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Biomedical subjects

G Calvo

Publications and source records attributed to G Calvo.

At least 19 recordsLinked to original sources
PubMed2003

Modelling the 3-year risk of myocardial infarction among participants in the Data Collection on Adverse Events of Anti-HIV Drugs (DAD) study.

OBJECTIVES: To estimate the 3-year risk of myocardial infarction (MI) among participants in the Data Collection on Adverse Events of Anti-HIV Drugs (DAD) study. METHODS: Conventional cardiovascular risk equations were applied to baseline data from the DAD study to estimate the 3-year risk of MI. Best estimates were obtained by simply applying the risk equations, with upper and lower limits based on worst case and optimistic case scenarios. Three-year risks of AIDS or death were also estimated based on a prognostic scoring system for patients receiving antiretroviral (ARV) treatment, and on estimated AIDS rates in untreated people with HIV for those patients not on ARVs or if they were to cease ARVs. RESULTS: Analyses were based on 17 600 patients (24.3% female) recruited into the DAD study with baseline data and no previous MI. The overall 3-year risk of MI was estimated to be 0.72% (lower limit 0.35, upper limit 1.12%), corresponding to a total predicted 127 (65-197) MIs over a 3-year follow-up period. The risk was much greater for men than women (0.92% vs. 0.07%), with only three (2-8) MIs predicted in women. The 3-year risk of MI was estimated to increase from 0.30% (0.20-0.38%) in ARV naive patients to 1.07% (0.43-1.77%) in patients receiving ARVs from all three drug classes. The estimated 3-year risk of AIDS or death was in the range 6.2% to 11.1% in patients receiving ARVs if they continued treatment, and 22.5% to 29.4% if they ceased ARVs. DISCUSSION: These models suggest that although the increase in relative risk of MI as a result of ARV treatment may be as high as threefold in a worst case scenario, the absolute risk is modest with a best estimate of 3-year risk less than or equal to 1% in all groups of patients, and is outweighed by the benefits of ARV treatment in terms of reduced risk of AIDS and death in most patients. As estimates are based on models not validated for people receiving ARV drugs, all estimates should be interpreted cautiously.

Adult↗
PubMed2003

Increased visual cortical excitability in ecstasy users: a transcranial magnetic stimulation study.

OBJECTIVES: To test the presence of abnormalities of visual cortical excitability in people using ecstasy as a recreational drug. METHODS: Ecstasy users and control subjects underwent single pulse transcranial magnetic stimulation (TMS) of the occipital cortex. The phosphene threshold was analysed and compared in the two groups. RESULTS: Phosphene thresholds were significantly lower in ecstasy users compared with control subjects, and were correlated negatively with frequency of ecstasy use. Frequency of use was positively correlated with the presence of visual hallucinations. The phosphene threshold of subjects with hallucinations was significantly lower than that of subjects without hallucinations. CONCLUSIONS: The use of ecstasy as a recreational drug is associated with an increased excitability of the visual cortex, possibly linked with massive serotonin release, followed by serotonin depletion, in this cortical area.

Adult↗
PubMed2002

The use of placebo-controlled and non-inferiority trials for the evaluation of new drugs in the treatment of postmenopausal osteoporosis.

Registration of new agents for the treatment of postmenopausal osteoporosis has been based over the past few years on placebo-controlled phase III trials with the incidence of patients with new vertebral/nonvertebral fractures as the most usual primary endpoint. The use of a placebo in diseases where an active treatment is available has been a matter of debate following the update of the Declaration of Helsinki by the World Medical Association which questioned this trial design. Current regulatory recommendations within the European Union suggest that placebo-controlled trials are still the best option when assessing the efficacy and safety of new drugs intended for the treatment of postmenopausal osteoporosis. This suggestion seems to be in apparent contradiction with the current content of the Declaration of Helsinki. This paper addresses the ethics and feasibility of placebo-controlled trials in the treatment of postmenopausal osteoporosis, in the light of available therapeutic options, and discusses possible alternative approaches in those patients where placebo treatment could be deemed to be unethical. It is concluded that placebo-controlled trials remain the most efficient design to establish the efficacy and safety of a new agent for the treatment of postmenopausal osteoporosis. Such trials are feasible and ethically acceptable in patients with osteoporosis but without prevalent vertebral fractures. Conversely, in patients with prevalent vertebral fractures, placebo-controlled trials are ethically questionable and non-inferiority trials are more appropriate. A relative margin of non-inferiority of 20-30% is suggested, to be discussed on a case by case basis.

Aged↗
PubMed2001

Degenerate parametric light scattering in periodically poled LiNbO3:Y:Fe.

