[Postprandial hyperglycemia as cardiovascular risk factor].
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Cardiovascular Diseases↗
Biomedical subjects
A Maldonado Martín
Publications and source records attributed to A Maldonado Martín.
[Study of 1,595 brucellosis cases in the Almeria province (1972-1998) based on epidemiological data from disease reporting].
OBJECTIVE: To know clinical, diagnostic, and treatment issues of brucellosis in the Almeria province. METHODS: Descriptive, epidemiological study from 1,595 disease report cards in the Almeria province during the 1972-1998 period. Issues concerning complications and treatment were reported in 890 cards (57.8%), symptoms, signs and hemograms in 565 (35.4%), and other diagnostic findings in all cards. The chi2 test was used to compare independent qualitative parameters for a 95% CI. RESULTS: In the early phase the most common symptom was asthenia (95.2%); sweating in the chronic stage (95.8%). The most commonly recorded sign was spleen enlargement (37.5%) and the most commonly reported complication was bone and joint involvement (22.8%). No changes in symptoms occurred over years. The hemogram revealed anemia in 30.3% of cases. Blood culture was positive for 91.2%. Regarding serological diagnosis, rose Bengal was positive for 99.2% of cases; the most common agglutination titer to Brucella or B. mellitensis was 1/640 (13.5%). The most commonly used therapy consisted of the association tetracycline plus streptomycin (42.4%). For 42.6% of cards, patients were transferred to hospital, particularly since 1984. CONCLUSIONS: Generally speaking, clinical data recorded in the reporting card regarding brucellosis disease reveal the clinical features of the disease, after a long surveillance period. Rose Bengal should be used as screening test for the diagnosis of this disease.
Brucellosis↗
[Nocturnal arterial pressure and the cardiovascular risk factors in patients with arterial hypertension].
BACKGROUND: Blood pressure (BP) has a circadian rhythm. Most of the people presents a BP fall between 10-20% during nighttime hours (dipper condition). Measurement of these circadian variations is performed by continuous blood pressure ambulatory monitoring. We have studied the possible relation between blood pressure nocturnal fall and cardiovascular risk factors in hypertensive patients. METHODS: We selected 100 hypertensive patients from the Hypertension and Lipids Unit of San Cecilio University Hospital of Granada, Spain. They were divided into two groups: dippers group and non-dippers, depending of whether or not the fall of nocturnal systolic and diastolic BP was > 10%. All patients included in the study underwent complete clinical history, exhaustive physical examination, complementary examinations, urine and hematology tests, and continuous blood pressure ambulatory monitoring by the Space Labs system. RESULTS: The heart rate was found to be significantly higher (p = 0.0253) in the hypertensive dippers group than in the non-dippers. The latter showed higher plasma creatinine values (p = 0.0343) and lower potassemia values (p = 0.0140) than the dippers group. The dippers group presented concentrations of HDL-cholesterol significantly higher (p = 0.008) and diurnal diastolic BP values (p = 0.0211) also higher than the other group. CONCLUSIONS: Non dippers hypertensive patients present a higher number of cardiovascular risk factors as well as a higher tendency to renal lesions, and worse prognosis than the dippers group.
Adult↗
[Zinc and chronic obstructive pulmonary disease].
BACKGROUND: To evaluate the zinc organic concentration in the chronic obstructive pulmonary disease (COPD) in relation to a control group. Also, to analyze if the serum zinc levels are related with zinc concentration in erythrocyte, nail and hair. PATIENTS AND METHODS: Forty patients of COPD have been studied, all males, average age 62 +/- 7 years and body mass index (BMI) of 27 +/- 4. Forty patients were included in the control group, with average age 57 +/- 9 years and BMI of 24 +/- 5. The patients with concomitant disease or booth treatment that could increase the zinc excretion were excluded. In all patients clinical history and examination, hematology and biochemistry tests, hepatic and lipid parameters, and nail, plasma, hair and erythrocyte zinc levels by atomic absorption spectrophotometry were done. Variance analysis and Pearson test were done. RESULTS: Blood, intraerythrocyte and nail zinc were similar in healthy subjects and patients; however, the median concentration of zinc in hair was significantly lower in patients (156 +/- 46 micrograms/g versus control group (185 +/- 64 micrograms/g) (p < 0.05). No differences were found between smokers and no smokers, and drinkers and no drinkers in relation with body concentration of zinc. CONCLUSION: The zinc concentration in hair can be a good method to evaluate the chronic deficiency in the human body. The COPD patients could be susceptible to develop zinc deficiency; the situation increases the possibility of infection diseases.
