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Biomedical subjects

J Alonso

Publications and source records attributed to J Alonso.

At least 181 records · Page 10Linked to original sources
PubMed1996

Validity and reproducibility of the Spanish Version of the Sickness Impact Profile.

The Perfil de las Consecuencias de la Enfermedad (PCE), the Spanish version of the Sickness Impact Profile (SIP), was administered to 352 individuals who were grouped into 4 subsamples according to type and severity of illness. Differences among scores in the subsamples were used for assessing the discriminating ability of the PCE and correlation of PCE scores with theoretically comparable measures for convergent validity. Test-retest reliability was studied in a subgroup of 129 patients. The PCE scores correlated well with self-perceived overall health (0.53), self-assessment of sickness (0.51), self-assessment of dysfunction (0.63), the Index of Restricted Activity (0.54), and the Index of Activities of Daily Living (0.45). A poor correlation with clinicians' assessment of dysfunction (0.29) and speech therapists' assessment of speech pathology (0.23) was found. Reproducibility across illnesses (0.95-0.98), types of administration (0.96-0.98), and interviewers (0.93-0.99) was very high. The PCE is equivalent to the original instrument in terms of validity and reliability, which allows its use in international studies.

Activities of Daily Living↗
PubMed1996

Scaling the Spanish version of the Nottingham Health Profile: evidence of limited value of item weights.

The Nottingham Health Profile (NHP) is a measure of health status developed in Great Britain and adapted into Spanish. the objective of the study was to obtain item weights for the Spanish version and to compare them with those of the original instrument, to further asses the cross-cultural equivalence of the new version. The usefulness of using weights in obtaining scores for the Spanish version was also evaluated. Weights for the Spanish items were obtained using Thurstone's method of paired comparisons in a sample of 1123 individuals. Correlations between Spanish and English weights ranged from 0.72 to 0.93. A comparison between unweighted, weighted, and randomly weighted NHP scores was also performed. Results showed extremely high correlations between these scoring strategies, and a similar consistently satisfied using unweighted scores. Item weights comparison provided evidence of the cross-cultural equivalence of the adapted version. Nevertheless, the unweighted NHP scoring is recommended because weighted NHP items do not improve the psychometric properties of the instrument.

Adult↗
PubMed1996

Glomerular up-regulation of EIIIA and V120 fibronectin isoforms in proliferative immune complex nephritis.

Fibronectin: (FNs) comprise a family of adhesive glycoproteins that are prominent components of mesangial extracellular matrix and accumulate during glomerular injury. By alternative splicing of an unique mRNA precursor, various FN isoforms can be originated. In rat, three regions of the molecule are involved: EIIIA, EIIIB and V. Because specific FN isoforms are expressed in embryogenesis and wound healing, conditions characterized by cell migration and adhesion, we examined the pattern of FN isoforms in the mild and severe phases of a progressive immune complex proliferative nephritis in rats. We constructed specific probes to analyze the splicing pattern of FN pre-mRNAs by ribonuclease protection assays. FN mRNAs containing EIIIA, EIIIB and V regions increased along, the progression of nephritis, though the increment of EIIIB-FN mRNA was modest. However, different regulation of all these isoforms was observed. The percentage of FN mRNA containing the EIIIA exon versus total FN increased with the severity of the disease, while the percentage of FN mRNA containing the EIIIB exon decreased. Relative V-FN mRNA expression versus total FN mRNA increased only in the severe phase. By means of specific antibodies we also studied the presence of EIIIA, EIIIB and V-FN proteins in the kidney. In the normal glomerutus, EIIIA-FN protein was barely detectable in the mesangium, increasing in the mild phase of nephritis. In the severe phase of nephritis, increased EIIIA-FN was localized in the mesangium, in Bowman's capsule and in crescents. By contrast, EIIIB-FN protein in the glomerulus was absent even in the severe phase. V120-FN protein, an isoform that mediates the attachment of leukocytes through the VLA-4 integrin, was present in the mesangium and glomerular capillary loops in control animals, and increased in the severe phase of nephritis, coinciding with a strong leukocyte infiltration. In conclusion, our results show that during immune glomerular injury there were marked changes in the pattern of FN isoforms expression. Since those isoforms, particularly V120 isoform, are important in cell adhesion and migration, their up-regulation may facilitate the recruitment of cells into the injured glomeruli. The blockade of the interaction between V120-FN and infiltrating leukocytes may represent a new approach to the treatment of nephritis.

