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1. Análisis de los ingresos evitables en un servicio de neurología

Author

Hernández-Hortelano E, González-Caballero G, Més-Sesé G, Plaza-Macías I, Sola-Martínez D, Alom-Poveda J, López-Hernández N, Martín-Bautista D, and García-Quesada Ma

Subjects
business.industry, Unnecessary Procedure, Medicine, Neurology (clinical), General Medicine, business, Humanities
Abstract

Introduccion. Los ingresos inadecuados a un servicio hospitalario generan costes innecesarios a nuestro sistema de salud. La mayoria de ingresos en un servicio hospitalario procede del area de urgencias. La presencia de un neurologo que atienda las urgencias hospitalarias constituiria un factor importante para racionalizar los criterios de hospitalizacion. Objetivos. Determinar el numero de ingresos evitables (IE) en un servicio de neurologia asi como definir las caracteristicas de estos. Pacientes y metodos. Estudio descriptivo prospectivo de los ingresos realizados en el Servicio de Neurologia del Hospital General Universitario de Elche (Alicante) durante tres meses. El neurologo determina la indicacion de ingreso. Se recogen los datos de filiacion del paciente, el diagnostico del ingreso, el diagnostico del neurologo, el motivo de adecuacion y el motivo de IE. Resultados. Se atendieron un total de 250 ingresos; 65 se consideraron IE (26%). Los diagnosticos mas frecuentes de los IE fueron: no neurologico (32,3%), sintomas y signos (15,4%), neuropatias (10,8%) y epilepsia (10,8%). Los motivos de IE fueron: no neurologico y traslado de servicio (30,8%), seguimiento en consultas externas de neurologia (CEN) (29,2%), estudio en CEN (21,5%), no neurologico y alta (16,9%) y no consta (1,5%). Los IE tuvieron una estancia media de 4,3 dias. Conclusiones. El numero de IE en nuestro servicio es mas elevado que en otros estudios. La disponibilidad de guardias de neurologia, la agilizacion de la realizacion ambulatoria de pruebas diagnosticas y el diseno de agendas flexibles de asistencia ambulatoria supondrian una reduccion en la utilizacion de recursos, y aumentaria la calidad del servicio asistencial.

Published
2006
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2. Isquemia vertebrobasilar: diagnóstico y pronóstico

Author

Plaza-Macías I

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Vertebral artery, Magnetic resonance imaging, General Medicine, medicine.disease, Brain ischemia, Text mining, medicine.artery, Vertebrobasilar ischemia, Basilar artery, Medicine, Neurology (clinical), Radiology, Vertebrobasilar insufficiency, business, Cerebral angiography
Published
1998
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3. Riluzol como tratamiento de la esclerosis lateral amiotrófica

Author

Plaza-Macías I, Perís-Martí J, Antón-Cano A, A Navarro-Ruiz, and Borrás-Blasco J

Subjects
business.industry, General Medicine, Disease, medicine.disease, Bioinformatics, Trunk, Riluzole, Clinical trial, medicine.anatomical_structure, Pharmacotherapy, medicine, Neurology (clinical), Amyotrophic lateral sclerosis, Adverse effect, business, Motor cortex, medicine.drug
Abstract

INTRODUCTION The Amyotrophic Lateral Sclerosis (ALS) is a disease characterized by the selective degeneracy of the superior motoneurons of the cortex motor and of the inferior motoneurons at level of the encephalic trunk and spinal marrow. Exist sporadic and familiar forms, being estimated an incidence of 1-2 cases by 100,000 inhabitants. The cause of the neuronal degeneracy is yet unknown, being implied, between other mechanisms, the glutamic exotoxicity is the responsible for the death neuronal. The riluzol is a benzothiazole derivative whose neuroprotector mechanism still it has not been totally clarified, though seems that reduces the neuroexcitatory action of the glutamic acid blocking his transmission. DEVELOPMENT Two clinical trials have been accomplished with similar characteristics: multicentre, randomized, double blind, and placebo-controlled. Between both studies have been included more than 1,100 patient, obtained significant statistic results in the prolongation of the survival time, however this effect was not going accompanied of an improvement in the muscular force neither of the pulmonary capacity, what is translated in which the riluzol does not modify the quality of life of the patient. The drug presents good tolerance and mild adverse effects and as consequence of this in 1996, the FDA approved his marketing and utilization in the treatment of the ALS. The approval of the riluzol as first agent for the treatment of the ALS has raised an important number of problems about the efficiency and cost of the treatment. CONCLUSION Though its benefits are modest, it is considered a starting point in the pharmacotherapy of the ALS.

