PubMed Health⌕ Search

Biomedical subjects

J Altimiras

Publications and source records attributed to J Altimiras.

At least 19 recordsLinked to original sources
PubMed1998

The ontogeny of cardio-respiratory function under chronically altered gas compositions in Xenopus laevis.

The importance of diffusion and perfusion in terms of oxygen transport was evaluated by chronically altering environmental O2 availability (hypoxia or hyperoxia) and blood O2 content (carbon monoxide) through development in Xenopus laevis. Oxygen consumption (MO2), individual wet mass, heart rate (fH), and stroke volume (SV) were measured in animals raised from eggs to pre-metamorphic climax while maintained at 11, 21 and 35 kPa O2, combined with and without 2 kPa carbon monoxide. Additionally, cardiac output (Q), and a recently defined O2 consumption/transport quotient (MO2 x QO2(-1)) were calculated. Wet mass, MO2, and fH, were not significantly different between controls and experimental treatments at any developmental stage. However, with hemoglobin oxygen transport blocked by carbon monoxide, the exposed larvae showed an increased SV, Q and MO2 x QO2(-1). Combined, these data suggest that in spite of impaired blood O2 convection, normal aerobic metabolism was maintained, indicating that direct diffusion of O2 plays an important role in supplying oxygen during early development.

Aging↗
PubMed1998

Relationships between blood pressure and heart rate in the saltwater crocodile Crocodylus porosus.

The cardiac limb of the baroreflex loop was studied in the saltwater crocodile Crocodylus porosus. The classical pharmacological methodology using phenylephrine and sodium nitroprusside was used to trigger blood pressure changes, and the resulting alterations in heart rate were analysed quantitatively using a logistic function. Interindividual differences in resting heart rates and blood pressures were observed, but all seven animals displayed clear baroreflex responses. Atropine and sotalol greatly attenuated the response. A maximal baroreflex gain of 7.2 beats min-1 kPa-1 was found at a mean aortic pressure of 6.1 kPa, indicating the active role of the baroreflex in a wide pressure range encompassing hypotensive and hypertensive states. At the lowest mean aortic pressures (5.0 kPa), the synergistic role of the pulmonary-to-systemic shunt in buffering the blood pressure drop also contributes to blood pressure regulation. Pulse pressure showed a better correlation with heart rate and also a higher gain than mean aortic, systolic or diastolic pressures, and this is taken as an indicator of the existence of a differential control element working simultaneously with a linear proportional element.

Alligators and Crocodiles↗
PubMed1998

Hypoxia elicits an increase in pulmonary vasculature resistance in anaesthetised turtles (Trachemys scripta).

In mammals and birds, low oxygen levels in the lungs cause a constriction of the pulmonary vasculature. This response is locally mediated and is considered to be important for local matching of perfusion and ventilation. It is not known whether reptiles respond in a similar fashion. The present study describes the effects of altering lung oxygen levels (at a constant FCO2 of 0.03) on systemic and pulmonary blood flows and pressures in anaesthetised (Nembumal, 50 mg kg-1) and artificially ventilated turtles Trachemys scripta. During severe hypoxia (1.5-3 kPa PO2), pulmonary blood flow decreased in all animals; systemic blood flow increased, resulting in an increased net right-to-left shunt blood flow. The redistribution of blood flows was associated with reciprocal changes in the vascular resistances within the pulmonary and the systemic circulations (Rpul and Rsys, respectively). At 1.5 kPa O2, Rpul increased from 0.09 0.01 to 0.15 0.03 kPa ml-1 min kg during normoxia (means 1 s.e.m., N=5). Concurrently, Rsys tended to decrease from a normoxic value of 0.12 0.01 to 0.09 0.02 kPa ml-1 min kg (P=0.08). The effects of hypoxia on the haemodynamic variables persisted following atropinisation (1 mg kg-1) and cervical vagotomy, suggesting that the increased Rpul during hypoxia is locally mediated. This study therefore demonstrates that turtles exhibit hypoxic pulmonary vasoconstriction, although the threshold is low compared with that of mammals.

