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Sanchez Lora F.J.,Hospital Clinico Universitario Virgen Of La Victoria | Ceballos Torres A.,Hospital Clinico Universitario San Cecilio Of Granada | Perez Hernandez I.A.,Hospital Clinico Universitario Virgen Of La Victoria Of Malaga
Salud(i)Ciencia | Year: 2013

Health-related quality of life reflects patient perceptions of their well-being in all aspects of their daily lives, and by studying and evaluating them the impact of the disease and treatment on the patient can be assessed. The instruments most often used to measure them are questionnaires, which are dynamic tools, because they are in a continuous process of development, improvement and validation. This paper includes an updated review of the instruments to measure different aspects of health-related quality of life (HRQoL) in patients with type 2 diabetes mellitus, which have been used or can be used with Hispanic-speaking patients. It provides guidance on the most suitable type of validated, generic and specific instruments to be used, depending on the objectives of clinicians and researchers interested in the feelings, self-appraisals or behaviors of type 2 diabetic patients. It details the main features of the questionnaires recommended, indications for their use, and references to entities that facilitate consultation and on-line access. Among those available, the SF-36 and EQ-5D have received most support in the scientific literature to assess the broader aspects of health status in diabetics. To assess the specific impact of diabetes it would be advisable to use ADDQoL and DQoL. It also offers General guidelines are also provided for greater familiarization with these measures and the methodology of use and interpretation of results. Copyright © Sociedad Iberoamericana de Información Científica (SIIC), 2013.


Toma C.,University of Barcelona | Toma C.,Biomedical Network Research Center on Rare Diseases | Hervas A.,Hospital Universitari Mutua Of Terrassa | Balmana N.,Biomedical Network Research Center on Rare Diseases | And 22 more authors.
World Journal of Biological Psychiatry | Year: 2013

Objectives. Neurotransmitter systems and neurotrophic factors can be considered strong candidates for autism spectrum disorder (ASD). The serotoninergic and dopaminergic systems are involved in neurotransmission, brain maturation and cortical organization, while neurotrophic factors (NTFs) participate in neurodevelopment, neuronal survival and synapses formation. We aimed to test the contribution of these candidate pathways to autism through a case-control association study of genes selected both for their role in central nervous system functions and for pathophysiological evidences. Methods. The study sample consisted of 326 unrelated autistic patients and 350 gender-matched controls from Spain. We genotyped 369 tagSNPs to perform a case-control association study of 37 candidate genes. Results. A significant association was obtained between the DDC gene and autism in the single-marker analysis (rs6592961, P = 0.00047). Haplotype-based analysis pinpointed a four-marker combination in this gene associated with the disorder (rs2329340C-rs2044859T- rs6592961A-rs11761683T, P = 4.988e-05). No significant results were obtained for the remaining genes after applying multiple testing corrections. However, the rs167771 marker in DRD3, associated with ASD in a previous study, displayed a nominal association in our analysis (P = 0.023). Conclusions. Our data suggest that common allelic variants in the DDC gene may be involved in autism susceptibility. © 2013 Informa Healthcare.


PubMed | Complutense University of Madrid, University of the Balearic Islands, Autonomous University of Barcelona, Hospital Clinico Universitario Virgen Of La Victoria Of Malaga and 6 more.
Type: | Journal: Actas espanolas de psiquiatria | Year: 2015

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobiological disorders in childhood, and is characterized by inappropriate levels of inattention, hyperactivity and/or impulsiveness, with an estimated prevalence of 5.29%. ADHD can have a negative impact upon all areas of the life of the patient. The main clinical guides accept multimodal treatment, involving both pharmacological and psychological measures, as the best management approach in ADHD (psychoeducational, behavioural and academic). Lisdexamfetamine dimesylate (LDX) is a new drug for the treatment of ADHD. A multidiscipline expert document has been developed, compiling the scientific evidence referred to this new molecule. The study also addresses the existing shortcomings in current drug therapy for ADHD and the contributions of LDX to routine clinical practice, in an attempt to help and guide physicians in the use of this new treatment. This document is endorsed by the ADHD and Psychoeducational Development task Group of the Spanish Society of Primary Care Pediatrics (Grupo de TDAH y Desarrollo Psicoeducativo de la Asociacin Espaola de Pediatra de Atencin Primaria, AEPap), the Spanish Society of Pediatric Neurology (Sociedad Espaola de Neurologa Peditrica, SENEP) and the Spanish Society of Out-hospital Pediatrics and Primary Care (Sociedad Espaola de Pediatra Extrahospitalaria y Atencin Primaria, SEPEAP).


Jimenez-Navarro M.F.,Hospital Clinico Universitario Virgen Of La Victoria Of Malaga | Garcia-Pinilla J.M.,Hospital Clinico Universitario Virgen Of La Victoria Of Malaga | Garrido-Sanchez L.,CIBER ISCIII | Alonso-Briales J.H.,Hospital Clinico Universitario Virgen Of La Victoria Of Malaga | And 6 more authors.
International Journal of Cardiology | Year: 2010

