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Biomedical subjects

R Gabriel Sánchez

Publications and source records attributed to R Gabriel Sánchez.

12 recordsLinked to original sources
PubMed2006

[Effects of NSAID on blood pressure among hypertensive patients with a high cardiovascular risk].

BACKGROUND: An elevation in the risk of cardiovascular (CV) events and blood pressure (BP) levels in patients treated with COX-2 inhibitors compared to non selective NSAID has been shown previously. OBJECTIVES: To compare the effects of NSAID (COX-2 inhibitors and non-selective) on BP levels and control of HT. To determine the association between NSAID use and coronary heart disease in HT patients with elevated CV risk. METHODS: Cross sectional epidemiological study in 8126 ambulatory HT patients, older than 40, with a high CV risk. We obtained data on personal variables, CV risk factors, previous CV history, CV medication, analgesic and anti inflammatory drugs (AID). Control of HT was classified: optimal, suboptimal and no control. Absolute CV risk was calculated according to the WHO-ISH score. RESULTS: 44.2% of subjects took ASA and 3.7% another NSAID. SBP was 5.90 mmHg (95%CI: 2.53-9.27 mmHg) higher (p < 0.05) in patients treated with NSAID than in those with no AID medication. Patients having ASA, both SBP and DBP were 5.89 mmHg (p < 0.01) and 2.25 mm Hg (p < 0.05) respectively, lower than in patients with NSAID. However, mean SBP was similar in the ibuprofen group compared to without AID; 11.12 mmHg lower (95%CI: 3.66-18.58) than in the group on NSAID (p < 0.05) and 8.82 mmHg (95%CI: 0.27-17.38) (p < 0.05) lower than in those on COX-2 inhibitors. CONCLUSIONS: Among HT patients, NSAID therapy (selective or not) is associated with a higher level of SBP than in those without such medication. However, patients treated exclusively with Ibuprofen show similar levels of SBP than without NSAID treatment. Frequency of ischemic disease was significantly higher in the group treated with COX-2 inhibitors than in the non-selective NSAID treated group or in patients without NSAID treatment.

Aged↗
PubMed2005

[Pain in Spanish rheumatology outpatient offices: EPIDOR epidemiological study].

OBJECTIVE: To establish the prevalence and characteristics of rheumatologic pain in Spanish adult population cared in specialized rheumatology offices. DESIGN: Cross selection study in a population of patients cared in rheumatology offices of public Spanish hospitals. SUBJECTS: 1,134 patients selected through random sampling based on waiting lists of patients, during a period of 1 week, in rheumatology offices of each participating hospital. MAIN OUTCOMES OF THE STUDY: Reason behind the consultation (a new patient [NP] or a patient for revision [RP]), characteristics of the patient (sex, age, habits [alcohol/tobacco], marital status), location, type, intensity, duration, tolerance and management of pain; treatment (pharmacological or non-pharmacological) carried out; satisfaction with the treatment; and association with fibromyalgia. RESULTS: The prevalence of pain in NP was 98.6% and in RP 95.1%, with a global prevalence of 96%, predominating mainly in adult sedentary women with fibromyalgia. The frequency of acute pain was 20.9% and this of chronic pain 79.1% [corrected] The prevalence of fibromyalgia was 12% (2.2% in men, and 15.5% in women). The most prevalent pattern of current dominant pain was this of the mechanical type. More frequent associated pathologies were: hypertension (21.7%), depression (14.4%), gastrointestinal diseases (13.8%) and anxiety (13.4%). All variables analyzed in the study showed changes according to age, sex, and type of patient (NP or RP). Most used treatment was pharmacological; more than 57.6% of patients were receiving NSAIDs. In NP, medical prescriber of the treatment was first the general practitioner (56.1%) followed by the rheumatologist (14.1%); in PR the first one was the rheumatologist (69.9%) followed by the general practitioner (16.5%). CONCLUSIONS: Our results show that the prevalence of the rheumatologic pain is very high, predominating mainly in adult women with fibromyalgia. Pain location, intensity, and type, associated pathology, and treatment vary according to age, sex, and type of patient. The most commonly used drugs for pain management were NSAIDs (58%); opiodes were only used in 6.4% of patients even though pain was intense in more than two-thirds.

Aged↗
PubMed2000

[Pattern of the distribution of total cholesterol and cHDL cholesterol Spanish children and adolescents: RICARDIN Study].

