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Biomedical subjects

J Matias-Guiu

Publications and source records attributed to J Matias-Guiu.

At least 19 recordsLinked to original sources
PubMed2005

Triflusal for preventing serious vascular events in people at high risk.

BACKGROUND: Aspirin is the standard treatment for secondary prevention of stroke and other vascular events. Several studies suggest that triflusal may have a better safety profile. OBJECTIVES: To determine in people at high risk of vascular events whether triflusal is an effective and safe treatment for primary and secondary prevention of serious vascular events. SEARCH STRATEGY: We searched the trials registers of the following Cochrane Review Groups: Stroke Group (last searched October 2004), Heart Group, Peripheral Vascular Diseases Group and Metabolic and Endocrine Disorders Group (last searched May 2003). In addition, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2003), MEDLINE (1977 to 2003) and EMBASE (1980 to 2003). We searched reference lists and contacted researchers in the field, authors of relevant trials and the drug manufacturer. SELECTION CRITERIA: Randomised and quasi-randomised studies comparing triflusal with placebo or aspirin in people at high risk of vascular events. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. The primary outcome was a serious vascular event (non-fatal acute myocardial infarction (AMI), non-fatal ischemic or hemorrhagic stroke, or vascular death). Other efficacy and safety measures collected were frequency of different vascular events, adverse events, minor and major hemorrhages. MAIN RESULTS: (1) Aspirin versus triflusal: five studies enrolled patients with stroke or transient ischemic attack (TIA) (4 trials; 2944 patients; followed for 6 to 47 months) or AMI (one trial; 2275 patients; followed for 35 days). Entry criteria were similar within each subgroup of patients. Patient groups were appropriately selected and well matched. The primary outcome in all trials was a composite outcome of vascular events. Trials had no important bias except in one study (217 patients). For the primary outcome of a serious vascular event there was no significant difference between triflusal and aspirin; the odds ratio (OR) was 1.04 (95% confidence interval (CI) 0.87 to 1.23). Significant differences were found for frequency of hemorrhages, both minor (OR 1.60, 95% CI 1.31 to 1.95) and major (OR 2.34, 95% CI 1.58 to 3.46) and for non-hemorrhagic gastrointestinal adverse events (OR 0.84, 95% CI 0.75 to 0.95). Sensitivity analysis of well versus poorly allocated trials showed no significant differences. (2) Triflusal versus placebo: two trials enrolled patients with unstable angina (281 patients) or peripheral arteriopathy (122 patients), who were followed for 6 months. Triflusal was associated with a reduction in serious vascular events (OR 2.29, 95% CI 1.01 to 5.19; OR greater than 1 favours triflusal) and with a higher frequency of adverse events (OR 1.68, 95% CI 1.00 to 2.80). AUTHORS' CONCLUSIONS: No significant differences were found between triflusal and aspirin for secondary prevention of serious vascular events in patients with stroke or TIA and AMI. However, our review cannot exclude moderate differences in efficacy. Triflusal was associated with a lower risk of hemorrhagic complications.

Aspirin↗
PubMed2002

Efficacy and tolerability in migraine prophylaxis of flunarizine in reduced doses: a comparison with propranolol 160 mg daily.

This was a phase-IV double-blind equivalence trial designed to assess the efficacy and tolerability of two doses of flunarizine (10 mg o.d.=FLU 10 mg and 5 mg o.d.=FLU 5 mg) in the prophylaxis of migraine, in comparison with slow-release propranolol (160 mg o.d.). A total of 808 subjects were treated in a treatment period of 16 weeks. 142 subjects discontinued the trial prematurely, mainly because of adverse events (n=58). The mean attack frequency in the double-blind period was 2.0 for the FLU 5 mg group, 1.9 for the FLU 10 mg group, and 1.9 for the propranolol group. The mean attack frequency in the last 28 days of the double-blind period was 1.8 for FLU 5 mg, 1.6 for FLU 10 mg, and 1.7 for propranolol. Both flunarizine groups were at least as effective as propranolol (P<0.001 in one-sided test). The percentage of responders (defined as subjects for whom attack frequency decreased by at least 50% compared to run-in) in the last 28 days of the double-blind period was 46% (118/259) for FLU 5 mg, 53% (141/264) for FLU 10 mg, and 48% (125/258) for propranolol. Statistical analysis showed that FLU 10 mg is at least as effective as propranolol (P<0.001) and showed a trend for noninferiority of FLU5 and propranolol (P=0.053). No statistically significant differences between the treatment groups were found for any of the secondary parameters. Overall, 190 subjects reported one or more adverse events during the run-in phase: 54 (20.5%) in the FLU 5 mg group, 76 (27.7%) in the FLU 10 mg group and 60 (22.3%) in the propranolol group. The results of this equivalence trial show that 10 mg flunarizine daily with a drug-free weekend is at least as effective as 160 mg propranolol in the prophylaxis of migraine for all evaluated parameters (one-sided equivalence tests) after 16 weeks of treatment. In addition, 5 mg flunarizine proves to be at least as effective as 160 mg propranolol when looking at the mean attack frequency for both the whole double-blind period and the last 28 days of treatment. However, in the analysis of responders, 160 mg propranolol seems to be slightly better than 5 mg flunarizine. In addition, no significant differences between the three treatments were found with regard to safety: all three treatments were generally well-tolerated and safe.

Adolescent↗
PubMed1998

Heart rate variability in multiple sclerosis during a stable phase.

