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J Alonso

Publications and source records attributed to J Alonso.

At least 37 records · Page 2Linked to original sources
PubMed2004

12-Month comorbidity patterns and associated factors in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project.

OBJECTIVE: Comorbidity patterns of 12-month mood, anxiety and alcohol disorders and socio-demographic factors associated with comorbidity were studied among the general population of six European countries. METHOD: Data were derived from the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross-sectional psychiatric epidemiological study in a representative sample of adults aged 18 years or older in Belgium, France, Germany, Italy, the Netherlands and Spain. The diagnostic instrument used was the Composite International Diagnostic Interview (WMH-CIDI). Data are based on 21 425 completed interviews. RESULTS: In general, high associations were found within the separate anxiety disorders and between mood and anxiety disorders. Lowest comorbidity associations were found for specific phobia and alcohol abuse-the disorders with the least functional disabilities. Comorbidity patterns were consistent cross-nationally. Associated factors for comorbidity of mood and anxiety disorders were female gender, younger age, lower educational level, higher degree of urbanicity, not living with a partner and unemployment. Only younger people were at greater risk for comorbidity of alcohol disorder with mood, anxiety disorders or both. CONCLUSION: High levels of comorbidity are found in the general population. Comorbidity is more common in specific groups. To reduce psychiatric burden, early intervention in populations with a primary disorder is important to prevent comorbidity.

Adolescent↗
PubMed2004

Disability and quality of life impact of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project.

OBJECTIVE: This manuscript examines the impact of mental health state and specific mental and physical disorders on work role disability and quality of life in six European countries. METHOD: The ESEMeD study was conducted in: Belgium, France, Germany, Italy, the Netherlands and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an in-home computer-assisted interview. Common mental disorders, work loss days (WLD) in the past month and quality of life (QoL) were assessed, using the WMH-2000 version of the CIDI, the WHODAS-II, and the mental and physical component scores (MCS, PCS) of the 12-item short form, respectively. The presence of five chronic physical disorders: arthritis, heart disease, lung disease, diabetes and neurological disease was also assessed. Multivariate regression techniques were used to identify the independent association of mental and physical disorders while controlling for gender, age and country. RESULTS: In each country, WLD and loss of QoL increased with the number of disorders. Most mental disorders had approximately 1.0 SD-unit lower mean MCS and lost three to four times more work days, compared with people without any 12-month mental disorder. The 10 disorders with the highest independent impact on WLD were: neurological disease, panic disorder, PTSD, major depressive episode, dysthymia, specific phobia, social phobia, arthritis, agoraphobia and heart disease. The impact of mental vs. physical disorders on QoL was specific, with mental disorders impacting more on MCS and physical disorders more on PCS. Compared to physical disorders, mental disorders had generally stronger 'cross-domain' effects. CONCLUSION: The results suggest that mental disorders are important determinants of work role disability and quality of life, often outnumbering the impact of common chronic physical disorders.

Adult↗
PubMed2004

Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project.

OBJECTIVE: Comprehensive information about access and patterns of use of mental health services in Europe is lacking. We present the first results of the use of health services for mental disorders in six European countries as part of the ESEMeD project. METHOD: The study was conducted in: Belgium, France, Germany, Italy, the Netherlands and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an computer-assisted interview done at home. The 21 425 participants were asked to report how frequently they consulted formal health services due to their emotions or mental health, the type of professional they consulted and the treatment they received as a result of their consultation in the previous year. RESULTS: An average of 6.4% of the total sample had consulted formal health services in the previous 12 months. Of the participants with a 12-month mental disorder, 25.7% had consulted a formal health service during that period. This proportion was higher for individuals with a mood disorder (36.5%, 95% CI 32.5-40.5) than for those with anxiety disorders (26.1%, 95% CI 23.1-29.1). Among individuals with a 12-month mental disorder who had contacted the health services 12 months previously, approximately two-thirds had contacted a mental health professional. Among those with a 12-month mental disorder consulting formal health services, 21.2% received no treatment. CONCLUSION: The ESEMeD results suggest that the use of health services is limited among individuals with mental disorders in the European countries studied. The factors associated with this limited access and their implications deserve further research.

