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J Soler Ramón

Publications and source records attributed to J Soler Ramón.

At least 19 recordsLinked to original sources
PubMed2004

[Early diabetic nephropathy and cardiovascular disease in a Mediterranean population: risk factors and treatment intensity].

The objective of this cross-sectional study was to evaluate the impact of early diabetic nephropathy on the presence of cardiovascular disease (CVD) in a Mediterranean population, as well as the prevalence in these patients of traditional cardiovascular risk factors and its treatment intensity in accordance with international recommendations. In 123 patients with type 2 diabetes and incipient nephropathy the presence of CVD, smoking, hypertension, dyslipemia, and their treatment was recorded. CVD prevalence was 34%. Age, nephropathy stage (micro/macroalbuminuria), and smoking were associated with the presence of CVD. Hypertension, dyslipemia, and smoking were present in 83%, 81%, and 59%, respectively. Coexistence of several risk factors was frequent and was associated with a higher incidence of CVD. 79% hypertensive patients and 43% dyslipemic patients received pharmacological treatment but only 17% and 9%, respectively, reached a good control of their disease. Patients with known CVD showed also a deficient control. Accordingly, early diabetic nephropathy induces a multiplier effect on the cardiovascular risk of a Mediterranean population. Higher prevalence and association with cardiovascular risk factors, with smoking in a predominant role, are associated with this higher risk. Despite this, the intensity of treatment and control of these risk factors is deficient, which means that a better and more intensive treatment should reduce the morbidity and mortality in these patients.

Aged↗
PubMed2000

[Anthropometry and the reference values of body composition by bioelectrical impedance in the adult population of L'Hospitalet de Llobregat].

BACKGROUND: The aim of the present study was to assess the anthropometric variables and the reference values of body composition in the adult population of L'Hospitalet de Llobregat, due to the lack of epidemiological studies on this matter in Spain. PATIENTS AND METHODS: We studied 234 normal subjects, 134 males, mean age 41.4 years, and 134 females, mean age 40.7 years, selected from the census of L'Hospitalet de Llobregat and representative of its population in sex and age. We determined anthropometric characteristics, body weight, height, body mass index, waist-hip ratio and body composition parameters: total body water, free fat mass, fat mass and body fat by bioelectrical impedance analyzer. RESULTS: Twenty-four males and 33 females were obese, and out of them 2 males and 4 women presented morbid obesity. The body mass index was higher either in males (p = 0.017) or in females (p = 0. 0001) in the last decades in relation to first decade, and in women was as consequence of higher fat mass (p = 0.0001). The waist-hip ratio was 0.93 (0.08) in male and 0.79 (0.07) in female, and it was high in males in the last decades. CONCLUSION: The present study points out the high prevalence of obesity in our city and the anthropometric characteristics and reference values of body composition in the normal population of L'Hospitalet de Llobregat, remarking the high body mass index in the last decades, especially in women due to an increase of fat mass. The waist-hip ratio was high in males in the last decades.

Adolescent↗
PubMed1999

[Changes in the lipid profile and thyroid function in adult patients with hypopituitarism after substitutive treatment with growth hormone].

BACKGROUND: Adult growth hormone (GH) deficiency is associated with changes in serum lipid levels that can modify after GH substitution. METHODS: We studied 18 patients with GH deficiency treated with GH for 18 or 24 months. RESULTS: A decrease of total cholesterol, LDL with an increase in HDL without triglycerides changes was observed. T4 levels decreased and T3 increased. CONCLUSIONS: The GH substitution treatment in patients with GH deficiency improves the lipid profile and promotes the T4 to T3 conversion.

Adult↗
PubMed1999

[Changes in body composition in adult patients with hypopituitarism after substitutive treatment with growth hormone].

