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Article ; Online: Prevención secundaria del ictus. Mucho por hacer.

Álvarez-Sabín, José

2011 Volume 136, Issue 8, Page(s) 340–342

Title translation	Stroke secondary prevention: still a lot to do.
MeSH term(s)	Humans ; Secondary Prevention ; Spain/epidemiology ; Stroke/epidemiology ; Stroke/prevention & control
Language	Spanish
Publishing date	2011-03-26
Publishing country	Spain
Document type	Editorial
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2010.09.021
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Article ; Online: Short and Mid-Term Predictors of Response to OnabotulinumtoxinA: Real-Life Experience Observational Study.

Alpuente, Alicia / Gallardo, Víctor José / Torres-Ferrús, Marta / Álvarez-Sabin, José / Pozo-Rosich, Patricia

Headache

2020 Volume 60, Issue 4, Page(s) 677–685

Abstract: Objective: To identify clinical predictors of excellent response to OnabotulinumtoxinA in patients with chronic migraine (CM) at 6 and 12 months of follow-up.: Background: Clinical predictors of response to OnabotulinumtoxinA are scarce and have not ... ...

Abstract	Objective: To identify clinical predictors of excellent response to OnabotulinumtoxinA in patients with chronic migraine (CM) at 6 and 12 months of follow-up. Background: Clinical predictors of response to OnabotulinumtoxinA are scarce and have not been clearly reproduced and analyzed in detail. So far, predictors of response to OnabotulinumtoxinA assess response in general or good response, but not an excellent response. Methods: Cohort study of patients attended in a specialized Headache Clinic in treatment with OnabotulinumtoxinA were classified according to their improvement in frequency: no-response (<25%) and excellent response (≥75%). A comparative analysis was carried out at 6 and 12 months identifying clinical predictors of excellent response to OnabotulinumtoxinA at each timepoint. Results: Data were collected from 221 patients. After 6 and also 12 months, we observed a statistically significant mean reduction in frequency and analgesic intake. At month 6, independent variables associated with excellent response (OR[95%CI]) were daily headache frequency (0.32[0.14-0.74]; P = .005), medication overuse (MO) (2.28[1.19-4.37]; P = .013), and a higher ratio of migraine days/month (MDM) (1.20[1.10-1.45]; P = .018) at baseline. At month 12, independent predictors of excellent response were patients with less than 30 years of migraine evolution (0.43[0.23-0.82]; P = .011), presence of anxiety (0.44[0.23-0.85]; P = .018), and aura (0.48[0.25-0.92]; P = .037). Excellent responders showed a higher improvement rate in pain intensity at 6 and 12 months. Conclusions: Patients with daily frequency and MO show a clinical improvement in short-term. Patients with comorbidities who start treatment earlier in the course of the disease need a longer duration of treatment. The profile of response to treatment with OnabotulinumtoxinA determines its minimum treatment duration and the timepoint of a meaningful response.
Language	English
Publishing date	2020-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	410130-3
ISSN	1526-4610 ; 0017-8748
ISSN (online)	1526-4610
ISSN	0017-8748
DOI	10.1111/head.13765
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Article ; Online: Enhancing blood pressure management protocol implementation in patients with acute intracerebral haemorrhage through a nursing-led approach: A retrospective cohort study.

Pancorbo, Olalla / Sanjuan, Estela / Rodríguez-Samaniego, María Teresa / Miñarro, Olga / Simonetti, Renato / Olivé-Gadea, Marta / García-Tornel, Álvaro / Rodriguez-Villatoro, Noelia / Muchada, Marián / Rubiera, Marta / Álvarez-Sabin, José / Molina, Carlos A / Rodriguez-Luna, David

Journal of clinical nursing

2024 Volume 33, Issue 4, Page(s) 1398–1408

Abstract: Aim: To evaluate the impact of nurse care changes in implementing a blood pressure management protocol on achieving rapid, intensive and sustained blood pressure reduction in acute intracerebral haemorrhage patients.: Design: Retrospective cohort ... ...

