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Biomedical subjects

J Redón

Publications and source records attributed to J Redón.

At least 37 records · Page 2Linked to original sources

[Ambulatory arterial blood pressure in normotensive children].

BACKGROUND: The aim of the present study was to obtain out patient blood pressure values in normotensive children based on age, height, and sex in order to determine reference values. METHODS: Out patient blood pressure monitorization was performed in 248 healthy normotensive children (129 males and 119 females, ages 6 to 16 years) (casual blood pressure < P95 specific for age and sex) over 24 hours by the Spacelabs 90207 oscilometric monitor on a normal schoolday. An appropriately sized armband was chosen for each case with the readings being programmed every 20 minutes between 6:00 a.m. and midnight and every 30 minutes for the remaining readings. The means of 24 hour blood pressure (all the readings obtained), day period (8 to 22 hours) and night period (midnight to 6:00 a.m.) and the circadian variability (difference and the ratio between the mean values of day and night) were calculated. The children were divided into subgroups according to sex, age (6-9, 10-12 and 13-16 years) and height (1.09-1.37; 1.38-1.51, and 1.52-1.75 meters). Monitorizations with a percentage of erroneous readings over 30% were excluded from the study. RESULTS: Only 7 children were excluded due to a high percentage of erroneous readings. The mean of the valid readings made in the remaining 241 cases was 62 +/- 7. A significant increase was observed in the values of out patients systolic blood pressure with age and height. The same was not seen in diastolic blood pressure. Nocturnal blood pressures were lower to the diurnal pressures (11% systolic, 22% diastolic). P95 was considered as the upper limit of normality for the means of each of the periods of systolic and diastolic blood pressure in each subgroup of sex, age and height. CONCLUSIONS: The blood pressure values obtained from a population of normotensive children may be useful to understand the behaviour of out patient blood pressure in children and establish the limit for defining high blood pressure.

Adolescent↗

[The prognostic value of plasma triglycerides in human immunodeficiency virus infection].

BACKGROUND: Infection with the human immunodeficiency virus (HIV) is associated with an increased prevalence of hypertriglyceridemia, which is more common in advanced stages of disease. Nevertheless, the role of hypertriglyceridemia as a predictive marker of progression of disease and/or mortality is not fully elucidated. METHODS: One-hundred nineteen patients with HIV infection attended at our Outpatient Clinic or hospitalized in our Service were retrospectively studied. At the beginning of the study and every six months a complete medical history and physical examination were obtained, with a complete blood count, serum biochemistry, total lymphocytes and CD4 subpopulations, cholesterol, triglycerides and IgA. With comparative purposes cholesterol and triglyceride values were also determined in a control group of healthy subjects with the same age and gender. The relationship between triglyceride levels and the other clinical and analytical parameters was evaluated by means of the Pearson linear correlation. The risk for developing clinical disease and survival were studied by the method proposed by Kaplan and Meier. RESULTS: The mean age of patients was 27 +/- 6 years and the male/female ratio was 86/33. Eighty-three percent (99) of patients consumed drugs parenterally. Compared with the control group, patients with HIV infection had hypertriglyceridemia (159 +/- 80 mg/dl vs 79 +/- 53 mg/dl) and hypocholesterolemia (143 +/- 41 mg/dl vs 174 +/- 36 mg/dl) (p < 0.05). There was a positive correlation between triglycerides and IgA levels (p < 0.01) and a negative correlation with serum albumin (p < 0.05). A higher risk towards progression of disease was not observed among patients with hypertriglyceridemia (TG > 143 mg/dl) in non-AIDS infected patients, nor mortality in the overall group. CONCLUSIONS: HIV infected patients have a higher prevalence of hypertriglyceridemia and hypocholesterolemia. Plasma triglycerides were not useful as a prognostic factor for the development of disease nor as mortality risk.

Adult↗

Do changes in dietary salt influence blood pressure of hypertensive patients pharmacologically controlled with verapamil? The Salt-Switching-Study (SSS).

To study how changes in dietary salt influence the blood pressure (BP) of pharmacologically controlled hypertensive patients, we have selected from a large multicenter trial two subgroups of 14 and 16 patients who attained BP control (office DBP < 90 mm Hg) after a 4-week treatment with verapamil SR 240 mg once daily, either under an unrestricted salt diet (high-salt; 14 patients) or under a moderately restricted salt diet (low-salt; 16 patients). All of them were switched to the opposite dietary salt regimen and continued on verapamil for 4 more weeks (Salt-Switching-Period). Office BP and ambulatory blood pressure monitoring (ABPM) were registered before and after the Salt-Switching-Period. Salt intake was checked by urinary sodium excretion (UNa). Patients switching from high- to low-salt reduced UNa from 180.9 +/- 22.9 to 89 +/- 28 mM Na/24h (P < 0.001) and patients switching from low- to high-salt increased UNa from 85 +/- 38.4 to 175.8 +/- 57.5 mM Na/24h (P < 0.001). No significant changes in BP were found by ABPM either in the group switching from high- to low-salt or in the group switching from low- to high-salt. In the latter group, a significant increase was observed in office DPB but not in SBP. Short-term changes in salt intake seem to have little influence on the BP of patients pharmacologically controlled with verapamil.