The first observation of parametric light scattering patterns (rings, lines, and dots) in bulk periodically poled nonlinear media is reported. Development of the scattering patterns proves efficient photorefractive grating recording and considerable parametric gain for seed radiation in this new nonlinear material. Several novel phase-matched parametric processes, caused by the periodicity of the domain structure, are revealed.

Journal Article↗
PubMed2001

Nitrendipine and enalapril combination therapy in mild to moderate hypertension: assessment of dose-response relationship by a clinical trial of factorial design.

Hypertension is an important cardiovascular risk factor and the goal of its pharmacologic treatment is to reduce morbidity and mortality. Treatment is usually initiated with a low dose of a single agent and titrated to a higher dose as required. As many as 50% of patients require the addition of a second agent to achieve satisfactory blood pressure control. The aim of this study was to assess the dose-response relationship of nitrendipine and enalapril alone or in fixed combination in the treatment of mild to moderate hypertension. A total of 496 patients were enrolled in a multicenter, randomized, double-blind, factorial-design, parallel-group clinical trial comparing placebo, nitrendipine (5, 10, and 20 mg) and enalapril (5, 10, and 20 mg) alone or in combination. After a single-blind, 2-week placebo run-in period, 414 patients whose diastolic blood pressure ranged between 90-109 mm Hg were randomly assigned to a treatment group. The combination of nitrendipine and enalapril, particularly regimens including nitrendipine 20 mg and enalapril 5 or 10 mg, were significantly superior to both monotherapies; mean diastolic blood pressure reductions from baseline to last visit were -12.5 and -14.3 mm Hg, respectively. Response surface analysis provided further evidence that these combinations were optimal in terms of anti-hypertensive efficacy. All treatments were well tolerated and the incidence of adverse events did not differ significantly between groups. In summary, the anti-hypertensive efficacy of the combination was found to be superior to both monotherapies at any doses. The dose combination achieving the greatest blood pressure reduction was nitrendipine 20 mg and enalapril 10 mg.

Adolescent↗
PubMed2000

Background for studies on the treatment of male osteoporosis: state of the art.

Male osteoporosis represents an important, although long underestimated, public health problem. Both in men and in women aging is accompanied by continuous bone loss and by an exponential increase in the incidence of osteoporotic fracture, with a female to male incidence ratio of about 2 to 3 to 1 in the elderly for hip and vertebral fractures. Morbidity after osteoporotic fractures appears to be more serious and mortality more common in men than in women. To date, no single treatment has been proved to be effective and safe in published prospective studies. The present report, based on a systematic search of the literature on male osteoporosis, summarises the state of the art on the clinical consequences of male osteoporosis and its risk factors, in relation to the present state of knowledge about female osteoporosis. This constitutes the background for the design of rational clinical development strategies for therapeutic interventions in male osteoporosis. From this review of the literature it is apparent that notwithstanding the existing sex differences in pathophysiology of osteoporosis and the difference in age-specific incidence of osteoporotic fractures, there are also important similarities between osteoporosis in women and men. The higher incidence of fracture in women than in men results from quantitative differences in risk factors rather than from different risk factors. Even though there are sex differences in bone geometry, incidence of fracture seems to be similar in men and women for a same absolute areal bone mineral density. However, the lack of data on the changes in fracture rates in men resulting from pharmacological intervention, leading to changes in bone mineral density or bone turnover, remains the main limitation for extrapolation of established treatment outcomes from women to men.

Age Factors↗
PubMed1997

[Secondary prevention of ischemic strokes: effect of dosage of aspirin].

INTRODUCTION AND OBJECTIVE: The value of acetylsalicylic acid (ASS) in the secondary prevention of ischemic stroke is well established. However, the optimum dose of AAS for stroke-threatened patients remains unsettled. This paper reviews the pattern of adverse reactions to AAS and their relationship to the dosage of ASS evaluated. METHOD: All the clinical trials in which AAS was used as the sole antiaggregant in the secondary prevention of ischemic stroke were reviewed. The crude odds ratio for the different adverse reactions was calculated using three sub tests: AAS versus placebo; AAS < 330 mg/d versus AAS > 330 mg/d; and each dosage level versus a placebo. RESULTS: There is an increased risk associated with the use of AAS as compared to a placebo with respect to gastrointestinal bleeding (OR 2.3, IC 95% (1.6-4.1)), peptic ulcer (10.1 (2.5-85.2)), intracerebral hemorrhage (2.2 (1.3-4)) and other hemorrhagic phenomena (2.6 (2-3.3)). CONCLUSIONS: There seems to be a direct relationship between the dosage of AAS and the frequency with which adverse reactions occur, except in the case of intracerebral hemorrhage. In the latter case there was no relationship with the dose given (0.8 (0.5-1.4)).

