V Fernández

Biomedical Research Institute of Malaga (IBIMA), Málaga, Andalusia, Spain

Are you V Fernández?

Claim your profile

Publications (31)51.73 Total impact


  • No preview · Article · Mar 2016

  • No preview · Article · Mar 2016
  • O. Fernández · V.E. Fernández · M. Guerrero
    [Show abstract] [Hide abstract]
    ABSTRACT: Myelin diseases have been classically classified into two types: demyelinating or myelinoclastic diseases (characterized by myelin destruction), and demyelinating or leukodystrophic diseases (as the result of the formation of chemically abnormal myelin or complete failure of myelination). CNS demyelinating diseases are idiopathic inflammatory diseases that are associated with selective destruction of myelin sheaths. Clinically, demyelinating diseases can take any of the following forms: chronic and frequently relapsing (multiple sclerosis, etc.), acute and monophasic (acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, etc.). Demyelinating diseases are classified taking into account its CNS distribution (diffuse or localized). Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system.
    No preview · Article · Apr 2015 · Medicine - Programa de Formación Médica Continuada Acreditado
  • O. Fernández · V.E. Fernández · M. Guerrero
    [Show abstract] [Hide abstract]
    ABSTRACT: Multiple sclerosis (MS) is the most frequent chronic neurologic disease affecting young adults. The cause of MS is not known, but autoimmune mechanism is accepted as pathogenic hypothesis. It is characterized by neurological dysfunction episodes spread over space and through time. As results, a wide variety of symptoms are observed depending on the area of central nervous systems affected. In 90% of patients MS is clinically characterized by recurrent attacks and exacerbations of neurologic dysfunction leading to progressive physical disability [relapsing-remitting (RR) multiple sclerosis (MS)]. After 10 years, 50% of patients evolve to a progressive course [secondary progressive (SP) MS]. Primary progressive (PP) MS is observed in 10% of patients. Clinical diagnosis is supported on clinical criteria for dissemination in space (presence of symptoms and signs denoting two independent lesions in CNS) and in time (2 or more episodes of neurological dysfunction). Currently, certainty diagnosis of MS is possible, in the majority of cases, by clinical symptomatology and paraclinical diagnostic methods [cerebral spinal fluid (CSF), evoked potential, magnetic resonance imaging]. Besides, earlier diagnosis after the onset of disease is achieved.
    No preview · Article · Apr 2015 · Medicine - Programa de Formación Médica Continuada Acreditado
  • O. Fernández · V.E. Fernández · M. Guerrero
    [Show abstract] [Hide abstract]
    ABSTRACT: Myelin diseases have been classically classified into two types: demyelinating or myelinoclastic diseases (characterized by myelin destruction), and demyelinating or leukodystrophic diseases (as the result of the formation of chemically abnormal myelin or complete failure of myelination). CNS demyelinating diseases are idiopathic inflammatory diseases that are associated with selective destruction of myelin sheaths. Clinically, demyelinating diseases can take any of the following forms: chronic and frequently relapsing (multiple sclerosis, etc.), acute and monophasic (acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, etc.). Demyelinating diseases are classified taking into account its CNS distribution (diffuse or localized). Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system.
    No preview · Article · Jan 2015
  • O. Fernández · V.E. Fernández · M. Guerrero
    [Show abstract] [Hide abstract]
    ABSTRACT: Multiple sclerosis (MS) is the most frequent chronic neurologic disease affecting young adults. The cause of MS is not known, but autoimmune mechanism is accepted as pathogenic hypothesis. It is characterized by neurological dysfunction episodes spread over space and through time. As results, a wide variety of symptoms are observed depending on the area of central nervous systems affected. In 90% of patients MS is clinically characterized by recurrent attacks and exacerbations of neurologic dysfunction leading to progressive physical disability [relapsing-remitting (RR) multiple sclerosis (MS)]. After 10 years, 50% of patients evolve to a progressive course [secondary progressive (SP) MS]. Primary progressive (PP) MS is observed in 10% of patients. Clinical diagnosis is supported on clinical criteria for dissemination in space (presence of symptoms and signs denoting two independent lesions in CNS) and in time (2 or more episodes of neurological dysfunction). Currently, certainty diagnosis of MS is possible, in the majority of cases, by clinical symptomatology and paraclinical diagnostic methods [cerebral spinal fluid (CSF), evoked potential, magnetic resonance imaging]. Besides, earlier diagnosis after the onset of disease is achieved.
    No preview · Article · Jan 2015
  • O. Fernández · V.E. Fernández · M. Guerrero
    [Show abstract] [Hide abstract]
    ABSTRACT: The development of new immunologic therapies and effective drugs against multiple sclerosis activity (beta interferon, glatiramer acetate, immunosuppressants, natalizumab, fingolimod, alemtuzumab, rituximab, ocrelizumab, daclizumab, teriflunomide, BG-12 or dimethylfumarate, laquinimod) has been made possible by the progress in the knowledge of its' pathology. Although escalating therapy is the strategy currently used, in the future other strategies must be evaluated: combined therapy, sequential therapy and induction and maintenance therapy. While the possibility of an effective cure for MS is being investigated, the physician must perform an interdisciplinary approach to the symptoms including drugs, rehabilitation, physiotherapy, occupational therapy, etc.
    No preview · Article · Jan 2015