Alternative Splicing↗
PubMed1996

Proline iminopeptidase gene from Xanthomonas campestris pv. citri.

The pip gene coding for the proline iminopeptidase (Pip) of Xanthomonas campestris pv. citri was cloned in an Escherichia coli leuB strain using a selective medium containing the dipeptide D-Ala-L-Leu as the sole source of L-leucine. Nucleotide sequencing of this gene revealed a 939 bp open reading frame encoding a 312 amino acid protein (35 126 Da). The deduced amino acid sequence showed 47% identity with the Pip from Neisseria gonorrhoeae. A lacZ-pip fusion gene was overexpressed in E. coli under the control of the Plac promoter. The Pip of X. campestris hydrolysed L-prolyl-p-nitroanilide with the highest efficiency, but was also able to hydrolyse L-alanyl-p-nitroanilide and D-alanyl-p-nitroanilide. The molecular mass of Pip was found to be 35 kDa by SDS-PAGE and 120 kDa by gel filtration, suggesting that the active enzyme is a multimer.

Amino Acid Sequence↗
PubMed1996

Using length of stay and inactive days in the hospital to assess appropriateness of utilisation in Barcelona, Spain.

STUDY OBJECTIVE: To compare the level of inappropriate utilisation of a teaching hospital in two different calendar years and to analyse the relationship between changes in appropriateness of utilisation and changes in average length of stay. DESIGN: Retrospective evaluation of the medical records of patients admitted to a hospital in two periods: 1988 and 1990. SETTING: Hospital Universitari del Mar, a teaching hospital with 440 beds located in Barcelona, Catalònia, Spain. PARTICIPANTS: Medical records were randomly selected from records of adults discharged from hospital with a principal diagnosis other than normal delivery or any psychiatric condition. Altogether 750 records with complete data were reviewed for 1988 and 633 for 1990. MEASUREMENTS AND MAIN RESULTS: The appropriateness evaluation protocol (AEP) was used to assess whether or not the admission and each day of the hospital stay were appropriate. For data analysis we used the extension of logistic regression that allows quantification of within-patient clustering of inactive days. The average length of stay (LOS) was 11.7 days in 1988 and 9.5 in 1990 (p < 0.001). In contrast, the proportion of inappropriate admissions was 12% in 1988 and 19% in 1990 (p < 0.001). Among those patients who were appropriately admitted, the average odds of a given day being inactive in 1990 was no lower (OR = 1.09) than the odds in 1988, but the clustering of inactive days was significantly (p < 0.001) lower in 1990. CONCLUSIONS: In the hospital studied, a lower average length of stay was not associated with an improved level of appropriate utilisation. Policies exclusively focused on lowering LOS may not directly lead to a reduction in inappropriate hospital utilisation.

Adolescent↗
PubMed1996

Validity and reliability of the St George's Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example.

