Soriano J.B.,Program of Epidemiology and Clinical Research |
Yanez A.,Program of Epidemiology and Clinical Research |
Renom F.,Respiratory Unit |
de la Pena M.,Hospital Universitario Son Dureta |
And 2 more authors.
Primary Care Respiratory Journal
Aims: We describe the set-up of a population-based study focussed on respiratory conditions, and describe a pilot study - the PULmons SAns Illes Balears (PULSAIB) study - aimed at investigating the natural history of COPD, obstructive sleep apnoea (OSA), and other common chronic diseases. Methods: A cross-sectional study was designed to survey two fieldwork areas, one rural and one urban, in the Balearic Islands, Spain. Tests conducted included a questionnaire, spirometry with post-bronchodilator (PBD) test, and portable respiratory polygraphy. Results: We assessed all processes and tools to be used, and piloted them in 175 participants from Bunyola (rural) and 130 participants from the Son Pizà area (urban). Within this first cross-sectional assessment of the Balearic population aged 30 to 80 years, we reportthe prevalence of airflow limitation defined as a PBD FEV1/FVC ratio <0.7 and the prevalence of OSA defined as an apnoea-hypopnoea index (AHI) >10/hour. Conclusion: A cohort study in the Balearic population to investigate the natural history of COPD and OSA is feasible. © 2010 Primary Care Respiratory Society UK. Source
Garcia Prim J.M.,University of Santiago de Compostela |
Moldes Rodriguez M.,University of Santiago de Compostela |
Alvarez Fernandez J.,Atencion Primaria |
Rey Rey M.J.,Atencion Primaria |
And 2 more authors.
Lung cancer (LC) is now the leading cause of cancer mortality in the world, therefore it would be useful to identify prognostic factors to determine patient outcome.The objective of this study is to evaluate the usefulness of platelet counts at the time of diagnosis as a prognostic factor. A retrospective study of patients with histological diagnostic evidence of LC was carried in our catchment area over a 3-year period. Survival adjusted for other factors was assessed according to the platelet count at the time of diagnosis. Patients with platelet levels within the reference range (RR) (135000-381000/ll) were divided into two groups, between 135000-258000/ll and 258000-381000/ll. A third group was made up of patients with platelet counts over 381000/ll. Adjusted survival was analysed using Cox regression models. Patients with high platelets have a 37% worse survival than those with a platelet level within the RR, but lower than 258000/ll. When tumour stage is included in the covariates, platelet levels are no longer an independent survival factor. In conclusion, platelet levels at the time of diagnosis could be a useful prognostic factor in LC. © 2009 Humana Press Inc. Source
Lesions detected in a colorectal cancer screening program in the Basque Country: First round (2009-2011) [Lesiones detectadas en el programa de cribado de cáncer colorrectal en el País Vasco: Primera ronda 2009-2011]
Portillo I.,Centro Coordinador Del Programa Of Cribado Cancer Colorrectal |
Idigoras I.,Centro Coordinador Del Programa Of Cribado Cancer Colorrectal |
Ojembarrena E.,Hospital Universitario Of Cruces |
Arana E.,Hospital Universitario Of Cruces |
And 3 more authors.