Abstract	Aim: To evaluate the impact of nurse care changes in implementing a blood pressure management protocol on achieving rapid, intensive and sustained blood pressure reduction in acute intracerebral haemorrhage patients. Design: Retrospective cohort study of prospectively collected data over 6 years. Methods: Intracerebral haemorrhage patients within 6 h and systolic blood pressure ≥ 150 mmHg followed a rapid (starting treatment at computed tomography suite with a target achievement goal of ≤60 min), intensive (target systolic blood pressure < 140 mmHg) and sustained (maintaining target stability for 24 h) blood pressure management plan. We differentiated six periods: P1, stroke nurse at computed tomography suite (baseline period); P2, antihypertensive titration by stroke nurse; P3, retraining by neurologists; P4, integration of a stroke advanced practice nurse; P5, after COVID-19 impact; and P6, retraining by stroke advanced practice nurse. Outcomes included first-hour target achievement (primary outcome), tomography-to-treatment and treatment-to-target times, first-hour maximum dose of antihypertensive treatment and 6-h and 24-h systolic blood pressure variability. Results: Compared to P1, antihypertensive titration by stroke nurses (P2) reduced treatment-to-target time and increased the rate of first-hour target achievement, retraining of stroke nurses by neurologists (P3) maintained a higher rate of first-hour target achievement and the integration of a stroke advanced practice nurse (P4) reduced both 6-h and 24-h systolic blood pressure variability. However, 6-h systolic blood pressure variability increased from P4 to P5 following the impact of the COVID-19 pandemic. Finally, compared to P1, retraining of stroke nurses by stroke advanced practice nurse (P6) reduced tomography-to-treatment time and increased the first-hour maximum dose of antihypertensive treatment. Conclusion: Changes in nursing care and continuous education can significantly enhance the time metrics and blood pressure outcomes in acute intracerebral haemorrhage patients. Reporting method: STROBE guidelines. Patient and public contribution: No Patient or Public Contribution.
MeSH term(s)	Humans ; Antihypertensive Agents/therapeutic use ; Blood Pressure/physiology ; Hypertension/drug therapy ; Pandemics ; Retrospective Studies ; Treatment Outcome ; Cerebral Hemorrhage/drug therapy ; Stroke/drug therapy
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2024-02-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1159483-4
ISSN	1365-2702 ; 0962-1067 ; 1752-9816
ISSN (online)	1365-2702
ISSN	0962-1067 ; 1752-9816
DOI	10.1111/jocn.17080
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Article ; Online: Interictal brain activity changes in temporal lobe epilepsy: A quantitative electroencephalogram analysis.

Fonseca, Elena / Quintana, Manuel / Seijo-Raposo, Iván / Ortiz de Zárate, Zuriñe / Abraira, Laura / Santamarina, Estevo / Álvarez-Sabin, José / Toledo, Manuel

Acta neurologica Scandinavica

2021 Volume 145, Issue 2, Page(s) 239–248

Abstract: Objectives: To evaluate the usefulness of quantitative electroencephalography (qEEG) in the analysis of baseline activity in patients with temporal lobe epilepsy (TLE) and identify measures potentially associated with disease duration and drug ... ...

Abstract	Objectives: To evaluate the usefulness of quantitative electroencephalography (qEEG) in the analysis of baseline activity in patients with temporal lobe epilepsy (TLE) and identify measures potentially associated with disease duration and drug resistance. Materials and methods: Cross-sectional study of adult patients with TLE and controls who underwent video-EEG monitoring. Representative artifact-free resting wakefulness baseline EEG segments were selected for quantitative analysis. The fast Fourier transform (FFT) approach was used for the power spectral analysis, with computation of FFT power ratios and alpha-delta and alpha-theta ratios for both hemispheres. The resulting measures were compared between TLE patients and controls and their values as predictors of epilepsy duration and drug resistance analyzed. Results: Thirty-nine TLE patients and 23 controls were included. The TLE patients had a lower alpha-delta ratio in the posterior quadrant ipsilateral to the epileptic focus and a lower alpha-theta ratio in the ipsilateral anterior/posterior quadrants and temporal region. A younger age at onset and longer epilepsy duration correlated with a higher theta power ratio in the contralateral anterior and posterior quadrants and temporal region. No qEEG measures predicted drug resistance. Conclusions: Quantitative electroencephalography background activity may contribute to the diagnosis of TLE and provide useful information on disease duration. A lower alpha-delta and alpha-theta ratio may be reliable baseline qEEG measures for identifying patients with TLE. A higher contralateral theta power ratio may be indicative of longer epilepsy duration.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Electroencephalography ; Epilepsy, Temporal Lobe/diagnosis ; Humans ; Temporal Lobe
Language	English
Publishing date	2021-10-22
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	90-5
ISSN	1600-0404 ; 0001-6314
ISSN (online)	1600-0404
ISSN	0001-6314
DOI	10.1111/ane.13543
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Article ; Online: The economic burden of newly diagnosed epilepsy in Spain.

