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Biomedical subjects

R Gálvez Vargas

Publications and source records attributed to R Gálvez Vargas.

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

[Risk factors associated with falls in institutionalized elderly population. A prospective cohort study].

BACKGROUND: Falls in elderly subjects are a frequent cause of morbidity and mortality. The present study investigated risk factors associated with falls in institutionalized elderly subjects. PATIENTS AND METHODS: The subjects of this prospective cohort study were 190 persons aged 65 years or older, who were able to walk unassisted. We recorded sociodemographic variables, morbidity, drugs, functional capacity, cognitive status, gait and balance. Crude and adjusted density ratios (DR) were calculated and Cox proportional risk analysis was performed. RESULTS: A total of 121 falls occurred in 7 persons, for a fall rate of 0.75 per person per year. Independent risk factors identified with multivariate analysis were diabetes mellitus (DR = 3.6), slow gait (DR = 1.7), failed Romberg test (DR = 3.2) and fall(s) during the previous 12 months (DR = 1.9). Drugs that were associated with significant risk were digitalis, antiarrhythmics, neuroleptics, antidepressants and oral bronchodilators. A higher number of chronic diseases acted as a protective factor. CONCLUSIONS: The main risk factors associated with falls in elderly were easy to identify. Analysis of these factors can help to identify elderly persons with a high risk of falls, and thus focus appropriate preventive measures on these subjects.

Accidental Falls↗
PubMed1998

[Frequency, characteristics and consequences of falls in a cohort of institutionalized elderly patients].

OBJECTIVE: Falls in the elderly are a major problem because of their high morbility and mortality rates and health expenditures. However, there are few studies about this problem in our country. The purpose of the present study was to know the frequency, features and consequences of falling among institutionalized elders. METHODS: We carried out a prospective cohort study using a sample of 190 persons aged 65 years and older living in two nursing homes. All subjects underwent a comprehensive evaluation at the onset of the study. During a mean follow-up period of 310 days, all falls were recorded. RESULTS: There were a total of 121 falls in 72 (37.9%) subjects, twenty five of whom (34.7%) experienced two or more falls. The fall incidence per person-year was 0.75. As compared with males, females had a density ratio (DR) of 2 (1.2-3.2; 95% confidence interval-CI). Falling was more frequent in the bedrooms and living rooms (43.8%). DISCUSSION: This results agree with others studies about the high fall incidence in the elderly and bring out new features about circumstances and consequences of falls.

Accidental Falls↗
PubMed1997

[Morbidity, mortality and the potential years of life lost attributable to tobacco].

BACKGROUND: The aim of this study was to evaluate the morbidity and mortality attributable to smoking. MATERIAL AND METHODS: A transversal study was performed in a reference population of residents of the province of Granada (Spain). The number of deaths in 1985, the number of patients admitted to public hospitals in 1987 and a sample of out patients in 1989 were gathered from the National Institute of Statistics and hospital registries, and a prospective collection from out patient clinics was also carried out. The diseases studied included: oropharyngeal, esophageal, pancreatic, laryngeal, lung, bladder and kidney carcinomas, ischemic cardiopathy, cerebrovascular stroke, peripheral arteriopathy and chronic obstructive lung disease (COPD). Statistical analysis was performed by populational etiologic fraction and the chi square test. RESULTS: Four point five percent of the total number of annual hospital admissions, 6.3% of the out patients, 15.9% of the mortality and 12.0% of the total number of potential years of life lost (TPYLL) were estimated to be attributable to smoking in individuals over the age of 15 years in the province of Granada. The most frequent causes of morbidity attributable to smoking were COPD and ischemic cardiopathy, and with regards to mortality, ischemic cardiopathy (28.5%), COPD (21.6%) and lung cancer (17.5%). Higher percentages were observed in males than in females and in the group from 46 to 65 years of age. CONCLUSIONS: Smoking is not only responsible for an important percentage of deaths, but also leads to premature death and a reduction in the quality of life which is translated into an excess of health care costs. Since the impact of smoking becomes particularly evident from 46 to 65 years of age, smoking prevention should be centered on the early years of life.

Age Distribution↗
PubMed1995

[Prevalence of cardiovascular risk factors in a working population].

