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Alcázar de San Juan, Spain

Martinez-Martin P.,National Center for Epidemiology | Jimenez-Jimenez F.J.,Sureste Hospital | Carroza Garcia E.,National Center for Epidemiology | Alonso-Navarro H.,La Mancha Centro Hospital Complex | And 4 more authors.
Journal of Clinical Epidemiology | Year: 2010

Objective: This study sought to assess the psychometric attributes of the Quality of Life in Essential Tremor Questionnaire (QUEST) by undertaking an independent validation. Study Design and Setting: This was an observational, multicenter, cross-sectional study carried out in Neurology Departments of general hospitals. The following assessments were applied: Louis Rating Scale, Clinical Assessment of Tremor, Clinical Global Impression of Severity (CGI-ET), Hospital Anxiety and Depression Scale (HADS), EQ-5D, and QUEST (Spanish version). Results: One hundred and eighteen consecutive patients were included. According to the CGI-ET, most of patients had mild (42.4%) or moderate (43.2%) impact of tremor on performing daily activities. Fully computable QUEST data were 60.2%. The QUEST Summary Index (QUEST-SI) displayed marginal floor or ceiling effect. On the whole, QUEST internal consistency and reproducibility were satisfactory (Cronbach's alpha values: 0.73-0.86; QUEST-SI intraclass correlation coefficient: 0.77). Factor analysis identified eight factors (73.6% of the variance) that could be grouped into six, relatively coincident with the questionnaire's dimensions. The QUEST-SI correlated moderately with the EQ-5D index (rS = -0.40), HADS-Depression (rS = 0.39), and CGI-ET (rS = 0.39), and strongly with the QUEST scale for self-evaluation of tremor severity (rS = 0.63). The standard error of measurement was 8.00. Conclusion: Apart from a substantial problem of acceptability, most of the tested psychometric attributes of the QUEST resulted satisfactory. © 2010 Elsevier Inc. All rights reserved. Source


Quiralte J.,University of Seville | Justicia J.L.,Stallergenes Iberica S.A. | Cardona V.,Allergology Service | Davila I.,University of Salamanca | And 3 more authors.
Immunotherapy | Year: 2013

Aim: Few studies have compared cluster immunotherapy and conventional administration regimens. The aim of this study was to establish the safety profile of these different regimens in patients with allergic respiratory diseases who received index-of-reactivity (IR)-standardized allergen extracts by the subcutaneous route. Materials & methods: The safety of subcutaneous immunotherapy (SCIT), administered by means of a 4-week cluster titration schedule (cluster-SCIT) or by an 8-week short conventional titration schedule (SC-SCIT), both with a target dose of 8 IR, was assessed in a retrospective, observational, multicenter study. Results: A total of 658 patients (339 cluster-SCIT and 319 SC-SCIT) were recruited from 92 sites in Spain. Injection site reactions occurred in 25.1 and 27.3% of patients treated with cluster-SCIT and SC-SCIT, respectively. Systemic reactions (European Academy of Allergy and Clinical Immunology criteria) were reported for 0.2% of doses and 1.5% of patients with cluster-SCIT, and 0.7% of doses and 4.4% of patients with SC-SCIT. Most reactions were mild and there were no grade 3 or 4 systemic reactions. No life-threatening systemic reactions, anaphylactic shock, or adverse events leading to therapy discontinuation were reported. Conclusion: The safety profile of the cluster regimen supports the use of accelerated SCIT schedules with IR-standardized allergen extracts compared with short conventional schedules, particularly if similar extracts and application methods are used. © 2013 Future Medicine Ltd. Source


Rabih S.A.,Hepatorenal Unit | Agudo R.G.,Hepatorenal Unit | Huidobro M.L.L.,La Mancha Centro Hospital Complex | Ferrus M.Y.,La Mancha Centro Hospital Complex | And 4 more authors.
Pancreas | Year: 2014

OBJECTIVES: The aims of this study were to determine the prevalence of exocrine pancreatic insufficiency (EPI) and chronic pancreatitis (CP) in patients with chronic alcoholic liver disease and to analyze the possible associated factors. METHODS: This is an analytical observational study of cases and controls for a sample of patients with chronic alcoholic and nonalcoholic liver disease. Exocrine pancreatic insufficiency was diagnosed using the C mixed-triglyceride breath test. Patients with abdominal pain underwent endoscopic ultrasonography for CP evaluation using the Wiersema criteria. RESULTS: A total of 154 patients were included, 129 with alcoholic liver disease (83 with cirrhosis) and 25 with nonalcoholic liver disease. Exocrine pancreatic insufficiency was found in 55.2% versus 16.7% (P < 0.001), 70% of patients without cirrhosis compared with 46.2% of patients with cirrhosis had pancreatic insufficiency (P = 0.017), and 82.7% of patients with alcoholic liver disease and abdominal pain had CP (P < 0.001). Exocrine pancreatic insufficiency was associated with the male sex, alcohol intake, abdominal pain, degree of liver failure, and the absence of portal hypertension. Chronic pancreatitis was correlated with age younger than 55 years and abdominal pain. CONCLUSIONS: Patients with alcoholic liver disease had a high prevalence of EPI and CP; this prevalence was even higher in patients who have not yet developed cirrhosis with liver failure or portal hypertension. © 2014 Lippincott Williams & Wilkins. Source


Garcia-Agudo R.,La Mancha Centro Hospital Complex | Aoufi Rabih S.,La Mancha Centro Hospital Complex | Araque Torres P.,La Mancha Centro Hospital Complex | Dolores Fraga Fuentes M.,La Mancha Centro Hospital Complex | And 3 more authors.
Transplantation Proceedings | Year: 2012

Introduction: The response to hepatitis B (HB) vaccine remains suboptimal among chronic kidney disease patients. The aim of this study was to analyze the efficacy of a hepatitis B vaccination schedule with two 4-double doses of conventional vaccine and four doses of adjuvant vaccine in chronic kidney disease patients evaluated for renal transplantation. Methods: In this prospective study, we recruited chronic kidney disease patients evaluated for renal transplantation to receive four 40-μg doses of hepatitis B virus vaccine (0, 1, 2 and 6 months) and another four 40 μg doses of hepatitis B virus vaccine and four 20 μg doses of adjuvant vaccine if they were nonresponders. AntiHBs titers were analyzed before every vaccine dose and 1 month after the fourth dose. Results: One hundred fifty-five patients were enrolled in the study. The response to the vaccination increased until the seventh dose: first dose, 5.4%; second, 29.5%; third, 66.7%; fourth, 75.9%; fifth, 83.3%; sixth, 87.3%; seventh, 92.5%; and eighth, 93.8%. AntiHBs titers after the first and second vaccination with Engerix were 10 to 99 mIU/mL in the 12% and 7.7%, 100 to 999 mIU/mL in the 30.1%, and 46.2%, and 1000 mIU/mL in the 34.9% and 15.4%, respectively. Fendrix was administrated in 6.2% of the patients and 75% of them obtained a response. AntiHBc-positive patients obtained a response with one vaccination cycle in the 71.4%. The response was influenced by age and was greater in women. Adverse events were found in 11.5% of the patients (inflammation and/or local pain), which were less frequent in men (8.9% versus 16.1%) and similar for both vaccines. Conclusion: The response to the hepatitis B vaccination with four double doses of conventional vaccine and revaccination with the same schedule and adjuvanted vaccine shows a high response rate in chronic kidney disease evaluated for renal transplantation. © 2012 Elsevier Inc. Source

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