Katia Iglesias | University of Neuchâtel (original) (raw)

Papers by Katia Iglesias

Alcohol and alcoholism (Oxford, Oxfordshire), Jan 29, 2014

Many studies have suggested a close relationship between alcohol use disorder (AUD) and major dep... more Many studies have suggested a close relationship between alcohol use disorder (AUD) and major depressive disorder (MDD). This study aimed to test whether the relationship between self-reported AUD and MDD was artificially strengthened by the diagnosis of MDD. This association was tested comparing relationships between alcohol use and AUD for depressive people and non-depressive people. As part of the Cohort Study on Substance Use Risk Factors, 4352 male Swiss alcohol users in their early twenties answered questions concerning their alcohol use, AUD and MDD at two time points. Generalized linear models for cross-sectional and longitudinal associations were calculated. For cross-sectional associations, depressive participants reported a higher number of AUD symptoms (β = 0.743, P < 0.001) than non-depressive participants. Moreover, there was an interaction (β = -0.204, P = 0.001): the relationship between alcohol use and AUD was weaker for depressive participants rather than non-de...

European Geriatric Medicine, 2012

ABSTRACT Objectives: To determine the risk of orthostatic hypotension (OH) due to antihypertensiv... more ABSTRACT Objectives: To determine the risk of orthostatic hypotension (OH) due to antihypertensive therapy in a geriatric inpatient population. Subjects and methods: This observational cohort study included 388 patients (mean age 80.7, 68.5% female) hospitalized in a geriatric clinic. OH risk was evaluated by orthostatic testing (OT), with manual measurement of blood pressure after 30 minutes supine (TO), and after 1 (T1), 3 (T3), and 5 (T5) minutes after rising in a vertical position. OH was defined by a >= 20 mmHg decrease in systolic blood pressure and/or a >= 10 mmHg decrease in diastolic blood pressure. Results: Age >= 80 years, history of falls and prescribed medication (antihypertensive, hypotensive, or both), were not significantly associated with OH or with OT positivity at any time point. The multivariate analysis showed that OH risk in T1 was 2.34 times higher than in T3 and T5 (confidence interval [1.49-3.68], P < 0.001). Presenting symptoms during OT increased the risk of obtaining a positive result by 3.67 times (confidence interval [1.52-8.87], P = 0.004). With each increase in one mini-mental state examination (MMS) point, a 9.9% decrease of OT positivity was observed (odds ratio = 0.907, confidence interval [0,84-0,98], P=0.016). Conclusion: The prescription of antihypertensive drugs was not significantly associated with the risk of OH in this geriatric inpatient population. OH screening in patients with cognitive impairment is critical, as with each decrease in one MMS point, OH risk increased by almost 10%.

European Journal of Emergency Medicine, 2015

Frequent Emergency Department (ED) users are vulnerable individuals and discrimination is usually... more Frequent Emergency Department (ED) users are vulnerable individuals and discrimination is usually associated with increased vulnerability. The aim of this study was to investigate frequent ED users&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of discrimination and to test whether they were associated with increased vulnerability. In total, 250 adult frequent ED users were interviewed in Lausanne University Hospital. From a previously published questionnaire, we assessed 15 dichotomous sources of perceived discrimination. Vulnerability was assessed using health status: objective health status (evaluation by a healthcare practitioner including somatic, mental health, behavioral, and social issues - dichotomous variables) and subjective health status [self-evaluation including health-related quality of life (WHOQOL) and quality of life (EUROQOL) - mean-scores]. We computed the prevalence rates of perceived discrimination and tested associations between perceived discrimination and health status (Fischer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact tests, Mann-Whitney U-tests). A total of 35.2% of the frequent ED users surveyed reported at least one source of perceived discrimination. Objective health status was not significantly related to perceived discrimination. In contrast, experiencing perceived discrimination was associated with worse subjective health status (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Frequent ED users are highly likely to report perceived discrimination during ED use, and this was linked to a decrease in their own rating of their health. Hence, discrimination should be taken into account when providing care to such users as it may constitute an additional risk factor for this vulnerable population. Perceived discrimination may also be of concern to professionals seeking to improve practices and provide optimal care to frequent ED users.