BACKGROUND: Adult growth hormone (GH) deficiency is associated with changes in body composition, with lower total body water (TBW) and fat free mass (FFM) and higher fat mass (FM). These changes can be modified after sustitutive treatment with GH. PATIENTS AND METHODS: We studied 20 patients, 14 males and 6 females with hypopituitarism and GH deficiency, the mean age was 40.3 years, as well as 20 comparable controls. The diagnosis of GH deficiency was based on the lack of GH response after an hypoglycemic test. We determined body composition by bioelectrical impedance. An initial 6 month double-blind placebo controlled phase was followed by an open treatment phase ending when the patients had received GH for 18 or 24 months. The initial dose was 0.125 U/kg/week during the first month and after 0.25 U/kg/week. RESULTS: The patients showed lower TWB and FFM and higher BF in relation to controls and after 3 months of GH treatment an increase of the TBW, FFM and a decrease in BF and waist/hip ratio was observed with a steady state in the changes of body composition after 3 months that continued 6 months after the GH treatment withdraw. Two patients presented maleolar oedema, 4 arterial hypertension that was settled with GH dose reduction and in the fourth patient the treatment had to be withdraw. Three patients presented carpal tunnel syndrome. In 4 patients the treatment was withdrawn. CONCLUSIONS: In patients with adult GH deficiency, we can observe differences in the body composition that can be significantly modified by GH treatment.

Adult↗
PubMed1998

[Results of treatment of Graves-Basedow disease with 131I at low calculated doses].

OBJECTIVE: To evaluate the results of treatment of Graves' disease with 131I at low calculated doses. METHODS: A total of 333 patients with Graves' disease were treated with low calculated doses of 131I on the basis of thyroid size and 131I uptake (mean doses = 6.6 +/- 1.9 mCi). The mean follow-up was 24.4 months (range 12-145). RESULTS: The accumulated likelihood of hypothyroidism at 145 months of follow-up was 89.8% (Kaplan-Meier method) and relapse 26%. Pretreatment levels of T3 above 9 nmol/l were associated with a lower incidence of hypothyroidism (p = 0.049, Mantel-Cox method). Pretreatment levels of T4 above 300 nmol/l were associated with a higher risk of therapy failure (odds ratio 3.27; 95% confidence interval = 1.3-8.2, Cox method). Age, sex, previous therapy with anti-thyroid agents or surgery, 131I uptake, initial and total dose of 131I, number of administered doses and development of transient hypothyroidism were not predictive of the evolution of thyroid function. CONCLUSION: Therapy of hyperthyroidism (Graves' disease) with low calculated doses of 131I shows a high incidence of hypothyroidism, also increasing the cost involved in estimating the dose and long-term follow-up.

Adult↗
PubMed1998

[Autoimmune thyroid pathology in recently diagnosed diabetes mellitus type 1].

OBJECTIVE: To analyze the prevalence of autoimmune thyroid disease among adult patients with recently diagnosed diabetes mellitus type I and its possible correlation with beta-cell autoimmunity markers (ICA, GAD, and IA 2) and with the presentation characteristics of diabetes mellitus. PATIENTS AND METHODS: A total of 100 patients diagnosed from 1992 to 1996 were included and anti-thyroid antibodies (Ac), anti-thyroglobulin (aTG) and antiperoxidase (aTPO) were measured. A comparison followed of the clinical characteristics, biochemical markers, and beta-cell immunity markers between the group of patients with positive and negative antibody determinations. Differences between groups were compared by the Student "t" test and non-parametric tests were used for cases not fulfilling the application conditions. RESULTS: Among the 100 patients, 25 had Ac+, two with previously known thyroid pathology and eight diagnosed at that moment. The group with Ac+ was characterized by a predominance of females (68% vs 32%; p = 0.001), lower bicarbonate levels (18.6 +/- 6.1 vs 21.3 +/- 6.4; p = 0.026) and higher requirements for insulin at discharge (0.77 +/- 0.22 vs 0.59 +/- 0.25 IU/kg; p = 0.002). Among patients in the Ac+ group, patients with thyroid pathology were characterized by a higher prevalence of females (90% vs 53.3%; p = 0.05) and a higher percentage of individuals with high anti-TPO titres (80% vs 33.3% higher than 400 IU/ml; p = 0.02). ICAs (66.6% vs 26.6% higher than 40 U JDF; p = 0.05) and IA2 (44.4% vs 0% higher than 12 IU/ml, p = 0.01). CONCLUSIONS: There is a high prevalence of thyroid pathology prevalence among our adult population with recently diagnosed DMI. Patients with thyroid autoimmunity have higher antibody titres to beta-cell and a somewhat more severe clinical presentation form. Prospective studies are required to determine the long term relevance of these differences.

Adult↗
PubMed1997

[Identification and validation of prognostic factors in differentiated thyroid carcinoma].

