PubMed Health⌕ Search

Biomedical subjects

J Montes Santiago

Publications and source records attributed to J Montes Santiago.

At least 19 recordsLinked to original sources
PubMed2006

[Goya, Fortuny, Van Gogh, Portinari: lead poisoning in painters across three centuries].

Patobiographic data of four brilliant painters who lived in three different centuries (Goya [XVIII], Fortuny and Van Gogh [XIX] and Portinari [XX]), were examined in search for a suspected lead poisoning. It is concluded that Goya's disease and deafness was probably caused by lead poisoning. Fortuny's death was probably precipitated by this illness in conjunction with malaria. This diagnosis is more problematic in Van Gogh and only a monograph favouring this was found. Portinari certainly suffered from lead poisoning and that finally caused his death. This source of the possible poisoning could be the high lead content of their paintings.

Famous Persons↗
PubMed2005

[What is the opinion of Spanish internists on osteoporosis?].

OBJECTIVE: To conduct an opinion survey on osteoporosis in Spanish internists. METHOD: Survey sent by mail and by personal visit to members of the Spanish Internists Society. Collection of data on opinion on the disease, diagnostic and therapeutic attitude and means available (general laboratory analyses, conventional radiology, biochemical markers of bone remodeling, densitometry and ultrasounds) and preference when choosing a certain treatment. RESULTS: A total of 538 internists answered. More than 90% of those surveyed consider that osteoporosis is a disease that should be treated by internists. A total of 93% consider that osteoporosis is a prevalent disease. More than 80% have access to densitometry. CONCLUSIONS: The majority of Spanish internists consider that osteoporosis is a disease that should be treated by internists and that it is a disease that enters into their action scope. In general, they have the means necessary for its study and treatment. Bisphosphonates constitute the drug of choice and calcium and vitamin D supplements are indicated in almost all the cases.

Aged↗
PubMed2004

[Henoch-Schönlein purpura in adults: a study of 9 cases].

OBJECTIVE: Schönlein-Henoch purpura (PSH) is a predominantly pediatric vasculitis with, generally, a benign prognosis. However, in adults can acquire greater severity and more frequency of renal involvement. We report our experience with 9 cases of this entity. MATERIAL AND METHODS: Retrospective review of the leukocytoclastic vasculitis admitted to our hospital in 1995-2002. Patients fulfilling > or =3 of Michels's criteria for PSH: a) palpable purpura; b) abdominal angina; c) gastrointestinal bleeding; d) hematuria; e) age >20 years; and f) absence of responsible medication), were identified. The incidence was 0.65 cases/100,000 inhabitants >15 years, without seasonal predominance. We identified 9 patients (7 males, age range: 22 to 88 years). There was palpable purpura in 100%, gastrointestinal involvement in 67%, renal in 78%, and oligoarticular in 22%. Recovery was uneventful, except for a case with previous renal insufficiency. CONCLUSIONS: We found a low frequency of articular involvement and high renal affectation but with an excellent prognosis.

Adult↗
PubMed2004

[Pulmonary embolism in medical inpatients. An approach to trends and costs in Spain].

BACKGROUND: Tromboprophylaxis for hopitalized patients has became a widespread practice in the lasts years. However, the trends in pulmonary embolism (EP) are insufficiently known. We analyzed the trends of EP during the 1997-1999 period in Spain at the hospitals of the National Health System (NHS) and theirs costs were also estimated. METHODS: Diagnosis-Related Group (DGR) 78 from the data of the national hospital discharge register was evaluated. Annual trends, age, sex and (for 1999) mortality, some comorbidities and costs according official data from the Spanish Ministry of Health were annotated. Mostly medical patients were included. Data were compared with those from the Servicio Gallego de Saúde (SERGAS) which maintain a high rate of hospitalary discharges declaration. RESULTS: During the 3-year period 14.021 cases of EP were observed. The 47% of the NHS cases were older than 75 and mortality was 6,8%. An annual increment of hospitalized cases was observed at SERGAS and NHS (in the last 5% at the end of the period). In 1999 costs were estimated in 16-20,2 millions euro. That was 0,097-0,12% of global hospitalary budget. CONCLUSIONS: Trends for hospitalizations for EP are increasing in Spain. It remains in doubt if a true increase in incidence or the improving notification and awareness are the responsibles for this increment. However, the data of SERGAS support the first possibility.

