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J Massó

Publications and source records attributed to J Massó.

14 recordsLinked to original sources

Angiotensin-converting enzyme (ACE) gene polymorphisms, serum ACE activity and blood pressure in a Spanish-Mediterranean population.

Angiotensin-converting enzyme (ACE) levels and ACE gene polymorphisms have been related with hypertension but with contradictory results between populations. We have investigated the association among the allelic distribution of the insertion-deletion (I/D) polymorphism of the ACE gene, identified by polymerase chain reaction (PCR), serum ACE activity determined by spectrophotometry, and the blood pressure (BP), in a Mediterranean population in the southwest of Europe. A total of 1322 randomised individuals were analysed, and a comparative study was conducted analysing 205 individuals from the group with highest BP (fifth quintyl) and 196 from the group with lowest BP (first quintyl). In addition we have studied the frequencies of alleles in separated groups of women and men. We conclude that in this population there is no association between I/D polymorphism and hypertension. However, we have found a statistically significant association between the presence of the D allele in the genotypes and an elevation of serum ACE activity.

Blood Pressure↗

Long-term results of the Spanish trial on treatment and survival of patients with predominantly mild heart failure.

A randomized open-label clinical trial was conducted to determine whether mortality, readmission, or quality of life differed between heart failure patients managed with captopril plus diuretics and those with digoxin plus diuretics. A total of 345 heart failure patients in New York Heart Association functional classes 2 and 3 without atrial fibrillation, dyspnea of bronchopulmonary origin, or hypertension not controlled with diuretics was randomized for digoxin (n = 175) or captopril (n = 170) treatment and followed up for a median of 4.5 years. Socioeconomic, demographic, electrocardiographic, echocardiographic, spirometric, and chest radiograph data were obtained at the initial examination. In a random sample of half the patients, ergometric, echocardiographic, and Holter records were obtained at entry and at 3 and 18 months. Patients were followed up for > or = 3 years. The end points were mortality, hospitalization for cardiac events, deterioration in quality of life, worsening of functional class, and need for digoxin or captopril in the captopril and digoxin groups, respectively. The trial had to be terminated prematurely owing to the difficulty in finding candidates free of angiotensin-converting enzyme (ACE)-inhibitor treatment. Baseline patient characteristics were similar in both groups. From the clinical point of view, only the 48-month mortality was relevantly lower (20.9 vs. 31.9%, respectively) among patients treated with captopril than that in those receiving digoxin (log rank test, p = 0.07). No statistically or clinically relevant differences were found in other end points or adverse effects. The results suggest but do not confirm the hypothesis that captopril treatment in mild to moderate heart failure might provide better long-term survival than digoxin.

Aged↗

[Comparative study of an expert system application in the prescription of medications].

BACKGROUND: The aim of this study was to evaluate the impact of a expert drug system implementation on the drug prescription habits and on drug cost in an university hospital. MATERIAL AND METHODS: During a 3 months period, the drug prescriptions to patients admitted to the Internal medicine, lung, gastroenterology and hepatology units, have been evaluated through the expert drug system (Medisource). This expert drug system functions in according to patients characteristics such as age, weight, height, sex, renal function and liver function. It recommends the correct dose, detects interactions and adverse effects and makes suggestions in pregnancy and lactation. It also offers alternative drugs with their cost. During the study period physicians were unaware of the investigation being performed. RESULTS: 836 patients (63.9 +/- 16.5 years) with an average hospital stay length of 11.6 +/- 6.7 days were studied. The most common diagnoses were: lung obstructive chronic disease, cirrhosis, gastrointestinal hemorrhage and cancer. The total amount of drug prescribed was 6,308. The expert system detected 458 overdosages and 33 underdosages, mainly in antibiotics and antiulcer drugs, and 1,722 interactions. The drug costs reduction that could be obtained following the expert system recommendations was 4.5% in antibiotic drugs and 23% in antiulcer drugs. CONCLUSION: The frequency of drug overdosage and underdosage in patients admitted in an university hospital is relatively high. The expert systems available for drug decisions could solve this problem.

Aged↗

Effect of the quality of infused energy on substrate utilization in the newborn receiving total parenteral nutrition.

Newborn infants (n = 26), subdivided into three groups in which only the nonprotein energy was manipulated, were studied during continuously administered total parenteral nutrition. Nonprotein energy intake was provided as a glucose/fat mixture, and fat energy represented 18% (group A), 29% (group B), and 40% (group C). Energy expenditure and substrate utilization were measured by indirect calorimetry during a 6-h period. Other analyses included 24-h urinary nitrogen excretion, glycemia, and lipid profile. The results showed that glucose oxidation increased with increasing total glucose intake (p < 0.05). Net fat oxidation was observed in all groups and increased with increasing percentage of energy infused as fat. The maximal oxidative glucose disposal rate observed was in group A (11.2 g/kg/d). Maximal fat oxidation observed was in group C (2 g/kg/d), in which energy delivered by fat represented 40%. This group was more energy efficient than the others. Oxygen consumption was not affected by modification of the source of energy, but carbon dioxide production was higher in group A (p < 0.05), as was the nonprotein respiratory quotient (p < 0.05). Despite differences in carbon dioxide production, arterial capillary PCO2 was not affected and, together with the higher (p < 0.05) minute ventilation, suggests that adequate pulmonary compensation occurred during the low-fat regimen. Arterial capillary PO2 was lower during the high-fat regimen (p < 0.05). Protein oxidation was greater in group A (1.14 +/- 0.32 g/kg/d) than in group B (0.70 +/- 0.21 g/kg/d) or group C (0.78 +/- 0.28 g/kg/d).(ABSTRACT TRUNCATED AT 250 WORDS)

Dietary Carbohydrates↗