BACKGROUND: The aims of this study are to identify prognostic factors of differentiated thyroid carcinoma and to validate the application of prognostic classifications obtained by others studies to another population. PATIENTS AND METHODS: The survival of 208 patients with differentiated thyroid carcinoma (129 papillary and 79 follicular carcinoma) was calculated by the Kaplan-Meier method. The mean follow-up was 7.5 years (1-17.7). Cox-proportional hazard model was used for variables influencing on survival (Mantel-Cox method). In addition, the EORTC, AGES, AJC, AMES and DeGroot classifications were tested. RESULTS: The independent prognostic factors identified were patient age > 60 years, tumor size > 6 cm and the presence of distant metastases. The absence of poor prognostic factors defined the low risk group (153 patients, survival 97% at 17.7 years of follow-up). The application of the other prognostic classifications differentiated several risk groups not in accordance with those obtained in the initial population. CONCLUSIONS: In this series of patients with thyroid carcinoma the main prognostic factors were age, tumor size and the presence of distant metastases. However, there are pitfalls in applying the prognostic classifications of published studies to another population.

Adenocarcinoma, Follicular↗
PubMed1997

[Prevalence and significance of lymphocyte infiltration in papillary carcinoma of the thyroid gland].

OBJECTIVE: We have investigated the prevalence, signification and prognostic value of lymphocytic infiltration associated to differentiated thyroid carcinoma in our series of differentiated carcinoma of the thyroid. METHODS: We studied the presence of lymphocytic infiltration in 223 patients effected of differentiated thyroid carcinoma, 138 of them were papillary carcinoma. The diagnostic was made with optic microscopy and we studied antithyroid antibodies in these patients. In survival analysis we studied all the variables of the patients and the event used as end point was death due to thyroid carcinoma, summarized in Kaplan-Meir curve and Cox method. RESULTS: We found eight patients with differentiated thyroid carcinoma, six with papillary carcinoma, and lymphocytic thyroiditis and in three cases, antithyroid antibodies were present at low levels. We did not found any difference between the two groups and the survival rate was similar. CONCLUSIONS: These data support that in our series the prevalence of lymphocytic infiltration was low and probably without prognostic signification.

Adult↗
PubMed1994

Study on growth hormone and insulin secretion in myotonic dystrophy.

Growth hormone (GH) levels were measured in 12 patients with myotonic dystrophy (MD; 7 men and 5 women, aged 21-49 years) and 14 volunteers after administration of 100 micrograms GH-releasing hormone (GHRH; 1-29). A 75-g oral glucose tolerance test was carried out to determine glucose, insulin, plasma C-peptide, and urinary C-peptide. The GH level in six MD patients responded normally to GHRH (group I), with a peak of 17.1 +/- 1.46 micrograms/l, compared with controls (27.8 +/- 19.6 micrograms/l, NS), and that in the other six patients responded subnormally, with a peak of 3.15 +/- 1.46 micrograms/l, lower than in controls and in group I patients (P < 0.001). In group I the insulin response to the glucose tolerance test showed hyperinsulinism and was lower than that in group II patients; stimulated C-peptide was also higher in group II than in group I and in controls; urinary C-peptide levels were parallel to those in previous data. In all MD patients there were a negative correlation between absolute values of GH response to GHRH and insulin response to glucose tolerance test (r = -0.79, P < 0.001). Our data suggest that the failure in GH release and peripheral insulin action is due to a generalized defect in cellular membrane function in MD patients.

Adult↗
PubMed1992

[The importance of computerized axial tomography in the etiological diagnosis of Addison's disease].

Sixteen cases of newly diagnosed Addison disease were studied by CT scan. An initial diagnosis was performed according to the clinical data of each patient, and a second diagnosis after examining the abdominal CT scan. According to the second diagnosis there were six patients with primary adrenal failure of probable autoimmune origin, six tuberculosis, two metastatic, one undetermined and one hemorrhagic. The second diagnosis coincided with the first one in 10 cases (62.5%), but was different in six cases (37.5%). Information obtained by CT scan modified the therapeutic attitude in 4 cases (25%). The main morphologic patterns of adrenal glands in CT scan (atrophy, calcification and enlargement) are commented as well as the importance of CT scan in the study of the more common etiologies of Addison's disease (tuberculosis, autoimmune, neoplastic metastasis and hemorrhage). It is concluded that the information obtained by CT scan is important in the etiological diagnosis of Addison disease and it is advised to perform it in all newly diagnosed cases.

Addison Disease↗