Biomedical subjects

C Marrero

Publications and source records attributed to C Marrero.

5 recordsLinked to original sources

PubMed2005

Psychometric field study of the new haemophilia quality of life questionnaire for adults: the 'Hemofilia-QoL'.

Although there is a worldwide interest in the assessment of health-related quality-of-life (HRQoL) in haemophilia patients, no non-disease specific instruments (for adults) are readily available. In this paper, a haemophilia-specific quality-of-life assessment measure for adults (the Hemofilia-QoL questionnaire) has been developed and tested for psychometric properties in 121 adults with haemophilia living in Spain. The Hemofilia-QoL questionnaire is a self-report modular instrument that assesses nine relevant HRQoL domains for patients with haemophilia (e.g. physical health, daily activities, joint damage, pain, treatment satisfaction, treatment difficulties, emotional functioning, mental health, relationships and social activity). Psychometric examination involved the assessment of data quality, scaling assumptions, reliability (internal consistency and test-retest) and validity (concurrent; external clinical criterion and sensitivity). The Hemofilia-QoL 36-item version questionnaire had acceptable internal consistency and retest reliability values. The questionnaire shows excellent concurrent validity (with the SF-36 Health Survey) and external clinical criterion validity (haemophilia clinical status) and sensitivity (health status changes) as well. The Hemofilia-QoL is now available for adult assessment and is ready for use in clinical research in Spain.

Adolescent↗

PubMed2004

Development of a new disease-specific quality-of-life questionnaire to adults living with haemophilia.

A haemophilia-specific health-related quality-of-life questionnaire (named 'Hemofilia-QoL') was developed to assess quality-of-life in adults with haemophilia, and was psychometrically tested. Seventy-three interviews with haemophilia patients and health care professionals were used to generate the items included in the questionnaire, and expert ratings on the items formulated were used to screen them for potential omission. This was followed by psychometric testing in a sample of 35 patients. Preliminary psychometric testing of the revised questionnaire version, which contains 10 domains (physical health, physical role, joint damage, pain, treatment satisfaction, emotional role, mental health, social support), showed acceptable reliability (alpha = 0.94 for the Hemofilia-QoL total score) and validity, and this will be examined in a subsequent study with a larger patient sample.

Adolescent↗

PubMed1998

Multiple sclerosis in Móstoles, central Spain.

OBJECTIVES: Until relatively recently southern Europe was regarded as having a medium to low multiple sclerosis prevalence, of about 20 or less per 100,000. However, recent studies in Sardinia, Sicily, continental Italy, Cyprus and Spain have yielded higher MS prevalence rates, between 32 and 102.6 per 100,000. We present the results of a prevalence study of MS in the municipality of M6stoles, central Spain. MATERIAL AND METHODS: To ascertain the prevalence of multiple sclerosis in M6stoles (195,979 inhabitants), an intensive study was undertaken using several sources of information. We used the Poser criteria in diagnosis. RESULTS: There were 85 patients (53 women and 32 men) classified as definite or probable, prevalence 43.4/100,000 (95% CI, 34.7 to 53.7). The incidence rate was 3.8/100,000/year (95% CI, 2.7 to 5.3) in the last 5 years. Mean age on prevalence day was 38.8+/-10.9 years. Mean age at onset was 31.7+/-9.3 years. Mean interval between initial symptoms and diagnosis was 1.7 years. Mean duration of disease was 7.6+/-6.1 years. Overall, 70.6% had a relapsing-remitting course, 18.8% had a primary progressive and 10.5% had a secondary progressive. Mean EDSS score was 2.7+/-1.9. CONCLUSION: The M6stoles study confirms the conclusions of previous smaller population studies that Spain is a moderately high or medium MS risk zone.

Adolescent↗

PubMed1998

[Early and late epileptic crisis following cerebral hemisphere ischemia].

INTRODUCTION: There is no agreement as to the frequency and characteristics of epileptic seizures (ES) associated with cerebrovascular disease (CVD). OBJECTIVE: To analyze the presence of early (Se) and late (SI) ES, factors related to these, prognosis and conversion to epilepsy. PATIENTS AND METHODS: We made a retrospective study of 386 patients with cerebral hemisphere ischemia (100 TIA and 286 infarcts). Follow-up was 29.69 +/- 13.92 months. Two groups were defined: a) Patients without ES, and b) patients with ES. Those occurring within 15 days of the episode of ischemia were considered to be Se and the others Sl. We studied the prognosis (modified Rankin scale on discharge from hospital) and mortality. RESULTS: Twenty three patients (6%) had crises (18 Se and 5 Sl). The commonest type was simple partial motor crises (13 or 56.5%) followed by generalized tonic-clonic crises (9 or 39.1%) which predominated in the Se group. There were 6 solitary crises (Se) and 17 (73.9%) recurrences (66.6% of the Se and 100% of the Sl) (p = 0.049). There was an association between the presence of a family history of epilepsy (p < 0.001) and increased risk factors for epilepsy and CVD, particularly previous ictus and cardiopathy respectively (p = 0.034). No patient with TIA or lacunar infarct had ES. Extensive infarcts showed and increased tendency to the associated with hemorrhagic transformation, involvement of the cortex (p < 0.001) and cardioembolic incidents (p = 0.025). They had a worse prognosis, led to more disability (p < 0.001) and earlier mortality (38.4%) (during the first three months) (p = 0.015). These factors were associated (p < 0.001). CONCLUSIONS: Postischemic cerebral seizures are frequent and have a high recurrence rate, especially in patients with extensive infarcts involving the cortex and these of embolic origin. The prognosis is worse when crises occur early.

Adolescent↗

PubMed1997

[Association of plasmapheresis and high doses of intravenous immunoglobulins in the treatment of myasthenia gravis].

INTRODUCTION: In the past decade good therapeutic results have been reported with high dosage of intravenous immunoglobulins (Ig i.v.) in various autoimmune disorders, including myasthenia gravis (MG). Plasmapheresis has been used successfully in this disorder on indications similar to those described for the use of Ig i.v.. We have used sequential treatment of plasmapheresis followed by high doses of intravenous gammaglobulin in MG, seeking complementary benefits from the two kinds of treatment. MATERIAL AND METHODS: The sample included 10 patients with MG (7 of Osserman's grade II-B, 1 of II-A and 2 of III). We began treatment with plasmapheresis, and then continued with an i.v. infusion of Ig at a dose of 400 mg/Kg/day for 5 days. To evaluate the response to treatment, we used the classification system for muscle weakness based on the Virginia University modification of Osserman's grades, on the clinical involvement grade scales and on functional activity. RESULTS: All patients showed statistically significant improvement of the parameters studied. Improvement started between the first and sixth day, following administration of Ig i.v. and persisted for the following 16 weeks. CONCLUSIONS: We consider that combined treatment with plasmapheresis and Ig i.v. may synergically potentiate the immunological effects since they have different mechanisms of action. The indication for this is limited to serious clinical conditions resistant to other treatment, to speed recovery.

Adult↗