Diagnosis-Related Groups↗
PubMed2003

[Oral or sublingual nifedipine: utility and long-term effectiveness of medical education to decrease its use in increased blood pressure].

OBJECTIVES: Despite the severe side effects reported, short acting nifedipine compounds (oral or sublingual) are still widely used for the considered hypertensive emergencies. The objective of this study was to study the effect of simple medical education measures on the prescription of such compounds in our institution. METHODS: In a previous survey we found that 67% of physicians involved in the care of hypertensive emergencies at our institution considered oral/sublingual nifedipine the therapy of choice. The recommendations in the JNC VI document were reviewed in a Clinical Session and each participating physician was provided with a translated copy and a letter with the reasoned answer. The Pharmacy Department provided a list of patients with the prescriptions of nifedipine upon request and programmed in the Emergency Department, Medical and Surgical Departments. Four time periods were considered: first or control (pre-session): September 1997-March 1998; second (immediately post-session): June 1998-December 1998; third (9-12 months post-session): January 1999-June 1999, and fourth (28-34 months post-session): September 2000-March 2001. At a later session the results were presented and a summary of results was submitted to Departments with a consensus note on the prescription of short acting nifedipine compounds. RESULTS: There were significative decrements in urgent and total doses and treated patients during the periods considered. This effect was sustained and in a three-year period reductions of 78% (Emergency Room), 91% (Medical Services) and 79% (Surgical Services) of prescriptions were noted. CONCLUSIONS: Simple measures of continuous medical education (scientific meetings, personal letters and facilitated access to scientific evidence) were highly effective in reducing prescriptions of short-acting nifedipine at our centre.

Administration, Oral↗
PubMed2003

[Seasonal changes in morbimortality caused by pulmonary thromboembolism in Galicia].

OBJECTIVES: The goal of this report was to analyze the seasonal variation in the pulmonary embolism (EP) hospitalizations and mortality at the hospitals of the Galician Service of Health (SERGAS) in the Northwest of Spain, during the period 1996-2001. METHODS: The Related Group of Diagnosis (DRG) 78 (pulmonary embolism) from the SERGAS hospital discharge dataset during the 6-year period was examined. Age, sex, month of discharge and seasonal period was annotated. RESULTS: A total of 2831 hospitalizations for TEP were recorded (44% males, mean inhospital stay: 12.8 days, 70% > 65 years). Monthly median was 38 discharges and the variations above and below this were +26% (December) and -25%) (July), respectively. There were more frequents hospitalizations in autumn (OR:1.35, 95%CI:1.19-1.53) and winter (OR: 1.29, CI: 1.14-1.46). Mortality peaked in spring (OR:2.18, CI: 1.18-4.05). Nearly 83% of these deaths occurred in persons > 75 years old. CONCLUSIONS: We observed a marked increase in EP hospitalizations during colder months and in mortality during spring. These observations may have implications in the adoption of preventive measures.

Aged↗
PubMed2002

[Progressive multifocal leukoencephalopathy in patients with AIDS: is there a change in patients treated with highly active antiretroviral therapies?].

