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Biomedical subjects

R Córdoba

Publications and source records attributed to R Córdoba.

At least 19 recordsLinked to original sources
PubMed2005

Pulmonary embolism in a patient with severe congenital deficiency for factor V during treatment with fresh frozen plasma.

Thrombosis is a rare complication in patients with congenital clotting factor deficiencies. In most cases, it is related to inherited procoagulant factors, use of central venous catheters or administration of coagulation factor concentrates. There are only a few case reports about thrombotic events during treatment with fresh frozen plasma (FFP). We report the case of a patient with homozygous inherited factor V deficiency, who developed a pulmonary embolism at a time of treatment with methylene blue treated FFP (MBFFP). The patient had only two other factors predisposing to thrombosis and both were acquired: obesity and bed rest. He started anticoagulant treatment with low molecular weight heparin (LMWH) while the deficient factors were replaced with MBFFP. After 8 days of treatment the patient developed a severe respiratory insufficiency. Pulmonary haemorrhage was considered among the differential diagnosis and LMWH was stopped. An inferior vena cava filter was placed without any further thrombotic complications. To our knowledge, there are no reports about patients with clotting factor deficiencies who developed a thrombotic event during treatment with MBFFP.

Adult↗
PubMed2000

[Value of brief questionnaires in predicting smoking cessation in primary care].

OBJECTIVES: 1. To study the factors predicting the giving-up of tobacco and to correlate the categories in the Smoker's Aid Programme (SAP) with levels of motivation and dependency, using brief questionnaires. 2. To find the annual percentage in the "winners" category, using the SAP methodology. DESIGN: Prospective, observational, intervention study without a control group of a random sample of smokers attending primary care clinics. SETTING: Four urban health centres in Zaragoza and Barcelona. INTERVENTIONS: Systematic intervention on smokers in the change phase (SAP category). Use of questionnaires on motivation/dependency and of biochemical checks that they had actually given up. PATIENTS: 362 patients of whom 288 smokers (79.5%) took part. Average age was 40.85 (SD: 15.7). 60.8% were males. MEASUREMENTS AND MAIN RESULTS: 21.4% of the smokers had tobacco-related pathology. The number of previous attempts to give up smoking was 1.6 (SD: 2.9) Patients smoked an average of 13.4 cigarettes for 22.2 years (SD: 15.7). Average age at start of consumption was 17 (SD: 4.7). Initial motivation on the Richmond Test was 4.78 (SD: 3.2); and average dependency according to the modified Fagerström Test (TFm) was 0.6 (SD: 0.7). The number of SAP interventions was 1.9 (SD: 2.9). By the end 15.6% of the patients had achieved "winner" status, which was confirmed in 95.6% of them by the biochemical test. The logistic regression model confirmed that the factors predicting giving up tobacco were age, the initial levels of motivation and the initial number of cigarettes. CONCLUSIONS: The short tests of motivation (Richmond) and, to a lesser extent, dependency (TFm) were good predictors of giving up tobacco and can be recommended in primary care.

Adult↗
PubMed1998

Effectiveness of brief intervention on non-dependent alcohol drinkers (EBIAL): a Spanish multi-centre study.

OBJECTIVE: The project was designed to compare the effectiveness of brief intervention (BI) versus simple advice (SA) in the secondary prevention of hazardous alcohol consumption. METHODS: A randomized controlled trial with a 12-month follow-up was conducted. A total of 74 community-based primary care practices (328 physicians) located in 13 Spanish autonomous regions were recruited initially. Out of 546 men screened, only 229 were randomized into BI (n = 104) and SA (n = 125); 44.6% of practices finalized the study. The interventions on the BI group consisted of a 15-minute counselling visit carried out by physicians which included: (i) alcohol quantification, (ii) information on safe limits, (iii) advice, (iv) drinking limits agreement, (v) self-informative booklet with drinking diary record and (vi) unscheduled reinforcement visits. The SA group spent 5 minutes which included (i), (ii) and (iii). RESULTS: There were no significant differences between both groups at baseline on alcohol use, age, socioeconomic status and CAGE score. After the 12-month follow-up there was a significant decrease in frequency of excessive drinkers (67% of BI group reached targeted consumption, versus 44% of SA; P < 0.001) as well as weekly alcohol intake reduction (BI reached 52 versus 32% in SA; P < 0.001). A trend to improve outcome with the number of reinforcement visits was found with BI. The only predictor of success was the initial alcohol consumption level. CONCLUSIONS: Brief intervention is more effective than simple advice to reduce alcohol intake on adult men who attend primary care services in Spain.

Adolescent↗
PubMed1997

[The evaluation of a self-measurement arterial pressure monitor: the OMRON-HM 722C].

