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E López-García

Publications and source records attributed to E López-García.

16 recordsLinked to original sources
PubMed2005

Changes in body weight and health-related quality-of-life in the older adult population.

BACKGROUND: No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults. OBJECTIVE: To examine the relationship between change in body weight and HRQL among the older adult population. METHODS: We carried out a prospective study from 2001 to 2003 of a cohort of 2364 persons, representative of the noninstitutionalized Spanish population aged 60 y and over. Weight changes during the period 2001-2003 were self-reported, and HRQL in 2003 was measured with the SF-36 questionnaire. Analyses adjusted for the principal confounders. RESULTS: Among nonobese women (body mass index (BMI) 18.5-29.9 kg/m(2)), and compared to those who underwent no important weight change, weight loss was associated with a clinically significant worsening in the role-physical, vitality, and social functioning SF-36 scales. Among obese women (BMI> or =30 kg/m(2)), weight gain led to a reduction in HRQL for four of the eight SF-36 scales, while weight loss was associated with worse scores in role-emotional and mental health scales. Results were usually similar for men, though of lower magnitude. In both sexes, weight change was associated with a reduction of over 5 points on several physical and mental scales of the SF-36, which indicates a clinically relevant worsening in HRQL. CONCLUSION: Weight change is associated with worse HRQL among the older adults, principally women. From the stance of HRQL, it is desirable to prevent weight gain, especially among the obese, and weight loss, especially among the nonobese.

Aged↗
PubMed2004

Obesity and socioeconomic position measured at three stages of the life course in the elderly.

OBJECTIVE: To investigate the association between socioeconomic position, measured at three stages of the life course, and obesity in the elderly. DESIGN: Cross-sectional study carried out in 2000-2001. SUBJECTS: In total, 4009 subjects aged 60 y and older, representative of the Spanish noninstitutionalised population. RESEARCH METHODS AND PROCEDURES: We estimated body mass index (BMI) and waist circumference (WC) by social class in childhood, by educational level and by adult social class, as well as the association between these two obesity measures and each socioeconomic characteristic after adjusting for the other two. RESULTS: In men, no relation was found between the two measures of obesity studied and socioeconomic circumstances throughout the life course. Nor was any relation found in women between social class in childhood and the two measures of obesity after adjusting for the other two socioeconomic variables. In contrast, BMI and WC in women showed a statistically significant inverse gradient with educational level and with adult social class after adjusting for age and the rest of the socioeconomic variables. CONCLUSIONS: In general, these results support the small amount of existing evidence on the association between obesity and abdominal obesity and socioeconomic position by educational level and adult social class. The results for social class in childhood do not support the existing evidence, and suggest that this association may depend on specific historic and cultural circumstances.

Abdomen↗
PubMed2003

A simple estimate of mortality attributable to excess weight in the European Union.

OBJECTIVE: To estimate the current burden of mortality attributable to excess weight in the European Union (EU). METHODS: Prevalence of overweight (body mass index, BMI 25-29.9 kg/m(2)) and obesity (BMI >or=30 kg/m(2)) were based on self-reported data from a survey with samples representative of the 15 EU Member States in 1997. Primary source of relative risk (RR) of death by BMI was the first American Cancer Prevention Study (CPS I). Additional calculations were performed to account for effect of smoking (using CPS I data for non- or never-smokers), for pre-existing illness (using the second CPS, CPS II, data for healthy never-smokers) and using RRs derived from European rather than US data (using data from a meta-analysis of prospective studies). Mortality attributable to excess weight was calculated by combining the prevalences of overweight and obesity, the RRs, and the number of deaths in the EU countries. RESULTS: Annual deaths attributable to overweight and obesity totalled approximately 279 000 when RRs for all subjects were used. When RRs for nonsmokers only were applied to the entire population, about 304 000 deaths were attributable to excess weight. In analyses using RRs which controlled for both smoking and history of disease, the number of deaths attributable to excess weight was estimated at about 337 000 based on European data and at about 401 000 based on US data. In the EU, therefore, a minimum of 279 000 deaths were attributable to excess weight (7.7% of all deaths, varying from 5.8% for France through 8.7% for the UK). More attributable deaths occurred among the obese (175 000) than among the overweight (104 000). Around 70% were cardiovascular disease deaths (195 000) and 20% cancer deaths (53 000). CONCLUSION: Mortality attributable to excess weight is a major public health problem in the EU. At least one in 13 annual deaths in the EU are likely to be related to excess weight.

Adult↗
PubMed2003

Relation between body weight and health-related quality of life among the elderly in Spain.