AIMS: Progressive multifocal leukoencephalopathy (PML) develops in up to 4-8% of all AIDS patients. Before highly active antiretroviral therapies (HAART) the median survival was only 4-6 months. In this study we analyzed epidemiological parameters in AIDS-related LMP patients in search for differences in the incidence and prognosis between before and after HAART era. METHODS: Retrospective review of clinical histories of patients diagnosed of AIDS and PML at Hospital Meixoeiro in Vigo, Spain, between 01/01/94-31/05/97 (Before-HAART period) and 01/06/97-30/04/00 (After-HAART period). PML was diagnosed by clinical and neuroimaging criteria, with biopsy in 2 cases and positive JC virus hibridation in CSF in another case. RESULTS: We identified 12 patients (global prevalence of 3.8%, without differences between periods): 11 males, 10 intravenous drugs users (IDU), mean age of 38 years (31-43). In 6, LMP was the first opportunistic infection. When PML was diagnosed, 6 patients had a HIV viral load (VL) > 250.000 copies of RNA/ml (range, 254.003-3.170.000), and overall a mean CD4 lymphocytes counts of 89 x 10(6)/ml (40-134). Three patients received cytarabine + Interferon with zidovudine (2 patients) and zidovudine + lamivudine (1 patient) and other patient HAART + cidofovir, but no improvement was observed. The median survival was 10 months in before-HAART group and 17 months in after-HAART group, with a survival > 48 months in 2 patients in the last group. CONCLUSIONS: LMP is observed in severely immunosuppressed IDU men (VL > log 5 copies RNA/ml and CD4 < 150 x 106/ml). Complementary treatments were ineffective and only in patients with HAART a prolonged survival was observed.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[Contribution of Galician hospitals to national and international Internal Medicine scientific meetings].

OBJECTIVES: To evaluate the scientific contributions of internal medicine services from Galicia to nationals and internationals specialty meetings and to describe theirs preferences in clinical research. MATERIAL AND METHOD: We analysed the communications from the Abstracts books of the last four Spanish Internal Medicine National Congress (1994-2000 period) in comparison with that of 1984, the last two European Congress (1999 and 2001) and the last World Congress (2000). Case reports were excluded. RESULTS: An increasing number of communicating hospitals and a sustained number of reports was observed with a minimum of 2 hospitals (1984) to a maximum of 12 (1996) with 5-6 hospitals on average. Number of communications became stable and reached 5% of the whole spanish reports. Cardiovascular and AIDS-Infectious diseases were the preferred research fields. CONCLUSIONS: An increment of scientific communications from a growing number of galician hospitals was observed. This scientific production became continuous and stabilized notoriously on cardiovascular and AIDS-infectious disease fields.

Bibliometrics↗
PubMed2001

[Seasonal changes in hospitalization and mortality resulting from chronic heart failure in Vigo].

OBJECTIVES: Circannual variation in morbi-mortality for ischemic heart disease is well-known but there are few data focusing on chronic heart failure (CHF). This report analyzes seasonal variations in CHF hospitalizations and mortality in Vigo, Northwest of Spain. METHODS: Data on hospital discharge reports with a diagnosis of CHF (3-digit ICD9 code 428) were obtained from the Clinical Documentation Service at Hospital Meixoeiro (419 beds, population: 167.000 inhabitants > 14 years old). Data were divided in three 4-months periods: winter (november-february, years: 1997-98, 98-99 and 99-00), spring (mars-june, years: 97, 98 and 99) and summer (july-october, years: 97, 98 and 99). Hospitalization rates and mortality were also studied at Cardiology, Internal Medicine and Geriatrics (attending to 81% of patients with CHF). RESULTS: A total of 1.472 CHF hospitalizations were registered (52% male, 83% > 65 years, mean inhospital stay: 13.8 days). Significatives winter increases were noted in global hospitalizations -4.9% (winter) vs. 3.2@1000 (summer) and overall medical services admissions -9.3% (winter) vs. 6.2@1000 (summer). These increases also were observed at specific medical services (Cardiology: +4.9%, Internal Medicine: +6.5%, Geriatrics: +3.2%). There was not seasonal differences in letality or attributable mortality for CHF. Death in patients with a diagnosis of CHF was 4 times more likely. (OR: 3.81; 95% CI: 3.28-4.42). CONCLUSIONS: There are a striking increase in winter hospitalizations for CHF. This diagnosis is associated with an excess of inhospital mortality. Preventive and therapeutic measures taking in account this observation are warranted to reduce the burden of this growing problem.

Aged↗
PubMed2000

[Usefulness of autoantibodies in the study of autoimmune liver diseases and prevalence of autoimmune extrahepatic manifestations].

