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Biomedical subjects

F Gómez

Publications and source records attributed to F Gómez.

At least 37 records · Page 2Linked to original sources
PubMed2001

Prevalence of hypertension in renal disease.

BACKGROUND: Hypertension (HTN) is very frequent in patients with renal disease and its prevalence increases as renal failure progresses. METHODS: We studied the prevalence of HTN in 1921 patients with different nephropathies. Patients on dialysis and renal transplant patients were not included in the study. HTN was defined as SBP>140 and/or DBP>90 mmHg, or requiring antihypertensive therapy. RESULTS: The prevalence of HTN in the total group of patients with renal diseases was 60.5%, but this prevalence varied widely depending upon the type of underlying nephropathy. The prevalence of HTN was practically universal in patients with renal vascular disease (93%) and in patients with established diabetic nephropathy (87%), and 74% of the patients with polycystic kidney disease, 63% of the patients with chronic pyelonephritis and 54% of the patients diagnosed with glomerulonephritis were hypertensive. The prevalence of HTN in patients with renal insufficiency (80%) is significantly higher than that in patients without renal insufficiency (43% P<0.001). In a multiple logistic regression analysis, the independent risk factors defining HTN in renal patients were: renal failure, age, the presence of diabetes, hypertriglyceridaemia and proteinuria. Antihypertensive treatment consisted of diet alone in 4% of the patients, one drug in 45%, two drugs in 36%, three medications in 13% and more than three drugs in 2.5%. The angiotensin-converting enzyme (ACE) inhibitors were the most frequently prescribed drug (39% of the patients treated in monotherapy) followed by calcium channel blockers (27%), diuretics (18%) and beta-blockers (9%). The most common combined therapy was a diuretic plus an ACE inhibitor. The percentage of patients with BP controlled according to current recommendations for renal patients (BP<130/85) was very low; SBP in only 49% and DBP in 24%. Control of both was only achieved in 10% of the patients. CONCLUSIONS: There is a high prevalence of HTN in renal patients, which depends on the type of nephropathy and the degree of renal failure. Other independent risk factors for HTN in patients with renal disease are: advanced age, the presence of diabetes, hypertriglyceridaemia and the severity of proteinuria. BP control in renal patients is quite poor and should be improved to reduce progression of the renal disease.

Blood Pressure↗
PubMed2001

Instability of lipoprotein(a) in plasma stored at -70 degrees C: effects of concentration, apolipoprotein(a) genotype, and donor cardiovascular disease.

BACKGROUND: There is considerable evidence to suggest that plasma lipoprotein(a) [Lp(a)] concentration is a cardiovascular risk factor. Confusing results in epidemiologic studies, however, suggest that the effects of storage should be further investigated. The influence of the assay method, the initial plasma Lp(a) concentration, and the apolipoprotein(a) [apo(a)] genotype are all factors that should be considered. METHODS: Blood was obtained from 65 survivors of premature myocardial infarction and 95 age-matched controls. The plasma samples were stored in sterile conditions at -70 degrees C for 5 years in the presence of antioxidant and antiproteolytic substances. Plasma Lp(a) was measured by immunoturbidimetry, and apo(a) alleles were determined by pulsed-field gel electrophoresis and Southern blotting. RESULTS: Plasma Lp(a) was significantly higher in patients. The mean kringle number for the smallest isoform was also lower in patients than in controls, but no differences were found in the distribution of the largest isoform. All patients and controls were heterozygotes. During storage, mean Lp(a) decreased significantly in samples from patients (-23%; P <0.001) but not in samples from controls (-9%; P, not significant). This was not related to the kringle number and was limited to samples with initial plasma Lp(a) concentrations between 41 and 345 mg/L. CONCLUSIONS: Plasma Lp(a) from patients is less stable than Lp(a) from controls, and the difference is not related to distribution of apo(a) genotypes but may be concentration-dependent. Differential sample stability may complicate the interpretation of several studies.

Adult↗
PubMed2001

Maritime health in Spain: integrated services are the key.