OBJECTIVE: This study examines the relation between body weight and the physical and mental components of health-related quality of life (HRQL) in the population aged 60 y and over in Spain. RESEARCH METHODS AND PROCEDURES: Cross-sectional study covering 3605 subjects, representative of the noninstitutionalised Spanish population aged 60 y and over. Information was collected through home-based personal interview and measurement of blood pressure and anthropometric variables. Logistic regression was used to examine the relation of suboptimal HRQL (score<100) on each SF-36 questionnaire scale with body mass index (BMI) and waist circumference. Separate regression models were constructed for each sex and adjusted for sociodemographic variables, tobacco and alcohol consumption, physical activity, arterial hypertension and diagnosed chronic disease. RESULTS: Mean age of the study population was 70.9 y for men and 72.2 y for women. The percentage of overweight subjects was 48.5% in men and 39.8% in women, and of obese subjects, 31.9 and 41.1% respectively. Men registered a better HRQL than women on most of the SF-36 scales. Compared to normal-weight subjects (BMI: 18.5-24.9 kg/m(2)), frequency of suboptimal physical functioning was higher among obese subjects (BMI>or=30 kg/m(2)), both male (OR: 1.91; 95% CI: 1.22-3.00) and female (OR: 2.58; 95% CI: 1.59-4.19). The aspects of physical functioning most affected were bending, kneeling or stooping, climbing stairs and strenuous effort. Male, though not female, obesity was nonetheless associated with a better HRQL on the SF-36 mental scales. Frequencies of suboptimal scores for overweight persons (BMI: 25-29.9 kg/m(2)) were similar to those for normal-weight subjects on most of the SF-36 scales. Results proved similar for subjects in both the 60-74 and 75-and-over age groups, and also when waist circumference was used as the measure of obesity (>102 cm in men and >88 cm in women). CONCLUSIONS: Obese men and women showed worse physical functioning than normal-weight persons. This occurred irrespective of whether subjects were over or under 74 y of age, or whether obesity was measured by BMI or waist circumference, and was not explained by unhealthy lifestyles or obesity-related chronic disease.

Aged↗
PubMed2001

[Chronic subdural hematoma in patients over 80 years of age].

INTRODUCTION: Chronic subdural hematoma (CSH) represents one of the most frequent types of intracranial hemorrhage. Most occur in elderly patients causing a variety of therapeutic problems associated to systemic diseases. PATIENTS AND METHODS: A retrospective study of 90 patients older than 80 years of age with chronic subdural hematoma treated in the last 15 years was undertaken. For clinical evaluation on admission and at discharge we used the classification of Markwalder. Surgical treatment was performed in all patients and a burr hole craniostomy with closed drainage system was used. RESULTS: On admission, 73 patients (80%) were in satisfactory condition (grades 0-2); 17 (20%) were grade 3 or 4. Seven (7.7%) patients died but none due to surgery. In 6 (6.6%) of the patients, surgical reintervention was required to remove a recurring CSH. In 76.6% of the patients, the results achieved were graded 0 or 1. CONCLUSIONS: In our experience CSH in elderly patients should be treated with minimal surgery with a simple drainage of the subdural space. The good results suggest that the procedure could be considered as a first procedure in these patients and that age or concomitant diseases do not appear to be poor prognostic factors.

Aged↗
PubMedDate not supplied

[Cerebellar hematomas: a surgically treatable stroke].

INTRODUCTION: Spontaneous cerebellar hematomas make up nearly 10% of the intracranial intraparenchymatous hemorrhages. In recent years several algorithms have been published for the management of these patients. OBJECTIVE: To study the type of treatment, conservative or operative, and the main prognostic factors. PATIENTS AND METHODS: We present a retrospective analysis of 52 cases of spontaneous cerebellar hematomas diagnosed over the past 10 years in the Hospital General de Galicia. We studied the clinical and radiological factors with the greatest effect on prognosis and the approach to treatment. RESULTS: We found a male/female ration of 2/3. The age of 90.3% of our patients was over 60 years. Arterial hypertension had previously been diagnosed in 55.7% of the cases. The clinical picture was characterized by the profile of a stroke with headache (90.3%), vomiting (63.4%) and impaired consciousness (50%) being the commonest presenting symptoms. The most important factors in prognosis were the level of consciousness and the size of the hematoma. The prognosis was worse in cases with hydrocephalus, intraventricular hemorrhage or extension of the hematoma towards the midline. Neither age, sex nor the previous diagnosis of arterial hypertension were of importance in prognosis. Mortality was 25%. CONCLUSIONS: The spontaneous cerebellar hematomas typically affect patients over the age of 60 years and present with headache and vomiting of sudden onset. In our series the major prognostic factors were the size of the hematoma and level of consciousness, and treatment was given in accordance with this.

