Biomedical subjects

Pedro Muñoz

Publications and source records attributed to Pedro Muñoz.

7 recordsLinked to original sources

PubMed2006

Apoptosis of neuronal cells induced by serum of patients with acute brain injury: a new in vitro prognostic model.

OBJECTIVE: To investigate whether serum draining from the jugular bulb of patients with traumatic or haemorrhagic brain injury induced apoptosis of neuronal PC12 cells in vitro and whether the apoptotic rate correlated with patients' outcome at 6 months. DESIGN AND SETTING: Prospective clinical investigation in a 21-bed intensive care unit (ICU) in a university hospital. PATIENTS: Seventy patients who had suffered from acute brain injury requiring intensive care. INTERVENTIONS: Jugular bulb vein and systemic samples were obtained on admission to the ICU and after 48 h. PC12 cells were incubated in the presence of 10% of heat-inactivated patient's sera and apoptotic rate was determined by flow cytometry using annexin V and 7-aminoactinomycin D. RESULTS: Regional serum draining from the lesions induced higher early apoptosis of PC12 cells than systemic serum. Early apoptotic rate, Glasgow coma score, APACHE II score and the presence of pupil abnormalities were associated with mortality at 6 months in univariate statistical analyses. In logistic regression analysis only early apoptotic rate was an independent factor associated with mortality at 6 months (odds ratio: 1.502, 95% CI 1.2-1.9; p<0.001). The final model has a sensitivity of 82.4% and a specificity of 84.8% for predicting death within 6 months. CONCLUSIONS: We developed a simple and reproducible in vitro model for predicting outcome in patients with traumatic or haemorrhagic brain injury that survived in the early phase. Our in vitro model combined with clinical and radiological measurements might improve the value of prognostic models to predict acute brain injury patients' outcome.

Adolescent↗

PubMed2006

Association of migraine and ESR1 G325C polymorphism.

Migraine is a genetically complex disorder in which sexual hormones influence the phenotype. ESR1 G594A polymorphism has been associated with migraine in Australians. We performed a case-control study with G594A and G325C polymorphisms to determine whether ESR1 is associated with migraine in our population. An association between G594A and migraine could not be demonstrated here. By contrast, we observed that the C325 allele conferred a 1.6 (95% confidence interval=1.1-2.4) higher risk for suffering from migraine in women than the G allele. Women carrying the C352C genotype were over 3 times more likely to suffer from migraine than those carrying the G325G genotype. Therefore, we conclude that ESR1 G325C polymorphism is associated with migraine in our population.

Adult↗

PubMed2006

The new questionnaire health-related quality of life for eating disorders showed good validity and reliability.

BACKGROUND AND OBJECTIVES: To describe the development and investigate the psychometric properties of a new instrument to measure health-related quality of life (HRQoL) for individuals with an eating disorder (ED). METHODS: Seven focus groups were convened and an extensive literature review was carried out to generate the items. The first draft of the questionnaire was pilot tested. Three hundred twenty-four ED patients took part in the final field study. The 12-Item Short Form Health Survey, the Eating Attitudes Test-26, and two items from the Eating Disorders Inventory-2 also were applied to examine the concurrent validity. Factor analysis, item scale correlation correcting for overlap, test-retest, Cronbach's alpha coefficient, known-groups validation, and the sensitivity of the questionnaire in different populations also were examined. RESULTS: The final Health-Related Quality of Life in Eating Disorders (HeRQoLED) questionnaire consisted of 50 items. Principal axis factor analysis identified eight subscales. Concurrent validity showed correlations >.40 with the criteria measures. Excellent reliability and stability were obtained. The HeRQoLED was sensitive in discriminating both between known-different groups and from the general population. CONCLUSION: The results provide evidence of the good psychometric properties of the new HeRQoLED questionnaire, except for one domain, which had to be eliminated.

Adult↗

PubMed2005

Thymidylate synthase promoter tandem repeat and MTHFD1 R653Q polymorphisms modulate the risk for migraine conferred by the MTHFR T677 allele.

There is growing evidence that folate metabolism is involved in migraine pathophysiology, mainly in migraine with aura. Even though folate metabolism is regulated by a number of enzymes, only two functional polymorphisms have been tested in association studies with migraine. Here, we have explored the possible role in migraine of other folate-metabolizing enzymes which are in close interdependency with 5',10'-methylenetetrahydrofolate reductase analyzing functional polymorphisms of these enzymes in a case-control study. Individually, thymidylate synthase (TS), methenyltetrahydrofolate cyclohydrolase formyltetrahydrofolate synthase (MTHFD1), or methionine synthase (MS) polymorphisms did not modify the general risk for suffering migraine. Nevertheless, we observed a strong interaction between TS and MTHFR mutated genotypes, which increased over 8-fold the risk for experiencing aura among migraineurs; MTHFD1 and MTHFR mutated genotypes also increased together the risk for migraine in general (OR = 3.08; 95% CI = 1.3-7.4). We conclude that the pathogenetic role of the MTHFR T677 allele in migraine is modulated by functional polymorphisms of TS and MTHFD1.

