Time filter

Source Type

Torremolinos, Spain

Lara F.J.P.,Antequera Hospital | Carranque G.,Virgen de la Victoria Hospital | Oehling H.,Antequera Hospital | Hernandez J.M.,Antequera Hospital | Oliva H.,Antequera Hospital
Diseases of the Esophagus | Year: 2014

Summary: Gastroesophageal reflux disease (GERD) has been related with certain psychological dimensions. The influence of mood, emotional intelligence, and perceived quality of life on clinical symptoms and outcome of antireflux surgery was evaluated in GERD patients with and without hiatal hernia. The study included 61 patients who were diagnosed with GERD between 2003 and 2008: 16 of them without hiatal hernia (group A) and 45 of them with hiatal hernia (group B). All of these patients had undergone laparoscopic antireflux surgery. Patients were clinically examined and evaluated with the following instruments: Short Form (SF)-36 Health Survey, Gastrointestinal Quality of Life Index, Hospital Anxiety and Depression (HAD) Scale, and Trait Meta-Mood Scale (TMMS)-24. Proportions were compared by using the chi-squared test; averages were compared by using the Student's t-test (with Bonferroni's correction). In general, our patients intervened for GERD showed results lower than normal or close to the lower limit of normal in the administered tests. Patients in the group without hernia were younger (P < 0.001) and with lower American Society of Anaesthesiologists risk. They showed higher scores in the SF-36 dimensions: Physical Functioning, Physical Role and Emotional Role, and lower scores in the Social Role (P < 0.001). They showed lower scores in the Emotional dimension of Gastrointestinal Quality of Life Index (P = 0.0068) and worse results in the Hospital Anxiety and Depression subscales of Anxiety (P < 0.001) and Depression (not significant). Men in the group without hernia showed higher scores than men in the group with hernia in the TMMS subscales corresponding to Emotional Clarity and Emotional Repair (P < 0.001). Women in the group with hernia showed higher scores than women in the group without hernia regarding Emotional Clarity (P = 0.0012). GERD patients showed poor results in all the tests, and patients without hiatal hernia compared with patients with hernia showed higher levels of anxiety, which interfered with their social life. Moreover, they showed lower tolerance to stress and higher frustration, fear, and worry. On the basis of such unfavorable phychoemotional results observed with GERD patients (especially those without hernia) in the different tests, we propose that improving our knowledge of the psychological profile of GERD patients - particularly those without hiatal hernia - could help in designing individualized medical and psychological therapies and increase success rates. © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus. Source

Barnoiu O.-S.,Carlos Haya Hospital | Garcia Galisteo E.,Carlos Haya Hospital | Baron Lopez F.,University of Malaga | Vozmediano Chicharro R.,Carlos Haya Hospital | And 4 more authors.
Urologia Internationalis | Year: 2014

Objectives: To assess the preoperative urodynamic predictors of urinary incontinence (UI) 1 year after robot-assisted radical prostatectomy (RARP) and to design a nomogram capable of predicting its occurrence. Materials and Methods: Our prospective study included 58 previously continent patients who underwent RARP, in most cases, bilateral nerve-sparing and bladder neck preservation. A urodynamic examination including a urethral pressure profile was performed preoperatively. Multivariate analysis was used to assess the predictors for the need to use 1 or more pads/day and a nomogram was constructed. Results: There was a 20.6% incidence of UI at 1 year after RARP. Bladder compliance, maximum urethral closure pressure and the development of bladder outlet obstruction, correlated well with the incidence of UI on the multivariate analysis (p = 0.043, 0.001, and 0.05, respectively). Conclusion: Bladder compliance <27.8 ml/cm H2O, maximum urethral closure pressure <50.3 cm H2O and the bladder outlet obstruction are independent urodynamic factors correlating with UI after RARP. The new nomogram can objectively predict a patient likelihood of requiring 1 or more pads/day 1 year after RARP with a good accuracy. © 2013 S. Karger AG, Basel. Source

Roca-Rodriguez M.M.,Virgen de la Victoria Hospital | Lopez-Tinoco C.,Puerta Del Mar Hospital | Fernandez-Deudero A.,Puerta del Mar Hospital Investigation Unit | Murri M.,Virgen Of La Victoria Hospital Investigation Unit Imabis | And 4 more authors.
Diabetes/Metabolism Research and Reviews | Year: 2012