Gastroenterologia y Hepatologia
Colorectal cancer (CRC) is a major public health problem due to its incidence and mortality. In May 2008, the Basque Country approved the implementation of a population-based colorectal cancer screening program, using the immunochemical fecal occult blood test (FOBT), in persons aged 50-69 years. Patients with a positive result were invited to undergo colonoscopy with sedation. Objetivo: Metodología: Resultados: Conclusiones: Colorectal cancer (CRC) is a major public health problem due to its incidence and mortality. In May 2008, the Basque Country approved the implementation of a population-based colorectal cancer screening program, using the immunochemical fecal occult blood test (FOBT), in persons aged 50-69 years. Patients with a positive result were invited to undergo colonoscopy with sedation. Objective: To describe the main results of the first round of the CRC screening program with FOBT (2009-2011) in terms of the detection rates and positive predictive value (PPV). Method: Retrospective study of participation rates and colonoscopic findings in persons with a positive FOBT result. Results: Invitations to attend screening were sent to 230.505 persons. A total of 148.249 FOBT tests were processed. The mean participation rate was 64.3% (95% CI: 64.1-64.5) and was higher in women than in men. The FOBT test was positive in 6.7% (95% CI: 6.6-6.8). Positive results were more frequent in men. Among persons with a positive result, colonoscopy was performed in 93.1%. There were significant differences between women and men in the detection rate of high-risk adenomas (OR: 0,45 95% CI 0,41-0,49), which, as with CRC (OR: 0,80 95% CI 0,66-0,96), were more frequent in men. The PPV for adenoma of any type was significantly higher in men (72.4 95% CI, 71.2-73.5) than in women (48.8% 95% CI 47.2-50.5), with differences by age group and type of adenoma. Conclusions: Participation rates and detection of advanced lesions and CRC were high. Because men have a higher risk of developing CRC, efforts should be made to increase their participation. The impact of the CRC screening program should be evaluated in the medium to long term. © 2012 Elsevier España, S.L. and AEEH y AEG. Source
Impact of comprehensive and intensive treatment of risk factors concerning cardiovascular mortality in secondary prevention: MIRVAS Study [Impacto de un tratamiento integral e intensivo de factores de riesgo sobre la mortalidad cardiovascular en prevención secundaria: estudio MIRVAS]
Moreno-Palanco M.A.,Hospital Universitario Of La Princesa |
Ibanez-Sanz P.,Hospital Universitario Of La Princesa |
Pablo C.C.-D.,Atencion Primaria |
Pizarro-Portillo A.,Hospital Universitario Of La Princesa |
And 2 more authors.
Revista Espanola de Cardiologia
Introduction and objectives: The aim was to determine whether secondary prevention involving the comprehensive and intensive treatment of cardiovascular risk factors reduces cardiovascular events and cardiovascular mortality at 3-year follow up. Methods: The study design comprised a randomized, controlled, open trial in a routine clinical practice setting. In total, 247 patients who presented with acute coronary syndrome or stroke were selected. They were randomized to comprehensive and intensive treatment of cardiovascular risk factors (n=121) or to follow-up based on usual care (n=126). The main study outcomes were the number of cardiovascular events and cardiovascular mortality at 3-year follow-up. The percentage of patients in whom each risk factor was successfully controlled was a secondary outcome. Results: Overall, 88.8% of patients assigned to the intensive treatment group had a low-density lipoprotein cholesterol level <100 mg/dl compared with 56.4% of the usual-care group (relative risk [RR]=1.57; 95% confidence interval [CI], 1.28-1.93), and 75.7% of diabetics had a hemoglobin A1c <7% compared with 28.6% of the usual-care group (RR=2.65; 95% CI, 1.13-6.19). There were four deaths due to cardiovascular causes and 26 nonfatal events in the intensive treatment group versus 17 deaths and 54 nonfatal events in the usual-care group. The cumulative survival rate at 3 years was 97.4% in the intervention group and 85.5% in the control group (p=.003). Conclusions: Secondary prevention involving comprehensive and intensive treatment of cardiovascular risk factors reduced both morbidity and mortality at 3-year follow up. © 2010 Sociedad Española de Cardiología. Published by Elsevier España, S.L. All rights reserved. Source
Cilleruelo Laiseca E.,Atencion Primaria
This article aims to describe the relationship between primary care and rehabilitation from the point of view of the primary care physician. A survey with open-ended questions was sent to primary care physicians. The physicians' view of rehabilitation and their training in this discipline, the relationship between the two disciplines and forms of referral, primary care physicians' preferences on the type of relationship they would like between the two levels of care are described and recommendations to achieve such a relationship are proposed. Primary care physicians view rehabilitation as a comprehensive specialty that could help their patients but which is little known. Very few primary care physicians have received training in rehabilitation. The relationship with specialists in this discipline varies according to location but is generally scarce, although primary care physicians see the specialty as essential. Referral is usually indirect. Rehabilitation continues to be associated with the locomotor apparatus and other applications are unknown. A rotation in rehabilitation for trainee primary care physicians would be desirable and joint sessions and protocols for referral are essential. Lastly, the article describes the protocol for referral and treatment implemented in the Basurto Hospital and primary care in the region of Bilbao, within the Basque health service. © 2011 Elsevier España, S.L. and SERMEF. All rights reserved. Source