Adrenal Medulla↗
PubMed1997

Adrenergic stimulation of sea bream (Sparus aurata) red blood cells in normoxia and anoxia: effects on metabolism and on the oxygen affinity of haemoglobin

The metabolic response of sea bream (Sparus aurata) red blood cells to adrenergic stimulation was determined in normoxia and anoxia. In the presence of oxygen, red blood cells swelled and then recovered their resting volume. Continuous monitoring of oxygen uptake displayed the kinetics of the increase in the oxygen affinity of haemoglobin. Cell volume recovery correlated with an activation of ATP consumption, and the energy equilibrium was restored by increasing the rates of respiration and glycolysis. When the respiratory chain was blocked, adrenergic stimulation increased the rates of ATP consumption and glycolysis of red blood cells. Moreover, adrenergic stimulation of deoxygenated erythrocytes also increased cell volume but did not enhance glycolysis or ATP consumption, and the cells remained swollen. Our results suggest that there is an oxygen-linked signal transducer that activates ATP-consuming processes, provided that the adrenergic stimulation occurs in the presence of oxygen.

Journal Article↗
PubMed1996

[Reliability of 3 sources of information about medication excipients].

OBJECTIVE: To find how reliably three sources of therapeutic information record the composition of excipients: the Vademecum, the pharmaceutical catalogue and the instructions sheets of pharmaceutical products. DESIGN: Descriptive study. SETTING: Primary care. PATIENTS AND OTHER PARTICIPANTS: Initially, 658 orally-taken products were selected. Whether four excipients (saccharine, saccharose, lactose and ethanol) appeared in these products' composition formulas was compared. RESULTS: In 70.6% +/- 5.11 there was discordance on the excipients in the composition formulas in one of the three sources of therapeutic information. The instructions sheets contained information on the number of excipients in 98.7% +/- 1.3 of the products, the pharmaceutical catalogue in 87.2% +/- 3.7 and the Vademecum in 65.7% +/- 5.3. So the Vademecum was the source of therapeutic information containing the highest percentage of products with no kind of information about excipients, followed by the catalogue and the instructions sheets. The instructions sheets were the best source of therapeutic information for 289 products. 10.3% of laboratories did not quantify their excipients in any of the three sources under study. CONCLUSIONS: The Vademecum and pharmaceutical catalogue do not include very reliable information about these four excipients in the composition formulas of pharmaceutical products. It is important to make available to doctors straightforward texts which provide more reliable and up-to-date information.

Drug Information Services↗
PubMed1996

[Presence of excipients in pharmaceutical products in 3 sources of therapeutic information].

OBJECTIVE: To evaluate the level of agreement between information compiled from the Vademecum, the Pharmaceutical Catalogue and instruction leaflets on the four excipients most commonly used to prepare pharmaceutical products (saccharin, saccharose, lactose and ethanol). DESIGN: Descriptive study. SETTING: Primary care. PATIENTS AND OTHER PARTICIPANTS: 658 orally administered preparations of pharmaceutical products were chosen. Their composition formulas in the Vademecum, Pharmaceutical Catalogue and instruction leaflets were compared with a theoretical model constructed as the most reliable source of information on excipients. RESULTS: Saccharin and saccharose were the most frequently described and quantified excipients, and lactose the least. Saccharin was quantified in 97.3% of cases in which it was used as an excipient, saccharose in 95%, ethanol in 91.4% and lactose in 17.5%. Saccharin is also the excipient which coincided most in the three sources examined, followed by saccharose, lactose and ethanol. The Vademecum did not state the presence of saccharose in 62% of preparations and of lactose in 39.7%. Instruction leaflets were the source with the lowest rate of failing to state the excipients. CONCLUSIONS: Saccharose and lactose are excipients frequently omitted from the composition of orally taken pharmaceutical products in the Vademecum. Instruction leaflets provide the most reliable source out of the three analysed. The need to make available for doctors simple texts, contributing more reliable and up-to-date information, is underlined.

