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Bertomeu-Gonzalez V, Sanchez-Ferrer F, Quesada JA, Nso-Roca AP, Lopez-Pineda A, Ruiz-Nodar JM. Prevalence of childhood obesity in Spain and its relation with socioeconomic status and health behaviors: Population-based cross-sectional study. Med Clin (Barc) 2024:S0025-7753(24)00199-4. [PMID: 38714468 DOI: 10.1016/j.medcli.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVES This study aims to assess the current state of childhood overweight and obesity in Spain, and its relationship with socioeconomic status and health-related behaviors. METHODS Population-based cross-sectional observational study, based on the 2017 National Health Survey in minors in Spain. This study included all children surveyed who were aged 1-14 years. Childhood obesity was estimated from the z-score of the body mass index. RESULTS The study included 4882 children aged 1-14 years (mean 7.5). The prevalence of obesity was 18.6% (95% confidence interval [CI] 18.5-18.7), while 13.5% (95% CI 13.4-13.6) were overweight. These figures represent over a million children in Spain who are obese and nearly 750,000 who are overweight. A north-south geographic gradient was apparent, with higher prevalence of unhealthy body weight in southern Spain. Factors associated with childhood obesity were low socioeconomic status, poor diet and sedentarism, among others. CONCLUSIONS Childhood overweight in Spain is strongly associated with socioeconomic status and other factors such as diet and sedentarism. Multidisciplinary public health interventions are needed to reduce this serious health problem in children.
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Affiliation(s)
- Vicente Bertomeu-Gonzalez
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Cardiology Section, University Hospital of San Juan de Alicante, San Juan de Alicante, Alicante, Spain; Center for Biomedical Research Network Cardiovascular Diseases (CIBERCV), Spain
| | - Francisco Sanchez-Ferrer
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Pharmacology, Pediatrics and Organic Chemistry Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain.
| | - Jose Antonio Quesada
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Ana Pilar Nso-Roca
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Adriana Lopez-Pineda
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Juan Miguel Ruiz-Nodar
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Center for Biomedical Research Network Cardiovascular Diseases (CIBERCV), Spain; Cardiology Service, General University Hospital of Alicante, Alicante, Spain
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Gutiérrez-Pastor A, Quesada JA, Soler-Martínez MM, Carratalá Munuera C, Pomares-Gómez FJ. Effect of switch from flash glucose monitoring to flash glucose monitoring with real-time alarms on hypoglycaemia in people with type 1 diabetes mellitus. Prim Care Diabetes 2024:S1751-9918(24)00075-5. [PMID: 38677966 DOI: 10.1016/j.pcd.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/29/2024]
Abstract
We aimed to evaluate the utility of the FreeStyle Libre 2 device for reducing time below range level 1 and level 2 compared with the Freestyle Libre device (without alarms) in people with type 1 diabetes mellitus. We conducted longitudinal observational follow-up study of a cohort of 100 people with type 1 diabetes mellitus who had switched from FreeStyle Libre to FreeStyle Libre 2 as part of routine clinical practice. Three months after switching to FreeStyle Libre 2, compared with results with FreeStyle Libre, there were a significant improvements in time below range level 1 (p = 0.02) and level 2 (p <0.001), time in range (p <0.001), time above range level 1 (p = 0.002), glucose management indicator (p= 0.04) and mean glucose (p= 0.04) during follow-up. Furthermore there was a significant direct association between age and change in TIR with a coefficient of 0.23, and a significant inverse association between age and change in TAR-1 with a coefficient of 0.11. Switching to a flash glucose monitoring system with alarms improves time below range, time in range and coefficient of variation in people with type 1 diabetes mellitus.
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Affiliation(s)
- A Gutiérrez-Pastor
- Department of Health of San Juan de Alicante, Provincial-Pla Hospital, Spain
| | - J A Quesada
- Department of Clinical Medicine, Miguel Hernández University, Elche, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
| | - M M Soler-Martínez
- Department of Health of San Juan de Alicante, Endocrinology and Nutrition, Spain
| | - C Carratalá Munuera
- Department of Clinical Medicine, Miguel Hernández University, Elche, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain.
| | - F J Pomares-Gómez
- Department of Health of San Juan de Alicante, Endocrinology and Nutrition, Spain
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Martínez-Perez P, Orozco-Beltrán D, Pomares-Gómez F, Gil-Guillén VF, Quesada JA, López-Pineda A, Nouni-García R, Carratalá-Munuera C. [Factors associated with dissatisfaction with pharmacological treatment in patients with type 2 diabetes mellitus: A cross-sectional study]. J Healthc Qual Res 2023; 38:120-127. [PMID: 35933321 DOI: 10.1016/j.jhqr.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/31/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Diabetes is a chronic disease with a high impact on both health and Quality of Life Related to Health (QLRH). To evaluate the satisfaction of treatment in patients with type 2 diabetes mellitus through the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and its relationship with sociodemographic variables, with antidiabetic medication and clinical-analytical variables. MATERIALS AND METHODS This cross-sectional study was conducted in General University Hospital of San Juan de Alicante between September 2016 and December 2017. Two hundred thirty-two patients diagnosed with type 2 diabetes mellitus at least 1 year before inclusion, treated with antidiabetic medication were included. The Spanish version of the DTSQ scale was used to measure satisfaction with treatment. Factors associated with low satisfaction were analyzed by applying the Chi-square test for qualitative variables and Student-T for quantitative variables. To estimate magnitudes of association, logistic models were adjusted. RESULTS Two hundred thirty-two patients were included in this study. 21.5% of the patients presented low satisfaction with the treatment. Patients who presented low satisfaction with treatment were associated with medications that could cause hypoglycemia (OR: 2.872 [1.195-6.903]), HbA1c levels higher than 7% (OR: 2.260 [1.005-5.083]) and drugs administered by the route oral (OR: 2.749 [1.233-6.131]). CONCLUSIONS Patients with type 2 diabetes mellitus who had a lower score on the DTSQ questionnaire were associated with medications that produced hypoglycaemia, and with higher levels of HbA1c higher than 7%, and those who took oral medication.
