Paqui RC | Universidad Complutense de Madrid (original) (raw)
Papers by Paqui RC
PLoS neglected tropical diseases, 2015
Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation u... more Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation units and determining the population at risk that will be targeted for mass drug administration (MDA). Prior to the current study, only 116 of the 832 woredas (districts) in Ethiopia had been mapped for LF. The aim of this study was to perform a nationwide mapping exercise to determine the number of people that should be targeted for MDA in 2016 when national coverage was anticipated. A two-stage cluster purposive sampling was used to conduct a community-based cross-sectional survey for an integrated mapping of LF and podoconiosis, in seven regional states and two city administrations. Two communities in each woreda were purposely selected using the World Health Organization (WHO) mapping strategy for LF based on sampling 100 individuals per community and two purposely selected communities per woreda. Overall, 130 166 people were examined in 1315 communities in 658 woredas. In total, 140 ...
Revista Española de Enfermedades Digestivas, 2004
To assess the effect of infliximab on quality of life in a series of patients with fistulizing Cr... more To assess the effect of infliximab on quality of life in a series of patients with fistulizing Crohn's disease. A prospective observational study was made. A total of 25 patients with single or multiple draining abdominal or perianal fistulas were selected for the study. All received an intravenous infusion of infliximab at a dose of 5 mg per kilogram of body weight in weeks 0, 2, and 6. The clinical activity was calculated every two weeks over a 10-week follow-up. HRQOL (SF-36 and IBDQ scores) were compared at baseline and at weeks 4 and 10. Sixty-four percent of patients had a clinical response to treatment with infliximab, with complete closure of fistulas. The mean values of CDAI decreased during follow-up, with a significant difference between weeks 0 and 10 (p < 0.01). Health-related quality of life (HRQOL), as measured by means of SF-36, showed an overall improvement in the physical domain (PCS) after 4 and 10 weeks (p < 0.05). An increase was also observed in IBDQ overall score on comparing the results obtained at week 0 and week 4 (p < 0.01). The social functioning domain of IBDQ was not significantly changed with treatment. Treatment with infliximab in active fistulizing Crohn's disease results in a significant increase in the quality of life of patients at short-term.
Value in Health, 2004
Abstracts younger ones. The objective of the present study was to assess the differences 65 years... more Abstracts younger ones. The objective of the present study was to assess the differences 65 years) and younger ones on hemodialysis ≥ in HRQoL between elderly patients (and renal transplantation during the first two years. METHODS: Longitudinal prospective study of 199 patients starting RRT. HRQoL was assessed using the SF-36 health survey at three, 12 and 24 months from the start of RRT. PCS, MCS and standardised scores by age and sex were obtained using Spanish general population norms. The tstudent test for unpaired samples was used to compare HRQol of elderly and younger at each moment. RESULTS: Preliminary data of 144 patients collected at three months, of 118 at 12 months and of 76 at 24 months are presented. Mean age was 63.5(14.31) and 60.5% were elderly patients. At three months, all patients were on hemodialysis; elderly patients had lower loss of HRQoL in Physical Functioning (p = 0.039), Role Physical (p = 0.005), General 0.0001), Role Emotional (p = 0.014), and PCS (p = 0.048), than younger < Health (p ones. At 12 months, elderly transplanted patients had lower loss of HRQoL in Physical Functioning (p = 0.018), General Health(p = 0.021) and Vitality (p = 0.067),and elderly patients on hemodialysis had less loss of HRQL in Physical Functioning (p = 0.002), Role physical (p = 0.044), Bodily Pain (p = 0.015), General Health (p = 0.001), Mental Health (p = 0.034) and PCS (p = 0.007). At 24 months, elderly transplanted patients had less loss of HRQoL in Physical Functioning (p = 0.017) Bodily Pain (p = 0.025), General Health (p = 0.027). CONCLUSIONS: It's the first time that it is demonstrated that, using standardised scores by age and gender, elderly patients have less loss of HRQoL than the younger ones during the first year on RRT. Life (HRQoL) between hemodialysis (HD) and peritoneal dialysis (DP). METHODS: This multicentric study is from 14 dialysis units in our country of a randomized sample of 221 patients, 152 in HD and 69 in DP. HRQoL was evaluated using EuroQoL-5D scale: 5 dimensions (Mobility-M, Self-Care-SC, Usual Activities-UA, Pain-P, Anxiety/ Depression-AD) and their Tariff (T), and the Visual Analogue Scale (VAS). Patients also answered the KDQOL-SF which includes the SF-36 with the physical and the mental component summary (PCS, MCS) and specific questions about kidney disease. Sociodemographic and clinical data, the Karnofsky Scale and a comorbidity index were also collected. SF-36 scores were standardized using the Spanish general population norms. RESULTS: Patients undergoing DP were