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Biomedical subjects

F Bermejo Pareja

Publications and source records attributed to F Bermejo Pareja.

At least 19 recordsLinked to original sources
PubMed2005

[Gait and stability disorders of the elderly. Clinical analysis of a series of 259 patients older than 70 years].

INTRODUCTION: Gait and stability disorders of the elderly are frequent and a cause of disability, but studies on their clinical features and etiology are scarce, including the relationship between both disorders. OBJECTIVES: To evaluate an extensive series of patients with gait and stability disorders, its clinical variants and posible pathogenic significance. PATIENTS AND METHODS: 259 patients older than 70 years consulting for chronic gait and stability symptoms in an outpatients neurologic clinic were retrospectively reviewed. Several clinical and evolution data are analyzed. RESULTS: Mean age was 78.8 years and 61.8% were women. 52 % were hypertensive. 161 cases had disequilibrium, 91 a cautious gait and seven other types of gait abnormality. 11 % had associated dementia. 27 % showed subcortical white matter abnormalities on computed tomography scan. In 28 cases a specific cause could be established. In follow-up 33.5 % worsened. Significant differences between cases of disequilibrium and cautious gait were increased age, functional disability and turn abnormality in the latter. CONCLUSIONS: Disequilibrium and cautious gait of the elderly share some clinical features, have few specific causes and vary from mild cases to a disabling < >.

Accidental Falls↗
PubMed2004

[Neurological investigation in Spain. Present and future].

OBJECTIVES: To analyze the situation of neurological research in relationship to the biomedical and neuroscience research in Spain. To discuss alternatives of neurology research for the future. METHODS: Author review. Review of neurology research bibliography by means of three quantitative bibliometric indexes of neurological publications in Medline (research in neurology, neurology evidence-based medicine publications, and clinical trials); and review of the database of grants funded by the FIS (Health Research Fund) in 1989 and in the 1994-2000 period. RESULTS: Spain is in a middle position in country biomedical publication ranking in Europe, although the Spanish expenditure from GNP granted to research is lower than the mean situation among EU countries. Investigation in neurosciences stands out in biomedical research in Spain, however the bibliometric indexes analyzed and the study performed of the database of the FIS are not favorable for Spanish Neurology. This study shows that, for the 1994-2000 period, the neurologists only performed 32.1% of the projects funded in clinical research, 6% in neurosciences; 66.7% in epidemiology; and 4.3% in management-public health. DISCUSSION AND CONCLUSIONS: The expenditure for biomedical research should be increased in Spain. Furthermore, clinical research and neurological clinical management research should be intensified. One of the better strategies to achieve this objective is to obtain medical part-time schedules for patient oriented research in hospitals. To solve this situation and to set up communication networks among basic neuro-scientific, clinicians and epidemiologists is one of the major challenges of the current neurological research in Spain.

Forecasting↗
PubMed1999

[Levodopa-induced psychosis in patients with idiopathic Parkinson disease].

BACKGROUND: To identify which clinical factors can modify the probability of the appearance of the psychotic syndromes in patients with idiopathic Parkinson's disease treated with levodopa. PATIENTS AND METHODS: 214 patients were retrospectively studied to evaluate the appearance of hallucinosis, delusions or mental confusion, from the beginning of the treatment with levodopa to a transversal evaluation along the course of the disease. To determine which clinical factors were independent predictors of psychosis, a multivariate logistic regression model was obtained, using the variables for which the univariate studies showed p values under 0.25. RESULTS: The multivariate model showed that the probability of developing psychosis during levodopa treatment was higher for the patients with intermediate or advanced stages of the disease (Hoehn and Yarh scale), at the beginning of the treatment (OR: 4.5; 95% CI: 1.86-11.23), when amantadine was administrated as associated drug (OR: 3.31; 95% CI: 1.19-9.23) and for the patients who presented motor fluctuations (OR: 3.08; 95% CI: 1.32-7.16). Univariate studies showed a significant association between levodopa psychosis and dyskinesias (univariate OR: 2.44; 95% CI: 1.12-5.33). Patients who suffered from psychotic complications had received significantly higher mean levodopa daily dose (p = 0.016) and the punctuation reached in the Folstein's Mini-Mental Scale was significantly lower (p = 0.0001). CONCLUSIONS: Levodopa psychosis appears in a "bad prognostic" group of patients, characterized by a greater motor and cognitive impairment and by the occurrence of other levodopa central adverse effects, higher doses of levodopa and a more frequent administration of other antiparkinsonian drugs.