BACKGROUND: Autoantibodies are prominent findings in the diagnosis of autoimmune liver diseases. However, their usefulness is limited due to the high reported prevalence in others nonautoimmune disorders. The purpose of this report was to assess the significance of these markers in patients with autoimmune liver diseases and to determine the prevalence of extrahepatic autoimmune phenomena. METHODS: We evaluated the samples from all the patients with altered biochemical liver parameters (ALT, AST, alkaline phosphatase or bilirubin) and a complete profile of autoimmunity [Anti-nuclear (ANA), anti-mitocondrial (AMA), anti-smooth muscle (SMA) and anti-liver/kidney microsomes (LKM1) antibodies] received in the Immunology Laboratory from 1993 to 1996. The records of the patients with at least one positive serologic marker were retrospectively reviewed. Autoimmune liver diseases (Autoimmune hepatitis (AIH), Primary biliary cirrhosis (PBC) and Overlap syndromes) were diagnosed according to composite clinical, analytical, histological or response-to-treatment parameters. RESULTS: Samples from 548 patients were analyzed. Of these 85 (15.5%) were positive for at least one antibody. Disorders and autoantibodies were: Autoimmune liver diseases: 18 (4 AIH, 11 PBC, 3 Overlap syndromes); alcohol-induced liver disease: 14 (5 ANA, 9 SMA), Chronic HCV infection: 28 (9 ANA, 17 SMA, 2 ANA + SMA), Chronic HCV + AIH: 2 (1 ANA, 1 ANA + SMA); other liver diseases: 7 (4 ANA, 1 AMA, 2 SMA); other diseases with liver involvement: 10 (8 ANA, 2 SMA); no liver disease (normal): 6 (3 ANA, 1 AMA, 2 SMA). In 75% (64/85) of the positivities processes regarded as immunological liver disease were not found. We identified in 12 out of 20 patients with autoimmune liver diseases others autoimmune extrahepatic processes; in 4 before a diagnosis of liver disease was made. CONCLUSIONS: Autoimmune serologic markers are useful in the study of liver diseases. However, due to inespecifity each individual patient deserves a careful evaluation. Autoimmune extrahepatic manifestations are often found and in some cases allow to recognize the hepatic involvement.

Autoantibodies↗
PubMed1998

[Lymphocyte activation in tuberculous pleuritis . Correlation with adenosine deaminase (ADA), peripheral blood lymphocytes, T cell receptor subfamilies, radiographic extension and levels of Il-6 and soluble Il-2 receptor].

We determined in 14 patients with pleural tuberculosis total lymphocyte count, T subsets and NK cells (CD56) in pleura and blood and it was found a preferential accumulation in pleura of CD3 T lymphocytes, TCR alpha beta, mainly CD4 subset, but not T or NK cells. In 5 pleuritis it was studied 40% of V beta TCR subfamilies in blood and pleura and in 2 pulmonary tuberculosis and one pleuritis all V beta and V alpha TCR subfamilies (trough PCR), without be observed a clear clonal expansion. It was not observed correlation among a) pleural and blood lymphocyte cellularity b) the amount of pleural effusion and the existence of lymphopenia or tuberculinic anergia c) levels of ADA and percentage of CD3 and CD4 cells in pleura. In 7 out 11 pleuritis a high expression of IL-2 receptor (CD25) was observed. In 24 patients with pleural and pulmonary tuberculosis there was not correlation between levels of SIL-2R and IL-6 and radiographic extension.

Adenosine Deaminase↗
PubMed1997

[Adrenocortical function in patients with active pulmonary tuberculosis].

STUDY OBJECTIVE: To assess adrenal function in patients with acute pleuropulmonary tuberculosis (APT) and compare it with that function in patients with community-acquired pneumonia (CAP). PATIENTS: Over a period of 6 months all consecutive patients 18 years of age or older with newly diagnosed APT and CAP were entered into the study. MEASUREMENTS: The whole patients had the following investigations: 1) Serum Na+, K+ and glucose concentrations 2) Systolic and diastolic blood pressures. 3) An ultrasonographic study of the adrenal glands. 4) A standard ACTH stimulation test. RESULTS: There was no significative difference in the serum cortisol level between the two groups at any time of the ACTH stimulation test (basal, 30 and 60 minutes), neither when taking into account the increments between basal and 60 minutes after stimulation serum cortisol levels. All patients in both groups had normal ACTH stimulation test with a peak stimulated cortisol level at 60 minutes > 504 nmol/L. CONCLUSIONS: We did not find evidence of adrenal cortical dysfunction in patients with acute pleuropulmonary tuberculosis or with community-acquired pneumonia in our hospital.

