[Congenital myotonic dystrophy in a rural health area].
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Catchment Area, Health↗
Biomedical subjects
M González Alvarez
Publications and source records attributed to M González Alvarez.
[Viral infection of the lower respiratory tract in hospitalized infants: etiology, clinical features and risk factors].
OBJECTIVES: The aim of this study was to assess the clinical and virological characteristics of lower respiratory tract (LRT) infection in hospitalized infants in Spain and to identify clinical, radiological or laboratory parameters that could, on admission, be associated with a more severe clinical course. PATIENTS AND METHODS: A prospective study of infants less than 24 months old hospitalized for LRT infection during six consecutive seasons was performed. RESULTS: A total of 617 infants were included in the study. Diagnosis was bronchiolitis in 64 %, wheezy bronchitis in 24.6 %, laryngitis in 4.4 % and pneumonia in 6.8 %. The mean age was 269 188 days, the male/female ratio was 1:6 and the mean hospital stay was 6.6 3.5 days. At least one viral agent was identified in 55.6 % of the episodes, of which 83.6 % were due to respiratory syncytial virus (RSV). Other less frequently identified viruses were parainfluenza in 7 %, adenovirus in 4.3 % and influenza in 4 %. Coinfection was identified in 6.2 % of RSV-positive infants. These infants were younger (p < 0.005), had higher respiratory distress assessment instrument (RDAI) scores and longer hospital stay than infants in the other etiologic groups. Chest radiographs were performed in 94.3 % of the infants and 39.5 % showed infiltrate or atelectasis. This radiological alteration was significantly associated with a fever of more than 38.5 C and reactive C protein concentrations of more than 30 mg/L (p < 0.001 and p < 0.002), but not with higher RDAI score, SaO2 equal to or less than 87 %, or longer hospital stay. In the crude analysis, hospitalization for more than 5 days was associated with lower age (p < 0.01), a mean RDAI score of more than 6 (p < 0.003), SaO2 equal to or less than 87 % (p < 0.01) and RSV infection (p < 0.001). However, in the multivariate analysis only SaO2 equal to or less than 87 % and RSV infection were significantly associated with prolonged hospitalization. CONCLUSION: The most common lower respiratory tract infections in hospitalized infants in Spain are the various types of RSV-positive bronchiolitis, which have a clinical pattern similar to that described in other countries. Hypoxia on admission and RSV infection are the most important risk factors for prolonged hospitalization.
Female↗
[Depression and Parkinson's disease: neurobiologic foundations and therapeutic management].
The prevalence of depression in Parkinson's disease (PD) is estimated to be around 40% and generally takes the form of dysthymia. Although psychological factors probably contribute to depression, data point to a relation to structural and biochemical changes linked to PD. Thus, the onset of motor impairment is often preceded by a depressive episode, although there is no consistency between the seriousness of motor disability and depression. Furthermore, depression aggravates the memory and language impairments of PD and is thought to be a risk factor for developing dementia. Regional cerebral blood flow abnormalities in the medial frontal and cingulate cortices and low 5-HIIA concentrations in cerebro-spinal fluid suggest that degeneration of the mesocorticolimbic dopaminergic system as well as dorsal raphe changes may be implicated. Assessment of depression in PD is difficult, as none of the currently available scales were specifically designed for patients with this disease Furthermore, there is a lack of well-controlled studies showing that current antidepressants are effective in PD patients or are safe for use when the motor, cognitive and autonomic impairments of PD are present.
Brain↗