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Affiliation(s)
- P Martínez-Perez
- Cátedra de Medicina de Familia, Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - D Orozco-Beltrán
- Cátedra de Medicina de Familia, Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - F Pomares-Gómez
- Servicio de Endocrinología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, España
| | - V F Gil-Guillén
- Cátedra de Medicina de Familia, Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - J A Quesada
- Cátedra de Medicina de Familia, Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España.
| | - A López-Pineda
- Fisabio, Fundación para el fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana, Valencia, España
| | - R Nouni-García
- Fisabio, Fundación para el fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana, Valencia, España
| | - C Carratalá-Munuera
- Cátedra de Medicina de Familia, Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
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Pallares-Carratala V, Carratala-Munuera C, Lopez-Pineda A, Quesada JA, Gil-Guillen V, Orozco-Beltran D, Alfonso-Sanchez JL, Navarro-Perez J, Martin-Moreno JM. Characterizing Diagnostic Inertia in Arterial Hypertension With a Gender Perspective in Primary Care. Front Cardiovasc Med 2022; 9:874764. [PMID: 35783866 PMCID: PMC9246269 DOI: 10.3389/fcvm.2022.874764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/24/2022] [Indexed: 11/15/2022] Open
Abstract
Background and Objectives Substantial evidence shows that diagnostic inertia leads to failure to achieve screening and diagnosis objectives for arterial hypertension (AHT). In addition, different studies suggest that the results may differ between men and women. This study aimed to evaluate the differences in diagnostic inertia in women and men attending public primary care centers, to identify potential gender biases in the clinical management of AHT. Study Design/Materials and Methods Cross-sectional descriptive and analytical estimates were obtained nested on an epidemiological ambispective cohort study of patients aged ≥30 years who attended public primary care centers in a Spanish region in the period 2008–2012, belonging to the ESCARVAL-RISK cohort. We applied a consistent operational definition of diagnostic inertia to a registry- reflected population group of 44,221 patients with diagnosed hypertension or meeting the criteria for diagnosis (51.2% women), with a mean age of 63.4 years (62.4 years in men and 64.4 years in women). Results Of the total population, 95.5% had a diagnosis of hypertension registered in their electronic health record. Another 1,968 patients met the inclusion criteria for diagnostic inertia of hypertension, representing 4.5% of the total population (5% of men and 3.9% of women). The factors significantly associated with inertia were younger age, normal body mass index, elevated total cholesterol, coexistence of diabetes and dyslipidemia, and treatment with oral antidiabetic drugs. Lower inertia was associated with age over 50 years, higher body mass index, normal total cholesterol, no diabetes or dyslipidemia, and treatment with lipid-lowering, antiplatelet, and anticoagulant drugs. The only gender difference in the association of factors with diagnostic inertia was found in waist circumference. Conclusion In the ESCARVAL-RISK study population presenting registered AHT or meeting the functional diagnostic criteria for AHT, diagnostic inertia appears to be greater in men than in women.
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Affiliation(s)
- Vicente Pallares-Carratala
- Health Surveillance Unit, Castellon Mutual Insurance Union, Castellón, Spain
- Department of Medicine, Jaume I University, Castellón, Spain
| | | | | | | | | | | | - Jose L. Alfonso-Sanchez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
- Preventive Medicine Department, General Hospital of Valencia, Valencia, Spain
| | - Jorge Navarro-Perez
- Biomedical Research Institute INCLIVA, Clinic University Hospital of Valencia, University of Valencia, Valencia, Spain
| | - Jose M. Martin-Moreno
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital of Valencia, University of Valencia, Valencia, Spain
- *Correspondence: Jose M. Martin-Moreno
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Múgica-Jauregui L, Orozco-Beltrán D, López-Pineda A, Gil-Guillén VF, Cheikh-Moussa K, Nouni-García R, Carratalá-Munuera C, Quesada JA. [Analysis of two health attendance models for the non-hospital emergencies in Gipuzkoa: Retrospective study]. J Healthc Qual Res 2021; 37:247-253. [PMID: 34972679 DOI: 10.1016/j.jhqr.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Out-of-hospital medical emergency services are defined as a functional organization that performs a set of sequential human and material activities. The objective of this study was to compare the mortality of patients attended by the out-of-hospital medical emergency services in 2 neighboring Spanish regions with different models of healthcare transport assistance for emergency care. MATERIAL AND METHOD Retrospective observational cohort study, done between June 1, 2007 and December 31, 2008 in 2 regions of Gipuzkoa, Alto Deba (AD) and Bajo Deba (BD). The study variables were age, sex and place of exposure (AD/BD), heart rate, blood pressure, initial reason for the call defined by the European Resuscitation Council, unconsciousness and digestive bleeding. 3452 subjects were analyzed. RESULTS The risk of in situ mortality in BD was 1.31 times higher than in AD (P=.050), that of hospital mortality in BD was 0.71 times lower than in AD (P=.011) and the risk of mortality at one year between counties and the combined mortality (in situ+hospital) did not contribute significant differences. CONCLUSIONS Mortality (in situ+in-hospital, and one year aftercare) of patients treated by the out-of-hospital emergency medical services in AD (non-medicalized healthcare transport model) was similar to that of the BD region (mixed healthcare transport model).
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Affiliation(s)
| | - D Orozco-Beltrán
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - A López-Pineda
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - V F Gil-Guillén
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - K Cheikh-Moussa
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - R Nouni-García
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
| | - C Carratalá-Munuera
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España.
| | - J A Quesada
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España
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Quesada JA, López-Pineda A, Gil-Guillén VF, Arriero-Marín JM, Gutiérrez F, Carratala-Munuera C. Incubation period of COVID-19: A systematic review and meta-analysis. Rev Clin Esp 2021; 221:109-117. [PMID: 38108501 PMCID: PMC7528969 DOI: 10.1016/j.rce.2020.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/30/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE The incubation period of COVID-19 helps to determine the optimal duration of the quarantine and inform predictive models of incidence curves. Several emerging studies have produced varying results; this systematic review aims to provide a more accurate estimate of the incubation period of COVID-19. METHODS For this systematic review, a literature search was conducted using Pubmed, Scopus/EMBASE, and the Cochrane Library databases, covering all observational and experimental studies reporting the incubation period and published from 1 January 2020 to 21 March 2020.We estimated the mean and 95th percentile of the incubation period using meta-analysis, taking into account between-study heterogeneity, and the analysis with moderator variables. RESULTS We included seven studies (n = 792) in the meta-analysis. The heterogeneity (I2 83.0%, p < 0.001) was significantly decreased when we included the study quality and the statistical model used as moderator variables (I2 15%). The mean incubation period ranged from 5.6 (95% CI: 5.2 to 6.0) to 6.7 days (95% CI: 6.0 to 7.4) according to the statistical model. The 95th percentile was 12.5 days when the mean age of patients was 60 years, increasing 1 day for every 10 years. CONCLUSION Based on the published data reporting the incubation period of COVID-19, the mean time between exposure and onset of clinical symptoms depended on the statistical model used, and the 95th percentile depended on the mean age of the patients. It is advisable to record sex and age when collecting data in order to analyze possible differential patterns.
