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Escribano Hernandez A.,Gerencia de Atencion Primaria | Vega Alonso A.T.,Direccion General de Salud Publica e IDI | Lozano Alonso J.E.,Direccion General de Salud Publica e IDI | Alamo Sanz R.,Direccion General de Salud Publica e IDI | And 2 more authors.
Gaceta Sanitaria | Year: 2010

Objective: Hypercholesterolemia is one of the cardiovascular risk factors more sensitive to preventive and control interventions. This study aims to determine the epidemiological pattern of dyslipidemic people in Castilla y Leon. Methods: A representative stratified two-stage sample of the population resident in Castilla y León (Spain) was obtained. A total of 4,013 people age 15 years and older were interviewed. Cardiovascular disease related variables were gathered from clinical records and medical examination. Total cholesterol, HDL-c, LDL-c, and triglycerides were measured. Results: Total cholesterol, HDL-c, LDL-c and triglycerides increase with age and, all but total cholesterol present gender differences. LDL-c and triglycerides are higher in men than in women under the age of 60, and lower from that age on, while HDL-c is always higher in women. Total cholesterol was ≥250. mg/dl in 14.6% of the sample and ≥200. mg/dl in the 56.3%. Only 49.6% of people with total cholesterol ≥250. mg/dl had been diagnosed and only 15.2% were under treatment. Age-adjusted total cholesterol was positively correlated with all cardiovascular risk factors. Furthermore, over 70% of the population presented, at least, one cardiovascular risk factor. Conclusions: The results above shows high levels of total cholesterol and LDL-c, low levels of HDL-c in males and the under diagnosis in clinical records. The association between hypercholesterolemia and other cardiovascular risk factors is similar to previous studies. © 2009 SESPAS.

Paz-Zulueta M.,University of Cantabria | Llorca J.,University of Cantabria | Llorca J.,Institute Of Investigation Marques Of Valdecilla Idival | Llorca J.,CIBER ISCIII | And 8 more authors.
PLoS ONE | Year: 2015

Background and Aim: Literature evaluating association between neonatal morbidity and immigrant status presents contradictory results. Poorer compliance with prenatal care and greater social risk factors among immigrants could play roles as major confounding variables, thus explaining contradictions. We examined whether prenatal care and social risk factors are confounding variables in the relationship between immigrant status and neonatal morbidity. Methods: Retrospective cohort study: 231 pregnant African immigrant women were recruited from 2007-2010 in northern Spain. A Spanish population sample was obtained by simple random sampling at 1:3 ratio. Immigrant status (Spanish, Sub-Saharan and Northern African), prenatal care (Kessner Index adequate, intermediate or inadequate), and social risk factors were treated as independent variables. Low birth weight (LBW < 2500 grams) and preterm birth (< 37 weeks) were collected as neonatal morbidity variables. Crude and adjusted odds ratios (OR) were estimated by unconditional logistic regression with 95% confidence intervals (95% CI). Results: Positive associations between immigrant women and higher risk of neonatal morbidity were obtained. Crude OR for preterm births in Northern Africans with respect to nonimmigrants was 2.28 (95% CI: 1.04-5.00), and crude OR for LBW was 1.77 (95% CI: 0.74-4.22). However, after adjusting for prenatal care and social risk factors, associations became protective: adjusted OR for preterm birth = 0.42 (95% CI: 0.14-1.32); LBW = 0.48 (95% CI: 0. 15-1.52). Poor compliance with prenatal care was the main independent risk factor associated with both preterm birth (adjusted OR inadequate care = 17.05; 95% CI: 3.92-74.24) and LBW (adjusted OR inadequate care = 6.25; 95% CI: 1.28-30.46). Social risk was an important independent risk factor associated with LBW (adjusted OR = 5.42; 95% CI: 1.58-18. 62). Conclusions: Prenatal care and social risk factors were major confounding variables in the relationship between immigrant status and neonatal morbidity. © 2015 Paz-Zulueta et al.

Abizanda Soler P.,Complejo Hospitalario Universitario Of Albacete | Lopez-Torres Hidalgo J.,Gerencia de Atencion Primaria | Romero Rizos L.,Complejo Hospitalario Universitario Of Albacete | Sanchez Jurado P.M.,Complejo Hospitalario Universitario Of Albacete | And 2 more authors.
Atencion Primaria | Year: 2012

