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Biomedical subjects

C Posadas Romero

Publications and source records attributed to C Posadas Romero.

At least 19 recordsLinked to original sources
PubMed1988

Systemic arterial hypertension and coronary atherosclerosis. Observations in survivors of a first myocardial infarction.

To determine the importance of systemic arterial hypertension (SAH) in the pathogenesis of coronary atherosclerosis (CA), the coronary stenosis (CSI), coronary diffuse atheromatous (CDAI) and coronary tortuosity (CTI) indices were assessed by selective coronary angiography (SCA) in 132 survivors of a definite first myocardial infarction (MI). Patients were divided into 2 groups according to the absence (group A, n = 60) or presence (group B, n = 72) of SAH. Group B was further subdivided into 2 subgroups: group B1, consisting of 62 patients receiving no antihypertensive treatment before admission, and group B2, consisting of 20 patients treated continuously for at least 2 years with a diuretic or diuretic + beta-blocker. There were no differences in age, topography of MI, serum total cholesterol and triglyceride concentrations, prevalence of diabetes mellitus or smoking habits, CSI and CTI among the groups or subgroups of patients. Group B had a higher CTI (7.2 +/- 2.8) than Group A (2.7 +/- 2.3, p less than or equal to 0.001). None of the above indices were statistically different between subgroups B1 and B2. Surprisingly, the degree and extent of CA assessed by CSI and CDAI were similar in this population, regardless of the presence or absence of SAH and whether or not patients were treated with a diuretic. Although hypertension was related to tortuosity of the coronary arteries, which does not have a strong role in the development of CA, it is possible that the hypertensive process is relevant to the installation of atheromatous disease but not to its progression. Further studies are needed to clarify this point.

Angiocardiography↗
PubMedDate not supplied

[Efficacy and safety of immediate-release niacin in patients with ischemic cardiopathy. Experience of the Instituto Nacional de Cardiología "Ignacio Chávez"].

UNLABELLED: Primary and secondary prevention trials have demonstrated that niacin improves the lipid profile and reduces coronary morbidity and mortality. OBJECTIVE: To investigate the safety and efficacy of niacin in daily doses of 1.5 and 3.0 g in patients with ischemic heart disease and dyslipidemia. PATIENTS AND METHODS: Sixty one male and female patients, aged 30 to 70 years were included. Thirty two patients were later excluded; 18 for adverse events and 14 for causes not related to niacin. RESULTS: In the 29 patients that finished the study, niacin in a dose-dependent manner, significantly reduced the levels of total cholesterol, LDL-cholesterol, triglycerides, apoB and LDL-C/HDL-C ratio, and significantly increased HDL-Cholesterol concentrations; a decrease in lipoprotein(a) was observed with both dosages, but the change was significant only with the 3.0 g/day. In 11 patients (38%) lipids and lipoproteins reached ideal concentrations. In 15 patients (52%) C-LDL/C-HDL was lower than or equal to 3.5 at the end of the study. CONCLUSIONS: Our results suggest that niacin is well tolerated by 62% of the patients. Niacin is a safe, effective and a low cost alternative in the treatment of patients with ischemic heart disease and dyslipidemia.

Adult↗
PubMedDate not supplied

[Fibrates in the secondary prevention of ischemic cardiopathy].

Clinical trials have demonstrated that reduction of low density lipoprotein cholesterol (LDL-C) reduces the incidence of major cardiac events in patients with coronary heart disease (CHD). Recently, two major secondary prevention trials that evaluated the impact of increasing low serum levels of high density lipoprotein cholesterol (HDL-C) and decreasing serum triglycerides on cardiovascular morbidity and mortality were published. This paper briefly summarizes the characteristics and results of these two studies. In the veterans Affairs HDL Intervention Study (VA-HIT), LDL-C was not changed; HDL-C increased 6.0% and triglycerides were reduced 31% by gemfibrozil. The lipid changes in the Bezafibrate Infarction Prevention (BIP) study were LDL-C -6.5%, HDL-C 18%; and triglycerides -21%. In VA-HIT, there was a 22% reduction (p = 0.006) in major CHD events, whereas in the BIP study a nonsignificant reduction of only 9.4% was observed. It is not clear why the effectiveness of fibrate therapy was different in the two studies. From these results it has been suggested that for most CHD patients, the 3-hydroxy-3-methylghutaryl coenzyme A reductase inhibitors (statins) will remain the initial drugs of choice, but fibrates may be of use in a subgroup of patients.

