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Biomedical subjects

P Betancor

Publications and source records attributed to P Betancor.

At least 19 recordsLinked to original sources

Effect of two forms of alendronate administration upon bone mass after two years of treatment.

The efficacy of alendronate in slowing the loss of bone mass, or even in increasing it, in osteoporotic patients and thus reducing the risk of new fractures has been described. Nevertheless, the way of taking this drug, together with its side effects, sometimes produces withdrawals. In this study, we analyzed if an alternative way of taking the alendronate improves the follow-up of the treatment and if it had the same effect on bone mineral metabolism than the traditional way of prescription. An open, intention-to-treat study, with follow-up of 2 yr was conducted. Eighty women suffering from postmenopausal osteoporosis were included in the study. They were classified in a random manner into two groups, each one of them received 10 mg/d alendronate, together with 1.2 g of calcium and 800 IU of Vitamin D3. Group I received the drug fasting, before breakfast, as usually prescribed and group II received the alendronate fasting, at noon, before lunch. Biochemical markers of bone remodeling were determined. Total alkaline phosphatase, osteocalcin, tartrate-resistant acid phosphatase, urine calcium/creatinine ratio, crosslinked N-telopeptides of type I collagen/creatinine ratio, serum calcium, and parathyroid hormone were also determined, and a lateral dorsolumbar radiography of the spine was performed. Bone mineral density was determined in the lumbar spine by dual-energy X-ray absorptiometry and quantitative computed tomography and by dual-energy X-ray absorptiometry in the proximal femur. Both groups showed an increase in bone mineral density in the lumbar spine and in the proximal femur, which was statistically significant after 1 yr of treatment in the range between 1.5% and 4.3%, depending on the anatomical localization where bone mineral density was measured. There was also an important decrease in the biochemical markers of bone remodeling, between 5.6% and 42.5%, depending on the biochemical marker; the decrease of amino-terminal telopetide during the first year was more important. The group that received alendronate in the morning reported a significantly higher number of withdrawals than the group that received the drug at noon. The alternative administration of 10 mg alendronate at noon had the same effect on bone mineral metabolism than its traditional administration in the morning, but the rate of withdrawals was significantly lower.

Absorptiometry, Photon↗

Prevalence and determinants of diabetes mellitus and glucose intolerance in a Canarian Caucasian population - comparison of the 1997 ADA and the 1985 WHO criteria. The Guía Study.

AIMS: To estimate the prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance in a Canarian population according to the 1997 ADA and the 1985 WHO criteria; and to study the cardiovascular risk factors associated with these categories. METHODS: A total of 691 subjects over 30 years old were chosen in a random sampling of the population (stratified by age and sex). An oral glucose tolerance test was performed (excluding known diabetic patients) and lipids were determined in the fasting state. Anthropometric and blood pressure measurements were performed, and history of smoking habits and medications was recorded. RESULTS: The prevalence of diabetes was 15.9% (1997 ADA) and 18.7% (1985 WHO); the prevalence of impaired fasting glucose and impaired glucose tolerance was 8.8 and 17.1%, respectively. The age-adjusted prevalence of diabetes (Segi's standard world population) for the population aged 30-64 years was 12.4% (1985 WHO). The risk factors significantly associated with diabetes (1997 ADA and 1985 WHO) were age, body mass index; waist-to-hip ratio, systolic and mean blood pressure, triglycerides, total cholesterol and low HDL-cholesterol. Age, body mass index and systolic blood pressure were associated with impaired fasting glucose and impaired glucose tolerance; triglycerides were also associated with impaired fasting glucose. CONCLUSIONS: The prevalence of diabetes mellitus and glucose intolerance in Guía is one of the highest among studied Caucasian populations. The new 1997 ADA criteria estimate a lower prevalence of diabetes. Impaired fasting glucose also had a lower prevalence than impaired glucose intolerance and the overlap of these categories was modest.

Adult↗

The distribution of two different vitamin D receptor polymorphisms (BsmI and start codon) in primary hyperparathyroidism.