Background: Early de novo diagnosis of diabetes mellitus in patients admitted with acute coronary syndromes who have undergone percutaneous coronary revascularization may have prognostic implications. The ideal diagnostic method and its time of performance are unknown due to the uncertain reproducibility of the oral glucose tolerance test (OGTT). Methods: We assessed 88 patients with no known diabetes mellitus admitted with an acute coronary syndrome who underwent successful percutaneous revascularization. The patients received an OGTT the day after coronary revascularization (7.7 ± 6 days after admittance in hospital) and 1 month later. Results: The mean age of the patients was 60.8 ± 10.3 years and 82% were men. The most common reason for admission was acute coronary syndrome without ST elevation (42%), followed by acute coronary syndrome with ST elevation (36%) and stable angina (21%). After the first OGTT, 66 patients (75%) were found to have carbohydrate metabolism disorders (41% glucose intolerance and 34% diabetes mellitus). After the second OGTT 39 patients (44.3%) had carbohydrate metabolism disorders (26% glucose intolerance and 18% diabetes mellitus). The correlation between both tests was low (weighted kappa, 0.23 ± 0.1; 0.03-0.43) (p = 0.02). Conclusions: The correlation of the OGTT done in patients admitted with acute coronary syndromes who underwent percutaneous coronary revascularization the day after admittance and the OGTT 1 month later was poor. The prevalence of carbohydrate intolerance in these patients was high. © 2008 Elsevier Ireland Ltd.


Marchal J.A.,University of Granada | Estebaranz J.,Fundacion IMABIS | Peran M.,University of Granada | Perez R.,Fundacion IMABIS | And 2 more authors.
European Journal of Clinical Investigation | Year: 2011

Background Preinfarction angina, a possible form of ischaemic preconditioning, improves the prognosis in patients who experience a major ischaemic event; though the associated pathophysiology is not yet fully understood. The aim of this study was to determine the possible involvement of endothelial progenitor cells (EPC), the vascular endothelial growth factor (VEGF) and the hepatocyte growth factor (HGF) in the development of preinfarction angina. Methods and results We studied 41 patients (60·5±12years; 34% women) and 14 healthy controls; 43·9% of the patients had preinfarction angina. No differences were found in the baseline characteristics of the two groups. Although the EPC, VEGF and HGF were raised as compared with the control group, no significant differences were found according to the presence or absence of preinfarction angina in the levels of EPC (baseline, P=0·25; day 3, P=0·11; day 7, P=0·32), VEGF (baseline, P=0·96; day 3, P=0·06; day 7, P=0·57) or HGF (baseline, P=0·18; day 3, P=1; day 7, P=0·86). An association was seen in the patients who had preinfarction angina between the EPC levels at baseline and on days 3 and 7 and the HGF on admission with the time from the angina to the STEMI (β=-0·070; β=-0·066; β=-0·081; β=-80·16; P<0·05), showing a reduction in the level of EPC cells for each hour passed since the event. Conclusions No differences were found in the release kinetics of EPC, VEGF or HGF after a first infarction according to whether the patients had angina during the week before the infarction. © 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.


Jimenez-Navarro M.F.,Hospital Clinico Universitario Virgen Of La Victoria Of Malaga | Ramirez-Marrero M.A.,Hospital Clinico Universitario Virgen Of La Victoria Of Malaga | Anguita-Sanchez M.,Hospital Reina Sofia Of Cordoba | Castillo J.C.,Hospital Reina Sofia Of Cordoba
Clinical Cardiology | Year: 2010

Background: Controversy exists concerning the influence of gender in the prognosis of patients with heart failure and no evidence is available fromspecific heart failure clinics. Hypothesis: Women with ambulatory heart failure are managed differently than men, although their prognosis might be better than men. Methods and Results: We analyzed the clinical characteristics, complementary test results, treatment, and prognosis in 4720 patientswith chronic heart failure seen in 62 specializedclinics forming part of amulticenter registry during a mean follow-up of 40 months. The mean age was 65 ± 12 years and 71%weremen. The men were younger than the women andmore often had a history of hyperlipidemia and ischemic heart disease.The men had a more advanced heart failure New York Heart Association (NYHA) functional class (III-IV) than the women and a greater frequency of systolic ventricular dysfunction. The men more often received treatment with β-blockers, vasodilators, and antiplatelet aggregators as well as higher mean doses as compared with the women. The overall survival after the follow-up was similar for both genders, although the women had lower rates of survival free of admission for heart failure. Conclusions: Despite themortality of women andmen with heart failure being similar, the rate of readmission for heart failure is greater in women in specialized heart failure clinics. These results may be associated with the pharmacological treatment differences observed. © 2010 Wiley Periodicals, Inc.


PubMed | Hospital Clinico Universitario Virgen Of La Victoria Of Malaga
Type: Comparative Study | Journal: Clinical cardiology | Year: 2010

Controversy exists concerning the influence of gender in the prognosis of patients with heart failure and no evidence is available from specific heart failure clinics.Women with ambulatory heart failure are managed differently than men, although their prognosis might be better than men.We analyzed the clinical characteristics, complementary test results, treatment, and prognosis in 4720 patients with chronic heart failure seen in 62 specialized clinics forming part of a multicenter registry during a mean follow-up of 40 months. The mean age was 65 +/- 12 years and 71% were men. The men were younger than the women and more often had a history of hyperlipidemia and ischemic heart disease. The men had a more advanced heart failure New York Heart Association (NYHA) functional class (III-IV) than the women and a greater frequency of systolic ventricular dysfunction. The men more often received treatment with beta-blockers, vasodilators, and antiplatelet aggregators as well as higher mean doses as compared with the women. The overall survival after the follow-up was similar for both genders, although the women had lower rates of survival free of admission for heart failure.Despite the mortality of women and men with heart failure being similar, the rate of readmission for heart failure is greater in women in specialized heart failure clinics. These results may be associated with the pharmacological treatment differences observed.

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