The maritime occupational health services in Spain are overviewed, and their coordination for seafarers and fishermen within the integrated governmental "Maritime Health Programme", which as from 1984 has been supervised by the Labour and Social Affairs Ministry. The institution in charge is the "Instituto Social de la Marina" (ISM) in Madrid (Mariners' Social Institute) established in 1919, which has organised a network of specialised health institutions in ports. They provide medical assistance on board ships and coastal preventive services for maritime workers. There is the Radio Medical Advice Centre in Madrid, local centres in ports, centres abroad, hospital ships and a repatriation centre. All of them are connected in a centralised database net of shared medical records in a confidential computerised system. Another institution is "Sanidad Exterior" which is related to vaccinations and hygienic problems in harbours. There is also a non profit national scientific medical organisation, the Spanish Society of Maritime Medicine (SEMM) established in 1989, and another society of Naval Medicine founded in 1995. There are also groups of specialists in underwater medicine and health problems of divers. A separate article is published on the SEMM and its activities.

Delivery of Health Care, Integrated↗
PubMed2000

Rapid modifications of somatostatin neuron activity in the periventricular nucleus after acute stress.

We have previously reported that stress induces a rapid increase in hypothalamic somatostatin (SS) release. In the present work, we investigated whether SS synthesis is also affected by this treatment. Male rats were subjected to 15-min immobilization (IMO) stress, and measurements of both SS mRNA levels and SS mRNA-containing cells were analyzed in the periventricular nucleus (PeV) by radioactive and nonradioactive in situ hybridization (ISH), respectively. In addition, SS content and total SS mRNA were measured in the whole hypothalamus by radioimmunoassay (RIA) and northern blot analysis, respectively. ISH was conducted by applying either a radioactive-labeled (35S) or a digoxigenin (DIG)-labeled oligonucleotide probe on histological sections containing the periventricular region of the anterior hypothalamic area (AHA). ISH analysis using radioactive label showed a significant increase in SS mRNA levels in stressed rats. In contrast, stress treatment decreased the number of DIG-labeled cells expressing SS mRNA in this region by 35% as compared to the same histological sections from naive control rats. In addition, a significant decrease in the total SS mRNA DIG-labeled area was observed. Finally, SS content and SS mRNA measured in the whole hypothalamus of stressed rats were markedly inhibited as compared to control rats. Our data show that IMO stress induces a significant and rapid increase in SS mRNA level accompanied by a decrease in the number of cells expressing SS mRNA in the PeV-AHA. The present results suggest that a subset of PeV SS neurons, which became silent at the onset of stress, are regulated independently of the remaining whole mass of PeV neurons. This differential control is in line with the cellular heterogeneity described in periventricular SS-producing neurons and with the multiple hypothalamic and pituitary functions assigned to SS.

Acute Disease↗
PubMed2000

Evaluation of a particle-enhanced turbidimetric immunoassay for the measurement of ferritin: application to patients participating in an autologous blood transfusion program.

OBJECTIVES: To evaluate a turbidimetric immunoassay for the measurement of ferritin, and to assay this method in a group of patients undergoing an autologous blood transfusion program. DESIGN AND METHODS: We used an ILab 900 analyzer. This instrument automates a particle-enhanced immunoturbidimetric assay with an analysis time of 9 min. This technique was compared with a microparticle immunoassay. The turbidimetric assay was used to measure ferritin in a group of 30 patients undergoing an autologous blood transfusion program. RESULTS: The assay was linear in the range 3-1400 microg/L (r = 0.9999). The intra- and inter-assay imprecision (CV) at 20, 97 and 469 microg/L were <3.0 and <5.0%, respectively. Recovery was 88. 7 to 97.4%. The detection limit was 3 microg/L. Hemoglobin (</=4 g/L), mild hyperbilirubilinemia (bilirubin </=50 micromol/L), triglycerides (</=10 mmol/L) and myeloma paraproteins did not interfere with the assay. The assay showed good correlation with a microparticle enzymoimmunoassay (r = 0.994) with a mean difference between methods of -6 +/- 16 microg/L. This method was sensitive, accurate, and fast enough for an efficient follow-up of autologous blood transfusion patients. CONCLUSIONS: The new automated serum assay for ferritin is an attractive alternative that avoids the need for dedicated instrumentation.