We describe the adaptation into Spanish of the St George's Respiratory Questionnaire (SGRQ), a self-administered questionnaire developed by Jones et al. (1991) covering three domains of health in airways disease patients: symptoms, activity and impacts. For the adaptation, the forward and back-translation method by bilinguals was used, together with professional committee and lay panel. Once tested for feasibility and comprehension, 318 male chronic obstructive pulmonary disease (COPD) patients with a wide range of disease severity completed the Spanish version of the SGRQ. The clinical status of the patients was evaluated concurrently with the measurement of health status. Lung function was assessed in the 2 months before or after the questionnaire administration. The Spanish version of the SGRQ was acceptable and easy to understand. Cronbach's alpha reliability coefficient was 0.94 for the overall scale and 0.72 for "Symptoms", 0.89 for "Activity", and 0.89 for "Impacts" subscales. Correlation coefficients between the overall score and dyspnoea and % forced expiratory volume in one second (FEV1) were 0.59 and -0.45, respectively, and these correlations were higher than those observed between the clinical variables and the Nottingham Health Profile, a generic measure of health-related quality of life. Results of the study suggest that the Spanish version of the SGRQ is conceptually equivalent to the original, and similarly reliable and valid. Although further studies should complete the adaptation work, results suggest that the SGRQ may already be used in Spain and in international studies involving Spanish respiratory patients. According to the present approach, it appears to be feasible to adapt a specific questionnaire on health-related quality of life in respiratory disease to another language and culture.

Cross-Cultural Comparison↗
PubMed1996

Neurospectroscopic alterations and globus pallidus hyperintensity as related magnetic resonance markers of reversible hepatic encephalopathy.

In patients with chronic hepatic encephalopathy, proton magnetic resonance spectroscopy can be used to detect specific metabolic abnormalities in the brain; MRI shows a hyperintense globus pallidus on T1-weighted sequences. We investigated the relationship between these two MR findings in a series of 25 patients with the use of quantitative data and a multiple regression analysis model. The cerebral increase in glutamine compounds and the decrease in myoinositol and choline correlated separately with globus pallidus hyperintensity, and each was complementary in accounting for this imaging finding. Such as association suggests that spectroscopic and imaging alterations are two different expressions of the reversible events that occur in the brain of patients with hepatic encephalopathy in that both disappear after liver transplantation. Globus pallidus hyperintensity seems to be a global indicator of the cerebral metabolic disorder, and the spectroscopic pattern denotes the specific metabolic alterations.

Aged↗
PubMed1996

[Usefulness of the preoperative electrocardiogram in elective surgery].

OBJECTIVES: To assess the prevalence of abnormal electrocardiograms (ECG) recorded routinely in patients undergoing elective surgery as well as the prevalence of ECG abnormalities that could not be predicted by the patient's medical history. To determine the influence of ECG results on patient care. To identify patient groups at high risk for abnormal ECG. PATIENTS AND METHODS: Retrospective study of 2,146 patients scheduled for non cardio-thoracic surgery requiring anesthesia. Two physicians reviewed the preoperative ECG reports in consultation with a cardiologist. The reports were considered normal, abnormal but expected or abnormal and unexpected based on agreement or not with the patient's medical history. RESULTS: The 161 (7.4%) patients for whom data was missing were excluded. Preoperative ECGs were performed in 1,898 (95.6%) cases. Abnormal ECG results were reported for 351 (18.5%), most often for men, patients over 45 years of age, those classified ASA III-V, those with cardiovascular disease, kidney failure and diabetes mellitus. Two hundred seventy unexpected abnormalities were found in 234 (12.3%) patients. Of these, 117 (43.3%) were considered major. The unexpected abnormalities motivated changes of attitude toward 4 (1.7%) patients, but new treatment was established for only 2 (0.8%) of them. The prevalence of unexpected abnormalities was higher in men, patients over 45 years of age and those classified as ASA III-V. CONCLUSIONS: The prevalence of unexpected preoperative ECG abnormalities among non cardio-thoracic surgical patients is high but the influence of such results is minimal. The sensitivity and specificity of preoperative ECG for detecting electrocardiographic abnormalities are low. We suggest that performance of ECG before surgery is useful in patients over 45 years of age or in those with cardiovascular disease, chronic kidney failure, diabetes mellitus, physical state ASA III-V and those for whom it has not been possible to obtain an adequate medical history or perform a complete physical.

Adolescent↗
PubMed1995

[The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results].

