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Biomedical subjects

M Gracia Naya

Publications and source records attributed to M Gracia Naya.

14 recordsLinked to original sources
PubMed1999

[Burden and management differences between migraine with and without aura in neurology clinics].

BACKGROUND: Migraine is one of the most important reason of neurological consultation in Spain. OBJECTIVE: The aim of the present study was to analyse the profile of the patient with migraine and investigate epidemiological, clinical and therapeutical differences between migraine with aura o without aura. PATIENTS AND METHOD: For three consecutive months all patients attending for the first time the Neurology clinics of the Health Service of Aragón, were given a specially designed questionnaire. RESULTS: 374 patients who met migraine diagnostic criteria were included. They were 10.7% of the all patients. The majority of the patients were women (70%). Patients with migraine without aura were 299 (79.9%). The average age was 33.6 +/- 15.1. The family doctor referred 87% of the patients. Further investigations were requested in 20% of the patients with migraine without aura and 49.3% with aura. Cerebral CT was performed in 5.6% of migraine without aura and in 38.6% of migraine with aura patients, MR in 0.6% of migraine without aura and in 6.6% of migraine with aura patients. Treatment was given to 73% of the migraine patients attending for the first time. Calcium antagonists (45.3%) were the most common used drugs. CONCLUSIONS: Migraine generates a considerable demand for neurological consultations. There are significant differences in investigations requested, treatments and follow-ups of patients with migraine with o without aura.

Adolescent↗
PubMed1995

[Wernicke encephalopathy in patients given parenteral nutrition].

Wernicke's encephalopathy is caused by thiamin deficiency and can be recognized by severe neurological symptoms that are occasionally accompanied by systemic signs. The syndrome is often found in alcoholics, although other causes have also been identified, such as intravenous feeding, in which the main pathogenic mechanisms are the administration of carbohydrates and the low standard dose of vitamin B1--in relation to the increase in metabolic load--delivered in a medium of substances that favor inactivation of the vitamin. We present 3 intravenously fed patients who developed the syndrome, even though in 2 cases they were given thiamin. Only the third patient's history included chronic alcoholism, and this patient also suffered severe cardiac symptoms and amaurosis. We believe that the amount of thiamin provided through parenteral nutrition, as well as the medium in which it is delivered, must be reviewed.

Adult↗
PubMed1994

[Failure of empirical treatment with ceftriaxone in motor neuron disease].

We describe two patients with lateral amyotrophic sclerosis who, after informed consent, received empirical treatment with intravenous cephtriaxone at a dose of 2 g/24 hours for three weeks, with no positive results. The pharmacokinetics of this cephalosporin is analyzed, along with the relationship between motor neuron disease, neuroborreliosis and immunoreactivity to Borrelia burgdorferi.

Aged↗
PubMed1993

[Neurological disease due to the varicella-zoster virus without a skin lesion].

We studied three cases of inflammatory neurological disease and serological evidence of varicella-zoster viral (VZV) infection without cutaneous manifestation. They corresponded to a case of cranial multi-neuritis, a case of aseptic meningitis, and another case of meningoencephalitis. Despite the infrequency of any such association, the spectrum of the neurological diseases associated with VZV without skin lesions is quite wide. We are motivated to present our experience by the belief that it is important to think about this possible etiology based on inflammatory areas at different levels of the Nervous System in patients who are still immunocompetent.

Abducens Nerve↗
PubMedDate not supplied

[Cost effectiveness of treatment with triptanes in Spain].

INTRODUCTION: Migraine is a very common disorder and frequent cause of consultation of the neurologist. The triptanes have been a great advance in the treatment of migraine attacks. At present it is the treatment of choice in severe attacks of migraine, but it is more expensive than the other drugs used for this. Taking into account the greater efficacy and the saving in direct and indirect costs which may be due to treatment with triptanes, its use may not only be effective but also efficient. OBJECTIVE: To analyze the cost effectiveness of the triptanes sold in Spain (sumatriptan, naratriptan, zolmitriptan, rizatriptan, almotriptan). MATERIAL AND METHODS: We analyzed the efficacy, therapeutic gain and number of different triptanes needed for treatment. We evaluated the cost of multiplying the result of the number needing treatment by the price of each unit of the drug. The results are expressed in pesetas and in euros. RESULTS: Rizatriptan gave the best results and was the cheapest triptan, followed by sumatriptan and zolmitriptan. When criteria of efficacy were used, naratriptan was the most expensive triptan, in spite of being the cheapest per unit. CONCLUSIONS: In chronic, recurrent disorders such as migraine, when the cost of treatment using triptans is assessed, one has not only to evaluate the cost per unit but also to introduce other parameters such as the efficacy of the drug, which is one of the most important.

Cost-Benefit Analysis↗
PubMedDate not supplied

[Thyroid ophthalmopathy ad a unique clinical manifestation of thyrotoxicosis].

Thyroid ophthalmopathy (TO) or Graves ophthalmopathy embraces a broad range of eye abnormalities which up to 90% of patients with hyperthyroidism (HT) are affected with. In some 10% of TO patients, this may begin oligosymptomatically, often with double vision and with neither clinical nor biochemical signs of thyroid disease. It is imperative to carry out a differential diagnosis with countless other causes for double vision and other eye socket processes. Ophthalmopathy may also occur in patients with hypothyroidism and for this reason some authors prefer to refer to it as dysthyroid orbitopathy. We present four cases of TO in which double vision was the first clinical sign of TO which in one case became severe, in two cases preceded hyperthyroid symptomatology and in the remaining case happened after hyperthyroidism had been corrected. The most valuable diagnostic test was orbit computerised tomography (CT) scan, which proved positive in all cases, and that, along with clinical tests and thyroid function data, confirmed a diagnosis of TO. All initially improved with corticosteroids although none completely regained eye movement during the time they were under supervision. The same happens in about 50% of patients who do not respond to treatment either with corticosteroids or with radiotherapy, and response is usually incomplete in those who do so respond.

Adrenal Cortex Hormones↗