Quintana, Manuel / Fonseca, Elena / Sánchez-López, Javier / Mazuela, Gonzalo / Santamarina, Estevo / Abraira, Laura / Álvarez-Sabin, Jose / Toledo, Manuel

Epilepsy & behavior : E&B

2021 Volume 125, Page(s) 108395

Abstract: Objective: The aim of this study was to determine the hospital burden and economic impact of epilepsy in adults in Spain and identify characteristics associated with higher direct medical costs.: Method: Patients newly diagnosed with epilepsy at the ... ...

Abstract	Objective: The aim of this study was to determine the hospital burden and economic impact of epilepsy in adults in Spain and identify characteristics associated with higher direct medical costs. Method: Patients newly diagnosed with epilepsy at the outpatient epilepsy unit of a tertiary hospital in Spain in 2012 were included. Sociodemographic and clinical data and use of health resources were collected retrospectively from electronic medical records from the time of diagnosis to the end of follow-up (2019). Direct costs (in 2012 Euro) were estimated and linear regression models built to explore predictors of higher costs. Results: We studied 110 patients with newly diagnosed epilepsy. Their mean (SD) age was 52.6 (19.6) years and 53.6% were men. Eighty-nine patients (80.9%) had focal epilepsy and 45 (40.9%) had an unknown etiology. At 6 months, 79.1% of patients were classified as responders and 17.6% as having drug-resistant epilepsy. The mean direct cost in the first year of epilepsy diagnosis was €3816.06, 49.7% of which was due to hospital admissions. The mean annual cost per patient was €2584.17, 51.4% of which was due to anti-seizure medications (ASMs). Focal epilepsy and poor response in the first 6 months of treatment predicted higher annual costs, while focal epilepsy and pre-existing comorbidities predicted higher costs in the first year. Conclusions: The direct cost of newly diagnosed epilepsy in adults in our area is €2584 per patient/year. Anti-seizure medication use is the main cost driver. Focal epilepsy, comorbidities, and poor response to ASMs are independent predictors of higher costs.
MeSH term(s)	Adult ; Cost of Illness ; Epilepsy/diagnosis ; Epilepsy/drug therapy ; Epilepsy/epidemiology ; Financial Stress ; Health Care Costs ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spain/epidemiology
Language	English
Publishing date	2021-11-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2021.108395
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Article: Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke.

Ramiro, Laura / Abraira, Laura / Quintana, Manuel / García-Rodríguez, Paula / Santamarina, Estevo / Álvarez-Sabín, Jose / Zaragoza, Josep / Hernández-Pérez, María / Ustrell, Xavier / Lara, Blanca / Terceño, Mikel / Bustamante, Alejandro / Montaner, Joan

Life (Basel, Switzerland)

2021 Volume 11, Issue 2

Abstract: Stroke is a major cause of disability and death globally, and prediction of mortality represents a crucial challenge. We aimed to identify blood biomarkers measured during acute ischemic stroke that could predict long-term mortality. Nine hundred and ... ...

Abstract	Stroke is a major cause of disability and death globally, and prediction of mortality represents a crucial challenge. We aimed to identify blood biomarkers measured during acute ischemic stroke that could predict long-term mortality. Nine hundred and forty-one ischemic stroke patients were prospectively recruited in the Stroke-Chip study. Post-stroke mortality was evaluated during a median 4.8-year follow-up. A 14-biomarker panel was analyzed by immunoassays in blood samples obtained at hospital admission. Biomarkers were normalized and standardized using
Language	English
Publishing date	2021-02-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life11020135
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Article ; Online: Effect of late-onset epilepsy on cognitive functioning in patients with small vessel disease.

Turon, Marc / Jiménez-Balado, Joan / Abraira, Laura / Fonseca, Elena / Quintana, Manuel / Toledo, Manuel / Delgado, Pilar / Maisterra, Olga / Salas-Puig, Xavier / Álvarez-Sabín, José / Santamarina, Estevo

Epilepsy & behavior : E&B

2021 Volume 123, Page(s) 108238

Abstract: Rationale: Late-onset epilepsy (LOE) often has underlying cerebrovascular cause and has been associated with neurocognitive deficits and dementia. Nevertheless, the interplay between these factors has not been studied thus far. Hence, we conducted a ... ...

