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Biomedical subjects

J Alonso

Publications and source records attributed to J Alonso.

At least 199 records · Page 11Linked to original sources
PubMed1995

Measurement of general health status in obstructive sleep apnea hypopnea patients.

Sleep apnea hypopnea syndrome (SAHS) is an entity that occurs frequently in the population and produces an elevated morbidity and mortality, especially at an apnea index greater than 20 events per hour. To our knowledge there are only a few studies available addressing the general health status of sleep apnea hypopnea patients. Such information may be useful for both clinical management and better understanding of the physiopathological mechanisms of the disease, particularly with the consideration that not infrequently the physiological disturbances found in such patients do not always agree with their own health perception. Therefore, the aim of the present study was to assess the general health status and the degree of daytime somnolence, as a major symptom in SAHS patients, and relate them to the number of respiratory events per hour. Measurements of general health status and the degree of daytime somnolence were assessed in 103 consecutive patients 50.4 +/- 12 years old [mean +/- standard deviation (SD)] with an apnea/hypopnea index (AHI) of 38 +/- 27 events per hour. Forty nonsnoring healthy subjects were used as the control group. During the afternoon preceding the full polysomnography, a medical history was taken; basic anthropometric data and the presence of other diseases were recorded. The Nottingham Health Profile (NHP) questionnaire and a questionnaire assessing the degree of daytime somnolence were administered to the patients. No significant differences were found in the general health status and the degree of daytime hypersomnolence when patients were divided into three groups according to the severity of the respiratory events during the night, but there were significant differences between SAHS patients and control subjects. It was concluded that in spite of the fact that SAHS patients showed a deterioration of general health status parameters in comparison with healthy subjects, these parameters do not correlate with the physiological disturbances of SAHS, expressed as the number of respiratory events per hour.

Adult↗
PubMed1995

Fibronectin (FN) decreases glomerular lesions and synthesis of tumour necrosis factor-alpha (TNF-alpha), platelet-activating factor (PAF) and FN in proliferative glomerulonephritis.

We have studied the effect of therapy with plasma FN on glomerular synthesis of PAF, TNF-alpha and FN, in experimental proliferative glomerulonephritis. Glomerular PAF, TNF-alpha and FN production were increased in rats with nephritis. Peak glomerular PAF production preceded, while peak glomerular TNF-alpha bioactivity coincided with maximal proteinuria. Rats treated with FN (5 mg/kg per 48 h) for 15 days had less proteinuria, glomerular and interstitial cell infiltration and glomerular PAF, TNF-alpha and FN synthesis than non-treated rats. In order to characterize further the mechanisms of action of FN, healthy rats were injected with either FN or saline. Peripheral blood mononuclear cells and neutrophils from healthy rats injected with FN secreted less TNF-alpha and PAF, respectively, than those obtained from saline-treated rats. Our data suggest that the beneficial effect of FN may be related to decreased number of glomerular leucocytes and decreased synthesis of inflammatory mediators and extracellular matrix.

Animals↗
PubMed1995

Involvement of tumor necrosis factor-alpha in the pathogenesis of experimental and human glomerulonephritis.

The evidence supporting a role for TNF-alpha in glomerular diseases can be summarized with the following: TNF-alpha can be secreted in the kidney by intrinsic renal cells and infiltrating phagocytes, as has been shown in vitro and in vivo during glomerular injury. TNF-alpha has proinflammatory actions which include cell death, chemotactic properties, and modulation of secretion of other inflammatory mediators, and extracellular matrix (Fig 5). Administration of exogenous TNF-alpha or agents that induce release of endogenous TNF alpha, such as endotoxin, increase the severity of experimental glomerular injury. Furthermore, the blockade of TNF-alpha action with specific antibodies, soluble receptors, or inhibitors improves the outcome of glomerulonephritis. Finally, several of the agents currently in use for the therapy of glomerular injury, such as corticosteroids and cyclosporine, are known to modulate the production of TNF-alpha. Specific TNF-alpha antagonists or inhibitors may have a role in the management of glomerulonephritis in the future.

Animals↗
PubMed1994

[Adaptation of a measure of dysfunction-related illness: the Spanish version of Sickness Impact Profile].