Adult↗

PubMed2005

Correlation between lipophilicity and triptan outcomes.

BACKGROUND: It has been suggested that triptans achieving higher central nervous system (CNS) levels should have an advantage in efficacy, if central actions are important. Objective.-Our aim was to correlate the efficacy and tolerability results of triptans with their lipophilicity. METHODS: Data for response and pain free at 2 hours, recurrence, adverse events (AE), CNS AE, and chest symptoms taken from Ferrari et al's meta-analysis publications for the recommended doses of oral triptans were correlated with their lipophilicity coefficients (logD(pH)7.4 = -2.1 almotriptan < -1.5 sumatriptan < -1.0 zolmitriptan < -0.7 rizatriptan < -0.2 naratriptan < 0.5 eletriptan). RESULTS: We found no significant correlation between lipophilicity coefficients and any of the analyzed parameters. There was, however, some correlation between lipophilicity and CNS AE (P = .09, r = 0.74) and, to a lesser degree, with a reduction in recurrence rate (r = -0.36). The r values for response and pain free with placebo correction ranged from 0.04 to 0.34, suggesting almost no correlation between lipophilicity and efficacy variables. CONCLUSIONS: According to this analysis, a higher lipophilicity does not seem crucial to improve triptan efficacy. This physico-chemical property, however, correlates with higher CNS AE and, possibly, lower recurrence rates.

Central Nervous System Diseases↗

PubMed2002

Quality of life in chronic daily headache: a study in a general population.

OBJECTIVE: To analyze the quality of life (QoL) of subjects with chronic daily headache (CDH) in the general population. METHODS: QoL was studied, using the generic instrument Short Form-36 (SF-36), in 89 unselected subjects from an epidemiologic study in the general population who fulfilled CDH criteria. SF-36 scores were adjusted for comorbid conditions. A total of 89 healthy matched subjects were recruited as a control group. An additional matched group of 89 otherwise healthy subjects with episodic migraine was recruited as controls only to those with transformed migraine (TM). RESULTS: CDH subjects showed a significant decrease in each health-related concept of the SF-36 as compared with healthy subjects. The highest decreases were seen for role physical, bodily pain, vitality, and social functioning. There was no significant difference in SF-36 scores in subjects with chronic tension-type headache as compared with TM subjects. TM individuals showed lower values in each health-related concept when compared with patients with episodic migraine, these decreases being significant for general health, vitality, and mental health. Finally, CDH subjects without analgesic overuse showed higher values in each concept of the SF-36 than those with analgesic overuse. Despite the low proportion of abusers in this study, differences were significant for physical functioning and bodily pain. CONCLUSIONS: In the general population, CDH reduced all QoL aspects studied with the SF-36. This reduction in QoL was most marked in subjects with analgesic overuse. QoL was affected more by the chronicity than by the intensity of pain.

Adolescent↗

PubMedDate not supplied

[Use of antihypertensive agents in Cantabria, Spain [1995-2002]: discrepancy with the published evidence].

OBJECTIVE: To ascertain the pattern of prescription of antihypertensive drugs in Cantabria and its variation from published evidence between 1995 and 2002. METHOD: We reviewed the database of the pharmaceutical data processing system of the Cantabrian Health Service on the consumption and cost of the drugs indicated in the treatment of hypertension. Consumption data is expressed in defined daily doses per thousand inhabitants and day (DID). RESULTS: Consumption of antihypertensive agents was 130.2 DID in 1995 and was 235 DID in 2002. The contribution of diuretics to overall consumption fell from 34.3% in 1995 to 25.8% in 2002, and that of beta-blockers fell from 6.5% in 1995 to 5.9% in 2002. The most commonly used group in all years was angiotensin converting-enzyme inhibitors, which represented 36.8% of consumption in 2002. Angiotensin-II antagonists showed the biggest rise, accounting for 13.2% of prescriptions in 2002 and for 26% of expenditure on antihypertensive agents. The pattern of use of the drugs utilized in the major published trials during this period showed no change or even fell, except in the case of enalapril. CONCLUSIONS: The present study confirms that the prescription antihypertensive drugs has considerably increased and that the consumption pattern of these drugs has changed. The discrepancy between these findings and those of the major trials could have significant economic implications.

Antihypertensive Agents↗