F Bermejo

Hospital 12 de Octubre, Madrid, Madrid, Spain

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Publications (110)292.35 Total impact

  • T. Vargas · C. Spuch · D. Antequera · C. Ugalde · J.A. Molina · F. Bermejo · E. Carro ·

    Journal of the Neurological Sciences 08/2009; 283(1):299-299. DOI:10.1016/j.jns.2009.02.225 · 2.47 Impact Factor
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    ABSTRACT: Most people with dementia in Spain live at home with their families. Current changes in the family structure are transforming the care of people with dementia through new cohabitation arrangenments and rotation practices. To describe the cohabitation arrangements of families of people with dementia in Spain and to understand the caregivers' characteristics related to rotation and the rejection of long term care institutions. A cross sectional study -NEDICES study- was conducted using both quantitative and qualitative methodologies.150 caregivers of people with dementia from two communities from Madrid, Spain, were surveyed using a questionnaire designed to describe cohabitation arrangements and care. Qualitative methods included: 13 caregivers participating in focus groups, and 3 caregivers in Semi Structured Interviews aimed to understand rotation practices and rejection to long term care institution. Characteristics related with rotation were: sex of persons with dementia, widowhood, socio-economic status, caregiver relationship and burden of the caregiver. The qualitative study showed that the use of the rotation was related to normative behaviors and with obligation feelings, along with a change in the role of women in the current Spanish family. The use of long term care institutions was related to geographical distance of the family. The results of this study suggest that rotation has appeared in Spain as a new mechanism of care for people with dementia, and its related to the rejection of long term care institutions.
    International Journal of Geriatric Psychiatry 02/2009; 24(2):142-8. DOI:10.1002/gps.2081 · 2.87 Impact Factor

