Biomedical subjects

S Romea Lecumberri

Publications and source records attributed to S Romea Lecumberri.

7 recordsLinked to original sources

PubMed2001

[Albumin-to-creatinine ratio as a diagnostic tool for type 2 diabetic nephropathy].

BACKGROUND: Given the low effectiveness of 24 hours determination of urinary albumin excretion (UAE) for the diagnosis of diabetic nephropathy in primary care, we aimed at evaluating the albumin: creatinine ratio (ACR) in the first voided morning urine sample as a diagnostic tool in this setting. PATIENTS AND METHOD: 214 patients with type 2 diabetes were studied. ACR and UAE were compared with correlation and lineal regression analyses. A receiver operating characteristic (ROC) curve analysis was performed to determine the discriminatory value for diagnosis of diabetic nephropathy. RESULTS: The correlation coefficient between ACR and UAE was 0.93 (p<0.01) and the ROC curve analysis showed a value of 2.4 g/mol for women and 1.4 g/mol for men. CONCLUSIONS: ROC curve analysis reveals that ACR is a useful method for diagnosing diabetic nephropathy, although the discriminatory value depends on sex.

Aged↗

PubMed2000

[Chronic complications of type 2 diabetes mellitus. Clinical course after 5 years of follow-up].

OBJECTIVE: To evaluate the modifications in the prevalence of complications and the incidence of end-points in diabetic patients observed for five years, and the effectiveness of a diabetes care protocol on the process indicators. DESIGN: Prospective observational study between 1991 and 1996. SETTING: Primary care centre. PARTICIPANTS: Diabetic patients monitored between 1991 and 1996. MEASUREMENTS AND MAIN RESULTS: Social and demographic variables, DM epidemiology variables, cardiovascular risk factors, complications and end-points were measured. 318 of the 352 patients selected in 1991 were followed. Average age was 68.6 (SD 11.2) and 39% were male. Mean observance was for 53 months (SD 10). There was an increase of insulin use (19%) and self-analysis (34.7%) both in men (chi 2 = 14.7, p < 0.001) and in women (chi 2 = 40.5, p < 0.001), independently of age (chi 2 = 37.77, p < 0.001). Complications increased: microvascular ones from 33.4% to 42.1%, macrovascular ones from 22.3% to 37.2%. The most common end-points were CVA (7.8%) and angor (3.6%). 22 patients died (6.9%), with ischaemic cardiopathy (30%) and neoplasm (30%) the most common causes. Hypertension increased from 51.6% to 59.8% and hypercholesterolaemia from 42.6% to 47%. Obesity (42%) and tobacco dependency (28%) remained stable. Systolic blood pressure went down by 4.7 mmHg and diastolic pressure by 3.76 mmHg, and in women, over-65s and those who had had the illness longest (> 10 years). 6.5% (CI 1-12.9%) of patients improved their blood pressure (< 135/85 mmHg). HbA1c worsened independently of sex, age or years of evolution of diabetes.

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PubMed1997

[Immunologic situation of hepatitis B in immigrants. Strategy for vaccination].

BACKGROUND: The aim of this study was to know the prevalence of the hepatitis B virus markers of infection in immigrants, to explain the demographic factors determinant for the convenience of hepatitis B immunization and to evaluate the usefulness of previous screening based on the prevalence of infection. SUBJECTS AND METHODS: Transversal descriptive study including 1,226 immigrants. Age, sex, birth place, serologic virus markers and vaccine convenience were analyzed. A logit model for each sex, the vaccination probabilities, contrasts related with a reference category and the odds ratios (OR) were estimated. RESULTS: 73.25% of immigrants were men. The mean of age was 29.57 (SD = 9.31) in men and 29.98 (SD = 13.89) in women. Men were mostly born in South Asia (32%) and women were in sub-Saharian Africa (35%). The probability of hepatitis B immunization convenience in both sex were 29.1% in those born in sub-Saharian Africa, and higher than 91.5% in those from America. This probability was higher than 85.8% up to twenty years old, and higher than 55.7% in older than forty. All zones showed a percentage of patients with hepatitis B immunization convenience greater than sub-Saharian Africa (OR +/- 2.4). CONCLUSIONS: Age and birth place explain the convenience of hepatitis B immunization. In the American immigrants it would result more efficient the massive immunization, while in the sub-Saharian population it would be better a previous screening because the prevalence of hepatitis B virus markers of infection is very high. Probability of hepatitis B immunization convenience decreases as age increases.

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PubMed1997

[Validation of a questionnaire for the diagnosis of urinary incontinence].