Adult↗

[An evaluation of the control of antihypertensive treatment by using ambulatory arterial pressure monitoring].

BACKGROUND: Outpatient monitoring of blood pressure (OPMBP) allows more precise values to be obtained and to observe the oscillations over 24 hours. Although this is widely used in the estimation of the antihypertensive efficacy of drugs, few studies have been performed on the evaluation of the control in treated patients. METHODS: One hundred eight patients (M/F 55/53, mean age 50 +/- 11 years, body mass index 29.7 +/- 4.4) with essential high blood pressure (HBP) were included in the study fulfilling the criteria of: a) DBP > 95 mmHg on 3 visits over a 2 month period, b) antihypertensive treatment maintained over 2 months and c) normal renal function (Cr < 115 mumol/l). Twenty-five patients were considered as having resistant HBP on presenting BP > 150/100 mmHg during the course of treatment with well combined and adequately dosed drugs, one of which was a diuretic. Twenty-four hour OPMBP was carried out in all the patients on a normal work day with a SpaceLabs 90202 monitor. Acceptable control was considered when the mean of the DBP throughout the day (08:00-22:00) was < 85 mmHg. RESULTS: Out of all the patients studied, 67 (62%) showed acceptable control and 27 (25%) showed normotensive values. Among the 25 refractory hypertensive patients 20 (40%) showed an acceptable control and 7 (28%) normotensive values. The only clinical difference between both groups was the presence of a greater degree of organic repercussion in the inadequately controlled group (chi 2 p < 0.05). Eight patients showed medium values of SBP over 24 h < 120 mmHg and 2 medium values of DBP over 24 h < 70 mmHg. CONCLUSIONS: Outpatient monitoring of blood pressure may be useful in the evaluation of the control of high blood pressure in patients submitted to pharmacologic treatment who do not present an adequate reduction in the values of blood pressure.

Adolescent↗

Altered blood pressure during sleep in normotensive subjects with type I diabetes.

This study was designed to examine the circadian pattern of blood pressure in children and young adults with type I diabetes who were completely normotensive by standard criteria. Forty-five patients and the same number of age- and sex-matched control subjects were studied. In diabetic children of 10-14 years of age, the nocturnal fall in systolic and diastolic blood pressures was intact. In diabetics of 15-20 years of age, the fall in systolic blood pressure was blunted; in diabetics of 21-37 years of age, the fall in both systolic and diastolic blood pressures during sleep was blunted. When data from all diabetic subjects were pooled and analyzed in a multiple linear regression model, mean blood pressure during sleep correlated best with urinary albumin excretion (r = 0.60). On the basis of this finding, we subdivided our patients into two groups: a microalbuminuric group (urinary albumin excretion > 30 mg per 24 hours; mean, 160.3 +/- 29.7; n = 11) and a normoalbuminuric group (urinary albumin excretion < 30 mg per 24 hours; mean, 6.6 +/- 6.5; n = 34). Both systolic and diastolic blood pressures during sleep were higher in microalbuminuric (121.1 +/- 3.3 and 69.3 +/- 2.5 mm Hg, respectively) than in normoalbuminuric diabetics (114.2 +/- 1.8 and 60.1 +/- 1.2 mm Hg, p < 0.05) or control subjects (113.3 +/- 1.2 and 60.1 +/- 1.2 mm Hg, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Dementia as a presentation symptom of giant cell arteritis].

Giant Cells Arteritis (GCA) can be presented sometimes with atypical manifestations which greatly difficult its diagnosis. We present a case of GCA in a 58-year-old man with dementia as first symptom. In the anamnesis, signs of rheumatic polymyalgia were observed, as well as a recently started dementia with a very disturbed mini-mental test. The analytic study showed anemia (Hb of 7.44 nmol/l, with 3.2 x 10(12) red cells and a GSR of 85 mm). The diagnosis of GCA was supported by a temporal biopsy. In a study of magnetic resonance, there were no evidences of brain infarct areas. After treatment with prednisone, normalization of GSR and a significant improvement of cortical functions were observed. GCA must be considered in the initial diagnosis of a patient with mental disorders, given that it is one of the curable causes of dementia.