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Affiliation(s)
- J A Quesada
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España
| | - A López-Pineda
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España.
| | - V F Gil-Guillén
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España
| | - J M Arriero-Marín
- Departamento de Neumología, Universidad Hospital de San Juan de Alicante, San Juan de Alicante, España
| | - F Gutiérrez
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España; Departamento de Enfermedades Infecciosas, Universidad Hospital de Elche, Elche, España
| | - C Carratala-Munuera
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España
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López-Pintor E, Grau J, González I, Bernal-Soriano MC, Quesada JA, Lumbreras B. Impact of patients' perception of COPD and treatment on adherence and health-related quality of life in real-world: Study in 53 community pharmacies. Respir Med 2020; 176:106280. [PMID: 33302143 DOI: 10.1016/j.rmed.2020.106280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Patient adherence to treatment in chronic obstructive pulmonary disease (COPD) is essential to optimize disease management. We aimed to assess the impact of patients' perception of their treatment and disease on adherence and Health-Related Quality of Life (HRQL) in patients attending a community pharmacy, where usually subjects have a better condition than those in clinical settings. METHODS We performed a cross-sectional study of 318 patients with COPD in treatment with inhalers in the last 3 months from 53 community pharmacies. We assessed HRQL with St George's Respiratory Questionnaire (SGRQ). Persistence was assessed from the three previous refills and adherence through the Test of Adherence to Inhalers test. RESULTS Persistence was achieved by 78.6% of the patients and 58.5% had good adherence. Patients having a multidose DPI and those with MDI showed a 2.8-fold and 4.1-fold increased association, respectively, with intermediate/poor adherence in comparison with those having a single dose DPI. Those patients who did not have knowledge about COPD (aOR 2.106, p = 0.006) and those who thought that the inhaler effectiveness was fair/poor (aOR 2.361, p = 0.006) were more likely to have intermediate/poor adherence. Overall SGRQ score was significantly worse in patients with intermediate/poor adherence (p = 0.036) and in those who thought the inhaler's effectiveness was fair/poor (p < 0.001). CONCLUSIONS The type of inhaler and patients' knowledge and perceptions of their disease and treatment were associated with good adherence and higher HRQL. Clinicians should promote shared-decision making in the choice of inhaler depending on patients' individual abilities and beliefs.
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Affiliation(s)
- E López-Pintor
- Department of Engineering, Area of Pharmacy and Pharmaceutical Technologies, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain.
| | - J Grau
- Pneumology Department, General Hospital of Elche, Alicante, Spain.
| | - I González
- Community Pharmacist in Alicante, Spain, Spanish Society of Community Pharmacy, SEFAC, Spain.
| | - M C Bernal-Soriano
- Department of Public Health, History of Science and Gynecology, Miguel Hernández University and CIBER en Epidemiología y Salud Pública, Crtra Alicante-Valencia km 81, Sant Joan d'Alacant, 03550, Alicante, Spain.
| | - J A Quesada
- Department of Clinical Medicine. Miguel Hernandez University, San Juan de Alicante, Alicante, Spain.
| | - B Lumbreras
- Department of Public Health, History of Science and Gynecology, Miguel Hernández University and CIBER en Epidemiología y Salud Pública, Crtra Alicante-Valencia km 81, Sant Joan d'Alacant, 03550, Alicante, Spain.
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Quesada JA, López-Pineda A, Gil-Guillén VF, Arriero-Marín JM, Gutiérrez F, Carratala-Munuera C. Incubation period of COVID-19: A systematic review and meta-analysis. Rev Clin Esp 2020; 221:109-117. [PMID: 33998486 PMCID: PMC7698828 DOI: 10.1016/j.rceng.2020.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023]
Abstract
Background and objective The incubation period of COVID-19 helps to determine the optimal duration of the quarantine and inform predictive models of incidence curves. Several emerging studies have produced varying results; this systematic review aims to provide a more accurate estimate of the incubation period of COVID-19. Methods For this systematic review, a literature search was conducted using Pubmed, Scopus/EMBASE, and the Cochrane Library databases, covering all observational and experimental studies reporting the incubation period and published from 1 January 2020 to 21 March 2020.We estimated the mean and 95th percentile of the incubation period using meta-analysis, taking into account between-study heterogeneity, and the analysis with moderator variables. Results We included seven studies (n = 792) in the meta-analysis. The heterogeneity (I2 83.0%, p < 0.001) was significantly decreased when we included the study quality and the statistical model used as moderator variables (I2 15%). The mean incubation period ranged from 5.6 (95% CI: 5.2–6.0) to 6.7 days (95% CI: 6.0–7.4) according to the statistical model. The 95th percentile was 12.5 days when the mean age of patients was 60 years, increasing 1 day for every 10 years. Conclusion Based on the published data reporting the incubation period of COVID-19, the mean time between exposure and onset of clinical symptoms depended on the statistical model used, and the 95th percentile depended on the mean age of the patients. It is advisable to record sex and age when collecting data in order to analyze possible differential patterns.
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Affiliation(s)
- J A Quesada
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
| | - A López-Pineda
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain.
| | - V F Gil-Guillén
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
| | - J M Arriero-Marín
- Departamento de Neumología, Universidad Hospital de San Juan de Alicante, San Juan de Alicante, Spain
| | - F Gutiérrez
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain; Departamento de Enfermedades Infecciosas, Universidad Hospital de Elche, Elche, Spain
| | - C Carratala-Munuera
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
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Quesada JA, Nolasco A. Relationship between patients' month of birth and the prevalence of chronic diseases. Med Clin (Barc) 2017; 148:489-494. [PMID: 27993405 DOI: 10.1016/j.medcli.2016.10.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/17/2016] [Accepted: 10/20/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Patients' month of birth can reflect exposure to certain factors during pregnancy and the first few months of life, which could influence the onset of chronic diseases during adulthood. The aim of this study is to evaluate the association between a patient's month of birth and the presence of chronic diseases in the Spanish population, by analysing the National Health Survey for the year 2006. PATIENTS AND METHODS We measured the association between 27 common chronic diseases and the month of birth, estimating the odds ratios and confidence intervals at 95%, using multivariate logistical models and adjusting the results for month of birth and potentially confounding variables. RESULTS The sample population was made up of a total of 29,478 individuals, representing approximately 44.7 million Spanish residents on 1 January 2007. Significant associations were found between the month of birth and several chronic diseases. There is a gender-differentiated risk pattern of developing chronic diseases according to the month of birth, with more significant associations and of greater magnitude being detected among men compared to women. CONCLUSIONS The associations detected might reflect early exposure to environmental factors in the uterus and during the first few months of life. More specific studies are required to gain a more in-depth understanding of these associations.
