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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Kongress Medizin und Gesellschaft 2007; 20070917-20070921; Augsburg; DOC07gmds764 /20070906/
    Publication Date: 2007-09-07
    Keywords: endokrine Disruptoren ; arbeitsplatzbedingte Expositionen ; Fallkontrollstudie ; Krebs ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    facet.materialart.
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Kongress Medizin und Gesellschaft 2007; 20070917-20070921; Augsburg; DOC07gmds908 /20070906/
    Publication Date: 2007-09-07
    Keywords: Pestizide ; Fall-Kontrollstudie ; Gallenwegstumore ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    ISSN: 1573-7284
    Keywords: Agricultural ; Environmental ; Industrial ; Public health
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The three main causes of contamination in the industrialized world are energy production, and industrial and agricultural activities. The aim of the present study was to examine changes in cause of death in order to contrast causes of death between agricultural and industrial areas. To this effect we have selected four zones — two predominantly industrial and two mainly agricultural — within the Valencian Community. Mortality figures were gathered corresponding to the same period 1976–1989, published by the Consellería de Sanitat i Consum of the Generalitat Valenciana (Valencian Community health authorities). Thirty large groups of causes of death were established for posterior analysis. Mortality rate was defined as the number of deaths per 100,000 inhabitants, standardizing the data by the direct method. A simple regression analysis was performed for each cause of death and in each health coverage area studied, to determine the tendencies characterizing each area in time. A statistical significance test was also carried out. A statistically significant increase (95% confidence interval) was observed for digestive cancer, respiratory cancer, benign tumors and non-specific neoplastic diseases in the industrial areas. In the agricultural areas, a significant decrease (95% confidence interval) was observed in tuberculosis and respiratory diseases and infections. Relative risk (RR) was calculated and thus, tuberculosis, mental and central nervous system disorders, respiratory infections and diseases, and male genital disorders were more frequent in agricultural areas.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-7284
    Keywords: Antacid ; Antiulcer drugs ; Drug prescription ; Pharmaco-epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: A study is made of the pharmaco-epidemiology of antacid (ATC class A02A) and antiulcer (A02B) drug prescriptions during the year 1992. Methods: Prescription data were extracted from 1941 case histories of patients over 15 years old from four health care centers in the Valencian Community (Spain). Dosage and treatment duration were evaluated, along with the way in which morbidity, self-evaluated health, the demographic pattern and lifestyle characteristics influence drug prescription. Results: The proportion of drug prescriptions increased with age in both sexes (p 〈 0.01). Drug use depended mainly on chronic diseases. In prescribing antacids, the most influential diagnosis was gastritis (ICD 534, OR: 157), followed by duodenal ulcer (ICD 532, OR: 152) and gastric ulcer (ICD 531, OR: 122), other gastrointestinal disorders (ICD 66, OR: 54) and undefined diagnoses (OR: 15). In the prescription of antiulcer drugs, the most influential diagnoses were gastric and duodenal ulcer (OR: 380 and 342, respectively), and a significant relation was observed with the diagnosis of osteomuscular diseases (OR: 6). Lifestyle and demographic pattern were of marginal importance. The estimated duration of treatment was 85 days. No significant differences were observed in either treatment duration or administered doses of almagate, ranitidine and omeprazole with respect to sex, age or diagnosis. Conclusions: Prolonged treatment is common for acid suppression. The widespread use of peptic ulcer drugs is mostly due to excessive prescription for non-ulcer dyspepsia. At the same time, many patients consume these drugs on a long-term basis in the absence of a clear diagnosis. This observation supports the need for appropiate diagnostic and prescription protocols to secure increased economical savings and management results.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-7284
    Keywords: Skin cancer ; Ultraviolet Radiation ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A retrospective study of 143 patients histologically diagnosed with non-melanoma skin cancer (NMSC) was carried out in order to evaluate the influence of ultraviolet (UV) radiation on the appearance of more than one NMSC in the same person. Descriptive statistical and logistic regression analyses were carried out for each variable and its possible interaction, in order to determine the potential appearance of multiple NMSC. The results obtained were in agreement with those of earlier studies. A significant relationship was observed between occupational UV exposure and individuals with more than one NMSC. Those patients tended to be blue-eyed and were chronically exposed to UV radiation as a result of occupational activities (although not always in leisure activities); most did not take protective measures such as the use of hats or creams.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-7284
    Keywords: Cancer ; Drinking water ; Nitrates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The concentrations of nitrates in public drinking water in the Mediterranean coastal province of Valencia are not only the highest in Spain but also in the whole of Europe. Intensive agricultural practices involve a traditional and growing use of nitrogen fertilizers. This and the terrain — poorly consolidated and porous in areas — favors the accumulation of nitrates in underground aquifers, thereby perhaps accounting for this contamination. The possible conversion of nitrates to nitrites under certain conditions of gastric achlorhydria, followed by their transformation to nitrosamines — substances known to be carcinogenic in experimental models — has led to a number of epidemiological studies of the possible relationship between high nitrate levels in public drinking water and mortality due to different cancers. The aim of the present study was to analyze the relationship between different levels of exposure to nitrates in the drinking water of the 258 municipalities in the province of Valencia and mortality due to cancer of the stomach, bladder, prostate and colon in this population. The cancer mortality rate was found to rise with increasing exposure to nitrates in the case of gastric cancer in both sexes, and in prostate cancer. These same results were obtained on calculating relative risk for the different age groups associated with the consumption of drinking water containing different levels of nitrates. Thus, in populations with nitrate concentrations in excess of 50 mg/1, relative risk for gastric cancer in the 55–75 years age group was 1.91 and 1.81 for males and females, respectively (p〈0.05). In the case of prostate cancer elevated relative risks were also encountered: 1.86 and 1.80 for the 55–75 and over 75 years age groups, respectively.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1573-7284
    Keywords: Breast cancer ; Mortality ; Morbidity ; Spain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A study of breast cancer mortality and cancer morbidity has been carried out in Spain recently for the period 1977–1988, covering the population of the 17 Autonomous Communities and 50 provinces of the country. Data was obtained from INE, Instituto Nacional de Estadistica (National Institute of Statistics), with age standardization using the indirect method. The different Autonomous Communities and provinces were compared in order to establish possible significant differences. The crude mean mortality rate was 21 cases per 100,000 inhabitants/year; Las Palmas, Gerona, Barcelona, the Balearic Islands, Navarra and Zaragoza have the highest mortality rates, with a proportional increment of 54% in that period. The crude national mean morbidity rate for the considered period was 64.0 cases per 100,000 inhabitants, and the proportional increment 180%. According to provincial figures, Alava had the highest fitted mean morbidity rate, 135 cases per 100,000 inhabitants, whilst the highest fitted mean rate was Las Palmas (28 cases/100,000 inhabitants), and the highest proportional increment was the rate for the province of Huesca (169%). When using the ANOVA test on the mean rate of the period, for mortality as well as morbidity, we observed significant differences among provinces and among Autonomous Communities (p ⩽ 0.05).