Adult↗
PubMed2000

17. Utility of Metabolic Imaging in Oral Squamous Cell Carcinoma (SCC) Staging. Experience in 30 Patients.

Purpose: SCC represents nearly 90% of all oral malignancies, with an increasing incidence. Accurate Tumour-Node-Metastasis staging (TNM) is mandatory for planning surgical options and chemotherapy-radiotherapy management. Positron Emission Tomography (PET) using 18F-Fluorodeoxyglucose (FDG) provides functional information about tumoral tissues that may improve preoperative staging obtained by conventional morphologic procedures (CT-MRI). The purpose of this study is to evaluate the accuracy of FDG-PET in oral SCC staging and to compare those data from conventional and PET studies according to the pathologic results obtained from surgical specimen.Methods: A prospective study of 30 patients was carried out, through a 26 months period. Inclusion criteria include positive biopsy for Oral SCC, no other malignancies during the past 5 year and surgery as preferred therapeutic option. All patients underwent CT, MRI, and FDG-PET studies consecutively. Results obtained from conventional and PET preoperative staging were compared with those from postoperative histopathological studiesResults: FDG-PET modified preoperative staging obtained by conventional morphologic studies in 21% cases, which was confirmed postoperatively by histological findings. Kappa test showed higher values for PET studies (0.89) than conventional studies (0.41), when compared with postoperative controlConclusion: FDG-PET may be helpful to improve the accuracy of conventional studies in oral SCC preoperative TNM staging, although no definitive conclusions can be withdrawn due to the limited size of the sample. Modifications of preoperative staging showed by PET are a matter of controversy and must be kept in mind for further studies.

Journal Article↗
PubMed2000

Isolation and characterization of a major allergen from the fish parasite Anisakis simplex.

BACKGROUND: Ingestion of raw or undercooked fish can lead to infection of human subjects by the fish parasite Anisakis simplex, a disease known as anisakiasis or anisakidosis. Patients sensitized to this fish parasite show high levels of total and specific IgE. Cross-reactions seem to explain the fact that specific IgE antibodies are also found in a high number of normal subjects, as reported in other parasitoses. OBJECTIVE: We sought to purify and characterize a major IgE-binding protein from the parasite. METHODS: A protein was purified from the crude parasite extract by means of ethanol precipitation and reversed-phase HPLC. Its clinical relevance was tested on 20 parasite-positive sera by using IgE and IgG4 immunoblotting. A monospecific human serum was used to study its localization in the parasite body. RESULTS: A 24-kd protein was purified, to which only 45% of the sera had specific IgG4, but 85% of sera had specific IgE. The protein was present only in the excretory gland, as shown by immunohistochemistry. N-terminal amino acid sequence (17 residues) showed no homology to previously described proteins. CONCLUSION: A simplex contains a potent allergen in the excretory gland. This major parasite allergen, named Ani s 1, could have important clinical relevance, as shown by the high number of positive sera in the specific IgE immunoblotting.

Allergens↗
PubMed2000

Upper limb ischemia induced by chronic licorice ingestion.

A young woman had an acute embolic episode that affected her right upper limb. An axillo-brachial thromboembolectomy was performed after which distal pulses were recovered. The patient had a long lasting history, longer than ten years, of continuous licorice ingestion. Blood samples showed severe hypokalemia that caused EKG changes. Transesophageal echocardiogram discovered mild mitral valve prolapse. The combination of surgery and potassium supplements was successful in treating this rare and potentially life-threatening disease.

Adult↗
PubMed2000

Multicenter retrospective study of response to interferon in chronic hepatitis B.

