Luis Rosero Bixby
Permanent URI for this collectionhttps://repositorio.sibdi.ucr.ac.cr/handle/123456789/16105
Browse
4 results
Search Results
Now showing 1 - 4 of 4
Item Metabolic control in a nationally representative diabetic elderly sample in Costa Rica: patients at community health centers vs. patients at other health care settings(BMC International Health and Human Rights, 8(5), 2008) Brenes Camacho, Gilbert; Rosero Bixby, Luisackground: Costa Rica, like other developing countries, is experiencing an increasing burden of chronic conditions such as diabetes mellitus (DM), especially among its elderly population. This article has two goals: (I) to assess the level of metabolic control among the diabetic population age 60 years old in Costa Rica, and (2) to test whether diabetic elderly patients of community health centers differ from patients in other health care settings in terms of the level of metabolic control. Methods: Data come from the project CRELES, a nationally representative study of people aged 60 and over in Costa Rica. This article analyzes a subsample of 542 participants in CRELES with selfreported diagnosis of diabetes mellitus. Odds ratios of poor levels of metabolic control at different health care settings are computed using logistic regressions. Results: Lack of metabolic control among elderly diabetic population in Costa Rica is described as follows: 37% have glycated hemoglobin 7%; 78% have systolic blood pressure > 130 mmHg 66% have diastolic blood pressure 80 mmHg; 48% have triglycerides 150 mg/d1; 78% have LDL 100 mg/di; 70% have HDL 40 mgldl. Elevated levels of triglycerides and LDL were higher in patients of community health centers than in patients of other clinical settings. There were no statistical differences in the other metabolic control indicators across health care settings. Conclusion: Levels of metabolic control among elderly population with DM in Costa Rica are not that different from those observed in industrialized countries. Elevated levels of triglycerides and LDL at community health centers may indicate problems of dyslipidemia treatment among diabetic patients; these problems are not observed in other health care settings. The Costa Rican health care system should address this problem, given that community health centers constitute a means of democratizing access to primary health care to underserved and poor areas.Item Crónica de la pandemia de Covid-19 en Costa Rica(Consejo Nacional de Rectores. Programa Estado de la Nación, 2021) Rosero Bixby, Luis; Jiménez Fontana, PamelaEsta crónica va más allá de una recopilación descriptiva de los principales indicadores que dan cuenta de la pandemia. A partir de referencias comparativas, tanto de naturaleza histórica como con la América Latina actual, el texto identifica las olas pandémicas, su severidad, y proporciona elementos sugestivos para valorar, de manera inicial, temas relevantes sobre la eficacia de las respuestas de política pública. Con todo, se trata de una primera aproximación que, naturalmente, debe ser complementada por estudios más exhaustivos en los distintos ámbitos en años venideros. El Aporte Especial, de carácter sintético, se organiza en cinco secciones además de esta introducción. La segunda sección efectúa una referencia histórica sobre pandemias anteriores en Costa Rica. La tercera parte brinda un contexto global para entender la pandemia del covid- 19. La cuarta y quinta secciones constituyen la parte medular del documento, pues se enfocan en la severidad y dinámica de esta pandemia, incluyendo análisis preliminares sobre la oportunidad y efectos de algunas respuestas públicas. El texto cierra con las conclusiones.Item Breast cancer and hormone replacement therapy : collaborative reanalysis of data from 51 epidemiological studies involving 52 705 women with breast cancer and 108 411 women without breast cancer(The Lancet, No.350, 1997) Collaborative Group on Hormonal Factors in Breast CancerFor almost half a century various oestrogens and progestagens have been prescribed to replace the cyclical production of ovarian hormones that normally ceases at the menopause. In the early years such hormone replacement therapy (HRT) was mostly in the form of oestrogenic compounds, but other hormones, mostly progestagens, have been increasingly used in combination with oestrogens. The relation between risk of breast cancer and use of HRT has been investigated in many epidemiological studies.1“1 The Collaborative Group on Hormonal Factors in Breast Cancer has brought together and reanalysed the worldwide data on this topic.Item Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica : data from the Costa Rican longevity and healthy aging study(Tropical Medicine & International Health; Volumen 21, Número 1, 2016) Harhay, Meera N.; Harhay, Michael O.; Coto Yglesias, Fernando; Rosero Bixby, LuisObjectives Recent studies in Central America indicate that mortality attributable to chronic kidney disease (CKD) is rising rapidly. We sought to determine the prevalence and regional variation of CKD and the relationship of biologic and socio-economic factors to CKD risk in the older-adult population of Costa Rica. Methods We used data from the Costa Rican Longevity and Health Aging Study (CRELES). The cohort was comprised of 2657 adults born before 1946 in Costa Rica, chosen through a sampling algorithm to represent the national population of Costa Ricans >60 years of age. Participants answered questionnaire data and completed laboratory testing. The primary outcome of this study was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Results The estimated prevalence of CKD for older Costa Ricans was 20% (95% CI 18.5–21.9%). In multivariable logistic regression, older age (adjusted odds ratio [aOR] 1.08 per year, 95% CI 1.07–1.10, P < 0.001) was independently associated with CKD. For every 200 m above sea level of residence, subjects' odds of CKD increased 26% (aOR 1.26 95% CI 1.15–1.38, P < 0.001). There was large regional variation in adjusted CKD prevalence, highest in Limon (40%, 95% CI 30–50%) and Guanacaste (36%, 95% CI 26–46%) provinces. Regional and altitude effects remained robust after adjustment for socio-economic status. Conclusions We observed large regional and altitude-related variations in CKD prevalence in Costa Rica, not explained by the distribution of traditional CKD risk factors. More studies are needed to explore the potential association of geographic and environmental exposures with the risk of CKD.