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Biomedical subjects

N Velasco

Publications and source records attributed to N Velasco.

At least 19 recordsLinked to original sources
PubMed1995

[Anorexigenic drugs in the treatment of obesity].

Obesity is highly prevalent and has several adverse effects on health. Its treatment is thus warranted and must aim to modify dietary and physical activity habits. The opinion of this association is that anorexigenic drugs with cathecolaminergic action (diethylpropion, phentermine, mazindol and phenylpropanolamine) or serotoninergic action (fenfluoramine and fluoxetine) may be used in moderate or severe obesity (BMI > 30 kg/m2) after a complete clinical assessment and in the context of an integral medical treatment. This association recommends a close surveillance of the use of these drugs, specially when formulated as non-proprietary prescriptions.

Appetite Depressants↗
PubMed1994

[Variability of measured energy expenditure in patients with acute pancreatitis: is it possible to obtain a reliable pathology factor for these cases?].

Energy expenditure was measured in 55 patients with acute pancreatitis, during variable periods ranging from 1 to 5 weeks and it was compared with estimated energy expenditure according to Harris Benedict equations. Patients with severe pancreatitis had similar measured and measured/estimated energy expenditure rations, compared to those with mild pancreatitis (1678 +/- 349.6 kcal/day and 1.1 +/- 0.19 vs 1632 +/- 383 kcal/day and 1.06 +/- 0.19). There was a high dispersion of measured/estimated rations (0.67 - 1.7) that precluded the calculation of a reliable energy expenditure correction factor for this disease. It is concluded that energy expenditure must be measured and not estimated, when planning an adequate nutritional support in patients with acute pancreatitis.

Acute Disease↗
PubMed1993

[Non-insulin-dependent diabetics with secondary failure: insulin therapy at bedtime combined with glibenclamide].

Secondary failure and the requirement is common in patients with non-insulin dependent diabetes mellitus. The combination of sulfonylureas with NPH insulin at bedtime has been proposed to avoid high doses of insulin. We treated 18 patients (2 men, age range 47-76 yr) non respondent to diet and glibenclamide, combining NPH insulin in an average dose of 0.3 +/- 0.03 U/kg BW at bedtime for 6 months. Fasting serum glucose improved from 256 +/- 11 to 132 +/- 6 mg/dl and HbA1C from 13.6 +/- 0.4 to 9.9 +/- 0.2%. Four patients achieved a good control (defined as a HbA1C < 9), 9 a fair control (HbA1C 9.1-10) and 5 persisted with a bad control (HbA1C > 10). Well controlled patients were younger, had a shorter duration of diabetes and had a non significantly higher body mass index. Fasting serum insulin and C peptide levels achieved after glucagon injection were not predictors of the metabolic response to combined therapy. Tolerance to treatment was good, without changes in blood pressure or serum lipids and with a low incidence of hypoglycemia. There was a mean increase of 3.6 kg in body weight. After 6 months of therapy, maximum achieved C peptide values after glucagon increased from 3.3 +/- 0.3 to 4.5 +/- 0.4 ng/ml. It is concluded that combined glibenclamide and NPH insulin at bedtime is useful to treat secondary failure in non-insulin dependent diabetic patients, but their response in variable and non dependent on their beta insular secretion.

Aged↗
PubMed1993

[Dyslipidemic patients with coronary cardiopathy. Effect of different doses of OMEGA-3 fatty acids on serum lipids and lipoproteins].

Twenty one male patients aged 35 to 70 years, with coronary artery disease and dislipidemia refractory to dietary treatment, were assigned to three parallel groups of 7 individuals each that received a supplemental dose of 2, 4 and 6 g/day of omega-3 fatty acids during 60 days. After a 30 days wash-out period and 60 of supplementation, subjects were weighed, a dietary survey was performed, serum levels of total cholesterol and triglycerides, the lipid content of serum lipoproteins and the content of EPA+DHA in plasma phospholipids were measured. A dose dependent increase in EPA+DHA content of phospholipids and no changes in weight or nutrient intake were observed during the supplementation period. With the 6 g dose, a significant reduction in total cholesterol, with a reduction in VLDL and increase in LDL cholesterol and a decline in VLDL triglycerides was observed. With the 4 g dose a reduction in total cholesterol at the expense of VLDL and HDL cholesterol and a reduction in VLDL triglycerides but no changes in total triglycerides was observed. No changes in serum lipids were observed with 2 g dose. In patients with type IIA hyperlipidemia, a significant positive correlation was observed between DHA+EPA content of plasma phospholipids and LDL cholesterol, this correlation was not observed in patients with IIB or IV phenotypes. It is concluded that omega-3 fatty acids are ineffective as the only treatment for dislipidemias refractory to diet.

Adult↗
PubMed1992

[Estimation of energy expenditure in clinical practice: applicability to individual multiple injury cases].

