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Biomedical subjects

V Gonzalez

Publications and source records attributed to V Gonzalez.

At least 37 records · Page 2Linked to original sources
PubMed1995

Prevalence and upper limit of cardiac hypertrophy in professional cyclists.

The term athlete's heart refers to an increased left ventricular mass. Few studies have assessed the prevalence and normal upper limit of cardiac hypertrophy in highly trained cyclists and this was the aim of this study. A group of 40 professional road cyclists [mean age 26 (SD 3) years] who had participated in European competitions for 3-10 years, were evaluated at the beginning of the 1992-93 season. Evaluation included a clinical history and physical examination, one and two-dimensional echocardiography, 12-lead resting electrocardiogram and a graded exercise test. Determination of the left ventricular mass index (LVMI) was performed using Devereux's formula with correction for the body surface area. Systolic and diastolic blood pressure were measured at rest and at peak exercise. Of the group 23 cyclists (58%) presented a LVMI greater than 130 g.m-2, 21 cyclists presented a diastolic ventricular thickness equal to or greater than 13 mm, with a superior limit of 19 mm; 3 cyclists presented asymmetrical septum hypertrophy; and the relationship between posterior wall and left ventricular diastolic radius was equal to or greater than 0.45 in 14 cases (35%). Electrocardiographic abnormalities of ST-T segment were seen in only 1 subject. No correlation was found between the degree of ventricular hypertrophy and arterial blood pressure. We concluded that these professional cyclists showed a high prevalence of cardiac hypertrophy (58%). The distribution of this hypertrophy was concentric in 20/33 and asymmetric in 3/23 of the subjects with left ventricular hypertrophy. The electrocardiograms were normal in 98% of the subjects.

Adult↗
PubMed1995

The prevalence of side effects with regular and sustained-release nicotinic acid.

PURPOSE: To document the prevalence and nature of the side effects that occur with the use of regular and sustained-release nicotinic acid in everyday clinical practice. PATIENTS AND METHODS: One hundred and ten patients seen in a private medical clinic who were given 133 separate trials of nicotinic acid during a 5-year period. The occurrence of side effects, particularly those severe enough to warrant discontinuing the drug, were carefully monitored. RESULTS: Forty-three percent of individuals given regular nicotinic acid and 42% of those given sustained-release nicotinic acid were forced to discontinue the medication because of side effects; some of these side effects necessitating discontinuing nicotinic acid did not occur until the patient had been taking the drug for 1 or 2 years. CONCLUSION: Nicotinic acid in both regular and sustained-release forms is a powerful drug when used in doses needed to treat lipid disorders and causes disturbing side effects a very high percentage of the time. No one should use nicotinic acid in these doses without continued careful supervision of a physician.

Adult↗
PubMed1995

Cardiac frequency throughout a working shift in coal miners.

Despite the ever-increasing mechanization of industrial activities, coal mining still remains a physically demanding occupation as it is not always possible to extensively mechanize the extraction process. To estimate the physical effort necessary to sustain coal mining activities in a poorly-mechanized mine, cardiac frequency (fc) was measured throughout the working shift with a Sport-Tester PE3000 (Polar Electro OY, Finland) in a representative sample of 73 Asturian miners engaged in a full spectrum of underground work. The mean +/- SD of the overall fc values measured in miners working at the coal face (Group 1, 33 subjects, mean age 32.7 years, age range 21-48 years) was 106.5 +/- 18.2 beats.min-1. In other miners (Group 2, 40 subjects, mean age 34.6 years, age range 23-48 years) corresponding figures were 103.1 +/- 17.7 beats.min-1 (p < 0.05). Subjects' average working shift fc (beats.min-1) was not related to age, measured (treadmill) VO2 max nor VO2 max.kg body weight-1, while average working-shift fc (%fc max) was weakly related to age (r = 0.396, p < 0.05), VO2 max (r = -0.295, p < 0.05) and VO2 max.kg body weight-1 (r = -0.352, p < 0.05). Working-shift peak fc (beats.min-1) was negatively related to age (r = -0.334, p < 0.05). Our study has provided the distribution of the overall fc values likely to be found in subjects working in these poorly-mechanized mines. However, average working-shift fc differs considerably from subject to subject and is largely unpredictable.

