Biomedical subjects

A Carvajal

Publications and source records attributed to A Carvajal.

At least 37 records · Page 2Linked to original sources

PubMed1999

Polymorphisms in the presenilin 1 and presenilin 2 genes and risk for sporadic Alzheimer's disease.

We examined the possible involvement of polymorphisms of the presenilin 1 (PS1) and presenilin 2 (PS2) genes in the risk for sporadic Alzheimer's disease (AD), either through an independent effect or through interaction with the existing apolipoprotein E (ApoE) risk, in 211 AD cases and 188 age-matched control subjects. No significant differences were obtained in any of the comparisons relating the effect of the PS1 and PS2 polymorphisms; thus, these polymorphisms do not appear to be sufficient risk factors by themselves for sporadic AD. Although the ApoE varepsilon4 genotype is the only definite predictor of risk, homozygosity for either the 1 allele of the PS1 or the C allele of the PS2 genes may increase the risk conferred by the presence of an ApoE epsilon4 allele. Additionally, combination of PS1/11 and PS2/CC genotypes might have a small synergistic effect on the risk for AD.

Adult↗

PubMed1999

[Anti-ulcer drug consumption in Spain].

OBJECTIVE: To check whether therapy to eradicate Helicobacter pylori has succeeded in reducing the consumption of traditional ulcer medication. DESIGN: A longitudinal, retrospective study of the use of medication. SETTING: Spain in the decade from 1988 to 1997. PARTICIPANTS: Pharmaceutical products belonging to the anatomical therapeutic group AO2B (for ulcers) and dispensed at the Social Security's expense. MEASUREMENTS AND MAIN RESULTS: Despite the widespread use of treatments to eradicate H. pylori, it was found that consumption of ulcer medication continued to increase markedly, from 5 daily doses per 1000 inhabitants in 1988 to 19 in 1997. In 1997 the two most frequently taken active principles in the group were omeprazole and ranitidine. Drugs indicated for gastric protection were also used much more. However, in absolute values, they stayed well below anti-H2 drugs and proton pump inhibitors. CONCLUSION: The introduction into Spain of therapy to eradicate H. pylori has failed to reduce the use of ulcer medication. The use of anti-H2 drugs and proton pump inhibitors for gastric protection may explain a part of the increase in consumption experienced by these two pharmacological groups.

Anti-Ulcer Agents↗

PubMed1999

Opioid consumption in Spain--the significance of a regulatory measure.

OBJECTIVE: To investigate the impact of new regulatory measures on opioid consumption in Spain during the period 1985-1998. METHODS: A search in the ECOM (Especialidades Consumo de Medicamentos) database of the Ministry of Health was made for the 1985-1998 period. This database contains information about drug preparations prescribed in primary care in the National Health System in Spain. RESULTS: Since 1985-1998, the overall opioid consumption has increased tenfold, from 94.7 DDD (defined daily dose) per million inhabitants per day to more than 1000 DDD. For the five drugs that require a special prescription form (morphine, methadone, pethidine, tilidine and fentanyl), the consumption has increased 13.5-fold. CONCLUSION: A huge increase in opioid consumption has occurred. In this increase, changes in supply and, to a lesser extent, regulatory measures have played an important role.

Analgesics, Opioid↗

PubMed1999

Breathing pattern in highly competitive cyclists during incremental exercise.