more frequently in employment, had a higher level of education, lower age (54.4 vs.63.2), less time on dialysis (33.6 vs.48.9 months), were less often diabetic (10.5%vs.23.3%). However, comorbidity (6.5 vs. 5.6), Karnofsky score (82.2 vs. 84.1), Sf-36 scores (PCS: 40.9 vs. 40.4; MCS: 47.9 vs. 47.3) and Tariff of EuroQoL-5D (0.74 vs. 0.70) were similar. Statistically significant differences were found in the VAS (64.7 vs. 55.9; p < 0.001) and in several specific dimensions of the KDQOL-SF in which patients in DP scored higher (better HRQoL): symptoms/problems of kidney disease (79.7 vs. 75.8; p = 0.05), effects of the renal disease (72.2 vs. 62.6; p = 0.005), social support (84.8 vs. 78.6; p = 0.013) and support of the dialysis staff (94.4 vs. 85.03; p = 0.001), although these scores are not standardized for age and sex in the absence of Spanish population norms for patients in dialysis. CONCLUSIONS: Patients undergoing DP show similar status of general health as those of HD, but seem to have a better perceived health in several specific problems related with renal disease. Results emphasize the importance of using, in comparative studies, specific scales for patients on dialysis. OBJECTIVES: No validated questionnaires are available for assessing symptoms and quality of life (QoL) in Italian women with lower urinary tract symptoms (LUTS). In a large multicentre observational study of women with LUTS (FLOW-Female LUTS: Observational Study in Women), we translated into Italian and validated the long and short forms of female-specific questionnaires (ICIQ-LF and ICIQ-SF). METHODS: The validation process consisted of forward and backward translation, test of comprehension, discriminant validity, test-retest reliability. A first set of women was interviewed after they had filled in the questionnaires. A comprehension rate was built as the percentage of correctly understood questions and pre-coded answers of all items by all patients. A case-control study was then performed. Cases were women aged >18 year affected by LUTS from at least 3 months and with negative dipstick. Controls were defined as healthy women of comparable age. All women were enrolled consecutively. In order to evaluate reliability, cases were retested after seven days and a correlation analysis was performed between the first and the second measurement (Pearson's r). Discriminant validity was assessed by comparing the scores of cases and controls with ANOVA. RESULTS: The comprehension rate was 99.4% for ICIQ-LF and 99.1% for ICIQ-SF. Four out of 16 patients did not correctly understand 1 item (hesitancy) of ICIQ-LF, which was changed. Cases and controls were respectively 42 and 47 (ICIQ-SF), 80 and 61 (ICIQ-LF). All the ICIQ-SF patients were valuable for test-retest, while only 25 patients for ICIQ-LF. Pearson coefficient between ratings was >0.93 for 23 out of 48 items of ICIQ-LF and 0.96 for ICIQ-SF total score (p < 0.001). Cases and controls were discriminated at ANOVA (p < 0.001) with both questionnaires. CONCLU-SIONS: These data show that ICI questionnaires are generally easy to understand, have a good to excellent reliability and a high discriminant validity. OBJECTIVES: To evaluate the sensitivity to change of the Spanish version of the ICIQ-UI SF questionnaire, in order to recommend its use in clinical practice to evaluate treatment outcome for Urinary Incontinence (UI). METHODS: Prospective study of 115 women with diagnostic of Stress UI (SUI) who received treatment for their incontinence: Pelvic floor training (PFT) or surgery. All the patients had clinical and urodynamic
Transplantation Proceedings, 2006
Our objective was to evaluate health-related quality of life in patients with advanced heart fail... more Our objective was to evaluate health-related quality of life in patients with advanced heart failure on the waiting list for a heart transplant. Materials and methods. The study was performed using the EUROQOL-5D questionnaire (EQ-5D) on 38 patients (age: 53 Ϯ 2 years, 82% men) who were analyzed consecutively during the pretransplant period, as well as at 3, 6, and 12 months after transplantation. We excluded pediatric transplants, retransplantations, heart and lung transplantation, and patients scoring below 17 points on the Folstein's Cognitive Mini-Examination. The studied variables included the five dimensions of the EQ-5D test: mobility, self-care, daily activities, pain-discomfort, anxiety and depression; a visual analog scale from 0 to 100; and perception of health status. Statistics included analysis of variance and chi-square tests. Significance was set at P Ͻ .05. Results. There were significant differences in all tested parameters. The worst values were observed prior to transplantation, with a significant improvement at 3 months. Conclusions. Patients with heart failure showed a significant impairment in healthrelated quality of life before transplantation. The improvement in health-related quality of life was significant and rapidly evident in the posttransplantation period. The most affected dimensions were activities of daily living and pain-discomfort. All dimensions became stable at 3 months, except for anxiety and depression. At 6 to 12 months, a plateau was reached in the feelings of well-being.