OBJECTIVE: To evaluate a self-measuring blood pressure (BP) monitor, the OMRON-HM 722C. DESIGN: Based on the protocol of the British Hypertension Society (BHS). SETTING: Urban health centre. PARTICIPANTS: A sample of 120 people (69 women) excluded those with a brachial perimeter under 24 centimetres or over 32. MEASUREMENTS AND MAIN RESULTS: Each subject had four BP measurements in succession, separated by a minute: a) Manually, with a mercury sphygmomanometer (MSM); b) with self-measurement monitor; c) with self-measurement monitor; d) with MSM. Means and SD of systolic and diastolic pressures, means and SD of the differences and a graphic representation of these by the Bland and Altman method, were calculated. The cumulative percentages of differences the same as or below 5, 10 and 15 mm Hg were calculated. 89.1% of systolic BPs, and 92.5% of diastolic BPs, showed mean differences between monitor and observer equal to or below 5 mm Hg. The size of the differences was grade A in both cases, according to the BHS criteria. CONCLUSION: The OMRON-HM 722C self-measuring monitor could be useful for self-measurement of BP at home by primary care patients.

Aged↗
PubMed1997

[Multicenter study on the efficacy of advice for the prevention of alcoholism in primary health care].

BACKGROUND: The aim of this study was to analyse and to verify the efficacy of systematic advice for alcoholism prevention, assessing the reduction of the number in risk drinkers. PATIENTS AND METHODS: A multicenter randomized controlled clinical trial was designed, to perform in general practitioner setting, on a sample of risk drinkers (alcohol intake > 280 g weekly, without dependence) sent by random in intervention group (systematic brief advice with support material and a five visit program during a year) and control group (once brief advice and a control in 1 year). The procedure to incorporate in both groups included physical exam, a blood test and the MALT questionnaire. A descriptive and analytic study on included variables was realised, assessing the percentage of drinkers who reduced alcohol intake below risk limit at the end of a year follow up, as well as the reduction intake in each group. RESULTS: Of the 139 included males, 75 were in the intervention group and 64 in the control group. The percentage of patients not excluded by MALT > 10, and/or liver disease, that finished the 1 year follow up, was 46%, being the sample average age of 43 +/- 11.8. Patients included in both groups were initially comparable. At the end of a year follow up there were statistically significant differences in: percentage of risk drinkers who decreased alcohol intake below 280 g weekly (82% intervention group; 47% control group); percentage of reduction in GPT, GGT, triglycerides, systolic blood pressure and the MALT questionnaire. CONCLUSIONS: The efficacy of isolated advice of general practitioner was proved to achieve the alcohol intake reduction below the risk limit accepted in male risk drinkers without alcohol dependence. The systematic follow up during a year significantly improves the results achieved with the isolated advice.

Adult↗
PubMed1995

[Family medicine research: analysis of papers accepted at national and international congresses].

OBJECTIVE: To analyse the thematic content and the origin of the free papers presented at four Family Medicine conferences (two national and two international) during 1992 and 1993; and to check the possibility of differences between Spanish and international lines of research. DESIGN: Descriptive study. MEASUREMENTS AND MAIN RESULTS: A total of 1,339 papers were classified. There were statistically significant differences (p < 0.001) in the thematic areas of Family Medicine (25.33% in international conferences, 7.77% national), Community Medicine (18.16% international, 28.20% national) and organisation of care (17.68% international, 30.16% national). The provinces with the highest number of contributions at national conferences were Barcelona, Madrid, Valencia and Zaragoza. At international conferences (WONCA) the greatest number of contributions came from the Scandinavian countries, Holland, the United Kingdom, Israel and Spain. CONCLUSIONS: Spanish investigators do not often tackle questions of under- and post-graduate training, professional attitude, clinical interviews or Bioethics. The papers at national conferences come mainly, in quantitative terms, from large provinces. The lower participation of liberal health systems like the German, French and North-American is noticeable.

Adult↗
PubMed1994

[Giving up tobacco and changes in biological parameters].

OBJECTIVE: To study the modifications in some biological parameters in patients who stop smoking. DESIGN: An analytic observational prospective study. SETTING: Urban Health Centre. PARTICIPANTS: 152 patients included in an intervention project against tobacco addiction. MEASUREMENTS AND MAIN RESULTS: Arterial pressure (systolic and diastolic), weight and base cardiac frequency were determined, using standard procedures at the start and end of the study year on smokers who gave up the tobacco habit and on those who continued smoking. Cessation was validated for those who gave up smoking. A non-significant reduction in arterial pressure, an average reduction of 6 beats per minute (p < 0.05) and an average weight increase of 1.5 kg (p < 0.05) were observed in the ex-smokers. CONCLUSIONS: Giving up tobacco produces a benefit not comparable to the light increase in weight observed in the ex-smokers. It would be useful to study whether proper dietary advice could minimise weight gain in recent ex-smokers.

Adolescent↗