Objective: To determine the normal values of some of the functional assessment tools most used in Spain. Design: Cross-sectional study of the first cut of a concurrent population based cohort. Setting: Albacete city Health Area. Participants: A total of 993 subjects aged 70 years or over and participants in the FRADEA (Frailty and dependence in Albacete, Spain) cohort. Main measurements: An analysis was made of disability and function questionnaires, which included, Barthel, Lawton and Short Form of the Late-Life Function and Disability Instrument (SF-LLFDI), Holden's Functional Ambulation Category (FAC), and functional tests: walking speed (m/s), Timed Up and Go (TUG) (sec), one-leg balance time (sec), timed 5 Times Sit to Stand Test (5STS) (seg), Short Physical Performance Battery (SPPB), grip strength (kg), and elbow flexion strength (kg). The means, quartiles and percentiles are described, in the global cohort and in the male and female sub-groups aged between 70 and 79 years or aged 80 years or over. Results: The quartiles of the different instruments were as follow: Barthel (80, 95, 100), Lawton (3, 6,8), SF-LLFDI (70, 111, 131), FAC (4, 5, 5), walking speed (0.51, 0.79, 1.00), TUG (13.8, 11.4, 9.8), one-leg balance time (3, 7, 15), 5STS (16.3, 13.0, 10.7), SPPB (7, 9, 11), grip strength (15, 20, 29), and elbow flexion strength (11, 20, 32). The younger ones, males and those living within the community showed a better performance in all the instruments. Conclusions: The normal values of a cohort of the elderly population based in Albacete using different functional assessment instruments are presented. These could be useful in clinical practice or research. © 2010 Elsevier España, S.L. Todos los derechos reservados.

Isabel Pedraza M.,Hospital Clinico Universitario | Herrero-Velazquez S.,Hospital Clinico Universitario | Lopez-Mesonero L.,Hospital Clinico Universitario | Ruiz-Pinero M.,Hospital Clinico Universitario | And 2 more authors.
Revista de Neurologia | Year: 2015

Introduction. The use of email can facilitate communication between the different levels of an organisation. Our primary care physicians have had an email service in the dedicated headache clinic (DHC) since November 2009, and our aim is therefore to analyse the use of email over that five-year period. Patients and methods. Data concerning the emails sent up until October 2014 were collected prospectively. The questions were classified as need for referral to the DHC (group 1), progress made by the cases seen in the DHC (group 2), training in headaches (group 3) or the treatment of the headaches suffered by primary care physicians themselves as patients (group 4). Results. A total of 274 email messages were analysed. Monthly consultations have increased (from 1.5 per month during the first year to 7.5 per month during the fifth). Findings showed that 10.2% of the email messages came from rural health centres and 89.8% were sent from urban health centres. Replies were sent within 2 ± 2.8 days (range: 0-24 days). Altogether 130 consultations were classified as belonging to group 1 (47.4%), in which referral through the normal channel was recommended in 60 cases (46.2%), via the preferential channel in 47 (36.2%) and non-referral was suggested in 23 cases (17.6%). Group 2 included 125 emails (45.7%) and in 80 cases there was no need to make a new appointment or to bring forward the existing one (64%). Thirteen visits (4.7%) were classified into group 3 and six (2.2%) in group 4. Conclusions. Our primary care physicians are using the email of the DHC on an increasingly more frequent basis. Its use makes it possible to detect patients whose appointment -whether the first or a follow-up-needs to be brought forward, as well as allowing issues to be solved without the need for referral. It is effective for the treatment of physicians who themselves have headaches and as a tool for continuing education. © 2015 Revista de Neurología.

Lopez Hidalgo M.J.,Hospital Nacional de Paraplejicos | Alejandre Lazaro G.,Gerencia de Atencion Primaria
Atencion Primaria | Year: 2010

Objective: To describe the content and structure of the websites of pharmaceutical companies (PC) with health information to patients. Design: Descriptive, cross-sectional. Main measurements: health topics treated, and 9 sections: objectives and target population; editorial policy, authoring, updating of content, personal data protection, interactivity, accessibility, advertising labels. Setting: Internet. Participants: All PC websites with patient health information in Spanish. Results: We studied 60 sites found. Most common: 19.3% neurology, mental health and 12% digestive diseases. Few specify the address of the person responsible for the site (51.7%), responsible for quality (10%) or the authors of the text (15%). Nearly 2/3 show the date of publication of content (66.7%), but only 13.3% updated. Privacy and data protection are mentioned in 65%, with only 28.3% allowing control of the use of personal data. Only 10% allow expressing doubts online and 1/3 of the sites have frequently asked questions. A total of 41.7% omitted to say their information does not replace medical advice. Educational materials (for children) can be downloaded in 11.7%. Almost all (93.3%) adapted their language to the recipient, but none are accessible to disabled people. The majority (86.7%) have the company logo on all pages. Only 16.7% are fronts for advertising, and only 9 sites have a quality seal (HONcode). Conclusions: Pages are designed to give superficial information on a disease than directly advertise a particular brand or active ingredient. However, their reliability has to be low due to the authors and sources of information being unknown. If Internet health information was truthful and backed up by authors or appropriate information sources, the Internet could well be a genuine health education tool. © 2009 Elsevier España, S.L. All rights reserved.

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