Biomedical subjects

V Martín-Sanz

Publications and source records attributed to V Martín-Sanz.

6 recordsLinked to original sources

PubMed1997

[Hypertensive subpopulations as defined by their natriuretic response to ambulation].

BACKGROUND: The heterogeneity among patients with essential hypertension is known. We observed in an earlier study a large spread in the values of fractional excretion of sodium in a group of subjects with mild essential hypertension after ambulation, suggesting possible subgroups among them. We defined as the retainer (R) group that which presented a reabsorption index (RI = fractional excretion of sodium during supine/fractional excretion of sodium after ambulation) < 2.5 and the non-retainer (NR) group as that whose RI < 2.5. We analyzed at what level the reabsorption of Na was produced and the differences between the possible groups. PATIENTS AND METHODS: We studied 51 mild essential hypertensive patients, 22 men and 29 women, in two consecutive periods -recumbent, 90 minutes; ambulation, 90 minutes-. We calculated the clearance of creatinine and lithium, fractional proximal and distal reabsorption of Na, plasma renin activity (PRA), plasma aldosterone (ALDO) and elimination of PGE2 and kallikrein in the urine; the plasma catecholamines at the end of the recumbent position and after 10 minutes in the upright position. The study was taken after at least ten days without treatment and following a diet with free Na intake. RESULTS: We did not encounter significant differences between the retainer (n = 19) and non-retainer (32) group with regard to age, sex, body mass index or elimination of Na/24 h. The lower natriuresis in ambulation in the R group compared with the NR group is due to a higher fractional reabsorption of sodium, proximal (83.7 +/- 4.9% vs 79 +/- 5.2; p < 0.01) as well as distal (96.8 +/- 2 vs 95.3 +/- 2%; p < 0.05). The increment in the PRA was greater in the R group (1.3 +/- 1.4 vs 0.8 +/- 0.8; p < 0.05) after ambulation; in the R group showed a lower index -increment in ALDO/increment in PRA- in response to postural change although without significancy. We observed a lower elimination of PGE2 and kallikrein in the R group as compared with NR group (p < 0.05). We did not find differences with regard to plasma catecholamines. CONCLUSIONS: Ambulation allows to distinguish two groups of essential hypertensive patients according to natriuresis. The lower natriuresis in ambulation on the part of the R group could be due to the increase in PRA and therefore of the angiotensin II at the level of the proximal tubule, and to a lower activity of natriuretic hormones (PGE21 kallikrein) at the distal level.

Adult↗

PubMed1995

Description of a new quotient that may differentiate blood pressure profiles in essential versus Cushing's syndrome-related hypertension.

Since the presence or absence of a nocturnal decrease in blood pressure values (BP) may suggest an increased risk of visceral complications or the existence of secondary hypertension, several methods have been described for evaluating the BP profile. Nevertheless, a universally accepted system to evaluate this item has not yet been established. Our aim in this study was to test different dispersion quotients (DQ) which estimate the differences between the mean of each hour, and the mean of all the readings in the 24 h period. These quotients may be employed regarding systolic (SBP) or diastolic (DBP) blood pressure, and may be referred to the whole period of 24 h, or to the subperiods morning (m), afternoon (a) or night (n). We have studied two non selected groups of essential (n = 20) or secondary (Cushing's syndrome, n = 17) hypertensives. We observed a marked decrease in these quotients, particularly DQ-SBP and nDQ-SBP, in secondary hypertensives (respectively 10.2 +/- 2.9 vs 15.6 +/- 4.2 and 11.8 +/- 5.0 vs 20.5 +/- 6.3, p < 0.0001), thus indicating, a blunted nocturnal fall of BP in these patients. Also the DQ and particularly DQ-SBP, nDQ-SBP and nDQ-DBP, showed a high positive and negative predictive value, sensitivity and specificity for pertaining to the Cushing's syndrome group (respectively: 0.75, 0.88, 0.88, 0.75; 0.86, 0.82, 0.77 0.90; and 0.78, 0.84, 0.82, 0.80).

Adolescent↗

PubMed1994

[Influences of hyperinsulinemia in the lipid profile of hypertensive patients].

