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Biomedical subjects

L Galiano

Publications and source records attributed to L Galiano.

14 recordsLinked to original sources

Efficacy and tolerability of entacapone in patients with Parkinson's disease treated with levodopa plus a dopamine agonist and experiencing wearing-off motor fluctuations. A randomized, double-blind, multicentre study.

The efficacy and tolerability of entacapone was investigated in a randomized, double-blind, placebo-controlled, 3-month study of 162 patients with Parkinson's disease (PD) treated with levodopa and a dopamine agonist and experiencing wearing-off motor fluctuations. Patients were randomized in a 3 : 2 ratio to entacapone 200 mg or placebo, administered with each dose of levodopa. Efficacy was judged on the improvement of "on" and "off" time while awake (Patient Diary and UPDRS part IV Item 39), Investigators' Global Assessment, the SF-36 Health Survey, and changes in levodopa dosages. Patients were monitored for adverse events, laboratory safety and vital signs throughout the study. Improvements in "on" time as assessed using patient diary data showed a trend in favour of entacapone, however these did not reach statistical significance. "Off" time while awake (UPDRS part IV Item 39) showed an improvement of at least one category in 36% of entacapone-treated patients, compared with 22% in the control group (p = 0.0038). The proportion of patients showing an improvement at the Investigators' Global Assessment was significantly higher (p = 0.0006) in the entacapone-treated group of patients. Also, the proportion of patients with a reduction in their daily levodopa dose was significantly higher (p = 0.02) in the entacapone group (28%) compared with placebo (13%). As expected, the most frequent adverse events were dopamine-mediated (dyskinesia: entacapone 31% versus placebo 13%), and harmless urinary discoloration. The modest increase in dyskinesias could be readily managed by levodopa down-adjustment, and, at study end there was no significant difference for the UPDRS "overall dyskinesia score" between entacapone and placebo. In conclusion, although the primary efficacy variable did not reach statistical significance, the present results demonstrate that entacapone provides additional antiparkinsonian benefits to levodopa therapy and is well tolerated in levodopa-treated PD patients experiencing wearing-off motor fluctuations despite adjunct dopamine agonist therapy.

Aged↗

[The risk of hemorrhage in long-term use of aspirin and triflusal].

INTRODUCTION: Different studies have shown that aspirin (AAS), in low doses, may lead to a considerable frequency of hemorrhagic complications when used in the long term. OBJECTIVE: We compare the long-term occurrence of hemorrhagic complications with low doses of AAS and high doses of triflusal. PATIENTS AND METHODS: Our series included 106 patients who took 900 mg triflusal per day (300 mg 3 times per day) and 111 who took AAS (330 mg/day once daily). The former were followed up for an average period of 48.3 months (20-94) and the latter for 46.3 months (2-84). The average follow-up period for the study was 47.3 months. The presence of hemorrhagic complications was evaluated, as was their frequency and follow-up curve. RESULTS: Compared with AAS, triflusal led to a 76% reduction in risk of hemorrhagic complications (2.8% against 10.8%; OR 0.24; IC 0.06-0.94). There was a slightly increased incidence of hemorrhages in the women's group. There were more hemorrhages than gastrointestinal hemorrhages (4.5% against 0.9%) and intracranial hemorrhages (1.8%-0.9%). The follow-up curve showed significant differences in the form of an increased risk of hemorrhagic complications with AAS. CONCLUSIONS: The risk of hemorrhage with AAS depended on the period of follow-up, in a similar manner to with oral anticoagulant agents, in patients with prophylaxis of cerebral infarct. On the other hand, this did not occur with triflusal, with which the risk was homogeneous and lower in the long term.

Adult↗

Occurrence of transient ischemic attacks in Alcoi: descriptive epidemiology.

A door-to-door survey of transient ischemic attack (TIA) and stroke was conducted in 3 towns of the Alcoi health area. The prevalence ratios found for TIA and stroke were 13/1,000 people (95% CI 8.8-17.9) and 21.5/1,000 (95% CI 15.8-27.2), respectively. The crude incidence rates for both TIA and stroke were 2.8/1,000 (95% CI 0.7-4.9). Methodological differences in the ascertainment of the cases may explain the variations in the rates between the present work and other studies in the literature.

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↗

[The prevalence rate for cardiovascular diseases antecedents in patients with migraine].

Throughout the many studies carried out on patients suffering from migraine, we find that a series of diseases or abnormalities with cardiovascular etiologies may be associated with the risk of migraine. In some studies published so far there is a greater prevalence of distinct cardiovascular diseases among those patients suffering from migraine. The shortage of case-control studies which might otherwise definitely establish a relationship between migraine and other cardiovascular diseases leads us to cautiously interpret the meaning of these associations. We studied family and personal history of cardiovascular disease in a group of patients with migraine, and we carried out a case-control study to try to establish the greatest risk of suffering from these diseases by our patients. We found that family antecedents of migraine with the next of kin was a risk factor for getting migraine and that Raynaud's disease was associated with a greater risk of suffering with this pathology.

Adult↗

[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↗

[The role of the age on the quality of life of patients older than 65 years of age with vertebrobasilar ischemia treated with nicardipine].

OBJECTIVES: To establish the role of the age on quality of life of a group of normotensive patients, older than 65 years with vertebrobasilar ischemia, treated with nicardipine. To evaluate the influence of the Nicardipine side effects on the quality of life of these patients within general practice prescription limits. METHOD: An epidemiological cohort study was performed during six months, in several Basic Health Areas distributed all round Spain. Nottingham Health Profile (NHP) was used to evaluate quality of life and was applied at the beginning and at the end of the study. Nicardipine side effects were collected in every evaluation. RESULTS: 838 patients were included in the study, mean age 72.4 +/- 6.8 years, 337 (40.2%) were males and 501 (59.8%) females. When we compared quality of life according to the age, no significant differences were obtained (RR = 0.89; CI 95% 0.77-1.30). NHP global score +/- SD was initially 36.5 +/- 22.8 and 24.5 +/- 19.1 at the end of the study, this result was statistically significant (p < 0.001), which means a percentage of improvement of 33%. These differences were also significant in every NHP area. Side effects were not frequent and with no correlation with quality of life of patients (p = ns). CONCLUSIONS: Our data show that neither the age nor side effects due to nicardipine have influence on quality of life of normotensive patients, older than 65 years with vertebrovascular ischemia, treated with nicardipine. Quality of life assessment can be an useful tool for therapeutical evaluation in these patients.

Aged↗

[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↗

[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↗

[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↗