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Biomedical subjects

M Díaz Curiel

Publications and source records attributed to M Díaz Curiel.

At least 19 recordsLinked to original sources

Postmenopausal women with Colles' fracture have bone mineral density values similar to those of controls when measured with calcaneus quantitative ultrasound.

BACKGROUND: It is a matter of controversy whether or not Colles' fracture is an osteoporotic fracture. Indeed, the usefulness of quantitative ultrasound in distinguishing Colles' fracture from normal fractures is also unclear. METHODS: A cross-sectional case-control study was done on 469 postmenopausal Spanish women, 121 with Colles' fracture and 348 controls. Assessment of risk factors for osteoporosis and measurement of calcaneus quantitative ultrasound were carried out using a Sahara, Hologic device. RESULTS: Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls, and no statistically significant differences were found. We estimated ROC curves for SOS and a score based on a linear combination of height and SOS (SH-Score). The areas under both curves were 0.56 and 0.61, respectively, which was statistically significant. To obtain 5% false-negative and 10% false-positive figures, the T-score cut-off for SOS was -2.45 and -0.045, respectively. Of these, only 9.2% were classified as high risk and 11% as low risk with 79.8% undetermined. CONCLUSIONS: Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls. Nevertheless, ROC curves calculated by a combination of height and SOS showed that quantitative calcaneus ultrasound may be a useful tool for identifying postmenopausal women with Colles' fracture. These results indicate that measuring bone mineral density with ultrasound only captures limited aspects of the pathophysiology of Colles' fractures.

Journal Article↗

[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↗

[Prevalence of osteoporosis assessed by densitometry in the Spanish female population].

BACKGROUND: Osteoporotic fractures represent an important clinic and socioeconomic problem. Although it is well known the incidence of fractures in Spain, we do not know how many persons are at risk. The World Health Organization (WHO) has approved a densitometric criteria to define osteopenia (OSPE) and osteoporosis (OSP). The aim of this study has been to evaluate the prevalence of OSP and OSPE in women of the Spanish population. SUBJECTS AND METHOD: With the data of a study of bone mass in the Spanish population, stratified according to age, using dual-energy X-ray absortiometry (DXA) with a QDR/1000 Hologic device and according the WHO criteria, we have calculated the prevalence of OSP and OSPE in normal Spanish women at the lumbar spine (LS) and/or femoral neck (FN). RESULTS: The prevalence of osteoporosis at LS is: 0.34% in the group aged 20-44 years; 4.31% in the group aged 45-49 years; up to 9.09% in the group aged 50-59 years; 24.29% in the 60-69 years, and 40.0% in the group aged 70-79 years. The overall prevalence of osteoporosis is 11.13%, confidence interval (CI) 95% from 9.4 to 12.8%. The prevalence of osteoporosis at FN is: 0.17% in the group aged 20-44 years, 0% in the 45-49 years, up to 1.3% in the 50-59 years, 5.71% in the 60-69 years and 24.24% in the group aged 70-79 years. The overall prevalence of osteoporosis is 4,29% (CI 95% 3.2-5.4%). The prevalence in female older than 50 years was 22.8% at LS and 9.1% at FN. 12.73% of Spanish women population has osteoporosis at LS or FN, which represent about 1,974,400 women; 2.68% of total population has osteoporosis in both sites. CONCLUSIONS: Even we do not include in this study women with established osteoporosis (with fractures), the number of Spanish women with osteoporosis is very high.

Absorptiometry, Photon↗

Usefulness of serum pyridinoline cross-linked carboxy-terminal telopeptides of type I collagen and osteocalcin in the study of the bone resorption rate in oophorectomized rats.