Proceedings of the National Academy of Sciences, 2009
A variety of viruses establish latency by integrating their genome into the host genome. The inte... more A variety of viruses establish latency by integrating their genome into the host genome. The integration event generally occurs in a nonspecific manner, precluding the prediction of functional consequences from resulting disruptions of affected host genes. The nonpathogenic adeno-associated virus (AAV) is unique in its ability to stably integrate in a site-specific manner into the human MBS85 gene. To gain a better understanding of the integration mechanism and the consequences of MBS85 disruption, we analyzed the molecular structure of AAV integrants in various latently infected human cell lines. Our study led to the observation that AAV integration causes an extensive but partial duplication of the target gene. Intriguingly, the molecular organization of the integrant leaves the possibility that a functional copy of the disrupted target gene could potentially be preserved despite the resulting rearrangements. A latently infected, Mbs85-targeted mouse ES cell line was generated to study the functional consequences of the observed duplication-based integration mechanism. AAV-modified ES cell lines continued to self-renew, maintained their multilineage differentiation potential and contributed successfully to mouse development when injected into blastocysts. Thus, our study reveals a viral strategy for targeted genome addition with the apparent absence of functional consequences. embryonic stem cells ͉ MBS85 ͉ gene targeting ͉ Rep ͉ AAVS1
do fue el de personal (media de 30,9%), que mostró una importante variabilidad entre centros, tan... more do fue el de personal (media de 30,9%), que mostró una importante variabilidad entre centros, tanto en cifras absolutas (coste personal/paciente/año entre 18.151 y 8.504 €) como porcentuales (entre 42,6 y 25,4%). Conclusiones: Existe una importante variabilidad de coste entre diferentes centros de HD, y ésta puede atribuirse fundamentalmente al coste de personal y fungible, que es superior en los CP respecto a los CC.
Value in Health, 2003
Keeping in mind that the benefits were measured by survival groups, the cost effectiveness was: €... more Keeping in mind that the benefits were measured by survival groups, the cost effectiveness was: €57/month of life for G1, 181 for G2, and 222 for G3. CONCLUSIONS: not having an adequate vascular access in order to start PHD, causes not only an important decrease of survival but more indirect costs as less benefit too.
Value in Health, 2012
Two-year of data on prescribed anti-diabetic medications were also available for the analyses. Da... more Two-year of data on prescribed anti-diabetic medications were also available for the analyses. Data from this cohort were compared to an age and gender control group of Aboriginal individuals without diabetes. Regression analyses were conducted to evaluate the impact of anti-diabetic medications on glycemic levels and control after covariate adjustment (e.g. age, gender, baseline HbA1c). RESULTS: A total of 323 individuals newly diagnosed with diabetes in 2002 were identified. The mean HbA1c levels increased from 6.8% at time of diagnosis to 8.2% at the end of the study in 2008. A similar trend was seen for fasting glucose levels. After adjusting for covariate, the results of the regression analyses indicated that continuous (versus no use) and intermittent (versus no use) use of anti-diabetic drugs have no significant impact on 2-year HbA1c levels. Other clinical results indicated that a large proportion of the Aboriginal people had uncontrolled hypertension and hyperlipidemia. The average number of visits to physician, number of hospitalization and the length of staying at hospital were higher among the Aboriginal people with diabetes compared to their control group. CONCLUSIONS: Consistent with previous studies, these findings suggest that a minority of Aboriginal people in Southwestern-Ontario achieved optimal glycemic control.
Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2011
Previous studies to determine the cost of haemodialysis (HD) in Spain have significant limitation... more Previous studies to determine the cost of haemodialysis (HD) in Spain have significant limitations: they are outdated or used indirect methods. There is also a lack of analysis performed simultaneously on Public centres (PC), with direct HD services, and partially state-subsidised centres (SC). This is an important issue since the two systems coexist in Spain. To estimate the cost of HD replacement therapy for chronic renal failure in several centres. This is a prospective and publicly-funded study, which estimates the costs for 2008 using a cost accounting system with specific allocation criteria. We collected demographic and comorbidity data for each centre. Six centres participated, two PC and four SC. There were no significant differences between centres in terms of patient demographics, time on haemodialysis and the Charlson comorbidity index. The total cost per patient per year ranged between € 46, 254 and € 33,130. The cost per patient per year (excluding vascular access and ...
Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2002
To study the changes in the health related quality of life (HRQOL) during the first year followin... more To study the changes in the health related quality of life (HRQOL) during the first year following renal transplant (RT), comparing azathioprine vs mycophenolate mofetil (MMF) in triple immunosuppressant therapy with prednisone and cyclosporine. Prospective, open and random study with 26 patients who received a primary cadaveric renal transplant consecutively. Analysis of clinical variables: delayed graft function (DGF), acute rejection (AR), infections and comorbidity; analytical: haemogram, albumin and serum creatinine, hepatic function, cyclosporin levels; instruments for assessing the HRQOL: Psychological General Well-being Index (PGWBI) and Euroqol-5d (EQ-5d) health questionnaire, which includes a self-assessment scale of the state of health, Visual Analogical Scale (VAS). Controlled collection of data upon discharge following renal transplant, and subsequently 1, 3, 6, and 12 months following the first questionnaire. There were no differences between patients on azathioprine o...
Nefrología : publicación oficial de la Sociedad Española Nefrologia
Nefrología : publicación oficial de la Sociedad Española Nefrologia
To establish the frequency and severity of somatic symptoms and emotional distress (anxiety and/o... more To establish the frequency and severity of somatic symptoms and emotional distress (anxiety and/or depression) among our chronic hemodialysis (CHD) patients and to study the relationship between them as well as their influence on the perceived health status. All patients who had been on CHD for a minimum of three months were eligible for the study. Eight of them were excluded: six because they were unable to answer the questionnaires and two because they refused to participate. The 58 remaining patients were the subject of our study (median age 68.5 years; median duration of HD 29.5 months). Diverse sociodemographic and clinical data were recorded. The patients answered the following questionnaires: 1) The "physical symptoms" dimension of the Kidney Disease Questionnaire; 2) A measure of anxiety (STAI); 3) A measure of depression (Beck Depression Inventory and Cognitive Depression Index); and 4) The Nottingham Health Profile (NHP). The most frequent and severe symptoms wer...
Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2000
OBJECTIVES: A new utility index derived of the SF-36, the SF-6D, was recently developed and has g... more OBJECTIVES: A new utility index derived of the SF-36, the SF-6D, was recently developed and has generated an increasing research in different groups of patients and has also been compared with other utility measures, as it is the EQ-5D. The purpose of present work was to evaluate the differences between the weighted and not weighted version of two utility measures: the Spanish SF-6D and EQ-5D. METHODS: A total of 1843 complete measures of the SF-36 and the EQ-5D (5 items and visual analogic scale-VAS) from 1283 patients who received a solid organ transplant (kidney, liver, heart or lung) were used. Data were collected at different moments during the first year after the surgery in the context of the Spanish Research Network on Transplantation. SF-6D values were calculated using the model proposed by its creator (weighted version) and without tariff values, as has been proposed by some authors (not weighted). EQ-5D values were calculated using Spanish VAS tariff (VAS-t), the time-trade off tariff (TTO-t) and also without tariff values (not weighted). Spearman correlation coefficients were calculated between SF-6D (weighted and not weighted) and EQ-5D values (VAS-t, TTO-t and not weighted). RESULTS: Mean value of weighted SF-6D was 0.67 (0.15) and not weighted, 0.72 (0.15). Mean values of EQ-5D VAS-t was 0.69 (0.24), of TTO-t, 0.70 (0.32) and of not weighted EQ-5D, 0.63 (0.33). SF-6D values had moderate correlation with EQ-5D VASt (r = 0.734) and EQ-5D TTO-t (r = 0.731) (both p < 0.001). Using the SF-6D index without tariff values, it had a high correlation with the weighted version of SF-6D (r = 0.969, p < 0.001), and moderate with the EQ-5D VAS-t (r = 0.754), EQ-5D TTO-t (r = 0.750) and no weighted EQ-5D (r = 0.784) (p < 0.001). CONCLUSIONS: The efforts made to get the preferences values and calculate the weights in utility indexes do not seem to add enough information to make them worthy.