  • Alzheimer's and Dementia 07/2008; 4(4). DOI:10.1016/j.jalz.2008.05.1046 · 12.41 Impact Factor
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    ABSTRACT: Leptin, a peptide hormone secreted by adipose tissue, exhibits a large range of central and peripheral actions. It has been proposed that the participation of leptin in diseases such as obesity is due to, at least in part, its impaired transport across the blood-brain barrier (BBB). Since, the mechanisms by which brain takes up leptin remain unclear, we set out to study how leptin may cross the BBB. We have used different immunoassays and lentiviral vectors to analyze the role of megalin in the transport of leptin in rodents and humans. We demonstrate that circulating leptin is transported into the brain by binding to megalin at the choroid plexus epithelium. Indeed, the downregulation of megalin expression in physiological and pathological situations such as aging and Alzheimer's disease was correlated with poor entry of leptin into the brain. Moreover, amyloid beta (Abeta) deposits of choroid plexus could be disturbing megalin function. The present data indicate that leptin represents a novel megalin ligand of importance in the levels and therapeutic actions of leptin into the brain.
    Neurobiology of aging 07/2008; 29(6):902-12. DOI:10.1016/j.neurobiolaging.2007.01.008 · 5.01 Impact Factor
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    ABSTRACT: Reported here is a new missense mutation V363I in exon 12 of the microtubule-associated protein tau (MAPT) gene associated with progressive nonfluent aphasia, with onset at the age of 69 years in a woman. Although near mute, she maintained complex activities and had no discernible deficits outside of language until the age of 75 years, when progressive gait and swallowing disturbances appeared. There was a history of late-onset aphasia and apraxia in her father. All of her children were asymptomatic adults, but psycholinguistic abnormalities were detected in those bearing the mutation, consisting of difficulties in comprehension, both reading (symbol discrimination and comprehension of oral spelling) and oral (matching sentences to pictures and comprehension of locative relationships). A mutation-bearing sibling showed no abnormalities at 70 years old, consistent with the limited penetrance expected in late-onset disease. The mutation, corresponding to a highly conserved residue in the fourth tubulin-binding repeat, was not present in 194 normal individuals with the same genetic background.
    American Journal of Alzheimer s Disease and Other Dementias 09/2007; 22(4):294-9. DOI:10.1177/1533317507302320 · 1.63 Impact Factor
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    ABSTRACT: The aim of this study was to re-analyze door-to-door studies on neurological diseases among the elderly, in which vascular risk factors (VRF) were studied, describing methodological characteristics and prevalence of VRF. The surveys were identified in two phases. They were aimed at ascertaining prevalence of stroke, dementias or Parkinsonisms and, at the time of individual screening, had collected data on at least three of the following VRF: arterial hypertension (AHT), smoking habit, diabetes mellitus and hypercholesterolemia. A questionnaire was drawn up to collect the data reported in each study, and a database was constructed. VRF prevalences were quantified and analyzed using logistic regression. The total of the re-analyzed population was 12,510 persons aged 70 years and over, residents in seven geographic areas during the period 1994-2002. Information available on VRF was essentially self-reported. The prevalence of self-reported AHT was 25.7 % in men and 44.2 % in women, and that of measured AHT was 61 % and 71.9 %, respectively. Populations with arterial pressure obtained by direct measurement registered 138 higher risks (OR: 1.74; 95 % CI: 1.51-2.01, and OR: 1.48; 95% CI: 1.33-1.64). Reported prevalence of diabetes, hypercholesterolemia and smoking habit were 14.3 %, 23.3% and 8.5 %, respectively. There was a high prevalence of VRF among the Spanish elderly population. However, its relationship with dementia, Parkinsonisms and cerebrovascular disease could not be studied due to the poor quality of the VRF data. The differences between measured and self-reported arterial pressure suggest the existence of undetected AHT and wide scope for prevention.
    Neurologia (Barcelona, Spain) 05/2007; 22(3):138-46. · 1.38 Impact Factor
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    ABSTRACT: Causes of ischemic stroke in young adults (15-45 years) are diverse, but undetermined etiology is common in a majority of studies. The present series study aims to evaluate causes and changes in the etiological diagnosis of ischemic stroke in young adult patients admitted to a tertiary medical center over a period of 27 years. We retrospectively reviewed the records of patients with a first-ever stroke in the age range of 15-45 years who were admitted to the '12 de Octubre' University Hospital between 1974 and 2002. 272 young adults with ischemic stroke were identified. The etiological diagnoses were: undetermined in 36% of patients, large-artery atherosclerosis in 21%, cardioembolism in 17%, non-atherosclerotic vasculopathy in 17%, and other specific etiologies in 9%. While in the first study period (1974-1988) 45% of patients were diagnosed with uncertain etiology, in the last period (1989-2002) only 26% were diagnosed with cryptogenic stroke (45% with two or more potential etiologies identified; 45% with no identified cause despite complete evaluation, and 10% with incomplete evaluation). The etiological diagnosis of stroke in young adults has changed over time as a result of improvements in diagnostic workup. While cryptogenic stroke was the most frequent diagnosis in the past, today specific causes (non-atherosclerotic vasculopathy, large-artery atherosclerosis, cardioembolism and hematological disorder) are identified in the majority of patients.
    European Neurology 02/2007; 57(4):212-8. DOI:10.1159/000099161 · 1.36 Impact Factor
  • Article: P1-213