Dementia↗

[Microalbuminuria in essential arterial hypertension].

BACKGROUND: The occurrence of microalbuminuria (mAlb) in essential hypertension (HT) was evaluated. METHODS: 100 patients were studied (56 males), with mean age 39 +/- 6 years, body mass index (BMI) 28 +/- 4. 32 had borderline HT, 47 had mild HT and 21 had moderate HT. 74 were in stage I of the WHO and 26 were in stage II. All had normal renal function (creatinine 91 +/- 12 mumol, Clcr 92 +/- 13 ml/m/1.73 m2) and no proteinuria as measured by sulphosalicylic acid. mAlb was immuno-nephelometrically measured in two 24-hour urine samples, and was given as urinary albumin excretion (UAE). In 62 patients, noninvasive ambulatory recording of blood pressure (NIAR) was carried out. In 39, ventricular mass was estimated by echocardiography. RESULTS: UAE was correlated with SPB24h (r = 0.39) and DBP24h, but not with SBP or DBP. UAE was greater in patients with moderate HT than in those with mild or borderline HT (p less than 0.01). UAE was less than 20 mg/24 h in 70 patients (group A) and greater than 20 mg/24 h in 30 (group B). The comparative analysis of the two groups showed different clinical BP values (SBP p less than 0.01; DBP p less than 0.001) and NIAR (SBP 24 h p less than 0.001; DBP 24 h p less than 0.05). In the 47 patients with mild HT the only differential parameter between groups A and B was SBP24h (p less than 0.05). Regarding echocardiographic data, in higher UAE levels a greater left ventricular mass index was found in males (chi-square p less than 0.05). CONCLUSIONS: Increased mAlb is associated with more severe HT. This finding may be helpful for the initial evaluation of hypertensive patients.

Adult↗

Aetiology of community acquired pneumonia in Valencia, Spain: a multicentre prospective study.

A year long multicentre prospective study was carried out in the Valencia region of Spain, to determine the cause of community acquired pneumonia. The study was based on 510 of 833 patients with pneumonia. Of these, 462 were admitted to hospital, where 31 patients died. A cause was established in only 281 cases--208 of bacterial, 60 of viral, and 13 of mixed infection. The most common microorganisms were Streptococcus pneumoniae (14.5%), Legionella sp (14%), Influenza virus (8%), and Mycoplasma pneumoniae (4%). There was a higher incidence of Legionella sp than in other studies.

Adolescent↗

[Acute rhabdomyolysis. A study of 44 cases].

Fourty four patients suffering non traumatic rhabdomyolysis (RM) are studied. The most frequently encountered etiologies were neurologic abnormalities in 26 patients, followed by infections in 7 patients and metabolic abnormalities in four cases. Eleven patients (25%) presented several associated factors. The clinical manifestations of RM were not very significant, with only 18% of patients presenting muscle pain, 38.6% proteinuria and 36.4% hematuria. A significant increase in K, CPK, LDH, and ASAT values was observed after the RM episode (p less than 0.05). Those patients with an infectious RM were older (p less than 0.05) and presented higher urea (p less than 0.01) and creatinine (p less than 0.05) values. Only two patients presented renal failure. One patient with septic shock died. RM is a relatively common condition, often secondary to multiple systemic processes, which can go unnoticed due to the underlying disease.

Acute Disease↗

Chemotherapy of advanced gastric carcinoma (stage IV): a randomized study of FAM versus 5-FU plus BCNU.

Forty-six patients with advanced gastric carcinoma (Stage IV) were evaluated in a prospective randomized comparison of two chemotherapy regimens (FAM versus 5-FU plus BCNU) to identify therapeutic activity. Treatment groups were well balanced with respect to known prognostic factors. Thirty-three patients had measurable disease and thirteen had only microscopic residual disease in the resection margins. The overall median survival of the entire group was 13.2 months. Two (6%) patients with measurable disease reached complete response (CR), 1 (3%) partial response (PR), 12 (36%) had stable disease (SD) and 18 (56%) had progressive disease (PD). The responders had not reached the median survival yet, the patients with SD had a median survival of 14.7 months and the PD 9.5 months. In the FAM arm there were 3 (18%) responders (2 CR and 1 PR), 7 (41%) SD and 7 (41%) PD, versus O responders, 5 (31%) SD and 11 (69%) PD in the 5-FU plus BCNU arm. In the FAM arm the median survival was 15.7 months versus 9.9 months in the other therapeutic arm. The statistical analysis indicated that survival associated with FAM regimen was superior to that reached with the 5-FU plus BCNU regimen. Thirteen patients with unmeasurable disease had a median survival of 15.9 months.

Adult↗