  • No preview · Article · Jun 2014 · Clinical Neurophysiology
  • Source
    Oscar Fernández · Victoria Fernández

    Preview · Article · Dec 2013 · Multiple Sclerosis
  • [Show abstract] [Hide abstract]
    ABSTRACT: The first European case of tetrodotoxin intoxication is reported in a patient who ingested a trumpet shellfish from the Atlantic Ocean in Southern Europe. He suffered general acute paralysis with respiratory failure necessitating ventilation. Early neurophysiologic studies showed complete peripheral nerve inexcitability, with no recordable sensory or motor responses, and normal electroencephalography. Tetrodotoxin was detected in high quantities in the patient's blood and urine through high performance liquid chromatography-mass spectrometry analysis. Seventy-two hours after admission the patient recovered normal strength, reflexes and sensation.
    No preview · Article · Dec 2013 · Neurophysiologie Clinique/Clinical Neurophysiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To establish clinical guidelines for the clinical use and interpretation of motor evoked potentials (MEP) in diagnosing and monitoring patients with multiple sclerosis (MS). Recommendations for MEP use and interpretation will help us rationalise and optimise resources used in MS patient diagnosis and follow up. Method We completed an extensive literature review and pooled our own data to produce a consensus statement with recommendations for the clinical use of MEPs in the study of MS. Results MEPs, in addition to spinal and cranial magnetic resonance imaging (MRI), help us diagnose and assess MS patients whose disease initially presents as spinal cord syndrome and those with non-specific brain MRI findings, or a normal brain MRI and clinical signs of MS. Conclusions Whenever possible, a multimodal evoked potential study should be performed on patients with suspected MS in order to demonstrate involvement of the motor pathway which supports a diagnosis of dissemination in space.
    Full-text · Article · Sep 2013 · Neurologia (Barcelona, Spain)
  • [Show abstract] [Hide abstract]
    ABSTRACT: Le premier cas européen d’intoxication par tétrodotoxine est rapporté chez un patient ayant ingéré un coquillage trompette de l’océan Atlantique, dans le sud de l’Europe. Il a développé une paralysie générale aiguë et une insuffisance des muscles respiratoire justifiant une intubation. Les études neurophysiologiques ont montré une inexcitabilité nerveuse initiale totale, motrice et sensitive, et un électroencéphalogramme normal. La tétrodotoxine du mollusque a été retrouvée en quantités élevées dans le sang et l’urine du patient par une analyse en chromatographie liquide à haute performance couplée à une spectrométrie de masse. L’évolution a été rapidement favorable en 72 heures.
    No preview · Article · Jan 2013 · Neurophysiologie Clinique/Clinical Neurophysiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Multiple Sclerosis (MS) is a heterogeneous disease of unknown etiology. The current hypothesis proposes a complex interplay between an environmental agent and the immune system that induces an abnormal response in genetically predisposed persons, leading to the autoimmune disease of MS. In recent decades the incidence and prevalence of MS seem to have increased, which may be better explained by environmental rather than genetic changes. Some infectious agents have been implicated as the possible culprits, as they could be involved in the appearance of autoreactive T cells against myelin using different mechanisms. Among microorganisms, certain bacteria, such as Chlamydia (Chlamydophila) pneumoniae have been suggested, but viruses have generally been associated with MS etiopathogenesis, with human herpesvirus 6 (HHV-6) and Epstein-Barr virus (EBV) being the best studied in recent years. Updating a previous review, we reanalyze the role of these microorganisms in MS etiology in detail and discuss the contributions of the hygiene hypothesis and environmental agents, both infectious and non-infectious, in the explanation of epidemiological changes in MS.
