Impact of transdermal drug delivery on treatment adherence in patients with Alzheimer's disease.

Objective: As a part of a study investigating which strategies are effective to improve pharmacological compliance among nonadherent Alzheimer's disease patients, we assessed the impact of the galenic form (oral medications or patches) on treatment adherence in patients with dementia of Alzheimer's type (DAT).

Design And Methods: We performed a 6-month prospective, multicenter, observational study with three study visits (baseline, 3 months and 6 months). Patients with mild-to-moderately severe DAT receiving medication for ≥3 months who were nonadherent to treatment were recruited.

Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery.

Background: Bariatric surgery (BS) is widely accepted for the treatment of patients with morbid obesity (MO). We aimed to determine presurgical predictors of and surgical technique-related differences in excess weight loss (EWL) 1 year after BS.

Methods: This retrospective study included 407 subjects (F/M 3:1, median age = 44 years) who underwent laparoscopic Roux-en-Y gastric bypass (RYGB, n = 307) or sleeve gastrectomy (SG, n = 100) at our University Hospital and were evaluated 1 year after surgery.

[Assessment of the strategies to improve therapeutic compliance in routine clinical practice in noncompliant patients with Alzheimer-type dementia].

Introduction And Aim: The potential benefits of the therapy for patients with chronic diseases such as Alzheimer's disease depends largely on adherence to the treatment. The main objective of this study was to assess which of the strategies used by physicians in clinical practice were effective in improving adherence in noncompliant patients with Alzheimer-type dementia (ATD).

Patients And Methods: An epidemiological, multicenter, observational, prospective, study in non-compliant patients with diagnosis of ATD with a baseline assessment and two follow-up visits at three and at six months.

Assessment of the information provided by the medical specialist on Alzheimer's disease and that retained by the patient caregivers.

Introduction: There is evidence of insufficient communication abilities by medical specialists as well as of the limited retentive capacities of patients with Alzheimer disease (AD) and their caregivers. The main reasons for this include the personal limitations of the physician, as well as external, emotional and social-cultural factors associated with the patients and their caregivers. The aim of this study is to compare the clinical information on AD provided by the physicians and that perceived by caregivers and to assess factors associated with differences in perception.

QTc prolongation: is clozapine safe? Study of 82 cases before and after clozapine treatment.

Objective: The most feared cardiological consequence of clozapine is sudden cardiac death. A potential marker of it is QTc interval (QTc) prolongation. This study aimed to determine the prevalence of QTc prolongation in patients before and after 18 weeks of clozapine treatment and to detect predictors of QTc prolongation.

[Profile of the informal carer associated with the clinical management of the Alzheimer's disease patient refractory to symptomatic treatment of the disease].

Introduction: Many factors influence the satisfaction and quality of life of informal caregivers of non-responder patients with Alzheimer disease (AD). Among these include, the course of the disease, cognitive impairment and behavioural disturbances of the patient, the level of family support and caregiver inherent factors such as, time commitment, psychological status and awareness of the disease. The aim of this work is to determine the profile of informal caregivers of non-responder AD patients and to evaluate the different factors that affect their quality of life, burden and overall satisfaction with treatment.

Aging phenotype and its relationship with IGF-I gene promoter polymorphisms in elderly people living in Catalonia.

Objectives: Genetic variations in the Insulin/IGF-I genes pathway have been related to longevity, dementia, metabolic diseases and cancer. The purpose of the present study was to investigate the 192 bp allele of IGF-I gene promoter and its relationship with metabolic syndrome (MS) components, mental and nutritional state, muscle strength and functional capacity in an aged Spanish population.

Design: Population-based study (Mataró Ageing Study), including 292 subjects (144 men and 148 women, mean age 77.

Subclinical nigrostriatal dopaminergic denervation in the cerebellar subtype of multiple system atrophy (MSA-C).

Nigrostriatal involvement is considered an additional feature in the new consensus criteria for the diagnosis of the cerebellar variant of multiple system atrophy (MSA-C). However, so far, only a few studies, which include a relative small number of patients, give support to this criterion. Our objective was to assess nigrostriatal dopaminergic innervation in patients with MSA-C without parkinsonism by use of dopamine transporter single photon emission computed tomography (DAT SPECT).

The importance of smell in patients with bronchiectasis.

Background: The aim of the study was to evaluate the sense of smell in patients with bronchiectasis.

Methods: Prospective controlled study was performed on 91 patients with bronchiectasis. Bronchiectasis patients were sub-classified depending on: the presence of chronic rhinosinusitis, with or without nasal polyps, and the bronchiectasis ethiology.

Preclinical arterial disease in patients with type 1 diabetes without other major cardiovascular risk factors or micro-/ macrovascular disease.

We aimed to investigate preclinical atherosclerosis in T1D and its relationship with glucose profile and endothelial/ inflammatory markers. Thirty-eight T1D patients without additional cardiovascular risk factors or micro-/macrovascular complications and 22 healthy matched subjects were included. FMD and cIMT/fIMT were performed in addition to 72-h continuous glucose monitoring and the measurement of endothelial/inflammatory markers.

[Early diagnosis of Alzheimer's disease: the prodromal and preclinical phase].

Introduction: Because Alzheimer's disease (AD) needs to be treated as soon as possible after onset, its early detection has become one of the core areas of research in the field of neurodegenerative diseases.

