scispace - formally typeset
Search or ask a question
Author

Maria Jose Poveda

Bio: Maria Jose Poveda is an academic researcher. The author has contributed to research in topics: Medicine & Depression (economics). The author has an hindex of 1, co-authored 1 publications receiving 295 citations.

Papers
More filters
Journal ArticleDOI
TL;DR: Antisecretory agent or nitrate treatment is associated with reduced UGIB RR in patients taking NSAID or aspirin, and protection was not apparent in patientsTaking anticoagulants.

298 citations

Journal ArticleDOI
TL;DR: In this paper , the association between key symptoms of fibromyalgia and the season of the year was investigated, and the existence of differences based on levels of anxiety or depression was determined.
Abstract: Fibromyalgia patients often report that certain seasons aggravate their symptoms. The main objective was to determinate the association between key symptoms of fibromyalgia and the season of the year. A secondary objective was to determinate the existence of differences based on levels of anxiety or depression.Convenience sample made up of 471 participants with fibromyalgia evaluated before starting multidisciplinary treatment. Demographic and meteorological data were collected. Clinical data were assessed with standardized instruments of pain intensity, functionality, fatigue, stiffness, sleep quality, anxiety and depression.The different groups of participants were homogeneous for age, gender, educational level, marital status and employment situation. No significant differences were found in pain intensity (F=1.334; P=.265), functionality (F=.402; P=.669), fatigue (F=.714; P=.490), stiffness (F=.299; P=.741), anxiety (F=.376; P=.687), depression (F=.608; P=.545), psychological distress (F=.261; P=.770), sleep quantity (F=1.507; P=.223) or sleep disturbances (F=.343; P=.710).No differences were found in the intensity of fibromyalgia symptoms, nor in the percentages of severity among the different seasons of the year. Anxiety was more prevalent than depression, possibly due to the characteristics of the sample itself, with the majority of patients with a dysfunctional profile.
Journal ArticleDOI
TL;DR: Fatigue in RA has a multi-causal pathway and all dimensions of fatigue appear to be related with subjective but not with objective variables, which could indicate that it is important to evaluate fatigue in a multidimensional perspective in elderly patients.
Abstract: Fatigue in RA has a multi-causal pathway. It is recommended that it should be measured in all RA studies using a validated instrument. Fatigue in elderly patients could have a different perception than in younger patients, identifying the associated factors could be a key to the management of this complex symptom.To compare fatigue and its associated factors in young and elderly patients with RA from two university hospitals.A cross-sectional analysis was performed in 167 RA patients diagnosed according to the 2010 ACR-EULAR criteria. Patients were divided into two groups based on age (≥60 and <60) for comparative purposes. Fatigue was assessed using 4 instruments: the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ), the fatigue subscale of the Short-form 36 survey (fatigue-SF36), the Visual Analogic scale of fatigue (VASf) and the Functional Assessment of chronic illness Therapy Fatigue Scale (FACIT-F). To compare the mean of fatigue between groups we used a T-Test.To determine in each group of patients (young and elderly patients) the relationship between the 4 subscales of fatigue (assessed by BRAF-MDQ) and the other variables (DAS28, CPR, ESR, hemoglobin, vitamin D, HAQ, RAID [Rheumatoid Arthritis Impact of Disease], SF36, Hospital Anxiety and depression Scale [HAD] and Brief Pain Inventory) a Spearman correlation was performed. A value of p < 0.05 was accepted as statistically significant.A total of 167 patients were included, 81 (48.5%) young and 86 (51.5%) elderly patients. We found fatigue (using 4 instruments) has not significant differences in young and elderly patients (Table 1). In young and elderly patients, physical, living, cognitive and emotional fatigue were correlated to RAID, SF36, HAD and pain but they were not associated to CRP, ESR, hemoglobin and vitamin D. In young patients, all dimensions of fatigue were associated with DAS28. Furthermore, in elderly patients we found a relationship between physical (p-value 0.044) and living fatigue (p-value 0.012) with DAS28, nevertheless cognitive and emotional fatigue (p-value 0.078 and 0.079 respectively) were not related.Table 1.Scores of the Fatigue Questionnaires used to assess fatigue in young and elderly patients with RA.Young Mean (SD)Elderly Mean (SD)p-valueFACIT-F36.5 (12.5)35.9 (11.7)0.2963VAS-F4.3 (2.8)3.8 (2.8)0.119SF36-Fatigue50.9 (23.9)51.0 (21.9)0.628BRAF-MDQ Physical9.2 (6.2)8.5 (6.3)0.4670 Living5.3 (5.6)4.2 (4.6)0.1446 Cognitive3.3 (3.8)4.2 (4.6)0.2932 Emotional3.5 (3.5)2.6 (2.7)0.0932In young and elderly patients, all dimensions of fatigue appear to be related with subjective but not with objective variables. In young patients, all dimensions of fatigue were associated with DAS28 but in elderly patients only physical and living fatigue were correlate to disease activity. These results could indicate that it is important to evaluate fatigue in a multidimensional perspective in elderly patients.