Canadian Urological Association Journal, 2014

Preoperative scores are widely used predictors of complications after major surgery. These scores... more Preoperative scores are widely used predictors of complications after major surgery. These scores, however, are not widely used in transurethral procedures. The aim of this study was to assess the value of the Charlson Comorbidity Index (CCI), the age-adjusted CCI, the American Society of Anesthesiologist score (ASA) and the Nutritional Risk Score (NRS) in predicting early morbidity after transurethral urological procedures. Consecutive patients undergoing transurethral resection of the bladder or the prostate were prospectively enrolled. The scores were calculated preoperatively; 30-day complications were prospectively recorded according to the Dindo-Clavien classification. Univariate logistic regression was performed to investigate the value of each score and of other factors (i.e., age, sex, body mass index, anemia, smoking habit, type of operation and anaesthesia) as predictors of complications. A multivariate model was then calculated using these predictors. Overall, 197 patients were included. The mean age was 72 (standard deviation ± 10). In total, 26.9% patients had at least 1 complication. Using univariate analysis, we found that each score significantly predicted complications. In multivariate analysis, only the ASA (odds ration [OR] 2.11; 95% confidence interval [CI] 1.01-4.43) and the NRS (OR 2.42; 95% CI 1.56-3.74) remained independent predictors. The best model incorporated ASA, NRS and gender, and predicted morbidity with an area under the curve of 76%. Our study&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s main limitations are population heterogeneity and limited sample size. The ASA and the NRS are important and independent determinants of early morbidity after transurethral procedures. The use of these indices may assist clinicians in the decision-making process to balance the possible benefits of transurethral procedures with the potential risks.

The Journal of Urology, 2013

The nutritional risk score is a recommended screening tool for malnutrition. While a nutritional ... more The nutritional risk score is a recommended screening tool for malnutrition. While a nutritional risk score of 3 or greater predicts adverse outcomes after digestive surgery, to our knowledge its predictive value for morbidity after urological interventions is unknown. We determined whether urological patients at nutritional risk are at higher risk for complications after major surgery than patients not at nutritional risk. We performed a prospective observational study in consecutive patients undergoing major surgery. A priori sample calculation resulted in a study cohort of 220 patients. Interim analysis was planned after 110 patients. The nutritional risk score was assessed preoperatively by a specialized study nurse. Nutritional care was standardized in all patients. Postoperative complications were defined previously using the standardized Dindo-Clavien classification. The primary end point was 30-day morbidity. Univariate and multivariate analysis was performed to identify predictors of complications. The study was discontinued due to significant results after interim analysis. A total of 125 patients were included in analysis from June 2011 to June 2012 and 15 were excluded because of incomplete data. Of 51 patients at nutritional risk 38 (74%) presented with at least 1 complication compared to 28 of 59 controls (47%). Patients at nutritional risk were at threefold risk for complications on univariate and multivariate analysis (OR 3.3, 95% CI 1.3-8.0). Cystectomy was the only other predictor of morbidity (OR 10, 95% CI 2-48). Patients at nutritional risk are more prone to complications after major urological procedures. Whether this increased morbidity can be reversed by perioperative nutritional support should be studied.

Blood Pressure Monitoring, 2014

Home blood pressure (BP) monitoring is recommended by several clinical guidelines and has been sh... more Home blood pressure (BP) monitoring is recommended by several clinical guidelines and has been shown to be feasible in elderly persons. Wrist manometers have recently been proposed for such home BP measurement, but their accuracy has not been previously assessed in elderly patients. Forty-eight participants (33 women and 15 men, mean age 81.3±8.0 years) had their BP measured with a wrist device with position sensor and an arm device in random order in a sitting position. Average BP measurements were consistently lower with the wrist than arm device for systolic BP (120.1±2.2 vs. 130.5±2.2 mmHg, P&amp;amp;amp;amp;amp;lt;0.001, means±SD) and diastolic BP (66.0±1.3 vs. 69.7±1.3 mmHg, P&amp;amp;amp;amp;amp;lt;0.001). Moreover, a 10 mmHg or greater difference between the arm and wrist device was observed in 54.2 and 18.8% of systolic and diastolic measures, respectively. Compared with the arm device, the wrist device with position sensor systematically underestimated systolic as well as diastolic BP. The magnitude of the difference is clinically significant and questions the use of the wrist device to monitor BP in elderly persons. This study points to the need to validate BP measuring devices in all age groups, including in elderly persons.

