Background Wearable sensors-based systems have emerged as a potential tool to continuously monitor Parkinson’s Disease (PD) motor features in free-living environments. Objectives To analyse the responsivity of wearable inertial sensor... more
Background Wearable sensors-based systems have emerged as a potential tool to continuously monitor Parkinson’s Disease (PD) motor features in free-living environments. Objectives To analyse the responsivity of wearable inertial sensor (WIS) measures (On/Off-Time, dyskinesia, freezing of gait (FoG) and gait parameters) after treatment adjustments. We also aim to study the ability of the sensor in the detection of MF, dyskinesia, FoG and the percentage of Off-Time, under ambulatory conditions of use. Methods We conducted an observational, open-label study. PD patients wore a validated WIS (STAT-ONTM) for one week (before treatment), and one week, three months after therapeutic changes. The patients were analyzed into two groups according to whether treatment changes had been indicated or not. Results Thirty-nine PD patients were included in the study (PD duration 8 ± 3.5 years). Treatment changes were made in 29 patients (85%). When comparing the two groups (treatment intervention vs ...
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Purpose: To study whether the incidence of bladder cancer in an industrialized area in North-Eastern Spain remains as high as in the nineties.Methods: Patients diagnosed with histologically confirmed primary bladder cancer, during... more
Purpose: To study whether the incidence of bladder cancer in an industrialized area in North-Eastern Spain remains as high as in the nineties.Methods: Patients diagnosed with histologically confirmed primary bladder cancer, during 2018-2019, in an area in North-Eastern Spain (430,883 inhabitants) were included. Crude incidence rates were estimated per 100,000 person-year based on the number of individuals getting their first diagnosis. Direct age-standardized incidence rates were calculated applying both the European and the World Standard Populations.Results: 295 patients were included (mean age 72.5±10.3 years; 89.8% men). The crude rate was 62.6 (95%CI:55.0-70.1) for men and 6.8 (95%CI:4.4-9.3) for women. The annual rate adjusted to the European Standard Population was 85.3 (95%CI:75.0-95.5) for men and 7.0 (95%CI:4.5-9.5) for women, and adjusted to the World Standard Population, 31.7 (95%CI:27.9-35.5) and 2.9 (95%CI:1.8-3.9) respectively. Conclusion: The incidence of bladder c...
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Methicillin-resistant Staphylococcus aureus (MRSA) asymptomatic colonization is common in long-term care facilities, but the burden of symptomatic infection appears to be low. It is not usually known whether a patient is colonized at the... more
Methicillin-resistant Staphylococcus aureus (MRSA) asymptomatic colonization is common in long-term care facilities, but the burden of symptomatic infection appears to be low. It is not usually known whether a patient is colonized at the time of admission to the geriatric facility. Our purpose was to determine the prevalence, characteristics and factors associated with MRSA colonization on admission, and the cumulative incidence of colonization over the following 6 months. Longitudinal and prospective study conducted over a 6-month period. All patients were screened at admission using nasal and ulcers swabs within the first 24h. Patients were screened also at the end of the study to assess carrier status. The prevalence of MRSA colonization was 7.6% at the entry (25 patients). In the multivariate analysis, advanced age, recent use of antibiotics, prior colonization by MRSA, and peripheral vascular disease were independent risk factors for colonization at admission. With standard precautions, the 6-month cumulative incidence of MRSA colonization was 4.2%. In our long-term care facility, MRSA colonization at the time of admission was frequent. Few patients were colonized during the study and no episodes of infection were reported. Probably, standard precautions, including hand washing and appropriate barrier procedures during the care of wounds, are the most useful control measures.