[1]Belza BL, Henke CJ, Yelin EH, Epstein WV, Gilliss CL. Correlates of fatigue in older adults with rheumatoid arthritis. Nurs Res. 1993 Mar-Apr;42(2):93-9.[2]Hewlett S, Dures E, Almeida C. Measures of fatigue: Bristol Rheumatoid Arthritis Fatigue MultiDimensional Questionnaire (BRAF MDQ), Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scales (BRAF NRS) for severity, effect, and coping, Chalder Fatigue Questionnaire (CFQ), Checklist Individual Strength (CIS20R and CIS8R), Fatigue Severity Scale (FSS), Functional Assessment Chronic Illness Therapy (Fatigue) (FACIT-F), Multi-Dimensional Assessment of Fatigue (MAF), Multi-Dimensional Fatigue Inventory (MFI), Pediatric Quality Of Life (PedsQL) Multi-Dimensional Fatigue Scale, Profile of Fatigue (ProF), Short Form 36 Vitality Subscale (SF36 VT), and Visual Analog Scales (VAS). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S263-86.None declared
Journal ArticleDOI
TL;DR: In this article , the authors determined the rate, characteristics, and associated factors of post-colonoscopy post-carcinoscopy CRC (PCCRC) with respect to its performance.
Abstract: Aims Post-colonoscopy CRC (PCCRC) has become an important quality indicator. Our aim was to determine its rate, characteristics, and associated factors.
Journal ArticleDOI
TL;DR: Li et al. as mentioned in this paper found that in patients with ankylosing spondylitis, high disease activity (assess by ASDAS) correlated with high levels of fatigue (lower levels on FACIT-F).
Abstract: Fatigue is a common symptom in chronic inflammatory diseases. The mechanism by which fatigue occurs is multidimensional. Previous studies suggested that several factors, including physiology, psychology and behavior, may contribute to its pathogenesis.Fatigue is considered one of the most common symptoms in patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) with an incidence of 50–70%.Fatigue is a major factor contributing to unsatisfactory treatment outcome and poor quality of life, or even disability. Therefore, from a clinical point of view, how to improve the symptom of fatigue remains a challenge. Identifying factors related to fatigue could be a key to the management of this complex symptom.To compare fatigue and its associated factors in patients with PsA and AS from two university hospitals.A cross-sectional analysis was performed in 105 patients (May – December 2022)Fatigue was assessed using 3 instruments: the fatigue subscale of the Short-form 36 survey (fatigue-SF36), the Visual Analogue scale of fatigue (VASf) and the Functional Assessment of chronic illness Therapy Fatigue Scale (FACIT-F). T-test was used to compare mean fatigue between PsA and AS patients.To determine in each patient group the relationship between fatigue (assessed by FACIT-F) and the other variables (DAPSA or ASDAS, CPR, ESR, hemoglobin, HAQ, Hospital Anxiety and depression Scale [HAD] and Brief Pain Inventory [BPI]) a Spearman correlation was performed. A value of p < 0.05 was accepted as statistically significant.A total of 105 patients were included, 55 (52.4%) PsA patients and 50 (47.6%) AS patients.We found that mean fatigue (using 3 instruments) had not significant differences in patients with PsA and AS (Table 1).In patients with PsA and AS, fatigue correlated to HAD, HAQ and pain, but not with CRP, ESR and hemoglobin (Table 2).In AS patients, high disease activity (assess by ASDAS) correlated with high levels of fatigue (lower levels on FACIT-F). However, in patients with PsA, fatigue and disease activity (DAPSA) were not related.In PsA and AS patients, fatigue seems to be related to subjective but not with objective (analytical) variables. In patients with AS, fatigue was related to disease activity, but in patients with PsA we found no correlation.[1]Li, Aissaoui N et al. Fatigue in patients with ankylosing spondylitis: prevalence and relationships with disease-specific variables, psychological status, and sleep disturbance. Rheumatol Int. 2012 Jul;32:2117-24.[2]Conaghan PG et al Relationship of pain and fatigue with health-related quality of life and work in patients with psoriatic arthritis on TNFi: results of a multi-national real-world study RMD Open 2020;6:e001240.Table 1.Mean of fatigue in PsA and AS patientsPsA Mean (SD)AS Mean (SD)p-valueFACIT-F38.1 (10.3)37.7 (11.4)0.88VAS-F3.8 (2.5)4.29 (2.8)0.396SF36-Fatigue53.4 (22)56.7 (21.8)0.45Table 2.Fatigue correlations in PsA and AS patientsPsAp-valueASp-valueDisease activity-0.190.164-0.63<0.001PCR0.010.9470.010.30VSG0.050.6800.040.325Hemoglobin-0.130.337-0.150.46HAQ-0.50<0.001-0.67<0.001HAD depression-0.75<0.001-0.61<0.001HAD anxiety-0.70<0.001-0.47<0.001Pain (BPI)-0.64<0.001-0.71<0.001NIL.None Declared.