Revue internationale de psychosociologie, 2010

Heroin Addiction and Related Clinical Problems

BMJ open diabetes research & care, 2015

Health-related quality of life (HRQoL) is considered a representative outcome in the evaluation o... more Health-related quality of life (HRQoL) is considered a representative outcome in the evaluation of chronic disease management initiatives emphasizing patient-centered care. We evaluated the association between receipt of processes-of-care (PoC) for diabetes and HRQoL. This cross-sectional study used self-reported data from non-institutionalized adults with diabetes in a Swiss canton. Outcomes were the physical/mental composites of the short form health survey 12 (SF-12) physical composite score, mental composite score (PCS, MCS) and the Audit of Diabetes-Dependent Quality of Life (ADDQoL). Main exposure variables were receipt of six PoC for diabetes in the past 12 months, and the Patient Assessment of Chronic Illness Care (PACIC) score. We performed linear regressions to examine the association between PoC, PACIC and the three composites of HRQoL. Mean age of the 519 patients was 64.5 years (SD 11.3); 60% were male, 87% reported type 2 or undetermined diabetes and 48% had diabetes f...

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2015

Not in Education, Employment, or Training (NEET) youth are youth disengaged from major social ins... more Not in Education, Employment, or Training (NEET) youth are youth disengaged from major social institutions and constitute a worrying concern. However, little is known about this subgroup of vulnerable youth. This study aimed to examine if NEET youth differ from other contemporaries in terms of personality, mental health, and substance use and to provide longitudinal examination of NEET status, testing its stability and prospective pathways with mental health and substance use. As part of the Cohort Study on Substance Use Risk Factors, 4,758 young Swiss men in their early 20s answered questions concerning their current professional and educational status, personality, substance use, and symptomatology related to mental health. Descriptive statistics, generalized linear models for cross-sectional comparisons, and cross-lagged panel models for longitudinal associations were computed. NEET youth were 6.1% at baseline and 7.4% at follow-up with 1.4% being NEET at both time points. Compar...

Evaluation & the health professions, Jan 26, 2014

Emerging adulthood is a period of life transition, in which youths are no longer adolescents but ... more Emerging adulthood is a period of life transition, in which youths are no longer adolescents but have not yet reached full adulthood. Measuring emerging adulthood is crucial because of its association with psychopathology and risky behaviors such as substance use. Unfortunately, the only validated scale for such measurement has a long format (Inventory of Dimensions of Emerging Adulthood [IDEA]-31 items). This study aimed to test whether a shorter form yields satisfactory results without substantial loss of information among a sample of young Swiss men. Data from the longitudinal Cohort Study on Substance Use Risk Factors were used (N = 5,049). IDEA, adulthood markers (e.g., parenthood or financial independence), and risk factors (i.e., substance use and mental health issues) were assessed. The results showed that an 8-item, short-form scale (IDEA-8) with four factors (experimentation, negativity, identity exploration, and feeling in between) returned satisfactory results, including...

ABSTRACT Purpose of the study There is little consensus on how to best evaluate exposure to occup... more ABSTRACT Purpose of the study There is little consensus on how to best evaluate exposure to occupational stress – one of today's significant occupational health concerns. The many methodological and conceptual tools necessary are still matter for debate. This study aimed to develop a general, validated, French language questionnaire to assess exposure to occupational stress, thus providing researchers and practitioners with a tool that has long been missing. Methods Employees from two companies (n = 129 and n = 142) filled in the questionnaire on organizational and social stressors (QSOS) as part of a social performance audit. This included measuring convergent validity using 3 additional questionnaires (on organizational commitment, organizational involvement, and Karasek's Job Content Questionnaire [JCQ]), and measuring reliability via a test–retest involving one of the companies. Results Data fitted the model quite well. The QSOS was split into 6 parts: uncertainty, lack of recognition, interpersonal relations, communication, change and values, and job design. Convergent validity and accuracy were very good. The QSOS was highly correlated to JCQ (r = 0.75, P < 0.001), organizational commitment (r = 0.48, P < 0.001) and organizational involvement (r = 0.45, P < 0.001). There was no statistically significant difference between the test and the retest. Discussion This study proposes a general, validated questionnaire to measure organizational and social stressors in companies. It addresses some of the methodological and conceptual issues raised in previous studies. This is a first step towards the development of an integrative tool in French for measuring exposure to occupational stress.

