[Economic evaluation of acute migraine attack treatment with triptans in Spain].
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Humans↗
Biomedical subjects
J Galván
Publications and source records attributed to J Galván.
Antisocial behavior: its relation to selected sociodemographic variables and alcohol and drug use among Mexican students.
This study is part of the National School Survey on drug use by high school students in Mexico. The validity, reliability, and results of the Antisocial Acts Scale in Mexico City (n = 3,501) are discussed. Using factorial analyses of the Antisocial Acts Scale, two major sources of variability were observed. The first one is related to antisocial acts with severe social consequences, in which violence and drug selling are included, and the second one is related to thefts. Significant differences were found in the number of offenses among groups of different gender, age, and occupation during the previous year. More antisocial acts were perpetrated by alcohol and drug users than by nonusers. In a logistic regression model, it was found that the main risk factors for perpetrating antisocial acts were being male, using alcohol, and using other drugs.
Adolescent↗
Right ventricular bypass for palliation of cardiac sarcoma.
A 33-year-old woman with a nonresectable right ventricular sarcoma and pulmonary outflow tract obstruction underwent a right ventricular bypass operation for symptomatic relief. The patient had an uneventful recovery and was asymptomatic on discharge, without jugular plethora or hepatomegaly. We consider this procedure to be an excellent palliative treatment of malignant right ventricular obstructive symptoms for improving the patient's quality of life.
Adult↗
Low flow veno-venous ECMO: an experimental study.
Clinical use of extracorporeal membrane oxygenation (ECMO) and carbon dioxide removal (ECCO 2R) have become well established techniques for the treatment of severe respiratory failure; however they require full cardiopulmonary bypass, representing major procedures with high morbidity. We theorized the possibility of an efficient low flow veno-venous extracorporeal membrane gas exchange method. Four mongrel 12 kg dogs were submitted to veno-venous extracorporeal membrane gas exchange via a jugular dialysis catheter using a low flow (10 ml/min) roller pump and a membrane oxygenator for a period of four hours. Respiratory rate was set at 4 breaths/min with a FiO 2 of 21% and ventilatory dead space was increased. Adequate gas exchange was obtained (pO 2139, pCO 224, Sat 99.4%), without major hemodynamic changes or hematuria. Our results demonstrate the feasibility of a low flow, less aggressive system. Further research should be considered.
Animals↗
[Polymicrobial endocarditis caused by Haemophilus influenzae and Streptococcus viridans. A chance association?].
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Aged↗
[Almotriptan in the treatment of migraine attacks in clinical practice: results of the TEA 2000 observational study].
BACKGROUND: Almotriptan, the most recent drug of the triptan family, has shown good efficacy and tolerability profile in clinical trials. OBJECTIVE: To assess almotriptan's tolerability and effectiveness in the setting of routine clinical practice. PATIENTS AND METHODS: 1,643 patients diagnosed of migraine according to IHS criteria were recruited by 317 neurologists in the TEA 2000 study. Patients were instructed to report data on migraine attacks in a diary for a three months follow-up period. Data from 4,253 migraine attacks were obtained. RESULTS: The incidence of adverse events was 0.02 per migraine attack (3,9 % of patients). Subjective clinical improvement after 30 minutes (33.2 y 37.1 %), pain improvement after 2 hours (65.5 % and 70.2 %), pain free response after 2 hours (26.6 % and 29.2 %), recurrence between 2 and 24 hours (21.2 % and 17 %) and a complete response by 24 hours (18.6 % and 22.9 %) were found. These results were obtained in both "intention to treat" and "per protocol" analyses, being even much better when only low pain intensity attacks were considered. CONCLUSIONS: The TEA 2000 study results demonstrate good effectiveness and excellent tolerability profile of almotriptan 12.5 mg in the daily clinical neurological practice. The results of this study confirm those obtained in clinical trials carried out before almotriptan was introduced into the market and that it is a good therapeutic choice for the symptomatic treatment for migraine attacks.
Adult↗
[Therapeutic strategies used by neurologists and primary care physicians in the symptomatic treatment of migraine. Findings from Strategia-I and Strategia-II opinion studies].
INTRODUCTION: Few studies have been carried out on the subject of stratification of medical care for migraines, and even fewer have been conducted with the aim of determining the attitudes adopted by physicians towards their patients when dealing with this issue. Strategia-I and II studies were designed for this purpose. SUBJECTS AND METHODS: The sample consisted of 162 neurologists and 3,168 Primary Care physicians (PCP). Participants in the studies filled out an opinion survey that was produced ad hoc and included the different possible strategies, namely a) Stepped care between attacks (the patient takes medication during several attacks and, if it is not effective, it is replaced by another in successive attacks); b) Stepped care within attacks (the patient treats his or her seizures with medication and, if it does not work, another is used as rescue medication); and c) Stratified care (the physician classifies the patient according to the degree of disability produced by the migraine and recommends the most appropriate drug at the start). RESULTS: Most participants in the study (90.7% of neurologists, 85.2% of PCP) reported using a single strategy. Stratified care was found to be the preferred choice by both collectives (67.6% of neurologists, 43.8% of PCP; p < 0.0001). Only 16% of the respondents admitted using some disability scale. Nonsteroidal antiinflammatory drugs are the medication chosen if disability is mild-moderate, while triptans are preferred if it is moderate-severe (92.9% of neurologists, 78.8% of PCP; p < 0.001). CONCLUSIONS: The strategy based on stratified care is the most widely used in visits to Neurology and Primary Care in Spain, although there are significant differences between the two collectives. Triptans are perceived as being the ideal medication in situations involving moderate-severe disability.
Clinical Protocols↗
[Poisoning by paralytic molluscan toxins in Oaxaca].
Toxic Red Tides are caused by marine dinoflagellates which synthesize neurotoxins that accumulate in bivalve mollusks. Upon ingestion, these shellfish can cause paralysis and death. During the month of December, 1989, 99 cases of Paralytic Shellfish Poisoning in the areas of Salina Cruz and Huatulco, Oaxaca, were reported; three of which died. The majority of the cases involved the ingestion of oysters and clams. A short time later, the Red Tide was reported appearing. One hundred and fifteen seafood samples were analyzed through a biologic test in mice to determine the quantity of saxitoxin. Oysters and clams showed levels reaching 4 000 U.R. Laboratory analysis of seawater found very high quantities of Gimnodinium catenatum and Gonyaulax catenella. The control measures consisted of the prohibition of the harvest and sale of all bivalve mollusks as well as a public warning to avoid the consumption of such shellfish.
Animals↗
[Heart position as a determinant of the voltage of the R wave in healthy subjects].
Although many factors have been reported to change the R wave amplitude of the electrocardiogram, the direct measurement without any consideration, has been the method of choice, which leads to controversial findings. We hypothesized that body mass index and heart position are the main modifiers of the R wave amplitude. To test this hypothesis 80 normal subjects were studied with standard electrocardiograms in which correlation with constitutional variables were performed and were also analyzed according to the electrocardiographic heart position. R wave amplitude showed a non-significant inverse relationship to body mass except in severe overweight subjects (p less than 0.05). When analyzed by position, levorotated and S1, S2, S3 hearts showed a significant increase in R wave voltage whereas horizontal and dextrorotated ones showed a diminished amplitude (p less than 0.01) independent of body weight. There was no relation between R wave voltage and body surface. We conclude that: Body mass is not an important modifier of R wave amplitude in thin, normal and light overweight subjects. Heart position may induce significant variation of R wave voltage according to the degree of the projection of the left ventricular electric field to the anterior thoracic surface.
Adolescent↗