AIM: The only agent known to have a lasting beneficial effect in chronic hepatitis B is interferon alpha, which achieves long-term remission in 25-40% of the patients. The goals of treatment are to induce clearance of HBV DNA from serum, to return serum aminotransferases to normal, and to improve histological findings in the liver. The most important factors predictive of response to treatment are high serum aminotranferases levels, low serum HBV DNA concentrations, and active histologic changes on liver biopsy. The aim of this study was to assess the response to interferon alpha in patients with chronic hepatitis B and to analyze the factors predictive of response. METHODS: We conducted a multicenter retrospective study to investigate the effect of interferon treatment in 132 patients with chronic hepatitis B in overall terms and based on HBeAg, and factors predictive of response. RESULTS: A overall sustained response was noted in 59 of 132 interferon-treated patients (45%) and 61 patients were nonresponders (46%). 12 patients relapsed (9%). None of the patients had negative HBsAg. No difference was observed in the response rate between the two treatment groups (HBeAg-positive and HBeAg-negative patients). Overall, high initial levels of serum AST and ALT predicted a good response. Age and liver biopsy findings were factors predictive of response in HBeAg-positive and HBeAg-negative patients respectively. Sex, epidemiological factors, treatment and type of virus did not correlate with the response to interferon. CONCLUSIONS: A sustained response to interferon alpha was observed in 45% of the patients with chronic hepatitis B. HBeAg seroconversion was found in up to 50% of HBeAg-positive patients. None of the patients had negative HBsAg. Overall, the response rate was higher in patients with high pretreatment serum aminotransferase levels. Age was the predictive factor in HBeAg-positive patients, and histological features were predictive in the HBeAg-negative group. However, further studies in a larger patient population are necessary to obtain well-substantiated conclusions.

Adolescent↗
PubMed1999

Amphiphilic and hydrophilic nature of sheep and human platelet phosphotyrosine phosphatase forms.

To date, although at least 75 different PTPases (protein-tyrosine-phosphate-phosphohydrolase, EC 3.1.3.48) have been identified, those detected in platelets are rather scarce. Based on previous results from our laboratory, we investigated the existence of new PTPases in platelets. Triton X-114 phase partitioning of Triton X-100-solubilized human and sheep platelet membranes allowed PTPase to be recovered in the detergent-rich (40-35%, respectively) and -poor phases (60-65%, respectively). Sedimentation analyses of both phases from the sheep species revealed hydrophilic 6S and 3.7S, and amphiphilic 7.5S and 10.3S PTPase forms. Sedimentation analyses of human platelet membrane-associated or cytosolic PTPase revealed hydrophilic 6.7S and 4.3S, and amphiphilic 5.5S and 10.8S forms, or hydrophilic 4S, 5.9S and 6.9S forms, respectively. Western blot analysis using monoclonal antibodies (MoAb) against human PTP1B, PTP1C, PTP1D and RPTPalpha (mouse anti-human PTPase MoAbs) showed that RPTPalpha was not present in platelets and that the PTP1C type and PTP1D type (but probably not the PTP1B type) were expressed in sheep species. Immunoblots also revealed that all PTPases detected were mainly membrane-associated, with similar percentages of cellular distribution in both species. All PTPases were mainly recovered in the detergent-poor phases from the Triton X-114 phase partitioning, although PTP1D from human species was also significantly present (30%) in the detergent-rich phase. Additionally, all PTPases sedimented within the same PTPase peak in sucrose gradients (sedimentation coefficients around 4S). These findings indicate that amphiphilic and hydrophilic PTPases different from PTP1B, PTP1C, PTP1D or RPTPalpha, with higher sedimentation coefficients and with higher activity when O-phosphotyrosine or a synthetic peptide phosphorylated on tyrosine were used as substrates, are present in platelets.

Animals↗
PubMed1999

[The truthfulness of the answers of children, adolescents and young people to surveys on tobacco consumption conducted in schools].