INTRODUCTION: The bb genotype of the BsmI polymorphism of the vitamin D receptor (VDR) is more common in primary hyperparathyroidism (HPT) than in the general population in Swedish and German women. However, little is known about the association of HPT with the start codon polymorphism of the VDR (defined by FokI). OBJECTIVE: To study the distribution of the VDR genotypes in a group of women with HPT compared with a control group. The bone mineral density (BMD) of different genotypes was also investigated. METHODS: VDR alleles were typed by polymerase chain reaction (PCR) assay around the polymorphic BsmI or FokI restriction sites in 67 control women (48.5 +/- 10 years) and 53 women with HPT (61.4 +/- 11 years). They were all Caucasian and born in the Canary Islands. Lumbar and proximal femur BMDs were measured by dual X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). RESULTS: The 'bb' genotype was equally frequent in controls and HPT subjects (46.3 and 45.3%, respectively). There was a trend towards a lower prevalence of the FF genotype amongst women with HPT as compared with controls (41.5 vs. 57.1%; P = 0.09). BMD was lower in patients with HPT compared with controls in the lumbar spine and the proximal femur. CONCLUSIONS: The association of the BsmI polymorphism of the VDR gene with HPT is not applicable to all geographical areas. In Canarian postmenopausal women suffering from HPT, VDR genotype distribution is similar to that found in controls. A possible association of HPT with the FokI polymorphism deserves further investigation.

Aged↗

Implantation of a composite bifurcated cryopreserved aorto-iliac-femoral homograft in a patient with Candida albicans endocarditis.

A 35 year old woman, cocaine addict, suffered Candida albicans aortic valve endocarditis complicated with embolisation of infected vegetations in the distal abdominal aorta. She underwent successful staged aortic valve replacement followed by transaortic and transfemoral thrombectomy. One month later an arteriogram disclosed partial occlusion of the left iliac artery, bilateral aneurysmal degeneration of both iliac arteries and right iliac artery-right iliac vein fistula. She was operated again, performing re-laparotomy and re-exploration. A composite bifurcated cryopreserved homograft was implanted end-to-side between the infrarenal abdominal aorta, right external iliac artery and left common femoral artery. The right iliac artery-iliac vein fistula was obliterated with suture. The patient had an uneventful recovery but a relapsing arterio-venous fistula was diagnosed by arteriography. Three months later she underwent percutaneous transluminal closure of the reopened fistula. At present, 17 months after the implantation of the homograft, the patient is symptom-free, on antifungal agents and with arteriographic and clinical evidence of a well-functioning arterial homograft.

Adult↗

Cardiac surgery in patients infected with human immunodeficiency virus.

From January 1991 through December 1999, 5 consecutive patients who were infected with human immunodeficiency virus presented in need of cardiac surgery. All were men; the median age was 44 years. Two of them presented with mitral and aortic infectious valve endocarditis, 1 with tricuspid endocarditis, 1 with prosthetic valve endocarditis, and 1 with pericarditis and pericardial tamponade. Under cardiopulmonary bypass, the 4 patients with endocarditis underwent these procedures: mitral and aortic valve replacement (2), tricuspid valve replacement (1), and aortic valve replacement (reoperation) and concomitant repair of a mycotic ascending aortic aneurysm (1). In the patient who had pericardial effusion, subxifoid pericardiostomy and drainage were performed, and a pericardial window was created. There was no intraoperative mortality. The patient with pericardial effusion died 8 days after surgery; he was in septic shock and had multiple organ failure. Two deaths occurred at 2 and 63 months, due to hemoptysis and sudden death, respectively. The 2 patients who underwent double valve replacement are alive and in good condition after a median follow-up of 71 months. Cardiac surgery is indicated in selected patients infected by the human immunodeficiency virus. These patients are frequently drug abusers or homosexual. Valvular endocarditis is the most common finding. Hospital morbidity and mortality rates are higher than usual in this group of patients.

AIDS-Related Opportunistic Infections↗

The range of bone mineral density in healthy Canarian women by dual X-ray absorptiometry radiography and quantitative computer tomography.

Bone mass measurements play a crucial role in the diagnosis of osteoporosis. According to a World Health Organization (WHO) Working Group, osteoporosis in women can be diagnosed if the value for bone mineral density (BMD) is 2.5 or more standard deviations below the mean value of a young reference population. This definition obviously requires the availability of normal data, which should ideally be obtained locally. The objective was establish normal values of BMD in the female Canarian population, by dual X-ray absorptiometry (DXA) in the lumbar spine and the proximal femur, and by quantitative computed tomography (QCT) in the lumbar spine, and to study the correlation between the results of both techniques and the changes with age. Seven hundred forty-four Healthy Canarian women, from 20-80 yr old were examined. Measurement of bone density was performed by an Hologic QDR 1000 densitometer (DXA) in the lumbar spine and proximal femur, and by a Toshiba scanner model 600 HQ in the lumbar spine. Both methods show that the peak bone mass is achieved in the fourth decade (30-39 yr). Bone density decreases thereafter with age in the lumbar spine (r = -0.3364 DXA and r = -0.6988 for QCT) and in the femoral neck (r = -0.3988). Bone density mean values obtained by DXA are very similar to those described in Spain and in other European female populations, using the same densitometer. The correlations between both techniques (DXA and QCT) were high and statistically significant (p < 0.001 in every case). Normal values in the normal Canarian women for DXA and QCT are provided. Our results are very similar to those previously described. These two techniques have a close correlation.