    No preview · Article · Jan 2013 · Current Immunology Reviews
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To establish clinical guidelines for the clinical use and interpretation of motor evoked potentials (MEP) in diagnosing and monitoring patients with multiple sclerosis (MS). Recommendations for MEP use and interpretation will help us rationalise and optimise resources used in MS patient diagnosis and follow up. Method: We completed an extensive literature review and pooled our own data to produce a consensus statement with recommendations for the clinical use of MEPs in the study of MS. Results: MEPs, in addition to spinal and cranial magnetic resonance imaging (MRI), help us diagnose and assess MS patients whose disease initially presents as spinal cord syndrome and those with non-specific brain MRI findings, or a normal brain MRI and clinical signs of MS. Conclusions: Whenever possible, a multimodal evoked potential study should be performed on patients with suspected MS in order to demonstrate involvement of the motor pathway which supports a diagnosis of dissemination in space.
    Full-text · Article · Sep 2012 · Neurologia
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Table s1a: List of the 31 MusiQoL items (English version). Complete list of the 31 MusiQoL items used in the English version
    Preview · Dataset · Oct 2011
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Table s1b. List of the 31 MusiQoL items (Spanish version). Complete list of the 31 MusiQoL items used in the Spanish version
    Preview · Dataset · Oct 2011
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Multiple Sclerosis International Quality Of Life (MusiQoL) questionnaire, a 31-item, multidimensional, self-administrated questionnaire that is available in 14 languages including Spanish, has been validated using a large international sample. We investigated the validity and reliability of the Spanish version of MusiQoL in Spain. Consecutive patients with different types and severities of multiple sclerosis (MS) were recruited from 22 centres across Spain. All patients completed the MusiQoL questionnaire, the 36-Item Short Form (SF-36) health survey, and a symptoms checklist at baseline and 21 days later. External validity, internal consistency, reliability and reproducibility were tested. A total of 224 Spanish patients were evaluated. Dimensions of MusiQoL generally demonstrated a high internal consistency (Cronbach's alpha: 0.70-0.92 for all but two MusiQoL domain scores). External validity testing revealed that the MusiQoL index score correlated significantly with all SF-36 dimension scores (Pearson's correlation: 0.46-0.76), reproducibility was satisfactory (intraclass correlation coefficient: 0.60-0.91), acceptability was high, and the time taken to complete the 31-item questionnaire was reasonable (mean [standard deviation]: 9.8 [11.8] minutes). The Spanish version of the MusiQoL questionnaire appears to be a valid and reliable instrument for measuring quality of life in patients with MS in Spain and constitutes a useful instrument to measure health-related quality of life in the clinical setting.
    Full-text · Article · Oct 2011 · BMC Neurology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although not definitively proven, there is commonly accepted to be a latitudinal gradient in the distribution of multiple sclerosis (MS), which is more frequent in temperate zones. The European Mediterranean countries are situated in a zone of median frequency, although ever increasing figures have been noted in the last decades. The objective of this study was to assess the current prevalence rate of MS in the province of Malaga, Southern Spain. The capture-recapture method (CRM) uses independent sources of data and permits the number of