Adrenal Cortex↗
PubMed1996

[Cellular immune response in tuberculosis: analysis of T-lymphocytes and their subsets, B-lymphocytes and natural cytotoxic cells in different tuberculosis states and body fluids].

BACKGROUND: The immune response to Mycobacterium tuberculosis is primarily mediated by T lymphocytes. In this study an investigation was made of T lymphocytes and their subsets, B lymphocytes and natural cytotoxic cells (Natural Killer, NK) in blood and organic fluids in different tuberculosis conditions. METHODS: Patients with localized pulmonary tuberculosis (LPT, n = 12), extensive pulmonary tuberculosis (EPT, n = 24), pleural tuberculosis (PLE, n = 14), disseminated tuberculosis (DIS, n = 10), recent Mantoux converters (MAN, n = 15) and healthy subjects (CON, n = 19) were studied. HIV+ and immunosuppressed patients were excluded. Total lymphocytes and T subsets (CD3, CD4, CD8, TCR alpha beta and gamma delta), B (CD19) and NK cells (CD56) in blood and pleural fluid (n = 7) and ascitic fluid (n = 3) were determined. RESULTS: An increase was observed in total lymphocytes and all T subsets (CD3, CD4, CD8, alpha beta and gamma delta) in MAN group compared with CON group (p < 0.05 for all determinations). A progressive lymphopenia of total lymphocytes and CD4 was observed with more extensive disease, particularly in the DIS group (p < 0.05). No differences were observed between groups regarding B lymphocytes and NK cells. In pleural effusions and ascitic exudates an accumulation of T lymphocytes, mainly CD4, was observed, with no increase in gamma delta T lymphocytes. CONCLUSIONS: 1) In patients with recent tuberculosis infection T lymphocytosis (total and subsets) occurs. 2) In the absence of HIV infection, a progressive lymphopenia occurs, particularly CD4, with extending disease. 3) In tuberculous pleural effusions and ascitic exudates and accumulation of CD4 T lymphocytes occurs, but not TCR gamma delta lymphocytes.

Adolescent↗
PubMed1995

Lymphocyte populations during tuberculosis infection: V beta repertoires.

The immune response to Mycobacterium tuberculosis is mediated by T lymphocytes. We studied the changes in lymphocyte populations occurring in peripheral blood, pleural fluid, and ascites during tuberculosis infection. For this purpose, we compared recent-onset patients (newly converted to positive Mantoux reactions) with previously diagnosed patients (individuals with organic lesions). Recent infection was associated with peripheral blood lymphocytosis involving T lymphocytes expressing either T-cell receptor alpha/beta or gamma/delta. Lymphocytosis involved both CD4 and CD8 cells. On the other hand, we detected no changes in the distribution of peripheral blood lymphocyte populations in previously diagnosed patients. No changes were found in the numbers of B lymphocytes or natural killer cells in either recently infected or previously diagnosed patients. The pleural effusion and ascitic fluid samples contained T lymphocytes expressing T-cell receptor alpha/beta, the majority of which were CD4+. These lymphocytes showed an inverted CD45RA-to-CD45RO ratio, and we found high-level expression of the interleukin-2 receptor (CD25) in some patients. The results are compatible with the existence of periods of cell activation in the pleural fluid (which are disclosed by the appearance of the CD25 antigen and the transition of CD45RA expression to CD45RO) together with nonactivation periods (loss of CD25 and persistence of CD45RO expression). We studied a fraction of the V beta repertoire in peripheral blood in both groups and the same fraction of the V beta repertoire in pleural fluid from patients with tuberculous pleuritis, demonstrating that, in recently infected subjects, lymphocytosis was produced by the increase in lymphocytes which expressed some specific V beta subfamilies that differed from one individual to another. In two of five patients studied, we found significant changes in the V beta repertoire between lymphocytes from peripheral blood and the pleural fluid samples.

Gene Rearrangement, beta-Chain T-Cell Antigen Rece↗