BACKGROUND: The RICARDIN Study multicenter study of cardiovascular risk factors in children and adolescents has described the standards of normality of blood cholesterol levels in the Spanish school population. The objective of the present study was to compare mean values of cholesterol between different regions of Spain, and to compare the global mean with a pool international study. Also, the pattern of total cholesterol and cHDL by age and sex using mathematical model is described, and comparison with two international studies carried out in USA and Japan is performed. SUBJECTS AND METHODS: 10,683 children aged 6 to 18 were selected from 7 different Spanish provinces (Madrid, Vizcaya, Lugo, Badajoz, Murcia, Asturias and Barcelona). Blood samples were obtained by capilar puncture (Reflotron). RESULTS: Mean values of total cholesterol was different among provinces, and globally, were lower than the international pooled population, although the pattern observed in each population was very similar. Total cholesterol curve for Spanish boys showed a curvilinear trend that can be estimated through a cubic function that explains 89% of observed data, while for girls the best estimate was obtained through an inverse function (R2 = 0.40). cHDL for boys showed a cubic function as the best estimate (R2 = 0.90), while for girls the best estimate was obtained through a quadratic function (R2 = 0.59). CONCLUSIONS: There are important physiological variations of total cholesterol level by age and sex in children and adolescents. The pattern of cholesterol does not follow a linear model but a curvilinear one, that need to be considered in clinically assessing individual determinations of cholesterol, since highest percentiles can vary by age and sex.

Adolescent↗
PubMed1997

[Decision making in cardiology: methodology].

This article reviews the methods employed in usual clinical thinking for making decisions, the problems and limitations inherent in them and claims that a more frequent utilization of the so called "Evidence Based Medicine" methods is a more valid and efficient alternative for medical decision making. We also describe the theoretical basis and strategies used in the medical decision process; the specific concepts and basic components for building decision trees are also shown. Finally, a real case is presented and approached step by step: the statement of the decision problem, its possible alternatives, the allocation of probabilities to each outcome based on the best available evidence, and the calculations of the expected values (projected usefulness, cost-effectiveness) and sensitivity analysis by means of specific software for making decisions.

Aged↗
PubMed1997

[Estimation of initial interobserver variability of forced spirometry in the multicenter epidemiological study IBERPOC. Scientific Committee of the IBERPOC study].

To estimate the interobserver variability and degree of agreement for basic spirometric parameters before beginning field work for the IBERPOC Project. Study of agreement between 7 observers (pneumologists) and a gold standard, using a scheme of incomplete balanced and randomized blocks with an equal number of spirometric measurements (n = 3) per patient and an equal number of measurements (n = 9) per observer performed at the same session. The study population consisted of 14 patients with different degrees of air flow obstruction and 7 normal volunteers. Statistically significant differences attributable to subjects (inter-patient variability) were found for the three variables analyzed. Variability attributable to the observer was found for FVC and FEV1 but not for FEV1/FVC. The greatest interobserver differences were found for FEV1, such that 4 of the 7 observers recorded values that were significantly different from the mean (p < 0.05). The differences were less marked for FVC and for the FEV1/FVC ratio, with only 2 observers recording significantly different values for each variable. The high degree of reproducibility as well as the excellent interobserver agreement found in this standardization session provide an a priori guarantee of validity for spirometric measurements and rule out the existence of differential bias in data recorded at the various geographic areas involved in the study.

Data Interpretation, Statistical↗
PubMed1996

[Drug consumption by people over 60 years of age in a rural area].

OBJECTIVES: To describe the frequency and distribution of the consumption of medicines in a census-based sample of people of 60 or over. To determine the association between the consumption of medicines and other socio-demographic and clinical (presence of disease) variables. DESIGN: An epidemiological crossover study based in the community. SETTING: Rural population: the Health District of Arévalo in Castilla y León. PARTICIPANTS: 825 subjects (446 women and 379 men) over 60, with an average age of 71,84. MEASUREMENTS: A standard questionnaire was used, containing medicine consumption, prescription, and clinical and demographic features. RESULTS: The consumption of medicines per person per day was 1,92. Therapeutic groups most consumed were, in this order, hypotension drugs, cardiotonics, antirheumatics, peripheral vasodilators, digestive system drugs, neurotropics and analgesics. The number of illnesses suffered by this age-group was 2,19. There is a strong connection between consumption of medicines and age, especially in the over 80's. CONCLUSIONS: 75% of the target population took some medicine each day. Consumption is higher among women than men. Cardiovascular drugs are the most frequently used therapeutic group. Consumption of medicines is directly related to age and the number of illnesses.

Age Factors↗
PubMed1996

[Research methods in clinical cardiology (I). Types of basic designs. Observational studies in clinical cardiology (I)].

Clinical investigation studies can be classified according to their purpose (causality, diagnosis, therapy, etc), by its research strategy (observation or intervention), by the characteristics of its design (descriptive or analytic) or according to the basic axes of the investigation process (directionality and time orientation); and the personal attributes (exposure and disease) of the study population. Among observational designs, the cross-sectional and ecological studies are the main representatives of descriptive research. Their main objectives are the estimation of disease prevalence and risk factor distribution in the population, as well as the comparison of prevalence and risk factor distribution among several populations. On the other hand, the aim of analytical studies is the identification of individual risk factors associated with the disease. The key difference between descriptive and analytical studies is the existence of a comparison group in the latter, which allow hypotheses testing. Examples or analytical studies are the case-control and cohort studies. This paper deal with the principles of basic design and methods of descriptive (cross-sectional and ecological), and case-control studies. Finally we outline the basic concepts and principles of the screening, a frequent objective in many cardiovascular surveys, specifically in primary prevention.

Case-Control Studies↗