Published
1998
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4. Prevalence of asymptomatic peripheral artery disease in patients with non-cardioembolic ischemic stroke,Prevalencia de enfermedad arterial periférica asintomática en pacientes con ictus isquémico no cardioembólico

Author

Álvarez-Sabín, J., Gil-Núñez, A., Quintana, M., Barbera, G., Alonso Leciñana Cases, M., Calleja Puerta, S., Casado Naranjo, I., Díez Tejedor, E., Escamilla Crespo, C., Fernández Fernández, O., Gállego Cullere, J., Lago Martín, A., López Fernández, J. C., Maestre Moreno, J., Martí-Fábregas, J., Martín González, R., Obach Tuca, V., Rebollo Álvarez-Amandi, M., Romero López, J., Rubio Borrego, F., Gómez Díaz-Castroverde, A., Vidal Sánchez, J. A., Moris La Tassa, G., Tejada García, J., Timiraos Fernández, J. J., Pérez Concha, T., Revilla García, M. A., Guereca Baranaiarn, L., Urtasunocariz, M., Ríos Gómez, C., Tejero Juste, C., García Gómara, M. J., Bravo Anguiano, Y., Gil Pujades, A., Palacios Marchesini, M., García Sánchez, S., Cano Orgaz, A., Purroy García, F., Obach Baurier, V., Arboix Damunt, A., Sanclemente Ansó, C., Rey Pérez, A., Canovas Verge, D., Fabregat Fabra, N., Rodríguez Campello, A., Comas Bergua, P., Cardona Cortela, P., Garcés Redondo, M., Robles Del Olmo, B., Olivella Rius, J., Martínez Ramírez, S., Torres Rodríguez, M. J., Pareja Martínez, A., Chamarro Lázaro, R., Pons Amate, J. M., Romero Martínez, M. A., Galiano Blancart, R. F., Vilar Fabra, C., Domínguez Sanz, F., Gracia Fleta, F., Plaza Macías, I., Villaverde González, R., Salamero Martínez, J. J., Medrano Martínez, V., Tortosa Conesa, D., Soria Torrecillas, J. J., Marey López, J., Romero López, J. M., Lustres Pérez, M., Ortega Casarrubios, M. A., Egido Herrero, J. A., Ruiz Ezquerro, J. J., Gómez Sánchez, J. C., Martín Polo, J., Gutiérrez Martin, F., Calleja Sanz, A. I., Peñas Martínez, M. L., Rojo Martínez, E., López Manzanares, L., Domingo García, J., García Castañón, I., Díaz Guzmán, J., Hernández Gallego, J. M., Sánchez Sánchez, C., Eimil Ortiz, M., González Santiago, R., Zabala Goiburu, J. A., Sánchez Del Valle, O., Morín Martín, M. M., Jiménez Caballero, P. E., Ferrero Ros, M., Vallejo Maroto, I., Gil Peralta, A., Aguilera Navarro, J. M., Carmona Nimo, E., García Moreno, J. M., Cueli Rincón, B., Hernández Ramos, F., Martínez Laso, A., Pilo La Fuente, B., Puerto Alonso, J. L., Tamayo Toledo, J. A., Moya Molina, M. A., Márquez Martínez, M., Gálvez Gálvez, C., Girón Úbeda, J. M., Del Saz Saucedo, P., Fernández Pérez, M. D., Antonio Arjona-Padillo, Olivares Romero, J., Peinado Cantero, M. L., Villegas Rodríguez, I., Vega Pérez, J. M., Maestre Martínez, M. A., Portillo Rivero, M. R., Sánchez Ortiz, C., Ochoa Sepúlveda, J. J., Bescansa Heredero, E., Vega López, O., Suárez Cuervo, A., Pueyo Morlans, M., Medina Rodríguez, A., Sáenz Galván, C., Marrero Falcón, C., and Mirdavood, S.

5. Prevalence of asymptomatic peripheral artery disease in patients with non-cardioembolic ischemic stroke | Prevalencia de enfermedad arterial periférica asintomática en pacientes con ictus isquémico no cardioembólico