Adult↗
PubMed1995

From graduate student to ethnic researcher: a challenging journey.

The goal of this position article is to convey the message to junior faculty with diverse personal characteristics (i.e., female, minority, or majority ethnic scholars) that obstacles encountered in their academic experience may be the result of being perceived as a symbol of sociohistorical problems. For conveying this message, I will tell my story by referring to what I have experienced as transitional phases: (1) "becoming an international student," (2) "from ambassador to minority," (3) "the great insight, sharing our problems," and (4) "overcoming using coping strategies in academic life." Emphasis will be given to coping strategies that I have developed for facing challenging sociohistorical problems while protecting my psychological well-being. Although the literature is sparse, coping strategies are discussed using available literature and personal experiences including the ability: (1) to assume that most problems affecting diverse junior faculty are sociohistorical, (2) to acknowledge the importance of finding mentors for the psychological well-being of junior faculty, (3) to stop replying to stereotypic views and to use energy and time more productively, (4) to respond selectively to collegial and student feedback, (5) to proactively establish collaborative activities, and (6) to have clear career development objectives. I conclude by recognizing the need for junior faculty to assume an advocacy role for creating a new era of equality and change in academe and in multicultural America. Thus, junior faculty need to undergo a major insightful realization leading to an awakening experience portrayed by the phrase: It is not only me.

Adaptation, Psychological↗
PubMed1994

The safety of exercise testing.

Although exercise testing is a safe activity for the vast majority of individuals being tested, complications during or soon after testing do occur, and safety is an extremely important consideration. In reviewing published rates of complications, it appears that complication rates around 5 per 10,000 tests and death rates around 0.5 per 10,000 tests might be expected. The rate of complications and deaths in our clinic is much lower than these published rates, but our population is, in general, a healthier population than those reported on in other studies. It is instructive to review the details of exercise tests in which complications have occurred, although sometimes it is impossible to predict that an untoward occurrence is imminent. Exercise testing soon after myocardial infarction or angioplasty can generally be conducted safely by knowledgeable professionals, although submaximal testing is recommended under these circumstances. Following accepted contraindications to testing and accepted indications for terminating an exercise test is still very important to ensure the safety of testing. If one desires to step outside these recognized guidelines, the anticipated benefits of testing must clearly outweigh the inherent risks. Any testing facility must have appropriate safety equipment, including a defibrillator, and personnel must be regularly drilled in responding to emergencies. In reviewing our experience at the Cooper Clinic, practical suggestions have been offered that should make exercise testing, which is already a very safe activity, even safer.

Angioplasty, Balloon, Coronary↗
PubMed1993

Structural and dynamic changes in the elastic arteries due to arterial hypertension and hypercholesterolemia.

Five groups of 20 patients each were studied to analyze the vascular dynamics and structure of the elastic arteries. Group I consisted of healthy young individuals (27 +/- 4 years); Group II of healthy adults (46 +/- 9 years); Group III of normotensive hypercholesterolemic adults (45 +/- 12 years and serum cholesterol > 239 mg/dl); Group IV of hypertensive normocholesterolemic adults (56 +/- 13 years); and Group V of hypertensive hypercholesterolemic adults (56 +/- 9 years). The differential arterial pressure was estimated and divided by the volume change (delta P/delta V) of the aorta and the carotid and brachial arteries. The volume change was calculated using the "cylinder formula", measuring the radius from the ultrasonographic vessel image and assigning the cylinder a height of 1 cm. The A/E index of the Doppler transmitral spectrum and the maximum velocity flow using Doppler in the above arteries were calculated. The presence of carotid atherosclerosis was observed and given an arbitrary scoring grade of 0, 1, or 2. A higher arterial and ventricular stiffness was found in the hypertensive patients regardless of the presence of hypercholesterolemia. A higher fall in Doppler velocity and an increase in atherosclerosis lesions were found in Group V. Based on the results of this study, it was concluded that vascular and left ventricular stiffness have a close relationship with arterial hypertension but not with hypercholesterolemia. The hypercholesterolemic patients had a higher prevalence of carotid atherosclerosis and a higher scoring grade of severity.

