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Biomedical subjects

J Ballesteros

Publications and source records attributed to J Ballesteros.

48 records · Page 3Linked to original sources
PubMed1987

Myofascial pain syndrome.

Myofascial pain, a general descriptive term, is applied to painful sensations that extend along one or more skeletal muscles and their fascia. Trigger points, discrete hyperesthetic areas within the muscle and its fascia, are characteristically found in myofascial pain. On the other hand, myofascial pain syndrome is a painful condition characterized by the presence of trigger points, local and referred pain, tenderness, referred autonomic phenomena as well as anxiety and depression. Patients affected by myofascial pain, trigger points, or myofascial pain syndrome, represent a significant population group requesting services in the offices of general practitioners, orthopaedic surgeons, and physicians treating musculoskeletal disorders.

Adult↗
PubMedDate not supplied

Dissociation between I2-imidazoline receptors and MAO-B activity in platelets of patients with Alzheimer's type dementia.

The I2-imidazoline receptor is expressed in brain and platelets and could represent a new binding domain on MAO-B enzyme. Brain I2-imidazoline receptors and MAO-B sites have been found to be increased in Alzheimer's disease. The study sought to evaluate I2-imidazoline receptors and MAO-B activity in platelets from patients with Alzheimer's type dementia (ATD) and matched controls. Preliminary saturation experiments of [3H]idazoxan binding to platelet purified mitochondrial membranes were performed to determine the maximal number of binding sites (Bmax) and the apparent dissociation constant (Kd). Afterwards, the I2-imidazoline receptor density ([3H]idazoxan at 8 and 20 nM in the presence of 2 x 10(-6) M efaroxan) was evaluated in 20 patients with ATD and 17 controls. MAO-B activity was quantified by [14C]PEA oxidation. All subjects were screened for cognitive evaluation by the Mini-Mental State Examination. The density of I2-imidazoline receptors was similar in ATD patients (8.4 and 14.3 fmol/mg protein) and controls (8.3 and 14.0 fmol/mg protein). MAO-B activity was 22% higher in ATD subjects. Significant correlations between I2-imidazoline receptors and MAO-B activity were observed. No relationships between I2-imidazoline receptors or MAO-B activity and the cognitive score were observed. In conclusion, platelet I2-imidazoline receptors do not show the increase of I2-imidazoline receptors previously observed in brain of subjects with ATD. The dissociation between I2-imidazoline receptors and MAO-B in platelets suggests that the enzyme contributes to but not exclusively represents the I2-imidazoline receptor.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

[HIV seroprevalence and exposure categories among adolescents tested at a sexually transmitted clinic diseases. Madrid, 1986-2000].

OBJECTIVE: To describe the time-trend in exposure categories and HIV seroprevalence among adolescents who underwent to voluntary testing in the period 1986-2000. METHODS: This study covered all adolescents, aged 13 to 19 years, at their first test for HIV in a sexually transmitted disease clinic in Madrid. Gender, age and HIV risk behaviours were collected. HIV diagnosis relies on ELISA test and Western blot confirmation. Time trends in HIV seroprevalence and exposure categories were analysed. RESULTS: A total of 1327 adolescents, 52% women and 22% under 18 years, were studied. The annual number of adolescents remained through the time, but injecting drug users (IDU) and IDU partners declined and female sex workers rose. 108 adolescents were diagnosed with HIV infection -71% were IDU-. HIV seroprevalence was 8.1% -31.3% in IDU-. It declined from 18.2% in 1986 to 1.5% in 1995, and after then it held steady under 4%. This decline involved several risk categories and was statistically significant in homo/bisexual men and female sex workers. The logistic regression analysis, adjusting for changes in exposure categories, showed an annual reduction in HIV seroprevalence (OR = 0.87; 95% CI, 0.81-0.94). CONCLUSIONS: HIV seroprevalence has decreased due to the fall of new young IDU and the decrease of seroprevalence within several exposure categories. HIV infections and risk behaviours continue happened among adolescents.

Adolescent↗
PubMedDate not supplied

[Effectiveness of medical advice for reducing excessive alcohol consumption. Meta-analysis of Spanish studies in primary care].