Aged↗
PubMed1999

[Interobserver variation in the diagnosis of stroke].

BACKGROUND: The variability in the diagnostic observations could be a problem both in the clinical and in the epidemiological field. Scarce data exist in the literature on this phenomenon, relatives to the field of the cerebrovascular illness, in their nosologic, semiologic and etiologic aspects. We pretend to study the interobserver variability in the diagnosis of the stroke, classifying it as absentee, present or possible in front of a given case. METHODS: 1. A questionnaire of 99 clinical cases has been elaborated, in order to be subjected to the evaluation of 10 neurologists (3 "junior", residents, 3 "senior" residents, and 4 "staff"); 2. The categories are: a) not stroke either transient ischaemic attack; b) probable stroke or transient ischaemic attack; c) transient ischaemic attack and d) stroke. 3. STATISTICAL ANALYSIS: by means of the statistic kappa of Fleiss (kappa) for several observers and several categories, determination of the standard error and 95% confidence intervals. RESULTS: In the diagnosis of the cerebrovascular illness: a) among all the observers: kappa = 0.49 (0.44-0.50); b) among staff: kappa = 0.51 (0.46-0.56); c) among residents: kappa = 0.47 (0.44-0.50). Global data in transient ischaemich attack diagnosis: kappa = 0.52 (0.49-0.55); in the diagnosis of the stroke: kappa = 0.57 (0.54-0.60); in the exclusion of stroke: kappa = 0.64 (0.62-0.67). CONCLUSIONS: With Fleiss' criteria, an acceptable to good agreement exists in the diagnosis of the stroke in base to the mere description of the clinical picture. This interobserver agreement is better if it is tried to exclude the stroke, and it could increase with the training of the neurologist.

Humans↗
PubMed1996

[Drug consumption by people over 60 years of age in a rural area].

OBJECTIVES: To describe the frequency and distribution of the consumption of medicines in a census-based sample of people of 60 or over. To determine the association between the consumption of medicines and other socio-demographic and clinical (presence of disease) variables. DESIGN: An epidemiological crossover study based in the community. SETTING: Rural population: the Health District of Arévalo in Castilla y León. PARTICIPANTS: 825 subjects (446 women and 379 men) over 60, with an average age of 71,84. MEASUREMENTS: A standard questionnaire was used, containing medicine consumption, prescription, and clinical and demographic features. RESULTS: The consumption of medicines per person per day was 1,92. Therapeutic groups most consumed were, in this order, hypotension drugs, cardiotonics, antirheumatics, peripheral vasodilators, digestive system drugs, neurotropics and analgesics. The number of illnesses suffered by this age-group was 2,19. There is a strong connection between consumption of medicines and age, especially in the over 80's. CONCLUSIONS: 75% of the target population took some medicine each day. Consumption is higher among women than men. Cardiovascular drugs are the most frequently used therapeutic group. Consumption of medicines is directly related to age and the number of illnesses.

Age Factors↗
PubMed1989

[Ambulatory neurological care outside of the hospital. Analysis of the demand registered during 18 months in a neurological outpatient clinic].

The major data from the care demand in a neurological outpatient clinic in the south area of Madrid are reported. 8.9 patients per 1,000 inhabitants are seen. The frequency of visits to this clinic is higher in females and with advancing age. More than one-half of the patients are diagnosed as having conditions not necessarily representing organic neurological disease. It is concluded that a better selection of the patients referred to this clinic should be adequate, as the number of neurologists per 100,000 inhabitants available in this country is not sufficient to care for so high an outpatient care demand.

Adolescent↗
PubMed1985

Carbidopa dosage modifies L-dopa induced side effects and blood levels of L-dopa and other amino acids in advanced parkinsonism.

Thirty-four patients with advanced Parkinson's disease showing intolerance to therapeutic doses of L-DOPA were treated with L-DOPA plus carbidopa at two different proportions. Ten patients preferred medication containing 10% carbidopa while 24 preferred 25% carbidopa. The increase of carbidopa reduced gastrointestinal disturbances and psychiatric side effects related to L-DOPA, but improvement of disability when measured according to objective tests was modest. Higher doses of carbidopa reduced peripheral DOPA metabolism and increased blood levels of tryptophan, 3-OM-DOPA and DOPA in relation to the administered dose.

Aged↗