Background: Gestational diabetes mellitus (GDM) has been recognized as a significant risk factor for metabolic syndrome and CVD. The aim of the study was to evaluate the relationships between levels of cytokines, components of metabolic syndrome and cardiovascular risk markers in women with previous gestational diabetes. Methods: Women (n=41) with gestational diabetes background (cases) and 21 healthy women (controls) in the postpartum period were enrolled. Demographic and clinical data, lipid and carbohydrate metabolism and uric acid and adipokine levels (TNF-α, IL-6, leptin and adiponectin) were compared and their relationships analysed. Metabolic syndrome prevalence was calculated by WHO and NCEP-ATPIII definitions. Results: There were significant differences between cases and controls: body mass index (kg/m2) 27.4±5.6 vs 23.9±3.6 (p=0.013), waist circumference (cm) 85.2±12.9 vs 77.5±9.0 (p=0.017), metabolic syndrome (WHO definition) 14.6% vs 0% (p=0.012), metabolic syndrome (NCEP-ATPIII definition) 22% vs 0% (p=0.002), low HDL 36.6% vs 9.5% (p=0.024), fasting glucose (mmol/L) 5.4±0.6 vs 4.9±0.2 (p<0.001), glucose 120′ oral glucose tolerance test (mmol/L) 5.8±1.7vs 4.7±0.8 (p=0.007), fasting insulin (μU/mL) 13.4±8.1 vs 8.4±4.3 (p=0.004), HOMA index 3.3±2.3 vs 1.8±1.0 (p=0.002), HbA1c (%) 5.4±0.2 vs 5.2±0.2 (p=0.021), uric acid (mg/dL) 4.1±1 vs 3.5±0.6 (p=0.009), leptin (ng/mL) 32025.5±19917.3 vs 20258.9±16359.9 (p=0.023), respectively. Conclusions: Women with previous gestational diabetes have central adiposity, atherogenic lipid profile, carbohydrate intolerance and adverse adipokine profile, all of which are risk factors for the future development of metabolic disease and CVD. © 2012 John Wiley & Sons, Ltd. Source

Mercado-Martinez J.,Santa Ana Hospital | Rivera-Fernandez R.,Hospital Universitario Puerta del Mar | Aguilar-Alonso E.,Infanta Margarita Hospital | Garcia-Alcantara A.,Virgen de la Victoria Hospital | And 4 more authors.
Intensive Care Medicine | Year: 2010

Objective: To analyse the influence on the prognosis of intensive care unit (ICU) patients with acute myocardial infarction (AMI): prognostic index score, Killip class, AMI site, thrombolysis and other variables that might improve prognostic capacity and functioning of the APACHE-II index. Design: Cohort study using prospectively gathered ARIAM project data. Setting: ICUs from 129 Spanish hospitals. Patients: ICU-admitted AMI patients in ARIAM database during 4-year period were retrospectively studied. Measurements and main results: The sample comprised 6,458 patients, 76.8% males, age 64.97 ± 12.56 years, APACHE-II score 9.49 ± 7.03 points and ICU mortality 8.9%. Mortality was higher for females (p < 0.001), anterior AMI site (p < 0.001), previous AMI (p < 0.001), delay-to-hospital arrival >180 min (p = 0.003) and non-receipt of thrombolysis (p = 0.015). ICU mortality was related to age (p < 0.001) and APACHE-II score (p < 0.001). In multivariate analysis, it was related to APACHE-II (OR 1.16), age (OR 1.05), gender (OR 1.64), previous AMI (OR 1.57), anterior AMI (OR 2.05) and delay >180 min (OR 1.37). Killip class, gathered in 1,893 patients, was significantly associated with ICU mortality, and two predictive models were constructed for this group using multivariate analysis. Area under ROC curve was 0.94 in one (Killip class, age, gender, APACHE-II) versus 0.92 in the other (same variables without APACHE-II). Conclusions: APACHE-II score and Killip class are useful for assessing the severity of patients with AMI and are complementary. Each can be used with a few commonly gathered clinical variables to construct prognostic models to assess severity. Their joint application yields a model with excellent discrimination capacity. © 2010 Copyright jointly held by Springer and ESICM. Source

Martin-Rodriguez J.F.,University of Seville | Madrazo-Atutxa A.,University of Seville | Venegas-Moreno E.,University of Seville | Benito-Lopez P.,University of Cordoba, Spain | And 6 more authors.
PLoS ONE | Year: 2013

Patients with active untreated acromegaly show mild to moderate neurocognitive disorders that are associated to chronic exposure to growth hormone (GH) and insulin-like growth factor (IGF-I) hypersecretion. However, it is unknown whether these disorders improve after controlling GH/IGF-I hypersecretion. The aim of this study was to compare neurocognitive functions of patients who successfully underwent GH-secreting adenoma transsphenoidal surgery (cured patients) with patients with naive acromegaly. In addition, we wanted to determine the impact of different clinical and biochemical variables on neurocognitive status in patients with active disease and after long-term cure. A battery of six standardized neuropsychological tests assessed attention, memory and executive functioning. In addition, a quantitative electroencephalography with Low-Resolution Electromagnetic Tomography (LORETA) solution was performed to obtain information about the neurophysiological state of the patients. Neurocognitive data was compared to that of a healthy control group. Multiple linear regression analysis was also conducted using clinical and hormonal parameters to obtain a set of independent predictors of neurocognitive state before and after cure. Both groups of patients scored significantly poorer than the healthy controls on memory tests, especially those assessing visual and verbal recall. Patients with cured acromegaly did not obtain better cognitive measures than naïve patients. Furthermore memory deficits were associated with decreased beta activity in left medial temporal cortex in both groups of patients. Regression analysis showed longer duration of untreated acromegaly was associated with more severe neurocognitive complications, regardless of the diagnostic group, whereas GH levels at the time of assessment was related to neurocognitive outcome only in naïve patients. Longer duration of post-operative biochemical remission of acromegaly was associated with better neurocognitive state. Overall, this data suggests that the effects of chronic exposure to GH/IGF-I hypersecretion could have long-term effects on brain functions. © 2013 Martín-Rodríguez et al. Source

Discover hidden collaborations