Journal Article↗

Effects of tamoxifen on serum lipid and apolipoprotein levels in postmenopausal patients with breast cancer.

Serum lipids and apolipoprotein levels were measured in twenty postmenopausal women with primary breast cancer, before and three months after tamoxifen therapy (10 mg twice a day). Tamoxifen caused a significant reduction in total serum cholesterol (10%; P < 0.02), and in low-density lipoprotein cholesterol (17%; P < 0.01), and a significant 47% increase in the subclass 2 of the high density lipoprotein cholesterol (P < 0.01). In addition, tamoxifen caused a 16% increase in apolipoprotein A-I, a 12% decrease in apolipoprotein B (P < 0.05), and a 37% reduction in the serum concentration of lipoprotein (a) (P < 0.01). These results show that tamoxifen brings about an important improvement in serum lipid profile.

Aged↗

Epidemiology of proximal femoral fracture in Gran Canaria (Canary Islands).

An epidemiological survey of proximal femoral fracture (PFF) was carried out in Gran Canaria (Canary Islands) in 1990. We identified 211 cases of PFF affecting residents, which gave an incidence of 161 per 100,000 per year (92 per 100,000 per year for men and 176 for women). Three quarters of all fractures occurred to residents of urban areas and nearly all fractures were caused by falls indoors. There was a higher incidence in winter than in summer months.

Africa, Western↗

Bone mineral metabolism is normal in non-insulin-dependent diabetes mellitus.

Because of the previous controversial findings in non-insulin-dependent diabetes mellitus (NIDDM), we measured bone-mineral density (BMD) by two different methods, studied biochemical markers of bone remodeling and calciotropic hormones (parathyroid hormone and calcitonin) in women with NIDDM, and compared the results with age-matched controls. Forty-seven women with NIDDM and 252 healthy nondiabetic women as controls were recruited for this study. BMD was measured by dual X-ray absorptiometry (DEXA) and by quantitative computed tomography (QCT). Biochemical markers of bone remodeling included plasma alkaline phosphatase (AP), osteocalcin (BGP), tartrate-resistant acid phosphatase (TRAP), parathyroid hormone (PTH), calcitonin (CT), and 24-h urine calcium, hydroxyproline. Diabetic patients were more obese with a higher body-mass index (BMI) than controls. Bone mass was normal in NIDDM, both by DEXA and by QCT. Biochemical markers of bone remodeling, PTH and CT were also normal. There was no statistical correlation between bone mass and any of the other measurements studied. There is no evidence that NIDDM produces any change in bone metabolism or mass.

Absorptiometry, Photon↗

Diagnostic usefulness of carbohydrate-deficient transferrin for detecting alcohol-related problems in hospitalized patients.

We evaluated the diagnostic usefulness of carbohydrate-deficient transferrin (CDT) for detecting alcohol-related problems (ARP) in hospitalized patients, assessed potential differences according to gender and age, and compared this value to the other screening measures conventionally used, namely the CAGE questionnaire and standard biological markers MCV (mean corpuscular volume) and GGT (gamma-glutamyltransferase). CDT sensitivity for detecting ARP was 70%, specificity 75% and area under the receiver operating characteristic curve 0.76%. Its sensitivity was shown to be lower both in the female group (65 vs 71%) as well as in the younger-age group whereas its specificity was lower in the liver-damaged group (55%). CDT diagnostic value did not exceed that of CAGE (sensitivity 78% and specificity 99%), MCV (sensitivity and specificity 74%) or GGT (sensitivity 82% and specificity 53%) but was better than those of other biochemical measures. We conclude that CDT is an effective biological marker for the detection of ARP among hospitalized patients, but that its diagnostic usefulness does not exceed that of some other alternative measures commonly used.

Adult↗