  • Article: P1-211

  • J Olazarán · P Mouronte · F Bermejo ·
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    ABSTRACT: Activities of daily living (ADL) are a major domain in the clinical assessment of Alzheimer's disease (AD) patients. However, ADL scales have not been sufficiently validated in Spain. Patients attending a neurology outpatient clinic were classified according to the global deterioration scale (GDS). Afterwards, an independent evaluator administers two scales of instrumental activities of daily living (IADL): Lawton and Brody's scale of IADL (SIADL) and Pfeffer's functional activities questionnaire (FAQ). The SIADL was scored in the original way (dichotomic) (SIADLd) and in an alternative way (ordinal) (SIADLo). Internal consistency (Cronbach alpha coefficient), test-retest reliability (intraclass correlation coefficient), diagnostic validity (sensitivity, specificity, number of patients correctly classified) and influence of different variables (regression analysis) were analyzed for the SIADLd, the SIADLo and the FAQ. Ninety-eight patients were recruited. Internal consistency, reliability and diagnostic validity were good or excellent for the three scales. The SIADLo showed better diagnostic and scale features than the SIADLd, but the FAQ surpassed both in all the studied variables. No scale was able to make a proper distinction between patients with subjective complaints (GDS 2) and patients without complaints (GDS 1). Sex and age influenced the SIADL score, but not the FAQ score. The FAQ reached a sensitivity of 0.95 and a specificity of 0.88 in the screening of dementia. The SIADL and the FAQ are useful, valid and reliable tools for the clinical assessment of AD patients. Ordinal scoring is more advantageous than dichotomic scoring in the SIADL, but the FAQ is preferable.
    Neurologia (Barcelona, Spain) 11/2005; 20(8):395-401. · 1.38 Impact Factor
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    ABSTRACT: Available studies offer only limited guidance on neuroimaging of non-acute headache patients. The aim of this study was to estimate the frequency of significant intracranial lesions in patients with headache and to determine the clinical variables helpful in identifying patients with intracranial lesions. All patients aged >or= 15 years attending the Neurology Clinic with non-acute headache were included in the study and followed prospectively. Every patient was investigated by neuroimaging studies, either computed tomography or magnetic resonance imaging. Neuroimaging results were classified as 'significant abnormalities', 'non-significant abnormalities' or 'normal'. Significant abnormalities included neoplastic disease, hydrocephalus, vascular malformations, Chiari malformation, large arachnoid cysts, intracranial haemorrhage, and acute cerebral infarcts. Consecutive patients (n=1876; 1243 women and 633 men) were included. Their mean age was 38 years (range 15-95 years). Neuroimaging studies detected significant lesions in 22 patients [1.2%, 95% confidence interval (CI) 0.7, 1.8]. The rate of significant intracranial abnormalities in patients with headache and normal neurological examination was 0.9% (95% CI 0.5, 1.4). The only clinical variable associated with a higher probability of intracranial abnormalities was neurological examination. The proportion of patients with headache and intracranial lesions is relatively small, but neither neurological examination nor the features in the clinical history permit us to rule out such abnormalities.
    Cephalalgia 02/2005; 25(1):30-5. DOI:10.1111/j.1468-2982.2004.00798.x · 4.89 Impact Factor
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    ABSTRACT: Cerebral venous and sinus thrombosis is an infrequent condition which presents with a wide spectrum of signs and a variable mode of onset. Sinus thrombosis may cause isolated intracranial hypertension but also may cause cerebral venous infarcts, which are frequently hemorrhagic. Treatment with antithrombotic agents is controversial because there is only one randomised controlled trial with unfractionated heparin. We report a 46- years-old man complaining of progressive headache, paraparesis and dysphasia. After admission, his neurological status worsened and he developed tetraparesis, depressed level of consciousness and seizures. A cranial computarized tomography (CT) scan showed multiple hyperdensities suggestive of hemorrhagic infarcts. Magnetic resonance imaging (MRI) study confirmed extensive cerebral venous thrombosis. Unfractionated heparin was administered for two weeks followed by acenocumarol. Within a few days his neurological status improved, and five weeks after admission the patient only hadd slight neurological deficit. After 11 years of follow-up, he has had a complete recovery. The G20210A mutation in the prothrombin gene was detected as a likely risk factor for venous thrombosis. Therapeutical and diagnosis aspects are discussed. We review the previous literature on the topic.
    Neurologia (Barcelona, Spain) 01/2005; 19(10):769-73. · 1.38 Impact Factor
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    J F Varona · F Bermejo · J M Guerra · J A Molina ·