In 37 multiple trauma patients the estimated and measured energy expenditures were compared. Predicted energy expenditure overestimated it in 89% of patients. The correction factor for the different pathologies was the principal source of error, since the measured/predicted basal energy expenditure ratio was 1.19 +/- 0.17. This ratio had a wide range of values (0.84-1.61) which renders the prediction of individual energy expenditure highly unreliable. Since the overestimation of energy requirements in the critically ill patients may convey important complications, the direct measurement of such requirements is recommended.

Adult↗
PubMed1990

[The effect of anti-insulin antibodies and of peptide C residual secretion on the metabolic control of diabetes type 1].

In 20 type I diabetic patients treated with conventional insulin preparations, we measured insulin antibodies and peptide C secretion. Peptide C levels 90 and 120 min after a standard breakfast correlated well with glucosylated Hb levels (r = -0.48 and -0.52, respectively). No correlation with free insulin levels was observed, in spite of a good correlation of the latter with blood glucose levels (r = -0.50 and -0.73, respectively). There was no relation between insulin antibody levels and peptide C or free insulin. Metabolic control was not affected by insulin antibodies. Insulin dose decreased in relation to the duration of the disease and reduction of body weight index and was not correlated to glycosylated Hb levels.

Adult↗
PubMed1990

[Cholestyramine in the treatment of hypercholesterolemia. Our experience in 11 cases].

Bile acid sequestrant resins are considered agents of choice in the therapy of hypercholesterolemia non responsive to diet treatment. We evaluated the effects of cholestyramine, 12 g per day during 4 weeks, in 11 adult patients with severe hypercholesterolemia. Total cholesterol decreased from 414 +/- 112 to 302 +/- 140 mg/dl (28%), LDL cholesterol from 330 +/- 122 to 226 +/- 143 (33%) and Apo B lipoprotein from 141 +/- 31 to 115 +/- 34 mg/dl (18%), p < 0.01. HDL cholesterol including fractions HDL2 and HDL3, Apo A1 and Triglyceride levels were not modified. No significant side effects on gastrointestinal function were observed. Thus, we confirm that cholestyramine is an effective therapy for severe hypercholesterolemia.

Adolescent↗
PubMed1989

Influence of legume intake on biliary lipids and cholesterol saturation in young Chilean men. Identification of a dietary risk factor for cholesterol gallstone formation in a highly prevalent area.

Chileans and North American Indians have one of the highest prevalence rates of cholesterol gallstones in the world. The most common theory to explain this has been the operation of some as yet undefined genetic risk factor in these populations. Searching for some common environmental factor for gallstones in Chileans and North American Indians, we found that beans and other legumes are common foods consumed by both populations. In this study we tested the hypothesis that legume intake may favor the production of biliary cholesterol supersaturation. We studied 20 young men subjected to a diet containing 120 g/day of legumes and a control diet without legumes for a period of 1 mo each. Both diets supplied identical quantities of energy, carbohydrates, protein, total fat, fiber, and cholesterol. Low-density lipoprotein cholesterol concentration decreased by 16% (p less than 0.001) after the legume diet. Biliary cholesterol saturation increased in 19 of the 20 subjects; the mean of the group markedly increased from 110% to 169% (p less than 0.001) after the legume diet. These results are consistent with the hypothesis that legume intake is a potential risk factor for cholesterol gallstone disease.

Adult↗
PubMed1986

The effect of the dihydroxylated metabolites of vitamin D and dietary phosphate restriction on bone disease in uraemic rats.

Uraemic rats maintained on either a high or a low phosphate diet for 12 weeks were allocated to one of the following oral vitamin D treatment groups and received: 1,25-dihydroxycholecalciferol [1, 25-(OH)2D3], 24,25-dihydroxycholecalciferol [24,25-(OH)2D3], both 1,25-(OH)2D3 and 24,25-(OH)2D3, or no vitamin D supplements. Mean serum creatinine concentrations were elevated to a similar extent in all groups. Mean serum concentrations of calcium, phosphate and alkaline phosphatase were not significantly different from normal in any of the groups. In the group receiving the high phosphate diet and no vitamin D supplements, calcified bone area measured by quantitative computerized histomorphometry was significantly lower than in the group receiving the low phosphate diet and no vitamin D supplements (0.01 greater than P greater than 0.001), and in the groups receiving high phosphate diet and either 1,25-(OH)2D3 (0.01 greater than P greater than 0.001) or 24,25-(OH)2D3 (0.01 greater than P greater than 0.001). We conclude that uraemic rats maintained on a high phosphate diet for 12 weeks develop skeletal demineralization, this process does not occur in rats on a low phosphate diet, and a decrease in calcified bone area may be prevented by treatment with either 1,25-(OH)2D3 or 24,25-(OH)2D3.

24,25-Dihydroxyvitamin D 3↗
PubMed1986

The effect of hemodialysis, vitamin D metabolites and renal transplantation on the skeletal demineralization associated with renal osteodystrophy: a computerized histomorphometric analysis.