BACKGROUND: The aim of the research was to adapt the Sickness Impact Profile (SIP) for their use in Spain. The Sickness Impact Profile is a questionnaire that measure the dysfunction related illness in 12 categories. It contain 136 items weighted by the relative importance in each category. In the present article we described the translation and the preliminary weighting process of each item and category. METHODS: In the translation we used the back-translation method by means of English-American and Spanish bilinguals. The items with equivalence B or C were discussed with a group of patients until to reach an agreement in the version. The scaling was carried out by 25 judges (health professionals). Following the same methodology as the original version, the judges firstly placed the relative values of each item in each category on an interval scale of 1 (minimal dysfunction) to 11 (maximal dysfunction) points; secondly the items most and least dysfunctional in each category were placed on a 1-15 interval scale (method of equal appearing intervals). RESULTS: In the translation process we identify 12 items with equivalence B or C. The results showed a high correlation between the values obtained by each judge and the mean values of the judges by item (0.64-0.81). The items were rated with a standard deviation of the mean of 1.91 and a standard deviation of the standard deviation of 0.52. The correlation between Spanish and American values was r = 0.84 (p < 0.001). CONCLUSIONS: Given the low number of non-equivalent items, the high agreement among the judges in the valuation of the items and the high correlations obtained between the Spanish and American weights, we conclude that the cross-cultural process have been satisfactory. The results should be to repeat in a sample of health consumers. The process of adaptation of the Spanish version will not finish until that the validity and reliability are similar to those of the original version.

Activities of Daily Living↗
PubMed1994

The Spanish version of the Nottingham Health Profile: a review of adaptation and instrument characteristics.

The increased interest in measuring health status implies a need for instruments that are appropriate and valid. Adaptation of existing instruments may be a cost-effective strategy. In this paper we describe the adaptation into Spanish of the Nottingham Health Profile (NHP), a self-administered perceived health questionnaire developed in the UK. The characteristics of the adapted questionnaire (validity, reliability, and sensitivity to change), as well as current and purposed applications, are discussed. Some of the principles that were applied in the described adaptation process may be useful for similar future research: involving the investigators that developed the original instrument; using a panel of lay individuals in the translation process; testing the characteristics of the adapted instrument by replicating previous studies with the original instrument, and organizing an international group for the development and use of the European versions of the NHP. Adaptation of health status measures is an opportunity for gaining comparability when measuring health, and for learning about cross-cultural differences in health-related quality of life.

Adult↗
PubMed1994

Reliability of the Spanish version of the Nottingham Health Profile in patients with stable end-stage renal disease.

OBJECTIVE: Since reproducibility of results is a basic prerequisite of health status measures for its use in prospective and evaluative studies, the reliability of the Spanish version of the Nottingham Health Profile (NHP), a multi-dimensional perceived health status measure, was assessed in a sample of stable end-stage renal disease (ESRD) patients. METHODS: The NHP was administered on two occasions four weeks apart to a group of hospital hemodialysis program patients who were clinically stable according to their physicians. Correlations of scores and agreement of first and second administrations were assessed together with internal consistency. Afterwards, analyses were repeated taking into account the time (before, during or after the dialysis) and the method of administration (self vs interviewer), and the interviewer. RESULTS: Spearman correlation coefficients (rs) between responses to the first and to the second administration were > 0.6 for all of the six dimensions of the NHP (range = 0.69-0.85) and in every sub-group analyzed (P < 0.01). Agreement percent (AP) between items was > 0.4 (0.48-0.65). Internal consistency was 0.91 for the whole profile and > 0.5 (0.58-0.86) when analyzed by individual dimensions. Reliability did not vary significantly with the time nor the method of administration (self or interviewer). CONCLUSIONS: Overall, results suggest that the Spanish version of NHP is sufficiently reliable to be used in ESRD patients. While a higher reliability would have been achieved by a shorter retest period, the study provides a realistic approximation to the reliability of the questionnaire in actual research and clinical applications.

Female↗
PubMed1994

Diuretic action of an aqueous extract of Lepidium latifolium L.

An aqueous extract of Lepidium latifolium L. given orally and intraperitoneally considerably enhanced urinary excretion (UV) in rats with respect to control groups. A slight increase in ion excretion was also observed. Other parameters such as specific gravity, nitrite, pH, glucose, ketone bodies, urobilinogen, and blood were also studied. A good correlation for the dosage rat/man for the aqueous extract was achieved.

Administration, Oral↗
PubMed1994

Analyzing health outcomes through international comparisons.

