[Epidemiology of multiple sclerosis in the health region of Alcoy: influence of the blood group].
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Blood Group Antigens↗
Biomedical subjects
J M Moltó
Publications and source records attributed to J M Moltó.
[Clinical features of migraine according to the questionnaire 'Alcoi-92' in the Comtat area].
INTRODUCTION: Headache is one of the commonest reasons for consultation and it might be useful to know its characteristics in order to determine which patients may need medical attention. OBJECTIVES: To carry out a randomized transverse study in a rural population using the validated questionnaire 'Alcoi-92', and to determine the clinical characteristics of the headaches detected. PATIENTS AND METHODS: A door to door survey was done by randomized selection of 790 persons aged over 18 and living in the Comarca del Comtat. A validated self-questionnaire was sent and this was followed by an interview with a doctor. RESULTS: Five hundred and forty-eight persons were interviewed. The standard prevalence of migraine is 19.6% with a sex incidence of 1:2.4 and an average age of 46.1 years. The average age of onset was 20.64 years. There were family histories of cerebrovascular accidents in 26.4% and of migraine in 57.1%. There were no differences in the use of toxic substances, of socio-economic status or of marital status. The commonest pre-existing pathology was arterial hypertension. The number of episodes of headache was one to seven per year in 50% of those with migraine, with an average duration of 4-24 hours, predominantly bilateral presentation and pulsatile in character with moderate repercussion in everyday activities. The commonest associated symptoms were photophobia and sonophobia. There were prodromal symptoms in 36.9%, most commonly confusion and photopsy. CONCLUSION: The questionnaire 'Alcoi-92' has been shown to be a useful tool for definition of the clinical characteristics of migraine.
Adolescent↗
[Atherosclerosis and brain circulation].
INTRODUCTION: Atherosclerosis affects the vascular system in a diffuse way and its is clearly implicated in some of the most prevalent diseases in western countries such as cerebrovascular and cardiovascular diseases. Knowing more about the underlying pathogenic mechanisms may contribute to a better understanding of this entities and the development of therapies for both its treatment and prevention. DEVELOPMENT: We review herein the concepts included in the term atherosclerosis, the growth of the atheromatous plaque and its complications and the cellular mechanisms which intervene in its development. We analyze how it influences brain hemodynamics and its implication in cerebrovascular ischemic disease paying attention to the dissimilarities with other vascular territories and the clinical syndromes which derive from its development on different vascular structures. CONCLUSIONS: Under the concept of ischemic cerebrovascular disease we can find a group of heterogeneous clinical syndromes, usually associated to different etiopathogenic mechanisms: cardioembolic, atherothrombotic or hemodynamic. Although their risk factors may be common, these processes are clearly different form each other. Therefore including ischemic brain infarctions all together without attending to their etiology may produce important methodological biases when interpreting the results in clinical trials or other studies, and may also be a suitable explanation for differences between authors.
Arteriosclerosis↗
[Descriptive epidemiology of the vascular risk factors in Bañeres. Study group 'Bañeres Project'].
INTRODUCTION: Epidemiological studies of the risk factors of cerebrovascular disease are of great interest, particularly the identification of factors which may be modified. Previous studies carried out in the Alcoi region of Alicante province, showed a high prevalence of cerebrovascular disease. The town of Bañeres was therefore chosen for confirmation of this data and identification of the frequency of vascular risk factors. OBJECTIVE: To compare the group of patients with cerebrovascular disease with the remainder of the population interviewed. PATIENTS AND METHODS: In a door-to-door study in Bañeres 1,832 people were interviewed as part of the Bañeres Project. The population aged over 45 years was interviewed and filled in a questionnaire for diagnosis of transient ischemic accidents. RESULTS: Arterial hypertension: estimated prevalence 500/1,000 inhabitants, relative risk 3.24; diabetes mellitus: estimated prevalence 195/1,000, relative risk 2.18; coronary artery disease: estimated prevalence 58/1,000, relative risk 1.88; peptic ulcer: estimated prevalence 75/1,000, relative risk 1.23; smoking: estimated prevalence 110/1,000, relative risk 0.46; complete arrhythmia: prevalence 73/1,000, relative risk 5.23. Family histories of cerebrovascular accident, arterial hypertension, diabetes and coronary artery disease were not significant. CONCLUSIONS: Arterial hypertension, diabetes mellitus and arrhythmia were significantly more prevalent amongst patients with vascular disease in our setting. We found no association with the other risk factors analyzed.
Aged↗
[A descriptive study of migraine in a rural population of Area del Comtat].
INTRODUCTION: Headache is one of the commonest causes of consultation in neurology. There are many studies of the prevalence of migraine showing considerable variation in the results obtained. OBJECTIVES: To find the prevalence of migraine, with and without an aura, by means of a randomized transverse study carried out in a previously selected rural population, using the validated questionnaire 'Alcoi-92'. To find the overall prevalence of migraine, specifically regarding age and sex and adjusted for the European population. PATIENTS AND METHODS: A door-to-door study was made by random selection of 790 persons aged over 18, in three towns in the comarca del Comtat, Alacant, Spain. A self-questionnaire was sent to all persons studies and subsequently they were seen by a medical interviewer. RESULTS: We interviewed 548 persons (overall response rate 78%). The average age was 52.5 +/- 19.3 years. Sex distribution of the population interviewed showed a predominance of females (52.9%) as compared to males (47.1%). According to the type of headache: other types of headache 62.32%, persons with no previous history of headache 20.07%, amplified migraine 16.6%, typical migraine 12.6%, cluster type migraine 0.18%. CONCLUSIONS: The overall prevalence of amplified migraine was 16.6%. According to diagnostic groups the frequency of migraine with aura was 2.9%, migraine without aura 9.7% and typical migraine 12.6%. A predominance of women was seen in all types of migraine. The frequency of migraine, adjusted for the European population was 19.6%. Prevalence during the past year, as a measure of activity of the disorder was 15.7%.