Catalogs, Drug as Topic↗
PubMed1996

[Trust of primary care physicians in the reliability of the vade mecum].

OBJECTIVES: To assess the reliability which doctors grant to the International Vademecum as a source of information, up-dating and on-going training in pharmacotherapy; also to find their knowledge of the presence of Saccharose as an excipient in the composition of several pharmaceutical products commonly used in primary care. DESIGN: A descriptive, crossover study using a self-filled postal questionnaire. SETTING: Badajoz health sector. PATIENTS AND OTHER PARTICIPANTS: Primary care doctors (general and paediatricians) from three health areas in the province of Badajoz. MEASUREMENTS AND MAIN RESULTS: A total of 178 doctors filled in the questionnaire (57.6% of the 309 doctors from the health centres). All the information in the Vademecum is considered useful and trustworthy by 68.2% of the doctors. Nor were there any significant differences in the assessment of the Vademecum between doctors with MIR (intern) training (63.6%) and without (71.1%). The Vademecum is used as a source of updating and on-going training in pharmacotherapy by 33.7% of doctors. Its use increases in line with the doctor's age and the time worked in primary care. Knowledge among doctors of the presence of saccharose as one of the excipients in the five pharmaceutical products analysed varied between 21.2% and 46.4%. CONCLUSIONS: Widespread acceptance and use of the Vademecum by primary care doctors and scant knowledge of the presence of Saccharose as an excipient in the pharmaceutical products analysed.

Adult↗
PubMed1995

Adverse reaction to streptokinase with multiple systemic manifestations.

We report the case of a 47-year-old woman with a history of mitral valve replacement with a mechanical prosthesis who was admitted to the hospital with a 3-month history of progressive exertional dyspnoea and was diagnosed as suffering from prosthetic valve thrombosis. Two consecutive courses of streptokinase were given as an intravenous infusion over 90 min at a dose of 1,500,000 IU each. Twenty minutes after the start of the second infusion (3 h and 20 min after the first one) she developed chills, fever, tachycardia and hypotension: symptomatic treatment was given and the infusion was completed. Two days later jaundice and choluria appeared with laboratory findings of hepatic cytolysis and cholestasis and renal insufficiency. The results of extensive microbiological and immunological investigations were not revealing. All the laboratory values spontaneously returned to baseline levels over the next 4 weeks. These abnormalities were attributed to an allergic reaction to streptokinase, although the exact pathogenic mechanisms involved are not known. We believe that further studies to elucidate the mechanism involved in the production of these effects are warranted in view of their potential clinical severity.

Female↗
PubMed1994

Computing heart rate variability using spectral analysis techniques: HRVUAB, a ready-to-use program.

The application of spectral analysis techniques to study the nervous modulation of the vertebrate heart have given interesting results in clinical studies although nearly nothing is known in lower vertebrates. A program to compute this heart rate variability is described in detail and preliminary results are shown. Data is first statistically qualified and fragmented in smaller segments, each being further processed through linear trend removal and normalization before the application of the Fast Fourier Transform algorithm to estimate the interval spectrum. All consecutive periodograms are averaged and the interval spectrum plotted and saved.

Algorithms↗
PubMed1993

[Influence of sex, age, and profession on transient work disability at a health center].

