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Biomedical subjects

S Giménez-Roldán

Publications and source records attributed to S Giménez-Roldán.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

[A study made on a data base of 2,471 patients with Parkinson disease and disorders of movement in Health District 1 of the autonomous region of Madrid. Observed demographic changes over 8 year-period].

INTRODUCTION: A specialised unit may influence favourably primary levels of health system by alerting physicians and patients on the existence of those pathologies most commonly seen. OBJECTIVES: To determine demographic changes and referral patterns observed in a hospital-based monographic outpatient clinic on Parkinson's disease and movement disorders along an eight-year period (1991-1998). PATIENTS AND METHODS: Database analysis of 2,471 patients attending a specialised unit covering an urban and rural population of 630,000 people in South-East Madrid city and county. RESULTS: We observed a slight, albeit non-significant reduction in the incidence of secondary parkinsonisms (40% of all parkinsonisms observed). This occurred despite a drastic reduction in drug-induced parkinsonisms, particularly those caused by cinnarizine/flunarizine and flupentixol. The reduction was balanced by a relative increase in neurodegenerative parkinsonisms, particularly Lewy body dementia. There was a sustained decrease in the time elapsed between onset of symptoms and identification of parkinsonisms as well as identification of its primary or symptomatic nature. The incidence of tardive dystonia (46.7%) of all symptomatic dystonias) remained unchanged. Essential tremor referrals markedly increased along the study period. CONCLUSIONS: Demographics features of patients attending a Parkinson's disease and movement disorder unit are submitted to changes over time. These probably reflect better awareness about these conditions by patients and physicians, ready access to hospital-based specialised units, and a greater demand for specialised care by the aged.

Adult↗
PubMedDate not supplied

[Dopamine agonists situation in Parkinson disease].

The development of a variety of side effects associated with long term treatment of Parkinson s disease has prompted the introduction of new drugs and new treatment strategies. The use of dopamine agonists in combination with levodopa has proved to be useful in advanced patients with motor fluctuations. Recent studies indicate that the use of dopamine agonists in monotherapy from the early stages of the disease can be as effective as levodopa for clinical improvement with the added advantage of a significant less presentation of diskinesias. Ropinirol the first dopaminergic agonist demonstrating this effect in a 5 year controlled study, has well tolerance, both in combination or in monotherapy. Although low doses can be useful for individual patients, doses of approximately 15 16 mg/day proved to be safe and effective in long term studies.

Antiparkinson Agents↗
PubMedDate not supplied

[Miguel Gayarre (1866-1936) and neurology in Madrid: a contribution to his biography].

Miguel Gayarre y Espinal (1886-1936) is considered to be, together with Achúcarro, one of the most scientifically influential persons on Lafora, and hence on the so-called Madrid Neurological School preceding the Spanish Civil War (late XIX and first third of the XX century). There is, however, a great deal of scarcity about personal biographic data on Gayarre. We document herein that Gayarre, after graduation, achieved his doctoral degree at the age of 29 by discoursing on a non-neurological subject (On essential paroxysmal tachycardia). It was only afterwards when Gayarre decided to become a pupil of Oppenheim, considered at the time to be a "pure" neurologist, in Berlin. His return to Spain might had been prompted following rejection to Oppenheim on the basis of creed and race to take the chair at La Charité Hospital after Westphal death. Although Lafora considered him "an excellent neurologist", Gayarre, as most other members of the Madrid Neurological School, combined his practice with Neurohistopathology as a student of Achúcarro, and with Psychiatry, to become Director of the Ciempozuelos Hospital for the Insane in Madrid.

Germany↗
PubMedDate not supplied

[Use of apomorphine in Parkinson s disease].

INTRODUCTION. Apomorphine is a D2 dopamine agonist, possibly underused despite its efficacy in situations where other medications have failed or lack of indication for stereotactic surgery. Rapidly effective (between 7 and 10 min) and potency approaching that of levodopa allows apomorphine to reduce reliably severe fluctuations, off period dystonia, biphasic dyskinesias or such symptoms as dysphagia, anismus of micturition difficulties. Unlike other agonists, apomorphine has a modest capacity to induce neuropsychiatric complications. Brief duration of response (<60 min) and the need of subcutaneous administration represent major difficulties in practice. OBJECTIVE and DEVELOPMENT. This review undertake some of the pharmacological properties of this orphan drug , its use in practice, and new pathways of development

Antiparkinson Agents↗
PubMedDate not supplied

[Effects of quetiapine at low doses on psychosis motor disability and stress of the caregiver in patients with Parkinson's disease].

