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Biomedical subjects

Esther Gómez-Gil

Publications and source records attributed to Esther Gómez-Gil.

6 recordsLinked to original sources
PubMed2006

Life events and inflammatory bowel disease relapse: a prospective study of patients enrolled in remission.

OBJECTIVES: The impact of life events in recurrence of inflammatory bowel disease (IBD) is unclear. We sought to determine whether stressful life events or the emotional impact of these events are associated with IBD relapses, hypothesizing that the exposure of life events among patients with inactive disease will increase the risk of subsequent relapses. METHODS: In this prospective study, 163 patients with inactive IBD, who had had at least one relapse in a 2-yr period before entry into the study, were enrolled. The Spanish version of the Social Readjustment Rating Scale (SRRS) (measuring life events), a measure of the emotional impact of these life events, and an IBD activity index were completed monthly up to the end of the study (maximum 11 months) or up to a relapse. Biological factors associated with an increased risk of relapse were identified in patients who relapsed. RESULTS: Fifty-one patients relapsed (32.9%), 104 remained in remission, and 8 dropped out. Multivariate Cox regression analysis with time dependent variables showed that the number of life events was not associated with the rate of relapse after adjustment for significant covariates on the subsequent month (hazard ratio = 0.88, 95% CI = 0.68-1.13, p = 0.33) or in the time-lagged analysis. The emotional impact of stressful events was also not associated with the risk of relapse. When patients who suffered a biological risk factor for relapsing were excluded in subsequent statistical analyses, similar results were obtained. CONCLUSIONS: Our results suggest that stressful life events do not trigger exacerbations in patients suffering from IBD.

Adolescent↗
PubMed2004

Decrease of the platelet 5-HT2A receptor function by long-term imipramine treatment in endogenous depression.

BACKGROUND: Animal studies have found that many antidepressants induce decreases in both the density and the functional activity of the serotonin 2A (5-HT2A) receptor subtype. However, the extrapolation of findings to humans has been inconclusive. A physiological platelet response mediated by this receptor, the serotonin-amplified platelet aggregation, was measured to study whether long-term antidepressant treatment induces changes in 5-HT2A receptor functioning in endogenous depressed patients. METHOD: The percentage of serotonin-amplified platelet aggregation to adenosine diphosphate (ADP) was studied in 15 untreated patients with major depressive disorder (DSM-IV) with endogenous features (Newcastle scale). This index was used as an indirect measurement of the functional status of platelet 5-HT2A receptors. Aggregation studies were repeated once remission of the symptoms was achieved during treatment with imipramine (150-300 mg/day). A group of 15 concurrent normal subjects was used as a control. RESULTS: A statistically significant decrease (p = 0.038) in the percentage of serotonin-amplified platelet aggregation to ADP was observed when remission was achieved (after 145 +/- 27 days). CONCLUSIONS: The results showed a decrease in a platelet functional response mediated by 5-HT2A receptors following effective imipramine treatment, suggesting that desensitization or down-regulation of the 5-HT2A receptor function could be linked to the therapeutic effect of some antidepressants. The data also support the use of platelet aggregometry as a surrogate measurement of antidepressant action, particularly in intra-subject designs.

Adult↗
PubMed2002

Platelet 5-HT2A-receptor-mediated induction of aggregation is not altered in major depression.

BACKGROUND: Studies of the 5-HT(2A) receptor subtype in major depression have focused on the density of these receptors in neuronal cells and platelets, showing an up-regulation secondary to a deficit in serotonergic activity in major depression. However, their functional state has often been disregarded. The aim of the study was to investigate whether depressed patients show abnormalities in the function of the 5-HT(2A) receptor pathway in platelets. METHOD: The percentage of serotonin-amplified platelet aggregation to adenosine diphosphate (ADP) was assessed in 30 untreated patients with major depressive disorder and in 15 controls. Since 5-HT(2A) platelet receptors mediate the serotonin-induced platelet aggregation response, this index was used as a measure of the functional status of the platelet 5-HT(2A) receptor pathway. RESULTS: There was no significant difference in the percentage of serotonin-amplified platelet aggregation to ADP between depressed patients and controls. No correlation with the severity of depression, as assessed by the Hamilton scale, was found. CONCLUSION: The results showed no consistent changes in the platelet aggregating responses to serotonin in the depressed patients. Therefore this study does not support the hypothesis of an alteration of the functional status of platelet 5-HT(2A) receptors in major depression.

Adenosine Diphosphate↗
PubMedDate not supplied

Lack of clinical relevance of routine chest radiography in acute psychiatric admissions.

To make clinically relevant recommendations for chest X-ray testing in acute psychiatric admissions, this study examined the current practice of this screening test in patients admitted to a University Hospital. The records of the 332 first consecutive admissions to the psychiatric ward were assessed. In 200 patients (60%) a chest X-ray was requested. The X-ray film was normal in 81.5% of patients. The remaining subjects presented abnormalities: nonrelevant in twenty-seven (13.5% of the total), and relevant in eleven (5.5%). Since all these relevant abnormalities were already known, in no cases was the test followed by changes in therapy or by additional diagnostic procedures. In almost all cases this screening test was of no practical value. Our findings challenge the systematic indication of chest X-ray in acute psychiatric patients, and suggest that the number of tests performed and the cost of medical care could be reduced by a more efficient use of past medical history and physical examination criteria, without compromising the quality of patient care.

Adult↗