Adult↗
PubMedDate not supplied

[Choroid plexus tumors].

INTRODUCTION AND OBJECTIVE: Tumors of the choroid plexus are rare tumors of neuro ectodermal origin, accounting for less 1% of intracranial tumors in all ages. Most cases present in children less than 2 years of age. These tumors have been classified according to histopathological criteria into papilloma and carcinoma. DEVELOPMENT: We review the epidemiological, clinical, neuropathological details, neuroradiological aspects and treatment of choroid plexus tumors. CONCLUSIONS: Choroid plexus tumors may present with overt intracranial hypertension with or without focal neurological signs. In the adult population, headaches are the most commonly encountered symptom. The CT characteristics of CPT are well characterized. On non enhanced studies the tumor appears as a smooth or lobulated mass, hyperdense in relation to surrounding brain parenchyma. With intravenous contrast, there is marked, homogeneous enhancement. With MRI these tumors showed an iso intensity in T1 weighted images and iso hypo intensity in T2 weighted images, with marked enhancement after gadolinium. The treatment of choice is total surgical excision with minimal damage to the surrounding neural elements. For carcinomas, adjuvant treatment in the form of chemotherapy supplemented by radiation therapy in older children.

Adult↗
PubMedDate not supplied

[Cerebral gliomatosis. A report of three cases and review of the literature].

INTRODUCTION: Cerebral gliomatosis is an infiltrating, non destructive process of glial type, with a diffuse growth pattern and great clinical variation in the initial symptoms. Confirmation of the diagnosis requires histological study of the lesion showing infiltration by well differentiated mature astrocytes (atypical forms are rare). We report three cases diagnosed by our department over the past five years. CASE REPORTS: Case1. A 64 year old man presented with olfactory crises and right homonymous hemianopsia. On cerebral MR there was an extensive left occipital cortico subcortical lesion infiltrating the genum of the corpus callosum, with irregular uptake of contrast material. CASE REPORT 2: A 68 year old woman was admitted complaining of paresia of her right arm which had worsened over the past two months. On MR there was an extensive left paraventricular subcortical lesion, involving the anterior temporal and capsulo lenticular regions. Case 3. A 63 year old woman complained of staggering gait and headache. On examination she had a right facial palsy and intention tremor of her right arm. All the patients died. In all cases stereotactic biopsy confirmed the diagnosis of cerebral gliomatosis. CONCLUSIONS: Cerebral gliomatosis is an infiltrating glial disorder with a poor prognosis. The clinical diagnosis is suggested on cerebral MR studies and confirmed on histological studies.

Aged↗
PubMedDate not supplied

[Opercular syndrome of vascular aetiology].

INTRODUCTION: Facio linguo masticatory paralysis resulting from bilateral lesion of the anterior opercular region, known today as Foix Chavany Marie syndrome, appears very frequently in adult patients as a consequence of generally ischemic vascular lesions, which directly affect the Rolandic opercula or the subcortical area surrounding them. However, forms that are secondary to infections, neoplasias and even unilateral lesions have been reported. CASE REPORT: Female patient, aged 70, with unknown auricular fibrillation, which started suddenly with right faciobrachial paresis secondary to a left striated ischemic infarction. Approximately 24 hours after beginning intravenous heparinization, the patient presents anarthria, facial hypomimia without asymmetries, dysphagia above all for liquids and bilateral lingual paresis. Extraoccular movements, blinking and corneal reflex were normal. Understanding of spoken and written language was maintained and there were no apraxias or agnosias. Neurological exploration was compatible with an opercular syndrome (OS). Urgent brain CT revealed the existence of a right cortiico subcortical temporal haemorrhage, in addition to the prior contralateral ischemia. The association of both lesions, ischemic and haemorrhagic, mirrored, justified all the symptomatology. DISCUSSION: Anterior OS is characterised by a bilateral voluntary central paresis of the muscles innervated by the 5th, 7th, 9th, 10th and 12th cranial pairs with preservation of emotional or automatic mobility. Underlying mechanisms are also discussed.

Aged↗
PubMedDate not supplied

["Household items" : an alternative task to "animals" in the assessment of semantic verbal fluency: a validation study].