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1573-7284
    Keywords: Asthma ; Atopic diseases ; Children ; Epidemiology ; Socio-economic status ; Tobacco smoke
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A cross-sectional survey of a cohort study was carried out between June and December 1994 in Valencia, Spain (population in 1994: 764,293 inhabitants). Two hundred sixty public and private schools randomly selected from the total of schools in Valencia were invited to participate; 3948 children aged 6–7 years cooperated in our study after informed consent was obtained from parents and school director. The survey in Valencia is part of the International Study of Asthma and Allergy in Childhood (ISAAC). Prevalences for asthma, rhinitis and atopic dermatitis were determined and contrasted with socioeconomic status (SES) among children. No statistically significant associations were established between the prevalences of asthma, rhinitis and atopic dermatitis, and SES. However, atopic dermatitis was found to be common among upper class children (21.5 per 100 children). Likewise, significant associations were observed between the severity of atopy (2 or 3 atopic manifestations) and SES (p=0.000), being greater for lower strata (4.5 per 100 children); for the three SES level significant differences were established (p = 0.008) regarding passive exposure to tobacco smoke in the home.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1573-7284
    Keywords: Evidence-based medicine ; General practice ; Primary care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: to estimate the proportion of interventions in general practice that are based on evidence. Design: a one-year cross-sectional study involving all consultations by patients over age 15 years seen in 34 national primary health care centers. Setting: the rural Castellón provincial district within the Valencian Community in eastern Spain, with a total population of 21,155 inhabitants. Subjects: of 1990 case histories registered in the course of one year, 4800 consultations were identified; of these, 2341 (49%) distinct diagnosis–intervention pairs were identified and coded. Main results: the evidence basis for the diagnosis–intervention pairs in the study was derived from a computerized search of the scientific literature published in 1992–1996. The quality of the evidence was classified according to the method of Ellis et al. Within the 2341 diagnosis–intervention pairs, there was positive evidence in support of the intervention used in 55%. The evidence basis was sound for 42%, with 38% being based on Type I (clinical trials) evidence and 4% on Type II evidence. The most frequently presenting diseases involved the circulatory (18.7%), respiratory (14.9%), nervous (14.2%), musculo-skeletal (12.5%) and nutrition and metabolism and digestive systems, with 12.1% each. Conclusions: clinical practice was clearly supported by positive evidence of all Types (I–III) in a total of 55% of interventions, and by good positive evidence of Type I or II in 42% of interventions. The percentage of evidence-based interventions in general practice serving a substantial population in rural Spain was lower than had been reported by some authors.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1573-7284
    Keywords: Atmospheric pressure changes ; Spontaneous pneumothorax
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spontaneous pneumothorax (SP) is a common respiratory condition that is easily recognized and treated, though the etiology remains largely unknown. Apart from individual factors, it has been suggested that changes in atmospheric pressure may trigger the onset of SP. Our aim was to examine the association between the onset of episodes of SP with atmospheric pressure changes in the general population of an area with a Mediterranean climate. A prospective survey was conducted to detect all episodes of SP in a region of Valencia (Spain) from January 1994 to January 1996. A total of 69 cases were identified; of these, 62 episodes of SP met the inclusion criteria for this survey. Climatic measurements during the two years studied were obtained from the Spanish National Meteorological Institute, including 6-hour readings of temperature, relative humidity, clear sunlight, atmospheric pressure, visibility, wind speed and rainfall. Associations were evaluated between the daily number of hospital admissions for SP and diurnal changes in atmospheric pressure involving rises and falls of as much as 7 and 10 mbar. In addition, the association of atmospheric pressure changes to time periods of 1 a.m., 7 a.m., 1 p.m. and 7 p.m. was assessed. Drops in atmospheric pressure below the fifth percentile and elevations above the ninety-fifth percentile were regarded as ‘unusual’. There was no association between the development of SP and changes in atmospheric pressure, and no correlation was found with repeated exposure to unusual changes of atmospheric pressure. Further research is needed using similar methods to establish comparisons between countries with different climates.
    Type of Medium: Electronic Resource
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