The purpose of our investigation was to analyse the breathing patterns of professional cyclists during incremental exercise from submaximal to maximal intensities. A group of 11 elite amateur male road cyclists [E, mean age 23 (SD 2) years, peak oxygen uptake (VO2peak) 73.8 (SD 5.0) ml kg(-1) min(-1)] and 14 professional male road cyclists [P, mean age 26 (SD 2) years, (VO2peak) 73.2 (SD 6.6) ml kg(-1) min(-1)] participated in this study. Each of the subjects performed an exercise test on a cycle ergometer following a ramp protocol (exercise intensity increases of 25 W x min(-1)) until the subject was exhausted. For each subject, the following parameters were recorded during the tests: oxygen consumption (VO2), carbon dioxide output (VCO2), pulmonary ventilation (VE), tidal volume (VT), breathing frequency (fb), ventilatory equivalents for oxygen (VE x VO2(-1)) and carbon dioxide (VE x VCO2(-1)), end-tidal partial pressure of oxygen and partial pressure of carbon dioxide, inspiratory (tI) and expiratory (tE) times, inspiratory duty cycle (tI/tTOT, where tTOT is the time for one respiratory cycle), and mean inspiratory flow rate (VT/tI). Mean values of VE were significantly higher in E at 300, 350 and 400 W (P < 0.05, P < 0.05 and P < 0.01, respectively); fb was also higher in E in most moderate-to-maximal intensities. On the other hand, VT showed a different pattern in both groups at near-to maximal intensities, since no plateau was observed in P. The response of tI and tE was also different. Finally, VT/tI and tI/tTOT showed a similar response in both P and E. It was concluded that the breathing pattern of the two groups differed mainly in two aspects: in the professional cyclists, VE increased at any exercise intensity as a result of increases in both VT and fb, with no evidence of tachypnoeic shift, and tE was prolonged in this group at high exercise intensities. In contrast, neither the central drive nor the timing component of respiration seem to have been significantly altered by the training demands of professional cycling.

Adult↗

PubMed1999

Effect of venlafaxine hydrochloride in different preparations of isolated guinea-pig and rat organ tissues.

A study was undertaken to know better the effects of venlafaxine hydrochloride on the responses of isolated rat vas deferens to noradrenaline and dopamine, those of isolated rat uterus to serotonin and histamine, and those of isolated guinea-pig ileum to acetylcholine and histamine. Venlafaxine hydrochloride increased the response of rat vas deferens to noradrenaline but not to dopamine. Venlafaxine did not alter the response of rat isolated uterus to serotonin. In rat uterus, venlafaxine did not modify the response to histamine but was able to increase it in guinea-pig ileum. An anticholinergic effect was observed with the lowest concentration tested. Although venlafaxine is a selective serotonine reuptake inhibitor in the central nervous system, serotonin uptake was not seen in the rat uterus. The anticholinergic effects observed in the present study might be consistent with some of the side-effects associated with venlafaxine.

Acetylcholine↗

PubMed1999

Heart rate response to professional road cycling: the Tour de France.

The aim of the present investigation was to evaluate the heart rate response of 8 professional cyclists (26+/-3 yr; 68.9+/-5.2 kg; V02max: 74.0+/-5.8 ml x kg(-1) x min(-1)) during the 3-week Tour de France as an indicator of exercise intensity. Subjects wore a heart rate telemeter during 22 competition stages and recorded data were analysed using computer software. Two reference heart rates (corresponding to the first and second ventilatory thresholds or VT1 and VT2) were used to establish three levels of exercise intensity defined as phases I ( VT2) is substantially lower than that of light, aerobic exercise (<VT1), a clear distinction must be made between the different type of stages (i.e. easy, flat parcours vs mountain stages or time trials) and the role of each cyclist in the team must be also considered.

Adult↗

PubMed1999

Analysis of the aerobic-anaerobic transition in elite cyclists during incremental exercise with the use of electromyography.