Catchment Area, Health↗
[Multiple sclerosis incidence in the Alcoi Health district. 12-year-long study (1986-1997)].
INTRODUCTION: To date, epidemiological studies on multiple sclerosis in Spain have been basically prevalence studies, and the data on incidence recorded have been the result of different methodologies, with no definition of the criteria for inclusion. OBJECTIVE: To carry out a study of incidence with prospective collection/review of cases over a prolonged period of time. PATIENTS AND METHODS: Over 12 years, between 1 March 1986 and 31 December 1997, we collected data prospectively for patients with a definite diagnosis of multiple sclerosis. The year of incidence was considered to be when the patient fulfilled clinical criteria for diagnosis of the disease. RESULTS: On 31 December 1997 in the Alcoi Health District there were 54 patients with clinically defined multiple sclerosis (a prevalence of 41.28 cases per 100,000 inhabitants). Of these, 45 patients were diagnosed during the period studied, with an average incidence of 2.82 cases per 100,000 inhabitants per year. Only 15 patients were confirmed before 1986. CONCLUSIONS: This is the most prolonged study of the incidence of multiple sclerosis carried out in Spain. The figures found for incidence are in contrast to those found in previous years for prevalence and incidence. Analysis of the data suggests that the incidence of multiple sclerosis in the Alcoi district has changed and has increased since the second half of the 1980s.
Adolescent↗
[The prevalence of multiple sclerosis in the Alcoi Health district].
INTRODUCTION: The epidemiological studies done in Spain in recent years show higher figures for the prevalence of multiple sclerosis than before. Spain is therefore now in the area with a high risk of contracting the disease. OBJECTIVE: We have made a new study to confirm the current prevalence of the disorder in the Alcoi Health District. PATIENTS AND METHODS: Between 1 March 1986 and the prevalence day, 31 December 1997 we recorded the patients with definite or probable multiple sclerosis, as defined on Poser's criteria, after intensive fieldwork and reevaluation of all possible patients by a neurologist from the Neurology Unit. On the prevalence day there were 130,786 inhabitants in the district. RESULTS: On the prevalence day we found 54 patients with definite multiple sclerosis and no patient with probable multiple sclerosis. The rate of prevalence was 41.28 cases per 100,000 inhabitants (95% CI: 31-53.6). During the study we counted an incidence of 45 cases with an average rate of 2.82 cases per 100,000 inhabitants per year. We also describe the clinical characteristics of the patients. CONCLUSIONS: The rate of prevalence found is much higher than that described for the district in studies using similar methodology. This increase, together with the discrepancy between the incidence found and the prevalence, makes us consider that possibly the prevalence has increased in recent years.
Adolescent↗
[The relation between carotid ultrasound changes and seropositivity to Chlamydia pneumoniae in patients with acute stroke].
INTRODUCTION: Several infectious agents have been found to be involved in atherogenesis over the past decade. Chlamydia pneumoniae is one of the commonest associated agents. In this study we have analysed the possible relationship between a high level of antibodies to Chlamydia, and the presence of carotid ultrasound changes in patients who have had strokes. PATIENTS AND METHODS: We studied 230 patients admitted consecutively to the Stroke Unit in our hospital, with the diagnosis of stroke. All the patients in the group had carotid duplex ultrasound studies to assess the degree of stenosis. All these patients also had serological studies using micro-immunofluorescence to detect antibodies to Chlamydia pneumoniae. RESULTS: Only 35 patients were found to have positive Chlamydia pneumoniae serology. The degree of atheromatosis was similar in the patients with high levels of IgG for Chlamydia pneumoniae and in those with normal serology. There was no statistically significant relation between the degree of stenosis and being seropositive for Chlamydiae. CONCLUSIONS: Our findings suggest that in an unselected population of stroke patients there is no relations between carotid atheromatosis and positive serology findings to Chlamydia pneumoniae. If there is any relationship between Chlamydia pneumoniae and carotid atheromatosis, serology does not seem to be a technique which is suitable for its assessment.
Acute Disease↗
[Should neurology residents have an educational rotation period at the local hospital?].
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Hospitals, General↗
[Comparative study of nicardipine versus placebo in the prevention of cognitive deterioration in patients with transient ischemic attack].
The neuropsychological follow up of transient ischemic attacks can provide a model for evaluating the efficiency of a drug in vascular dementia. A double blind study has been conducted using nicardipine, a calcium-antagonist, as opposed to a placebo in 40 patients with transient ischemic attacks, over a six month period. The patients were evaluated according to a Wechsler's intelligence scale, and their memory was also tested before and after this period. Although no alterations were registered on either scale, some differences did appear in certain sub-tests, especially as regards the verbal coefficient. This pilot study has provided information concerning the possible beneficial effect of the drug, which should be proven by means of a larger-scale study.
Aged↗