Development: Attempts to characterise the incipient phases of the disease have evolved from the appearance of the heterogeneous concept of mild cognitive impairment in the last twentieth century to the diagnostic criteria proposed for AD by current research. These criteria make it possible to perform an early diagnosis of AD (in the prodromal phase) that is at the same time aetiological, since it is backed up by objective biological markers which will be discussed in this work.

Controversies in the treatment of chronic rhinosinusitis.

Chronic rhinosinusitis (CRS) including nasal polyps is a chronic inflammatory disease involving the mucosa of the nose and one or more paranasal sinuses. Despite differing hypotheses, the cause remains poorly understood. The key issue is the maintaining of ostial patency.

Clinical experience using electroconvulsive therapy in adolescents with schizophrenia spectrum disorders.

Objectives: The aim of this study was to evaluate the effectiveness and safety of electroconvulsive therapy (ECT) in adolescent patients diagnosed with schizophrenia spectrum disorders (SSD).

Methods: All patients diagnosed with SSD who received ECT in the Child and Adolescent Psychiatry and Psychology Department in a general hospital in Barcelona, Spain, from January, 2003, to December, 2007, were identified retrospectively. As part of the usual evaluation protocol, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scales were administered before ECT, after the acute ECT phase (CGI), and at 6 months from baseline.

Pancreas and kidney transplantation: long-term endocrine function.

Objective: To describe the characteristics of metabolic control and beta-cell function in the long-term follow-up of patients with type-1 diabetes (T1D) who have undergone pancreas and kidney transplantation (PKTx).

Patients And Methods:   Twelve patients (eight males/four females) with normal pancreas and kidney graft function for more than 15 yr were included. Patient age at the time of transplantation was 35.

Nutritional pyramid for post-gastric bypass patients.

Background: Life-long nutrition education and diet evaluation are key to the long-term success of surgical treatment of obesity. Diet guidelines provided for bariatric surgery patients generally focus on a progression through dietary stages, from the immediate post-surgical period to 6 months after surgery. However, long-term dietary guidelines for those surgically treated for obesity are not readily available.

Neuropsychological profile of prodromal Alzheimer's disease (Prd-AD) and their radiological correlates.

This study describes the cognitive profile of Prd-AD, the neuropsychological tests that may predict progression to dementia, and to study their brain structural correlates. We enrolled 24 stable amnesics who did not develop dementia after two years follow-up; 27 patients were considered as Prd-AD, in the initial visit, since they fulfilled NINCDS-ADRDA criteria after two years; 31 Alzheimer's disease (AD) patients and 27 controls (CTR). Structural magnetic resonance imaging (MRI), as well as a neuropsychological battery was performed at the initial visit.

Calcium and vitamin D supplementation after gastric bypass should be individualized to improve or avoid hyperparathyroidism.

Background: Precise calcium (Ca) and vitamin D intestinal absorption after gastric bypass (GB) remains unknown. We evaluated the effect of receiving or not Ca and vitamin D supplementation on Ca, PTH, and vitamin D axis in patients undergoing GB.

Methods: Two hundred twenty-two patients were evaluated prior to GB and at 1 year.

Endometrial stromal sarcoma. Is there a place for radiotherapy?

Objectives: The optimal approach in the management of endometrial stromal sarcoma (ESS) remains unclear. The aim of the present study was to retrospectively report the outcome of patients treated for ESS in our hospital over a 27-year period in order to evaluate the treatment results and the role of radiotherapy.

Patients And Methods: From 1979 to 2006, 13 patients with ESS were treated at the Hospital Clínic of Barcelona.

[Hyperhydrosis update].

Nearly 3% of the population has hyperhidrosis. Quality of life is affected, impacting on social relationships and professional activity, and social anxiety disorder can sometime develop. We review the definition and causes of hyperhidrosis and the clinical evaluation of patients.

Donepezil provides greater benefits in mild compared to moderate Alzheimer's disease: implications for early diagnosis and treatment.

We assessed the cognitive and functional outcomes of donepezil treatment in mild versus moderate Alzheimer's disease (AD) patients. We performed a 6-month prospective, observational, multicenter study of the progression of cognitive and functionality abilities in a large sample patients with AD who initiated treatment with donepezil in monotherapy. According to baseline mini mental state examination (MMSE), patients were divided in two groups: mild AD (MMSE ≥ 21) and moderate AD (MMSE <21).

How to deal with prognostic factors and radiotherapy results in uterine neoplasms with a sarcomatous component?

Purpose: Uterine tumours with a sarcomatous component are rare neoplasms with a wide pathologic heterogeneity in which the stage is the main prognostic factor. These aspects and their aggressiveness make the analysis of prognostic factors and radiotherapy difficult. The aim of this study was to evaluate the prognostic factors by stages and to assess the impact of prognostic factors and the effect of radiotherapy on the outcome of the disease.

United airways: the impact of chronic rhinosinusitis and nasal polyps in bronchiectasic patient's quality of life.

Background: The nose and the bronchi belong, in anatomical and physiopathological terms, to the concept of united airways. Associations between upper and lower airways diseases have been demonstrated in allergic rhinitis and asthma, nasal polyposis (NP) and asthma, chronic rhinosinusitis (CRS) and chronic obstructive pulmonary disease, and more recently CRS/NP and bronchiectasis (BQ).

Objective: To evaluate the impact of CRS on quality of life (QoL) of patients with BQ, and to correlate these findings with the pulmonary status, nasal symptoms, and general health status.