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    ABSTRACT: There have been few studies of the long-term prognosis of young adults with ischemic stroke. The present study aimed to evaluate the long-term clinical outcome in a large series of young adults with ischemic stroke admitted to a tertiary medical center over the last 27 years, and to identify possible predictors for mortality, stroke recurrence and poor functional recovery. We retrospectively reviewed 272 young adults (15-45 years) with a first-ever ischemic stroke admitted to the Neurology Department of University Hospital "12 de Octubre" between 1974 and 2001. Follow-up assessments were performed by review of medical records and telephone interviews. Nine patients (3%) died as the result of their initial stroke and follow-up information about the status of 23 (8%) patients was not available. The remaining 240 patients (89%) were followed. Two hundred and ten of them (88%) were alive with a mean follow-up of 12.3 years and 30 (12%) died during follow-up. The average annual mortality rate was 1.4%, being notably higher during the first (4.9%) than in the subsequent years (0.9%) after the initial stroke. Ninety per cent of the followed patients were independent and 53% returned to work, although adjustments were necessary for 23% of them. The annual stroke recurrence rate during the first year was 3.6% dropping to 1.7% in subsequent years. Age over 35 years, male gender, the presence of cardiovascular risk factors and large-artery atherosclerosis in the carotid territory were predictors of negative long-term outcome after the initial stroke. The long-term prognosis for the ischemic stroke in the young is better than in the elderly, but the risk of mortality in young adults with ischemic stroke is much higher than in the general population of the same age. A bad prognosis is associated with an atherosclerotic risk profile, with a higher mortality and recurrent stroke rates and poorer functional recovery. The main functional limitation in the young survivors of their initial ischemic stroke occurs in work activity, since most patients are independent but almost half of them do not return to work.
    Journal of Neurology 01/2005; 251(12):1507-14. DOI:10.1007/s00415-004-0583-0 · 3.38 Impact Factor
  • J Olazarán · R Trincado · F Bermejo · J Benito-León · J Díaz · S Vega ·
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    ABSTRACT: To determine whether selective memory impairment (SMI) on an adapted Mini-Mental State Examination (aMMSE) test increases risk of future dementia in a population-based survey of central Spain. SMI is a strong predictor of dementia in the elderly. However, most approaches have used extensive memory batteries, which are not always suitable for screening purposes. The basal cohort consisted of 2982 poorly educated individuals aged 65 or over. Dementia, stroke and parkinsonism cases were previously excluded. At entry, participants received a structured interview including an aMMSE. Two groups were created according to basal cognitive performance, namely: (1) aMMSE > 23 and no word remembered on the aMMSE delayed-recall task (SMI group); and (2) aMMSE > 23 and at least one word remembered on the delayed-recall task (control group). In a three-year follow-up wave, conversion rate to dementia was calculated and logistic regression was performed. Of a total of 2507 subjects who completed the two evaluations, 280 qualified for SMI at entry. In the SMI group, 25 subjects (8.9%) developed dementia vs 26 subjects (1.2%) in the control group. Taking the two groups together, and once demographic and medical variables had been controlled, a low delayed-recall score increased dementia conversion rate (OR 0.47, 95% CI 0.34-0.64). Alzheimer's disease was the main cause of dementia (79.8%). Memory impairment is a risk factor for future dementia in the neurologically-healthy elderly. This can be observed in a subgroup of subjects with SMI defined on the aMMSE delayed-recall subscore. Some other measurements should be added to the SMI construct to improve its predictive validity.
    International Journal of Geriatric Psychiatry 12/2004; 19(12):1173-80. DOI:10.1002/gps.1236 · 2.87 Impact Factor
  • José Felipe Varona · Juan Manuel Guerra · Félix Bermejo ·
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    ABSTRACT: Stroke in young adults (15-45 years) is a rare condition. Up to 10% of patients with a first stroke admitted to the hospital belong in this age group. Stroke in the young patient is different from stroke in the elderly in several aspects such as etiology and prognosis. Usually, the management of stroke in young adults warrants an exhaustive etiological work-up. In this article, we review the most relevant issues in the study of young adults who suffer from stroke.
    Medicina Clínica 02/2004; 122(2):70-4. · 1.42 Impact Factor
  • José Felipe Varona · Juan Manuel Guerra · Félix Bermejo ·
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    ABSTRACT: Stroke in young adults (15–45 years) is a rare condition. Up to 10% of patients with a first stroke admitted to the hospital belong in this age group. Stroke in the young patient is different from stroke in the elderly in several aspects such as etiology and prognosis. Usually, the management of stroke in young adults warrants an exhaustive etiological work-up. In this article, we review the most relevant issues in the study of young adults who suffer from stroke.
    Medicina Clínica 01/2004; 122(2):70–74. DOI:10.1016/S0025-7753(04)74145-7 · 1.42 Impact Factor
  • R García-Ramos · T Moreno · A Camacho · V González · F Bermejo ·
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    ABSTRACT: We analyze the demand and to describe the neurological assistance in a university hospital. We have performed a retrospective and descriptive study of patients attended in the emergency services by neurologists from June 2000 to May 2001. The inventory and analysis has been carried out across a database in which we codify the reports of the patients diagnosed by means of CIE-9. We have been selected one month where we have collected all calls that neurologist have received, not only those of which reports was realized and codified. The total number of neurological patients attended in a year was 1,864 representing 2.85% of all emergencies. The most frequent diagnostic were: cerebrovascular stroke (24.57%), epilepsy (13.06%) and headache (6.07%). Few seasonal variation was noted. There was no difference for sex. In the month's study there were 426 patients, which represented 7.78% of all medical urgencies. The most frequent calls came from internal medicine (65.02%). Neurological emergencies constitute a large percentage of third level hospital's emergencies which justify a neurologist in the medical emergencies team.
    Neurologia (Barcelona, Spain) 11/2003; 18(8):431-8. · 1.38 Impact Factor
  • J. F. Varona · J. M. Guerra · M. Morales · F. Bermejo · J. A. Molina ·