OBJECTIVE: To validate a questionnaire applied in the Primary Care (PC) clinic which enables urinary incontinence (UI) and its different types to be diagnosed. DESIGN: A descriptive crossover study. SETTING: A Urodynamics hospital out-patients clinic. PARTICIPANTS: Patients referred from PC to be tested for UI by Urodynamics. INTERVENTION: A self-filled questionnaire prior to the Urodynamics test to give a rough idea of the type of UI. Analysis of patients' characteristics and the internal validity of the questionnaire by comparing it with the Urodynamics test. MEASUREMENTS AND MAIN RESULTS: The sample was 59 men and 432 women. For the rough diagnosis of UI caused by straining in women, a five-question survey had a positive predictive value (PPV) of 77.2% for four affirmative replies, which went up to 83% if maximum exterior flow was included. For the UI group arising from anticholinergic treatment, a four-question survey had low PPV (57.6%), but this figure went up to 85.7% with a flowmeter. CONCLUSIONS: A questionnaire to study the type of UI, along with further tests, approached the aetiological diagnosis of incontinence in women. A Urodynamics study, however, always needs to be performed on men.

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PubMed1996

[Indicators for evaluating social problems in daily health care practice].

OBJECTIVES: To define some social indicators which allow the social problems of primary care patients to be studied. DESIGN: A descriptive, crossover study. SETTING: A health district with a socially depressed urban population. PATIENTS: Consecutive sampling of 403 patients. MEASUREMENTS AND MAIN RESULTS: Social risk factors were standardised in function of these criteria: economic, cultural, family, housing, old age and social margination. From these some social indicators were identified, with which a questionnaire with a person-to-person interview was filled in and then the clinical records reviewed. 35% of patients had social problems. We found no connection with gender or age. Pathologies related to the existence of social problems were: mental disorders, infectious diseases, liver and digestive diseases and ill-defined symptoms and signs. There were also more out-patient visits and hospital stays by patients with social problems. CONCLUSIONS: An active search for social problems reveals a much higher occurrence than expected. The finding of a connection between the existence of social problems and determined psychological and organic pathologies could assist the patient's diagnosis and treatment.

Adult↗

PubMedDate not supplied

[Dietary knowledge: a comparative study between health professionals and the general population].

BACKGROUND: The aim of the study was to assess physicians knowledge about salt and cholesterol content of selected foods, compared with general population knowledge. METHODS: A cross-sectional study made in Ciudad Sanitaria y Universitaria de Bellvitge (Barcelona). 106 physicians (66% of total) and 71 students were surveyed voluntarily. The general population sample was chosen from Hospital outpatients by systematic random sampling method. RESULTS: A self-administered questionnaire about salt and cholesterol high or low content of some foods demonstrated statistically significant differences (p < 0.001) when the average score was compared between health care professionals and the general population group, but in many cases right answer percentage did not arise 60 percent. CONCLUSIONS: Although health care professionals knowledge about salt and cholesterol content of diet is higher than among general population, they need a better and continuous formation in this issue.

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PubMedDate not supplied

[The allocation of the pharmacy budget to health centers].

OBJECTIVE: To design a mathematical model which permits pharmacy budgets to be assigned to Health Centres (HC), examining the social and demographic variables and health service usage which explain the variability of the pharmaceutical expenditure (PE) of the HCs. DESIGN: A descriptive, crossover study. SETTING: 17 HC of the Insitut Català de la Salut (Catalan Health Service) in the city of Barcelona during 1994. MEASUREMENTS AND MAIN RESULTS: Relationships among the following variables at the 17 HCs were studied: pharmaceutical expenditure per inhabitant (PEi), frequency of attendance (FRA), care pressure (CP), percentage of the population 65 or over (P65), percentage of the population with medical records (PPR), index of family economic capacity (IFEC), ratio of comparative mortality (RCM) and ratio of potential years of life lost (RPYLL). In the bivariant analysis, those variables with a statistically significant linear correlation with PEi were FRA (r = 0.67; p < 0.01), PPR (r = 0.56; p <0.01), IFEC (r = -0.68; p < 0.01), RCM (r = 0.61; p < 0.01) and RPYLL (r = 0.62; p <0.01). In the multivariant analysis, IFEC, P65 and FRA enabled 94% of the PEi variability to be explained (r2 = 0.94; p < 0.001). Through multiple regression a mathematical formula for calculating the PE of HCs was obtained. CONCLUSION: The model presented enables pharmacy budgets to be assigned to the HCs if the IFEC, P65 and FRA of the population attended is known.

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