BACKGROUND: The present study, performed within the International Quality of Life Assessment project (including researchers from 15 countries) presents preliminary results of the process of adaptation of the SF-36 to be used in Spain. METHODS: The adaptation was based on the translation/back-translation methodology. Meetings of translators, researchers and patients were organized in order to produce successive versions. A study involving 47 individuals was carried out to assess the relative value (through a visual analogue scale) of each response choice of the questionnaire items. Finally, internal consistency and reproducibility of the Spanish version of the SF-36 was assessed by administering the questionnaire to 46 patients with stable coronary heart disease in two different occasions 2 weeks apart. RESULTS: The average ratings of equivalence of the translated version with the original were high regardless of the difficulty of translation. The rank ordering of mean scores for each responses choice agreed with the ranking assigned in the questionnaire in all cases. Cronbach's Alpha was higher than 0.7 for all dimensions (range: 0.71-0.94) except for Social Functioning scale (alpha = 0.45). Intraclass correlation coefficients between both administrations of the questionnaire ranged from 0.58 to 0.99. CONCLUSIONS: The adaptation process of the SF-36 has concluded with an instrument apparently equivalent to the original and with an acceptable level of reliability. Nevertheless, other basic characteristics of the adapted questionnaire (i.e. validity and sensitivity to changes) should be also assessed.

Adult↗
PubMed1995

Population awareness and control of hypertension and hypercholesterolemia. The Atherosclerosis Risk in Communities study.

BACKGROUND: A national program for hypertension detection and control was implemented in the 1970s, whereas a similar program for control of hypercholesterolemia has been implemented in recent years. We studied the levels of awareness, treatment, and control of these conditions in US population samples during a 3-year period (1987 to 1989). METHODS: The levels of awareness, treatment (by medication), and adequate control of hypertension (systolic blood pressure, > or = 140 mm Hg; diastolic blood pressure, > or = 90 mm Hg; or antihypertensive medication) and hypercholesterolemia (serum cholesterol level, > or = 6.21 mmol/L [> or = 240 mg/dL], or lipid-lowering medication) were studied among participants in the baseline examination of the Atherosclerosis Risk in Communities Study, including 15,739 individuals aged 45 to 64 years. RESULTS: Eighty-four percent of the hypertensive subjects and 42% of the hypercholesterolemic subjects were aware of their conditions. Overall, 50% of the hypertensive subjects and only 4% of the hypercholesterolemic subjects had their conditions both treated and controlled. Rates of hypertension prevalence, awareness, and control remained stable during the 3-year study period. Hypercholesterolemia prevalence decreased from 30% in 1987 to 25% in 1989; its awareness increased from 31% to 50% during the same period. Hypertensive women were more likely than hypertensive men to be aware and treated, whereas hypercholesterolemia awareness was higher in men than in women. Hypertension awareness was highest in black women, but black hypertensive subjects were less likely than whites to be treated and to have their hypertension controlled. Black hypercholesterolemic subjects were less likely to be either aware or treated. CONCLUSIONS: After the recent implementation of the National Cholesterol Education Program, the levels of awareness, treatment, and control of hypercholesterolemia are improving at a high rate, although they are still substantially lower than those for hypertension. Further improvement is necessary, particularly among certain population groups, such as blacks.

Age Distribution↗
PubMed1995

Detection of pectinesterase in polyacrylamide gels.

A rapid and sensitive method of detecting pectinesterase activity following electrophoresis or isoelectric focusing in polyacrylamide gels is described. The method uses ruthenium red and requires no addition of substrate when making the gels, thus obviating direct enzyme-substrate contact during electrophoresis. Because of its versatility, the method can be used in a wide variety of applications, such as plant and microbial taxonomy, enzyme purification and characterization, or as an analytical method in fresh and processed plant technology.

Carboxylic Ester Hydrolases↗
PubMed1995

Fatal meningoencephalitis caused by Scedosporium inflatum (Scedosporium prolificans) in a child with lymphoblastic leukemia.

