Hospital Clinic iversitari Of Barcelona

Barcelona, Spain

Hospital Clinic iversitari Of Barcelona

Barcelona, Spain

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Molinuevo J.L.,Hospital Clinic iversitari Of Barcelona | Molinuevo J.L.,Institute dInvestigacio Biomedica August Pi i Sunyer | Gomez-Anson B.,Hospital Of La Santa Creu I Sant Pau | Monte G.C.,Hospital Of La Santa Creu I Sant Pau | And 4 more authors.
Archives of Gerontology and Geriatrics | Year: 2011

This study describes the cognitive profile of Prd-AD, the neuropsychological tests that may predict progression to dementia, and to study their brain structural correlates. We enrolled 24 stable amnesics who did not develop dementia after two years follow-up; 27 patients were considered as Prd-AD, in the initial visit, since they fulfilled NINCDS-ADRDA criteria after two years; 31 Alzheimer's disease (AD) patients and 27 controls (CTR). Structural magnetic resonance imaging (MRI), as well as a neuropsychological battery was performed at the initial visit. The key findings were: Prd-AD patients were characterized by prominent episodic memory dysfunction and minimal semantic memory and executive dysfunction. Semantic fluency test (Sem-Flu), delayed text memory test (Del-text-mem) and memory alteration test (M@T) (including both episodic and semantic memory), together with trail making test A (TMT-A), resulted significant predictors for dementia development in this group of amnesic patients. This optimal predictive model obtained an estimated accuracy of 53% after two years follow-up. M@T and semantic Sem-Flu test performance presented high correlation with decreased gray matter density in the left lateral temporal lobe. We conclude that Prd-AD is characterized by prominent episodic memory dysfunction and minimal semantic memory and executive dysfunction which are related with left medial, inferior and lateral temporal density loss, predominantly in the left side. © 2010 Elsevier Ireland Ltd.


PubMed | Hospital Universitario La Paz, Biomedical Research Institute Sant Pau, Hospital Universitario Of Cruces, University of Cordoba, Spain and 12 more.
Type: Journal Article | Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion | Year: 2016

Pituitary adenomas are uncommon, difficult to diagnose tumors whose heterogeneity and low incidence complicate large-scale studies. The Molecular Registry of Pituitary Adenomas (REMAH) was promoted by the Andalusian Society of Endocrinology and Nutrition (SAEN) in 2008 as a cooperative clinical-basic multicenter strategy aimed at improving diagnosis and treatment of pituitary adenomas by combining clinical, pathological, and molecular information. In 2010, the Spanish Society of Endocrinology and Nutrition (SEEN) extended this project to national level and established 6 nodes with common protocols and methods for sample and clinical data collection, molecular analysis, and data recording in a common registry (www.remahnacional.com). The registry combines clinical data with molecular phenotyping of the resected pituitary adenoma using quantitative real-time PCR of expression of 26 genes: Pituitary hormones (GH-PRL-LH-FSH-PRL-ACTH-CGA), receptors (somatostatin, dopamine, GHRH, GnRH, CRH, arginine-vasopressin, ghrelin), other markers (Ki67, PTTG1), and control genes. Until 2015, molecular information has been collected from 704 adenomas, out of 1179 patients registered. This strategy allows for comparative and relational analysis between the molecular profile of the different types of adenoma and the clinical phenotype of patients, which may provide a better understanding of the condition and potentially help in treatment selection. The REMAH is therefore a unique multicenter, interdisciplinary network founded on a shared database that provides a far-reaching translational approach for management of pituitary adenomas, and paves the way for the conduct of combined clinical-basic innovative studies on large patient samples.


PubMed | U.S. National Institute on Aging, Autonomous University of Barcelona, Hospital Clinic iversitari Of Barcelona, University of Aveiro and 2 more.
Type: | Journal: Neurobiology of aging | Year: 2016

We have previously reported the whole genome genotyping analysis of 2 consanguineous siblings clinically diagnosed with early onset Alzheimers disease (AD). In this analysis, we identified several large regions of homozygosity shared between both affected siblings, which we suggested could be candidate loci for a recessive genetic lesion underlying the early onset AD in these cases. We have now performed exome sequencing in one of these siblings and identified the potential cause of disease: the CTSF c.1243G>A:p.Gly415Arg mutation in homozygosity. Biallelic mutations in this gene have been shown to cause Type B Kufs disease, an adult-onset neuronal ceroid lipofuscinosis with some cases resembling the impairment seen in AD.


Labrador-Horrillo M.,Autonomous University of Barcelona | Valero A.,Hospital Clinic iversitari Of Barcelona | Velasco M.,Hospital Arnau Of Vilanova | Jauregui I.,Hospital Universitario Basurto | And 6 more authors.
Expert Opinion on Biological Therapy | Year: 2013

Objective: To collect data on the efficacy and safety of omalizumab in 110 patients from 9 Spanish hospitals suffering from chronic spontaneous urticaria (CSU) refractory to conventional treatment. Methods: A retrospective, descriptive analysis was performed, showing the data of 110 patients suffering from refractory CSU who received omalizumab as an off-label treatment in 9 Spanish hospitals from October 2009 to September 2012. Results: Ninety (81.8%) patients exhibited a complete or significant response, 12 (10.9%) had partial response, and 8 (7.2%) showed no response. Sixty-six (60%) patients were able to stop all concomitant medications, remaining asymptomatic treated with omalizumab alone. No serious adverse events were reported. Conclusions: Omalizumab shows excellent efficacy and safety profile in a large series of CSU patients in real-life practice. This drug will contribute to settle the debt with CSU patients contributing to restore their quality of life. © Informa UK, Ltd.


