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P Lardelli Claret

Publications and source records attributed to P Lardelli Claret.

At least 19 recordsLinked to original sources
PubMed2002

Influence of driver nationality on the risk of causing vehicle collisions in Spain.

STUDY OBJECTIVE: To estimate the association between driver nationality and the risk of causing a collision between vehicles in motion. DESIGN: Retrospective, matched by collision, case-control study. SETTING: Collisions that occurred in Spain during the period from 1990 to 1999 were studied. PARTICIPANTS: Responsible (case) and non-responsible (control) drivers identified in the databases of the Dirección General de Tráfico (General Traffic Directorate) who were involved in a collisions between two or more four wheeled vehicles in motion, in which only one of the drivers had committed a traffic violation. MAIN RESULTS: Crude odds ratios (ORs) for the effect of driver nationality on the risk of causing a collision were significantly higher for foreign drivers than for Spanish drivers, and ranged from a minimum of 1.19 (95% CI 1.09 to 1.29) for Portuguese drivers to a maximum of 2.06 (1.88 to 2.27) for British drivers. Corresponding adjusted ORs were slightly lower, but were still significantly higher than 1 for all nationalities except Italian, Belgian, and American (USA). Adjusted ORs were usually higher for collisions that occurred in urban areas than on open roads. CONCLUSIONS: Authorities responsible for traffic safety, and drivers in general, should consider foreign drivers in Spain at particularly high risk for causing collisions, especially in urban areas.

Accidents, Traffic↗
PubMed1999

[Relationship between preoperative urine cultures and prostatic gland cultures in patients treated for benign prostatic hyperplasia].

OBJECTIVES: 1.--Investigate the bacteriuria preoperative in patients who will be operate on for Being Prostatic Hyperplasia (BPH). 2.--Define the prevalence of the prostatic colonization or infection. 3.--Try to correlate the bacteriological findings of urine and prostate, and find the degree of concordance between the microorganisms which can be commonly found in urine and prostatic tissue. METHOD AND MATERIALS: Prospective series of 175 patients undergoing prostatectomy for obstructive symptoms. The protocol revealed, among others variables: the preoperative urine culture; the presence or the absence of catheter; and the quantitative bacteriological culture of prostatic tissue. The information could be analised and its results could be obtained later on. The analysis stages consisted of both a descriptive and an analytic study. RESULTS AND CONCLUSIONS: 1.--Only 36 patients (20.6%) presented bacteriological increase of microorganisms (> or = 10(4) UFC/ml) in the preoperative urine culture. The Escherichia coli was the most common microorganism, followed by the Enterococcus faecalis, coagulase-negative Staphylococcus and the Pseudomona aeruginosa. A single microorganism grew in 31 out of the 36 positive cultures. 2.--The prevalence of the infection or colonization of the prostatic tissue was 25.1% (44 patients). The most common isolated microorganism was the coagulase-negative Staphylococcus followed by the Escherichia coli and the Enterococcus faecalis, in concentrations of at least 10(4) UFC/gr of tissue in the 79.6%. A single microorganism was isolated in 32 out of 44 patients. 3.--The proportion of positive prostatic cultures, in patients with positive urine culture (38.3%), was significantly higher than the one obtained in patients with negative urine cultures (16.5%) (p < 0.0001). Nevertheless, 52.3% of the 44 patients with positive prostatic cultures had negative urine culture, and only 21 (58.3%) out of the 36 patients with positive urine cultures presented a bacteriological growth in prostate. The degree of concordance (Kappa index) between the microorganisms which were found in preoperative urine and prostatic tissue is low or none for the majority of them.

Aged↗
PubMed1999

[Inflammatory changes in the obstructed prostate: the correlation between the bacteriological and histological findings].

OBJECTIVES: To analyze the incidence and nature of the prostatic inflammatory changes, to determine the prevalence of prostatic colonization or infection in patients undergoing surgery for benign hyperplasia of the prostate (BPH) and to correlate the inflammatory lesions with the bacteriological findings. METHODS: A prospective study was conducted on 175 patients undergoing surgery for BPH. All patients were entered into a study protocol that included quantitative bacterial cultures of the prostatic tissue and histological analyses of the surgical specimens. Data of previously defined variables were entered into a data base for subsequent analysis comprised of a descriptive and an analytical study. RESULTS: 44 of the 175 patients (25.1%) had a positive bacterial culture of prostatic tissue. Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%), regardless of the presence or absence of bacteria. Of these 68 patients with a histologically demonstrated inflammation of the prostate, only 19 (27.9%) had positive prostatic tissue cultures. The incidence of granulomatous prostatitis was 1.1%. CONCLUSIONS: Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%). The presence of bacteria was demonstrated in the prostates of a significant number of patients (25.1%) who underwent adenomectomy for BPH. No differences were found between the patients with a positive or negative bacterial culture and histological evidence of prostatitis.