Bezafibrate↗
PubMedDate not supplied

[Postprandial lipemia in subjects with primary hypoalphalipoproteinemia and hypoalphalipoproteinemia associated with diabetes].

The postprandial (PP) elevations in triglyceride rich lipoproteins (TRL) are potentially atherogenic. We compared PP lipemia in non insulin dependent diabetes mellitus (NIDDM) with hypoalphalipoproteinemia (HA) and patients with primary HA. Eight males in each group, mean age +/- SD 54 +/- 10 years, were studied for 12 hours after the ingestion of a fat load (65 g of fat/square meter of body surface). Plasma glucose, triglycerides (TG) and cholesterol (C) in plasma and in the different lipoprotein fractions were measured. The PP triglyceridemia was significantly greater in NIDDM patients with HA and correlated with the fasting TG concentrations. The curve pattern of the lipemia (% delta) was otherwise similar in the patients with secondary or primary HA; only the triglyceridemia persisted for a longer period of time in the latter but was otherwise similar to that of the NIDDM patients with lower basal triglyceride values. Patients with primary HA may have a disturbed metabolism of triglyceride rich lipoproteins which have a delayed depuration during the postprandium. Basal HDL-C in patients with HA cannot predict the PP triglyceridemia.

Adult↗
PubMedDate not supplied

[Postprandial lipemia in the non-insulin-dependent diabetes mellitus patient. Effect of gemfibrozil].

The postprandial (PP) elevations in triglyceride rich lipoproteins are potentially atherogenic. To describe the characteristics of PP lipemia after a fat load in non insulin dependent diabetes mellitus (NIDDM) and evaluate the response to a fibric acid derivative, seven males with NIDDM were studied for 12 hours after the ingestion of a fat load (65 g of fat/square meter of body surface). Plasma glucose, and triglycerides and cholesterol levels were measured in total plasma and in the different lipoprotein fractions. The fat load study was repeated after four weeks of treatment with gemfibrozil (GEM) 600 mg x 2. PP triglyceridemia correlated significantly with the fasting triglyceride concentrations. Basal triglyceride levels diminished significantly with the use of gemfibrozil and so did the magnitude of the PP triglyceridemia. Otherwise the curve patterns of lipemia were similar before and after the use of the fibrate; only the triglyceridemia persisted for a longer period of time. Patients with NIDDM may have a significant PP lipemia which is not likely related to the diabetes per se as to the increased triglyceride levels frequently observed in these patients.

Cholesterol, HDL↗
PubMedDate not supplied

[The efficacy of cholestyramine as a hypocholesterolemic agent and its tolerance in a Mexican population].

The tolerance and efficacy of cholestyramine (12-16 gr/day) was evaluated in 19 patients with primary type-IIa hyperlipoproteinemia. All patients were on an isocaloric low-cholesterol diet that began at least one month before entry, and was continued during the eight weeks of the study. Cholestyramine significantly (p less than 0.001) lowered the plasma levels of cholesterol and of low density lipoprotein cholesterol from means of 288 +/- 46 mg/dl to 244 +/- 44 mg/dl and from 221 +/- 50 mg/dl to 171 +/- 46 mg/dl respectively. These were reductions of 15 and 22%. The magnitude of response to cholestyramine was unrelated to age, sex, cause of the hypercholesterolemia (familial or polygenic) or basal cholesterol levels. The drug was well tolerated. Only one patient was excluded because gastrointestinal discomfort. Because of its safety and efficacy, cholestyramine can be recommended as a first choice drug in the treatment of hypercholesterolemia.

Adult↗
PubMedDate not supplied

[The effect of psyllium plantago in slightly to moderately hypercholesterolemic patients].

The hypocholesterolemic effect of psyllium plantago (PP) was evaluated in 14 individuals with polygenic hypercholesterolemia. Subjects with secondary dyslipidemias were excluded. Since their admission until the end of the study all the patients had to follow an isocaloric diet, with less than 10% of the calories provided as saturated fats, P/S relation greater than 1 and daily intake of less than 300 mgr of cholesterol. The study was divided in two stages; the first one, from week -6 to 0 evaluated exclusively the response to diet, and the stage II, from week 0 to +12, evaluated the response to PP. The PP in envelopes with 3.4 grs each, was taken dissolved in water three times daily before meals. In the weeks -6, 0, +4, +8 and +12 were done lipid profiles that included; total cholesterol, triglycerides, and high density cholesterol. Cholesterol of the low density lipoproteins was obtained with the formula of Friedewald modified by De Long. The use of PP produced at week 12 a reduction of 8% in total cholesterol and 11% in LDL cholesterol. With non significant changes in triglycerides and HDL-C. We conclude that PP can be used as a complement of diet in the management of polygenic hypercholesterolemia.