PLoS neglected tropical diseases, 2015
Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation u... more Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation units and determining the population at risk that will be targeted for mass drug administration (MDA). Prior to the current study, only 116 of the 832 woredas (districts) in Ethiopia had been mapped for LF. The aim of this study was to perform a nationwide mapping exercise to determine the number of people that should be targeted for MDA in 2016 when national coverage was anticipated. A two-stage cluster purposive sampling was used to conduct a community-based cross-sectional survey for an integrated mapping of LF and podoconiosis, in seven regional states and two city administrations. Two communities in each woreda were purposely selected using the World Health Organization (WHO) mapping strategy for LF based on sampling 100 individuals per community and two purposely selected communities per woreda. Overall, 130 166 people were examined in 1315 communities in 658 woredas. In total, 140 ...
Revista Española de Enfermedades Digestivas, 2004
To assess the effect of infliximab on quality of life in a series of patients with fistulizing Cr... more To assess the effect of infliximab on quality of life in a series of patients with fistulizing Crohn&amp;#39;s disease. A prospective observational study was made. A total of 25 patients with single or multiple draining abdominal or perianal fistulas were selected for the study. All received an intravenous infusion of infliximab at a dose of 5 mg per kilogram of body weight in weeks 0, 2, and 6. The clinical activity was calculated every two weeks over a 10-week follow-up. HRQOL (SF-36 and IBDQ scores) were compared at baseline and at weeks 4 and 10. Sixty-four percent of patients had a clinical response to treatment with infliximab, with complete closure of fistulas. The mean values of CDAI decreased during follow-up, with a significant difference between weeks 0 and 10 (p &amp;lt; 0.01). Health-related quality of life (HRQOL), as measured by means of SF-36, showed an overall improvement in the physical domain (PCS) after 4 and 10 weeks (p &amp;lt; 0.05). An increase was also observed in IBDQ overall score on comparing the results obtained at week 0 and week 4 (p &amp;lt; 0.01). The social functioning domain of IBDQ was not significantly changed with treatment. Treatment with infliximab in active fistulizing Crohn&amp;#39;s disease results in a significant increase in the quality of life of patients at short-term.
Value in Health, 2004
Abstracts younger ones. The objective of the present study was to assess the differences 65 years... more Abstracts younger ones. The objective of the present study was to assess the differences 65 years) and younger ones on hemodialysis ≥ in HRQoL between elderly patients (and renal transplantation during the first two years. METHODS: Longitudinal prospective study of 199 patients starting RRT. HRQoL was assessed using the SF-36 health survey at three, 12 and 24 months from the start of RRT. PCS, MCS and standardised scores by age and sex were obtained using Spanish general population norms. The tstudent test for unpaired samples was used to compare HRQol of elderly and younger at each moment. RESULTS: Preliminary data of 144 patients collected at three months, of 118 at 12 months and of 76 at 24 months are presented. Mean age was 63.5(14.31) and 60.5% were elderly patients. At three months, all patients were on hemodialysis; elderly patients had lower loss of HRQoL in Physical Functioning (p = 0.039), Role Physical (p = 0.005), General 0.0001), Role Emotional (p = 0.014), and PCS (p = 0.048), than younger < Health (p ones. At 12 months, elderly transplanted patients had lower loss of HRQoL in Physical Functioning (p = 0.018), General Health(p = 0.021) and Vitality (p = 0.067),and elderly patients on hemodialysis had less loss of HRQL in Physical Functioning (p = 0.002), Role physical (p = 0.044), Bodily Pain (p = 0.015), General Health (p = 0.001), Mental Health (p = 0.034) and PCS (p = 0.007). At 24 months, elderly transplanted patients had less loss of HRQoL in Physical Functioning (p = 0.017) Bodily Pain (p = 0.025), General Health (p = 0.027). CONCLUSIONS: It's the first time that it is demonstrated that, using standardised scores by age and gender, elderly patients have less loss of HRQoL than the younger ones during the first year on RRT. Life (HRQoL) between hemodialysis (HD) and peritoneal dialysis (DP). METHODS: This multicentric study is from 14 dialysis units in our country of a randomized sample of 221 patients, 152 in HD and 69 in DP. HRQoL was evaluated using EuroQoL-5D scale: 5 dimensions (Mobility-M, Self-Care-SC, Usual Activities-UA, Pain-P, Anxiety/ Depression-AD) and their Tariff (T), and the Visual Analogue Scale (VAS). Patients also answered the KDQOL-SF which includes the SF-36 with the physical and the mental component summary (PCS, MCS) and specific questions about kidney disease. Sociodemographic and clinical data, the Karnofsky Scale and a comorbidity index were also collected. SF-36 scores were standardized using the Spanish general population norms. RESULTS: Patients undergoing DP were more frequently in