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Affiliation(s)
- Jose Antonio Quesada
- Departamento de Enfermería Comunitaria, Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, España.
| | - Andreu Nolasco
- Departamento de Enfermería Comunitaria, Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, España
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Quesada JA, Melchor I, Nolasco A. Point process methods in epidemiology: application to the analysis of human immunodeficiency virus/acquired immunodeficiency syndrome mortality in urban areas. Geospat Health 2017; 12:506. [PMID: 28555483 DOI: 10.4081/gh.2017.506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
The analysis of spatio-temporal patterns of disease or death in urban areas has been developed mainly from the ecological studies approach. These designs may have some limitations like the ecological fallacy and instability with few cases. The objective of this study was to apply the point process methodology, as a complement to that of aggregated data, to study HIV/AIDS mortality in men in the city of Alicante (Spain). A case-control study in residents in the city during the period 2004-2011 was designed. Cases were men who died from HIV/AIDS and controls represented the general population, matched by age to cases. The risk surfaces of death over the city were estimated using the log-risk function of intensities, and we contrasted their temporal variations over the two periods. High risk significant areas of death by HIV/AIDS, which coincide with the most deprived areas in the city, were detected. Significant spatial change of the areas at risk between the periods studied was not detected. The point process methodology is a useful tool to analyse the patterns of death by HIV/AIDS in urban areas.
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Affiliation(s)
- Jose Antonio Quesada
- Research Unit on Mortality Analysis and Health Statistics, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante.
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Nolasco A, Moncho J, Quesada JA, Melchor I, Pereyra-Zamora P, Tamayo-Fonseca N, Martínez-Beneito MA, Zurriaga O, Ballesta M, Daponte A, Gandarillas A, Domínguez-Berjón MF, Marí-Dell'Olmo M, Gotsens M, Izco N, Moreno MC, Sáez M, Martos C, Sánchez-Villegas P, Borrell C. Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996-2007 (MEDEA project). Int J Equity Health 2015; 14:33. [PMID: 25879739 PMCID: PMC4392789 DOI: 10.1186/s12939-015-0164-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/17/2015] [Indexed: 11/30/2022] Open
Abstract
Background Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996–2001 and 2002–2007. Methods We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. Results Preventable avoidable mortality made a significant contribution to general mortality (around 7.5%, higher among men), having decreased over time in men (12.7 in 1996–2001 and 10.9 in 2002–2007), though not so clearly among women (3.3% in 1996–2001 and 2.9% in 2002–2007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. Conclusions Preventable mortality decreased between the 1996–2001 and 2002–2007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more deprived zones. It is in these deprived zones where actions to reduce and monitor health inequalities should be put into place. Primary healthcare may play an important role in this process.
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Affiliation(s)
- Andreu Nolasco
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia. Campus de San Vicente del Raspeig s/n. Apartado 99, Universidad de Alicante, 03080, Alicante, España.
| | - Joaquin Moncho
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia. Campus de San Vicente del Raspeig s/n. Apartado 99, Universidad de Alicante, 03080, Alicante, España.
| | - Jose Antonio Quesada
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia. Campus de San Vicente del Raspeig s/n. Apartado 99, Universidad de Alicante, 03080, Alicante, España.
| | - Inmaculada Melchor
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia. Campus de San Vicente del Raspeig s/n. Apartado 99, Universidad de Alicante, 03080, Alicante, España. .,Registro de Mortalidad de la Comunidad Valenciana, Servicio de Estudios Epidemiológicos y Estadísticas Sanitarias, Subdirección General de Epidemiología y Vigilancia de la Salud. Conselleria de Sanitat, Plaza de España 6, 03010, Alicante, España.
| | - Pamela Pereyra-Zamora
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia. Campus de San Vicente del Raspeig s/n. Apartado 99, Universidad de Alicante, 03080, Alicante, España.
| | - Nayara Tamayo-Fonseca
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia. Campus de San Vicente del Raspeig s/n. Apartado 99, Universidad de Alicante, 03080, Alicante, España.
| | - Miguel Angel Martínez-Beneito
- Área de Desigualdades en Salud. FISABIO-CSISP, Conselleria de Sanitat, Avenida de Cataluña, 21, 46020, Valencia, España. .,Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España.
| | - Oscar Zurriaga
- Área de Desigualdades en Salud. FISABIO-CSISP, Conselleria de Sanitat, Avenida de Cataluña, 21, 46020, Valencia, España. .,Servicio de Estudios Epidemiológicos y Estadísticas Sanitarias, Subdirección General de Epidemiología y Vigilancia de la Salud. Conselleria de Sanitat, Avenida de Cataluña, 21, 46020, Valencia, España. .,Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España.
| | - Mónica Ballesta
- Department of Epidemiology, Regional Health Council, Murcia, Spain.
| | - Antonio Daponte
- Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN). Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, Cuesta del Observatorio, 4. Ap. Correos 2070, Granada, 18080, España.
| | - Ana Gandarillas
- Servicio de Epidemiología. Subdirección de Promoción de la Salud y Prevención. Dirección General de Atención Primaria, Consejería de Sanidad Comunidad de Madrid, C/ San Martín de Porres, n° 6, 1ª planta, 28035, Madrid, España.
| | - M Felicitas Domínguez-Berjón
- Servicio de Informes de Salud y Estudios. Subdirección de Promoción de la Salud y Prevención. Dirección General de Atención Primaria, Consejería de Sanidad Comunidad de Madrid, C/ San Martín de Porres, n° 6, 1ª planta, 28035, Madrid, España.
| | - Marc Marí-Dell'Olmo
- Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España. .,Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, 08023, Barcelona, España. .,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
| | - Mercè Gotsens
- Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España. .,Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, 08023, Barcelona, España. .,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
| | - Natividad Izco
- Dirección General de Salud Pública y Consumo, Gobierno de La Rioja, Calle Vara de Rey n° 8, 1ª planta, 26071, Logroño, España.
| | - M Concepción Moreno
- Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España. .,Instituto de Salud Pública y Laboral de Navarra, C/ Leyre, 15, 31003, Pamplona, Navarra, Spain.
| | - Marc Sáez
- Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España. .,Grupo de Investigación en Estadística, Econometría y Salud (GRECS), [Research Group on Statistics, Econometrics and Health (GRECS)], Universidad de Girona. Calle de la Universidad 10, Campus de Montilivi, 17071, Girona, España.
| | - Carmen Martos
- Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España. .,Instituto Aragonés de Ciencias de la Salud, Avda. San Juan Bosco, n°13, 50009, Zaragoza, España.
| | - Pablo Sánchez-Villegas
- Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN). Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, Cuesta del Observatorio, 4. Ap. Correos 2070, Granada, 18080, España.
| | - Carme Borrell
- Ciber de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5 28029, Madrid, España. .,Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, 08023, Barcelona, España.