OBJECTIVES: To investigate the validity and reliability of surface electromyography (EMG) as a new non-invasive determinant of the metabolic response to incremental exercise in elite cyclists. The relation between EMG activity and other more conventional methods for analysing the aerobic-anaerobic transition such as blood lactate measurements (lactate threshold (LT) and onset of blood lactate accumulation (OBLA)) and ventilatory parameters (ventilatory thresholds 1 and 2 (VT1 and VT2)) was studied. METHODS: Twenty eight elite road cyclists (age 24 (4) years; VO2MAX 69.9 (6.4) ml/kg/min; values mean (SD)) were selected as subjects. Each of them performed a ramp protocol (starting at 0 W, with increases of 5 W every 12 seconds) on a cycle ergometer (validity study). In addition, 15 of them performed the same test twice (reliability study). During the tests, data on gas exchange and blood lactate levels were collected to determine VT1, VT2, LT, and OBLA. The root mean squares of EMG signals (rms-EMG) were recorded from both the vastus lateralis and the rectus femoris at each intensity using surface electrodes. RESULTS: A two threshold response was detected in the rms-EMG recordings from both muscles in 90% of subjects, with two breakpoints, EMGT1 and EMGT2, at around 60-70% and 80-90% of VO2MAX respectively. The results of the reliability study showed no significant differences (p > 0.05) between mean values of EMGT1 and EMGT2 obtained in both tests. Furthermore, no significant differences (p > 0.05) existed between mean values of EMGT1, in the vastus lateralis and rectus femoris, and VT1 and LT (62.8 (14.5) and 69.0 (6.2) and 64.6 (6.4) and 68.7 (8.2)% of VO2MAX respectively), or between mean values of EMGT2, in the vastus lateralis and rectus femoris, and VT2 and OBLA (86.9 (9.0) and 88.0 (6.2) and 84.6 (6.5) and 87.7 (6.4)% of VO2MAX respectively). CONCLUSION: rms-EMG may be a useful complementary non-invasive method for analysing the aerobic-anaerobic transition (ventilatory and lactate thresholds) in elite cyclists.

Adult↗

PubMed1999

Trace elements and electrolytes in human resting mixed saliva after exercise.

OBJECTIVES: Exercise is known to cause changes in the concentration of salivary components such as amylase, Na, and Cl. The aim of this investigation was to evaluate the effect of physical exercise on the levels of trace elements and electrolytes in whole (mixed) saliva. METHODS: Forty subjects performed a maximal exercise test on a cycle ergometer. Samples of saliva were obtained before and immediately after the exercise test. Sample concentrations of Fe, Mg, Sc, Cr, Mn, Co, Cu, Zn, Se, Sr, Ag, Sb, Cs, and Hg were determined by inductively coupled plasma mass spectrometry and concentrations of Ca and Na by atomic absorption spectrometry. RESULTS: After exercise, Mg and Na levels showed a significant increase (p < 0.05) while Mn levels fell (p < 0.05). Zn/Cu molar ratios were unaffected by exercise. CONCLUSIONS: Intense physical exercise induced changes in the concentrations of only three (Na, Mg, and Mn) of the 16 elements analysed in the saliva samples. Further research is needed to assess the clinical implications of these findings.

Adult↗

PubMed1999

Heart dimensions may influence the occurrence of the heart rate deflection point in highly trained cyclists.

OBJECTIVES: To determine whether the heart rate (HR) response to exercise in 21 highly trained cyclists (mean (SD) age 25 (3) years) was related to their heart dimensions. METHODS: Before performing an incremental exercise test involving a ramp protocol with workload increases of 25 W/min, each subject underwent echocardiographic evaluation of the following variables: left ventricular end diastolic internal diameter (LVIDd), left ventricular posterior wall thickness at end diastole (LVPWTd), interventricular septal wall thickness at end diastole (IVSTd), left ventricular mass index (LVMI), left atrial dimension (LAD), longitudinal left atrial (LLAD) and right atrial (LRAD) dimensions, and the ratio of early to late (E/A) diastolic flow velocity. RESULTS: The HR response showed a deflection point (HRd) at about 85% VO2MAX in 66.7% of subjects (D group; n = 14) and was linear in 33.3% (NoD group; n = 7). Several echocardiographic variables (LVMI, LAD, LLAD, LRAD) indicative of heart dimensions were similar in each group. However, mean LPWTd (p<0.01) and IVSTd (p<0.05) values were significantly higher in the D group. Finally, no significant difference between groups was found with respect to the E/A. CONCLUSIONS: The HR response is curvilinear during incremental exercise in a considerable number of highly trained endurance athletes-that is, top level cyclists. The departure of HR increase from linearity may predominantly occur in athletes with thicker heart walls.

Adult↗

PubMed1999

The importance of physical fitness in the performance of adequate cardiopulmonary resuscitation.