non-registered cases of a given disease to be estimated, and by doing so, to avoid ascertainment bias. Use of this method showed the estimated prevalence rate of MS in the province of Malaga, Southern Spain, to be 125/10(5) (95% confidence interval: 102/10(5)-169/10(5)), higher than the figures published previously. Although we recognize that these data need to be confirmed in further studies and in other areas of the country using a similar method, we believe this study is the first to find such high figure of prevalence, being very similar to the figures reported in recent years in other southern European countries.
    No preview · Article · Aug 2011 · Multiple Sclerosis
  • [Show abstract] [Hide abstract]
    ABSTRACT: Multiple sclerosis (MS) can be considered a disease that appears in genetically predisposed persons who, by chance, are also affected by some unknown environmental factor, probably infectious, that sets in motion an abnormal immune response leading to an autoimmune disease. Infectious agents are involved in the appearance of autoreactive T cells against myelin via various mechanisms, such as molecular mimetism or acting as superantigens. Numerous possible microorganisms have been suggested, including bacteria like Chlamydophila pneumoniae and many viruses, e.g., canine distemper virus, measles, varicella zoster, human herpes virus 6 (HHV-6) and Epstein-Barr virus (EBV). The association with EBV is the best studied over recent years. The frequency (incidence and prevalence) of MS seems to be increasing, which is better explained by the effect of some environmental factor. In this study we analyze some of the infectious agents that have been associated with the disease and discuss the hygiene hypothesis, which is one of the possible explanations for the epidemiological changes reported over recent decades.
    No preview · Article · Jan 2011 · Current Immunology Reviews
  • [Show abstract] [Hide abstract]
    ABSTRACT: Natalizumab is a monoclonal antibody shown to be highly effective in the treatment of relapsing-remitting multiple sclerosis (RRMS). Patients treated with natalizumab can develop antibodies directed against this agent that may affect the efficacy and safety of the drug. In this observational study, the kinetics of the appearance and the incidence of anti-natalizumab antibodies were followed prospectively for 18 months in a cohort of 64 consecutive patients treated with natalizumab for relapsing MS. Blood samples were drawn immediately before starting natalizumab therapy and each month afterwards. The presence of antibodies against natalizumab was assessed by enzyme-linked immunosorbent assay (ELISA) in all patients. Anti-natalizumab antibodies were detected in nine (14.1%) natalizumab-treated patients, three (4.68%) of whom were transiently positive while six (9.37%) were persistently positive (these patients discontinued natalizumab). All positive titres were observed during the first 4 months of treatment. One patient with a hypersensitivity reaction also had persistent antibodies. We conclude that antibodies against natalizumab develop early, within the first 6 months of therapy with natalizumab. Although no antibodies were detected after 4 months of therapy in this particular study, this does not rule out their development later on in exceptional cases.
    No preview · Article · Dec 2010 · Multiple Sclerosis

Publication Stats

315 Citations
51.73 Total Impact Points

Top co-authors View all

Institutions

  • 2013
    • Biomedical Research Institute of Malaga (IBIMA)
      Málaga, Andalusia, Spain
  • 2006-2013
    • Hospital Regional Universitario de Málaga
      • Departamento de Neurología
      Málaga, Andalusia, Spain
  • 2004-2012
    • Instituto de Neurociencias
      Alicante, Valencia, Spain
  • 2011
    • University of Malaga
      Málaga, Andalusia, Spain
  • 2002
    • Centro Informático Científico de Andalucía
      Hispalis, Andalusia, Spain