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J Seguí

Publications and source records attributed to J Seguí.

At least 19 recordsLinked to original sources
PubMed2001

Panic disorder in a Spanish sample of 89 patients with pure alcohol dependence.

High rates of anxiety disorders, including panic disorder (PD), have been found in patients suffering from alcohol dependence (AD). It has been suggested that alcoholic subjects with PD represent a more severe subgroup of patients. Eighty-nine patients with 'pure' AD (without abuse of other drugs) were examined and compared for the presence of PD. Several clinical scales were administered to assess symptomatology and severity. Twenty-three patients (25.8%) met the criteria for PD. The mean age at onset for alcohol use was 18.7 versus 28.5 years for PD onset. Our finding of an earlier onset for alcoholism than for PD in a sample of Spanish patients illustrates the potential importance of transcultural factors. These patients were more likely to be women and to have first-degree relatives with PD. Overall, alcoholic patients with comorbid PD showed greater clinical severity. They were found to have more comorbidity with axis I disorders (major depression and dysthymia), greater clinical severity, and a history of more suicide attempts.

Adult↗
PubMed2001

Phyllodes tumor of the breast with actin inclusions in stromal cells: diagnosis by fine-needle aspiration cytology.

The occurrence of hyaline inclusions in stromal cells in fibroepithelial tumors of the breast is very uncommon. These inclusions, characteristic of infantile digital fibromatosis, are comprised of actin filaments. This report illustrates a case of a benign phyllodes tumor of the breast with inclusion bodies, identified by fine-needle aspiration. Histologically, many of the stromal cells contained round intracytoplasmic inclusions, with positivity for smooth muscle actin.

Adult↗
PubMed2001

Small cell carcinoma of the urinary bladder. Presentation of 23 cases and review of 134 published cases.

OBJECTIVE: To investigate the morphological diagnostic criteria and biology of the urinary bladder small cell carcinoma (SCC). METHODS: Study of 23 cases of bladder SCC, looking for the clinical presentation, pathological features and evolution, and review of 134 previously published cases. RESULTS: The SCC is infrequent (0.48-1%), 50% of them have areas of transitional cell carcinoma, supporting the metaplastic theory. The classic small cell morphology is the best diagnostic criterion. The neurone-specific enolase and chromogranin A are good markers, but not indispensable. An early metastatic incidence (56%) with a high mortality rate (68.7%), mostly before 2 years after the diagnosis, is the typical evolution. Only the patients with additional cis-platinum-based chemotherapy have better prognosis. CONCLUSION: The pathologist should watch out for the presence of SCC and the urologist should consider the possibility of combined treatment for these cases.

Aged↗
PubMed2000

Psychiatric and psychosocial disorders in patients with systemic lupus erythematosus: a longitudinal study of active and inactive stages of the disease.

The objective was to analyze psychiatric disorders and psychosocial dysfunction in patients with systemic lupus erythematosus (SLE), studied longitudinally during active and subsequent inactive stage of their disease. During a 6 month period of study, we selected 20 consecutive patients with SLE who presented with a SLE flare. All patients fulfilled the 1982 revised criteria of the American College of Rheumatology for the classification of SLE. When patients entered the study, we performed psychiatric (CIS, RDC, STAI, HD, BDI, GHQ and MMS) psychosocial (GAS and VAS-P) scores assessment. One year later, we repeated the psychiatric and psychosocial assessment when patients showed inactive disease. The 20 patients evaluated were women, with a mean age of 34 y (SE 14.4, range 20-57). According to CIS evaluation, we diagnosed 8 (40%) psychiatric cases in the acute episode of SLE. The RDC diagnosis showed generalized anxiety in 5 patients, panic disorders in 2 patients and generalized anxiety plus depressive symptoms in one patient. One year later, when patients did not show disease activity, we diagnosed 2 (10%) psychiatric cases (P<0.05). When SLE patients were clinically inactive, they showed lower levels of psychological distress (GHQ scale, 1.8 vs 5.6, P<0.001), with a lower grade of anxiety measured by both HA (3.2 vs 8.2, P<0.01) and STAI-S (7.95 vs 20.90, P<0.001) scales. We also found a lower score in pain perception (VAS-P) (2.80 vs 4.25, P<0. 01) and higher occupational activity (VAS-P) (83.9 vs 66.2, P<0.01) and general functioning (GAS) (93.75 vs 83.50, P<0.05) during the inactive stage. No significant differences were found when we compared cognitive impairment, grade of depression and physical disability between inactive and active stages. We conclude that in SLE patients, psychiatric and psychosocial disorders during acute episodes are usually mild and seem to be related to the psychological impact of disease activity on patients. This type of psychiatric pathology is similar to that which would be expected in other groups coping with a stressful event, indicating that our patients did not react in a way specifically determined by their systemic disease.

