLUSIONS: Warfarin prophylactic is insufficiently prescribed, especially in older than 75 years (with high baseline risk of stroke and no counter-indications). There was inadequate prescription in 73.4% cases.

Administration, Oral↗
PubMed2005

[Effects of HIV status and other variables on the outcome of tuberculosis treatment in Spain].

OBJECTIVE: To analyze the effect of human immunodeficiency virus (HIV) status and other variables on the outcome of tuberculosis treatment in Spain. PATIENTS AND METHODS: Multicenter retrospective cohort study in 6 autonomous communities of Spain (from May 1996 to April 1997). Data on treatment outcome were collected for new cases of tuberculosis in accordance with European guidelines. Follow up of patients continued for 3 months after scheduled end of treatment. RESULTS: Of the 4899 patients included, 3417 (69.7%) had a satisfactory outcome, 438 (8.9%) died before or during treatment, and 1044 (21.4%) had a potentially unsatisfactory outcome. On stratification by HIV status, satisfactory outcome, mortality, and potentially unsatisfactory outcome were reported for 43.4%, 21.5%, and 35.1%, respectively, of HIV-positive patients; 71%, 6.2%, and 22.8%, respectively, of HIV-negative patients; and 74.3%, 7.5%, and 18.2%, respectively, of patients with no HIV status available. HIV modified the effect of several variables on the outcome of treatment, and so separate logistic regression models for each HIV category were constructed. Among HIV-positive patients, mortality increased in patients with neoplastic disease and in users of drugs by nonintravenous routes of administration, whereas potentially unsatisfactory outcomes increased in intravenous drug users and in women. CONCLUSIONS: In Spain, the outcome of tuberculosis treatment is much worse in HIV-positive patients. Drug use and presence of neoplastic disease substantially affect mortality.

Adolescent↗
PubMed2005

[Relationship between the quality of professional life and the burnout of primary health care doctors].

OBJECTIVE: To know the relationship, if this exists, between the quality of professional life (CPL) and the burnout of primary health care staff. DESIGN: Transversal study employing CVP-35 test and MBI (Maslach Burnout Inventory), both sent by postmail. SETTING: 3 urban centers and 3 rural centers. Total: 131 professionals. MEASURES: In the CVP-35 test, scores from 0 (minimum) to 100 (maximum) are obtained. Maslach categorised each dimension into high, medium and low level. RESULTS: 71.7% answered. Medium age 44 years, average of 1339 sanitary cards. The number of visits/day was 37, home visits 1 per day. The CVP average was 4.48 (95% CI, 4.08-4.88). The damage perception in the post 5.9 (95% CI, 5.6-6.1); the professional intrinsic motivation 6.5 (95% CI, 6.2-6.7), and the manager support 3.8 (95% CI, 3.6-4.1). MBI: high depersonalization 54.3%, emotional exhaustion (r=0.6; P<.0001), intrinsic motivation, and personal accomplishment (r=0.46; P<.0001) and professional quality of life front emotional fatigue (r= -0.4; P < .0005). CONCLUSIONS: CPL and burnout measure different but related dimensions. Therefore, its utility is dependent on the objectives. Target elements, which can improve the quality of professional life, can be identified from these tools.

Adult↗
PubMed2004

[Antimicrobial susceptibility of the bloodstream infections: a study in a nonteaching hospital].

BACKGROUND: To try established antimicrobial susceptibility patterns and frequency of both nosocomial and community-acquired bloodstream infections and and to try identified the prognostic factors that can be modified. MATERIAL AND METHODS: A prospective study of 310 bloodstream infections with clinical significance detected in a non teaching hospital over period from October 2000-2001. A blood culture were identified by Bact-Alert system and the confirmation was performed by MicroScan system; an antimicrobial susceptibility test was performed by reference microdilution methods as described by NCCLS. We studied sentinel antimicrobial/organism combinations with potential clinical importance. Data were computerized using SPSS. Qualitative variables were compared using the X2 test or the Fisher exact test, and quantitative variables with t Student or ANOVA. RESULTS: Gram positive and Candida were frequently recovered in nosocomial bloodstreams. The proportion of oxacillin-resistant S. aureus isolates was 24% and the penicillin resistant pneumococci was 14%. Vancomycin was universal active against gram positive. Gram negatives were often recovered in community bloodstream. The proportion of EBSL E. coli isolates was < 2% and the proportion of multiresistance Pseudomonas aeruginosa was higher among UCI isolates. An independent risk factors for death identified after multivariate analysis was the inappropriate antimicrobial therapy OR 2.6. CONCLUSIONS: Ongoing surveillance of microbial pathogens and their resistance profiles is essential on local scale and permit the selection of appropriate antibiotic therapy which would be reduce the mortality.

Drug Resistance, Microbial↗
PubMed2002

[Assessment of drug treatment for hypertension in a health centre as a function of associated chronic pathologies and degree of control of the hypertension].