Aged↗
PubMed1999

[Bacterial content of the enucleated prostate gland].

OBJECTIVE: To determine the prevalence of prostatic colonization or infection in patients undergoing prostatic surgery for obstructive symptoms due to benign hyperplasia of the prostate (BPH), to identify and quantitate the microorganisms isolated in quantitative bacterial tissue cultures, and to determine the influence of open surgery vs endoscopy on the microbiological findings. METHODS: A prospective study was conducted on 175 patients undergoing surgery for BPH. All patients were entered into a study protocol that included quantitative bacterial cultures of prostatic tissue. Data of previously defined variables were entered into a data base for subsequent analysis comprised of redefinition of the variables and descriptive and analytical studies. RESULTS: 44 of the 175 patients (25.1%) had a positive bacterial culture of prostatic tissue. Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%), regardless of the presence or absence of bacteria. Of these 68 patients with histologically demonstrated prostatic inflammation, only 19 (27.9%) had a positive prostatic tissue culture. The incidence of granulomatous prostatitis was 1.1%. CONCLUSIONS: The presence of bacteria was demonstrated in prostates of a significant number of patients (25.1%) undergoing prostatectomy for BPH. The microorganisms most frequently isolated in the quantitative bacterial cultures were, by order of frequency, coagulase negative Staphylococci, Escherichia coli and Enterococcus faecalis, which were present in concentrations of at least 10(4) CFU/Gm in prostatic tissue of 79.6% of the cases. No differences were found between the type of procedure the patient underwent and the presence or absence of prostatic infection.

Enterococcus faecalis↗
PubMed1997

[Effects of chronic diseases on the use of primary care by the aged].

OBJECTIVE: To analyse how often elderly people attend Primary Care (PC) consulting rooms and how attendance is affected by the number and kind of chronic pathologies those elderly people suffer. SETTING: A medical list from each of three Health Centres in the city of Granada was chosen. PATIENTS: All those over 65 registered on these lists from 1990 to 1994 inclusive, 711 people in total, were included. The number of attendances and chronic illnesses were obtained from the Clinical Records. The outcome variable "Mean Annual Consultations" (MAC) over the study period was analysed by ANOVA and multiple linear regression. RESULTS: MAC was 5.79 (SD 4.20), with a range from 0 to 27 consultations. MACs were significantly higher among the elderly registered at the Doctors' Health Centre (p < 0.001), among women (p < 0.05) and for the presence of any of the pathologies under consideration (p < 0.01) except dementia. A relationship was found between the number of comorbidities and MAC (p < 0.001). In the scaled multiple regression analysis, the number of comorbidities, the first variable introduced into the model, explained 33% of variability in use. CONCLUSIONS: The number of chronic pathologies strongly determines elderly people's attendance at PC consulting rooms, independently of the kind of illness they suffer from.

Aged↗
PubMed1997

[Factors associated with the incidence of hospital readmission].

BACKGROUND: To identify factors associated with hospital readmission, especially those potentially avoidable. This information could be useful to reduce the incidence of hospital readmissions. METHODS: A paired (1:1) case-control study nested into the cohort of first admissions at the Granada University Hospital, Spain, in 1990. All patients readmitted at the hospital within 3 years after release from the index-admission by the same diagnostic or complications of it comprised the case group. For each case, a control patient was matched for both primary diagnosis on admission and index-admission date. Information on risk factors associated with hospital readmission was obtained retrospectively from medical records. The relation between these risk factors and readmission was estimated from odds ratio both crude and adjusted using conditional logistic regression analysis. For the readmitted subsample, multiple linear regression models were applied to identify factors associated to the length of time between the index episode and the first readmission. RESULTS: Variables with consistent positive associations with readmission include male sex (odds ratio = 2.86, 95% confidence interval = 1.37-5.88), widowed or single status (2.66, 10.7-6.59) and severity at index admission (3.20, 1.57-6.51). Factors related to quality of health care did not influence readmission risk. CONCLUSIONS: Factors depending of the patient seem to be the most important variables associated to the incidence of hospital readmission.