Adult↗
PubMed2004

Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project.

OBJECTIVE: To assess psychotropic drug utilization in the general population of six European countries, and the pattern of use in individuals with different DSM-IV diagnoses of 12-month mental disorders. METHOD: Data were derived from the European Study of the Epidemiology of Mental Disorders (ESEMeD/MHEDEA 2000), a cross-sectional psychiatric epidemiological study in a representative sample of 21 425 adults aged 18 or older from six European countries (e.g. Belgium, France, Germany, Italy, the Netherlands and Spain). Individuals were asked about any psychotropic drug use in the past 12 months, even if they used the drug(s) just once. A colour booklet containing high-quality pictures of psychotropic drugs commonly used to treat mental disorders was provided to help respondents recall drug use. RESULTS: Psychotropic drug utilization is generally low in individuals with any 12-month mental disorder (32.6%). The extent of psychotropic drug utilization varied according to the specific DSM-IV diagnosis. Among individuals with a 12-month diagnosis of pure major depression, only 21.2% had received any antidepressants within the same period; the exclusive use of antidepressants was even lower (4.6%), while more individuals took only anxiolytics (18.4%). CONCLUSION: These data question the appropriateness of current pharmacological treatments, particularly for major depression, in which under-treatment is coupled with the high use of non-specific medications, such as anxiolytics.

Adolescent↗
PubMed2003

Utility of proton MR spectroscopy in the diagnosis of radiologically atypical intracranial meningiomas.

Our aim was to evaluate the usefulness of proton MR spectroscopy ((1)H MRS) in the diagnosis of radiologically atypical brain meningiomas. We studied 37 patients with intracranial meningiomas with MRI and (1)H MRS (TE 136 ms). Their spectra were quantitatively assessed and compared with those of 93 other intracranial brain neoplasms: 15 low-grade and 14 anaplastic astrocytomas, 30 glioblastomas and 34 metastases. The most characteristic features of meningiomas were the presence of alanine, high relative concentrations of choline and glutamine/glutamate and low concentrations of creatine-containing compounds, N-acetyl-containing compounds and lipids. These resonances were assembled in algorithms for two-way differentiation between meningioma and the other tumours. The performance of the algorithms was tested in the 130 patients using the leave-one-out method, with 94% success in differentiating between meningioma and other tumour. Of the 37 meningiomas, five (14%) were thought atypical on MRI, and in only one of these, found to be malignant on histology, was a diagnosis other than meningioma suggested by the algorithm. The other four were correctly classified. We suggest that (1)H MRS provides information on intracranial meningiomas which may be useful in diagnosis of radiologically atypical cases.

Adolescent↗
PubMed2003

The concentrations and bioconcentration factors of copper and zinc in edible mushrooms.

Copper and zinc contents have been determined in up to 28 species of edible mushrooms from different sites in the province of Lugo (NW Spain). Two hundred thirty-eight collected samples were analyzed by an anodic stripping voltammetric technique using a drop mercury as the working electrode. The results showed that the element concentrations were species-dependent, and the highest metal levels corresponded to the following species: Calvatia utriformis (235.5 mg Cu/kg), Macrolepiota procera (217.8 mg Cu/kg), and Agaricus macrosporus (217.7 mg Cu/kg) and Calvatia utriformis (265.8 mg Zn/kg), Lactarius delicious (231.0 mg Zn/kg), and Agaricus macrosporus (221.3 mg Zn/kg) for Cu and Zn, respectively. All mushroom species bioaccumulated copper and zinc. Nevertheless, some individual samples of the species, such as Hydnum repandum, Cantharellus cibarius, and Coprinus comatus, were bioexclusors (BCF < 1). The hymenophore in mushrooms showed higher mean metal levels than the rest of the fruit bodies, with statistically significant differences. The copper and zinc concentrations were compared to literature data and levels set by legislation. It can be concluded that the consumption of these mushrooms cannot be considered a toxicological risk, and they provide an important nutritional requirement to the diet.

