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J R Domínguez

Publications and source records attributed to J R Domínguez.

14 recordsLinked to original sources

[Heart disease in acromegaly. Study of 27 patients].

BACKGROUND: The patients with acromegaly have an increased propensity to develop cardiovascular complications. The aim of this study was to evaluate the most relevant clinic, echocardiographic and Holter recording findings in acromegaly and its correlation with the growth hormone (GH) levels and duration of the disease. PATIENTS AND METHODS: 27 patients with acromegaly were evaluated. The basal levels of GH and insulin-like growth factor 1 (IGF-1) were measured at the time of cardiological study and compared with the spontaneous GH secretion during 12-24 hours previously studied. Echocardiogram was made using complete M-mode, two dimensional and spectral Doppler ultrasound mechanical system. Additionally an standard EKG and a Holter recording were performed during 24 hours. RESULTS: There was a strong correlation between basal levels of GH and integrated concentration of GH during the study of spontaneous secretion (r = 0.92; p < 0.01). The prevalence of symptomatic cardiovascular complications in this study was 49%, including 3 patients who died for cardiovascular events. The echocardiographic study showed a high prevalence of left ventricular hypertrophy (66.7%), diastolic dysfunction (63%) and impaired systolic function (18.5%). There was no correlation between GH and IGF-1 levels and echocardiographic findings. Conversely the degree of hypertrophy was related to the duration of the disease and the presence of arterial hypertension. The diastolic function only was related with the presence of hypertension. We found supraventricular arrhythmic events and malignant premature ventricular complexes in 6 and 6 patients, respectively. The EKG showed a high fiability to detect ventricular hypertrophy but no rhythm events. CONCLUSIONS: The high prevalence of cardiovascular complications in acromegaly, most of them asymptomatic, and its clinical relevance, advise the necessity to perform systematic cardiovascular evaluation in these patients.

Acromegaly

[Pharyngeal carriers of Neisseria meningitidis and N. lactamica in childhood].

A prospective study was undertaken with the purpose of finding out the proportion of pharyngeal carriers of N. meningitidis and N. lactamica among our infantile school population. Seven groups constituted by, approximately, 200 infants each, were studied along two years. Samples were taken in two different schools, for each each group, at a period of average incidence (February, April, June and October). Infants were between five and six years of age and made a total of 1,315 individuals, which we consider representative of our school infantile population. Positivity for N. lactamica was around 20%, whereas 10% of infants were carriers of N. meningitidis. Among the latter 56% were group B, 15% group Y, 5% group A and 20% agglutinated spontaneously. The remainder fell into several serogroups (10 unclassifiable, six 29E and one each, X, W135 and Z). Concerning group B serotypes, except for 22 not typable cases, most carriers were serotype 2, while the remainder were distributed in seven other serotypes. These findings are comparable to those seen in the population with clinical disease. However the number of carriers remained constant and, in contrast to what happened with clinical patients, was unrelated to seasonal variations. Resistance of N. meningitidis to chemotherapy was the following: sulfadiazine 100%, ampicillin 19%, rifampicin 20% and penicillin 0%. The latter can not be considered a good choice in prophylaxis.

Anti-Bacterial Agents

[Pancreatic insufficiency: an infrequent manifestation of primary hyperparathyroidism].

A case of malabsorption of pancreatic etiology secondary to primary hyperparathyroidism (HPT) is reported. Normalization of calcemia was achieved with parathyroidectomy and oral administration of pancreatic enzymes was initiated. HPT is an infrequent cause of pancreatic inflammatory disease. Although its association is controversial, its inclusion among the causes of exocrine pancreatic failure allows correct diagnosis and therapeutic management with a favorable prognosis.

Combined Modality Therapy