BACKGROUND: Hypertension and dyslipemia are associated with a greater frequency than that randomly expected. The increase in insulinic resistance hyperinsulinemia is one of the factors implicated in the pathogenesis of this association. In the present study the lipid profile of hypertensive patients is analyzed according to the degree of insulinemia. METHODS: The lipid profile (total cholesterol, fraction linked to low density lipoproteins cLDL, high density cHDL, triglycerides and plasma apolipoproteins A1 and B were determined in 87 patients with essential high blood pressure. Moreover an oral overdose of 75 g of glucose was administered with determinations of glycemia, insulinemia and C peptide at the time of glucose administration, 60 and 120 minutes. RESULTS: Upon separation of the hypertense patients into two groups according to the insulinemia achieved following an oral overload of glucose, those hypertensives with a greater degree of insulinemia showed a significant increase in triglycerides (p < 0.05) and also a significant decrease in cHDL (p < 0.001). The hypertensive patients with lower insulinemia showed a significant increase in total cholesterol (p < 0.05) and fraction linked to LDL although the latter was not significant. CONCLUSIONS: Two different lipid profiles may be observed in hypertensive patients: one linked to hyperinsulinemia and characterized by an increase in triglycerides and a decrease in cHDL and another with no relation with hyperinsulinemia which is manifested by an increase in total cholesterol and cholesterol transported by the LDL.

Adult↗

PubMed1993

[Candida albicans spondylodiscitis].

Infections by Candida sp. have increased notably and cause not only local but also systemic infections. It is rarely mentioned as an etiologic agent of osteomyelitis. Two cases of candidiasic spondylodiscitis are presented with the first being in a 33 year old intravenous drug using male who consulted for mechanical lumbar pain. Spondylodiscitis L2-L3 was observed upon radiological study. Aspiration puncture was carried out and the cultures were negative. Surgical biopsy was performed with spondylodiscitis and an abscess in the spine being observed. C. albicans was isolated in the culture. Pathological study confirmed the diagnosis. Cutaneous and sternocostal involvement was also concommitantly presented. The patient was treated with amphotericin B with a favorable evolution. The second case was in a 35 year old male with burns over 65% of his body due to a laboral accident. Three months after admission the patient presented lumbar pain irradiating to the groin and thigh. Bone destruction of the second lumbar vertebra and an abscess of the right psoas were observed upon CT scan. Puncture biopsy was performed and C. albicans was isolated. Histopathologic study demonstrated osteomyelitis by Candida sp. Treatment with amphotericin B was started. Posteriorly urea and creatinine was raised. Treatment was continued with fluconazole with good therapeutic response.

Adult↗

PubMed1993

[Psittacosis of avian origin as etiology of community-acquired pneumonia with severe onset].

We present two cases of community acquired pneumonia (extra-hospital) of severe onset, secondary to Chlamydia psittaci of avian origin. Each patient have bought a parakeet in the same pet-shop, and took care of them personally. Both developed a respiratory insufficiency, one of them needing mechanical ventilation. Out of nine relatives to whom serological determinations were performed, there was evidence of infection in two of them, but only one referred an auto-limited febrile syndrome during that period of time. Psittacosis incidence is discussed as origin of community acquired pneumonias, as well as its epidemiology, diagnosis and treatment.

Adult↗

PubMed1992

[Influence of arterial pressure and plasma renin activity on tubular reabsorption of sodium].

BACKGROUND: With the aim of confirming the possible existence of an increase in the fractional proximal reabsorption of sodium in the development of essential hypertension, the tubular dynamics of sodium were compared by the lithium clearance technique in a group of hypertensive patients and controls. METHODS: Following a week of drug suspension 186 patients with slight or moderate essential hypertension and 37 normal subjects with homogeneous sodium ingestion were studied. A clearing period of 90 minutes prior to the administration of a tracing doses of lithium was considered to calculate the fractional proximal and distal reabsorption of sodium in terms of glomerular filtration. In addition to global comparison of the measurements, the hypertensives were classified and compared according to mean arterial pressure (MAP) and percentages of plasma renin activity (PRA). RESULTS: No differences were found in tubular dynamics of sodium between hypertensive and normotensive patients. Neither did the degree of hypertension induce differences. However, upon classifying the patients according to PRA, it was found that those with PRA higher than 0.5 ng/ml-1/h-1 had less secondary natriuresis to a greater fractional distal reabsorption of sodium (p < 0.05). CONCLUSIONS: The findings of the this study do not support the possible existence of a primary defect of the transport of sodium in the proximal tubule in the origin and/or maintenance of essential arterial hypertension.

Absorption↗