Alcohol Drinking↗
[Risk factors in the elderly. A study of 143 patients].
UNLABELLED: Growing old is a process of natural diminish with decrease of biological answer to extrinsic and intrinsic factors and a bigger risk of presenting cardiovascular and metabolic processes. The aim of this study has been to analyse the incidence of cardiovascular factors in an aged population from Almería. PATIENTS AND METHODS: The group is by 172 patients (29 gave up); average global age 72.6 +/- 6.1 (85 women and 58 men). In all cases history and a whole clinic exam have been undertaken; general analytical study (glucose, creatinine, hepatic function cholesterol, HDL-c, LDL-c, trigliceride fibrinogen, microalbuminuria, etc.); blood pressure. STATISTICS: T Students, varianza analysis, Kolmogorov-Smirnov test. RESULTS: With regard to overweight, this was bigger in women (32.1 +/- 4.8 Kg/m2) in relation to men (27.9 +/- 4 Kg/m2). The most frequent risk factor has been hypertension (50.3%) followed by over weight-obesity (46.8%) and hypercholesterolemia (45.4%), only 11.2% did not present any risk factor; shile three factors appeared in 29.5%. Hypertension patients have more risk factors (increase of cholesterol and triglicerids, obesity, diabetes) than normotensive old patients; also diabetic patients have a bigger cardiovascular and lipid risk than non diabetic patients. The ingestion of estatinas or fibrates improves the lipid profile of old patients. In summarizing, conventional therapy can improve the cardiologic and metabolic situation, decreasing so the morbidity and mortality of old patients.
Aged↗
[Lymphoblastic stimulation in cirrhotic and non-cirrhotic chronic alcoholics].
OBJECTIVE: To study whether there exists a functional change in lymphocytes in chronic alcoholic patients compared with chronic alcoholic cirrhotic patients. An open, prospective study was performed of the in vitro proliferative response (lymphoblastic transformation) of lymphocytes to phytohemagglutinin, mitogen pokeweed, and concanavalin A. PATIENTS: 73 males (51.4 +/- 12 years) divided on the basis of alcoholic intake and/or chronic liver disease in: social drinkers (< 80 g ethanol/day), 23; excessive drinkers (80-160 g ethanol/day), 14; chronic alcoholics (> 160 g ethanol/day), 21; and cirrhotic patients with no current alcohol consume, 15 cases. RESULTS: In social drinkers, excessive drinkers and cirrhotic patients similar proliferative responses to mitogens were observed, with no significant differences between groups. CONCLUSIONS: Our findings support the concept that chronic alcoholism has immunosuppressive effects which precede the emergence of liver cirrhosis.
Alcoholism↗
Metabolic and antihypertensive effects of nifedipine in hypertensive patients.
We studied the effects of nifedipine on blood pressure and on clinical and analytical parameters in hypertensive patients. Seven male and eight female subjects (mean age of 46.27 +/- 5.38 years, range of 41-56 years) with essential arterial hypertension were given nifedipine (20 mg b.i.d.) for 3 months. Before and after treatment, history, blood pressure, and biochemical values were recorded [blood: Na, K, Ca, creatinine, uric acid, triglycerides, cholesterol, HDL cholesterol, antidiuretic hormone (ADH), and aldosterone; urine: Na, K, Ca, creatinine, ADH, aldosterone, and percentage fraction of Na, K, and Ca excreted]. After 3 months of treatment, we found (a) significant decreases in systolic (147 +/- 18 vs. 166 +/- 16 mm Hg, p less than 0.001) and diastolic blood pressure (90 +/- 8 vs. 107 +/- 8 mm Hg, p less than 0.0007), triglycerides (107 +/- 47 vs. 120 +/- 49 mg/dl, p less than 0.0007), and cholesterol (236 +/- 4 vs. 257 +/- 44 mg/dl, p less than 0.00075) in blood, and in K excretion (50 +/- 19 vs. 46 +/- 19 mEq/g of creatinine, p less than 0.0007) and excreted fraction of K (49 +/- 6% vs. 8 +/- 5%, p less than 0.0012) in urine; (b) significant increases in HDL cholesterol (65 +/- 13 vs. 58 +/- 13 mg/dl, p less than 0.001) in blood, and in Na (115 +/- 73 vs. 109 +/- 69 mEq/g of creatinine, p less than 0.0007) in urine; and (c) no significant change in the remaining biochemical parameters, or in heart rate. Secondary effects included flushing (34%), headache (20%), ankle swelling (17%), dizziness (13%), palpitations (4%), and pruritus (4%).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Zinc levels after intravenous administration of zinc sulphate in insulin-dependent diabetes mellitus patients.