Aspirin↗
PubMed1993

[Perinatal and maternal pathology in 38 pregnant women with endemic goiter].

In a group of 38 pregnant women with primary, uni- or multinodular non-toxic endemic goitre, who were clinically euthyroid, 7.8% (3 cases) had previously undergone strumectomy for benign pathologies of the goitre and 10.5% (4 cases) received L-thyroxine therapy during pregnancy at a dose of 50 or 100 micrograms/day; during the course of pregnancy goitre was asymptomatic in 37 women (97.4%) and an endocystic hemorrhage occurred in 1 (2.6%) case. The goitre increased in volume in 42.1% (16 cases) of pregnant women monitored to term. Out of 20 patients undergoing ELISA of hormonal levels, 6 (30%) revealed TSH concentration more than twice the maximum normal value with normal concentrations of other thyroid hormones. There was a significant inverse correlation (r = 0.525) between T4 and TSH. Birth at term occurred at 39.9 +/- 2.6 weeks and was spontaneous in 78.9% of cases (30 cases) and laparotomic in 21.1% (8 cases). Perinatal pathologies included: 1 case (2.6%) of endo-uterine fetal death, 1 case of oligoamnios and 1 of IUGR. Funicular pathologies were observed in 13.1% of patients (5 cases). The Apgar index was > 8 in the 37 live births. The mean weight of male and female neonates and neonates from nulliparas and pluriparas was within the norm. When the data examined were compared to the results of the control group it was seen that there were no statistically significant differences.

Adult↗
PubMed1993

[Obstetric and perinatal implications of thyroid pathology in pregnancy. Review of the literature].

The authors review the published data on thyroid pathology and pregnancy. Attention is focused in particular on alterations in thyroid function and the iodine metabolism during pregnancy, thyroid interactions between the fetus, the placenta and the maternal organism, the control of fetal thyroid hormonal production, thyroid hormones and fetal development, endemic goitre and pregnancy, endemic cretinism, hypothyroidism in pregnancy, mixematous coma, hyperthyroidism in pregnancy, thyroid cancer in pregnancy and perinatal thyroid disease (hypothyroidism and hyperthyroidism).

Adult↗
PubMed1985

Plasma glucagon-immunoreactive components in early life in dogs.

High plasma concentrations of C-terminal immunoreactive glucagon (IRG) have been found during early life in several mammalian species. We have analyzed the plasma IRG of 12 h to 60 day-old dogs in terms of the 4 peaks (IRG greater than 20,000, IRG9000, IRG3500 and IRG2000) obtained by gel filtration on Bio-Gel P-30. Significant changes with age and in response to administered agents were confined to IRG9000 and IRG3500. IRG9000 was 9-fold higher in 12-36 h old dogs than in adults (108 +/- 24 pg/ml pancreatic glucagon equivalents v. 12 +/- 3 pg/ml, mean +/- SEM) and showed a decline to 2-fold higher (27 +/- 5 pg/ml) at 31-60 days. IRG3500 was higher than in the adult only during the first 36 h of life (36 +/- 5 pg/ml v. 15 +/- 3 pg/ml). Arginine infusion (0.5 g/kg over 15 min) caused an increase in plasma levels of both IRG9000 and IRG3500 in the newborn, whereas in adult dogs only IRG3500 was increased. Insulin injection (0.2 U/kg intravenously) causing a marked hypoglycemia had no significant effect on the plasma level of any IRG component in newborn dogs. Dihydrosomatostatin infusion (10 micrograms/kg bolus +/- 90 micrograms/kg over 30 min) caused a decrease in both IRG9000 and IRG3500. The increased basal level and secretory response to arginine of IRG9000 in newborn dogs may reflect an immaturity of the A cells, whereby more of this component, which may represent a precursor of pancreatic glucagon, is secreted than in the adult. The immature A cells also appear to have an impaired secretory response to hypoglycemia.

Aging↗
PubMed1975

[Anatomic aspects of Prinzmetal's angina: apropos of an anatomo-clinical case].

Report of one case of Prinzmetal variant of angina pectoris with a typical clinical and electrocardiographic picture in a man aged 87. Severe arrhythmias resulted in death of the patient. On autopsy a moderate narrowing of the anterior interventricular artery was demonstrated. In that relation, a review of the literature on the anatomical lesions and coronary arteriographic data of Prinzmetal angina was performed. It showed that in some cases Prinzmetal angina could be observed while the coronary artery lesions were very moderate. The pathogenesis of these facts was discussed.

Aged↗