There is increasing interest in the conduct of international studies that compare health care outcomes. This paper draws from the literature in sociology, anthropology, and psychology to examine the problems that can be encountered when collecting primary data for comparative purposes. Issues of study design, selection, development, and adaptation of instruments, problems encountered in collecting primary data, and techniques for analyzing comparative data are discussed. The paper is intended as a primer for health services researchers conducting comparative outcomes research in international settings.

Data Collection↗
PubMed1994

The potential role of inflammatory and fibrogenic cytokines in the glomerular diseases.

In recent years increasing evidence has been accumulated on the role of cytokines in mediating glomerular and renal damage. Many such cytokines are released in the inflamed glomeruli by leukocytes and intrinsic glomerular cells. Cytokines not only recruit inflammatory cells into the injured glomeruli, but also induce a variety of responses on glomerular cells that range from a direct toxic effect to shape changes, proliferation, and induction of the release of inflammatory mediators and extracellular matrix, and could promote further glomerular damage. Moreover, exogenous administration of cytokines has induced glomerular injury in healthy animals and has enhanced renal damage in animals with glomerulonephritis. Anti-cytokine strategies have proved to be effective therapeutical alternatives in experimental models of glomerular diseases and may provide a more specific approach to the management of human glomerulonephritis.

Animals↗
PubMed1993

[The prevalence of mental illness in primary care and its relation to the degree of consultation frequency].

OBJECTIVE: To establish the prevalence of psychic malaise within the population that consults the general medical clinic of our health center and the relationship between that prevalence and the frequency of consultation. DESIGN: Transversal descriptive study applying the GHQ test (28 items) to a sample obtained by mathematical sampling, using a questionnaire to collect sociodemographic data. SITE. The Health Center Segovia II (La Albuera) during November and December 1991. PATIENTS OR OTHER PARTICIPANTS: 360 patients over the age of fifteen were selected; 252 answered the test. MAIN MEASUREMENTS AND RESULTS: Considering the GHQ test as positive when score seven or more, a prevalence of psychic malaise of 33% was obtained. We found a statistically significant relationship between positive GHQ test and the frequency of consultation (p < 0.001) and female gender (p < 0.01). No statistically significant relationship was found between psychic malaise and the following variables: age, marital status, educational level and occupation. CONCLUSIONS: There is a high prevalence of psychic malaise within the population attending our general practice which can produce an increase in the demand. A biopsychosocial approach to all patients, with the aim of identifying that kind of problem and approaching it adequately, could reduce the use of health resources.

Adolescent↗
PubMed1993

[Inadequate hospital admissions and inactive days of hospital stay in patients with chronic obstructive pulmonary disease and lung neoplasms].

BACKGROUND: This study was carried out to evaluate the hypothesis that the proportion of inadequate hospital admissions and days is greater in patients with pulmonary neoplasm than in patients with chronic obstructive pulmonary disease (COPD) given the therapeutic and diagnostic features of both diseases and to establish the applicability of the Appropriateness Evaluation Protocol (AEP). METHODS: A retrospective review was performed of the medical records of patients admitted for COPD and pulmonary neoplasm. Two external physicians reviewed the clinical histories using the AEP. Admissions and hospital days considered as potentially inadequate by the reviewers were supervised by a clinical epidemiological panel which confirmed and identified the causes for inadequacy. One hundred sixty-six patients admitted with COPD and 79 with pulmonary neoplasm selected by a systematic sample of admissions whose principal diagnosis was COPD or pulmonary neoplasm were studied over one year in a tertiary level teaching hospital in Barcelona. RESULTS: It was found that 4.8% of the admissions with COPD and 15.5% of the days of hospital stay were inappropriate while in patients with pulmonary neoplasm 14% of the admissions and 40% of the days of hospital stay were inappropriate. The main causes of inadequacy were: social (33.3% in patients with COPD); patients inadequately admitted but who remained in hospital to undergo diagnostic tests which could have been performed on an out patients basis (46% in patients with pulmonary neoplasm). CONCLUSIONS: Inappropriateness was greater in admissions and in hospital days with greater diagnostic components (pulmonary neoplasm) than in fundamentally therapeutic cases (COPD). The Appropriateness Evaluation Protocol was valid in this hospital with the supervising panel being very useful in the judgement of cases not clearly established in the protocol. The level of inadequacy was found to be similar to that of other studies although the results are not directly comparable.

Aged↗