[Quality of life and perceived general health state related to seizure type and frequency, electroencephalographic findings, cognitive impairment, therapeutic response and secondary effects in persons with epilepsy]. / Calidad de vida y percepcion de salud general de personas con epilepsia en funcion de las crisis, la afectacion neurocognitiva, la electroencefalografia, su respuesta al tratamiento y los efectos secundarios.

INTRODUCTION. The perceived quality of life (QoL) in persons with epilepsy has demonstrated to be a relevant factor for the continuity of treatment and for the patients' own general health perception. Currently, the positive concept of QoL is used to assess the psychosocial factors of the epilepsy, replacing the concept of stigma. AIM. To analyze the relationship between QoL and general health perception, with several relevant clinical parameters in a sample of persons with epilepsy, in order to draw conclusions that help to suggest a more global approach to the disease. PATIENTS AND METHODS. We applied the Spanish versions of the QOLIE-10, the GHQ-12, and MMSE, and registered the clinical parameters (diagnostic, years of illness, electroencephalographic patterns, seizure type and frequency, response to medication, and side effects) in a sample of 29 persons with epilepsy. RESULTS. QoL and perceived general health are two unrelated factors respect to the clinical features. QoL is closely related to the frequency and type of crisis, whilst the years of illness and the level of neurocognitive impairment are not related with QoL. CONCLUSIONS. From the clinical point of view, it must be taken into account the relationship between the persons with epilepsy perceived QoL with factors such as the seizure frequency, side effects of the medication, and the general health perception, in order to obtain the best response and treatment adherence.

TITLE: Calidad de vida y percepcion de salud general de personas con epilepsia en funcion de las crisis, la afectacion neurocognitiva, la electroencefalografia, su respuesta al tratamiento y los efectos secundarios.Introduccion. La calidad de vida (CdV) percibida por las personas con epilepsia ha demostrado ser un factor relevante para la continuidad en el tratamiento y en la percepcion de salud general de los pacientes. Actualmente se usa el concepto positivo de CdV para evaluar los aspectos psicosociales de la enfermedad, en lugar del concepto de estigma. Objetivo. Estudiar las relaciones entre la CdV y la percepcion de salud general y los parametros clinicos mas relevantes en una muestra de personas con epilepsia que acuden a una consulta ambulatoria de neurologia, para obtener orientaciones que ayuden a una valoracion mas global del paciente y su enfermedad. Pacientes y metodos. Se aplico la adaptacion española del inventario Quality of Life in Epilepsy, el 12-item General Health Questionnaire, el miniexamen cognitivo y se registraron los parametros clinicos (diagnostico, años de enfermedad, hallazgos electroencefalograficos, tipo de crisis, respuesta a la medicacion y efectos secundarios) en una muestra de 29 personas con epilepsia ambulatorias. Resultados. La CdV y la percepcion de distres por la enfermedad son dos factores distintos respecto a las caracteristicas clinicas. La CdV se relaciona con la frecuencia de las crisis y los efectos secundarios de la medicacion, mientras que los años de enfermedad o la alteracion neurocognitiva no poseen apenas relacion. Conclusiones. Desde el punto de vista clinico, se debe tener en cuenta la relacion entre la CdV percibida y factores como la frecuencia de crisis, los efectos secundarios de la medicacion y la percepcion de salud general de las personas con epilepsia para obtener la mejor respuesta y adherencia al tratamiento.

Intestinal involvement secondary to the antiphospholipid syndrome (APS): clinical and immunologic characteristics of 97 patients: comparison of classic and catastrophic APS.

OBJECTIVE: To analyze the clinical and laboratory characteristics of 97 patients with intestinal involvement secondary to the antiphospholipid syndrome (APS) (37 patients with classic APS and 60 with catastrophic APS). METHODS: A computer-assisted (PubMed) search of the literature was performed to identify all cases of intestinal involvement associated with the APS from 1983 to December 2005. In addition, we analyzed the web-site-based international registry of patients with catastrophic APS ("CAPS Registry"). RESULTS: There were no differences in distribution by gender, mean age, and previous clinical manifestations of APS between the 2 groups. The prevalence of abdominal pain as the presenting manifestation of intestinal ischemia was higher in patients with classic APS (76% versus 37%; P < 0.005). The main difference in histopathologic findings between the 2 groups was the higher rate of microthrombosis in patients with catastrophic APS (75% versus 4%; P < 0.0005). The mortality rate was higher in patients with catastrophic APS (55% versus 17%; P < 0.0005). Follow-up was available in 22 patients with classical APS: 17 of them were discharged on oral anticoagulation and with a mean follow-up of 13 months (range, 1 to 48); all were in good health without the development of new thrombotic events. CONCLUSIONS: Intestinal involvement, although infrequent, is an important complication in patients with APS, especially in those with catastrophic APS. This would support the need for systematic screening for aPL in all cases of mesenteric thrombosis or ischemic colitis without clear underlying predisposing factors, and for systematic screening procedures in all classic APS patients complaining of abdominal pain.