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Quesada JA, Nolasco A, Moncho J. [Comparison of Google and Yahoo applications for geocoding of postal addresses in epidemiological studies]. Rev Esp Salud Publica 2014; 87:201-6. [PMID: 23775108 DOI: 10.4321/s1135-57272013000200009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Geocoding is the assignment of geographic coordinates to spatial points, which often are postal addresses. The error made in applying this process can introduce bias in estimates of spatiotemporal models in epidemiological studies. No studies have been found to measure the error made in applying this process in Spanish cities. The objective is to evaluate the errors in magnitude and direction from two free sources (Google and Yahoo) with regard to a GPS in two Spanish cities. METHOD 30 addresses were geocoded with those two sources and the GPS in Santa Pola (Alicante) and Alicante city. The distances were calculated in metres (median, CI95%) between the sources and the GPS, globally and according to the status reported by each source. The directionality of the error was evaluated by calculating the location quadrant and applying a Chi-Square test. The GPS error was evaluated by geocoding 11 addresses twice at 4 days interval. RESULTS The overall median in Google-GPS was 23,2 metres (16,0-32,1) for Santa Pola, and 21,4 meters (14,9-31,1) for Alicante. The overall median in Yahoo was 136,0 meters (19,2-318,5) for Santa Pola, and 23,8 meters (13,6- 29,2) for Alicante. Between the 73% and 90% were geocoded by status as "exact or interpolated" (minor error), where Goggle and Yahoo had a median error between 19 and 23 metres in the two cities. The GPS had a median error of 13.8 meters (6,7-17,8). No error directionality was detected. CONCLUSIONS Google error is acceptable and stable in the two cities, so that it is a reliable source for Para medir elgeocoding addresses in Spain in epidemiological studies.
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Affiliation(s)
- Jose Antonio Quesada
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias, Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, España.
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13
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Tamayo-Fonseca N, Quesada JA, Nolasco A, Melchor I, Moncho J, Pereyra-Zamora P, López R, Calabuig J, Barber X. Self-rated health and mortality: a follow-up study of a Spanish population. Public Health 2013; 127:1097-104. [PMID: 24144258 DOI: 10.1016/j.puhe.2013.09.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 04/28/2013] [Accepted: 09/09/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Self-rated health (SRH) is known to be a valid indicator for the prediction of health outcomes. The aims of this study were to describe and analyse the associations between SRH and health status, socio-economic and demographic characteristics; and between SRH and mortality in a Spanish population. STUDY DESIGN Longitudinal study. METHODS A sample of 5275 adults (age ≥21 years) residing in the Valencian Community (Spanish Mediterranean region) was surveyed in 2005 and followed for four years. SRH was categorized into good and poor health. The response variable was mortality (dead/alive), obtained from the local mortality register. Logistic regression models were adjusted in order to analyse the associations between SRH and health status, socio-economic and demographic characteristics; odds ratios were calculated to measure the associations. Poisson regression models were adjusted in order to analyse the associations between mortality and explanatory variables; the relative risk of death was calculated to measure the associations. RESULTS Poor SRH was reported by 25.9% of respondents, and the mortality rate after four years of follow-up was 3.6%. An association was found between SRH and the presence of chronic disease and disability in men and women. A perception of poor health vs good health led to a mortality risk of 3.0 in men and 2.7 in women. SRH was predictive of mortality, even after adjusting for all other variables. In men and women, the presence of disability provided additional predictive ability. CONCLUSIONS SRH was predictive of mortality in both men and women, and acted as a mediator between socio-economic, demographic and health conditions and mortality.
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Affiliation(s)
- N Tamayo-Fonseca
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, Alicante, Spain
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14
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Rodríguez JN, Quesada JA, Sánchez JL, Martino ML, Prados D. [Information and worry among patients with non-oncohematological pathologies upon arrival at the hematology clinic]. Sangre (Barc) 1999; 44:364-70. [PMID: 10618914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
PURPOSE Patients are frequently referred to the haematologist to be studied due to the presence of processes that are not properly haematological. We have studied the group of outpatients with non-oncohaematological pathologies referred to our external haematology clinic to evaluate their knowledge about the reason for consultation, the existence or not of worry upation and its degree at the arrival. PATIENTS AND METHODS We have made a prospective study including all patients with non-oncohaematological processes (n = 204) who were referred for the first time to our external consultation between April and October 1997. We evaluated in each patient, using an inquest, the following data: age, sex, origin (hospital consultations or urban or rural health centres), reason for consultation, knowledge of the reason for consultation (yes/partially/no), existence or not of worry (yes/no) and when present, its degree (low, moderate, high). The inquiry was made to the parents in those patients aged under 12 years. We have analyzed all adults, each group of adult patients (rural, urban, hospital) separately and compared one group to each other, all pediatric patients and we have compared as well the overall results obtained with adult patients with those from the parents of pediatric patients. RESULTS 1) Adult patients (n = 169; 78 referred from hospital, 59 from urban and 32 from rural health centres): with respect to the knowledge of the reason for consultation 49.7% of them knew it perfectly, 20.1% partially, and 30.2% did not know about it. 48.5% of patients arrived worried to the clinic, 16.6% of them with a high degree, 17.8% moderate and 14.2% low. 2) Adults referred from primary health care (urban versus rural health centres): We have found neither significant differences in the knowledge of the reason for consultation, worry or its degree with respect to age, sex or origin (urban or rural), nor in the worry or its degree with respect to the patient knowledge of the reason for consultation. 3) Adults referred from other hospital units: The mean age of patients who knew the reason for consultation was significatively lower than that observed in the group who did not (respectively 43.3 and 57 years) (p = 0.003). These differences did not exist with respect to sex. Differences in the existence or not of worry with respect to sex were almost significant, women arrive more worried than men (57.1% and 31.8% respectively, p = 0.07). No significant differences were found in the existence or not of worry and its degree with respect to age or knowledge of the reason for consultation. 4) Comparison between both groups of adults patients (hospital consultation and health centres): No significant differences in the knowledge of the reason for consultation, existence or not of worry and its degree have been found with respect to the other parameters studied. 5) Paediatric patients (n = 35; 8 referred from hospital, 14 from urban and 13 rural health centres): With respect to the knowledge of the reason for consultation 62.9% of them knew it perfectly, 17.1% partially and 20% did not know about it. 80% of patients' parents arrived worried at consultation, 45.7% with a high degree, 20% moderate and 14.3% low. 6) Comparison between paediatrics and adult patients: we have only found significative differences in the existence or not of worry (80% and 48.5% respectively, p = 0.001) and its degree (65.7% of parents with moderate or high worry and 34.4% of adults, p = 0.0004). Parents of paediatric patients arrive at our consultation more worried and with a higher worry degree than the other adults. CONCLUSION We consider that patients referred to our external consultation of haematology for the first time arrive with a poor knowledge of their reason for consultation. This observation does not seem to have any relation with age, sex or origin (hospital consultations, urban or rural health centres). (ABSTRACT TRUNCATED)
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Affiliation(s)
- J N Rodríguez
- Servicio de Hematología, Hospital Juan Ramón Jiménez, Huelva
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15
