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Biomedical subjects

J Matías-Guiu

Publications and source records attributed to J Matías-Guiu.

At least 37 records · Page 2Linked to original sources

[Validation of Allen's scale for the diagnosis of stroke].

INTRODUCTION: The importance of cerebrovascular pathology demands the most exact and complete diagnosis possible, by general physical and neurological examination and complementary techniques including computerized tomography (CT). Without CT, diagnosis may be delayed, for which reason such authors as Allen have put forward scales which by means of diagnostic scoring distinguish between stroke types. AIM: To validate the Allen scale as opposed to CT scan in a series of patients suffering from haemorrhagic and ischaemic stroke. MATERIALS AND METHOD: Sixty-two consecutive hospitalized patients suffering from stroke were studied, who all underwent CT scan within fifteen days of admission. RESULTS: The group consisted of 62 patients, 33 males (53%) and 29 females (47%) having an average of 70.2 +/- 11.2 years. The most frequent type of stroke was ischaemic (63%) as opposed to haemorrhagic (37%). Globally for all strokes we obtained the following results: Sensitivity (S) = 61%, Specificity (Sp) = 40%, positive predictive value ( + PV) = 84% and negative predictive value (-PV) = 17%. For ischaemic stroke the results were as follows: S = 76%, Sp = 66%; +PV = 67% and -PV = 76%. Finally for haemorrhagic stroke the results were S = 43%; Sp = 100%; +PV = 100% and -PV = 75%. CONCLUSIONS: The Allen scale has not proved to be a valid instrument in stroke diagnosis due to its low sensitivity and specificity especially in cases of haemorrhagic stroke.

Aged↗

[Stroke in young people].

We retrospectively studied 75 consecutive patients with acute stroke. They made up 3.7% of all acute cerebrovascular pathologies. Average age of patients was 37.45 (SD 7.37) and the number of men exceeded women at a ratio of 1.8:1 73% had ischaemic pathology. Those risk factors most often found were tobacco and alcohol consumption and migraine. The most frequent causes were arteriosclerosis and cardioembolism. Etiological diagnosis was not reached in a third of cases. Most patients were treated with antiagregants with aspirin being the most used at a dose of about 200 mg per day. Initial death rate was 4% and more than 60% of patients were asymptomatic or with minimal deficiencies upon discharge.

Adolescent↗

[Daily defined doses of parkinsonian drugs in Alcoi].

BACKGROUND: Some authors have suggested that the use of DDD (defined daily doses) of L-dopa may be useful as an indicator of the frequency of Parkinson's disease. AIM: To determine the measurement for L-dopa and selegiline in Alcoi. MATERIAL AND METHODS: We have obtained the intakes for L-dopa and selegiline between January and December, 1990 and we have calculated the DDD/1,000 inhab/day. RESULTS: During the study period, we have found that the mean intakes were 18,000.969 mg and 53,800 mg for L-dopa and selegiline, respectively. And so, the L-dopa intake in Alcoi was 0.60 DDD/ 1,000 inh, and the selegiline intake was 0.21 DDD/1,000 inh. DISCUSSION: Comparing the other data of the literature, specially in scandinavian countries, the obtained intake for L-dopa was low, and that could indicate that the frequency of the disease in Alcoi was lower.

Antiparkinson Agents↗

[Changes in the cerebral flow velocity induced in the middle cerebral artery by acute stress studied by transcranial Doppler ultrasonography].