Adult↗
PubMedDate not supplied

[The heart and diabetes mellitus].

The atherosclerotic process in the diabetic patient, is more common, it is noticed at early ages, advances more rapidly and almost equally affects males and females. This data, can not be explained on the basis of the association with other coronary heart disease risk factors, there is an intrinsic atherogenic factor attributed to diabetes, and can be related, to the early hyperinsulinemia, coagulation and lipid disorders, hyperglycemia or diabetic microangiopathy. Coronary heart disease has an increased prevalence in diabetic patients, that is not related with diabetes duration or the type of treatment. Early and late morbimortality after acute myocardial infarction and/or revascularization surgery is twice as common in the diabetic patient. Diabetic cardiomyopathy related to small vessels disease is still a matter of controversy and many authors doubt about its relevance in clinical practice. The presence of autonomic neuropathy with the cardiovascular denervation syndrome carries a poor prognosis. Early cardiovascular changes in asymptomatic patients, are detected with non-invasive test, and can help to introduce measures to protect individuals at a greater risk.

Cardiomyopathies↗
PubMedDate not supplied

[The importance of radiology in the localization of pheochromocytoma].

The usefulness of different radiologic studies in localizing the tumor was evaluated in 26 patients with a firmly established diagnosis of pheochromocytoma. The site of the lesion was correctly identified in 8% of the cases by the plain abdominal x-ray films: in 11% by the plain thoracic films; in 34% by uronephrotomography; in 88% by angiography and in 6 patients (100%) in whom computed tomography scans (CT) were performed. The tumors were intra-adrenal in 19 patients and extra-adrenal in the remaining 7 cases. Of the latter, two were found in the organ of Zuckerkandl, two were abdominal para-aortic, two others in the para-aortic region of thorax, and one with intra an extra-adrenal tumors. It is concluded that CT scans are quite successful in preoperative localization of pheochromocytoma. The non-invasive nature of the technique makes it the method of choice in the anatomical localization of this type of tumors.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Non-insulin-dependent diabetes mellitus and hyperlipoproteinemia in patients with ischemic cardiopathy].

Cardiovascular disease (CVD) constitutes the main cause of death in diabetes mellitus (DM): Previous studies at the "Instituto Nacional de Cardiología de México" have investigated the metabolic alterations of survivors of a myocardial infarction (MI), but none of them had focused on the metabolic profile of the diabetic patient. We compared two groups of patients with ischemic heart disease (IHD), one with (DMG) and one without (NDMG) Diabetes Mellitus, to investigate differences in the prevalence and nature of hyperlipoproteinemias (HLP) and other risk factors of atherosclerosis. DMG consisted of 117 patients (75 male, 42 female) and NDMG consisted of 119 patients (91 male y 28 female). (Female NDMG vs female DMG p less than 0.05). The presence of risks factors of atherosclerosis was investigated in all patients, and total cholesterol (chol) triglycerides (TG) and glucose were measured in post-absorptive phase. There were no differences regarding mean age (DMG: 60 +/- 8 years, NDM: 60 +/- 11 years), Quetelet Index (Kg./mt2: DMG: 26.5 +/- 3, NDMG: 26.7 +/- 3), TG: (DMG: 246.2 +/- 125, NDMG: 223.5 +/- 129) or Chol (DMG: 216 +/- 42 mg/dl, NDMG: 225 +/- 45 mg/dl). Hypertriglyceridemia was significantly higher in patients with DM, as a whole and when both sexes were studied separately (p less than 0.05). Hypercholesterolemia was significantly higher in NDMG (p less than 0.05) and without significance, in diabetic women. (p less than 0.05). Type IV phenotype was higher in DMG (p less than 0.05) whereas phenotypes IIa and IIa + IIb were more prevalent among non-diabetics (p less than 0.001, p less than 0.0001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[Hypoalphalipoproteinemia and atherosclerosis. Genetic and biochemical profile of 10 families].