Author

Jose Alvarez-Sabin, Gil-Núñez, A., Quintana, M., Barbera, G., Álvarez-Sabín, J., Alonso Leciñana Cases, M., Calleja Puerta, S., Casado Naranjo, I., Díez Tejedor, E., Escamilla Crespo, C., Fernández Fernández, O., Gállego Cullere, J., Lago Martín, A., López Fernández, J. C., Maestre Moreno, J., Martí-Fábregas, J., Martín González, R., Obach Tuca, V., Rebollo Álvarez-Amandi, M., Romero López, J., Rubio Borrego, F., Gómez Díaz-Castroverde, A., Vidal Sánchez, J. A., Moris La Tassa, G., Tejada García, J., Timiraos Fernández, J. J., Pérez Concha, T., Revilla García, M. A., Guereca Baranaiarn, L., Urtasunocariz, M., Ríos Gómez, C., Tejero Juste, C., García Gómara, M. J., Bravo Anguiano, Y., Gil Pujades, A., Palacios Marchesini, M., García Sánchez, S., Cano Orgaz, A., Purroy García, F., Obach Baurier, V., Arboix Damunt, A., Sanclemente Ansó, C., Rey Pérez, A., Canovas Verge, D., Fabregat Fabra, N., Rodríguez Campello, A., Comas Bergua, P., Cardona Cortela, P., Garcés Redondo, M., Robles Del Olmo, B., Olivella Rius, J., Martínez Ramírez, S., Torres Rodríguez, M. J., Pareja Martínez, A., Chamarro Lázaro, R., Pons Amate, J. M., Romero Martínez, M. A., Galiano Blancart, R. F., Vilar Fabra, C., Domínguez Sanz, F., Gracia Fleta, F., Plaza Macías, I., Villaverde González, R., Salamero Martínez, J. J., Medrano Martínez, V., Tortosa Conesa, D., Soria Torrecillas, J. J., Marey López, J., Romero López, J. M., Lustres Pérez, M., Ortega Casarrubios, M. A., Egido Herrero, J. A., Ruiz Ezquerro, J. J., Gómez Sánchez, J. C., Martín Polo, J., Gutiérrez Martin, F., Calleja Sanz, A. I., Peñas Martínez, M. L., Rojo Martínez, E., López Manzanares, L., Domingo García, J., García Castañón, I., Díaz Guzmán, J., Hernández Gallego, J. M., Sánchez Sánchez, C., Eimil Ortiz, M., González Santiago, R., Zabala Goiburu, J. A., Sánchez Del Valle, O., Morín Martín, M. M., Jiménez Caballero, P. E., Ferrero Ros, M., Vallejo Maroto, I., Gil Peralta, A., Aguilera Navarro, J. M., Carmona Nimo, E., García Moreno, J. M., Cueli Rincón, B., Hernández Ramos, F., Martínez Laso, A., Pilo La Fuente, B., Puerto Alonso, J. L., Tamayo Toledo, J. A., Moya Molina, M. A., Márquez Martínez, M., Gálvez Gálvez, C., Girón Úbeda, J. M., Del Saz Saucedo, P., Fernández Pérez, M. D., Arjona Padillo, A., Olivares Romero, J., Peinado Cantero, M. L., Villegas Rodríguez, I., Vega Pérez, J. M., Maestre Martínez, M. A., Portillo Rivero, M. R., Sánchez Ortiz, C., Ochoa Sepúlveda, J. J., Bescansa Heredero, E., Vega López, O., Suárez Cuervo, A., Pueyo Morlans, M., Medina Rodríguez, A., Sáenz Galván, C., Marrero Falcón, C., and Mirdavood, S.

7. [An analysis of avoidable admissions to a neurology service].

Author

Més-Sesé G, Plaza-Macías I, González-Caballero G, Sola-Martínez D, Hernández-Hortelano E, Martín-Bautista D, López-Hernández N, García-Quesada MA, and Alom-Poveda J

Subjects
Adult, Aged, Aged, 80 and over, Diagnosis, Differential, Diagnosis-Related Groups, Diagnostic Errors, Female, Hospitals, General statistics & numerical data, Hospitals, University statistics & numerical data, Humans, Male, Middle Aged, Nervous System Diseases diagnosis, Nervous System Diseases epidemiology, Patient Admission economics, Prospective Studies, Spain, Unnecessary Procedures economics, Hospital Departments statistics & numerical data, Neurology statistics & numerical data, Patient Admission statistics & numerical data, Unnecessary Procedures statistics & numerical data
Abstract

Introduction: Inappropriate admissions to a hospital service generate unnecessary costs for our health care service. Most admissions to a hospital service come from the emergency department. The presence of a neurologist to attend hospital emergencies would be an important factor allowing admission criteria to be streamlined., Aims: To determine the number of avoidable admissions (AA) in a neurology service, and to define their characteristics., Patients and Methods: We conducted a prospective, descriptive study of the admissions that took place in the Neurology Service of the Hospital General Universitario de Elche (Alicante) over a period of three months. The neurologist determines whether admission is indicated or not. We collected demographic data concerning the patient, the admission diagnosis, neurological diagnosis, the reason for appropriateness and the reason for AA., Results: A total of 250 admissions were attended; 65 were considered to be AA (26%). The most frequent diagnoses in the cases of AA were non-neurological (32.3%), clinical findings (15.4%), neuropathies (10.8%) and epilepsy (10.8%). The reasons leading to AA were non-neurological and transfer to another service (30.8%), follow-up by neurology outpatient department (NOD) (29.2%), NOD study (21.5%), non-neurological and discharge (16.9%) and not specified (1.5%). The mean length of stay in the case of AA was 4.3 days., Conclusions: The number of AA in our service is higher than that found in other studies. On-duty neurologists, streamlining outpatient diagnostic testing and the design of flexible schedules for outpatient care would reduce the amount of resources that are used, while at the same time increasing the quality of the health service.