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Research Interests: Psychology, Psychiatry, Treatment Outcome, Medicine, Dopamine, and 15 moreHumans, Female, Male, Clinical Sciences, Pathological Gambling, Hypersexuality, Aged, Compulsive behavior, Binge eating, Neurosciences, Parkinson Disease, Pathological, Impulsive behavior, Severity of Illness Index, and dopaminergic
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To assess the use of intracameral cefazolin in preventing endophthalmitis in cataract surgery. Ophthalmology Department, L'Hospitalet de Llobregat, Barcelona, Spain. This study was of phacoemulsification... more
To assess the use of intracameral cefazolin in preventing endophthalmitis in cataract surgery. Ophthalmology Department, L'Hospitalet de Llobregat, Barcelona, Spain. This study was of phacoemulsification procedures performed from January 2002 to December 2007. In January 2004, intracameral cefazolin given at the end of the surgery was added to the prophylaxis protocol of cataract surgery. The cumulative incidence of postoperative endophthalmitis before and after the addition of intracameral cefazolin was compared. During the study period, 18579 phacoemulsification procedures were performed. In the 2-year period before introduction of intracameral cefazolin prophylaxis, 25 cases of endophthalmitis were diagnosed in 5930 surgeries, leading to a cumulative incidence of 0.422% (95% confidence interval [CI], 0.279%-0.613%). After the introduction of cefazolin, 6 cases of endophthalmitis were diagnosed in 12649 surgeries, an incidence of 0.047% (95% CI, 0.019%-0.099%). When only microbiologically proven cases were considered, the cumulative endophthalmitis incidence was 0.388% (95% CI, 0.252%-0.572%) in the first study period and 0.032% (95% CI, 0.010%-0.076%) in the second study period (P<.0000001). The relative risk for presenting with endophthalmitis in the first study period compared with the second period was 8.89 (95% CI, 3.65-21.65). A 2.5 mg/0.1 mL intracameral bolus of cefazolin provided excellent prophylactic effectiveness, with a reduction in the incidence of endophthalmitis from 0.422% to 0.047%, corresponding to a relative risk reduction of 88.7% (95% CI, 72.6%-95.4%). Cefazolin fulfills international recommendations on antimicrobial prophylaxis for surgical site infections and is easier to obtain in developing countries.
Research Interests: Surgery, Incidence Geometry, Medicine, Endophthalmitis, Cataract surgery, and 15 moreHumans, Female, Male, Cataract, Antibiotic Prophylaxis, Incidence, Clinical Sciences, Aged, Phacoemulsification, Confidence Interval, Cumulative Incidence, Postoperative Period, Acute Disease, Cefazolin, and Anterior Chamber
Research Interests: Ophthalmology, Blindness, Adolescent, Medicine, Humans, and 15 moreChild, Female, Male, Equatorial Guinea, Clinical Sciences, Aged, Prevalence, Middle Aged, Optometry and Ophthalmology, Adult, Public health systems and services research, Vision Disorders, Cross Sectional Studies, Ivermectin, and Onchocerciasis
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Research Interests: Psychology, Gerontology, Medicine, Activities of Daily Living, Humans, and 15 moreFemale, Male, Interpersonal Relations, Cohort, Sample Size, Health Status, Clinical Sciences, Aged, Retrospective Studies, Age Factors, Geriatric Assessment, Cross Sectional Studies, Cohort Studies, Disabled Persons, and Disability Evaluation
El objetivo principal de este artículo es describir el perfil de las revistas científicas españolas. Los resultados que se presentan proceden de una encuesta a 1.280 revistas científicas españolas incluidas en la base de datos Dulcinea... more
El objetivo principal de este artículo es describir el perfil de las revistas científicas españolas. Los resultados que se presentan proceden de una encuesta a 1.280 revistas científicas españolas incluidas en la base de datos Dulcinea (edición 2012), obteniendo una tasa de respuesta del 43,8% (n=561). Como objetivos específicos, el estudio se planteó caracterizar las revistas científicas y analizar las peculiaridades de las mismas en torno a una serie de parámetros que conforman las dimensiones económico-financiera, estratégica y operativa de las revistas en el periodo observado. El análisis ha permitido observar cómo el modelo de financiación de las revistas científicas españolas se sostiene principalmente de las ayudas institucionales, cómo la mayoría de las revistas carece de una estructura organizativa estable y depende, en gran medida, del trabajo voluntario y cómo el debate sobre las limitaciones y dificultades que afectan al desarrollo del acceso abierto sigue vigente.
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Objetivo: Analizar la precision diagnostica y aplicabilidad de Mediktor en pacientes reales que acuden a un servicio de Urgencias. Metodo: Estudio observacional prospectivo realizado en el ambito de urgencias de un hospital terciario... more
Objetivo: Analizar la precision diagnostica y aplicabilidad de Mediktor en pacientes reales que acuden a un servicio de Urgencias. Metodo: Estudio observacional prospectivo realizado en el ambito de urgencias de un hospital terciario universitario. A los pacientes con patologias medicas y quirurgicas (cirugia y traumatologia) que no precisaban asistencia medica inmediata (niveles 3-5, escala andorrana MAT), se les entrego una Tablet PC para responder al interrogatorio de Mediktor. En virtud de las respuestas el software adjudicaba un listado de 10 pre-diagnosticos ordenados por probabilidad, que se ocultaban tanto al paciente como al medico responsable, para no modificar el proceso habitual. Posteriormente se analizo el grado de coincidencia entre el diagnostico medico y los diagnosticos ofrecidos por Mediktor. Resultados: 1.015 pacientes fueron encuestados, de los cuales 622 se consideraron validos para analizar. Se excluyeron los pacientes sin diagnostico al alta, los menores de 1...