OBJECTIVE: To assess the suitability of whatever hypertension medication is prescribed for the associated pathology in each patient, and to analyse the monitoring of blood pressure figures. DESIGN: A cross-sectional descriptive study.Setting. Urban health centre. PATIENTS: The target population were the hypertension patients being treated with medication and monitored at the health centre. Stratified random sampling by quotas of the total number with hypertension was performed. The sample numbered 219 patients. MEASUREMENTS: The clinical history of each patient selected was reviewed. To evaluate the hypertension treatment, we established three levels of suitability with regard to the accompanying pathology of each patient (suitable, intermediate, unsuitable), using the 1999 Hypertension Protocol of the Spanish Society of Family and Community Medicine. RESULTS: Out of 219 cases, treatment was suitable in 71 (32.4%), intermediate in 91 (41.6%), and unsuitable in 57 (26%). The most frequently indicated drug group was the angiotensin converting enzyme inhibitor (ACEI) group and, jointly, ACEI and diuretics. Regarding the monitoring of blood pressure: 66.5% had very good monitoring, 23.2% partial and 9% poor. CONCLUSIONS: Most treatments are at an intermediate level of suitability: without beneficial or undesirable effects on the associated pathology. This makes us think we need to optimize the drug indicators for hypertension.

Aged↗
PubMed2001

[Results of anti-tuberculosis treatment in six autonomous regions in Spain].

BACKGROUND: To analyze tuberculosis treatment outcome in Spain. PATIENTS AND METHOD: A retrospective cohort study was performed of 6 Autonomous Regions of Spain: Asturias, Catalonia, Galicia, La Rioja, Murcia and Basque Country. Study subjects were new cases of tuberculosis identified through the MPTR who were not in prison at the time of diagnosis (May 1996-April 1997). Information was gathered from the patients' clinical records. Guidelines issued for tuberculosis treatment outcome monitoring in Europe were followed. RESULTS: A total of 4,899 new cases of tuberculosis met the criteria for inclusion. Out of them, 4,240 (86.6%) had enough information on tuberculosis treatment outcome in their clinical record. Results showed that 3,417 cases (69.7%) had a satisfactory outcome, 438 (8.9%) died before or during treatment and 1,044 (21.4%) met the definition of a potentially unsatisfactory outcome. There were important differences in treatment outcome between regions. There were also variations by nationality, age group, HIV status, history of intravenous drug use, history of alcohol abuse and site of disease. CONCLUSIONS: According to the results of our study, the proportion of new cases of tuberculosis that had a satisfactory outcome at the end of treatment do not reach WHO recommended level to effectively control the disease. Therefore, it is necessary to analyze the situation and to propose measures to improve it.

Adolescent↗
PubMed1998

[Prediction of mortality and quality of life in polytraumatized patients: APACHE II versus APACHE III].

OBJECTIVE: To evaluate the APACHE II and III prognostic assessment systems as predictors of mortality in polytraumatized patients and to compare each system's admission assessments to the patient's quality of life one month, six months and one year later. PATIENTS AND METHODS: A prospective study of 130 polytraumatized patients admitted to the critical care unit was carried out. A polytraumatized patient was defined as "presenting two or more traumatic lesions that were immediately or eventually life-threatening". We studied age, sex, type of trauma, mortality, mean APACHE II and APACHE III scores during the first three days in the critical care unit for patients who survived and those who died, estimating relative risk of mortality by APACHE II and APACHE III, and quality of life one month, six months and one year after admission using Karnofsky scores (KPS). RESULTS: Mean patient age was 46.47 +/- 20.19 years; 78% were men and 22% women. Overall mortality was 20%. The most frequent trauma was craniocerebral (70.76%), followed by injuries ot the chest (53.8%) and extremities (46.15%). Mean APACHE II and APACHE III scores during the first three days were 10.22 +/- 5.33 and 32.75 +/- 16.42, respectively. Mean APACHE II and III scores were significantly higher (p = 0.02) in patients who died than in survivors (14.33 +/- 5.43 and 9.7 +/- 5.2, respectively, for APACHE II; and 43.27 +/- 17.68 and 30.16 +/- 15.79, respectively, for APACHE III). For each point increase of APACHE II or III scores, relative risk of mortality increased 1.09% (p = 0.03) and 1.02% (p = 0.03), respectively. Patients with APACHE II scores over 12 were 3.53 times more likely to die (p = 0.02). Patients with APACHE III scores over 35 were 3.05 times more likely to die (p = 0.02). One month after admission, 6.4% of patients had a KPS of 100 (normal, as before trauma), 35.8% achieved this score six months after admission and 82% after one year (p = 0.01). Mean APACHE III upon admission was significantly lower (p = 0.045) in patients who achieved KPS 100. CONCLUSIONS: The APACHE II and APACHE III prognostic systems predict relative risk of death in polytraumatized patients. APACHE III, but not APACHE II, at admission is significantly related to quality of life one year later.

APACHE↗
PubMed1995

[Family medicine tutors: attitudes and activities of tutoring].