International Journal of Language & Communication Disorders, 2014

The few studies that have evaluated syntax in autism spectrum disorder (ASD) have yielded conflic... more The few studies that have evaluated syntax in autism spectrum disorder (ASD) have yielded conflicting findings: some suggest that once matched on mental age, ASD and typically developing controls do not differ for grammar, while others report that morphosyntactic deficits are independent of cognitive skills in ASD. There is a need for a better understanding of syntax in ASD and its relation to, or dissociation from, nonverbal abilities. Syntax in ASD was assessed by evaluating subject and object relative clause comprehension in adolescents and adults diagnosed with ASD with a performance IQ within the normal range, and with or without a history of language delay. Twenty-eight participants with ASD (mean age 21.8) and 28 age-matched controls (mean age 22.07) were required to point to a character designated by relative clauses that varied in syntactic complexity. Scores indicate that participants with ASD regardless of the language development history perform significantly worse than age-matched controls with object relative clauses. In addition, participants with ASD with a history of language delay (diagnosed with high-functioning autism in the DSM-IV-TR) perform worse on subject relatives than ASD participants without language delay (diagnosed with Asperger syndrome in the DSM-IV-TR), suggesting that these two groups do not have equivalent linguistic abilities. Performance IQ has a positive impact on the success of the task for the population with ASD. This study reveals subtle grammatical difficulties remaining in adult individuals with ASD within normal IQ range as compared with age-matched peers. Even in the absence of a history of language delay in childhood, the results suggest that a slight deficit may nevertheless be present and go undetected by standardized language assessments. Both groups with and without language delay have a similar global performance on relative clause comprehension; however, the study also indicates that the participants with reported language delay show more difficulty with subject relatives than the participants without language delay, suggesting the presence of differences in linguistic abilities between these subgroups of ASD.

European Archives of Oto-Rhino-Laryngology, 2014

Patients with cleft palate are prone to velopharyngeal insufficiency. In minor cases or when hype... more Patients with cleft palate are prone to velopharyngeal insufficiency. In minor cases or when hypernasal speech does not resolve after velopharyngoplasty, an augmentation pharyngoplasty with autologous fat can be proposed. The aim of the present study is to evaluate the short-term (within 2 months) and long-term efficiency (during the 24 months following the procedure) of our procedure in the setting of velopharyngeal insufficiency related to a cleft palate. Twenty-two patients with cleft palate related velopharyngeal insufficiency were included in this retrospective study. All patients were operated following the same technique, in the same institution. The pre- and postoperative evaluations included a nasometry, a subjective evaluation using the Borel-Maisonny score, and a nasofibroscopy to assess the degree of velopharyngeal closure. Scores of Borel-Maisonny and nasometry were compared before, shortly after the procedure (within 2 months) and long term after the procedure (within 24 months). Forty-one procedures in 22 patients with a cleft palate performed in our institution between October 2004 and January 2012 were included in the study. Nine patients had a previous velopharyngoplasty with persistent rhinolalia despite intensive speech therapy. In 14 patients the procedure was repeated because of recurrent hypernasal speech after the first injection. The average number of procedures per patient was 1.8. Postoperative nasometry and Borel-Maisonny scores were statistically significantly improved and remained stable until the end of the follow-up (median 42 months postoperative) in most patients. Complications were rare and minor. Autologous fat injection is a simple procedure for treatment of minor velopharyngeal insufficiencies in patients with cleft palate, with good long-term results and few complications.