Cited by
More filters
Journal ArticleDOI
TL;DR: This work focuses on this revolution of understanding and management of peptic ulcer disease over the past 25 years, largely because of the increasingly widespread use of non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin.

1,264 citations

Journal ArticleDOI
TL;DR: The results do not rule out a clinically meaningful difference in cardiovascular events due to use of a PPI, but the two groups did not differ significantly in the rate of serious adverse events, though the risk of diarrhea was increased with omeprazole.
Abstract: Methods We randomly assigned patients with an indication for dual antiplatelet therapy to receive clopidogrel in combination with either omeprazole or placebo, in addition to aspirin. The primary gastrointestinal end point was a composite of overt or occult bleeding, symptomatic gastroduodenal ulcers or erosions, obstruction, or perforation. The primary cardiovascular end point was a composite of death from cardiovascular causes, nonfatal myocardial infarction, revascularization, or stroke. The trial was terminated prematurely when the sponsor lost financing. Results We planned to enroll about 5000 patients; a total of 3873 were randomly assigned and 3761 were included in analyses. In all, 51 patients had a gastrointestinal event; the event rate was 1.1% with omeprazole and 2.9% with placebo at 180 days (hazard ratio with omeprazole, 0.34, 95% confidence interval [CI], 0.18 to 0.63; P<0.001). The rate of overt upper gastrointestinal bleeding was also reduced with omeprazole as compared with placebo (hazard ratio, 0.13; 95% CI, 0.03 to 0.56; P = 0.001). A total of 109 patients had a cardiovascular event, with event rates of 4.9% with omeprazole and 5.7% with placebo (hazard ratio with omeprazole, 0.99; 95% CI, 0.68 to 1.44; P = 0.96); high-risk subgroups did not show significant heterogeneity. The two groups did not differ significantly in the rate of serious adverse events, though the risk of diarrhea was increased with omeprazole. Conclusions Among patients receiving aspirin and clopidogrel, prophylactic use of a PPI reduced the rate of upper gastrointestinal bleeding. There was no apparent cardiovascular interaction between clopidogrel and omeprazole, but our results do not rule out a clinically meaningful difference in cardiovascular events due to use of a PPI. (Funded by Cogentus Pharmaceuticals; ClinicalTrials.gov number, NCT00557921.)

1,079 citations

Journal ArticleDOI
TL;DR: The American College of Cardiology Foundation (ACCF) Task Force on Clinical Expert Consensus Documents (ECDs) as mentioned in this paper developed by the ACCF and other cosponsors are intended to inform practitioners, payers, and other interested parties of the opinion of the ACC and document cosponsors concerning evolving areas of clinical practice and/or technologies that are widely available or new to the practice community.
Abstract: This document has been developed by the American College of Cardiology Foundation (ACCF) Task Force on Clinical Expert Consensus Documents, the American College of Gastroenterology (ACG), and the American Heart Association (AHA). Expert consensus documents (ECDs) are intended to inform practitioners, payers, and other interested parties of the opinion of the ACCF and document cosponsors concerning evolving areas of clinical practice and/or technologies that are widely available or new to the practice community. Topics chosen for coverage by ECDs are so designed because the evidence base, the experience with technology, and/or the clinical practice are not considered sufficiently well developed to be evaluated by the formal American College of Cardiology/American Heart Association (ACC/AHA) practice guidelines process. Often the topic is the subject of ongoing investigation. Thus, the reader should view ECDs as the best attempt of the ACCF and other cosponsors to inform and guide clinical practice in areas where rigorous evidence may not be available or the evidence to date is not widely accepted. When feasible, ECDs include indications or contraindications. Topics covered by ECDs may be addressed subsequently by the ACC/AHA Practice Guidelines Committee as new evidence evolves and is evaluated. The Task Force on ECDs makes every …

824 citations

Journal ArticleDOI
TL;DR: These guidelines were developed under the auspices of the American College of Gastroenterology by a committee of experts in the field, reviewed by its Practice Parameters Committee, and approved by the Board of Trustees to be considered valid at the time of production based on the data available.