The aim of the present investigation was to evaluate the influence of the physical fitness of a cardiopulmonary resuscitation (CPR) provider on the performance of and physiologic response to CPR. To this end, comparisons were made of sedentary and physically active subjects in terms of CPR performance and physiologic variables. Two study groups were established: group P (n=14), composed of sedentary, professional CPR rescuers (mean [+/-SD]; age, 34+/-6 years; VO2max, 32.5+/-5.5 mL/kg/min), and group Ex (n=14), composed of physically active, nonexperienced subjects (age, 34+/-6 years; VO2max, 44.5+/-8.5 mL/kg/min). Each subject was required to perform an 18-min CPR session, which involved manual external cardiac compressions (ECCs) on an electronic teaching mannequin following accepted standard CPR guidelines. Subjects' gas exchange parameters and heart rates (HRs) were monitored throughout the trial. Variables indicating the adequacy of the ECCs (ECC depth and the percentage of incorrect compressions and hand placements) also were determined. Overall CPR performance was similar in both groups. The indicators of ECC adequacy fell within accepted limits (ie, an ECC depth between 38 and 51 mm). However, fatigue prevented four subjects from group P from completing the trial. In contrast, the physiologic responses to CPR differed between groups. The indicators of the intensity of effort during the trial, such as HR or percentage of maximum oxygen uptake (VO2max) were higher in group P subjects than group Ex subjects, respectively (HRs at the end of the trial, 139+/-22 vs 115+/-17 beats/min, p < 0.01; percentage of VO2max after 12 min of CPR, 46.7+/-9.7% vs 37.2+/-10.4%, p < 0.05). These results suggest that a certain level of physical fitness may be beneficial to CPR providers to ensure the adequacy of chest compressions performed during relatively long periods of cardiac arrest.

Adult↗

PubMed1999

Determination of the maximum steady state of lactate (MLSS) in saliva: an alternative to blood lactate determination.

Based on previous research which shows parallelism between the saliva and blood lactate response during incremental exercise, we hypothesized that a "maximum salivary lactate steady state" (saliva-MLSS) might exist. Thus, the aim of the present investigation was to establish 1) which lower limit for the increase in salivary lactate concentration during a constant workload (i.e., from the 10th to the 20th min) test could be used to determine the saliva-MLSS and 2) if the exercise intensity corresponding to the saliva-MLSS is identical to that evoking the (blood) MLSS. Twelve male amateur athletes of mean ( +/- SD) age 24 +/- 5 year were selected for the study. Based on the results of a previous maximal cycle ergometer test for lactate threshold (LT) determination, each subject performed consecutive constant workload tests of 20-min duration on separate days for MLSS determination. Blood and saliva (25 microl) samples were collected at 0, 10, and 20 min during the tests for lactate determination. A Student's t-test for paired data demonstrated that a salivary lactate increase of 0.8 mM corresponded to the saliva-MLSS. At this value, indeed, no significant differences were observed between the mean V(.)O(2) and W values corresponding to the MLSS and the saliva-MLSS. In conclusion, the present findings indicate that 0.8 mM is the lower limit for the increase in saliva lactate concentration during a constant load test and thus is that which might be used as a reference to determine saliva-MLSS. Furthermore, saliva-MLSS might be used as an alternative to MLSS determination in blood samples.

Adult↗

PubMed1999

The salivary amylase, lactate and electromyographic response to exercise.

Twelve trained young males (age: 24 +/- 5 years) performed an incremental test to exhaustion during which capillary blood and saliva samples were obtained to determine the blood lactate (LT) and salivary amylase (T(sa)) thresholds. The root mean-square voltage of electromyographic activity (rms-EMG) of the vastus lateralis muscle was also recorded to detect the electromyographic threshold (EMG(T)). No significant difference was found between the exercise intensity corresponding to the LT, T(sa) or EMG(T).

Adult↗

PubMed1999

Physiological parameters determined at OBLA vs. a fixed heart rate of 175 beats x min-1 in an incremental test performed by amateur and professional cyclists.