Agaricales↗
PubMed2003

Burden of illness of Crohn's disease in Spain.

OBJECTIVE: To evaluate the burden of Crohn's disease in Spain. DESIGN: Observational, cross-sectional study of patients affected with Crohn's disease who were attended to in hospitals in Spain. METHODS: Three structured questionnaires were used: one completed by the gastroenterologists to obtain demographic, clinical and disease activity data; a phone interview to obtain epidemiological and drug utilisation data; and the Spanish version of the Short-Form Health Survey (SF-36). RESULTS: The annual cost per patient was estimated at Euro 6808-Euro 2104 from direct medical costs and Euro 4704 from indirect costs. Approximate effect sizes for health-related quality of life were as follows: 0.8 for general health, social function, role functioning--physical and vitality; 0.5 for role functioning--emotional, body pain and mental health; and 0.2 for physical function. CONCLUSION: Crohn's disease causes a significant decrease in health-related quality of life for patients and a considerable economic cost to society, mainly due to hospitalisations and loss of productivity. This burden indicates the importance of health programmes and interventions in reducing the heavy impact of the disease on both patients and society.

Adult↗
PubMed2003

[Bone scintigraphy and somatostatin receptor scintigraphy in pediatric patients with bone involvement in Langerhans cell histiocytosis].

Langerhans cell histiocytosis (LCH) is a granulomatous disease which can involve multiples sites of the body. Diagnostic imaging is of utmost importance in the management of these patients. Up to now radiographic skeletal survey and bone scintigraphy (BS) have been used to assess bone involvement (both with low specificity). Magnetic resonance imaging (MRI) and CT have been used to assess visceral involvement but with the limitation that they cannot give information about the functional status. Recently somatostatin receptor scintigraphy (SSRS) has been proposed to detect active lesions and to monitor response to treatment. The aim of this study is to assess bone and somatostatin receptor scintigraphy in the detection of bone involvement in LCH in children. Twenty scintigraphies (12 SSRS and 8 BS) were performed in seven patients (3 girls and 4 boys) aged at diagnosis: 18 month-12 years (mean age 6 years). The findings obtained in the scintigraphies were compared with clinical evolution and other imaging techniques. Bone scintigraphy detected all the LCH bone lesions, and discovered one unknown lesion. SSRS scintigraphy visualised the active lesions in 3 patients (clinical and other imaging techniques were also positive). SSRS was negative in one patient classified as disease free and another in clinical remission. SSRS detected 2 new unknown bone lesions, but could not detect LCH bone lesions confirmed in other imaging techniques in 2 patients. Somatostatin receptor and Bone scintigraphy can be used to detect active LCH bone lesions in children and can help to monitor response to treatment. Further studies with more patients are needed to confirm the diagnostic usefulness of these techniques.

Biomarkers↗
PubMed2003

The Spanish version of the Child Health and Illness Profile-Adolescent Edition (CHIP-AE).

The aim of the study was to obtain a conceptually equivalent Spanish version of the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), and to test its feasibility, reliability and preliminary construct validity. The methodology used for adaptation was forward-back translation, including two focus groups with adolescents and a panel of experts. Reliability and validity were assessed in healthy convenience samples from school settings (n = 417). Three different illness groups (n = 67) were used to examine differences in health status between healthy, acutely ill, chronically ill and mentally ill adolescents. Preliminary construct validity was examined by comparing mean scores for each of the subdomains to determine if they differed in predicted ways according to age, gender and illness group. The majority of items (154 out of 203) were conceptually equivalent to the original version. Some items (46) had to be modified to increase clarity and/or to adapt them for use in Spain and 3 items were considered not applicable. Single construct subdomains achieved alpha coefficients between 0.65 and 0.92, and intraclass correlation coefficients (ICC) between 0.57 and 0.93. The mentally ill group presented the worst scores in most domains. The Spanish CHIP-AE is acceptable for Spanish adolescents and shows adequate metric characteristics, which are similar to those reported in the US version.