Abstract	Rationale: Late-onset epilepsy (LOE) often has underlying cerebrovascular cause and has been associated with neurocognitive deficits and dementia. Nevertheless, the interplay between these factors has not been studied thus far. Hence, we conducted a retrospective cross-sectional study aimed to explore how unprovoked epileptic seizures along with vascular-related factors contribute to neurocognitive impairments in patients with cerebral small vessel disease. Methods: Twenty-seven patients with LOE aged > 60 years with concomitant cerebral small vessel disease (cSVD) and a matched group of cSVD without epilepsy were cognitively assessed. Demographic, clinical, and vascular information were obtained and vascular burden score was calculated for each patient. Multiple linear regression models were used to explore the relationship between epilepsy and cognitive measures adjusting for demographic and vascular risk factors. Results: Compared with cSVD, cSVD-LOE group showed a poorer performance on verbal memory measures, visuomotor tracking and speed processing and phonetic fluency. In the multiple regression analysis, the presence of epilepsy was found to be the major predictor for verbal memory dysfunction, specifically in verbal short recall (p = 0.008) and verbal learning (p < 0.001). No interactions between vascular burden and epilepsy were found. Conclusion: Patients who had cSVD with concurrent LOE showed poorer performance on memory function compared with patients with cSVD without epilepsy, and they showed a different cognitive profile from that typically manifested by patients with cSVD. The presence of epilepsy, but not seizure localization nor vascular burden, was the major contributor to the decrease in verbal memory.
MeSH term(s)	Cognition ; Cognitive Dysfunction ; Cross-Sectional Studies ; Epilepsy/complications ; Humans ; Retrospective Studies
Language	English
Publishing date	2021-08-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2021.108238
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Article ; Online: Medium-term effects of COVID-19 pandemic on epilepsy: A follow-up study.

Lallana, Sofía / Fonseca, Elena / Restrepo, Juan Luis / Quintana, Manuel / Seijo-Raposo, Iván / Abraira, Laura / Santamarina, Estevo / Álvarez-Sabín, José / Toledo, Manuel

Acta neurologica Scandinavica

2021 Volume 144, Issue 1, Page(s) 99–108

Abstract: Objective: To analyze the medium-term impact of the COVID-19 pandemic on epilepsy patients, focusing on psychological effects and seizure control.: Methods: Prospective follow-up study to evaluate the medium-term effects of the COVID-19 pandemic on a ...

Abstract	Objective: To analyze the medium-term impact of the COVID-19 pandemic on epilepsy patients, focusing on psychological effects and seizure control. Methods: Prospective follow-up study to evaluate the medium-term effects of the COVID-19 pandemic on a cohort of epilepsy patients from a tertiary hospital previously surveyed during the first peak of the pandemic. Between July 1, 2020, and August 30, 2020, the patients answered an online 19-item questionnaire, HADS, and PSIQ scales. Short- and medium-term effects of the pandemic confinement and the perception of telemedicine were compared. Results: 153 patients completed the questionnaire, mean ± SD age, 47.6 ± 19.3 years; 49.7% women. Depression was reported by 43 patients, significantly more prevalent than in the short-term analysis (29.2% vs. 19.7%; p = .038). Anxiety (38.1% vs. 36.1%; p = 0.749) and insomnia (28.9% vs. 30.9%, p = .761) remained highly prevalent. Seventeen patients reported an increase in seizure frequency (11.1% vs. 9.1%, p = .515). The three factors independently associated with an increase in seizure frequency in the medium term were drug-resistant epilepsy (odds ratio [OR] = 8.2, 95% CI 2.06-32.52), depression (OR = 6.46, 95% CI 1.80-23.11), and a reduction in income (OR = 5.47, 95% CI 1.51-19.88). A higher proportion of patients found telemedicine unsatisfactory (11.2% vs. 2.4%), and a lower percentage (44.8% vs. 56.8%) found it very satisfactory (p = .005). Conclusions: Depression rates increased significantly after the first wave. Depression, drug-resistant epilepsy, and a reduction in family income were independent risk factors for an increased seizure frequency. Perception of telemedicine worsened, indicating need for re-adaptation.
MeSH term(s)	Adult ; Aged ; COVID-19/epidemiology ; Depression/epidemiology ; Epilepsy/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Socioeconomic Factors
Language	English
Publishing date	2021-04-27
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	90-5
ISSN	1600-0404 ; 0001-6314
ISSN (online)	1600-0404
ISSN	0001-6314
DOI	10.1111/ane.13439
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Article: Sleep Quality and Levodopa Intestinal Gel Infusion in Parkinson's Disease: A Pilot Study.