OBJECTIVE: To analyse whether the variables of gender, age and type of job of those in full-time work affect short-term unfitness for work (SUW) in a study undertaken within our health area. DESIGN: A prospective and retrospective study of all the SUW. SETTING: Primary Care. An urban Health Centre. PARTICIPANTS: Those people with full-time jobs registered at the Centre. MAIN MEASUREMENTS AND RESULTS: The entire 1098 certificates of SUW issued in 1990 were processed. The population pyramid and job distribution among those in full-time work was obtained by a random sample of 5% of the active population. When time off for maternity (TOM) was excluded, women accounted for 44.8% of SUW and men 55.2%. There were no significant differences with the percentages these figures represent for the active population as a whole. The number of SUW per 100 people in work was 15.9 for men and 21.5 and 17.4 for women (including and excluding TOM, respectively). The average length of SUW, excluding maternity, was 27.06 days for men and 26.8 for women. On the question of age, those under 19 and over 40 contributed least to the SUW percentage. Additionally, those under 19 and over 60 were the proportions of the population least prone to SUW. On the question of type of job, we found a higher contribution to absenteeism than expected within Groups 3 and 4 and less in Groups 0/1, 5 and 7/8/9. The longest average length of time for SUW was in Group X (84.2 days/SUW). CONCLUSIONS: Excluding TOM, gender does not appear to be a variable that affects SUW. Age group and type of job are variables affecting SUW. It will be necessary to undertake research into whether there are additional social or labour factors which might explain.

Absenteeism↗
PubMed1992

Knowledge of medication in hospitalized chronic respiratory patients.

Object of the study was to assess educative needs in the field of drug therapy among 99 chronic patients with advanced chronic lung disease admitted to the Respiratory Service of the Hospital Sta. Creu i Sant Pau (Barcelona, Spain). The knowledge of the patients about their previous drug treatment, sources of information as well as patients' conception of side-effects, was gathered from medical records and by means of a questionnaire. The majority of patients studied were male (63%), aged over 60 years (average 63 +/- 12), illiterate or with basic education (88%), had a chronic obstructive, pulmonary disease (76%) and with an important degree of chronicity. They had been treated for their condition during a mean of 8.4 years and took an average of 4.6 drugs. 31% Of patients did not answer any question about their medication properly and only 17% gave a correct answer to all the questions. The lower the age and the higher the educational level, the higher the proportion of correct answers to knowledge questions. 35% Of the patients stated not to have been informed about their medication and 55% stated that they had read the patient package inserts.

Age Factors↗
PubMed1992

[An analysis of the interruptions in general medicine consultations].

AIM: To find out the number and nature of the interruptions which occur in general medical consultations. DESIGN: Prospective study lasting two months. SITE. Two representative primary care consulting rooms in an urban health centre (a family and community medicine teaching centre). PATIENTS AND OTHER PARTICIPANTS: All the interruptions which occurred on the days chosen within the period of study were analysed. MEASUREMENTS AND MAIN RESULTS: The two consulting rooms had an average of 10 and 6.8 interruptions a day: which suggests that, in 91% and 54% respectively of the consultations that took place, some type of interruption occurred. The average length of the interruptions was 35 and 16 seconds, which represented 3.2% and 1.1% of the total time of the consultations. The members of staff who caused most interruptions were janitors (30.6% and 37%), followed by clerks (24.1% and 22.5%). However those who took the most time in their interruptions were clerks (25.4% of the total time in one consulting room) and nurses (30.3% of the total time in the other consulting room). The majority of the interruptions (63% and 53%) were considered unjustified. The handling over of analyses and further tests (15.8% and 21.4%); the bringing-in of certificates stating inability to work (16.5% and 18.1%); and the bringing-in or taking-out of clinical notes (15.1% and 11.2%) accounted for the most common causes of interruption. CONCLUSIONS: There is a need to organise the health centre's infrastructure so that as few interruptions as possible take piece actually during a consultation, given the bad effect they have on the doctor-patient relationship.

Age Factors↗
PubMed1989

Prevention of aortocoronary vein-graft attrition with low-dose aspirin and triflusal, both associated with dipyridamole: a randomized, double-blind, placebo-controlled trial.

