[Isolated pulmonary valve endocarditis in a healthy heart].
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Aged↗
Biomedical subjects
F de la Peña
Publications and source records attributed to F de la Peña.
[Infective endocarditis in the elderly].
BACKGROUND: The influence of age on the clinical presentation and on the prognosis of infective endocarditis (IE) is unclear. Our aim was to analyse the epidemiologic, clinical and bacteriological characteristics of IE in the elderly compared with younger adult patients. PATIENTS AND METHODS A retrospective study of all patients with IE non intravenous drug users diagnosed in our hospital during the period from 1990 to 2000. We used the Duke criteria to compare the characteristics of 46 episodes of definitive IE in elderly patients (>65 years old ) and of 46 episodes in younger adult patients (20-64 years of age ). RESULTS: No significant differences were observed among the two groups with respect to the delay in diagnosed, possible source of infection, the frequency of positive blood cultures and the type of infective organism, clinical presentation and evolution of the IE. Elderly patients more often had risk factors predisposing (degenerative valvular disease, prosthetic valve and pacemaker ), which decreased the sensitivity of transthoracic echocardiography to 46.5% compared with 64.4% in the younger patients. Transesophageal echocardiography improved the diagnostic of IE in the 37.2% in elderly patients. The patients in the both groups underwent surgical therapy with similar frequency (36.9% in the elderly and the 39.1% in the younger adult patient ) and the mortality rate not was significantly higher in the elderly (19.5%) than in the younger adult patients (10.8%). CONCLUSIONS: The age itself is not a poor prognostic, and should not be used prejudicially in denying a early and aggressive treatment of the patients with IE.
Adult↗
Pemphigus foliaceus associated with cilazapril.
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Aged↗
Risk factors for osteoporotic hip fractures in Mexicans.
BACKGROUND: Osteoporosis (OP) and its fractures are a major problem due to their impact in morbidity and mortality in the elderly. Although this entity is well studied in other countries, OP and its fractures have not been evaluated carefully in our population. The objective was to assess risk factors for osteoporotic hip fracture in Mexicans. METHODS: A total of 295 subjects, 152 cases and 143 controls, were studied. Cases were patients with hip fracture, of both sexes and 45 years of age or older. Controls were healthy subjects who were in hospital waiting rooms accompanying patients without hip fractures. A questionnaire covering known possible risk factors for osteoporotic hip fracture was administered by the same evaluator to all subjects. Pelvic roentgenograms, anterior-posterior view, were obtained in both cases and controls to perform the Singh index and the cortical index of the femur. RESULTS: Fractures were present in (72.2%) of women. Weight and any alcohol ingestion were associated with an increased risk of hip fracture. The odds ratio (OR) for low weight by the Quetelet Index was 4.03 (95% CI 1.93-8.39) p < 0.001. Any alcohol intake was associated with an OR of 1.73 (95% CI 1.04-2.90) p < or = 0.03 for the total group, and 2.78 (95% CI 1.25-6.14) p < or = 0.003 for women. Controls had a significantly higher mean daily calcium intake compared to cases (mean, SD 575.9 +/- 297.2 vs. 490.4 +/- 245.5, p < or = (0.007). Family history, smoking, physical activity, pregnancies, breastfeeding or concomitant diseases were not associated with risk of hip fracture. CONCLUSIONS: This study confirmed the risk factors for osteoporotic hip fracture in Mexicans, previously shown for other ethnic groups. Further research in different factors, such as rate of bone turnover, anthropometric dimensions, and genetic studies (osteoporosis gene) are needed in order to define the differences among ethnic groups.
Aged↗
[Validity and reliability of the Spanish version of Yale-Brown obsessive-compulsive rating scale for children and adolescents].
INTRODUCTION: The Children Yale-Brown Obsessive- Compulsive Scale (CY-BOCS) constitutes a very good instrument for the evaluation of obsessive-compulsive disorder (OCD) symptoms, by a clinical interview administered to the patient and parent, that includes summary score of the clinician. OBJECTIVE: We are proposing a Spanish version of instrument, which is rated during a brief clinical interview to the parents and the patients. We are presenting data reliability and validity using two out-patient samples. METHODS: After the translation to Spanish, a back translation and adaptation to Spanish of the CY-BOCS, twenty eight out-patients (75 % male) with a mean age 12.1 (+/- 2.7) from two clinical settings on Mexico City evaluated. Reliability was evaluated by computing the internal consistency (Cronbach's alpha) on all interviews. assess interrater agreement, the interviews were videotaped and scored by three independent raters and all of them included both the child and the parent interview. The CY-BOCS total scored was correlated with the K-SADS-PL diagnosis. RESULTS: The CY-BOCS total score for all subjects was 16.5 +/- 9.8. Cronbach's alpha coefficient was 0.87; Pearson correlation of total CY-BOCS score with the K-SADS-PL diagnosis was 0.60 (p < or = 0.05). The intraclass correlations coefficients for the parents, youngsters and clinician 0.96, 0.94 and 0.92, respectively. CONCLUSIONS: The Spanish version of the CY-BOCS reliable and valid instrument, useful for both clinicians and researchers in child and adolescent OCD assessment.
Adolescent↗
[Interrater reliability of the Spanish version of Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL)].
INTRODUCTION: The K-SADS-PL diagnostic interview is useful for the cross-sectional and longitudinal evaluation of psychopathology in children and adolescents. The objective of this article was to describe the interrater reliability of the Spanish version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL). METHOD: The interview was translated, back-translated and adapted to Spanish. Forty psychiatric outpatients (aged 6 to 17 years) were evaluated. The interviews were videotaped and scored by three independent raters. All of them included both the child's and parent's interview. Interrater reliability was obtained for affective, anxiety and conduct disorders using the Cohen's kappa coefficient. RESULTS: Kappa coefficients were between the good and excellent range for present and lifetime disorders (major depressive disorder kappa = 0.76, any anxiety disorder kappa = 0.84, attention deficit hyperactivity disorder kappa = 0.91 and conduct disorder, kappa = 1). CONCLUSION: The Spanish version of the K-SADS-PL is a reliable instrument for the assessment of psychopathology in children and adolescents.
Adolescent↗
[Construction, validity and reliability, of the screening scale "FASCT" for attention deficit hyperactivity disorder in adults (self-reported and observer versions)].
INTRODUCTION: Research about the reliability of retrospective self-report rating scales for attention deficit hyperactivity disorder (ADHD) in adults has been limited. METHOD: A self-report scale named "FASCT" was created with two versions: self-reported and observer. The self-reported version was applied to 393 subjects and the observer version to 377. An exploratory and confirmatory factorial analysis was made in order to obtain the final adaptation of both versions. Finally they were applied to 205 subjects and 105 of their first degree relatives. RESULTS: Cronbach's alpha for the self-reported version was 0.84 and 0.87 for the observer version. The total score that had the best balance between sensitivity and 1-specificity was 23 points for each version of the "FASCT". Correlation between both versions was 0.88. The correlation coefficient between the Wender-UTAH scale and self-reported version was 0.71 and for the observer version was 0.66. Agreement degree between dichotomized total score and the diagnosis made by structured interview was 0.82, for the self-reported version and 0.88 for the observer version. Sensitivity and specificity for the self-reported version were 80.36 and 97.9, respectively. Sensitivity and specificity values for the observer version were 95.4 and 96.3 respectively. CONCLUSIONS: Both versions of the "FASCT" scale were shown to be valid and reliable for adult ADHD screening.
Adult↗