De Fabregues, Oriol / Ferré, Alex / Romero, Odile / Quintana, Manuel / Álvarez-Sabin, José

Parkinson's disease

2018 Volume 2018, Page(s) 8691495

Abstract: Background: Sleep problems in patients with advanced Parkinson's disease (PD) have a deleterious impact on quality of life.: Objective: To assess the effect of levodopa-carbidopa intestinal gel (LCIG) infusion on sleep quality in advanced PD patients. ...

Abstract	Background: Sleep problems in patients with advanced Parkinson's disease (PD) have a deleterious impact on quality of life. Objective: To assess the effect of levodopa-carbidopa intestinal gel (LCIG) infusion on sleep quality in advanced PD patients. Methods: Seven patients participated in a prospective pilot study. Before and after 6 months of LCIG infusion, an overnight polysomnography was performed and the Epworth Sleepiness Scale, fatigue scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory, and the Hamilton Anxiety Rating Scale were administered. Results: PSG showed low sleep efficiency. REM sleep without atony was found in 5 patients. After 6 months of LCIG infusion, the percentage of REM sleep decreased as well as the number of arousals especially due to reduction of spontaneous arousals and periodic leg movements during REM sleep, but differences were not statistically significant. Also, scores of all study questionnaires showed a tendency to improve. Conclusion: The results show a trend toward an improvement of sleep quality after 6 months of LCIG infusion, although differences as compared to pretreatment values were not statistically significant. The sleep architecture was not modified by LCIG. Further studies with larger study samples are needed to confirm these preliminary findings.
Language	English
Publishing date	2018-11-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573854-9
ISSN	2042-0080 ; 2090-8083
ISSN (online)	2042-0080
ISSN	2090-8083
DOI	10.1155/2018/8691495
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Article ; Online: Incidence and mortality in adults with epilepsy in northern Spain.

Quintana, Manuel / Sánchez-López, Javier / Mazuela, Gonzalo / Santamarina, Estevo / Abraira, Laura / Fonseca, Elena / Seijo, Iván / Álvarez-Sabin, Jose / Toledo, Manuel

Acta neurologica Scandinavica

2020 Volume 143, Issue 1, Page(s) 27–33

Abstract: Objectives: We aimed to determine the regional incidence and mortality of adult epilepsy, compare mortality rates with the expected in the general population, and identify predictors of shorter survival.: Materials and methods: We included all ... ...

Abstract	Objectives: We aimed to determine the regional incidence and mortality of adult epilepsy, compare mortality rates with the expected in the general population, and identify predictors of shorter survival. Materials and methods: We included all consecutive newly diagnosed epilepsy visited at a university hospital in Spain throughout 2012. We collected all relevant clinical data up to December 2018. We analyzed the incidence of epilepsy in our catchment area, studied mortality rates, and explored factors predictive of shorter survival. Results: The annual incidence of epilepsy among adults was 37.7 cases/100,000 inhabitants. We studied 110 patients with newly diagnosed epilepsy. Mean age was 52.6 years, and 53.6% were men. Eighty-nine patients (80.9%) had focal epilepsy, 50 (45.5%) had a structural etiology, and 45 (40.9%) had an unknown cause. Nineteen patients died over a median follow-up of 5.3 years. Mortality was almost four times higher than expected in general population and was increased in patients aged 40-59 years. Mortality rates were 5.5%, 12%, and 16.8% in the first, second, and third year, after which they remained stable to the end of follow-up. Independent predictors of mortality were age (p = 0.001), tumor-related epilepsy (p = 0.003), and generalized seizures (p = 0.020). Conclusions: There is a high incidence of epilepsy among adults in our geographic area, with a mortality rate quadrupling that expected for the general population. Age, generalized seizures, and tumor-related epilepsy are independently associated with a higher risk of death.
MeSH term(s)	Adolescent ; Adult ; Aged ; Epilepsy/diagnosis ; Epilepsy/mortality ; Female ; Follow-Up Studies ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Mortality/trends ; Retrospective Studies ; Spain/epidemiology ; Young Adult
Language	English
Publishing date	2020-10-13
Publishing country	Denmark
Document type	Journal Article ; Observational Study
ZDB-ID	90-5
ISSN	1600-0404 ; 0001-6314
ISSN (online)	1600-0404
ISSN	0001-6314
DOI	10.1111/ane.13349
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