A blood lactate concentration of 4 mmol x l-1 (OBLA) is frequently used as an indicator of the maximal steady state of lactate (MLSS) for workload planning in training programs. The aim of the present investigation was to compare several metabolic parameters determined at OBLA and at a fixed heart rate of 175 beats x min-1 (HR175) in amateur cyclists (AC) and professional cyclists (PC). Sixteen AC and 22 PC performed an exercise test on a cycle ergometer following a ramp protocol (25 W x min-1, 70-80 rpm) to exhaustion. Gaseous exchange was monitored throughout the test. VO2, %VO2 max, and power output (W) corresponding to OBLA and HR175 were determined and mean values compared using a Student's t-test. Findings indicated higher VO2 max and W in general in PC (p<0.01), and higher VO2 and W at OBLA and HR175 in PC (p<0.01). No significant difference was found between values determined at OBLA and HR175 in the AC group, while in the PC group, VO2, %VO2 max, and W were higher at OBLA. These observations suggest the possible use of a fixed, reference HR of 175 beats x min-1 to determine the exercise intensity corresponding to OBLA in amateur cyclists. This was not the case for the professional cyclists.

Exercise↗

PubMed1998

Further analysis of the genome of porcine epidemic diarrhoea virus.

We report here the continued determination and analysis of the nucleotide sequence of both wild type (wt) and cell culture adapted (ca) porcine epidemic diarrhoea coronavirus (PEDV). These studies were undertaken with two objectives in mind: the identification of common and divergent features in the genomic sequences of wt and ca PEDV which can explain the differences in virulence of these isolates and the further exploration of the relationship of PEDV to other coronaviruses.

Animals↗

PubMed1998

Under-reporting of adverse drug reactions. Estimate based on a spontaneous reporting scheme and a sentinel system.

OBJECTIVE: Spontaneous reporting is the most common method used in pharmacovigilance and the best one to generate signals on new or rare adverse drug reactions (ADRs). Under-reporting is a major drawback of this system. The objective of this study was to quantify the extent of under-reporting in general practice and to assess the factors which influence it. METHODS: Details of ADRs collected through a short intensive survey were compared with primary care spontaneous reports received by the Castilla y Leon Regional Pharmacovigilance Centre during a 12-month reference period. The survey was undertaken by a random sample of 146 general practitioners (GPs), providing care to 149,487 people. The pharmacovigilance centre received reports concerning the whole regional population (2.5 million) covered by primary health care. The under-reporting coefficient (U) was estimated as the ratio between the number of effects observed by physicians in the survey and those spontaneously reported to the pharmacovigilance centre. RESULTS: The overall under-reporting rate was 1144 [95% confidence interval (CI): 928-1409]. Under-reporting was greater for psychiatric (2119; 945-4752) and gastrointestinal (1946; 1424-2659) disorders. Severe effects were more reported (U = 605; 151-2431) than moderate (863; 473-1575) and mild (1209; 973-1503) ones. The under-reporting rate was lower for drugs recently marketed (706; 406-1230) and slightly lower for unlabelled effects (1031; 641-1657). CONCLUSION: The under-reporting rate of ADRs is considerable, though not homogeneous for the different cases. This should be taken into account when comparing adverse effects (AEs) for different drugs. Under-reporting seems to be positively selective, as it involves mainly the less severe and better-known effects, preserving the value of spontaneous reporting for signal detection.

Adolescent↗

PubMed1998

Active compression-decompression cardiopulmonary resuscitation in standing position over the patient (ACD-S), kneeling beside the patient (ACD-B), and standard CPR: comparison of physiological and efficacy parameters.