OBJECTIVE: To discover the attitude of tutors to tutoring and describe how they apply the teaching programme during the period interns spend at the Health Centre. DESIGN: Crossover study. Stratified random sampling by Teaching Units. SETTING: Primary Care Centres with teaching accreditation. PARTICIPANTS: 258 tutors from the state-wide Teaching Programme. MEASUREMENTS AND MAIN RESULTS: Tutors' attitudes and the activities undertaken with the interns were studied by means of a self-filled questionnaire. The attitudes scale revealed a good attitude toward tutoring. Above all ability to motivate (73%) was required of the good tutor. Shared quotas was the commonest model of tutoring (85%). Clinical care was the activity the tutors developed best (70%), with the doctor-patient relationship in second place (46%). The majority discussed the Clinical History with their intern (75%). Few supervised the carrying out of procedures (36%). 68% of interns performed at least one piece of research, although tutors thought they should do more investigative work (41%). During the three intern years, the relationship was hardly ever maintained (13%). CONCLUSIONS: Tutors' attitude to tutoring is adequate. There is agreement with the basic features of the Programme, which is best developed in the area of care. The general model is that of a shared quota. Teaching must be improved in the non-care aspects, with specific training being made available to tutors.

Attitude↗
PubMed1994

[Validation of the chronometer test as a method of screening for hypoacusis in patients aged 65 years and older].

OBJECTIVE: Evaluation of the chronometry test as a screening procedure for hypoacusia compared with tonal audiometry, in patients over 65 years. DESIGN: Cross-sectional study. SETTING: Mariañamansa health area (Ourense). PATIENTS: The first 49 patients over 65 who came to the medical consultations in June and July 1992 were selected, irrespective of the reasons for their visit; there were 17 males and 32 females, with and average age of 72.4 +/- 4.6 and 71.9 +/- 4.5. Only one patients consulted directly about loss of hearing. MEASUREMENTS AND MAIN RESULTS: A statistically significant association was found between the chronometry test and the audiometry test (gold-standard), significant at p < 0.005 for the left ear and p < 0.05 for the right ear. The test achieved a sensitivity of 0.85 and specificity of 0.76 in the case of the left ear, and 0.84 (sensitivity) and 0.56 (specificity) for the right ear. The kappa rate was 0.55 for the right ear and 0.67 for the left ear, showing agreement that went well beyond chance. CONCLUSIONS: In our view, the chronometry test constitutes an cheap, effective, simple, and replicable procedure for the detection of hypoacusia in patients aged over 65, and one which can usefully be used when no audioscope is available.

Aged↗
PubMedDate not supplied

[Study of the prevalence of urinary incontinence in women from 18 to 65 and its influence on their quality of life].

OBJECTIVE: To find the prevalence of urinary incontinence (IU) in women of working age and its impact on their quality of life (QL). DESIGN: Descriptive, cross-sectional study. SETTING: Urban health district in Ourense. PARTICIPANTS: 1000 women between 18 and 65 were selected at random from a total of 8443. MAIN MEASUREMENTS: The prevalence of UI was evaluated by means of a questionnaire designed for the study and sent by mail. In addition, the Incontinence Impact Questionnaire translated into Spanish was used. This was to assess QL in women with UI. RESULTS: The reply rate was 43.6%, with 20% prevalence of UI. Mean age of the women studied was 43.4 (95% CI, 42.1-44.6); and for those with UI, 50.3 (95% CI, 48.4-52.4). 56.8% of women with UI had not been to the doctor. Mean score of impact on QL (from 0 to 90) was 12.7 points. 87.7% of those affected scored less than 30 points; and 1.5% were above 60 points. CONCLUSIONS: High prevalence of UI was found in women of working age, with low rate of medical consultation, probably because for most women it only lightly affected their QL.

Adult↗
PubMedDate not supplied

[Polipharmacy in the antipsychotic prescribing in practices psychiatric out-patient clinic].

INTRODUCTION: Due to the lack of scientific studies in the psychopharmacological treatment of psychosis, the references advise against the use of antipsychotic polypharmacy (AP). This study investigates the situation of this matter and its relationship with the introduction of atypical antipsychotics (AA) in our daily out-patient practice. METHODS: The study group included 160 patients, with ICD-10 diagnosis of non-affective psychosis and illness evolution of at least two years, whose ages ranged from 18 to 65 years, without mental retardation, who came to the out patient clinic at least once during the first semester of 2002 and, in order to make a comparison, at least one other time 9 to 12 months before. The retrospective study was done using the clinical records. RESULTS: In both moments studied, more than 50 % of the patients (65 % and 63.4 % respectively) had AA as their only treatment. AP was 25.6 % and 26.9 % respectively, 19.4 % of all patients were always in AP. At the end of the study, patients on AP were being prescribed a higher dose of chlorpromazine equivalents per day (p < 0.001) and more anticholinergics (p < 0.001). CONCLUSIONS: Our results show that in out patient settings AA have been consolidated as the first treatment option and that AP is a very common and stable phenomenon.

Adolescent↗