BACKGROUND: The prevalence of tobacco consumption in scholars has been determined by self-governed inquiries, methodology that presents limitations of reliability and validity. This obstacle has been endeavoured to overcome through methodological inspections such as the test-retest valuation. On the contrary, the available analytical methods (i.e., determination of cotinine in urine or determination of carbon monoxide [CO] in exhaled air) have not been used up to now in this type of studies. Their use together with the inquiries could complement the results of the questionnaires and verify their reliability. POPULATION AND METHODS: 814 scholars took part in the survey, being valid the results of 809, 385 male students and 424 female students, 13 to 24 years old (mean 15.90, SD 1.73) from an urban high school and another in the rural area. The survey included a survey and the measurement of CO levels in exhaled air in the same scholar centre. RESULTS: 257 scholars stated that they had never tried tobacco and in 15 of them (5.8%) levels of CO were equal or higher than 10 ppm (14.26, SD 4.35 ppm). 589 students stated that were not regular smokers; in 46 of them (7.8%) levels of CO were superior to 10 ppm (13.87, SD 4.68). The morning when the survey was held 629 students assured that they had not smoked: in 52 of them (8.3%) levels of CO higher than 10 ppm were observed. The mean level of CO observed in these students was 13.5 (SD 4.4) ppm. In our survey, the measurement of CO in exhaled air allowed us to show percentage between 5.8 and 8.3% of students whose answers to the different questions were not reliable. CONCLUSIONS: The reliability of the results, observed through the carrying out of surveys, can be determined with the use of analytical methods that, owe to their simplicity, can be used massively. We have not found any relation between the shortage of reliability and the variants studied (age, sex or habitat), which reaffirms the difficulty in identifying variants that can determine those "deceives" and demands for its identification the need of practicing analytical determinations.

Adolescent↗
PubMed1999

Abnormalities of hypothalamic-pituitary-adrenal and hypothalamic-somatotrophic axes in Fawn-Hooded rats.

Fawn-Hooded (FH) rats show central and peripheral abnormalities in serotoninergic functions and have attracted attention as an animal model of some pathologies, including depression and hypertension. In addition, these rats show a reduced growth rate. As the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in both depression and hypertension, and the hypothalamic-somatotrophic (HSM) axis has a major role in growth, these two endocrine axes were characterised in FH rats as compared with outbred Sprague-Dawley (SD) rats in basal conditions. FH rats showed normal serum ACTH and corticosterone concentrations, but reduced serum corticosterone binding capacity. At a central level, normal expression of mRNA for glucocorticoid type II receptors in the hippocampal formation and mRNA for corticotrophin-releasing factor (CRF) in the paraventricular nucleus of the hypothalamus were observed in FH rats, whereas expression of mRNA for CRF in the central nucleus of the amygdala was enhanced compared with the expression in SD rats. Serum GH concentrations were normal in FH rats, IGF-I tended to be lower, and mRNA for somatostatin (SRIF) in the periventricular nucleus of the hypothalamus was significantly lower in FH rats than in SD rats. The reduced SRIF gene expression in rats with normal or slightly reduced GH and IGF-I, respectively, might be secondary to a defective central and peripheral response to IGF-I, compatible with the reduced growth of FH rats. The present results suggest that FH rats have abnormalities in both HPA and HSM axes that might be related to some of their physiopathological characteristics.

Adrenocorticotropic Hormone↗
PubMed1999

Early, intermediate, and late acute stages in Chagas' disease: a study combining anti-galactose IgG, specific serodiagnosis, and polymerase chain reaction analysis.

The acute phase of Chagas' disease was classified as early, intermediate, and late based on the levels of anti-Galalpha, 3Gal IgG (Gal) and specific IgM (M) and IgG (G) anti-T. cruzi reactivity. While the early phase was M+G-Gal-, the intermediate phase was M+G-Gal+, M+G+Gal-, or M+G+Gal+, and the late phase was M-G+Gal+. This sequence of stages was consistent with our previous studies on acute-phase proteins. Analysis by the polymerase chain reaction (PCR) of parasite DNA in 65 blood samples of children living in Cochabamba, Bolivia showed a significant correlation (90.8%) between ELISA and PCR positivity. A lower correlation was observed between indirect hemagglutination, PCR (58%), and ELISA. Electrocardiographic analysis of 43 children studied by the PCR did not show any alteration typical of acute chagasic myocarditis. The PCR positivity was observed in eight samples where only Gal was increased, suggesting a very early T. cruzi infection, when specific antibodies were not yet present. By associating anti-Gal IgG with specific serology, early T. cruzi infection can be detected with greater precision. We suggest the use of anti-Gal antibody reactivity as an aid for the detection of recent T. cruzi infections, at least in endemic areas where diseases caused by other trypanosomatids do not overlap.