employment, had a higher level of education, lower age (54.4 vs.63.2), less time on dialysis (33.6 vs.48.9 months), were less often diabetic (10.5%vs.23.3%). However, comorbidity (6.5 vs. 5.6), Karnofsky score (82.2 vs. 84.1), Sf-36 scores (PCS: 40.9 vs. 40.4; MCS: 47.9 vs. 47.3) and Tariff of EuroQoL-5D (0.74 vs. 0.70) were similar. Statistically significant differences were found in the VAS (64.7 vs. 55.9; p < 0.001) and in several specific dimensions of the KDQOL-SF in which patients in DP scored higher (better HRQoL): symptoms/problems of kidney disease (79.7 vs. 75.8; p = 0.05), effects of the renal disease (72.2 vs. 62.6; p = 0.005), social support (84.8 vs. 78.6; p = 0.013) and support of the dialysis staff (94.4 vs. 85.03; p = 0.001), although these scores are not standardized for age and sex in the absence of Spanish population norms for patients in dialysis. CONCLUSIONS: Patients undergoing DP show similar status of general health as those of HD, but seem to have a better perceived health in several specific problems related with renal disease. Results emphasize the importance of using, in comparative studies, specific scales for patients on dialysis. OBJECTIVES: No validated questionnaires are available for assessing symptoms and quality of life (QoL) in Italian women with lower urinary tract symptoms (LUTS). In a large multicentre observational study of women with LUTS (FLOW-Female LUTS: Observational Study in Women), we translated into Italian and validated the long and short forms of female-specific questionnaires (ICIQ-LF and ICIQ-SF). METHODS: The validation process consisted of forward and backward translation, test of comprehension, discriminant validity, test-retest reliability. A first set of women was interviewed after they had filled in the questionnaires. A comprehension rate was built as the percentage of correctly understood questions and pre-coded answers of all items by all patients. A case-control study was then performed. Cases were women aged >18 year affected by LUTS from at least 3 months and with negative dipstick. Controls were defined as healthy women of comparable age. All women were enrolled consecutively. In order to evaluate reliability, cases were retested after seven days and a correlation analysis was performed between the first and the second measurement (Pearson's r). Discriminant validity was assessed by comparing the scores of cases and controls with ANOVA. RESULTS: The comprehension rate was 99.4% for ICIQ-LF and 99.1% for ICIQ-SF. Four out of 16 patients did not correctly understand 1 item (hesitancy) of ICIQ-LF, which was changed. Cases and controls were respectively 42 and 47 (ICIQ-SF), 80 and 61 (ICIQ-LF). All the ICIQ-SF patients were valuable for test-retest, while only 25 patients for ICIQ-LF. Pearson coefficient between ratings was >0.93 for 23 out of 48 items of ICIQ-LF and 0.96 for ICIQ-SF total score (p < 0.001). Cases and controls were discriminated at ANOVA (p < 0.001) with both questionnaires. CONCLU-SIONS: These data show that ICI questionnaires are generally easy to understand, have a good to excellent reliability and a high discriminant validity. OBJECTIVES: To evaluate the sensitivity to change of the Spanish version of the ICIQ-UI SF questionnaire, in order to recommend its use in clinical practice to evaluate treatment outcome for Urinary Incontinence (UI). METHODS: Prospective study of 115 women with diagnostic of Stress UI (SUI) who received treatment for their incontinence: Pelvic floor training (PFT) or surgery. All the patients had clinical and urodynamic
Transplantation Proceedings, 2006
Our objective was to evaluate health-related quality of life in patients with advanced heart fail... more Our objective was to evaluate health-related quality of life in patients with advanced heart failure on the waiting list for a heart transplant. Materials and methods. The study was performed using the EUROQOL-5D questionnaire (EQ-5D) on 38 patients (age: 53 Ϯ 2 years, 82% men) who were analyzed consecutively during the pretransplant period, as well as at 3, 6, and 12 months after transplantation. We excluded pediatric transplants, retransplantations, heart and lung transplantation, and patients scoring below 17 points on the Folstein's Cognitive Mini-Examination. The studied variables included the five dimensions of the EQ-5D test: mobility, self-care, daily activities, pain-discomfort, anxiety and depression; a visual analog scale from 0 to 100; and perception of health status. Statistics included analysis of variance and chi-square tests. Significance was set at P Ͻ .05. Results. There were significant differences in all tested parameters. The worst values were observed prior to transplantation, with a significant improvement at 3 months. Conclusions. Patients with heart failure showed a significant impairment in healthrelated quality of life before transplantation. The improvement in health-related quality of life was significant and rapidly evident in the posttransplantation period. The most affected dimensions were activities of daily living and pain-discomfort. All dimensions became stable at 3 months, except for anxiety and depression. At 6 to 12 months, a plateau was reached in the feelings of well-being.
