Girona Catalonia, Spain
Girona Catalonia, Spain

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Fenoll R.,Hospital Del Mar | Pujol J.,Hospital Del Mar | Pujol J.,Centro Investigacion Biomedica En Red Of Salud Mental | Esteba-Castillo S.,Institute dAssistencia Sanitaria IAS | And 14 more authors.
Journal of Alzheimer's Disease | Year: 2017

Background: Neural tissue alterations in Down syndrome are fully expressed at relatively late developmental stages. In addition, there is an early presence of neurodegenerative changes in the late life stages. Objective: The aims of this study were both to characterize white matter abnormalities in the brain of adult Down syndrome patients using diffusion tensor imaging (DTI) and to investigate whether degenerative alterations in white matter structure are detectable before dementia is clinically evident. Methods: Forty-five adult non-demented Down syndrome patients showing a wide age range (18-52 years) and a matched 45-subject control group were assessed. DTI fractional anisotropy (FA) brain maps were generated and selected cognitive tests were administered. Results: Compared with healthy controls, non-demented Down syndrome patients showed lower DTI FA in white matter involving the major pathways, but with more severe alterations in the frontal-subcortical circuits. White matter FA decreased with age at a similar rate in both DS and control groups. Conclusions: Our results contribute to characterizing the expression of white matter structural alterations in adult Down syndrome. However, an accelerated aging effect was not demonstrated, which may suggest that the FA measurements used are not sufficiently sensitive or, alternatively, age-related white matter neurodegeneration is not obvious prior to overt clinical dementia. © 2017 - IOS Press and the authors. All rights reserved.


Bonet L.,University of Valencia | Izquierdo C.,Institute dAssistencia Sanitaria IAS | Escarti M.J.,Hospital Clinico Of Valencia | Sancho J.V.,ESIC Business School | And 3 more authors.
Revista de Psiquiatria y Salud Mental | Year: 2017

There is a growing interest in mobile Health interventions (m-Health) in patients with psychosis. The aim of this study is to conduct a systematic review in order to analysethe current state of research in this area. The search of articles was carried out following the PRISMA criteria, focusing on those studies that used mobile technologies in patients with psychosis during the period from 1990 to 2016. A total of 20 articles were selected from the 431 studies found. Three types of studies are distinguished: 1) Analysis of quality and usability, 2) Improving treatment adherence and reducing hospital admissions, and 3) Analysisof patient symptoms. Conclusions: m-Health interventions are feasible, and are easy to use for patients with psychosis. They evaluate the evolution of psychotic symptoms more efficiently, and improve adherence to treatment, as well as symptoms and hospital admissions. However, a particular strategy does not stand out over the rest, because differences in methodology make them difficult to compare. © 2017 SEP y SEPB.


Gomez-Marcos M.A.,Primary Care Research Unit | Gomez-Marcos M.A.,Castilla and Leon Health Service SACYL | Gomez-Marcos M.A.,University of Salamanca | Gomez-Marcos M.A.,Primary Care Research Unit of The Alamedilla | And 61 more authors.
BMC Cardiovascular Disorders | Year: 2016

Background: Carotid intima-media thickness (C-IMT) is a reliable predictor of cardiovascular events. We Investigated the relationship between markers of glycemia and C-IMT in intermediate-risk cardiovascular patients. Methods: This study analyzed 427 subjects, aged 35 to 74 years (mean, 60.3 ± 8.5 years), 55 % women, enrolled into the MARK study. Including 231 subjects defined as normal glucose, 104 subjects classified as prediabetes and 92 with type 2 diabetes mellitus. Carotid ultrasound was used to measure C-IMT and the presence of plaques. Fasting plasma glucose (mg/dl) and glycated hemoglobin (%) (HbA1c) were measured using standard enzymatic automated methods. Postprandial glucose (mg/dl) was self-measured by patients at home 2 h after meals (breakfast, lunch and dinner) for 1 day. Results: The C-IMT shows a positive correlation with fasting plasma glucose, postprandial glucose and HbA1c. Multiple linear regression analysis showed a positive association between HbA1c and C-IMT, with a 0.016 mm and 0.019 mm increase in mean and maximum C-IMT per 1 % increase in HbA1c. In addition, an association between fasting plasma glucose and C-IMT was found with an increase of 0.004 and 0.005 mm in mean and maximum C-IMT per 10 mg/dl in fasting plasma glucose. We also observed a graded association between fasting plasma glucose, postprandial glucose and HbA1c and the presence of carotid target organ damage (TOD), with an odds ratio of 1.013, 1.010 and 1.425, respectively. Conclusion: The results of this study suggest that the fasting plasma glucose and HbA1c, but not postprandial glucose, are associated with C-IMT media and maximum. The patients who present with a metabolic glucose alteration have more risk of developing carotid TOD. Trial registration: ClinicalTrials.gov; Identifier: NCT01428934. © 2016 The Author(s).