Diabetic patients commonly have increased urinary excretion of zinc, although blood concentrations may be normal, lowered, or raised. We analyzed zinc levels in plasma and urine after an intravenous overload of zinc sulphate (8 mg) in 22 patients with insulin-dependent diabetes mellitus (IDDM) and 22 healthy individuals. No significant differences were found in basal levels of serum zinc in either group (111 +/- 29 micrograms/dl in IDDM vs 119 +/- 19 micrograms/dl in controls), although urinary excretion of zinc was significantly raised in diabetics (1396 +/- 622 micrograms/24 h) versus controls (611 +/- 235 micrograms/24 h). After zinc overload, both serum and urinary levels of this element varied between the two groups. Serum zinc in IDDM patients initially increased more markedly, and subsequently showed a more significant decline, than in controls. Urinary zinc levels in IDDM patients, in contrast to control values, showed no increase after overload. These alterations in serum and urinary zinc concentrations suggest that our diabetic patients may be zinc-deficient.
Adult↗
[Hashimoto thyroiditis: postpartum course].
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Adult↗
Trace elements in drug addicts.
We studied trace elements (zinc, copper, magnesium, iron, and lithium) by atomic absorption spectrophotometry in the plasma and erythrocytes of 120 subjects: 20 healthy controls and 100 parenteral drug addicts (69 heroin and 31 heroin + other drugs). Plasma Zn and intraerythrocytic Zn and Fe were decreased, whereas plasma and intraerythrocytic Cu were significantly increased in the group of drug addicts with respect to the healthy controls. Moreover, a period of abstinence longer than 10 days was associated with lower plasma levels of Zn and Li in subjects who had taken drugs shortly before they were examined. The presence of serological markers against HBV and HIV did not seem to influence the behavior of the trace elements in blood.
Adolescent↗
[20 cases of carcinoid tumors of the digestive system].
We are presenting 20 cases of carcinoid tumors of the digestive system. We shall evaluate: age, sex, localization and histopathology, symptomatology, therapeutics and evolution. Appendicular carcinoids were the most frequent: 13 cases. All were chance findings in the histopathological examination of surgically resected appendix in eight acute appendicitis and in four laparotomies for other reasons. Histologically the classic pattern predominated, with formation of cellular nidus, with the cells being argentaffin. These characteristics permit classifying them as tumors derived from the embrionary middle intestine. No appendicular carcinoid developed metastasis. The extirpation was always curative, partially due to the small size and to the facility of obstructing the appendicular lumen. Four cases were gastric carcinoids. Their cells grouped forming trabeculas or were arranged irregularly, being negative for argyrophil and argentic tinction (tumors derived from the cephalic intestine). Two of them presented associated peptic ulcer (histamine implication). The two remaining ones came for studies related to asthenia, anorexia and weight loss, and in both cases hepatic metastasis without carcinoid syndrome were found. Two less frequent localizations were Meckel's diverticulum and ampulla of Vater. The latter developed hepatic metastasis without carcinoid syndrome. The only carcinoid syndrome was found in a patient who died due to adult respiratory distress without having localized the primary tumor.
Adult↗
[Acute mountain sickness].