712 citations

Journal ArticleDOI
TL;DR: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy and addresses the diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH).
Abstract: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH). Main Recommendations MR1. ESGE recommends immediate assessment of hemodynamic status in patients who present with acute upper gastrointestinal hemorrhage (UGIH), with prompt intravascular volume replacement initially using crystalloid fluids if hemodynamic instability exists (strong recommendation, moderate quality evidence). MR2. ESGE recommends a restrictive red blood cell transfusion strategy that aims for a target hemoglobin between 7 g/dL and 9 g/dL. A higher target hemoglobin should be considered in patients with significant co-morbidity (e. g., ischemic cardiovascular disease) (strong recommendation, moderate quality evidence). MR3. ESGE recommends the use of the Glasgow-Blatchford Score (GBS) for pre-endoscopy risk stratification. Outpatients determined to be at very low risk, based upon a GBS score of 0 – 1, do not require early endoscopy nor hospital admission. Discharged patients should be informed of the risk of recurrent bleeding and be advised to maintain contact with the discharging hospital (strong recommendation, moderate quality evidence). MR4. ESGE recommends initiating high dose intravenous proton pump inhibitors (PPI), intravenous bolus followed by continuous infusion (80 mg then 8 mg/hour), in patients presenting with acute UGIH awaiting upper endoscopy. However, PPI infusion should not delay the performance of early endoscopy (strong recommendation, high quality evidence). MR5. ESGE does not recommend the routine use of nasogastric or orogastric aspiration/lavage in patients presenting with acute UGIH (strong recommendation, moderate quality evidence). MR6. ESGE recommends intravenous erythromycin (single dose, 250 mg given 30 – 120 minutes prior to upper gastrointestinal [GI] endoscopy) in patients with clinically severe or ongoing active UGIH. In selected patients, pre-endoscopic infusion of erythromycin significantly improves endoscopic visualization, reduces the need for second-look endoscopy, decreases the number of units of blood transfused, and reduces duration of hospital stay (strong recommendation, high quality evidence). MR7. Following hemodynamic resuscitation, ESGE recommends early (≤ 24 hours) upper GI endoscopy. Very early ( MR8. ESGE recommends that peptic ulcers with spurting or oozing bleeding (Forrest classification Ia and Ib, respectively) or with a nonbleeding visible vessel (Forrest classification IIa) receive endoscopic hemostasis because these lesions are at high risk for persistent bleeding or rebleeding (strong recommendation, high quality evidence). MR9. ESGE recommends that peptic ulcers with an adherent clot (Forrest classification IIb) be considered for endoscopic clot removal. Once the clot is removed, any identified underlying active bleeding (Forrest classification Ia or Ib) or nonbleeding visible vessel (Forrest classification IIa) should receive endoscopic hemostasis (weak recommendation, moderate quality evidence). MR10. In patients with peptic ulcers having a flat pigmented spot (Forrest classification IIc) or clean base (Forrest classification III), ESGE does not recommend endoscopic hemostasis as these stigmata present a low risk of recurrent bleeding. In selected clinical settings, these patients may be discharged to home on standard PPI therapy, e. g., oral PPI once-daily (strong recommendation, moderate quality evidence). MR11. ESGE recommends that epinephrine injection therapy not be used as endoscopic monotherapy. If used, it should be combined with a second endoscopic hemostasis modality (strong recommendation, high quality evidence). MR12. ESGE recommends PPI therapy for patients who receive endoscopic hemostasis and for patients with adherent clot not receiving endoscopic hemostasis. PPI therapy should be high dose and administered as an intravenous bolus followed by continuous infusion (80 mg then 8 mg/hour) for 72 hours post endoscopy (strong recommendation, high quality evidence). MR13. ESGE does not recommend routine second-look endoscopy as part of the management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH). However, in patients with clinical evidence of rebleeding following successful initial endoscopic hemostasis, ESGE recommends repeat upper endoscopy with hemostasis if indicated. In the case of failure of this second attempt at hemostasis, transcatheter angiographic embolization (TAE) or surgery should be considered (strong recommendation, high quality evidence). MR14. In patients with NVUGIH secondary to peptic ulcer, ESGE recommends investigating for the presence of Helicobacter pylori in the acute setting with initiation of appropriate antibiotic therapy when H. pylori is detected. Re-testing for H. pylori should be performed in those patients with a negative test in the acute setting. Documentation of successful H. pylori eradication is recommended (strong recommendation, high quality evidence). MR15. In patients receiving low dose aspirin for secondary cardiovascular prophylaxis who develop peptic ulcer bleeding, ESGE recommends aspirin be resumed immediately following index endoscopy if the risk of rebleeding is low (e. g., FIIc, FIII). In patients with high risk peptic ulcer (FIa, FIb, FIIa, FIIb), early reintroduction of aspirin by day 3 after index endoscopy is recommended, provided that adequate hemostasis has been established (strong recommendation, moderate quality evidence).

611 citations