The results of lipoprotein studies performed in 67 members of 10 kindreds with familial hypoalphalipoproteinemia are presented. Probands were ten patients referred to the Lipid Clinic of the National Institute of Cardiology for evaluation of their lipid profile, all of whom had history of a definite myocardial infarction occurring before they had reached age 60. Their only plasma lipid abnormality was a reduction of the cholesterol fraction associated with high-density lipoproteins (C-HDL) below the corresponding age-sex specific fifth percentile. We studied 57 other individuals including probands spouses and available first-degree relatives. All participants were clinically examined and their complete coronary risk factor profile was assessed. After a 12 hour fast, plasma samples were obtained for lipid analysis, total cholesterol and trïglycerides were measured by enzymatic methods, C-HDL was determined in the supernatant after plasma precipitation with magnesium chloride: phosphotungstic acid. Low-density lipoprotein cholesterol (C-LDL) was estimated with the formula proposed by DeLong. For every family a pedigree was constructed and statistically analyzed to assess the within-family clustering of low C-HDL levels and the pattern of transmission of the abnormal phenotypes. Mean C-HDL level for propositii was 24.3 mg/dl, the corresponding value for the C-LDL/C-HDL ratio (atherogenic index) was 4.9 and it was elevated above 3.5 (average coronary risk) in 7/10 (70%) of these patients. Obesity, defined by a Quetelet index above 28 in men and 26 in women was present in 4/10 (40%) of the probands, 3/10 (30%) had stable non insulin-dependent diabetes mellitus, prevalence figures for the other coronary risk factors was very low. In addition to probands, the hypoalphalipoproteinemic phenotype was found in 30/57 (52.6%) subjects including spouses (two cases) and first-degree relatives. For these 30 cases the mean C-HDL value was 32 mg/dl. In all ten reported kindred, we clearly observed either horizontal, vertical or both types of within-family transmission of the aberrant phenotype. This finding was considered to be most compatible with the presence of a primary genetic abnormality affecting C-HDL metabolism in all these kindreds in spite of the fact that some of the probands had some conditions like diabetes or obesity that are sometimes associated with secondary reductions of C-HDL. Due to the lack of a reliable biochemical marker, the distinction between primary and secondary hypoalphalipoproteinemia in individual cases is frequently impossible, for this reason the diagnostic assessment depends on family studies.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMedDate not supplied

[Amiodarone keratopathy. Prospective longitudinal study].

In order to investigate the frequency of corneal micro-deposits of amiodarone and its relationship to age, sex, dose and treatment duration, we studied one-hundred-fifty consecutive patients from 1982 to 1986. The average age was 33.8 +/- 17.5 years for eighty woman and seventy men. The mean weekly dose was of 1.1 +/- 0.3 g and the duration was 23.7 +/- 15.3 months. A complete eye examination was performed in all cases. The corneal micro-deposits were classified in three levels according to their density. In one-hundred-fourteen cases there were corneal micro-deposits; sixty-nine had grade I, thirty grade II and fifteen grade III. None had visual disturbances. There was only a direct statistical correlation between age and micro-deposit levels. Nine cases had also deposits of pigment in the lens. Two cases presented atypical keratopathy which by their involution after withdrawal of the drug was considered to be amiodarone-related. Fifteen cases presented chronic blepharitis, and ten, chronic non-secreting conjunctivitis. Therefore, age is a determinant factor for corneal accumulation of amiodarone micro-deposits.

Adolescent↗
PubMedDate not supplied

[The renin-angiotensin-aldosterone system in compensated and uncompensated cardiac insufficiency].

Renin Activity (PRA), Aldosterone (PA), Sodium (PNa) and Potassium (PK) in plasma and Aldosterone (UA), Sodium (UNa) and Potassium (UK) in 24 hrs urine were measured in 11 cases of heart failure compensated with treatment (HFCT) consisting in digoxin 0.25 mg daily, furosemide 40 to 80 mg daily, potassium chloride 1.5 g daily and low salt diet and in 12 cases of refractory heart failure (RHF). Mean and standard deviation of PRA, PA, PNa, PK, UA, UNa and UK were 9.7 +/- 8.2 mg/cc/hr. 24.2 +/- 14.0 mg/100 cc, 142.2 +/- 4.7 mEq/1, 4.9 +/- 0.3 mEq/1, 8.7 +/- 9.1 ug/24 hrs, 89.3 +/- 50.0 mEq/24 hrs and 50.0 +/- 26.7 mEq/24 hrs, respectively for cases with HFCT and 61.7 +/- 37.5, 120.3 +/- 125.8, 133.1 +/- 4.3, 4.9 +/- 0.4, 21.3 +/- 19.2, 9.9 +/- 19 and 33.3 +/- 12.0 respectively for subjects with RHF. The statistical analysis of PRA, PA, PNa and UNa, revealed differences between the two groups with p values of less than or equal to 0.05, less than or equal to 0.001, less than or equal to 0.001, less than or equal to 0.001, respectively. The other values were statistically non significant. These data suggest the existence of an stimulatory state of the renin-angiotensin-aldosterone system (RAAS) in the RHF and a normal state in HFCT. The lack of electrolytic changes suggestive of aldosteronism in RHF may be due to an alteration of aldosterone receptors or to hemodynamic renal factors. In heart failure hemodynamic changes rather than humoral factor seems to control RAAS.

