29 research outputs found

    Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours : results from the COPPADIS cohort

    Get PDF
    The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose

    Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

    Get PDF
    Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

    Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

    Get PDF
    Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

    Técnicas en cirugía bariátrica: experiencia en 78 casos Techniques of bariatric surgery: analysis of 78 cases

    No full text
    Objetivos: La cirugía bariátrica ha demostrado su eficacia en pérdida de peso y reducción de comorbilidades en el obeso mórbido. Los objetivos de nuestro trabajo fueron: evaluar los resultados con las técnicas de Scopinaro y Bypass gástrico, mediante cirugía abierta y laparoscópica. Material y métodos: 78 pacientes con obesidad mórbida intervenidos desde el año 2000 al 2005. 50 pacientes fueron intervenidos por cirugía abierta y 28 por laparoscopia. Se realizó bypass gástrico en 54 pacientes, la técnica Scopinaro en 20 y gastroplastia vertical anillada en 3. El tiempo de seguimiento fue desde 6 y 60 meses. Se recogieron los resultados obtenidos con las diversas técnicas y vías quirúrgicas. Resultados: El porcentaje de pacientes con pérdida de exceso de peso inferior al 50% a los dos años fue del 5% y del 13%, y superior al 75% fue del 55% y del 40% en el bypass gástrico y el Scopiraro respectivamente. Todas las comorbilidades mejoraron significativamente. La estancia media fue inferior (p Objetives: Bariatric surgery has demonstrated its efficacy in weight loss and in reducing the comorbidities in the morbid obesity patient. The objectives of this study were to analyze the effectiveness and complication of the Scopinaro and gastric bypass techniques as well as the results from open surgery verses laparoscopy. Design: Retrospective study from 1999-2005. Subject and methods: 78 patients with morbid obesity were operated. 50 patients underwent open surgery and 28 underwent laparoscopy. Gastric bypass was performed in 54 patients, Scopinaro was performed in 20 patients and Vertical Banded Gastroplasty (VBG) was performed in 3 patients. The follow up time was between 6 and 60 months. The results obtained with Scopinaro and gastric bypass were compared as well as the results from open surgery verses laparoscopy. Results: The percentage of patients with a percent of excess weight loss under 50% in two years was of 5% and 13%, and the excess weight loss over 75% was of 55% ad 40% in the gastric bypass and the Scopinaro technique respectively. All the comorbidities improved.The average stay was decreased in the case of laparoscopy.The non-nutritional complications were increased for most cases in open surgery with the emphasis in eventrations, infections of the wound and respiratory complications. The nutritional complications were superior with Scopinaro´s technique. Conclusions: Based on our study, we would recommend the performance of gastric bypass for laparoscopy due to the reduced average stay and less nutritional and surgical complications. The literature results vary and therefore we consider necessary further control and random studies to correctly establish these comparisons

    Comparación de resultados previos y posteriores a la aplicación de un protocolo de actuación en cirugía bariátrica Effect of a multidisciplinar protocol on the clinical results obtained after bariatric surgery

    No full text
    Introducción: La cirugía bariátrica ha demostrado ser un tratamiento eficaz para la pérdida de peso en pacientes con obesidad severa, recomendándose la aplicación de un protocolo de actuación multidisciplinar. Objetivos: Evaluar la utilidad de la implantación de un protocolo de actuación en cirugía de la obesidad basado en el Documento de consenso español de la SEEDO. Métodos: Estudio restrospectivo comparativo de resultados de pacientes intervenidos previamente (51 pacientes) y tras la implantación del protocolo (66 pacientes). Se recogieron datos de: antropometría , comorbilidades pre y postcirugía, complicaciones nutricionales y quirúrgicas postcirugía, test de Calidad de Vida validado, y hábitos alimentarios. Resultados: Los abandonos (17,6%) y el alcoholismo (5,8%) fueron mayores en pacientes preprotocolo frente postprotocolo (4,5% y 3% respectivamente) con diferencias estadísticamente significativas. La mortalidad fue del 2% en los preprotocolo y del 0% en los postprotocolo. Los hábitos alimentarios fueron mejores en los postprotocolo, presentando mayor porcentaje de trastornos de conducta alimentaria los preprotocolo (5,1%) aunque sin significación estadística. La mejoría de la calidad de vida fue superior en los postprotocolo en todos los items, pero solo con significación estadística en la actividad sexual (p 0,004). El 70,5% de los pacientes preprotocolo tenían más de una complicación nutricional frente al 32,8% de los postprotocolo (p Introduction: Bariatric surgery has been shown to be an effective therapy for weight loss in patients with severe obesity, and the implementation of a multidisciplinar management protocol is recommended. Objectives: To assess the usefulness of the implementation of a management protocol in obesity surgery based on the Spanish Consensus Document of the SEEDO. Methods: Retrospective comparative study of the outcomes in patients previously operated (51 patients) and after the implementation of the protocol (66 patients). The following data were gathered: anthropometry, pre-and post-surgery comorbidities, post-surgical nutritional and surgical complications, validated Quality of Life questionnaire, and dietary habits. Results: Withdrawals (l7.6%) and alcoholism (5.8%) were higher in patients pre- versus post-implementation of the protocol (4.5% vs. 3%, respectively), the differences being statistically significant. The mortality rate was 2% in the pre-protocol group and 0% in the postprotocol group. The dietary habits were better in the post-protocol group, the pre-protocol group presenting a higher percentage of feeding-behavior disorders (5.1%) although not reaching a statistical significance. The improvement in quality of life was higher in the post-protocol group for all items, but only reaching statistical significance in sexual activity (p = 0.004). In the pre-protocol group, 70.5% of the patients had more than one nutritional complication vs. 32.8% in the post-protocol group (p 50% in 81.3% in the pre-protocol group vs. 74.8% in the pos-protocol group) or the comorbidities. Conclusions: Bariatric surgery achieves excellent outcomes in weight loss, comorbidities, and quality of life, but presents nutritional, surgical, and psychiatric complications that require a protocol-based and multidisciplinary approach. Our protocol improves the outcomes regarding the withdrawal rates, feeding-behavior disorders, dietary habits, nutritional complications, and quality of life