Sousa M.,University of Aveiro | Pereira A.,University of Aveiro | Costa R.,University of Aveiro | Rami L.,Hospital Clinic iversitari Of Barcelona
Archives of Gerontology and Geriatrics | Year: 2015

Objective: The Memory Alteration Test is a screening test able to discriminate the amnestic mild cognitive impairment (A-MCI) and mild Alzheimer disease from subjective memory complain group (SMC-G). The aim of this study was to analyze the European Portuguese experimental version of the Memory Alteration Test (M@T-PT). Methods: Were described the successive stages of the translation and adaptation procedure used to develop the M@T-PT. The psychometric properties were explored using principal component analysis (PCA) with varimax rotation, internal consistence, convergent validity and receiver operating characteristics (ROC) curves. Chi-squared, ANOVAs and Pearson's correlation were also analyzed. A total of 330 people with an age greater or equal to 54 years old participated. According to their cognitive state they were classified as normal controls (. n=. 28), SMC-G (. n=. 81) or A-MCI (. n=. 221). Results: The PCA for the M@T-PT indicated that the total variance explained by three components was 48.07%. A high internal consistent was obtained (. α=. 0.93). Convergent validity was verified using M@T-PT and Mini-Mental State Examination (. r=. 0.83, p<. 0.001) and Montreal Cognitive Assessment (. r=. 0.86, p<. 0.001). An optimal cut-off point was 32 points with sensitivity of 97%, specificity of 71% to differentiate SMC-G from A-MCI. Conclusions: M@T-PT is an easily applicable screening test with discriminants validity and is a psychometrically sound instrument for use in older people in Portugal. © 2015 Elsevier Ireland Ltd.


Molinuevo J.L.,Hospital Clinic iversitari Of Barcelona
Expert review of neurotherapeutics | Year: 2012

As a part of a study investigating which strategies are effective to improve pharmacological compliance among nonadherent Alzheimer's disease patients, we assessed the impact of the galenic form (oral medications or patches) on treatment adherence in patients with dementia of Alzheimer's type (DAT). We performed a 6-month prospective, multicenter, observational study with three study visits (baseline, 3 months and 6 months). Patients with mild-to-moderately severe DAT receiving medication for ≥3 months who were nonadherent to treatment were recruited. The main variable was adherence rate recorded at each visit. Patients were adherent if they missed <20% of the doses of their medication and they took it at the dose, manner and timing prescribed by the physician >80% of times. Secondary variables included strategies followed by physicians to improve adherence and reasons for nonadherence reported by patients. A total of 649 patients (35.2% men) were included. The percentage of adherent patients reached 73.6% at 3 months and rose to 85.9% at 6 months. The most common reasons for nonadherence were forgetfulness, avoidance of adverse events and refusal of treatment. Modification of treatment was the most frequent strategy followed by physicians for improving treatment adherence at baseline, and the only intervention that substantially improved adherence at the 3-month visit (the percentage of patients treated with patches increased from 6.1% at baseline to 64.8% at 3-month visit). Patients using patches were more likely to comply than patients using capsules/tablets, as demonstrated by logistic regression analysis. The results suggested that the transdermal patch may improve adherence, which may lead to an increase of treatment benefits in patients with DAT.


PubMed | Hospital Clinic iversitari Of Barcelona
Type: Journal Article | Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion | Year: 2015

Since the onset of cross hormone therapy (CHT) in transsexual individuals, there has been concern about possible chronic side effects. Our objective was to assess baseline differences in lipid profile in individuals with gender identity disorder in relation to prior CHT, and changes in the lipid profile and other cardiovascular (CV) risk factors after 24 months of treatment.Retrospective longitudinal study including all individuals assisted for the first time in the Gender Identity Unit of Catalonia from 2006 to 2010. Socio-demographical, anthropometric and laboratory data were collected.We evaluated 247 transsexuals, 150 male to female (MtF: 60.7%) and 97 female to male (FtM; 39.3%). At baseline, FtM transsexuals were younger and had started prior CHT less often than MtF (13.4% vs. 64.7%; p<0.001). During follow up, in MtF weight and BMI increased significantly, as well as systolic and diastolic blood pressure, though these latter remained within normal range. No significant differences in lipid profile were observed. FtM transsexuals also presented an increase in weight and BMI, without differences in blood pressure. A general worsening in lipid profile was observed in this group, with increased total cholesterol (166.0 35.1 vs. 175.6 38.2mg/dL; p=0.001), triglycerides (70.6 30.7 vs. 102.3 68.5 mg/dL; p<0.001) and LDL cholesterol (103.8 28.7 vs. 112.8 30.3 mg/dL; p=.013) and decreased HDL cholesterol (52.2 12.2 vs. 45.4 13.8 mg/dL; p=0.001), even though final levels were all within normal range.There is no detectable increase in CV risk factors in MtF transsexuals who were treated with currently prescribed estrogenic compounds, while a slight worsening in lipid profile takes place in the FtM group, though within normal limits.