INTRODUCTION: Former systematic reviews have backed the efficacy of medical counselling, a form of brief intervention, on the treatment of excessive drinkers detected in primary care settings. Nevertheless, these results cannot be applied without criticism to Mediterranean populations which, so far, have not been represented in the aforementioned studies. The aim of the present study was to update the results on the efficacy of brief interventions in primary care by pooling Spanish studies. METHODS: Studies were searched for by using appropriate databases and also by consulting to experts in the field to retrieve grey literature. Pooled estimations of effect sizes were calculated for two outcomes, the reduction in the amount of alcohol consumption and the decrease in the number of excessive drinkers. RESULTS: Two over the 5 retrieved studies were not included in a former review. The effect size regarding the decrease of alcohol consumption was medium (d = 0.46; 95% CI, 0.29 to 0.63; p < 0.0005; the intervention group outperformed the control by a 22%) and small for the decrease in the frequency of excessive drinkers (OR = 1.55; 95% CI, 1.06 to 2.26; p = 0.02; the intervention group outperformed the control by a 11%). The analysis by complimented protocols at the end of the study showed an effect size 1.5 times larger than the analysis performed on intention-to-treat basis. CONCLUSIONS: The results of this meta-analysis support the efficacy of brief intervention for excessive drinkers in primary care settings in Spain.

Adult↗
PubMedDate not supplied

Structural changes in endothelial cells of developing rat liver in the transition from fetal to postnatal life.

Endothelial fenestrae in the microcirculatory walls of fetal (18th and 21st days), newborn (1st and 5th days), and adult rat livers have been studied by an interactive analysis of scanning electron microscope images. Our results show that liver endothelial cells contain different fenestration patterns depending on both their specific location in the liver acinus and the developing period. Portal vessels have a continuous endothelium in both fetal and postnatal livers as in the adult liver. Endothelial cells in central veins change from highly fenestrated in the fetal and neonatal livers to continuous in the adult liver. The number of fenestrae per square micrometer of endothelium is similar along the sinusoidal network of fetal liver, but increases in the zone 3 sinusoids of newborn liver through the adult liver, where it has tripled the number in the zone 1 sinusoids. Porosity values in sinusoidal endothelium progressively decrease in the fetal to postnatal transition due to the disappearance of large fenestrae (greater than 250 nm) which accompanies the residual hemopoietic activity. While we do not known which factors specifically regulate these fenestration patterns, their configuration in fetal liver, before hepatic tissue has assumed its heterogeneous functioning postnatally, is worthy of note.

Aging↗
PubMedDate not supplied

[Effectiveness of typical and atypical neuroleptics in the control of behavioral and psychopathological symptoms of dementia. Results of a retrospective study].

INTRODUCTION: Presence of disruptive behavioural and psychological symptoms in dementia (BPSD) is highly prevalent and, as a consequence, neuroleptics are frequently used in these patients to control BPSD. Several reviews have shown the clinical equivalence of different classes of neuroleptics in BPSD control, although that equivalence has been only indirectly assessed by comparing the combined results of different types of active drugs versus placebo. Thus, little is known on the comparative effectiveness, head to head, of different neuroleptics on BPSD. The aim of this study was to gather preliminary information on the effectiveness of typical (haloperidol, thioridazine) and atypical (olanzapine, risperidone) neuroleptics on BPSD. METHODS: Multicenter, observational and retrospective study using chart reviews of patients with dementia to assess neuroleptic prescriptions and clinical outcomes at 12 weeks on treatment. RESULTS: No significant differences on BPSD improvement were found by type of neuroleptic (n=78; Kruskal- Wallis exact test; p=0.47). There also were no differences by neuroleptics when the analysis was stratified by levels of cognitive decline (Kruskal-Wallis exact test; p=0.86 and 0.87 for moderate and severe levels of deterioration, respectively). Recorded side effects were worse in the haloperidol group (n=19) regarding rigidity (Fisher's exact; p=0.01), tremor (Fisher's exact p=0.03) and akathisia (Fisher's exact; p=0.03). CONCLUSIONS: Our findings support the equivalence in effectiveness of several classes of neuroleptics commonly used to treat BPSD. Nevertheless these results need to be confirmed by adequately powered randomized trials and further pharmacoepidemiological studies to assess their safety.

