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J Matías-Guiu

Publications and source records attributed to J Matías-Guiu.

86 records · Page 5Linked to original sources
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[Profile of the migrainous patients according to drug intakes].

Migraine headache is a common, recurrent and often incapacitating disorder resulting in a substantial loss of work days and productivity, significant consumption of medicines, and considerable economic cost. We performed this study in order to determine the characteristic features of migrainous patients with regular or frequent intake of ergotamine preparations and non steroidal anti-inflammatory drugs (NSAIDs) and the existence of significant differences between both groups. 186 patients were included in the study, 36.6% suffering from migraine without aura and 63.4% from migraine with aura. 24.7% were males and 75.3% females. Mean age of the sample was 35.6 +/- 12.9 years. With regard to medication used for immediate relief of headache, 74.7% patients reported an intake of analgesics and 25.3% ergotamine preparations. In patients with analgesic intake the mean age was significantly lower than in patients with ergotamine for treatment of migraine. When clinic features of these two headache groups were examined, the duration of migraine attacks in the analgesic group was significantly higher (p = 0.0014) than in the ergotamine group, and the severity of migraine was lower (p < 0.05) than in this group. Among associated symptoms, nausea and vomiting were significantly less frequent (p = 0.024) in the analgesic group than in the group of patients with ergotamine intake.

Adult↗
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[Epidemiology of migraine].

Knowing the epidemiology of migraine is important for a host of reasons. Migraine is one of the most prevalent types of headache. In addition, it constitutes a pathology which due to its cyclic, recurring and highly incapacitating characteristics has enormous repercussions on the quality of life of those affected; it is responsible for the loss of an important number of working days and of production; responsible too for the vast consumption of medicaments and consequently represents a considerable economic cost. An epidemiological study, however, of its pathology poses countless difficulties owing to its characteristics and its association with risk factors. In this present work we review the obstacles to carrying out migraine epidemiological studies and we also comment upon many such studies found in the literature. In each section we present the data obtained in such studies as were performed by our working group.

Adolescent↗
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[Factors brought on by migraine].

Migraine is a paroxysmic abnormality in which asymtomatic periods alternate with the appearance of attacks. Such attacks are the end result of a chain of events leading on to the acute clinical syndrome. Amongst those phenomena which occur in the days prior to the attack starting, the factors which bring such attacks on have been widely studied by a great number of researchers. Identifying these initiating factors is a fundamental preventive element and looking into the behavioural mechanisms of such factors could prove useful in clarifying the pathogenic mechanisms of migraine. In the present study we review most of the works which have sought to identify these factors concerning the development of attacks and to work out their behavioural patterns.

Coffee↗
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[Stress as a precipitating factor in migraine].

Stress is the precipitating factor in migraine which is most commonly recognized by patients. There are many affected who describe headaches brought on by stressful situations and events, although they also speak of the onset of their attacks during the period of calm immediately after such moments of stress. There are however few objective works in the literature which study the relationship between stress and migraine. In the present work we review that literature which does exist concerning such a relationship.

Adult↗
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[The assessment of neurological care needs in the health sector of de San Juan de Alicante by key-informants model].

BACKGROUND: Specific health care planning should be based on the care request according the most adjusted evaluations method. Data obtained from each geographic area may be most comparable with other from close areas. AIM: To determinate the neurological needs in the health area 16 of Valencian Community that includes the care corresponding to Hospital of San Juan de Alicante. MATERIAL AND METHOD: We conducted a survey among key informants using the primary care physicians of the area. The population of the healthy area is 144,781 people and includes 78 primary care physicians. We used the formula proposed by Kurtzke in 1982 in order to calculate the neurological time. RESULTS: We obtain a response rate of 82% the total number of neurological hours requested was 5,823.84 hours by year, which supposes a need of 8.82 neurologists by 100,000 people and nears a needs of 12.77 neurologists for the healthy area. These data are clearly higher that the obtained in other close areas using the same methodology (5 neurologists by 100,000 inh in Alcoi, 6 neurologists by 100,000 inh in the area corresponding to General Hospital of Alicante). The topics that require more than 100 hours by year are: migraine (1,205), lumbar backache (1,104), alcoholism (762), cranial trauma (442), deafness (285), stroke (272), seizures (181), disk herniation (166), cervical backache (140), zoster (162), psychosis (118), which supposes 83.12% of the whole neurological time. CONCLUSIONS: The data situated the area within a model of direct neurological care similar to that in the United States.

Health Planning↗
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[Prevalence of migraine in a population of university students].

A group of universities not related with health sciences were interviewed using the questionnaire 'Alcoi 1992', based on the operational diagnostic criteria of the International Headache Society (IHS), to evaluate the prevalence of migraine. This questionnaire for the diagnosis of migraine was validated in 1993, showing a high sensibility and specificity for the diagnosis of migraine. Sensitivity, specificity, predictive value and chance-corrected agreement rate for the diagnosis of migraine was 100%, 94%, 90% (PVpos), 1008 (PVneg) and 0.71 respectively. The study group was composed by 96 students, men and women; the mean age of the group was 21 years old. The prevalence of headache, migraine, tensional headache and cluster headache was 95.4%; 7.58%; 12.2% and 1.52% cases respectively. The prevalence for male of headache, migraine, tensional headache and cluster headache was 92.5%, 12.5%, 15.9% and 2.5% cases respectively. The prevalence for female of headache, migraine, tensional headache and cluster headache was 100%; 0%; 5.5% and 0% cases respectively. The questionnaire appears like an useful, fast and easy method for the evaluation of diagnosis of migraine in populations groups.