Adult↗
PubMed1999

Differential clinical features of early-onset panic disorder.

BACKGROUND: Although panic disorder (PD) begins typically in adulthood, an earlier onset is not uncommon. Recent studies on early-onset PD indicate that this subgroup of patients may display distinct clinical characteristics. OBJECTIVE: To compare a subgroup of early-onset PD patients with the rest of the sample. METHOD: A consecutive series of 442 patients with PD were included. Family histories were investigated, and clinical assessment employed the following instruments: Hamilton's scales, Global Functioning Scale, Marks-Mathews' Fears and Phobia Scale, and Panic-Associated Symptom Scale. The age threshold for 'early-onset' was considered at 18 years. RESULTS: A total of 45 patients (10.2%) exhibited early-onset PD, with a mean age at onset of 14.6. They were younger and had a longer duration of illness than later-onset patients. No differences were found in severity of panic symptoms, anxiety or depressive symptoms, and social functioning. They had more comorbidity with simple phobia, social phobia, and substance dependence. Rates of PD among first-degree relatives were higher in the early-onset group. CONCLUSION: Early-onset PD patients displayed a greater familial loading, but clinical severity of their panic-agoraphobia symptoms was not higher. Comorbidity was greater with phobic and substance-related disorders.

Adult↗
PubMed1998

[Subtyping panic disorders according to their symptoms].

BACKGROUND: Panic disorder (PD) is a common illness associated with high levels of disability and with a high utilisation of non-psychiatric health services which is inefficient in most cases. A better understanding of the clinical subtyping of PD may improve diagnosis both in psychiatric and medical settings. The present study is aimed at assessing the frequency, factorial grouping and comorbidity of PD symptoms in a naturalistic sample of patients. PATIENTS AND METHODS: All consecutive cases of PD (n = 442) who contacted with two outpatient clinics in Barcelona (Spain) were assessed by two experienced interviewers. Assessment instrument included SCID-UP-R interview and inventory of panic symptoms based on DSM-III-R. RESULTS: Palpitations (86.7%), shortness of breath (76.5%), fear of dying (69.9%) and dizziness (63.6%) were the most frequent and intense symptoms reported by the PD patients. The principal component analysis revealed four factors which explained the 56% of the variancel "cardiorespiratory" (23.2%), "depersonalization-derealization" (15.8%), "vestibular" (10%) and "mixed" (7%). CONCLUSIONS: The frequency of presentation of symptoms was similar to other studies. However some disimilarities appeared that may be attributed to transcultural differences as well as terminological problems and the range of symptoms assessed. Factors found in the present study support the clinical subtyping of PD in 3 groups characterised by cardiorespiratory symptoms and fear of dying, cognitive symptoms (depersonalization-derealization) and vestibular symptoms such as dizziness and faintness.

Adult↗
PubMed1998

Semiology and subtyping of panic disorders.

To date, the quantitative psychopathology of panic disorder (PD) has been less well studied than that of other psychiatric conditions such as schizophrenia or major depression. The aim of the present study was to assess the frequency and factorial grouping of symptoms in a naturalistic sample of PD patients. A total of 274 consecutive cases of PD who contacted an out-patient clinic in Barcelona, Spain were assessed by two experienced interviewers. The assessment instruments included the Structured Clinical Interview for DSM-III-R Upjohn version (SCID-UP-R) and an inventory of panic attack symptoms based on DSM-III-R. Of the patients who presented at the unit during the assessment period, 8.5% presented with PD. Palpitations, shortness of breath, fear of dying and dizziness were the most frequent and intense symptoms reported by the PD patients. Principal-component analysis revealed four factors which accounted for 57% of the variance, including 'cardiorespiratory' (26.1%) and 'vestibular' (15.1%) factors, and two additional factors with mixed symptoms. The frequency of presentation of symptoms was similar to that reported in other studies. However, some discrepancies were observed that may be attributed to transcultural differences as well as to terminological problems and the range of symptoms assessed. These factors may also explain some of the differences found in factor analysis groupings in previous studies. Our findings support the symptom subtyping of PD.

