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Biomedical subjects

J M Delgado

Publications and source records attributed to J M Delgado.

89 records · Page 5Linked to original sources
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Instrumentation, working hypotheses, and clinical aspects of neurostimulation.

The paper describes instrumentation developed in our laboratory for the therapy of neurological disorders, including (a) hybrid stimulator for chronic use which retains constant current characteristics, providing a low resistance path during the quiescent phase between pulses to minimize the postpulse charge; (b) brain radio stimulators, crystal controlled, with digital logic section and an optoelectric sensor for telemetry of the intensity used; (c) external stimoceiver for experimental and clinical use, combining multichannel stimulator and EEG telemetric instrument; (d) transdermal stimoceivers, totally implantable for two-way communication with the brain through the intact skin; and (e) implantable microprocessor for detection of EEG signals which are used to trigger contingent brain stimulation. Our working hypotheses for chronic brain stimulation include (a) electrical modification of the functional set point of specific cerebral areas; (b) feedback-controlled stimulation; and (c) establishment of artificial neuronal links with the aide of the computer. The paper concludes with a discussion of the indications for therapeutic use of brain stimulation and criteria for patient selection.

Animals↗
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[The assessment of neurological care needs in the health sector of de San Juan de Alicante by key-informants model].

BACKGROUND: Specific health care planning should be based on the care request according the most adjusted evaluations method. Data obtained from each geographic area may be most comparable with other from close areas. AIM: To determinate the neurological needs in the health area 16 of Valencian Community that includes the care corresponding to Hospital of San Juan de Alicante. MATERIAL AND METHOD: We conducted a survey among key informants using the primary care physicians of the area. The population of the healthy area is 144,781 people and includes 78 primary care physicians. We used the formula proposed by Kurtzke in 1982 in order to calculate the neurological time. RESULTS: We obtain a response rate of 82% the total number of neurological hours requested was 5,823.84 hours by year, which supposes a need of 8.82 neurologists by 100,000 people and nears a needs of 12.77 neurologists for the healthy area. These data are clearly higher that the obtained in other close areas using the same methodology (5 neurologists by 100,000 inh in Alcoi, 6 neurologists by 100,000 inh in the area corresponding to General Hospital of Alicante). The topics that require more than 100 hours by year are: migraine (1,205), lumbar backache (1,104), alcoholism (762), cranial trauma (442), deafness (285), stroke (272), seizures (181), disk herniation (166), cervical backache (140), zoster (162), psychosis (118), which supposes 83.12% of the whole neurological time. CONCLUSIONS: The data situated the area within a model of direct neurological care similar to that in the United States.

Health Planning↗
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[Neurological education of general practitioners. Results of a survey carried out among 196 general practitioners].

We have carried out a survey among professional general practitioners in our province with the aim of getting to know their opinion concerning their own training in Neurology. The survey included questions about the adequacy of training, the nature of any deficiency therein (be it theoretical and/or practical) and ability to analyse and attend a neurological patient. The percentage of replies was 78% out of a total of 196 surveys. 78.8% of those questioned consider that their neurological training has not been sufficient either for clinical or general practice; while 43.8% believe that this insufficiency is due to a lack of practical training, 1.8% think the fault lies in a lack of theoretical training, and 54.32% consider that it is due to a lack of both practical and theorectical training. 61.2% of those questioned claim to have difficulties with neurological explorations, and 55.6% claim they have greater difficulties attending a neurological patient than other patients classified within other internal medical specialties. 76% consider that it is either partially or totally false to claim that these difficulties are unimportant due to the lack of treatment for neurological illnesses, although 69.4% consider it to be partially or totally true that they will never be able to achieve diagnosis of a neurological patient due to a lack of the required complementary investigations. 43.9% consider that continued training in Neurology is not useful because it is a repetition of training received at university. As a consequence, there is an imbalance between neurological training and the need to attend the patient at the level of general practice, which should be set right by making the theoretical training given during graduation more suitable, and by increasing and improving practical credits.

Data Collection↗
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Stereotactic radiosurgery with linear accelerator.

Stereotactic radiosurgery is a method that applies a radiation dose to a limited and well-defined volume while the irradiation of adjacent healthy tissues is minimized. It is most commonly used in the treatment of intracranial lesions because the skull hardness assures the stable location of its contents. Treatment of the rest of the body has recently been proposed and carried out, using original immobilization systems. Stereotactic radiosurgery was first described in 1951 by the Swedish neurosurgeon Lars Leksell who originally used X-rays and then high-energy protons as a source of radiation. In the '80s photons from linear accelerators were used as radiation source, with various stereotactic systems and computerized treatment planning. The method used with all radiosurgical systems, regardless of the source of irradiation, is similar. The lesion is detected with common diagnostic imaging and adequate location frames. At present, to prevent errors in location, MRI and CT data are matched using an Image Fusion computer program. The objective of stereotactic radiosurgery is to destroy tumor cells or to induce changes in tissues that, as in brain arteriovenous malformations lead to the occlusion of their abnormal vessels. Stereotactic radiosurgery is increasingly used today in the treatment of a variety of intracranial lesions to the patients' benefit.

Brain Neoplasms↗