Proceedings of the National Academy of Sciences, 2009
A variety of viruses establish latency by integrating their genome into the host genome. The inte... more A variety of viruses establish latency by integrating their genome into the host genome. The integration event generally occurs in a nonspecific manner, precluding the prediction of functional consequences from resulting disruptions of affected host genes. The nonpathogenic adeno-associated virus (AAV) is unique in its ability to stably integrate in a site-specific manner into the human MBS85 gene. To gain a better understanding of the integration mechanism and the consequences of MBS85 disruption, we analyzed the molecular structure of AAV integrants in various latently infected human cell lines. Our study led to the observation that AAV integration causes an extensive but partial duplication of the target gene. Intriguingly, the molecular organization of the integrant leaves the possibility that a functional copy of the disrupted target gene could potentially be preserved despite the resulting rearrangements. A latently infected, Mbs85-targeted mouse ES cell line was generated to study the functional consequences of the observed duplication-based integration mechanism. AAV-modified ES cell lines continued to self-renew, maintained their multilineage differentiation potential and contributed successfully to mouse development when injected into blastocysts. Thus, our study reveals a viral strategy for targeted genome addition with the apparent absence of functional consequences. embryonic stem cells ͉ MBS85 ͉ gene targeting ͉ Rep ͉ AAVS1
do fue el de personal (media de 30,9%), que mostró una importante variabilidad entre centros, tan... more do fue el de personal (media de 30,9%), que mostró una importante variabilidad entre centros, tanto en cifras absolutas (coste personal/paciente/año entre 18.151 y 8.504 €) como porcentuales (entre 42,6 y 25,4%). Conclusiones: Existe una importante variabilidad de coste entre diferentes centros de HD, y ésta puede atribuirse fundamentalmente al coste de personal y fungible, que es superior en los CP respecto a los CC.
Value in Health, 2003
Keeping in mind that the benefits were measured by survival groups, the cost effectiveness was: €... more Keeping in mind that the benefits were measured by survival groups, the cost effectiveness was: €57/month of life for G1, 181 for G2, and 222 for G3. CONCLUSIONS: not having an adequate vascular access in order to start PHD, causes not only an important decrease of survival but more indirect costs as less benefit too.
Value in Health, 2012
Two-year of data on prescribed anti-diabetic medications were also available for the analyses. Da... more Two-year of data on prescribed anti-diabetic medications were also available for the analyses. Data from this cohort were compared to an age and gender control group of Aboriginal individuals without diabetes. Regression analyses were conducted to evaluate the impact of anti-diabetic medications on glycemic levels and control after covariate adjustment (e.g. age, gender, baseline HbA1c). RESULTS: A total of 323 individuals newly diagnosed with diabetes in 2002 were identified. The mean HbA1c levels increased from 6.8% at time of diagnosis to 8.2% at the end of the study in 2008. A similar trend was seen for fasting glucose levels. After adjusting for covariate, the results of the regression analyses indicated that continuous (versus no use) and intermittent (versus no use) use of anti-diabetic drugs have no significant impact on 2-year HbA1c levels. Other clinical results indicated that a large proportion of the Aboriginal people had uncontrolled hypertension and hyperlipidemia. The average number of visits to physician, number of hospitalization and the length of staying at hospital were higher among the Aboriginal people with diabetes compared to their control group. CONCLUSIONS: Consistent with previous studies, these findings suggest that a minority of Aboriginal people in Southwestern-Ontario achieved optimal glycemic control.
Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2011
Previous studies to determine the cost of haemodialysis (HD) in Spain have significant limitation... more Previous studies to determine the cost of haemodialysis (HD) in Spain have significant limitations: they are outdated or used indirect methods. There is also a lack of analysis performed simultaneously on Public centres (PC), with direct HD services, and partially state-subsidised centres (SC). This is an important issue since the two systems coexist in Spain. To estimate the cost of HD replacement therapy for chronic renal failure in several centres. This is a prospective and publicly-funded study, which estimates the costs for 2008 using a cost accounting system with specific allocation criteria. We collected demographic and comorbidity data for each centre. Six centres participated, two PC and four SC. There were no significant differences between centres in terms of patient demographics, time on haemodialysis and the Charlson comorbidity index. The total cost per patient per year ranged between € 46, 254 and € 33,130. The cost per patient per year (excluding vascular access and ...
Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2002
To study the changes in the health related quality of life (HRQOL) during the first year followin... more To study the changes in the health related quality of life (HRQOL) during the first year following renal transplant (RT), comparing azathioprine vs mycophenolate mofetil (MMF) in triple immunosuppressant therapy with prednisone and cyclosporine. Prospective, open and random study with 26 patients who received a primary cadaveric renal transplant consecutively. Analysis of clinical variables: delayed graft function (DGF), acute rejection (AR), infections and comorbidity; analytical: haemogram, albumin and serum creatinine, hepatic function, cyclosporin levels; instruments for assessing the HRQOL: Psychological General Well-being Index (PGWBI) and Euroqol-5d (EQ-5d) health questionnaire, which includes a self-assessment scale of the state of health, Visual Analogical Scale (VAS). Controlled collection of data upon discharge following renal transplant, and subsequently 1, 3, 6, and 12 months following the first questionnaire. There were no differences between patients on azathioprine o...
Nefrología : publicación oficial de la Sociedad Española Nefrologia
Nefrología : publicación oficial de la Sociedad Española Nefrologia
To establish the frequency and severity of somatic symptoms and emotional distress (anxiety and/o... more To establish the frequency and severity of somatic symptoms and emotional distress (anxiety and/or depression) among our chronic hemodialysis (CHD) patients and to study the relationship between them as well as their influence on the perceived health status. All patients who had been on CHD for a minimum of three months were eligible for the study. Eight of them were excluded: six because they were unable to answer the questionnaires and two because they refused to participate. The 58 remaining patients were the subject of our study (median age 68.5 years; median duration of HD 29.5 months). Diverse sociodemographic and clinical data were recorded. The patients answered the following questionnaires: 1) The "physical symptoms" dimension of the Kidney Disease Questionnaire; 2) A measure of anxiety (STAI); 3) A measure of depression (Beck Depression Inventory and Cognitive Depression Index); and 4) The Nottingham Health Profile (NHP). The most frequent and severe symptoms wer...
Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2000
OBJECTIVES: A new utility index derived of the SF-36, the SF-6D, was recently developed and has g... more OBJECTIVES: A new utility index derived of the SF-36, the SF-6D, was recently developed and has generated an increasing research in different groups of patients and has also been compared with other utility measures, as it is the EQ-5D. The purpose of present work was to evaluate the differences between the weighted and not weighted version of two utility measures: the Spanish SF-6D and EQ-5D. METHODS: A total of 1843 complete measures of the SF-36 and the EQ-5D (5 items and visual analogic scale-VAS) from 1283 patients who received a solid organ transplant (kidney, liver, heart or lung) were used. Data were collected at different moments during the first year after the surgery in the context of the Spanish Research Network on Transplantation. SF-6D values were calculated using the model proposed by its creator (weighted version) and without tariff values, as has been proposed by some authors (not weighted). EQ-5D values were calculated using Spanish VAS tariff (VAS-t), the time-trade off tariff (TTO-t) and also without tariff values (not weighted). Spearman correlation coefficients were calculated between SF-6D (weighted and not weighted) and EQ-5D values (VAS-t, TTO-t and not weighted). RESULTS: Mean value of weighted SF-6D was 0.67 (0.15) and not weighted, 0.72 (0.15). Mean values of EQ-5D VAS-t was 0.69 (0.24), of TTO-t, 0.70 (0.32) and of not weighted EQ-5D, 0.63 (0.33). SF-6D values had moderate correlation with EQ-5D VASt (r = 0.734) and EQ-5D TTO-t (r = 0.731) (both p < 0.001). Using the SF-6D index without tariff values, it had a high correlation with the weighted version of SF-6D (r = 0.969, p < 0.001), and moderate with the EQ-5D VAS-t (r = 0.754), EQ-5D TTO-t (r = 0.750) and no weighted EQ-5D (r = 0.784) (p < 0.001). CONCLUSIONS: The efforts made to get the preferences values and calculate the weights in utility indexes do not seem to add enough information to make them worthy.