The aim of this work was to determine sensitivity and specificity of serum pyridinoline cross-linked carboxy-terminal telopeptides of type I collagen (ICTP), a new biochemical marker of bone resorption, in order to study the rate of bone resorption associated with osteopenia development after oophorectomy in rats. The diagnostic accuracy of the bone formation marker osteocalcin (BGP) was also evaluated. Twelve-week-old female Wistar rats were used: (1) control group: sham-operated, treated with a placebo (n = 25); (2) OOX: oophorectomized rats treated with a placebo (n = 12), and (3) OE: oophorectomized rats treated with 17alpha-ethinyl estradiol 0.1 mg/kg/day for 3 months. The rats were sacrificed after treatment, and lumbar bone mineral density, BGP, and ICTP (serum assays specific for rat) were determined. As expected, OOX animals developed osteopenia. OOX rats showed a significant decrease (p < 0. 05) in bone mineral density as compared with the control group, and OE rats showed no significant differences with respect to the control group. With respect to biochemical markers of bone remodeling, the OOX group showed a significant increase in BGP and ICTP (p < 0.005 and p < 0.05, respectively) with respect to control rats. However, the values of BGP and ICTP were similar in the OE group and in control animals. Areas under receiver operation characteristic curves corresponding to BGP and ICTP were 95 and 87%, respectively (p = 0.523). The results of the present work show that BGP and ICTP, the new resorption assay developed for rats, are reliable markers to be used in the study and follow-up of bone remodeling in OOX rats.

Animals↗

Variable efficacy of bone remodeling biochemical markers in the management of patients with Paget's disease of bone treated with tiludronate.

The aim of this work was to evaluate the response of different biochemical bone markers to tiludronate administration in Paget's disease of bone. Ten patients (five men and five women), 56-77 years old (67 +/- 6.5), were treated for 3 months with tiludronate tablets (400 mg/day). Bone formation markers: alkaline phosphatase (AP), bone alkaline phosphatase (bAP), osteocalcin (BGP), and procollagen I carboxyterminal propeptide (PICP) in serum; and bone resorption markers: serum cross-linked carboxyterminal telopeptides of type I collagen (ICTP), urinary hydroxyproline/creatinine (Hyp/Cr), pyridinoline/Cr (Pyr/Cr), and alpha-1 collagen chain products degradation (CrossLaps) were assessed. Samples were taken before and at monthly intervals for 3 months after treatment began. The results of the present work show that serum AP and bAP are sensitive and reliable biochemical markers of bone formation in the follow-up of tiludronate in this disease. Serum PICP shows less sensitivity than serum AP, and serum BGP is not indicated as biochemical marker in these types of studies. Urinary hydroxyproline seems to be the most reliable biochemical marker of bone resorption. More studies should be performed with urinary Pyr and CrossLaps determinations. Serum ICTP is not adequate for the follow-up of tiludronate treatment in Paget's disease of bone.

Administration, Oral↗

[Psoas abscess: report of 8 cases and review of the literature].

Eight cases of psoas abscesses (PA) are reported and a comparative study is made with other series as well as a review of the literature. Cases in our series are analysed and an assessment is made of microbiological etiologies, the presence of an origin and its spreading into the surrounding tissues or their primary character, and particularly the diagnostic and therapeutic usefulness of CT-guided percutaneous drainage. Diagnosis was ascertained by CT in all seven cases in which it was performed; percutaneous drainage was performed in five cases and allowed the microbiological categorization of the abscess and an appropriate antibiotic therapy. Laparotomy was performed in only one case; and in two other cases only antibiotics were administered. A favourable outcome occurred in seven out of the eight cases. One of the two patients treated with antibiotics only died. Blood cultures were positive in only three patients. In summary, PA in our series were secondary to bone, urologic or digestive origins in 87.5% of cases. With regard to the causative agent, 37.5% of cases were caused by S. aureus and 50% by gram negative and/or anaerobic organisms. The diagnostic yields of echocardiography and CT were 40% and 100%, respectively. Percutaneous drainage ascertained the microbiological diagnosis in 100% of cases when it was performed, as well as a therapeutic regimen associated with the use of antibiotics. No relapses were recorded in the follow-up of patients. Therefore, we believe that therapy of PA should be based on the association of percutaneous drainage and antibiotics.

Adult↗

[Spontaneous bacterial peritonitis in the cirrhotic patient].

