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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. Source

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. Source

Mora M.,Hospital Clinic iversitari Of Barcelona | Mansego M.L.,University of Navarra | Mansego M.L.,Hospital Clinico Universitario Of Valencia | Serra-Prat M.,Research Unit and Ciberhep | And 4 more authors.
Aging Clinical and Experimental Research | Year: 2014

Background and aims: Cognitive state and brain volume have been related to body mass index, abdominal fat, waist-hip ratio, components of metabolic syndrome (MS) and ghrelin. Genetic variations within the ghrelin gene have been recently associated to MS. The aim of our study was to investigate cognitive state by Mini-Mental State Examination (MMSE) in relation to MS components (ATP-III criteria) and ghrelin gene polymorphisms in dwelling individuals aged ≥70. Methods: 280 subjects (137 men/143 women, age 77.03 ± 5.92) from the Mataró Ageing Study were included. Individuals were phenotypically characterized by anthropometric variables, lipids, glucose, blood pressure and MMSE. SNPs -501AC (rs26802), -994CT (rs26312), -604GA (rs27647), M72L (rs696217) and L90G (rs4684677) of the ghrelin gene were studied. Genotypes were determined by polymerase chain reaction and SNapshot minisequencing. Results: 22.1% had MMSE <24. MMSE <24 was associated with age (p < 0.001), female gender (p = 0.016), low education (p < 0.001) and glucose impairment or diabetes (p = 0.040). MMSE was influenced by obesity, central obesity, MS and glucose impairment. This latter association remained significant after adjustment by gender, age, alcohol, educational level, GDS and ApoE genotype (p = 0.009). Ghrelin SNPs were associated to MMSE: M72L C/A genotype showed lower score than C/C (p = 0.032, after adjusting for confounders 0.049); L90G A/T genotype showed lower score than A/A (p = 0.054, after adjusting 0.005). MMSE <24 was associated to L90G (39.1% in A/T genotype vs 19.3% in A/A, p = 0.026, after adjusting for confounders p = 0.002, OR 6.18 CI 1.93-21.75). Conclusions: Glucose impairment and L90G Ghrelin gene variant influence cognitive function in old dwelling individuals participating in the Mataró Ageing Study. © Springer International Publishing 2014. Source

Labrador-Horrillo M.,Autonomous University of Barcelona | Valero A.,Hospital Clinic iversitari Of Barcelona | Velasco M.,Hospital Arnau de 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. Source

Ortega E.,Hospital Clinic iversitari Of Barcelona | Ortega E.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Ciberdem | Amor A.J.,Hospital Clinic iversitari Of Barcelona | Rojo-Martinez G.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Ciberdem | And 5 more authors.
Medicina Clinica | Year: 2015

Background and objective To describe the prevalence of cardiovascular disease (CVD) in type 1 diabetes (T1DM) and to compare it with that observed in type 2 diabetes (T2DM) and normal population in Spain. Patients and methods Cross-sectional study (18-70 years-old). Information on CVD was available from a nurse-administered questionnaire (Di@bet.es Study, NORMAL = 3,430, T2DM = 312) and from a physician reporting form (T1DM = 1,382). Differences in the crude and adjusted prevalence of coronary heart (CHD), cerebrovascular (CNSD), peripheral vascular (PVD) and overall CV (CVD) disease were investigated between T1DM vs. NORMAL, and T1DM vs. T2DM groups. Results We found differences in age, body mass index, proportion of women, dyslipemia and antihypertensive medication between T1DM vs. NORMAL and T1DM vs. T2DM (all P <.001). Smoking prevalence was not different between T1DM vs. T2DM and it was lower in T1DM compared to NORMAL (P <.0001). The percentage of CHD, CNSD, PVD, and overall CVD in T1DM vs. NORMAL was 3.0 vs. 2.5 (P =.31), 0.70 vs. 1.10 (P =.22), 2.61 vs. 0.20 (P <.0001), and 5.1 vs. 3.44 (P <.01), respectively. The prevalence in T2DM (vs. T1DM) was 11.3 (P <.0001), 3.5 (P <.0001), 4.2 (P =.13), and 17% (P <.0001), respectively. Multiple logistic regression adjusted models showed a higher prevalence of CHD (odds ratio [OR] 2.27, 95% confidence interval [95% CI] 1.41-3.67), PVD (OR 15.35, 95% CI 5.61-42.04), and overall CVD (OR 2.32, 95% CI 1.55-3.46), but not for CNSD (OR 0.49, 95% CI 0.19-1.27) in T1DM compared to NORMAL. No differences were found between T1DM and T2DM. Conclusions We found a higher prevalence of CVD in a Mediterranean population of T1DM individuals compared with non-diabetic subjects. This prevalence was similar to that observed in T2DM. © 2014 Elsevier España, S.L.U. All rights reserved. Source

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