OBJECTIVES: Multiple sclerosis (MS) frequently causes disturbances of autonomic functions. Cardiovascular dysautonomia has been studied by classic autonomic tests and, recently, by heart rate variability analysis in some isolated periods. Multiple authors recommended performing heart rate variability analysis with a 24 h ECG recording to increase its sensitivity. MATERIAL AND METHODS: We analyzed the heart rate variability in time and frequency domains in 34 MS patients and 24 age and sex-matched healthy control subjects, in order to evaluate the effects of MS on sympathetic and parasympathetic cardiovascular regulatory functions measured from 24-h electrocardiogram. RESULTS: Low frequency power (0.01) and low frequency/high frequency power (0.01) were significantly higher in multiple sclerosis patients independently, all together or in subgroups. Very low frequency (0.01) and high frequency (0.001) power were higher in less affected multiple sclerosis patients. Variability in time domain (0.05) were lower in most affected multiple sclerosis patients. CONCLUSIONS: These results suggest that multiple sclerosis causes cardiovascular autonomic dysregulation manifesting as impaired heart rate variability. This illness seems to cause an increase in sympathetic cardiovascular tone; the parasympathetic tone is most variable and depends on clinical and paraclinical findings, but the illness progression seems to provoke a decrease in it.

Adult↗
PubMed1997

[Muscarinic receptors on lymphocytes].

INTRODUCTION: The presence of muscarinic receptors on lymphocytes and possible modifications in their number and affinity may be related to cholinergic changes found in muscarinic receptors at a central level. OBJECTIVE: The objective of this paper is to bring the technique for the determination of lymphocyte muscarinic receptors by means of their union with radioligands for application in the study of disorders involving the cholinergic system, such as Alzheimer's disease, up to date. MATERIAL AND METHODS: We therefore made a density gradient isolation of lymphocytes from healthy subjects and made a trial of union or binding with N-methyl-escopolamine marked with tritium (3H-NMS) on intact lymphocytes. RESULTS: We were unable to specifically label the muscarinic receptors. However, we have shown the usefulness of the technique, using rat anterior cerebral homogenate. CONCLUSIONS: We consider whether the absence of specific union with the lymphocyte muscarinic receptor is due to technical problems as is often described in the literature, or possibly due to the absence of these receptors on the lymphocyte as suggested by other authors and proved using molecular biology techniques to be the case for the M2 receptor subtype.

Animals↗
PubMed1994

Occurrence of transient ischemic attacks in Alcoi: descriptive epidemiology.

A door-to-door survey of transient ischemic attack (TIA) and stroke was conducted in 3 towns of the Alcoi health area. The prevalence ratios found for TIA and stroke were 13/1,000 people (95% CI 8.8-17.9) and 21.5/1,000 (95% CI 15.8-27.2), respectively. The crude incidence rates for both TIA and stroke were 2.8/1,000 (95% CI 0.7-4.9). Methodological differences in the ascertainment of the cases may explain the variations in the rates between the present work and other studies in the literature.

Adult↗
PubMed1990

Multiple sclerosis in Spain: an epidemiological study of the Alcoy health region, Valencia.

Alcoy is a defined health region in eastern Spain, at 3 degrees E-38 degrees N, with a single neurology department and includes 33 towns with a total population of 133,915 inhabitants. We have evaluated the prevalence and incidence of multiple sclerosis (MS) by analysing this region. Six new cases have been detected (2.24/100,000/year) and the prevalence rate was 17.17/100,000, the highest in Spain at the moment. However, we found an irregular distribution in the different towns in so far that 15 of our 23 patients lived in a particular subregion, which means a prevalence of 44.59/100,000. Our study shows that the area of Alcoy is a medium MS risk region according to the thesis of Kurzke, although high MS areas may be found, thus confirming that MS distribution in southern Europe is not uniform.

Adult↗
PubMed1990

Ischemic stroke in young adults. II. Analysis of risk factors in the etiological subgroups.

A prospective study on 386 consecutive patients affected of ischemic stroke (IS) has been analysed in relation to etiologies, comparing them with a control group of 100 people. The atherotrombotic etiology subgroups are associated with family history of stroke, risk factors, atheromatosis, occlusive peripheral arteriopathy, previous of stroke, high levels of hematocrit and hemoglobin, impaired lipid fractions and high levels of uric acid. The cardiac embolism etiology subgroups are associated with the presence of personal history of stroke, just as the mitral valva prolapse (MVP) patients group. The migraine group is significantly related with the intake of oral contraceptives.

Adult↗
PubMed1989

Platelet aggregation in transient global amnesia.

We found a correlation between increased platelet aggregation parameters and transient global amnesia and no differences between patients with transient global amnesia and transient ischemic attacks. Our findings support the theory of a vascular mechanism for transient global amnesia.

Amnesia↗
PubMed1989

Ischemic stroke in young adults. I. Analysis of the etiological subgroups.

An ischemic stroke (IS) group including 386 patients under 50 years old is analysed taking into account different etiological subgroups and comparing risk factors against a control group of 100 people. The series points out the presence of 66.1% patients included in the inconclusive-atherothrombosis group, of which 22.7% had defined criteria of atheromatosis, while 11.6% were diagnosed of lacunar infarct. 13.5% of cases were considered as cardiac origin embolisms, and 14.1% were affected of mitral valve prolapse. The migraine group includes 4.9% of the patients while 17.6% belong to the miscellaneous group. The comparison of each of these groups with the control group showed significant differences for family history of stroke, personal history of peripheral arteriopathy, tobacco, arterial hypertension and previous IS.

Adolescent↗