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Alió JL, de la Hoz F, Pérez-Santonja JJ, Ruiz-Moreno JM, Quesada JA. Phakic anterior chamber lenses for the correction of myopia: a 7-year cumulative analysis of complications in 263 cases. Ophthalmology 1999; 106:458-66. [PMID: 10080200 DOI: 10.1016/s0161-6420(99)90103-3] [Citation(s) in RCA: 200] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To perform a prospective, clinical trial to determine the potential cumulative complications of patients implanted with angle-supported phakic intraocular lenses (PIOLs) for the correction of myopia. DESIGN Nonrandomized, prospective, comparative trial. PARTICIPANTS Two hundred sixty-three eyes of 160 consecutive patients were included. INTERVENTION Angle-supported anterior chamber intraocular lenses were implanted into phakic eyes. MAIN OUTCOME MEASURES Night halos and glare were recorded. Central endothelial cell count, postoperative inflammation, applanation tonometry, cataract development, retinal detachment, and pupil ovalization were recorded by the same physician. RESULTS Night halos and glare were reported as significant by 20.2% at 1 year and 10% at year 7 of follow-up. This complication was significantly lower in the larger optical zone PIOL (ZSAL-4) than in the ZB5M/ZB5MF group (P < 0.05). Acute postoperative iritis was observed in 4.56% of cases. High intraocular pressure that required antiglaucoma medications appeared in 7.2% of cases. Central corneal endothelial cell density was significantly decreased at postoperative month 3 (P < 0.0001). The percentages of cell loss were 3.76% at month 3 and 1.83% at year 1, and then the percentages decreased by 1.37% more at year 2, 0.72% at year 3, 0.3% at year 4, 0.6% at year 5, 0.4% at year 6, and 0.56% at year 7. The total cumulative loss of central endothelial cells after 7 years was 8.37%. Pupil ovalization was present in 5.9% of cases, although smaller degrees of this complication were observed in another 10.3%. Retinal detachment appeared in 3% of cases. The PIOL explantation was decided in 11 cases (4.18%) because of cataract development (9 cases) and extreme pupil ovalization associated with severe glare (2 cases). The Kaplan-Meier cumulative survival analysis study showed an expected period free from complication of 86.5% for IOP elevation, 98.75% for endothelial cell count inferior to 1500 cells/mm2, 86.97% for pupil ovalization, 95.43% for retinal detachment, and 89.02% for explantation. CONCLUSIONS Angle-supported PIOL appeared to be well tolerated by the corneal endothelium with a low rate of other complications. Pupil ovalization seemed to be a specific problem for this type of PIOL.
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Affiliation(s)
- J L Alió
- Instituto Oftalmológico de Alicante, Spain
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García-Ayala A, García-Hernández MP, Quesada JA, Agulleiro B. Gonadotropic and thyrotropic cells from the Mediterranean yellowtail (Seriola dumerilii; Risso, 1810): immunocytochemical and ultrastructural characterization. Anat Rec (Hoboken) 1998; 250:448-58. [PMID: 9566535 DOI: 10.1002/(sici)1097-0185(199804)250:4<448::aid-ar8>3.0.co;2-t] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Gonadotropins GTH I and GTH II from the pituitary of Mediterranean (M.) yellowtail (Seriola dumerilii) were isolated and characterized, and antisera to the whole GTH II molecule (anti-My alpha,betaGTH II) and to its beta-subunit (anti-My betaGTH II) were obtained. At the light microscopic level, anti-My alpha,betaGTH II reacted with My betaGTH II-immunoreactive cells (GTH II cells), thyroid-stimulating hormone (TSH) cells, and a third cell population, which could have been GTH I cells. The aim of this study was the ultrastructural characterization of GTH and TSH cells in M. yellowtail using the immunogold method in order to provide a basis for future research into reproduction of this species. METHODS Pituitaries from mature male and female specimens reared in captivity were dissected out and processed for electron microscopy. The immunogold method was carried out by using anti-My alpha,betaGTH II, anti-My alpha,betaGTH II preabsorbed with the alpha subunit of the M. yellowtail GTH (My alphaGTH-subunit), anti-My betaGTH II, anti-human (h) alpha,betaTSH, and anti-h betaTSH sera to reveal gonadotropic and thyrotropic cells. RESULTS M. yellowtail gonadotropic cells were very heterogeneous with regard to their size, shape, and ultrastructural features. Cells were found with numerous, round, variably electron-dense, secretory granules and globules; others were found with their cytoplasm occupied mostly by dilated cisternae of rough endoplasmic reticulum (RER) and scarce secretory granules; and other intermediate cell forms were found that showed varying proportions of secretory granules and dilated RER. The secretory granules and globules were immunogold labeled with anti-My alpha,betaGTH II, and the reaction was weaker in the latter. A similar immunogold-labeling pattern was found with anti-My betaGTH II and with anti-My alpha,betaGTH II preabsorbed with the My alphaGTH-subunit, although some cells that showed the same ultrastructural features described above were not immunogold labeled and could have been GTH I cells. Thyrotropic cells had small, round, secretory granules of medium or high electron density that were immunogold labeled with anti-My alpha,betaGTH II, anti-h alpha,betaTSH, and anti-h betaTSH sera, but not with anti-My betaGTH II or anti-My alpha,betaGTH II serum preabsorbed with the My alphaGTH-subunit. All of the cell forms described for gonadotropes and thyrotropes were also found in a state of involution. CONCLUSIONS Gonadotropes that are of a single morphological type but that vary in ultrastructure are present in the pituitary of captive M. yellowtail. GTH II- and putative GTH I-producing cells were distinguishable from one another and from TSH cells by their different reactions to anti-My alpha,betaGTH II, anti-My betaGTH II, and anti-My alpha,betaGTH II preabsorbed with the My alphaGTH-subunit.
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Affiliation(s)
- A García-Ayala
- Department of Cell Biology, Faculty of Biology, University of Murcia, Spain
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Rodríguez JN, Fernández-Jurado A, Martino ML, Diéguez JC, Moreno MV, Quesada JA, Polo B, Cañavate M, Amian A, Prados D. [Acute myeloid leukemia in those over 70 years of age. Experience using low-dose ara-C treatment]. Sangre (Barc) 1998; 43:35-9. [PMID: 9580427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The treatment of elderly patients with acute myeloid leukaemia (AML) remains controversial. We present the results of the treatment of a group of patients aged above 70 years with AML diagnosed in our Hospital since 1990. PATIENTS AND METHODS We have studied retrospectively the cases of AML in patients older than 70 years diagnosed in our Service since January 1990 to June 1996. Induction treatment was performed, in all cases but one, with two cycles of Ara-C 10 mg/m2/12 h s.c. for 21 days and after haematological recuperation, if complete remission had been achieved, monthly maintenance treatment with Ara-C (25 mg/m2/12 h oral x 5 days), prednisone (40 mg/m2/day x 5 days) y vincristine (1 mg/m2 i.v. x 1 day) was begun. RESULTS During the period of study 48 patients with AML have been diagnosed in our Service, among them 22 (45.8%) were older than 70 years. One of them could not be considered for the study as not all data from him could be compiled. Among the other 21 patients 5 presented previous haematological processes (4 myelodysplastic syndrome and 1 Waldenström's macroglobulinemia). Initial diagnosis according to FAB classification for AML was as follows: 7 M1, 6 M2, 4 M4, 2 M5 and 2 M6. From these 21 patients 2 received no treatment due to rapid progression and death, among the other 19, one was directly treated with a modification of the maintenance treatment with vincristine and prednisone without response (survival 2 months). The other 18 patients were treated with low-dose Ara-C (described above), among them 3 (16.7%) were not evaluable as they did not finish the first cycle of induction treatment; 8 (44.4%) showed no response; 2 (11.1%) achieved partial remission and 5 (27.8%) complete remission. One patient did not show any response after two cycles of low-dose Ara-C but she obtained complete remission when treated with Ara-C and idaurubicin. Overall mean survival was 5.7 months (median 2; 95% confidence interval 1.6-9.8 months). In the group of patients treated with low-dose Ara-C mean survival was 6.6 months (median 3.5; 95% confidence interval 1.9-11.2 months). CONCLUSION We consider that the treatment with low-dose Ara-C is a valid option in the treatment of elderly patients (aged 70 or above) with AML because 28% complete remissions can be achieved, specially in those ones in which other more aggressive treatments are not possible.