Adolescent↗
PubMed1996

Strong c-Jun immunoreactivity is associated with apoptotic cell death in human tumors of the central nervous system.

Strong c-Jun immunoreactivity, but not c-Fos expression, was observed in typical apoptotic cells in medulloblastomas, central neuroblastomas, malignant astrocytomas and glioblastomas, and in lymphocyte-like cells bearing nuclear fragmented DNA in medulloblastomas. In contrast, only a few proliferating cells, as revealed with PCNA immunohistochemistry, colocalized c-Jun. These results support the concept that strong c-Jun expression is associated with certain forms of cell death in human tumors of the central nervous system.

Apoptosis↗
PubMed1996

Jun expression is found in neurons located in the vicinity of subacute plaques in patients with multiple sclerosis.

The expression of members of the Fos and Jun families is examined by immunohistochemistry in the brains of two patients with multiple sclerosis (MS). Strong c-Jun immunoreactivity is observed in the cytoplasm of neurons located in the vicinity of subacute plaques, but not in neurons of brain compartments not compromised by MS and in the neighborhood of chronic plaques. Strong c-Jun immunoreactivity also contrast with weak c-Jun immunoreactivity of corresponding neurons in control brains. In addition, punctate Jun D immunoreactivity is observed in the neuropil of the same areas that express c-Jun. No immunoreaction is found to c-Fos, Fos-related antigens and Jun B in these areas. The present results suggest that selective Jun neuronal expression in the vicinity of subacute plaques is a consistent reaction to demyelination and axonal damage.

Adult↗
PubMed1996

Amyloid deposition is associated with c-Jun expression in Alzheimer's disease and amyloid angiopathy.

Since the PAD gene (also called promoter of Alzheimer's disease amyloid A4 precursor gene or amyloid beta-protein precursor promoter) has two AP-1 consensus sequences, and members of the Fos and Jun families are the major components of the transcription factor activator protein-1 (AP-1), we have investigated the localization of c-Fos and c-Jun immunoreactivity and its relationship to beta-amyloid deposition in the brains of patients with Alzheimer's disease and amyloid angiopathy. c-Jun, but not c-Fos, immunoreactivity is observed in the muscular layer of meningeal and cerebral blood vessels with amyloid angiopathy, and in the soma of glial cells and cellular processes of unknown origin surrounding beta-amyloid deposits in the brain. These results show that c-Jun may participate in the cascade of events leading to increased beta-APP (beta-amyloid precursor protein) production and beta-amyloid deposition in the brains of patients with Alzheimer's disease and amyloid angiopathy.

Alzheimer Disease↗
PubMed1995

Costs and offset effect in panic disorders.

BACKGROUND: The study is aimed at assessing the costs before and after the diagnosis and the provision of effective treatment for panic disorder (PD), and the offset effect related to the psychiatric encounter. METHOD: A 24-month prepost design was used to collect data on clinical status and health care services utilisation in a natural environment. The 61 PD patients' assessment included the SCID-UP, ratings on general functioning, improvement, severity of symptoms and level of disability. All health care services used and lost workdays were recorded. RESULTS: Both sociodemographic characteristics and the outcome show that this was a standard group of PD patients, who received effective treatment for their condition. The total direct costs of health care use during the previous year and the year after the diagnosis were, respectively, US$ 29,158 and US$ 46,256. The indirect costs of lost productivity were US$ 65,643 in period I and US$ 13,883 in period II. CONCLUSIONS: A strong offset effect (94%) has been found in this study, significantly greater than the one described for psychiatric disorders as a whole. The costs of nondiagnosis are usually overlooked when estimating the global costs of PD. Methods for improving early detection of PD may substantially reduce the costs incurred before diagnosis.

Absenteeism↗
PubMed1994

[The use of services, the effect of compensation and the costs of a panic disorder].