    Anales de Edafología y Agrobiología Tomo 35 Número 3-4

    No full text
    Estudio de la materia orgánica del ranker atlántico. II. Análisis químico y espectral del humus, por P. Rodríguez Seoane, T. Carballas y F. Guitián Ojea .-- lnfluencia de P, Mn, Cu, Zn y .Mo en el contenido mineral del Trijolium subterraneum L. (var. Tal/arook). I. Macronutrimentos, por T. González Carreño y H. Carbajal Aced.-- Influencia de P, Mn, Cu, Zn y Mo en el contenido mineral del Trijolium subterraneum L. (var. Tallarook). II. Oligoelementos, por T. González Carreño y H. Carbajal Aced.-- Contribución al estudio de la influencia del 2-4-5-TP y nutrientes foliares en la cinética del crecimiento y desarrollo del limón fino, por A. Ortuño, J. Gómez, J. Rodríguez. A. García Lidón, F. L. Cánovas y J. Millán.-- Efecto de algunos herbicidas sobre un prado permanente, por J. Segura, E. Vieitez y R. Fábregas.-- Parámetros de actividad funcional en el diagnóstico de la deficiencia de hierro y manganeso, por O. Carpena, S. Llorente, A. León y A. Torrecillas.-- Crecimiento y desarrollo del fresón de la Sierra de Francia. ll. Evolución en un ciclo y diferencias con la edad de la planta, por R. Martínez-Carrascoy L. Sánchez de la Puente.-- Materiales amorfos (SiO., Al,O, y Fe,O), en integrados. Andosol-tierra parda oligotrófica de las islas de Tenerife y Gomera, por E. Femández Caldas, M. L. Tejedor Salguero, J. M. Hernánde.z Moreno y O. Cabezas Vieitez.-- Inhibidores fenólicos de la germinación en Erica arborea L., por J. L. Alonso, F. de Landa y E. Vieitez.-- Evolución de la materia orgánica en los suelos pardos de la submeseta meridional, por F. Velasco de Pedro.-- Relaciones suelo-planta, respecto a nitrógeno, en el trigo cultivado en el campo, por G. Fuentes Rodríguez y L. Sánchez de la Puente.-- Rubefacción e hidromorfismo en suelos de terrazas del Guadalquivir. l. Datos geomorfológicos, fisiográficos y morfológicos, por G. Paneque, L. Clemente y W. GarcéS.-- Rubefacción e. hidromorfismo en suelos de terrazas del Guadalquivir. II. Datos físicos químicos y mineralógicos, por L. Clemente, G. Paneque y W. Garcés.-- Nota inicial. Estudio comparado de la fracción arcilla de la facies Madrid y la facies rojiza de Guadalajara, por M. T. Garrcía-Gonzáles y J. L. Moreno Alvarez.-- José María Alhareda. X aniversario de su fallecimiento.- Notas. Constitución de nueva Junta de Gobierno del Patronato «Alonso de Herrera».-- Comisión Permanente de la Junta de Gobierno del Patronato Alonso deHerrera.-- Nombramientos de Consejeros Adjuntos del Patronato Alonso de Herrera.-- Nombramiento del Pro F. Lucena Conde como Director Honorario del Centro de Edafología y Biología Aplicada de Salamanca y del Instituto de Orientación y Asistencia Técnica del Oeste.-- Nombramiento del Director del Centro de Edafología y Biología Aplicada de Salamanca.-- Nombramiento de Director de la Estación Experimental La Mayora.-- Variaciones en la Estación Experimental de Aula Dei.-- Variaciones en la Secretaría del Instituto de Alimentación y Productividad Animal.-- Variaciones en los Centros.-- Consejo Técnico Administrativo de La Mayora.-- Nombramientos de miembros del Consejo Técnico Asesor del Patronato .Alonso de Herrera.-- Nombramientos de Profesores Agregados.-- Curso Internacional de Fertilidad de Suelos y Nutrición Vegetal.-- PrimeraPeer reviewe
    corecore