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Affiliation(s)
- J N Rodríguez
- Servicio de Hematología, Hospital Juan Ramón Jiménez, Huelva
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Palmer CJ, Lindo JF, Klaskala WI, Quesada JA, Kaminsky R, Baum MK, Ager AL. Evaluation of the OptiMAL test for rapid diagnosis of Plasmodium vivax and Plasmodium falciparum malaria. J Clin Microbiol 1998; 36:203-6. [PMID: 9431947 PMCID: PMC124834 DOI: 10.1128/jcm.36.1.203-206.1998] [Citation(s) in RCA: 141] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The development of rapid and specific diagnostic tests to identify individuals infected with malaria is of paramount importance in efforts to control the severe public health impact of this disease. This study evaluated the ability of a newly developed rapid malaria diagnostic test, OptiMAL (Flow Inc., Portland, Oreg.), to detect Plasmodium vivax and Plasmodium falciparum malaria during an outbreak in Honduras. OptiMAL is a rapid (10-min) malaria detection test which utilizes a dipstick coated with monoclonal antibodies against the intracellular metabolic enzyme parasite lactate dehydrogenase (pLDH). Differentiation of malaria parasites is based on antigenic differences between the pLDH isoforms. Since pLDH is produced only by live Plasmodium parasites, this test has the ability to differentiate live from dead organisms. Results from the OptiMAL test were compared to those obtained by reading 100 fields of traditional Giemsa-stained thick-smear blood films. Whole-blood samples were obtained from 202 patients suspected of having malaria. A total of 96 samples (48%) were positive by blood films, while 91 (45%) were positive by the OptiMAL test. The blood films indicated that 82% (79 of 96) of the patients were positive for P. vivax and 18% (17 of 96) were infected with P. falciparum. The OptiMAL test showed that 81% (74 of 91) were positive for P. vivax and 19% (17 of 91) were positive for P. falciparum. These results demonstrated that the OptiMAL test had sensitivities of 94 and 88% and specificities of 100 and 99%, respectively, when compared to traditional blood films for the detection of P. vivax and P. falciparum malaria. Blood samples not identified by OptiMAL as malaria positive normally contained parasites at concentrations of less than 100/microl of blood. Samples found to contain P. falciparum were further tested by two other commercially available rapid malaria diagnostic tests, ParaSight-F (Becton Dickinson, Cockeysville, Md.) and ICT Malaria P.f. (ICT Diagnostics, Sydney, Australia), both of which detect only P. falciparum. Only 11 of the 17 (65%) P. falciparum-positive blood samples were identified by the ICT and ParaSight-F tests. Thus, OptiMAL correctly identified P. falciparum malaria parasites in patient blood samples more often than did the other two commercially available diagnostic tests and showed an excellent correlation with traditional blood films in the identification of both P. vivax malaria and P. falciparum malaria. We conclude that the OptiMAL test is an effective tool for the rapid diagnosis of malaria.
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Affiliation(s)
- C J Palmer
- Center for Disease Prevention, University of Miami School of Medicine, Florida 33136, USA
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Baum MK, Shor-Posner G, Zhang G, Lai H, Quesada JA, Campa A, Jose-Burbano M, Fletcher MA, Sauberlich H, Page JB. HIV-1 infection in women is associated with severe nutritional deficiencies. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 16:272-8. [PMID: 9402074 DOI: 10.1097/00042560-199712010-00008] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Nutritional deficiencies may contribute to immune dysregulation, and have been shown to be sensitive markers of HIV-1 disease progression. Only limited information exists, however, regarding the nutritional profile of HIV-1-seropositive drug abusers. Immune and nutritional measurements were obtained in a subsample of 125 subjects from a larger cohort of drug users being followed for HIV-1 infection and cofactors of disease progression. Nutritional deficiencies, particularly vitamins A, E, and zinc, were widespread with up to 86% of the drug users exhibiting at least one nutritional alteration. Although immune parameters (CD4 count, CD8 count, beta2-microglobulin) were similar in the HIV-1-infected men and women, women had significantly poorer overall nutritional status, as measured by plasma proteins, which are considered to be sensitive markers of malnutrition. A comparison of individuals with advanced disease (CD4 count <200/mm3) revealed significantly lower levels of plasma prealbumin (p < .01), selenium, (p < .05), and greater deficiency of vitamins A (p < .01) and E (p < .05) in women than in men. The greater severity of nutritional deficiencies noted in HIV-1-infected women may be an important determinant of disease progression and survival.
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Affiliation(s)
- M K Baum
- Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Florida 33136, USA
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García-Hernández MP, García-Ayala A, Quesada JA, Agulleiro B. Immunocytochemical and ultrastructural characterization of melanotropin and adrenocorticotropin cells from the Mediterranean yellowtail (Seriola dumerilii, Risso 1810). Anat Rec (Hoboken) 1997; 249:74-80. [PMID: 9294651 DOI: 10.1002/(sici)1097-0185(199709)249:1<74::aid-ar9>3.0.co;2-f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Melanotropin (MSH) and adrenocorticotropin (ACTH) are pituitary hormones derived from a common precursor: the proopiomelanocortin (POMC), which is processed differently in the melanotropic and corticotropic cells of several vertebrates. While ACTH is a major final product in corticotropes, it is further processed into alpha-MSH and corticotropin-like intermediate lobe peptide (CLIP) in melanotropes. Cells which are immunoreactive to ACTH (ACTH cells) and to both alpha-MSH and ACTH (MSH cells) have been described in a number of teleosts, including the Mediterranean yellowtail, by light microscopic immunocytochemistry. However, these cells have been ultrastructurally characterized only in a few species. In this paper, we use electron microscopy to identify and characterize the cells producing MSH and ACTH in M. yellowtail (Seriola dumerilii). METHODS Pituitaries from adult specimens were dissected and processed for conventional and immunocytochemical electron microscopy. An immunogold technique was performed using anti-synthetic alpha-MSH and anti-human (h) ACTH (1-24) sera. RESULTS MSH cells had round secretory granules with a granular content of varying electron density and compactness, which were immunogold-labeled with anti-alpha-MSH. Homogeneous and electron-dense secretory granules found in the Golgi area of these cells reacted with both anti-alpha-MSH and anti-hACTH (1-24). ACTH cells had round secretory granules with a homogeneous and medium or high electron-dense core and narrow clear halo, which were grouped in the cell area near the neurohypophysis (NH). Some granules showed an osmiophilic semicore in the medium electron-dense content, which has not been described in other teleost pituitary cells. Immunogold-labeling over the secretory granules only was obtained with all the antisera used. Some ACTH cells showed involutive features. CONCLUSIONS MSH and ACTH are respective final products of the POMC in two ultrastructurally different cells of the pituitary of M. yellowtail, MSH and ACTH cells. The immature granules in the Golgi area of MSH cells seem to be the site of proteolitic cleavage of ACTH into alpha-MSH and CLIP.