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Research Interests: Psychology, Depression, Medicine, Humans, Female, and 12 moreMale, Aged, Middle Aged, Agomelatine, Parkinson´s Disease, Clinical Psychopharmacology, Sleep-Wake Disorders, Parkinson Disease, Acetamides, Psychology and Cognitive Sciences, Outcome assessment (Health care), and Medical and Health Sciences
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Hypertension, together with other contributing risk factors, is a major risk for cardiovascular disease. The aim of this study was to assess the cardiovascular risk in the Spanish hypertensive population according to the 2003 European... more
Hypertension, together with other contributing risk factors, is a major risk for cardiovascular disease. The aim of this study was to assess the cardiovascular risk in the Spanish hypertensive population according to the 2003 European Society of Hypertension-European Society of Cardiology (ESH/ESC) guidelines criteria and to determine the control rate of the main cardiovascular risk factors (CVRF). Observational and transversal study including 22,639 patients with essential hypertension, who have been admitted to primary care units and hypertension units in Spain. Dyslipemia (52.1%), diabetes (36.6%) and smoking (22.3%) were the most prevalent CVRF. Cardiovascular risk stratification according to the ESH/ESC guidelines showed that more than 70% patients were considered at high added risk (36.9%) or at very high added risk (35.8%), whereas only 7.6% were classified in the low-risk stratum. Blood pressure was the worst controlled risk factor among hypertensive patients (80.6%). Total ...
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It is difficult to draw definite conclusions about the prevalence and clinical characteristics of patients with resistant hypertension because of the heterogeneity of study designs described in published studies. To estimate the... more
It is difficult to draw definite conclusions about the prevalence and clinical characteristics of patients with resistant hypertension because of the heterogeneity of study designs described in published studies. To estimate the prevalence of resistant hypertension, the associated cardiovascular risk factors and the degree of target-organ damage, and to analyze the differences between true resistant hypertension (TRH) and white-coat resistant hypertension (WCRH). Cross-sectional study. Patients who visited the Hypertension Clinic with resistant hypertension were sequentially included. Resistant hypertension was defined as an average of three measurements of systolic blood pressure, >/= 160 mmHg or a diastolic blood pressure >/= 95 mmHg, or both, in patients treated with a triple-drug regimen, over at least 2 months. Twenty-four-hour ambulatory blood pressure monitoring and M-mode bi-dimensional echocardiography were performed. WCRH was defined as a mean daytime ambulatory bloo...
Research Interests: Cardiology, Medicine, Echocardiography, Humans, Internal Medicine, and 15 moreHypertension, Diabetes mellitus, Blood Pressure, Female, Male, Risk factors, Clinical Sciences, Aged, Middle Aged, Blood Pressure Monitoring, Adult, Left ventricular hypertrophy, Cardiovascular Diseases, Risk Factors, and Ambulatory Blood Pressure
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ABSTRACT
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ABSTRACT
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ABSTRACT Blood pressure is frequently high during the initial phase of stroke and usually decreases spontaneously during the first hours or days after onset. Some studies have shown that high blood pressure during the acute phase of... more
ABSTRACT Blood pressure is frequently high during the initial phase of stroke and usually decreases spontaneously during the first hours or days after onset. Some studies have shown that high blood pressure during the acute phase of stroke is associated with a poor prognosis, although results from observational studies have shown inconclusive and contradictory results. A U-shaped relationship has been observed between initial blood pressure at time of admittance and stroke mortality. There is no general agreement about whether the high blood pressure should be treated, but most guidelines recommend treatment when the rise entails persistent systolic readings of ≥ 220 mmHg and diastolic readings of ≥ 120 mmHg. Even in these cases, it should be necessary to avoid abrupt or intense blood pressure reductions in lieu of more gradual ones and which are less than 20 %-25%. In patients with cerebral hemorrhagia, or with ischemic stroke in which fibrinolytic or anti-coagulant treatment must be initiated, it must be assured that blood pressure levels are lower than 180/105 mmHg. Temperature increases during the acute phase of stroke is associated with poor neurological evolution and a noteworthy increase in morbidity and mortality. Some studies have demonstrated that hyperglucemia during the acute phase of stroke is associated with a poorer prognosis, but the results of various studies have not been conclusive.