Activities of Daily Living↗
PubMed2003

The European Schizophrenia Outpatient Health Outcomes Study: baseline findings across country and treatment.

OBJECTIVE: To describe the baseline findings and study population of the Schizophrenia Outpatient Health Outcomes (SOHO) Study. METHOD: The SOHO study is an ongoing, large, prospective, long-term observational study of schizophrenia treatment in 10 European countries. The study population consists of out-patients who initiate therapy or change to a new antipsychotic. RESULTS: A total of 1096 investigators enrolled 10 972 patients. Approximately 60% of patients were men and the mean age was 40 years. Patients treated with clozapine and more than one antipsychotic are more severely ill, patients receiving depot medications have a history of non-compliance, and patients receiving their first antipsychotic for schizophrenia are most likely to receive an atypical agent. CONCLUSION: The SOHO study population appears to represent European out-patients with schizophrenia in whom a treatment decision is required. Baseline findings reflect European clinical practice with respect to patients treated with individual antipsychotics.

Adult↗
PubMed2003

The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia.

OBJECTIVE: To describe the development and validation of the Clinical Global Impression-Schizophrenia (CGI-SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. METHOD: The CGI-SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter-rater reliability, all patients were assessed by two clinicians. RESULTS: Symptoms were assessed in 114 patients. Correlation coefficients between the CGI-SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). CONCLUSION: The CGI-SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice.

Adult↗
PubMed2003

A Rasch model analysis to test the cross-cultural validity of the EuroQoL-5D in the Schizophrenia Outpatient Health Outcomes Study.

OBJECTIVE: To investigate the pan-European, cross-cultural validity of the EuroQol-5D (EQ-5D) for assessing quality of life in the Schizophrenia Outpatient Health Outcomes (SOHO) Study. METHOD: The EQ-5D items investigated were mobility, self-care, usual activities, pain/discomfort and anxiety/depression. A Rasch rating scale model (a form of differential item functioning) was used to identify invariance of item calibrations for the 10 European countries participating in the SOHO study. RESULTS: There was general congruence in the EQ-5D item calibration pattern. The rank of average EQ-5D item calibrations was similar for all countries except Denmark. Denmark showed slight misfits for mobility and pain/discomfort. CONCLUSION: The EQ-5D is an appropriate measure of health-related quality of life across European countries and translations.

Adult↗
PubMed2003

The European Schizophrenia Outpatient Health Outcomes (SOHO) study: rationale, methods and recruitment.

OBJECTIVE: The objective of the European Schizophrenia Outpatient Health Outcomes (SOHO) study is to understand the comparative costs and outcomes of antipsychotic drug treatment, with specific focus on olanzapine. The study will also provide a large database for research into the treatment and outcome of schizophrenia. The role of observational studies in the assessment of the effectiveness of antipsychotic agents is reviewed, and the rationale, design and recruitment issues surrounding the SOHO study are presented. METHOD: SOHO is a 3-year, prospective, observational study of the health outcomes associated with antipsychotic treatment in Europe. RESULTS: Over 10 000 patients have been recruited from 10 countries. Baseline evaluation included measures of clinical status, social functioning, quality of life, service use and pharmacological treatment. Patients will be followed for 3 years. CONCLUSION: The SOHO study will complement randomized controlled trial findings on the treatment of schizophrenia and will address relevant clinical and policy research questions.

Activities of Daily Living↗
PubMed2003

Assessment of drinking water contamination at springs along the road to Santiago (NW Spain).

With the aim of assessing the potability of drinking water, 31 different springs sited along the road to Santiago "The French Way" in Galicia (NW Spain) were studied. Twenty-one parameters, according to Spanish Legislation have been determined by Official Methods. It was observed that the parameters: pH, nitrate, ammonia, total coliforms, fecal coliforms and fecal streptococcus did not always comply with the levels established by Spanish Legislation. The bacteriological characters were the most restrictive of the sanitary quality of drinking water, only 19% of the springs were drinkable during all the study. According to the Factorial Analysis in Principal Component applied to the obtained results, it was concluded that the parameters: conductivity, hardness, dry residue, nitrate and fecal coliforms can be very indicative for assessing water sanitary quality.