APACHE↗
PubMed1996

[Validity and reliability of the family Apgar family function test].

OBJECTIVE: The aim of this study is to analyse the validity and reliability of the Apgar family questionnaire on family function. DESIGN: A crossover and descriptive study. SETTING: Urban health centre. PATIENTS: 656 patients of the Zaidín-Sur health centre in Granada were interviewed at home. The questionnaire was repeated an average of 6 days later to 60 of the patients (30 with an interviewer and 30 filling in their own). MEASUREMENTS AND MAIN RESULTS: The within-class correlation coefficients for the 5 items in the Apgar-family we over 0.55, both for self-filled and interviewer questionnaires; the scale coefficients were 0.86 and 0.81, respectively. Item-scale correlation varied between 0.61 and 0.71. Crombach's alpha was 0.84 and none of the items, when taken out of the scale, increased the alpha. The factorial analysis isolated only one factor. 16% of the sample had dysfunctional Apgar-family: the average score was 8.4. After adjustment (multiple logistic regression), the following were significantly linked to family dysfunction: lack of social support; being widowed or separated/divorced; greater perception of susceptibility to, or seriousness of, illness; being an over-user of the health service; and being a woman. CONCLUSIONS: The Apgar-family questionnaire on family function is valid and reliable.

Cross-Over Studies↗
PubMed1996

[Validity and reliability of the Duke-UNC-11 questionnaire of functional social support].

OBJECTIVE: The aim of this study is to analyse the validity and reliability of the functional social support questionnaire, Duke-UNC-11. DESIGN: Descriptive. Crossover study. SETTING: Urban health centre. PATIENTS: 656 patients were interviewed in their homes. 60 had the questionnaire repeated (30 self-filled and 30 using an interviewer) an average of 6 days later. MEASUREMENTS AND MAIN RESULTS: The intraclass correlation coefficients of the 11 items in the Duke-UNC-11 were above 0.50, for both self-filled and interviewer questionnaires; the ones on the scale were 0.92 and 0.80, respectively. The factorial analysis separated two sub-scales, confidential support (7 items) and affective support (4 items). Low social support was significantly associated to: being over 40, widowed or divorced, living alone, over-user, worse subjective health, greater chronic morbidity, mental health disorder and family dysfunction. The multiple linear regression equation managed to explain 30% of the variability of social support, in which family function (family APGAR) explained 23.5%, education 3.3%, perception of internal health control 2%, mental health 1.2% and perception of susceptibility to/seriousness of illness 0.3%. CONCLUSIONS: The questionnaire Duke-UNC-11 is valid and reliable.

Adult↗
PubMed1993

[Inter-episode continuity of primary health care: proposal for an indicator].

The objective of this study was to assess the quality of the data included in patients' personal histories and to prepare an indicator of the continuity of health care between episodes of illness based on the information contained in these records. The study was descriptive. Public health specialists from the Department of Preventive Medicine of the University of Granada, Spain, participated in the design and analysis, and the field work was carried out by specialists from family and community medicine from the Zaidín-Sur Health Center of Granada, where the research was conducted in April to December 1989. For the study, 1581 personal histories were analyzed. The most complete records were those having to do with personal background (37% of the personal histories evaluated) and the most complete histories were those of pediatric patients, women, and persons who participated in programs organized by the health center. The degree of completeness of the records was low. Based on the indicator developed, only 16% of the histories at the Center contained sufficient information to allow continuity of care. It is recommended that simple records systems be created and that primary care physicians be educated in the collection of essential data.

Adult↗
PubMed1992

[Stress urinary incontinence. Our results with the Burch's technique].

The aim of the surgical procedures utilized in the treatment of stress urinary incontinence (SUI) is to correct the posterior ureterovesical angle defect, thereby improving transmission of intraabdominal pressures to the urethra. We report our experience on 61 patients that had been diagnosed with SUI at our service from June 1984 to December 1990. Treatment was by the same operative procedure (Burch Technique) in all patients. The methods of exploration and the prognostic factors that might influence the outcome of the procedure are described. The short-term (3 months) success rate was 95%, the medium-term (1 year) 85.7% and the long-term (5 years) 77.1%. We underscore the convenience of prophylactic heparin therapy to prevent possible thromboembolic complications.

Aged↗
PubMed1991

[The hospital stay as a modifier of the effect of other risk factors for hospital infection].