Spontaneous bacterial peritonitis in cirrhotic patients is a severe complication which frequently decompensate the underlying disease and which is associated, even in our days, to a 50% mortality. Hence, the relevance of an adequate exploration, as weil as an early treatment. The acknowledge of several variants, as are the concepts of bacterascites and neutrocytic ascites with negative culture required the use of updated diagnostic criteria. In addition to the already known clinical and bacteriological characteristics of the ascitic fluid infection, we have also intended to review new aspects of this entity referred to in the literature published in the past years, as are the followings; study of possible predictive factors of this complication and factors which have an influence on its mortality, in order to be able to implement the most adequate preventive its mortality, in order to be able to implement the most adequate preventive its mortality, in order to be able to implement the most adequate preventive and curative therapeutics.

Bacterial Infections↗

[Differences in the cellular response of the immune system in patients with Paget's disease of bone after elcatonin and etidronate administration].

A cellular immunological defect is present in patients with Paget's disease of the bone. Low counts of CD4, high counts of CD8, and a low CD4/CD8 ratio were observed in 58 patients compared with controls. These findings were not correlated with the metabolic activity of the disease. After therapy with Elcatonine an improvement in the cellular immunological defect was observed in 15 patients. Etidronate improved the biochemical bone patterns but no changes were observed in the number of lymphocytic subpopulations. These changes can be related to the improvement in the bone metabolic disorder or be the result of an effect on the altered immunity in this disease.

Aged↗

[Nephrolithiasis and bone involvement in primary hyperparathyroidism. The relative role of vitamin D].

In order to analyze the role of 1,25(OH)2 D3 in bone and renal presentation forms of primary hyperparathyroidism (PHP), 61 patients, whose diagnosis had been confirmed surgically, were studied. An increase in serum 1,25(OH)2 D3 levels was found in PHP when compared to normal controls (49.1 +/- 2.8 pg/ml vs 34.1 +/- 1.4 pg/ml) (p less than 0.5). This increase directly correlates with serum alkaline phosphatase and creatinine clearance and inversely correlates with age. When patients were divided into two groups: A (n = 35) and B (n = 26) according to normal or increased 1,25(OH)2 D3 respectively, no difference was found in the clinical presentation forms of PHP. However, higher values of the biochemical parameters and bone remodeling markers were found in group B than in group A. This suggests the role of 1,25(OH)2 D3 as a modulator of metabolic activity in PHP and its possible therapeutic character in the clinical control of asymptomatic forms.

Adolescent↗

[Cortical and trabecular bone lesions in insulin-dependent diabetes mellitus].

To determinate which type of bone is damaged in IDDM, we assessed the bone mineral content (BMC) in both cortical and trabecular bones, in a group of 48 IDDM patients without hepatic or kidney diseases, or any other pathology with implications in the mineral metabolism. For the evaluation techniques of single photon absorptiometry (SPA) and double photon absorptiometry (DPA) were used. All the patients controlled their disease with insulin. The results showed the presence of osteopenia in both types of bone. It was more evident in male group. In the patients group the mean value of serum osteocalcin (BGP) was significantly decreased (2.34 +/- 1.05) in comparison with the controls (p less than 0.001). The deficient of BMC is neither related with the parameters of new bone formation nor with the time of disease evolution.

Absorptiometry, Photon↗

[A microbiological and clinical study of 57 cases of spontaneous bacterial peritonitis in liver cirrhosis patients].

We studied fifty seven episodes of cirrhotic spontaneous bacterial peritonitis in order to know its microbiological, clinical and evolutive characteristics. One third of the patients had presented some previous peritonitis episodes. Ninety three percent of the patients referred some symptoms at time of diagnosis. Ascitic fluid Gram stain showed the presence of bacteria in 72% of the samples. Culture of ascitic fluid was positive for a single microorganism in 50 cases (88%). Seventy seven percent of microorganisms were Gram negative being Escherichia Coli in 63% of cases. Hemoculture was positive in 68% of cases with an almost complete correspondence with germs found in ascites. Seventy four percent of patients presented some complication throughout their hospital stay being the most frequent renal failure (49%) and encephalopathy (46%). Sixty three percent of patients died being the mortality rate higher amongst the older patients and amongst those who did not present neither high temperature or peritonism, or those who developed some complication.

Aged↗