BACKGROUND: The behavior of brain flow on acute stress has not been previously evaluated. Transcranial Doppler ultrasonography (TD) is a bloodless method to evaluate the speed of cerebral flow in the arteries of the Willis polygon. The present study was designed to analyze the changes which occur in the same during two situations of acute stress. METHODS: The mean speed of cerebral flow (MS) and the pulsation rate (PR) of the right and left middle cerebral artery (MCA) were measured basally and following a mental stress test (calculation) and physical stress (cold test) by TD and through the temporal window. Twenty-five healthy volunteers (18 women and 8 men) with a mean age of 27.8 +/- 7.3 years were studied. RESULTS: In response to mental stress an increase was observed in MS in both the right MCA (10 +/- 8.6 cm/sec) and the left MCA (10.4 +/- 8.7 cm/sec) with a decrease in the MCA (0.14 +/- 0.23 in the right MCA, 0.14 +/- 0.18 cm/sec in the left MCA). In response to the cold test an increase in MS (7.3 +/- 7.5 cm/sec in the right MCA, 14.8 +/- 14.7 cm/sec in the left MCA) was also observed with a decrease in the PR (0.2 +/- 0.2 in the right MCA and 0.2 +/- 0.16 in the left MCA). No significant differences were observed in the changes induced in the right or left artery or in those induced by the mental or cold tests. CONCLUSIONS: These results suggest that the acute stress produces an increase in cerebral flow in the arteries of the Willis polygon.

Adult↗

Cardiovascular reflexes in Parkinson disease.

We have investigated the autonomic function of 95 patients with Parkinson disease (PD) by testing their cardiovascular reflexes and compared the results with those of 53 healthy volunteers. 51.1% of the patients were on antiparkinsonian therapy. The patients showed a smaller heart rate response to deep breathing with a mean exhalation-inspiration difference of 87.73 +/- 7 (p: 0.0005), a smaller heart rate response to standing with a mean 30: 15 index of 1.18 +/- 0.25 (p: 0.01), and a smaller blood pressure rise to handgrip with a mean rise of 9.53 +/- 8.76 mmHg (p: 0.005). We found a higher percentage of patients with established sympathetic lesion (41% vs 34%) or atypical patterns of global autonomic function involvement (33% vs 26%), but the percentage of subjects with parasympathetic lesion was similar in both, patients and controls (16% vs 15%). We found no significant difference on cardiovascular performance between treated and untreated patients. The patients with autonomic impairment were older than the patients with normal autonomic function. Our findings suggest that patients with PD have a true autonomic dysfunction.

Adult↗

Cardiovascular reflexes in patients with vascular headache.

We have investigated the autonomic function of 75 patients with migraine by examining cardiovascular reflex function. The results were compared with those of 78 healthy volunteers. Measurements were made between attacks. Patients with migraine showed a smaller heart-rate response to deep breathing but a greater heart-rate response and higher blood pressure to standing when compared to controls. Migraine patients had a higher percentage of established sympathetic lesions (51% vs 17%) and severe (25% vs 5%) or atypical (24% vs 11.5%) global autonomic dysfunction. No significant differences were found among patients with migraine with aura, migraine without aura, and migraine with prolonged aura. Our findings indicate that patients with migraine have sympathetic hypofunction.

Adolescent↗

Placebo-controlled trial of nimodipine in the treatment of acute ischemic cerebral infarction.

Nimodipine is a 1,4-dihydropyridine derivative that shows a preferential cerebrovascular activity in experimental animals. Clinical data suggest that nimodipine has a beneficial effect on the neurologic outcome of patients suffering an acute ischemic stroke. Our double-blind placebo-controlled multicenter trial was designed to assess the effects of oral nimodipine on the mortality rate and neurologic outcome of patients with an acute ischemic stroke. One hundred sixty-four patients were randomly allocated to receive either nimodipine tablets (30 mg q.i.d.) or identical placebo tablets for 28 days. Treatment was always started less than or equal to 48 hours after the acute event. The Mathew Scale, slightly modified by Gelmers et al, was used for neurologic assessment. Mortality rate and neurologic outcome after 28 days were used as evaluation criteria. We considered 123 patients to be valid for the analysis of efficacy. Mortality rates did not differ significantly between groups. Neurologic outcome after 28 days of therapy did not differ between groups. However, when only those patients most likely to benefit from any intervention (Mathew Scale sum score of less than or equal to 65 at baseline) were analyzed separately in post hoc-defined subgroups, the nimodipine-treated subgroups showed a significantly better neurologic outcome. This result suggests that some patients with acute ischemic stroke will benefit from treatment with nimodipine tablets.

Adult↗