BACKGROUND: A high prevalence of cardiovascular risk factors (RF) has been reported in Spain. The aim of this study was to determine the main RF of heart disease (cholesterol, smoking, high blood pressure (HBP), diabetes, obesity, and sedentarism) in laboral population from Granada, Spain. METHODS: The sample included 1,555 workers (1,193 males and 362 females, mean age 42.3 years). The percentage of participation was 91.9%. Information was collected directly (standardized self administered questionnaire) and from the physicians of the companies (protocolized anamnesis, physical examination and electrocardiogram) for each worker. Serum cholesterol was measured in venous blood by an enzymatic autoanalyzer. A description of the phenomennon was studied and likewise, the multivariate models of logistic regression were adjusted to evaluate the association of the other RF with hypercholesterolemia. RESULTS: Serum cholesterol level higher than 200 mg/dl (5.17 mmol/l) was presented in 69.3% of the sample. The prevalence of HBP was 8.4%. Forty-four point two percent were smokers (48.9% males and 28.7% females). A body mass index higher than 25 kg/m2 was presented in 65.2%. The prevalence of diabetes was 3.5% and 18% of the workers classified themselves as sedentary. Only 2.8% of the males and 11.6% of the females were absolutely free of the RF studied. Diabetes, age, obesity, HBP and smoking (> 10 cigarettes/day) were significantly associated with a higher probability to present hypercholesterolemia. CONCLUSIONS: A high prevalence of classical risk factors related to cardiovascular disease, with the exception of high blood pressure, was observed, thus making the application of preventive measures necessary.

Adolescent↗
PubMed1995

[Changes in arterial pressure and smoking habit following 3 years of multifactorial intervention].

BACKGROUND: The feasibility of successfully reducing cardiovascular risk factors is supported by large studies. Nevertheless, controversy remains about the actual efficacy of some lifestyle interventions. This report assess the effectiveness of different levels of intervention at the work-site on blood pressure and smoking. METHODS: At the beginning of the program 1.193 men and 362 women were included in it. Individualized face-to-face counseling was given to employees by four different occupational physicians. After 3 years, 980 individuals remained in the study. The differences among the four groups allowed us to distinguish three different levels of intensity of interventions and a fourth group that was the reference one. Observed changes in blood pressure were compared using analysis of covariance. Adjusted odds ratio of smoking quit rates were calculated by logistic regression. RESULTS: Intensive intervention was significantly different from control group and the group of mild intervention. Moderate intervention was the only one to bring about a significant reduction of arterial blood pressures. This reduction was consistent with the lower threshold used in this group to classify diastolic blood pressure as high. Smoking quit rate was 22% for intensive and moderate interventions. Adjusted odds ratio for quitting smoking was 5.81 (95% CL 1.29-26.14) for moderate and 8.2 (IC 95% 1.75-38.46) for intensive intervention. CONCLUSIONS: A lower threshold for starting intervention measures on blood pressure is suggested to achieve better results. As the intensity of interventions was stronger, smoking quit rates were higher.

Adult↗
PubMed1994

[Proportion of disease attributable to tobacco in the province of Granada].

BACKGROUND: Smoking is the main cause of preventable morbidity and mortality in Europe. The effect of smoking is not constant with the diseases related to it. The goal of this study is to estimate poblational etiologic fractions (PEF), as the proportion of disease attributable to smoking in the reference population, for those disease clearly related to smoking in Granada. METHODS: The PEF depend upon relative risk (RR) and the proportion of exposed subjects in the target population. Meta-analytic procedures, following the Woolf's method, were applied to estimate weighted RR between smoking and each one of the diseases studied. A survey on a random sample of all Granadian population to assess the prevalence of smoking was performed. RESULTS: The PEF were always higher for males than for females. In males, the highest figures were for lung cancer (85%) and chronic obstructive lung disease (84%); whilst in females lung cancer and peripheral artery disease reached the greatest figures, 55% and 51%, respectively. CONCLUSIONS: The figures obtained outline the need for improving antismoking campaigns and allow to quantify the maximum potential benefit to be got if smoking was quit by the Granadian population.

Adolescent↗
PubMed1993

[The estimation of the cost of nosocomial infection in an intensive care unit].

BACKGROUND: Nosocomial infection (NI) represents an increase of hospital morbidity and mortality. The data available concerning the hospital expenses due to the prolongation of hospital stay associated to NI are fundamentally derived from American studies. The aim of this study was to evaluate the direct cost of nosocomial infection in an intensive medicine unit (IMU). METHODS: A study of cases and paired controls was carried out with a cohort study made up of 88 cases and 88 controls paired by age and severity (APACHE II grading). Previously identified confusion factors were controlled in the analysis. RESULTS: The mean stay in the IMU for infected patients was 17.2 days and for non infected patients 6.8 days. When these stays were adjusted by the variables associated with both NI and in the IMU this became 14.2 days for infected patients and 9.9 days for uninfected patients. The prolongation of stay in the IMU due to NI was 4.3 days. The extra cost for the hospital due to infection acquired by a patient's during stay in the IMU was estimated as 239,441 pesetas. CONCLUSIONS: The methodology used was considered as valid for estimating the prolongation of stay in intensive medicine units attributed to nosocomial infection. The high economic expense which nosocomial infection represents emphasizes the justification for measures of control of this entity.