Adolescent↗
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[Prevalence of migraine in the medical student population as determined by means of the 'Alcoi 1992' questionnaire].

A group of medical students were interviewed using the 'Alcoi 1992' questionnaire based on the diagnostic criteria of the International Headache Society (IHS) in order to assess the prevalence and various characteristics of migraine. This questionnaire for headache diagnosis was approved in 1993, showing both high sensitivity and exactness in diagnosing migraine. Sensitivity, exactness, predictive value and agreement index of the questionnaire in migraine diagnosis were 100%, 94%, 90% (positive) or 100% (negative) and 0.71% respectively. The group was made up of 96 students of both sexes, with an average age of 23.3 years (standard deviation 1.87). A total of 92 students, 35 male and 57 female, reported headaches. The total prevalence rate for headache was 95.8%, the reliability interval (RI) being 76.7-114.9. In the case of female students, the prevalence rate for headache was 96.6% (RI 71.7-121.5) and in the case of male students it was 94.6% (RI 63-125.7). A total of 20 students, six male and 14 female, fulfilled the criteria for migraine. The overall prevalence rate for migraine was 20.8% (RI 11.9-29.7), the prevalence for females being 23.7% (RI 11.6-35.8) and that for males 16.2% (RI 3.7-28.7). The questionnaire would appear to be a useful, rapid and simple method in the assessment of migraine diagnostic.

Adolescent↗
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[Neurological education of general practitioners. Results of a survey carried out among 196 general practitioners].

We have carried out a survey among professional general practitioners in our province with the aim of getting to know their opinion concerning their own training in Neurology. The survey included questions about the adequacy of training, the nature of any deficiency therein (be it theoretical and/or practical) and ability to analyse and attend a neurological patient. The percentage of replies was 78% out of a total of 196 surveys. 78.8% of those questioned consider that their neurological training has not been sufficient either for clinical or general practice; while 43.8% believe that this insufficiency is due to a lack of practical training, 1.8% think the fault lies in a lack of theoretical training, and 54.32% consider that it is due to a lack of both practical and theorectical training. 61.2% of those questioned claim to have difficulties with neurological explorations, and 55.6% claim they have greater difficulties attending a neurological patient than other patients classified within other internal medical specialties. 76% consider that it is either partially or totally false to claim that these difficulties are unimportant due to the lack of treatment for neurological illnesses, although 69.4% consider it to be partially or totally true that they will never be able to achieve diagnosis of a neurological patient due to a lack of the required complementary investigations. 43.9% consider that continued training in Neurology is not useful because it is a repetition of training received at university. As a consequence, there is an imbalance between neurological training and the need to attend the patient at the level of general practice, which should be set right by making the theoretical training given during graduation more suitable, and by increasing and improving practical credits.

Data Collection↗
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[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↗
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[Determination of basal GH in dementias].

We have studied the plasmatic levels of the growth hormone (GH) in a control group consisting of 72 subjects with an average age of 69.7 +/- 8.4 years and in a group of 37 patients with an average age of 69.3 +/- 9.6, of which 28 were demented (15 with degenerative dementia and 13 with non-degenerative dementia); 8 suffered from Parkinson's disease, and the rest showed signs of failing memory due to age. When comparing the plasmatic levels of GH between the patients' group and the control group we did not find significant differences between the demented and the control group, nor between the sub-groups of non-degenerative dementia or of those suffering from Parkinson's disease, when compared to the control group. However, we did find a reduction of GH that was statistically significant in the sub-group of degenerative dementia and the control group. This reduction in GH plasmatic values indicates a specific alteration in this type of process, which may be of certain use when searching for a hormonal marker for degenerative type dementia.

Aged↗
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[Hormonal markers of stress in acute cerebrovascular pathology].

Various studies carried out over the last decade have shown that high glucose levels in the blood foster ischaemic brain damage associated with a worse evolution of such pathologies. The aim of the study we performed was to try to shed some light on whether stress in these patients raised their glucose levels adding to a worsening of the patient's clinical picture. We studied 318 consecutive patients suffering from stroke. We determined fasting glucose levels, prolactin and cortisol within the first few hours of hospitalization and afterwards at seven to ten days and again at one month after the stroke. Clinical severity was evaluated using Toronto and Mathew neurological scales and the degree of incapacity was measured using the Barthel functional scale on the three aforementioned occasions and Rankin's modified scale six and twelve months after the stroke. Clinical severity the first hours after stroke was significantly related to glucose levels, such relationship not being observed with prolactin and cortisol. Nor did we observe any significant association between glucose and these hormones. Likewise the anxiety scale had no relationship with any hormone. Studying medium and long term functional incapacity, glucose significantly correlated with the Rankin scale although with low dependence, such a relationship not being found either with prolactin or cortisol. Our work would seem to indicate that blood glucose behaviour is independent of prolactin and cortisol levels since we found no such relationship between them.

Aged↗