Aged↗
PubMedDate not supplied

[Predictors of rehospitalization in schizophrenia].

OBJECTIVES: The aim of this study is to determine the predictive value on rehospitalization of sociodemographic variables, positive/negative symptoms and thought disorders. The results are part of research project founded by the Basque Health Department. METHODS: A 18 month follow-up study of a cohort of 60 patients with acute exacerbation of schizophrenia was carried out. The assessment was performed with DSM III-R diagnostic criteria, PANSS and CGI rating scales, and SCID-P semistructured interview. All patients received antipsychotic treatment. The sociodemographic and disease data, the dimensional score of the PANSS subscales, the score of CGI scale, the items 2, 12, 13 and 14 of the PANSS as indicators of formal thought disorders; and the items 1, 5, 6, 17 and 23 of the PANSS as content thought disorders were established as predictors. The predictive value was determined by the Cox regression test (Lee 1992). RESULTS: We did not find predictive value either in the PANSS scores or in the 9 thought disorders evaluated (Wald and RR tests were not significative). Nevertheless, considering the values of standard error obtained in the Cox regression we were not in a position to assure that they did not have an incidence in the hospitalizations. The CGI was the only scale that showed prognostic value (Wald test = 1.9945; RR = 1.7499). Our results indicated that the lower number of previous hospitalizations (Wald test = 1.1437; RR = 1.1437) and the high level of studies (Wald test = 2.4258; RR = 1.8052) diminished the risk of rehospitalization. CONCLUSIONS: 1 o The predictive value on rehospitalization for the positive/negative symptoms and thought disorders was not confirmed. 2 o CGI is the only scale with predictive value. That fact makes us consider the importance of what German psychiatrists called "smelling the schizophrenia" or "The smell of schizophrenia". 3 o Our results indicate that the lower number of previous hospitalizations, and the high level of studies diminish the risk of rehospitalization.

Adolescent↗
PubMedDate not supplied

[Positive and negative symptoms in schizophrenia: standards of change during acute exacerbation].

INTRODUCTION AND OBJECTIVES: The temporal stability of the positive and negative symptoms in schizophrenia deserves a special interest due to its consequences in the outcome and the treatment of the disease. This study determines the temporal stability of positive/negative subtypes in schizophrenia during the acute phase. MATERIAL AND METHODS: This is a clinical, observational and prospective study of a dynamic cohort of patients with acute exacerbation of schizophrenia defined by DSM III-R criteria. Patients with severe and unstable organic pathology, substance dependence, mental organic disorder, mental retardation, depression, or medicamentous parkinsonism were excluded. Clinical assessment was performed with the PANSS scale. Schizophrenic subtypes were established according to inclusive and restrictive criteria of PANSS. All patients were treated with new antipsycotics and biperiden if necessary. RESULTS: 51 patients were assessed for 8 weeks. In the baseline, the negative subtype (63.3% and 52.5% by inclusive and restrictive system respectively) and paranoid form (45.1%) were predominant. Three types of analysis were performed to determine the temporal stability: 1. Concordance (Kappa index). The concordance of the inclusive and restrictive System, regarding to the baseline assessment, indicated that both criteria had a low temporal stability. 2. Mc Nemar Ji Square. This test showed that these changes were bi-directional except for the first visit, which was significant through the restrictive system (higher change from the negative to other subtypes). 3. Transition analysis among groups by First Order Morkov Chains analysis indicated that this change was stationary (the change was the same in all phases). CONCLUSIONS: 1o The variable "time" has to be considered for the definition of subtypes in schizophrenia. 2o The restrictive system is more specific. It allows to identify a subgroup of patients with "Negative" schizophrenia with a high specificity and validity in clinical and epidemiological studies. 3o The use of the baseline visit as a reference (gold standard) is recommended because it exits a higher concordance among criteria and a more florid psychopathology.

Acute Disease↗