    European Journal of Internal Medicine 09/2003; 14. DOI:10.1016/S0953-6205(03)91287-8 · 2.89 Impact Factor
  • J. F. Varona · J. M. Guerra · F. Bermejo · J. A. Molina ·

    European Journal of Internal Medicine 09/2003; 14. DOI:10.1016/S0953-6205(03)91479-8 · 2.89 Impact Factor
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    ABSTRACT: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare inherited cerebrovascular disease. The onset of clinical symptoms occurs with migraine with aura, transient ischemic attacks, recurrent subcortical ischemic infarcts, neuropsychiatric changes reaching subcortical dementia. Brain magnetic resonance images show multiple deep cerebral infarcts in white matter and basal ganglia and diffuse leukoencephalopathy. Neuropathologic hallmark consists of deposition of small electron dense granular patches related to the basement membrane of vascular smooth muscle cells with degeneration of smooth muscle cells and media and luminal obliteration. Recently, the genetic characteristics of this disorder have been reported. Missense mutations in notch3 gene localized in chromosome 19 are involved in its pathogenesis. Only three families from Spain have been reported. Here we describe a patient with typical clinical symptoms, neuroimaging and pathology of CADASIL. C406T (Arg110Cys) mutation in notch3 gene was found. We comment on the clinical symptoms of different members of the patient's family.
    Neurologia (Barcelona, Spain) 06/2003; 18(4):229-33. · 1.38 Impact Factor

Publication Stats

2k Citations
292.35 Total Impact Points


  • 1990-2009
    • Hospital 12 de Octubre
      • • Servicio de Neurología-Neurofisiología
      • • Servicio de Bioquímica Clínica
      Madrid, Madrid, Spain
  • 1984-2007
    • Hospital Universitario 12 de Octubre
      Madrid, Madrid, Spain
  • 1998
    • Hospital Universitario de Móstoles
      Madrid, Madrid, Spain
  • 1994
    • Complutense University of Madrid
      Madrid, Madrid, Spain
    • Madrid Salud
      Madrid, Madrid, Spain
  • 1984-1989
    • Hospital Universitario Madrid Montepríncipe
      Madrid, Madrid, Spain