It has been suggested that the risk of hospital infection differs according to the moment of hospital stay. Through a retrospective cohort of 843 surgery patients the effect of several factors on nosocomial infection risk is studied as a function of the duration of the hospital stay. It was observed that the studied variables (operation, type of surgery, age and severity of underlying disease) had a predisposing effect on the appearance of infection in short stays (less than 14 days), being the effect greater in longer stays. It is concluded that hospital stay can act as a modifier of the effect of several factors on the risk of hospital infection.

Cross Infection↗
PubMedDate not supplied

[Trends in traffic accident mortality in Spain, 1962-1994].

OBJECTIVE: To assess the evolution of the traffic accident mortality rate in Spain from 1962 to 1994, and the role played by its four theoretical components: motorization index (vehicles/population), accidentability index (accidents/vehicles), harmfulness index (victims/accidents) and fatality index (deaths/victims). METHODS: Data from the National Population Census and the Bulletin of the Dirección General de Tráfico were collected to estimate the above mentioned indicators for all accidents and accidents in road and urban zones. Simple and multiple partial correlation coefficients among variables were calculated. Poisson regression models were also obtained. RESULTS: An increasing trend during the whole period was observed for the national traffic accident mortality rate, especially from 1982 to 1989 in the younger age groups, followed by a decrease since 1990. The aforementioned four components were significatively associated with the mortality rate. The strength of this association was especially high for the motorization index and for the harmfulness index when all accidents and road accidents were considered. For urban accidents, the fatality index rate is the component most strongly associated with mortality rate. The role played by the accidentability index in the magnitude of the mortality rate seems less important. CONCLUSIONS: The growing exposure rate to traffic accidents observed in Spain (measured by the motorization index) is not directly influenced by public heath strategies. Therefore, it seems advisable to emphasize the development of measures focused to control the other three components of traffic accident mortality rate, especially those related with harmfulness and fatality.

Accidents, Traffic↗
PubMedDate not supplied

[Geographical variability in the severity of traffic accidents in Spain].

OBJECTIVE: The aim of this study is to analyze the geographical variability of the severity of traffic accidents in Spain, from 1985 to 1994, and to compare several severity indicators. METHODS: The mean values --from 1985 to 1994-- of the following indicators were obtained for each province: mortality index (deaths/accidents), harmfulness rate (victims/accidents), fatality rate (deaths/victims), motorization index (vehicles/inhabitants) and population density. Variability measures among provinces were obtained for each one. Provinces were then grouped in tertiles according to the magnitude of each indicator. Simple correlation coefficients among indicators were calculated. Poisson regression models were obtained, using severity indicators as the dependent variables. RESULTS AND CONCLUSIONS: Geographical variability was especially high for mortality index and fatality rate. For all severity indicators, lower values were found in provinces with the highest population densities and important metropolitan areas. Harmfulness and fatality rates play an independent role upon mortality index.

Accidents, Traffic↗
PubMedDate not supplied

[The use of incidence density in assessing the risk factors for nosocomial infection].

Several authors have suggested that incidence density should be used in studying nosocomial infection. We assess several risk factors for hospital infection by two ratios, the incidence density ratio (IDR) and the relative risk (RR), in an historical cohort of 843 patients. The variables analyzed were: operation, its length, type of surgical wound, severity of underlying disease, and age. The IDR figures were always lower than those yielded by the RR. For example, the IDR for operated patients was 2.78, whereas RR yielded a figure of 6.46, or the IDR for patients greater than 60 years old was 0.96, whereas the RR achieved a significant value of 1.67. This suggests that the use of IDR to analyze risk factors for nosocomial infection improves comparability of results obtained in different hospital settings. Also, it may allow a more exact quantification of an effect. These facts influence implementation of nosocomial infection control measures.

Age Factors↗
PubMedDate not supplied

[Inequalities in health: perinatal and infant mortality in Spain].

The interregional variation coefficient (VC) has been considered as an accurate measure of the dispersion of regional infant, neonatal, postneonatal and perinatal mortality rates. Thus, trends of annual VC have been analyzed, for each rate, from 1940 to 1986, to identify the evolution in time of the regional differences with respect to these mortality rates. None of the four mortality rates showed a decreasing trend in their respective VCs. This may indicate that interregional differences do not change along time. The postneonatal mortality rate has been shown to have the highest VCs during the study period (ranging from 23 to 40%), with an independent evolution with respect to neonatal mortality rate, probably because the factors that influence both rates are clearly different.

Fetal Death↗