Twenty-three patients with end-stage renal failure treated by hemodialysis or transplantation were followed for up to 10 years. Sequential full thickness iliac crest bone biopsies were obtained to assess the effects on bone disease of hemodialysis, treatment with 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] and 24,25-dihydroxycholecalciferol [24,25-(OH)2D3] and renal transplantation. The biopsies were analyzed by a computerized histomorphometric technique which allowed accurate measurements of calcified bone and osteoid areas. Serum aluminum and parathyroid hormone concentrations were also monitored. Hemodialysis was associated with a loss of calcified bone and an increase in osteoid areas. The progressive bone loss was arrested but not reversed following treatment with either 1,25-(OH)2D3 or 24,25-(OH)2D3. Osteoid area was unchanged or reduced following treatment with 1,25-(OH)2D3 in all but three patients who had serum aluminum concentrations in excess of 5 mumol/l. 24,25-(OH)2D3 was not effective in reducing osteoid area, and combined treatment with 1,25 and 24,25-(OH)2D3 had no effect beyond that expected with 1,25-(OH)2D3 alone. Bone biopsies showed loss of calcified bone and an increase in osteoid areas one year and more after successful renal transplantation in five patients. Nineteen of the 23 patients developed serum aluminum concentrations greater than 3 mumol/l, probably because of the use of oral aluminum hydroxide as a phosphate binding agent. In these patients serum parathyroid hormone concentrations greater than 600 pg/ml appeared to prevent the development of osteopenia.

24,25-Dihydroxyvitamin D 3↗
PubMed1985

Gastroesophageal sphincter pressure and histological changes in distal esophagus in patients with achalasia of the esophagus.

A prospective study was performed in 17 patients with achalasia of the esophagus determining the manometric characteristics of the gastroesophageal sphincter, correlating it with histological analysis by biopsies taken during surgery at the distal narrowed segment of the esophagus, at the location of the sphincter. The histological findings were compared to 10 control cases. Presence or absence of ganglion cells at the Auerbach's plexuses and appearance of smooth muscle fibers were evaluated. Only one case (6%) had Chagas' disease. The mean sphincter pressure was 41 mm Hg, with incomplete relaxation in all patients. Histological analysis showed a complete disappearance of ganglion cells in 94% of the cases and a decrease in the number of neurons with marked chronic inflammatory cells in one case (6%). In all control cases, the ganglion cells were normal. Smooth muscle fibers were normal on light microscopy. No relationship was found between resting gastroesophageal sphincter pressure, length and relaxation, and histological findings at the distal esophagus. These findings suggest that the denervation in the majority of cases is located in the Auerbach plexus, with complete absence of ganglion cells and, therefore, absence of postganglionic nerve fibers.

Adolescent↗
PubMed1985

Surgical treatment of high gastric ulcer.

The purpose of this study has been to review the late results of surgical treatment of 244 patients with endoscopically proved benign chronic gastric ulcer located 5 cm or less from the cardia. In five patients, a total gastrectomy with esophagojejunostomy was performed. Proximal gastrectomy was used in 3 patients, mesogastrectomy in 5 patients, a partial Schoemaker's procedure in 73 patients, Pauchet's procedure in 70 patients, and Csendes' procedure in 23 patients. Nonresective procedures were employed in 67 patients and included the Kelling-Madlener procedure in 23 patients, pyloroplasty alone in 10 patients, gastrojejunostomy alone in 4 patients, local or wedge excision of the ulcer in 9 patients, and vagotomy and pyloroplasty in 21 patients. The follow-up evaluation was performed in 91 percent of the patients (mean 9 years postoperatively, range 5 to 15 years), with emptying endoscopy in all nonresected patients. A high mortality was observed after total or proximal gastrectomy, as well as after nonresective procedures. After the other resective techniques, low postoperative morbidity and mortality were observed. No recurrent ulcer was seen after the resective procedures. Based on these results, we propose that when the ulcer is located 5 cm below the cardia, Schoemaker's or Pauchet's procedure should be performed; if the ulcer is located 2 cm or less from the cardia, Csendes' procedure or the Kelling-Madlener procedure should be employed.

Adult↗
PubMed1985

Functional characteristics of the glomerular filter in the IgA-nephropathy.

The purpose of the present study was to compare the functional characteristics of the glomerular filter in patients having a well defined glomerulonephritis, the IgA nephropathy, with those of normal age-matched controls. A bolus intravenous injection of inulin (60 mg/kg), para-amino hippuric acid (36 mg/kg) and Rheomacrodex (130 mg/kg) was administered to each subject and followed by the timed collection of venous blood and urine samples. Compared to the controls, the nine patients with IgA nephropathy had no significant differences in renal plasma flow or glomerular filtration rate. The control group showed filtration of the neutral graded dextrans which diminished in a linear fashion with increasing molecular size. In contrast, the IgA patients showed two-phased glomerular sieving with a reduction in the filtration of dextrans sized 40 A or less and an increased filtration of those larger than 50 A. These changes in dextran filtration indicate the appearance of a population of larger than normal pores in the glomerular filter in the IgA nephropathy, although concomitant alterations in the electrostatic properties of the filter mechanism cannot be excluded.

Adolescent↗