INTRODUCTION: The semantic verbal fluency (SVF) is usually evaluated with the task animals in 1 minute . This is a test widely applied in the screening of cognitive impairment. In our best knowledge there are not other alternatives categories for this task validated in our environment (Spanish as mother tongue, Spain). OBJECTIVE: To validate the category households items as an alternative parallel task to animals in the assessment of SVF. PATIENTS AND METHODS: Prospective assessment of two categories (animals and household items) in two groups: normal controls and patients with Alzheimer s disease (AD). RESULTS CONTROL GROUP: n= 22 (13 M, 9 W); age: 73 5 years, education: 12 5 years; MMSE MEC 35: 30 4; Animals : 15 4. Percentile distribution 10th: 11; 50th: 15; 90th: 20; household items : 17 4. Percentile distribution: 10th: 12; 50th: 17; 90th: 22. AD group: n= 24 (9 M, 15 W); age: 74 5 years; education: 11 5 years; MMSE MEC 35: 17 8; Animals : 6 3. Percentile distribution: 10th: 2; 50th: 6; 90th: 9; household items : 6 4. Percentile distribution: 10th: 1; 50th: 6; 90th: 11. It is observed a positive correlation between the two categories (Spearman s Rho: 0.83, p< 0.0001). CONCLUSIONS: Both SVF categories had a similar distribution and a high correlation. This findings demonstrated the validity of the household items as an alternative and parallel form to animals in the assessment of SVF in patients with cognitive impairment or dementia.

Aged↗
PubMedDate not supplied

[De novo arachnoid cyst treated with a cystoperitoneal shunt].

INTRODUCTION: Arachnoid cysts (AC) are benign pathological structures that are typically found during childhood, and represent approximately 1% of all intracranial lesions. Unlike cases of secondary cysts with a known causation, which can be attributed to inflammatory processes or traumatic brain injuries, the causation of the primary cysts is unknown. In the cases reported to date, the cysts present from the first imaging study conducted, which is why they are considered to be of a prenatal origin. CASE REPORT: A boy who, at the age of 5 months, is found to have an AC of considerable dimensions that did not appear in a transfontanellar echographic study carried out for other reasons at the age of 2 months. CONCLUSION: The importance of this case lies in the fact that it has been possible to show the appearance of a cyst after birth in a sequence of images in the case of a pathology which, according to all the theories and tests, is considered to have a congenital causation.

Arachnoid Cysts↗
PubMedDate not supplied

[Evaluation of patients who do not visit neurology units].

AIMS: Our aim was to study the relation between non-attendance at neurology units and the delay that exists, as well as the demographic factors that may come to bear on non-attendance. PATIENTS AND METHODS: Data on neurology outpatients over the period between November and December 2002 were collected prospectively. Both patients who were referred for evaluation and those on their first programmed visit were included in the study. RESULTS: The total number of subjects was 1,035, with an average age of 55.31 +/- 19.84 (14-96). Of these, 605 were females and 430 were males, with no significant differences in the age of the two groups. 40% of the cases came from rural areas. 237 (22.9%) did not attend the visit. We found a statistically significant relation between age and non-attendance (t=2.67; p=0.008, Student's t). There was also a relation between not going to the visit and the delay that existed (t=5.84; p=0.000, Student's t). Patients who were referred from the Casualty department missed their visit more often those who were sent by their GP (Pi2=2.4; p=0.07, chi2). The date on which they received the appointment was also related to non-attendance (t=2.55; p=0.011, Student's t). CONCLUSIONS: Non-attendance was associated, above all, with the delay, with youth, being sent from casualty and with the length of time since they received notice of the visit.

Adolescent↗
PubMedDate not supplied

[Spontaneous intracranial hypotension: the value of isotope cisternoscintigraphy using 99mTc-DTPA].

INTRODUCTION: Spontaneous intracranial hypotension (SIH) is an infrequent clinical entity that is found predominantly in young adults and is characterised by the presence of acute or subacute headaches that appear on standing up and subsides on lying down. CASE REPORT: A 35-year-old female with a three-month history of holocranial headaches, accompanied by dizziness and gait instability, which increase on standing up and diminish to a certain extent on lying down, associated to bilateral tinnitus. The patient's history included a slight strain made 4 months earlier, with a sudden non-irradiated pain in the back of the neck that got better spontaneously. On the basis of the clinical and radiological findings from an MRI scan of the head and neck, our service was asked to perform a cisternoscintigraphy. CONCLUSIONS: Isotope cisternoscintigraphy using 99mTc-DTPA confirmed the diagnosis of the process and enabled us to locate the CSF leak. We therefore think it advisable to highlight its value in the diagnosis of SIH syndrome so as to be able to avoid the use of other invasive complementary explorations that entail a certain degree of morbidity and mortality.

Adult↗