Acute mountain sickness is a pathologic reaction as a result of bad adaptation to high altitudes (greater than 2.500 meters). The main symptoms are headache, nausea, vomits, and insomnia. When severe it can produce oliguria, retinal hemorrhage, ataxia and sometimes coma. Its etiology is not well known. It is considered that the first producer factor of the disease is tissular hypoxia secondary to low partial oxygen pressure existing in areas of high sea level. The treatment consists of descent and the use of dexametasone and acetazolamide.
Acute Disease↗
[Hemolytic anemias caused by erythrocyte enzyme disorders].
The congenital alterations of red cell enzymes are one of the most frequent causes of red cell hemolysis. The enzyme defects have more important effects on the red cells than any other cells in the body with the same alteration. It is because red cells do not have a protein regenerating system, this meaning that they have to keep the enzyme level during the circulation time. In order to study this defect, they are classified as follows: a) defects of glycolytic pathway; b) defects of glutathionE++ pathway; c) defects of the nucleotidic metabolism. The most frequent defects are: the deficiency of: G6PD, of pyruvate kinase, of glucose phosphate isomerase and probably pyrimidine 5'-nucleotidase deficiency.
Anemia, Hemolytic↗
[Zinc in patients with ascites].
The concentrations of zinc (Zn) in blood and ascitic fluid (AF) in 48 patients with ascites (alcoholic liver cirrhosis: 32; liver carcinoma associated to cirrhosis: 7; different malignant neoplasias: 9). In addition, total protein, albumin and alpha 2-globulin as well as zinc, were determined in ascitic fluid. There was a decrease of zinc levels in serum, total protein, albumin and alpha 2-globulin in ascitic fluid of cirrhotic patients compared to neoplastic patients. The zinc concentration in ascitic fluid was related to the concentration of total protein, albumin, alpha 2-globulin. There is a parallel correlation between seric zinc and AF zinc.
Adult↗
[Cerebral atrophy in chronic alcoholism].
The brain's morphologic changes induced by chronic abuse of ethanol are studied, using the computerized tomography (CT) of 1005 clinical records reviewed during 1982-1987 at "Hospital Universitario de Granada", only 33 were selected as patients suffering from chronic alcoholism, CTs having been performed. The results were compared with 33 CTs of non-drinking patients. The ventricular index (VI), the evans' index (EI), the transversal diameter of third ventricle (TD) and cerebral sulcus evaluation were the values analysed to estimate the degree of cerebral atrophy. It was proven that a significant decrease of VI, an increase of EI, TD and cerebral sulcus in chronic alcoholic patients exists compared to non-drinkers. 70% of the alcoholic patients had cerebral atrophy. The conclusion of this study is that chronic alcoholism is an important causal factors of the cerebral atrophy process, regardless of age, alcohol intake quantity and/or the existence of other associate pathology.
Adult↗
[Erythrocyte morphometry in alcoholism].
The aim of this study is to evaluate the erythrocyte morphology (area, perimeter, shape) and its correlation with high alcohol intake and the conventional blood test (MCV, GOT/GPT, and activated PTT). 60 persons were studied (20 non-drinkers, 20 chronic alcoholics and 20 with hepatic cirrhosis). The erythrocyte area and perimeter was significantly higher, in patients other than the group of non-drinkers. This is directly related to the alcohol intake and liver damage. We believe, that the study of the morphology of the erythrocyte is of interest as a "biological marker" related to the grade of alcoholism.
Adult↗
[The incidence of consumption coagulopathy in liver cirrhosis].
DIC in patients affected by cirrhosis, accompanied by portal hypertension and splenomegaly, has been suspected in the past. The main aim of this study is to ascertain the incidence of this phenomenon. We carried out coagulation and fibrinolytic tests in 113 cirrhotic patients and 20 healthy control persons. We found chronic consumption coagulopathy at analysis level in 28 cases (24.8%) with a decrease of fibrinogen, factor V, kallikrein, platelets, prothrombin complex activity, increase of PDF, partial thromboplastic time and euglobulin lysis. 25 cases had active cirrhosis, with ascites, variceal bleeding and/or hepatic encephalopathy; 3 were non-active cirrhosis. Only 7 patients had clinical DIC. We observed that coagulation disorders increased with more active cirrhosis.
Adult↗