Adolescent↗
PubMed1998

The effect of chronic administration of antidepressants on the circadian pattern of corticosterone in the rat.

Although antidepressant administration has been reported to alter the pituitary adrenal (PA) axis, the results are puzzling. In the present work, two possible factors contributing to these contradictory results were studied in adult male Sprague-Dawley rats: (i) the type of antidepressant and (ii) the time of day at which samples were taken. Samples were taken under nonstressful conditions. In expt 1, the acute effects of two doses (10 and 20 mg/kg) of the tricyclics clomipramine (CMI), desipramine (DMI) and imipramine (IMI), and the non-specific monoamine oxidase inhibitor (MAOI) phenelzine were studied. Only phenelzine increased plasma corticosterone with the low dose, whereas phenelzine and DMI increased plasma corticosterone with the high doses when measured 30 min after drug administration. In a second experiment, it was observed that after 12 daily doses of the drugs (20 mg/kg), all drugs increased plasma corticosterone at 30 min after the last drug administration. When the circadian pattern of corticosterone was studied in the same experiment, starting on the day after the last drug administration, a significant interaction of drug by time of day was found. Drugs caused changes in the normal levels of plasma corticosterone at certain times and DMI, IMI and phenelzine reduced the number of rats showing the normal corticosterone peak at 1900 hours. No significant effect of drugs on corticosteroid-binding globulin (CBG) was found. In a third experiment, phenelzine and IMI were administered as before, but samples were taken at several times both on the day of the last drug administration and on the following day. The two drugs altered the normal circadian pattern of corticosterone in a somewhat different way, but both caused a reduction of the corticosterone peak at lights off on the day after the last drug administration. The normal relative thymus weight observed in all groups (exp. 2) suggests that the overall biological activity of corticosterone was probably not affected by antidepressants. The present results indicate that most antidepressants are able acutely to activate the PA axis after repeated administration in a similar way or even more-strongly than after the first administration, and that some of these drugs alter normal circadian pattern of corticosterone. No evidence for decreased resting PA activity was found in antidepressant-treated rats.

Animals↗
PubMed1998

[Sex differences in experimentation and tobacco consumption by children, adolescents and young adults].

Studies carried out in the past ten years have found the prevalence or smoking among children and adolescents to be high, with the greatest increase observed for girls and young women, indicating increasing gender-related differences. The aim of our study was to determine the prevalences and differences among children and adolescents of both sexes with regard to experimentation and use of tobacco products and to determine any possible influence related to urban or rural environment. Eight hundred fourteen students participated, with 809 providing valid data for study: 385 males and 424 females ranging in age from 13 to 24 years old (15.90 +/- 1.73 years). The subjects studied in either an urban or a rural school. Data was collected on campus by questionnaire and carbon monoxide in expired air was measured. Smoking had been tried by 68.2%: 241 males (62.5%) and 31 females (73.3%) (p < 0.001). Habitual smoking was reported by 27.2%: 78 males (20.2%) and 142 females (33.4%) (p < 0.001). Mean ages of experimenters (16.18 +/- 1.78 years) and smokers (16.55 +/- 1.85 years) were higher than the mean age of non-experimenters (15.29 +/- 1.43) (p < 0.001). Habitual smokers consumed a mean 2.71 +/- 1.68 cigarettes/day and consumption was similar for both sexes. CO in expired air was 12.61 +/- 6.39 ppm in these smokers, significantly higher (p < 0.001) than that found in experimenters and non smokers (p 0.001). One hundred eighty students (22.2%), 119 females and 61 males (p < 0.001), reported having smoked on the morning of the study. In total, 81.8% of the students who described themselves as smokers had smoked that morning: 78.2% of the males and 83.9% of the females. CO in this group was 13.95 +/- 1.69 ppm, significantly higher than that found for the other groups (non smokers or experimenters). We found no significant differences between number of cigarettes/day smoked by students who reported being habitual smokers and the number consumed the morning of data collection by students who had smoked the day of the study. Changes can be observed in patterns of tobacco use among children and young people. We found that nearly all aspects related to experimentation and consumption of tobacco are significantly higher in females.

Adolescent↗