Published
2006

8. [A descriptive study of intrahospital consultation to a neurological department].

Author

Más Sesé G, Hernández Hortelano E, González Caballero G, Martín Bautista D, Plaza Macías I, Sola D, and Alom Poveda J

Subjects
Adult, Aged, Female, Hospitals, Humans, Male, Middle Aged, Nervous System Diseases diagnosis, Nervous System Diseases physiopathology, Retrospective Studies, Hospital Departments statistics & numerical data, Neurology, Referral and Consultation
Abstract

Introduction: Intrahospital consultation (IC) is a little analyzed activity within daily neurologist hospital care. It entails an extra investment of time and resources. This study aims to describe the number and characteristics of the IC to a neurological department in our setting and to emphasize its importance within daily neurological health care., Methods: We performed an eighteen-month retrospective study of the requests for consultations received during this period in the Neurology Service of the Hospital General Universitario. The following variables were analyzed: demographic information, number and type of IC, time of response, syndromic diagnosis, complementary tests requested and resolution of patients., Results: 224 IC in 210 patients were seen. The average time of response was 1.57 days, although it was modified because of type of IC (normal: 1.7 days; for preference: 1.5 days; urgent: 0.2 days). The specialities that requested most consultations were cardiology (12.9%) and internal medicine (12.5 %). The most frequent reasons for consultation were: signs and symptoms (27.2%), focal neurological deficit (22.8%) and cognitive impairment (17.9%). CT scan and MRI were the most common complementary tests. A total of 25.4% of patients were referred to neurology outpatient clinic for follow-up., Conclusions: IC is an infrastudied activity in the literature. We consider it necessary to analyze this kind of care in every hospital in order to improve the organization and the planning of the day-to-day hospital activity

Published
2006

9. [Riluzole as a treatment for amyotrophic lateral sclerosis].

Author

Borrás-Blasco J, Plaza-Macías I, Navarro-Ruiz A, Perís-Martí J, and Antón-Cano A

Subjects
Humans, Neuroprotective Agents pharmacology, Riluzole pharmacology, Amyotrophic Lateral Sclerosis drug therapy, Neuroprotective Agents therapeutic use, Riluzole therapeutic use
Abstract

Introduction: The Amyotrophic Lateral Sclerosis (ALS) is a disease characterized by the selective degeneracy of the superior motoneurons of the cortex motor and of the inferior motoneurons at level of the encephalic trunk and spinal marrow. Exist sporadic and familiar forms, being estimated an incidence of 1-2 cases by 100,000 inhabitants. The cause of the neuronal degeneracy is yet unknown, being implied, between other mechanisms, the glutamic exotoxicity is the responsible for the death neuronal. The riluzol is a benzothiazole derivative whose neuroprotector mechanism still it has not been totally clarified, though seems that reduces the neuroexcitatory action of the glutamic acid blocking his transmission., Development: Two clinical trials have been accomplished with similar characteristics: multicentre, randomized, double blind, and placebo-controlled. Between both studies have been included more than 1,100 patient, obtained significant statistic results in the prolongation of the survival time, however this effect was not going accompanied of an improvement in the muscular force neither of the pulmonary capacity, what is translated in which the riluzol does not modify the quality of life of the patient. The drug presents good tolerance and mild adverse effects and as consequence of this in 1996, the FDA approved his marketing and utilization in the treatment of the ALS. The approval of the riluzol as first agent for the treatment of the ALS has raised an important number of problems about the efficiency and cost of the treatment., Conclusion: Though its benefits are modest, it is considered a starting point in the pharmacotherapy of the ALS.

Published
1998

10. [Vertebrobasilar ischemia: diagnosis and prognosis].

Author

Plaza-Macías I

Subjects
Basilar Artery diagnostic imaging, Cerebellum diagnostic imaging, Cerebellum pathology, Cerebral Angiography, Humans, Magnetic Resonance Imaging, Prognosis, Tomography, X-Ray Computed, Vertebral Artery diagnostic imaging, Basilar Artery pathology, Brain Ischemia diagnosis, Brain Ischemia etiology, Vertebral Artery pathology, Vertebrobasilar Insufficiency complications, Vertebrobasilar Insufficiency pathology
Published
1998

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