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García-Ayala A, García-Hernández MP, Quesada JA, Agulleiro B. Immunocytochemical and ultrastructural characterization of prolactin, growth hormone, and somatolactin cells from the Mediterranean yellowtail (Seriola dumerilii, Risso 1810). Anat Rec (Hoboken) 1997; 247:395-404. [PMID: 9066917 DOI: 10.1002/(sici)1097-0185(199703)247:3<395::aid-ar11>3.0.co;2-k] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Prolactin (PRL), growth hormone (GH), and somatolactin (SL) are structurally related pituitary hormones that belong to a peptide family. Whereas growth hormone and prolactin are present in the hypophysis of all vertebrates, somatolactin, a recently discovered hormone, has been found only in fish. It has been demonstrated immunocytochemically in a few teleost species; ultrastructurally, cells producing this hormone have been characterized only in one species of salmon. In this paper, we identify and characterize ultrastructurally the cells producing these three hormones in Mediterranean yellowtail (Seriola dumerilii). METHODS Pituitaries from adult specimens were dissected out and processed for electron microscopy. The immunogold technique was performed in some ultrathin sections using fish primary antibodies. RESULTS PRL cells had round, peripherally distributed, very electron-dense, homogeneous secretory granules of variable size. GH cells had dense, round secretory granules with a conspicuous scalloped membrane, which were grouped in the cell area near the neurohypophysis. SL cells had round, polymorphic, or very irregularly shaped secretory granules, the last seeming to arise from the fusion of various secretory granules. The population of secretory granules varied greatly from one cell to another. In all cases, immunogold labeling was seen exclusively in the secretory granules. Exocytosis was observed in all cell types. Some of the PRL, GH, and SL cells showed involutive features. CONCLUSIONS PRL, GH, and SL, although structurally and functionally related, are secreted by ultrastructurally different cells in the pituitary of M. yellowtail.
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Affiliation(s)
- A García-Ayala
- Department of Cell Biology, Faculty of Biology, University of Murcia, Spain
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Amián A, Rodríguez JN, Muñiz R, Diéguez JC, Moreno MV, Quesada JA, Cañavate M, Fernández-Jurado A, Martino ML, Prados D. [Comparative study of the stability of oral anticoagulant treatments (warfarin vs acenocoumarol)]. Sangre (Barc) 1996; 41:9-11. [PMID: 8779047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the stability of the effect of two oral anticoagulants, one of them (acenocoumarol) with a short half life and the other one with a long half life (warfarin) in patients in the stable phase of treatment (at least 2 months with treatment before entering the study). PATIENTS AND METHODS During a year period (January-December 1993) a comparative study of two groups of 53 patients each was performed: group 1 patients were treated with warfarin and group 2 with acenocoumarol. Both groups were paired with respect to age, sex, diagnosis for anticoagulant therapy and desired therapeutic range (INR 3-4.5). The mean value of controls per patient, the dosage changes, the evolutive controls and the incidence of haemorrhagic and thromboembolic episodes were studied. RESULTS The controls performed in group 1 were 728 in total with a mean value of 13.74 per patient and 800 in group 2 with a mean value of 15.09 per patient. A change in the dosage was performed in 214 controls in patients of group 1 and in 269 of group 2. Seventeen patients had 38 haemorrhagic episodes (2 major and 36 minor) in group 1, and 6 of group 2 had 20 episodes (2 major and 18 minor). Significant differences were observed in the mean value of controls (p = 0.04), the evolutive controls (p < 0.001), the global incidence of haemorrhages (p = 0.008) and incidence of minor ones (p = 0.006). No significant differences in dosage were observed. In both groups no thromboembolic episodes during the period of study were reported. CONCLUSIONS Anticoagulant treatment with warfarin is more stable than with acenocoumarol. The total controls and the mean value of controls per patient are decreased. Nevertheless with warfarin we have observed a greater incidence of haemorrhagic episodes.
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Affiliation(s)
- A Amián
- Servicio de Hematología y Hemoterapia, Hospital Juan Ramón Jiménez
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Abstract
BACKGROUND In vertebrates the thymus is primarily regarded as a lymphoid organ whose importance lies in its capacity to produce a large number of lymphocytes that enter the circulation as T cells. In higher vertebrates the organ has also been regarded as a site for myelopoiesis, but this capacity has not been observed in fish. In this study we describe morphologically the presence of intrathymic developing myeloid cells in the sea bass. METHODS The thymus samples were morphologically studied by transmission electron microscopy. RESULTS We describe the coexistence of cells in different stages of erythropoiesis and granulopoiesis that appear to be developing in situ in some thymus lobes. Degenerated thymocytes and epithelial-reticular cells occur simultaneously in the same areas. CONCLUSIONS The coexistence of different cellular components of erythropoiesis and the heterophilic series of granulopoiesis with areas of necrosis suggests a relationship between both processes that is influenced by the microenvironment. Our observations also suggest that the presence of intrathymic developing myeloid cells may imply a nonimmunological role for the thymus.
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Affiliation(s)
- M Avilés-Trigueros
- Departamento de Biología Celular, Facultad de Biología, Universidad de Murcia, Spain
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Albinana J, Quesada JA, Certucha JA. Children at high risk for congenital dislocation of the hip: late presentation. J Pediatr Orthop 1993; 13:268-9. [PMID: 8459026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Several studies of risk factors and screening for congenital dislocation of the hip (CDH) have been reported, but some children are diagnosed too late and poor prognosis can be expected even with selective screening programs. The frequency of risk factors in late CDH presentation is not known.
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Affiliation(s)
- J Albinana
- Pediatric Orthopaedic Surgery Division, Hospital Niño Jesus, Madrid, Spain
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