PubMed | Hospital Clinic iversitari Of Barcelona
Type: Comparative Study | Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion | Year: 2014

Patients with type 1 diabetes (T1DM) treated with continuous subcutaneous insulin infusion (CSII) have available several specific features of these devices. The aim of this study was to evaluate the relationship between real use of them and the degree of glycemic control in patients using this therapy.Forty-four T1DM patients on CSII therapy with or without real-time continuous glucose monitoring (CGM) were included. Data from 14 consecutive days were retrospectively collected using the therapy management software CareLink Personal/Pro() and HbA1c measurement performed at that period. The relationship between the frequency of usie of specific features of insulin pumps (non-sensor augmented or sensor-augmented) and glycemic control was analyzed.Mean HbA1c in the group was 7.5 .8%. Mean daily number of boluses administered was 5.1 1.8, with 75.4% of them being bolus wizards (BW). Daily number of boluses was significantly greater in patients with HbA1c <7.5% than in those with HbA1c>7.5% (5.3 1.6 vs. 4.3 1.6, P=.056). There was a trend to greater use of BW in patients with better control (82.8 21.4% vs. 69.9 29.1%, P=.106). HbA1c was lower in patients using CGM (n=8) as compared to those not using sensor-augmented pumps (7.6 .8 vs 7.1 .7, P=.067), but the difference was not statistically significant.More frequent use of BW appears to be associated to better metabolic control in patients with T1DM using pump therapy. In standard clinical practice, augmentation of insulin pump with CGM may be associated to improved glycemic control.


PubMed | Hospital Clinic iversitari Of Barcelona
Type: Journal Article | Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion | Year: 2015

Pregnancy in women with type 1 diabetes (T1D) involves greater risks as compared to non-diabetic women, but less information is available about blood glucose and weight control after delivery. Our aim was to evaluate the postpartum metabolic profile (blood glucose and weight control) of women with T1D and the factors related to those metabolic outcomes.A retrospective, observational study of 36 women with T1D during pregnancy and for up to one year after delivery.Fifty percent of patients attended a preconceptional planning program (PPP), and 44.4% of women were treated with continuous subcutaneous insulin infusion. Mean preconceptional HbA1c and body mass index (BMI) were 7.21.2% and 23.85.0 respectively. In the total cohort, blood glucose control significantly worsened one year after delivery (HbA1c: 7.21.2 vs 7.61.2%, P<0.001). Lower preconceptional HbA1c values were found in patients who attended PPP (6.60.5 vs. 7.81.4%; P=0.02), and were maintained for one year after delivery. No differences were found in body mass index (BMI) from the pregestational period to one year after delivery in any of two groups (No PPP 22.54.6 vs 23.24.8, P=0.078; PPP 25.43.4 vs 25.53.4 kg/m(2), P=0.947). Preconceptional HbA1c was shown to be the most important determinant of metabolic control (=0.962, p<0.001) and weight one year after delivery (=0.524, p=0.025) and weight gain during pregnancy (=0.633, p=0.004).Pregnant women with T1D return to prepregnancy body weight one year after delivery, especially those with lower HbA1c levels and BMI before pregnancy. However, blood glucose control deteriorates after delivery, suggesting the need for changes in clinical practice after delivery.


PubMed | University of Aveiro and Hospital Clinic iversitari Of Barcelona
Type: Journal Article | Journal: Archives of gerontology and geriatrics | Year: 2015

The Memory Alteration Test is a screening test able to discriminate the amnestic mild cognitive impairment (A-MCI) and mild Alzheimer disease from subjective memory complain group (SMC-G). The aim of this study was to analyze the European Portuguese experimental version of the Memory Alteration Test (M@T-PT).Were described the successive stages of the translation and adaptation procedure used to develop the M@T-PT. The psychometric properties were explored using principal component analysis (PCA) with varimax rotation, internal consistence, convergent validity and receiver operating characteristics (ROC) curves. Chi-squared, ANOVAs and Pearsons correlation were also analyzed. A total of 330 people with an age greater or equal to 54 years old participated. According to their cognitive state they were classified as normal controls (n=28), SMC-G (n=81) or A-MCI (n=221).The PCA for the M@T-PT indicated that the total variance explained by three components was 48.07%. A high internal consistent was obtained (=0.93). Convergent validity was verified using M@T-PT and Mini-Mental State Examination (r=0.83, p<0.001) and Montreal Cognitive Assessment (r=0.86, p<0.001). An optimal cut-off point was 32 points with sensitivity of 97%, specificity of 71% to differentiate SMC-G from A-MCI.M@T-PT is an easily applicable screening test with discriminants validity and is a psychometrically sound instrument for use in older people in Portugal.

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