Adult↗
PubMed1992

Computer-assisted corneal topography in parents of patients with keratoconus.

Recently developed computer-assisted devices allow detection of early topographic abnormalities of the cornea, including mild or abortive forms of keratoconus. To address the possibility that keratoconus is an inherited condition, we examined both parents of 12 randomly selected patients with keratoconus whom we were following up. Of the 12 sets of parents, at least one parent in each of seven sets had abnormal corneal characteristics. Using previously determined quantitative criteria (eg, central corneal steepening, greater steepening inferiorly than superiorly, and asymmetry between the two eyes) to distinguish normal from keratoconic corneas we found evidence of keratoconus in at least one of the 14 parents. The remaining five patients had parents with normal corneal characteristics. These data support the hypothesis that keratoconus is sometimes an inherited condition, exhibiting, at least in some families, autosomal dominant inheritance with incomplete penetrance.

Adult↗
PubMed1991

Pericentric inversion of chromosome 13: familial study and review of the literature.

A family is described in which a pericentric inversion of chromosome 13 (13(p11 q22] was discovered after amniocentesis was performed in a patient with a previous stillborn child with multiple congenital abnormalities, and one surviving Down syndrome offspring with the maternal inversion and an additional trisomy 21. No association between pericentric inversion of chromosome 13 and other chromosomal abnormalities was found in the literature. This study discuss the possible involvement of this type of inversion in the occurrence of chromosomal and phenotypic alterations in the carrier offspring, as well as its role in genetic counseling and in the indication of prenatal diagnosis.

Adult↗
PubMed1989

Echocardiographic assessment of cardiac function in the rabbit: a preliminary study.

A technique for obtaining M-mode echocardiograms in sedated adult rabbits of both sexes, New Zealand and California breeds, is described. Despite the fact that with rabbits there are certain technical difficulties in obtaining the M-mode echocardiograms, our preliminary results indicate that the following measurements could be the most useful and accurate: 1) left ventricular systolic time intervals; 2) right ventricular systolic time intervals; 3) right ventricular end-diastolic dimension; 4) left atrial internal dimension; 5) left ventricular end-diastolic and end-systolic dimensions; 6) systolic slope of the interventricular septum; 7) mid-diastolic partial closure of the mitral valve (EF slope); and 8) systolic slope of the posterior aortic wall.

Animals↗
PubMed1987

Arthritis patient education: a review of the literature.

Arthritis is one of the most prevalent chronic diseases and the number one disabler of the elderly. Even though arthritis is a major cause of morbidity and a contributor to early mortality, relatively few studies have been undertaken to examine effects of arthritis patient education. This review was undertaken to (1) provide a summary of arthritis patient education studies, (2) summarize the effectiveness of arthritis patient education in changing knowledge, behavior, psychological status, and health status, (3) address critical issues/problems in arthritis patient education study methodology, and (4) suggest guidelines for future design, implementation, and evaluation of arthritis patient education programs. In addition, we discuss implications of past studies for future practice.

Arthritis↗
PubMed1985

Intraoperative contrast two-dimensional echocardiography. Evaluation of the presence and severity of aortic and mitral regurgitation during cardiac operations.

We have used contrast two-dimensional echocardiography in the intraoperative evaluation of aortic and mitral regurgitation in 35 patients undergoing cardiac operations. All of them underwent previous cardiac catheterization in order to document the presence and severity of regurgitation. With the pericardium open, a catheter was introduced into the left ventricle (to document mitral regurgitation) or into the ascending aorta (to document aortic regurgitation). The two-dimensional echocardiographic probe was placed on the anterior surface of the right ventricle to obtain a basal image, equivalent to a conventional parasternal longitudinal view. Dextrose in water (5 ml) was rapidly hand-injected through the catheter, while echocardiograms were recorded on videotape. The observation of contrast medium (microbubbles) flowing in the retrograde direction through the incompetent valve was carefully evaluated with the same scoring system used in the hemodynamic laboratory. In 34 cases there was agreement between angiographic and echocardiographic evaluation of the presence and severity of mitral and aortic regurgitation. Only one case was evaluated as mild aortic regurgitation by angiography and moderate aortic regurgitation by echocardiography. There were no false positives or false negatives in the study. In view of the high degree of correlation between contrast two-dimensional echocardiography and hemodynamic data, we suggest that our method is an important tool for the cardiac surgeon. In addition, the present approach overcame the disadvantages of the conventional intraoperative methods, most of which are performed in a nonbeating or fibrillating heart.