Ammonia↗
PubMed2003

Assessment of heavy metal contamination of seawater and marine limpet, Patella vulgata L., from Northwest Spain.

In the present work, both seawater and limpets (Patella vulgata L.) were collected from different sampling points in the Vigo estuary area (Galicia, NW Spain) and their heavy metal concentrations (Zn, Cd, Pb, Cu) were determined by means of a voltammetric technique. The results showed a direct relationship between the heavy metal levels in seawater and the content in biological samples, especially those obtained from limpet soft tissues, directly related to the increasing importance of anthropogenic environmental contamination. Heavy metal concentrations were usually higher in soft tissues than in shell, with a maximum difference corresponding to Cd and Zn (average of 93.6 and 86 folds, respectively). As expected, heavy metal content was higher in animal samples situated in inner part of the estuary zone, except for cadmium content in soft tissues, where a maximum of 5.62 ppm was quantified in limpet soft tissues collected next to the open sea area. Statistical analysis allowed the establishment of a clear relationship between Zn and Cd content in both shells and soft tissues from limpet, and especially between Zn and Cu in soft tissues (p < 0.001).

Animals↗
PubMed2003

Home hospitalisation of exacerbated chronic obstructive pulmonary disease patients.

It was postulated that home hospitalisation (HH) of selected chronic obstructive pulmonary disease (COPD) exacerbations admitted at the emergency room (ER) could facilitate a better outcome than conventional hospitalisation. To this end, 222 COPD patients (3.2% female; 71+/-10 yrs (mean+/-SD)) were randomly assigned to HH (n=121) or conventional care (n=101). During HH, integrated care was delivered by a specialised nurse with the patient's free-phone access to the nurse ensured for an 8-week follow-up period. Mortality (HH: 4.1%; controls: 6.9%) and hospital readmissions (HH: 0.24+/-0.57 controls: 0.38+/-0.70) were similar in both groups. However, at the end of the follow-up period, HH patients showed: 1) a lower rate of ER visits (0.13+/-0.43 versus 0.31+/-0.62); and 2) a noticeable improvement of quality of life (delta St George's Respiratory Questionnaire (SGRQ), -6.9 versus -2.4). Furthermore, a higher percentage of patients had a better knowledge of the disease (58% versus 27%), a better self-management of their condition (81% versus 48%), and the patient's satisfaction was greater. The average overall direct cost per HH patient was 62% of the costs of conventional care, essentially due to fewer days of inpatient hospitalisation (1.7+/-2.3 versus 4.2+/-4.1 days). A comprehensive home care intervention in selected chronic obstructive pulmonary disease exacerbations appears as cost effective. The home hospitalisation intervention generates better outcomes at lower costs than conventional care.

Aged↗
PubMed2002

Normalization of T2 signal abnormalities in hemispheric white matter with liver transplant.

OBJECTIVE: To determine whether edema can be assessed by MRI using T2-weighted signal intensity of hemispheric white matter in cirrhotic patients. METHODS: Fast-FLAIR and magnetization transfer images were obtained before (24) and after (11) liver transplantation. T2-weighted abnormalities on baseline scans and their time-course changes were analyzed and compared with MT ratios (MTR). RESULTS: Fast-FLAIR baseline images showed faint to substantial, bilateral, symmetric increased signal intensity along the hemispheric white matter in or around the corticospinal tract in 23/24 patients. After liver transplantation the signal abnormalities gradually recovered. This gradual decrease in signal intensity correlated with an increase in MTR values. CONCLUSION: Asymptomatic symmetric high-signal intensity in the hemispheric white matter on fast-FLAIR MR images is present in cirrhosis. Normalization of this finding after successful liver transplantation and its correlation with MTR values suggest that this signal abnormality reflects mild edema.

Adult↗