INTRODUCTION: Quetiapine is a novel neuroleptic drug with pharmacological properties close to clozapine, the most effective drug in the management of psychotic symptoms in patients with Parkinson s disease (PD). Unlike clozapine, however, quetiapine does not induce agranulocytosis and therefore no haematologic controls are required. OBJECTIVES: To assess tolerability and effectiveness of low dose quetiapine on psychotic symptoms, sleep disturbances and stress of the caregiver in PD patients with dopaminomimetic psychosis. PATIENTS AND METHODS: We carried out a 16 week, prospective, open label study on the effects of quetiapine in 7 consecutive PD patients with psychosis. A ceiling dose was arbitrarily established at 25 mg/d. Antiparkinsonian medication remained unchanged throughout the study. Motor symptoms were assessed with UPDRS motor subscale portion, Schwab England scale, and Hoehn Yahr diseases staging. The effects on hallucinations and paranoia, sleep disorder, and stress in the caregiver were scored separately, aside from a global score on the Neuropsychiatric Inventory (NPI). Global impression of both, investigators and caregiver was obtained at study conclusion. A patient died from unrelated causes. RESULTS: Under a mean quetiapine dose of 24.9 mg/d (12.5 37.2) motor impairment during on periods remained unchanged, both according to patients and caregiver whereas mean UPDRS motor score remained unchanged (35.5 4.5 versus 32.8 5.2). Levodopa induced dyskinesias disappeared in the single patient with this complication. Improvement occurred in mean NPI global score, as well as subscores for hallucinations and paranoia, and caregiver stress. In over half the patients, effectiveness was scored as very good or good both by examiners and caregivers. A confusional episode occurred in one patient under 25 mg/d but readily resolved while maintaining the benefit following dose reduction to 12.5 mg. CONCLUSION: Quetiapine at low doses appears a useful alternative for psychotic symptoms, sleep disorders and stress of the caregiver in patients with PD

Aged↗
PubMedDate not supplied

[Advances in the treatment of the dystonias].

Except in Wilson's disease, few secondary dystonias are susceptible to benefit from an aetiological treatment. The somatic distribution of dystonia often determines the therapeutic strategy. Thus, stereotactic surgery may be the treatment of choice for hemidystonia while anticholinergic medication may alleviate generalized dystonia, particularly in childhood. Finally, local infiltrations of botulinum toxin are particularly useful for various forms of local and segmental dystonia. Certain subsyndromes as myoclonic dystonia, levodopa sensitive dystonia and paroxysmal choreoathetosis may benefit from relatively specific treatment strategies.

Blepharospasm↗
PubMedDate not supplied

[Frequency of neurocysticercosis at a hospital in Madrid (1980-1989)].

Neurocysticercosis (NCC) in Spain remains localized in well-defined endemic areas. Due to massive immigration from these rural areas toward urban outskirts under expanding industrialization during the 1960s and the widespread used of CT-scan, a relatively large number of NCC cases were subsequently detected in some hospitals in Madrid, reportedly with a trend towards decline from 1970 onwards. We carried-out an estimation on the frequency of this disease covering a 10-year period (1980-1989) by tracing all suspected diagnosis of NCC by CT-scan in Madrid General Hospital, one of the largest centers in this city covering some 672,351 people. Thirteen cases fulfilling diagnostic criteria for NCC has been seen by different clinical services for the past 10 years, mostly by neurologists. The patients were evenly distributed along the study period. Eleven patients were Spaniards, and all but two were born in geographic areas recognized as endemic for the disorder, mainly Castilla, Extremadura and Andalucia. At least 38 per cent of the patients were detected by CT-scans performed for unrelated conditions. Only 5 patients were considered to be suffering from active CNS infestation on the basis of CSF pleocytosis, immune CSF reactions for NCC or both. Most cases were adults or aged individuals (mean age, 46 years) but the only two Spanish adolescents were born in Madrid city. Two patients were of Hispanic origin (Chili and Venezuela), comprising some 25 per cent of all NCC seen for the past five years.

Adolescent↗