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Biomedical subjects

J Alonso

Publications and source records attributed to J Alonso.

298 records · Page 17Linked to original sources
PubMedDate not supplied

[Epidemiology of mental disorders in Spain: methods and participation in the ESEMeD-Spain project].

INTRODUCTION: The ESEMeD-Spain study is part of a European project on the epidemiology of mental disorders, which is also part of a World Health Organization initiative called World Mental Health Surveys. The main objectives of the study are to estimate the prevalence of mental disorders in Spain; to analyze their association with sociodemographic variables and predisposing and protective factors; to evaluate their impact on the quality of life; and to describe and evaluate the health care received by people with mental disorders. METHODS: A representative sample of the noninstitutionalized Spanish population older than 18 years is interviewed. Sample size is 5,500 people. The instrument used in the interviews is the Composite International Diagnostic Interview (CIDI), a questionnaire designed to be used by lay interviewers that allows the diagnosis of psychiatric disorders. Strict quality control of field work has been established. Furthermore, approximately 200 subjects are re-interviewed by a psychiatrist using the Structured Clinical Interview for DSM-IV (SCID) and several questionnaires to measure clinical severity. RESULTS: Field work started in September 2001 and finished in November 2002. Up to Ap ril 2002, more than 4,300 people have been interviewed. Preliminary response rate has been 68.7%. Comparison of the age and gender of the study sample with the general Spanish population shows high representativeness. CONCLUSIONS: The ESEMeD-Spain project will produce un - precedented scientific information about the epidemiology of mental disorders in Spain.

Adult↗
PubMedDate not supplied

[Complete atrioventricular canal and tetralogy of Fallot: surgical considerations].

Nine patients with complete atrioventricular canal and tetralogy of Fallot underwent intracardiac repair of both anomalies between 1982 and 1989. The ages of the patients ranged from 6 months to 7 years. Six of the 9 had one or more previous systemic-pulmonary artery shunts. Two-dimensional echocardiography showed diagnostic characteristics of both malformations in all patients. The diagnosis was confirmed by cardiac catheterization and cineangiography. The ventricular septal defect was repaired by a combined right atrial and ventricular approach in every patient. Outflow tract reconstruction was performed with the use of a transannular patch (4), infundibular patch (4), and a valved conduit (1). There were no hospital deaths. Meningitis was responsible for the death of a patient 2 years after repair. We recommend early palliation, complete repair in those older than 4 or 5 years, surgical technique depending on the anatomical findings, combined atrial and ventricular approach, 2 separate patches to close the ventricular septal defect in required cases, adjusted correction of the right ventricular outflow tract, and careful postoperative care.

Child↗
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Successful surgical treatment of a case of listeria monocytogenes endocarditis.

Endocarditis due to listeria monocytogenes is rare with only twenty one cases to our knowledge appearing in the world's literature to date. We report a further case with a successful surgical outcome and stress the importance of surgery in the treatment of infective endocarditis. There is a clear predilection of this organism for the left side of the heart and systemic embolization is frequent. In contrast to other clinical forms of listeriosis, endocarditis has not been associated with debilitating states or immunosuppressive treatments. Though clinical and laboratory data suggest a similarity with other types of bacterial endocarditis, the prognosis is more unfavorable and the mortality rate higher.

Aortic Valve↗
PubMedDate not supplied

Cutaneous infection with rapidly growing mycobacteria in patients with systemic rheumatic disease.

We report two patients with systemic rheumatic disease being treated with steroids whose cases were complicated by subcutaneous nodules. In both, clinical and histological features suggested cutaneous infection and M. chelonae was isolated from skin specimens. Antibiotic therapy in both and surgery in one led to healing after a prolonged course. A review of the literature and our experience with these two patients suggest that rheumatic patients on steroid therapy are at risk of infection with these unusual pathogens. Knowledge of the risk factors and the distinctive picture of cutaneous mycobacteriosis should improve its diagnosis and therapy.

Adult↗
PubMedDate not supplied

[Usefulness of preoperative chest radiography in elective surgery].

OBJECTIVES: To study the prevalence of abnormalities in preoperative chest X-rays taken of patients undergoing elective surgery; to determine radiological abnormalities not expected based on the patient's case history and their influence on treatment; and to identify patients with high risk of presenting abnormal radiographs. PATIENTS AND METHODS: This retrospective study included 2,146 consecutive patients entering the hospital over a period of one year for non-cardiopulmonary surgery requiring anesthesia. Two physicians reviewed the radiodiagnostic reports on routine preoperative chest X-rays requested by surgeons. The reviewers classified the results as normal, expected abnormal and unexpected abnormal based on concordance or not between the patient's case history and the radiologist's report. RESULTS: Of the original 2,146 patients, 160 (7.4%) were excluded from the study because of incomplete case histories and/or physical exams. X-rays were taken of 1,880 (94.6%) of the 1,986 patients remaining in the study. Abnormalities were found in 508 (27%), most often in men, patients over 45, those classified as ASA III-V and those with a history of cardiovascular or lung disease, or smokers of more than 20 cigarettes/day. In 254 (13.5%), the abnormalities were not expected based on the patient's history; the physician's attitude changed toward 11 of these (4.3%), 5 of whom had cancer. Unexpected abnormalities were detected in 2 patients (0.8%) during physical examination and the real index of unexpected attitude changes based on case history and physical examination was 9 (3.5%). A new treatment based on unexpected radiological abnormalities was chosen for only 2 (0.8%) patients. The prevalence of unexpected radiological abnormalities was higher in men, in those over 45 years old and in those classified as ASA III-V. CONCLUSIONS: The prevalence of unexpected abnormalities in routine preoperative chest X-rays taken before non-cardiothoracic elective surgery is high, but the influence of their detection on patient management is minimal. The results of our study suggest that X-rays should be recommended for patients over 45; those with a history of cardiovascular or lung disease, or of cancer; smokers of more than 20 cigarettes/day; those classified as ASA III-V; and those with incomplete case histories or physical examinations.

Adolescent↗