The purpose of this investigation was to compare the efficacy of three different cardiopulmonary resuscitation techniques: (a) standard cardiopulmonary resuscitation (CPR), (b) active compression-decompression cardiopulmonary resuscitation (ACD-CPR) with the rescuer standing beside the patient (ACD-B), and (c) ACD-CPR with the rescuer in a standing position over the patient (ACD-S). The physiological responses of the rescuers when performing these techniques were also evaluated. A total of 14 experienced professional rescuers of a mobile intensive care unit (32+/-6 years), participated in this investigation. On 3 different days (randomised order), each of them performed on a manikin (a) CPR, (b) ACD-B, and (c) ACD-S. Parameters indicative of both CPR performance (time to exhaustion, compression depth and efficacy), and rescuers' physiological responses (blood lactate; minute ventilation (VE); heart rate (HR); oxygen uptake VO2; respiratory exchange rate (RER); and percentage of VO2max) were monitored during the trials. The main findings of this investigation were: (a) the evidence of a greater physiological load for the rescuers during the ACD-CPR techniques compared to CPR, which caused a longer performance time with CPR as compared to ACD-CPR; (b) the overall absence of physiological differences between ACD-B and ACD-S; and (c) a modest decrease in mechanical efficacy for ACD-S when compared to ACD-B.

Adult↗

PubMed1998

Lactation inhibits the potentiating effect of galanin upon the GnRH-induced LH release observed in diestrous-1 rat.

Recent demonstrations of no changes in hypothalamic gonadotropin releasing hormone (GnRH) gene expression and GnRH levels detected at the pituitary gland in diestrous and lactating rats, indicate that lactational hypogonadotropism in this species is not associated with inhibition of hypothalamic GnRH synthesis and secretion. Hypothalamic galanin potentiates GnRH effects on luteinizing hormone (LH) secretion in male and cycling rats. To explore the interaction between GnRH and galanin during lactation, we studied in vitro the effects of pulsatile stimulation with those peptides upon LH synthesis and secretion from rat pituitaries on diestrous 1 or day 10 of lactation. Hemipituitaries were separately incubated in 1 ml Dulbecco's Minimal Essential Medium supplemented with 1% penicillin-streptomycin and fetal calf serum, at 37 degrees C in 5% CO2-air. The hemipituitaries were stimulated during 12 h with hourly pulses, 6 min each, of (a) gonadotropin releasing hormone (GnRH 25 ng/pulse), (b) rat galanin (600 ng/pulse), (c) GnRH plus galanin, or (d) saline. Medium was collected before each pulse to determine LH by radioimmunoassay. After the 12 h pulsatile regime total RNA was extracted and both actin and beta-LH mRNA were determined by reverse transcriptase polymerase chain reaction. There was a significant stimulation of LH secretion by GnRH (ANOVA, p < 0.001) without significant differences between diestrous and lactation pituitaries. Galanin alone did not modify LH secretion but it potentiated the effect of GnRH upon pituitaries from diestrous (p = 0.036) but not lactating rats. Neither peptide alone or its combination modified pituitary beta-LH mRNA levels. Results show that galanin regulates differently the secretion and synthesis of LH at the pituitary level. The disappearance of galanin-induced potentiation of GnRH effects upon LH secretion during lactation might contribute to the hypogonadotropism of lactation in the rat.

Animals↗

PubMed1997

[Changes in the pattern of opioid analgesic consumption in Spain].

BACKGROUND: Data from different sources have proved an infrautilization of opioid analgesics in Spain. A descriptive study has been conducted in order to know the utilization of these drugs and changes in the pattern of use in the last few years. MATERIAL AND METHOD: To know the consume of narcotic analgesic drugs, N02A group of the Anatomic Therapeutic Classification, a search was developed in the ECOM database from the Spanish Ministry of Health. This database contains information of drug preparations prescribed throughout the National Health Care System. RESULTS: The consumption of opioid analgesics in Spain has been multiplied by 5.2 during this period. It has increased from 94.7 defined daily dose per 1,000,000 inhabitants in 1985 to 489.4 in 1994. The most consumed drug in 1994 was dihydrocodeine, followed by tramadol. The number of defined daily dose per inhabitant and day of parenteral administration have decreased during the last years. CONCLUSIONS: Availability of new analgesic opioid drugs with better pharmacokinetic profiles has contributed to an increase of their consume in Spain.

Administration, Oral↗