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Biomedical subjects

Pedro Serrano

Publications and source records attributed to Pedro Serrano.

10 recordsLinked to original sources
PubMed2005

The gap between dyslipidemia control perceived by physicians and objective control patterns in Spain.

OBJECTIVE: It is well-known that adequate control of dyslipidemia is low. But little is known about how well physicians perceive the control of their dyslipidemic patients. This study examines physicians' subjective perception of dyslipidemia control, and compares it with control determined objectively with published guidelines. METHODS: A total of 33,913 patients were studied cross-sectionally in 164 Spanish outpatients' clinics. Of these patients, 5583 were evaluable patients with a documented diagnosis of dyslipidemia. Control of dyslipidemia was evaluated by two methods: the physician's opinion on their patient's lipid levels (adequate control or inadequate control), and the proportion of patients who objectively reach the LDL-cholesterol goals of the National Cholesterol Education Program (NCEP/ATPIII). RESULTS: Physicians perceived that 44% (95% CI 42.7-45.3%) of their patients had an adequate control of their dyslipidemia, but only 32.8% (95% CI 31.6-34.0%) were objectively controlled. Subjective control hardly changed across the NCEP cardiovascular risk groups, but objective control was lower in the 2372 coronary heart disease patients (15.1%) and in the 1407 moderately high-risk patients (29.6%) than in the 1804 lower risk patients (58.5%). Physicians' perception of control was significantly and independently associated with objective control (P<0.001). CONCLUSIONS: Physicians overestimate dyslipidemia control in the majority of their patients. Misperception of control by physicians may contribute to the low achievement of objective control.

Ambulatory Care Facilities↗
PubMed2005

Regio- and stereoselective synthesis of aminoinositols and 1,2-diaminoinositols from conduritol B epoxide.

[Chemical reaction: See text] A systematic approach to the regio- and stereoselective synthesis of aminoinositols and 1,2-diaminoinositols arising from tetra-O-benzylconduritol B epoxide (9) and its aziridine analogue 22, respectively, is described. In all cases, the synthetic methodologies rely on the regio- and stereocontrolled azidolysis of the starting precursors to give the corresponding trans regioadducts. Subsequent functional group manipulation under strict configurational control affords the isomeric cis adducts. Chemoselective functionalization of the diamine moiety in 1,2-diaminoinositol derivatives can be achieved by the proper design of the reaction sequence and choice of reagents. The described protocols allow efficient access to each of the eight possible configurations of the 1,2-diamino and 1,2-amino alcohol moieties from chemical modifications of the epoxide moiety on the common precursor 9.

Amines↗
PubMed2005

On the regio- and stereoselective synthesis of aminocyclitols from cyclitol epoxides: the effect of Li as a chelating agent.

Experimental and theoretical studies on the influence of Li ions on the regio- and the stereoselectivity of the reaction of cyclitol epoxides with nitrogen nucleophiles have been carried out. Model studies with NaN3 as a nucleophile in the absence of Li ions predict a mixture of C1 and C2 regioadducts. The inclusion of two Li ions as a chelating agent favours the operation of a low populated "all-axial" conformation leading ultimately to the C1 adducts. In all cases, the results can be rationalised by geometric and energetic considerations of the corresponding transition states. Predictions of the theoretical calculations are in good agreement with the experimental results using primary and secondary amines as nucleophiles, and thus confirm the validity of this study.

Chelating Agents↗
PubMed2005

New aminocyclitols as modulators of glucosylceramide metabolism.

A series of 13 aminocyclitol derivatives belonging to two different families is described. Their configuration is governed by the regio- and stereocontrolled epoxide opening of a suitably protected conduritol-B epoxide. Studies on several glycosyl processing enzymes indicate that some of them are good inhibitors of glucosylceramide hydrolase. A rationale to account for preliminary structure-activity relationships is provided.

Enzyme Inhibitors↗
PubMed2003

Risk of upper gastrointestinal bleeding associated with non-aspirin cardiovascular drugs, analgesics and nonsteroidal anti-inflammatory drugs.

OBJECTIVE: To evaluate the risk of upper gastrointestinal bleeding associated with non-aspirin cardiovascular drug therapy, common analgesics and individual nonsteroidal anti-inflammatory drugs (NSAIDs). METHODS: The case group was made up of 1122 consecutive patients admitted with bleeding from a peptic lesion. The 2231 control subjects consisted of 1109 patients hospitalized for other reasons and 1122 outpatients from the same geographical area. The relative risk was calculated by unconditional logistic regression after adjusting for confounding factors. RESULTS: The use of the antiplatelet agent triflusal, and other commonly used cardiovascular drugs, such as beta-receptor blockers and calcium channel blockers, was not associated with increased risk of upper gastrointestinal bleeding. The use of angiotensin-converting enzyme inhibitors reduced the risk of bleeding by 30% (odds ratio 0.7; 95% confidence interval 0.5-0.96). Use of ketorolac (odds ratio 59.4; 95% confidence interval 7.7-454) and piroxicam (odds ratio 19.6; 95% confidence interval 9.3-35.3) carried the highest risk. Use of paracetamol and tramadol was not associated with increased risk of bleeding, but the non-narcotic agent metamizol was associated with a small increase in risk of upper gastrointestinal bleeding (odds ratio 2.6; 95% confidence interval 1.3-5.2). CONCLUSIONS: The use of the antiplatelet agent triflusal and other cardiovascular drugs apart from low-dose aspirin was not associated with gastrointestinal bleeding. The use of either NSAIDs or aspirin increased the risk of gastrointestinal bleeding but, among the analgesics, only metamizol induced a small increase in the risk of gastrointestinal bleeding.

Aged↗
PubMed2003

Telepsychiatry in the Canary Islands: user acceptance and satisfaction.

A telepsychiatry service, using ISDN videoconferencing, was established to provide psychiatric consultations for the population of El Hierro, the most westerly of the Canary Islands. During the first year of routine operation, a total of 40 patients had 40 initial and 126 follow-up teleconsultations. The main reason for the consultation identified in the general practitioner's referral form was to establish a diagnosis (60% of patients); the second most common reason was the management of a patient previously diagnosed (20% of patients). According to the results of a questionnaire survey, patients' acceptance of and satisfaction with the technology were high. In their first teleconsultation, about a third of them said that they experienced some initial inconvenience, but this disappeared after a few minutes. Ninety per cent of the patients considered that they received the follow-up care they required. Telepsychiatry was considered by physicians and patients as an adequate vehicle for mental health-care.

Adolescent↗
PubMedDate not supplied

Combinatorial approach to N-substituted aminocyclitol libraries by solution-phase parallel synthesis and preliminary evaluation as glucocerebrosidase inhibitors.

Libraries of N-substituted aminocyclitol derivatives of the scyllo and racemic chiro series by means of parallel solution-phase methodology with the help of robotic technology are described. Chemical diversity has been introduced by reaction of selected scaffolds with a set of aldehydes, acyl chlorides, sulfonyl chlorides, chloroformates, and amines to afford the corresponding amines, amides, sulfonamides, carbamates and ureas, respectively. The optimized methodology has proven excellent, in terms of overall purities of the resulting libraries, for the production of amides. Sulfonamides and carbamates have been obtained in slightly lower purities, while amines afforded modest results. Selected library members have been evaluated as inhibitors of recombinant glucocerebrosidase with K(i) values ranging in the low micromolar scale for the most active members.

Alcohols↗