BACKGROUND: The use of general health care services by psychiatric patients has decreased drastically following correct diagnosis. This phenomenon, called offset effect, allows the use of inefficient health care services to be evaluated and contributes to the estimation of the relative impact of the disorder in addition to the estimation of the benefits of the training campaigns and/or the implementation of services. The aim of this study was to evaluate the offset effect and the costs of the panic disorder (PD) in a natural environment. METHODS: The clinical data and the use of health care services over 12 months prior to diagnosis and 12 months following diagnosis were collected. Clinical evaluation of 61 patients with PD included a standard interview (SCID-UP), scales of general functioning, improvement, severity of the symptoms and the level of disability. The number of work days missed was also reported. RESULTS: The sociodemographic features, clinical evolution and the rate of response to treatment were comparable to those referred in other studies performed in a natural medium. The direct costs of treatment of AP were 1,795,000 pesetas (1,547,000-1,889,000) higher during the year following the first psychiatric consultation, mainly due to the costs of the visits to the psychiatrist and the medication. On the contrary, the indirect costs were 5,435,000 pesetas less during this period. CONCLUSIONS: In this study on the treatment of patients with the panic disorder a strong offset effect (94%) was found being much greater than that described for general psychiatric disorders. Adequate psychiatric treatment induces in the next 12 months an increase in the cost due psychiatric consultation and medication, however reduces the total costs when absenteeism is taken into account.

Adolescent↗
PubMed1992

The structure of two IgMs showing different activity from a patient with Waldenstrom's macroglobulinaemia.

The two monoclonal IgMs (IgM1 and IgM2) were characterized from a patient Waldenström's macroglobulinaemia that resulted in a gammapathy. Heavy and light chains were isolated from the IgM. The complete primary structure of the two light chains and the NH2-terminal region of the two heavy chain molecules were determined. The sequence data indicated that the heavy and light chains from both IgMs belong to the same (III and II) lambda subgroups. By testing their antibody activity it was found by immunofluorescence and immunoblotting that only IgM2 reacts with an intermediate filament protein.

Adult↗
PubMed1991

[Subgroups of drug abuse patients who consume buprenorphine].

We assessed the buprenorphine use in a sample of studied 184 patients with DSM III-R diagnostic criteria for opioid dependence who attended the Sta. Eulalia's CAS (outpatients facility) during 18 months period The lifetime prevalence of buprenorphine was 79% (43.5% of them were occasional users and 35.5% habitual; whereas the point prevalence was 16.8% (6.5% occasional users and 10.3% habitual). We compared the clinical characteristics of this patients, those who use the drug habitually and those who take it occasionally. The first group showed a longer time of opioid abuse (p less than 0.05) and they were more involved in drug traffic (p less than 0.001), mostly buprenorphine. These patients may present higher levels of clinical severity and social conflicts. Anyway they are usually polydrug users who consume more frequently flurnitracempan, cocaine, heroine, alcohol and cannabis (p less than 0.001). The usual ways of obtaining the buprenorphine are illegal traffic and GP's prescription in the Public health care facilities often by menace and intimidation. For consuming buprenorphine the abusers crush the pill, dilute it and them inject the solution i.v. The subgroup of patients who use buprenorphine occasionally only take in when don't have heroine and clinically they are not so deteriorated.

Age Factors↗
PubMed1991

[The prevalence of buprenorphine consumption in a sample of outpatient drug abusers].

We studied 184 patients with DSM III-R diagnostic criteria for opioid dependence who attended the Sta. Eulalia's CAS (outpatients facility) during 18 months in order to measure the buprenorphine use. We collected the data from the patient's reports on the present buprenorphine use. The period prevalence was 79% (43.5% of them were occasional users and 35.5% habitual; whereas the point prevalence was 16.8% (6.5% occasional users and 10.3% habitual). The average of buprenorphine use was 6.1 +/- 9.9 months. Main method of consume is crushing the pill then dilute it and then injecting the solution e.v. The usual way of getting the substance is from illegal market (about 65% of patients get it in this way). About the third of our patients have been involved in the illegal traffic of in this drug anytime. From the data presented above we conclude that a more strict control of buprenorphine in highly recommended.

Buprenorphine↗