A fatal case of meningoencephalitis caused by Scedosporium inflatum (Scedosporium prolificans) in a 5-year-old boy with acute myeloblastic leukemia who was given intrathecal treatment is reported. Itraconazole treatment was ineffective. The fungus was identified on brain sections at autopsy and was not observed in any other organ. As no other portal of entry was detected, meningoencephalitis may have originated via direct introduction of the fungus at therapeutic lumbar puncture.

Child, Preschool↗
PubMed1995

Re-scaling the Spanish version of the Sickness Impact Profile: an opportunity for the assessment of cross-cultural equivalence.

The Sickness Impact Profile (SIP), a behaviour-based measure of health status developed in the US, was adapted into Spanish. The aim of this study was to obtain the item weights of the Spanish version, to compare these weights with those of the original instrument, and to assess cross-cultural differences that may affect scale equivalence. Following the original work, weights for the Spanish items were obtained using the equal appearing intervals methodology in two groups of judges: 25 health professionals and 120 consumers. Correlation between professionals' and consumers' item weights was 0.93, thus data were combined for further analysis. Correlations between Spanish and American item weights was 0.89 (p < 0.001). Among each SIP category, correlations ranged from 0.61 to 0.99. Cultural differences were found among social items belonging to the social interaction category. While specific cultural differences exist when specific item weights were compared, overall cultural differences were not relevant. For practical purposes, the American and Spanish versions of the SIP should be considered cross-culturally equivalent.

Adult↗
PubMed1995

[The quality-of-life questionnaire with asthma patients: the Spanish version of the Asthma Quality of Life Questionnaire].

This paper describes the translation to Castilian and adaptation of a quality of life measurement instrument: the Asthma Quality of Life Questionnaire (AQLQ). The AQLQ, developed by Juniper et al, contains 32 items, 5 of which relate to habitual activities that the patient can choose from among a list of 26 possibilities. Answers are given on a scale of 7 points. To adapt this instrument for use in Spain, we subjected it to a process of translation/back translation by bilingual informants. The translated and original versions of each item, activity and answer option were evaluated as being totally equivalent (A), fairly equivalent but with some questionable wording (B), or of questionable equivalence (C). The naturalness and correctness of the Spanish version were also evaluated on a scale of 1 to 10. Three (9%) items and 1 (4%) activity were considered to be of questionable equivalence (C) and 12 (37%) items and 1 activity (4%) were considered to be of type B equivalence. The questionable aspects of types B and C equivalence were discussed in 2 meetings, along with expressions that were equivalent but unnatural or grammatically incorrect; the first meeting involved researchers and translators and the second was held with a group of 6 asthmatics. Consensus was finally obtained for each item and activity included in the second draft. That draft was then administered to another group of 7 patients in order to check comprehension and equivalence, after which a definitive version was produced by the researchers.(ABSTRACT TRUNCATED AT 250 WORDS)

Asthma↗
PubMed1995

Relationship of health behaviours to five-year mortality in an elderly cohort.

To assess the risk of mortality associated with different health behaviours in a Mediterranean elderly population, we have analysed the mortality experience of a cohort of 1219 non-institutionalized men and women aged 65 years or over, who had participated in the 1986 Health Interview Survey of Barcelona. At baseline, self-reported information on smoking, alcohol consumption, physical activity, and hours of daily sleep was collected through face-to-face home interviews. After 5 years of follow-up, a total of 224 (18.4%) participants had died. After adjusting for age, level of education and perceived health status, current smokers at baseline had a relative risk of dying during the follow-up of 3.0 [95% confidence interval (CI) 1.78, 5.04] compared with non-smokers. Those reporting moderate alcohol consumption had a relative risk of dying of 0.38 (95% CI 0.17, 0.86) compared with abstainers. Finally, individuals who reported a sedentary life-style had a risk of dying of 1.53 (95% CI 1.08, 2.15) compared with the more active. Although limited for interpreting associations as causal relationships, our results add to the evidence that the adverse effects on survival of smoking and of being sedentary extend later into life. Because of the high prevalence of a sedentary life-style among elderly people, results suggest that promoting physical activity may have an important role in enhancing survival in this age group.

Activities of Daily Living↗