Masferrer L.,Institute dAssistencia Sanitaria IAS | Masferrer L.,University of Girona | Garre-Olmo J.,Girona Biomedical Research Institute | Caparros B.,University of Girona
Journal of Substance Use | Year: 2016

Background: Drug-dependent people are one of the most vulnerable populations to death by suicide. This study aims to explore the occurrence and related factors for risk of suicide in a sample of 196 bereaved substance-dependent patients.Methods: Sociodemographic characteristics, bereavement and drug-related variables and symptoms of complicated grief (CG) were examined in a sample of 196 bereaved drug-dependent patients abstemious at least during the last month. A multiple linear regression analysis was adjusted to identify predictors of risk of suicide.Results: 61.2% of patients reported risk of suicide. Those participants with risk of suicide were separated or widowed, without work, reported family antecedents of suicide attempts as well as personal suicide attempts and symptoms of CG.Conclusion: Results indicate that the occurrence of the risk of suicide among drug-dependent people is very high and some risk factors are identified. Clinicians should pay particular attention to the bereaved drug-dependent patients with risk factors in order to identify people more vulnerable to present suicide risk. © 2016 Taylor & Francis Group, LLC.


Masferrer L.,Institute Dassistencia Sanitaria Ias | Masferrer L.,University of Girona | Garre-Olmo J.,Girona Biomedical Research Institute | Caparros B.,University of Girona
Heroin Addiction and Related Clinical Problems | Year: 2015

Background: People with substance use disorders frequently present life stories marked by suffering and loss. Few studies have assessed the role of bereavement of a significant person in the drug dependent population. Aim: This study explored the loss of a significant person among 196 bereaved drug dependent patients before and after the age when they consider that their drug consumption increased. Methods: Socio-demographic characteristics, bereavement and drug related variables were examined. Perceived relationship between the significant loss and drug consumption was also assessed. Complicated grief symptomatology was measured by the Spanish version of the Inventory of Complicated Grief (ICG). Results: 83.2% of all participants stated that, after suffering the loss, they increased drug consumption. 12.3% of the patients who first increased drug consumption and after suffered the loss of a significant person reported a relapse after the loss. However, 54% of the participants who first experienced the loss and after increased their drug consumption did not perceive any relationship between the loss and their own drug consumption. The most frequent losses were the parents (father and mother), sibling being the third most significant loss. 34.2% of patients reported symptoms of complicated grief. Conclusions: Results show a relationship between the loss and the important increase of substance consumption. This study suggests the importance of including the process of grief psychotherapy within the treatment of drug dishabituation for those cases which presented symptoms of complicated grief. © Icro Maremmani.


Masferrer L.,Institute Dassistencia Sanitaria Ias | Masferrer L.,University of Girona | Garre-Olmo J.,Girona Biomedical Research Institute IDIBGI | Caparros B.,University of Girona
Heroin Addiction and Related Clinical Problems | Year: 2016

Background: People with substance use disorders present high psychopathological comorbidity. Research has demonstrated that bereaved individuals with Complicated Grief (CG) symptomatology present unusually severe and prolonged symptoms, and that affects important domains. Aim: This study aimed to assess the association between clinical syndromes and CG symptoms among patients with Substance User Disorder (SUD). Methods: A convenience sample of 196 bereaved drug-dependent patients was studied. Sociodemographic characteristics, bereavement and drug-related variables as well as psychopathology were examined. CG symptomatology was measured by the Spanish version of the Inventory of Complicated Grief (ICG). Anxiety, Major Depressive Disorder and Posttraumatic Stress Disorder (PSTD) were assessed by utilizing the clinical syndrome section of the Spanish version of MCMI-III. A logistic regression analysis was adjusted to identify which variables were associated with CG symptoms. Results: 78.1% were men, and mean age in the sample was 45.59 years (SD=10.14). 34.2% of participants reported symptomatology of CG. Individuals with CG symptoms showed 31.2% higher frequency of Anxiety, 12.5% higher Major Depression and 7.4% higher PTSD. The symptomatology of CG was associated with the presence of Major Depressive Disorder (OR= 1.029) as well as PTSD (OR=1.041). Conclusions: Depression and PTSD were associated with symptomatology of CG. This study suggests the importance of carrying out a rigorous and accurate differential diagnosis of CG symptomatology as well as clinical syndromes among addicted people. © 2016, Pacini Editore S.p.A. All rights reserved.

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