Adolescent↗
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↗
PubMed1991

[Epidemiology of brucellosis in the Granada province (I). Occupational risks].

BACKGROUND: Brucellosis is a health problem in the Granada province. The major aim of the present study was to evaluate the professional risk to acquire brucellosis in Granada. METHODS: An epidemiologic study where the cases of brucellosis were found by active search was carried out. The study period was the year 1984. The patients (overall 804) were investigated in their residence area with a questionnaire where the major risk factors were considered. RESULTS: The disease was more common in males than in females (RR = 3); it had a significant tendency to increase with decreasing sizes of the urban nucleus (chi MH = 16.9, p less than 0.0001); and it had a significant relationship with the proportion of peasants and cattle workers in the region (r = 0.66, p less than 0.05). The professional group with the highest risk were veterinaries, in whom the disease was 31 times more common than in the rest of the population. CONCLUSIONS: Emphasis is made, in addition to other points, on the need to increase health education in the groups of more affected professionals.

Adolescent↗
PubMed1991

Preoperative stay as a risk factor for nosocomial infection.

To evaluate the relationship between duration of preoperative stay and the risk of nosocomial infection, we studied 449 patients who underwent surgery at the University Hospital of Granada during the first six months of 1986. Patients were chosen from two cross-sectional surveys. Nosocomial infection was studied throughout each patient's hospital stay. Other variables included preoperative stay, age, severity and total length of stay. The data were analyzed by comparing nosocomial infection for different lengths of preoperative hospitalization, age and severity by calculating the Odds Ratio. The effects of age and severity were studied by stratifying patients by duration of preoperative stay. Two multivariate regression models were used to confirm the results of the stratified analysis. The results suggest that lengthening the preoperative stay may increase the risk of nosocomial infection in surgical wounds and in other sites, and may simultaneously potentiate the effects of other risk factors such as age and severity of the patient's condition, whose influence on susceptibility to infection increases with the duration of preoperative stay.

Adolescent↗
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↗
PubMed1990

[Infection by the human immunodeficiency virus in the Spanish population (II). A meta-analysis of the time and geographic trends].

The aim of this research was to study the prevalence of infection by the human immunodeficiency virus (HIV) among the Spanish population. Due to the lack of available data we have applied meta-analysis techniques. We analyzed 67 original publications on this field appeared between 1985 and 1989. The prevalence of the illness has progressively increased among the risk groups (ADVP, homosexuals, prostitutes, heterosexual transmission) but not in hemophilic patients. The geographical distribution showed statistically significant differences being Barcelona as the province with the area of highest prevalence of the infection in ADVP and homosexuals.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Infection by the human immunodeficiency virus among the Spanish population (I). Qualitative meta-analysis].

A meta-analysis of the original papers on human immunodeficiency virus (HIV) published in Spain was performed to better know the characteristics of HIV infection in Spain. Between 1985 and 1989, 67 investigations fulfilled the inclusion criteria. They were evaluated by means of a quantified questionnaire. The mean quality of the investigations was 44.65 +/- 1.5%. A bias in the selection was highly probable in 80% of the studies, whereas a bias in information and in confusion was less frequent (35.8% and 77.6%, respectively). The investigations of more quality were those carried out recently at the University in collaboration with other Institutions and with participation of sanitary personnel published in microbiologic journals.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[The health content of school education programs].

A sample of 949 primary schoolchildren was evaluated. The sample was representative of the medium and advanced cycles in private and public schools from the city of Granada. When then different variables were analyzed, no significant differences were found for "sex" or "type of school". In "geographical areas" there were no differences for acceptable level of knowledge; however, there were differences when a higher level was required: the maximum success rate for the medium cycle was in the central area (40.5%) and the lowest in the Chana area (2.9%). Fort the advanced cycle, the maximum was in the central area (41.9%) and the lowest in Cartuja (13.3%). Similar findings were obtained for sociocultural status: the higher class had 52.7 for the medium cycle and 51.7% for the advanced cycle. It is concluded that the familial milieu is highly influential.

Child↗
PubMed1989

Prevalence of dental caries in school children of the province of Granada (Spain).

A sample of 3,347 students between 5 and 14 years of age was selected from the entire student population in the province of Granada (Spain) to study the prevalence of dental caries and several risk factors for the disease. Decay was ascertained in the study population by means of the following indices: df, DMF, and DMFS. Risk factors considered were the level of oral hygiene, number of between-meal sugar-containing food, and flouride concentration in drinking water. The indices mentioned showed a clear relationship to the age of the participants in the study. The level of oral hygiene did not show a clear association with dental caries measured through the df and DMF indices. Curiously, a higher correlation was noted between the disease in deciduous teeth and fluoride concentration than between the disease in permanent teeth and the latter factor.

Adolescent↗