Adult↗
PubMed1983

Comparative efficacy and side effects of ursodeoxycholic and chenodeoxycholic acids in dissolving gallstones. A double-blind controlled study.

In a double-blind controlled study of ursodeoxycholic acid (400 and 800 mg/day) and chenodeoxycholic acid (375 and 750 mg/day), in comparison with placebo, ursodeoxycholic acid was significantly more effective than chenodeoxycholic acid in dissolving gallstones after 12 mo of treatment. Although there continued to be better dissolution during ursodeoxycholic acid treatment (dissolution complete in 30% and partial in another 30% of the patients) than during chenodeoxycholic acid treatment (dissolution complete in 7% and partial in 40%) at 24 mo, this difference between the treatment groups was no longer statistically significant. The incidence of floating stones was significantly higher in the patients who dissolved their stones than in those who did not (p less than 0.001). The three failures of dissolution of floating stones during bile acid treatment were associated with chenodeoxycholic acid therapy--two of them with the 750-mg and the third with the 375-mg doses. Gallstone dissolution with ursodeoxycholic acid occurred in spite of a rise in biliary cholesterol saturation, which was consistent with a nonmicellar mechanism of cholelitholysis. Furthermore, more than threefold serum elevations of L-alanine aminotransferase were observed only during chenodeoxycholic acid therapy. They occurred in 2 patients treated with 375 and 750 mg/day, respectively. The enzyme levels normalized after discontinuation of chenodeoxycholic acid and have remained normal for 13 and 8 mo, respectively, after the institution of treatment with 800 mg/day of ursodeoxycholic acid. There was no correlation between the liver tests and biliary levels of lithocholic acid. Of all the symptoms studied, only constipation showed changes that approached statistical significance (p = 0.0681). There was a significant improvement of constipation in the combined chenodeoxycholic acid groups when they were compared with the combined ursodeoxycholic acid groups. The total bile acid pool expanded significantly in both the chenodeoxycholic acid and in the 800-mg ursodeoxycholic acid treatment groups. The marked increases of biliary ursodeoxycholic acid and chenodeoxycholic acid, respectively, indicated compliance with the treatment in all but 1 bile acid-treated patient. Neither serum triglycerides nor serum cholesterol showed significant changes in any of the treatment groups. The study shows that ursodeoxycholic acid dissolves gallstones faster and with fewer side effects than chenodeoxycholic acid. The results of the study are also consistent with the view that ursodeoxycholic acid is cholelitholytic at a lower dose than is chenodeoxycholic acid.

Alanine Transaminase↗
PubMed1980

Follow-up of adolescent psychiatric inpatients.

Psychiatric hospital services for adolescents have steadily increased in recent years and great interest has been generated in determining treatment outcome. In this study, 74 adolescent inpatients completed structured telephone interviews one year after discharge. The questions probed school, job, and family adjustment, as well as drug and alcohol use, participation in treatment, and legal problems. At the time of discharge, they had undergone objective, standardized psychologic tests including personally, locus of control, and parent-adolescent communication assessments. Statistically, the discharge locus of control test correlated with several areas studied. The more external the locus of control at discharge, the greater the likelihood of poor peer relations, poor family relations, and poor job adjustment at one-year follow-up. The discharge personality alienation scale was found to correlate inversely to school adjustment one year later. High emotional discomfort shown by the personality test was associated with increased likelihood of being in treatment at follow-up. Finally, a statistical profile of the adolescents one year after discharge is presented.

Adolescent↗