A randomized, double-blind, placebo-controlled trial was performed in 209 patients to evaluate the efficacy of a low dose of aspirin plus dipyridamole or that of a new antiplatelet agent (triflusal) plus dipyridamole in the prevention of aortocoronary vein-graft occlusion. An angiographic control performed in 161 patients 9 days after surgery showed no significant differences between groups, but a new control on 138 of those patients 6 months later did show significant linear trends towards fewer distal anastomosis occlusions (P = 0.027) from the placebo (24%, 22/91) to the aspirin (16%, 17/106) and to the trifusal groups (12%, 10/86), and towards fewer new occlusions (P = 0.056) from 12% (9/78) to 10% (10/99) and to 2.6% (2/78), respectively, in the same groups. A multivariate logistic regression model, used to determine the effect of 33 variables on distal anastomosis occlusion at 6 months control, demonstrated that diameter of distal bed (P = 0.006), moderately to severely atherosclerotic distal bed (P = 0.003) and the interactions between poor distal bed and triflusal (P = 0.005) were independent predictors of occlusion. Thus, triflusal plus dipyridamole appeared superior to low-dose aspirin plus dipyridamole in the prevention of vein-graft occlusion, independently of coronary and vein-graft determinants of occlusion.

Adult↗
PubMed1982

Delivering pharmaceutical services from a decentralized pharmacy--health care system in Spain.

This article presents a practical demonstration of a decentralized pharmacy system improving the quality of pharmaceutical services. The authors explain the working system of a satellite pharmacy in one of the pavilions of the Hospital de la Santa Creu i Sant Pau in Barcelona, Spain. Clinical pharmacists working in this satellite become deeply involved in drug information, quality control programs, pharmacokinetics, patient education, research, and teaching activities.

Delivery of Health Care↗
PubMedDate not supplied

[Usefulness of information leaflets about drugs for hospitalized patients with chronic diseases].

To know how patients perceive the information leaflets about medicines, it has been carried out a study in a sample of 65 patients admitted to a hospital for chronic respiratory or cardiac diseases. A 47.7% of patients expressed that the main information provided by the leaflet was such concerning to the purpose of the drug, whereas a 18.5% pointed out such concerning to side effects and management of unexpected circumstances. Sixty three percent of patients expressed that leaflets did not provide them new information. A relevant percentage of patients did not know the meaning of some terms frequently used in leaflets and package-inserts (80% of mistakes in the interpretation of "take the drug on an empty stomach"). It is concluded that the information leaflets can be useful in the framework of a good physician-patient relationship, as a reminder, and to reinforce the knowledge that the patient already has. It is considered that the most appropriate time for the education of chronic patients about drugs is when the treatment is prescribed for the first time.

Aged↗
PubMedDate not supplied

[The temporary work incapacities of professional administrative workers and nurses].

We show the results of a retrospective study designed to assess the features of transient job disability (TJD) episodes of workers from two groups (clerks and nurses) from an urban health basic zone with 24,536 inhabitants, out of which 6,009 were active workers registered in social security databases. Population pyramid and job distribution in active workers were obtained from a random sample including 5% of the active population, out of which 17% were clerks and 5.54% nurses. There were 1098 TJD episodes in 1990; 32.4% of them involved clerks and 8.3% nurses. The mean length of episodes was 28.2 days in nurses and 27.8 days among clerks, compared to 32.4 days in the active population. These differences remained (p < 0.001) even after excluding TJD episodes of pregnant women, in whose case the mean length of episodes involving male or female workers was the same. The percentage of TJD episodes was higher among female nurses and clerks, than among the whole female population. Influenza was responsible for 20.5% of TJD in clerks against 14.3% among nurses and 14.8% in the whole active population. We conclude that, in the groups studied, the rate of job absenteeism was higher than in the whole population, and higher in female than in males. However, in the whole population, there were no differences in TJD rates between males and females. We discuss that several factors other than illness may explain the differences among groups.

Absenteeism↗