Adult↗
PubMedDate not supplied

[Lipid and lipoprotein levels in athletes in different sports disciplines].

The purpose of this study was to investigate the effects of long-term high level physical exertion on plasma lipids and lipoproteins. Ninety-one young athletes, 70 men and 21 women, who practiced sports such as running, swimming, rowing, boxing and soccer, were studied. The control group included 101 healthy subjects, 77 men and 24 women, with sedentary life style. The mean plasma levels of total cholesterol (TC) (p = 0.04), low-density lipoprotein cholesterol (LDL-C) (p = 0.04) and the atherogenic index (p = 0.01) were lower, and high-density lipoprotein cholesterol (HDL-C) (p < 0.005) significantly higher in male athletes than in controls. Mean plasma lipids and lipoproteins concentrations were not significantly different in sportswomen when compared with their controls. The prevalence of hypercholesterolemia, hypertriglyceridemia and low HDL-C levels, were lower in male and female athletes of the five sport disciplines than in sedentary controls; however, only hypercholesterolemia (p < 0.05) and the atherogenic index (p < 0.01) were statistically different. These results, consistent with data previously published, show that low plasma levels of TG and high levels of HDL-C characterizes the athletes who practice an aerobic physical activity; additionally, in male athletes we found that long-term exercise appears to reduce LDL-C plasma levels. This latter finding agree with most, but not all, studies in the literature. We conclude that athletes have a lipid profile that may be protective against the development of atherosclerosis.

Adolescent↗
PubMedDate not supplied

[Lipoprotein(a) in heterozygote familial hypercholesterolemia].

Familial hypercholesterolemia (FH) is the genetic lipid disorder with a higher risk to develop coronary heart disease (CHD). In the heterozygous patients there are, however, variability in the atherosclerosis age of onset and severity. In recent years, it has been reported elevated levels of Lp(a) in FH, and it is proposed that this lipoprotein contributes to the development of CHD in these patients. This study evaluates the relationship between Lp(a) levels and the presence of CHD in FH. We included 38 patients with heterozygous FH with or without CHD (13 and 25 respectively), and a control group. In comparison to the control group, FH patients had significant elevated levels of Lp(a) (median 8.1 vs 16 mg/dL), and a greater prevalence of hyper Lp(a) (with a cut-off level of 30 mg/dL) (11.4 vs 25.7%). FH patients with CHD had higher levels of Lp(a) than those without CHD (22.8 vs 14.4 mg/dL). A significative negative correlation between age of onset of CHD and Lp(a) levels was found in females. CHD in FH was associated with male gender, older age, higher prevalence of hypertension, higher waist/hip ratios, higher levels of triglycerides and prevalence of hypertriglyceridemia. Our findings suggest that Lp(a) may play a role as an additional risk factor to develop atherosclerosis in FH.

Adult↗
PubMedDate not supplied

[Metabolic control and the prevalence of dyslipidemia in children and adolescents with insulin-dependent diabetes mellitus].

Cholesterol, triglycerides and lipoprotein levels were assayed in serum of 152 children and teenagers with IDDM and in 228 non-diabetic siblings. A poor control of diabetes, reflected by high levels of glycosylated hemoglobin and/or high fasting blood glucose, was associated with statistically significant increases in total cholesterol, LDL-cholesterol and triglycerides, and a reduction in HDL-cholesterol. Mean total cholesterol levels in diabetic patients (171 +/- 33 mg/dL for males and 199 +/- 53 mg/dL for females) were statistically higher than those in their siblings (158 +/- 30 mg/dL and 164 +/- 33 mg/dL respectively). The prevalence of hypercholesterolemia (HC) and hypertriglyceridemia (HTG) were higher in the diabetic patients but statistically significant exclusively in females (prevalences of 40% vs 12% for HC and 30% vs 9% for HTG with a p value < 0.005). The diabetic patients in good metabolic control had similar lipid levels to those of their non-diabetic siblings. These data support the hypothesis that poor control of blood glucose is associated with atherogenic lipid profiles. The prevalence of hypercholesterolemia is impressively high in our diabetic population and indicates that all IDDM patients should have a serum lipid and lipoprotein analysis done annually; blood glucose control and dietary guidelines should be improved in these cases.

Adolescent↗