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Research Interests: Humanities and Medicine
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Research Interests: Medicine and Fisioterapia
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ABSTRACT
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Research Interests: Psychology, Depression, Medicine, Prospective studies, Humans, and 14 moreAntidepressant, Female, Male, Randomized Trial, Aged, Middle Aged, Analysis of Variance, FLUOXETINE, Triazoles, Pilot Projects, Clinical Psychopharmacology, Parkinson Disease, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Ophthalmology, Medicine, Visual acuity, Cataract surgery, Humans, and 15 moreFemale, Male, Intraocular Pressure, Cataract, Data Collection, Clinical Sciences, Aged, Middle Aged, Hyaluronic Acid, Optometry and Ophthalmology, Adult, Phacoemulsification, Ocular Hypertension, Best Corrected Visual Acuity (BCVA), and Postoperative Complications
In the validation of medical expert systems, agreement among different human specialists on a random sample of cases may be taken as a substitute to a missing gold standard. Distance measures between pairs of experts, extensively... more
In the validation of medical expert systems, agreement among different human specialists on a random sample of cases may be taken as a substitute to a missing gold standard. Distance measures between pairs of experts, extensively described in previous studies, do not take into account the influence of chance-expected agreement. A weighted kappa index, with three different weighting schemes, is proposed as an alternative to be applied in the general situation of N cases assessed by E experts about K possible diagnoses, each of them qualified with one of G ordinal categories. A hierarchical cluster analysis, applied to the kappa matrices generated, allows for the classification of the expert system among clinical specialists, providing a relative assessment of its diagnostic ability. The above methodology is applied to the validation of two medical expert systems, PNEUMON-IA and RENOIR.
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A prospective observational study was aimed at assessing the role of blood pressure (BP) during the first 24 h from stroke onset on the outcome of acute ischaemic stroke. Subjects admitted within the first 3 h from stroke onset were... more
A prospective observational study was aimed at assessing the role of blood pressure (BP) during the first 24 h from stroke onset on the outcome of acute ischaemic stroke. Subjects admitted within the first 3 h from stroke onset were included. Stroke severity was evaluated with the Canadian Stroke Scale (CSS). Functional recovery was defined as a modified Rankin Scale score < or =2. One hundred subjects were included. In a logistic regression model, the independent predictors of poor functional recovery at discharge were: age (OR = 1.12; 95% CI 1.04-1.21; p = 0.0033), non-lacunar stroke subtype (OR = 4.31; 95% CI 1.07-17.31; p = 0.0395), diabetes mellitus (OR = 8.38; 95% CI 1.67-41.95; p = 0.0097), a CSS score at admission < or =8 (OR = 28.64; 95% CI 5.59-146.68; p<0.0001), an average systolic BP during the first 6 h > or =180 mmHg (OR = 13.34; 95% CI 1.34-133.10; p = 0.0272) and a lower diastolic BP average from 6 to 24 h (OR for 5 mmHg increase: 0.57; CI 95% 0.36-0.88; p = 0.0115). Similar results were observed after 3 months of follow-up. In ischaemic stroke patients, systolic BP over 180 mmHg in the first 6 h and a decrease of diastolic BP during the 6-24 h from stroke onset were independent predictors of a poor functional recovery.
Research Interests: Cardiology, Medicine, Logistic Regression, Prospective studies, Humans, and 15 moreInternal Medicine, Diabetes mellitus, Blood Pressure, Female, Blood, Male, Regression Analysis, Clinical Sciences, Aged, Middle Aged, Prognosis, Ischaemic Stroke, Patient discharge, Diastole, and modified Rankin Scale
Research Interests: Self Care, Adolescent, Medicine, Humans, Hypertension, and 14 moreBlood Pressure, Circadian Rhythm, Female, Male, Clinical Sciences, Ambulatory, Aged, Middle Aged, Blood Pressure Monitoring, Adult, Sensitivity and Specificity, Confidence Interval, Ambulatory Blood Pressure, and white coat hypertension
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