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Biomedical subjects

B Gil Extremera

Publications and source records attributed to B Gil Extremera.

At least 19 recordsLinked to original sources
PubMed2006

[Some reflections and findings of a Hypertension [corrected] Unit in Spain].

The Hypertension Unit, University Hospital San Cecilio of Granada, on fulfilling 15 years and after the experience acquired in this extended period, wants to stress various "facts": 1) the importance of correctly measuring blood pressure, avoiding rounding off "numbers" and making three consecutive measurements, taking the mean value of the last two; 2) carefully using the concept of "white coat" hypertension; the continuous follow-up of these cases and the use of ambulatory blood pressure monitoring reveal that they are really hypertensive; 3) using those values less than 130/85 mmHg as normality values; 4) the high rate of risk factors (obesity, diabetes, hyperuricemia, smoking, etc.) accompanying recently diagnosed hypertension; and 5) the need to give an intensive treatment in many cases (high doses, greater number of drugs, etc.). The experience of more than fifteen years and thousands of patients seen support the ideas included herein.

Hospital Departments↗
PubMed2002

[Study of 1,595 brucellosis cases in the Almeria province (1972-1998) based on epidemiological data from disease reporting].

OBJECTIVE: To know clinical, diagnostic, and treatment issues of brucellosis in the Almeria province. METHODS: Descriptive, epidemiological study from 1,595 disease report cards in the Almeria province during the 1972-1998 period. Issues concerning complications and treatment were reported in 890 cards (57.8%), symptoms, signs and hemograms in 565 (35.4%), and other diagnostic findings in all cards. The chi2 test was used to compare independent qualitative parameters for a 95% CI. RESULTS: In the early phase the most common symptom was asthenia (95.2%); sweating in the chronic stage (95.8%). The most commonly recorded sign was spleen enlargement (37.5%) and the most commonly reported complication was bone and joint involvement (22.8%). No changes in symptoms occurred over years. The hemogram revealed anemia in 30.3% of cases. Blood culture was positive for 91.2%. Regarding serological diagnosis, rose Bengal was positive for 99.2% of cases; the most common agglutination titer to Brucella or B. mellitensis was 1/640 (13.5%). The most commonly used therapy consisted of the association tetracycline plus streptomycin (42.4%). For 42.6% of cards, patients were transferred to hospital, particularly since 1984. CONCLUSIONS: Generally speaking, clinical data recorded in the reporting card regarding brucellosis disease reveal the clinical features of the disease, after a long surveillance period. Rose Bengal should be used as screening test for the diagnosis of this disease.

Brucellosis↗
PubMed2000

[Nocturnal arterial pressure and the cardiovascular risk factors in patients with arterial hypertension].

BACKGROUND: Blood pressure (BP) has a circadian rhythm. Most of the people presents a BP fall between 10-20% during nighttime hours (dipper condition). Measurement of these circadian variations is performed by continuous blood pressure ambulatory monitoring. We have studied the possible relation between blood pressure nocturnal fall and cardiovascular risk factors in hypertensive patients. METHODS: We selected 100 hypertensive patients from the Hypertension and Lipids Unit of San Cecilio University Hospital of Granada, Spain. They were divided into two groups: dippers group and non-dippers, depending of whether or not the fall of nocturnal systolic and diastolic BP was > 10%. All patients included in the study underwent complete clinical history, exhaustive physical examination, complementary examinations, urine and hematology tests, and continuous blood pressure ambulatory monitoring by the Space Labs system. RESULTS: The heart rate was found to be significantly higher (p = 0.0253) in the hypertensive dippers group than in the non-dippers. The latter showed higher plasma creatinine values (p = 0.0343) and lower potassemia values (p = 0.0140) than the dippers group. The dippers group presented concentrations of HDL-cholesterol significantly higher (p = 0.008) and diurnal diastolic BP values (p = 0.0211) also higher than the other group. CONCLUSIONS: Non dippers hypertensive patients present a higher number of cardiovascular risk factors as well as a higher tendency to renal lesions, and worse prognosis than the dippers group.

Adult↗
PubMed2000

[Zinc and chronic obstructive pulmonary disease].

BACKGROUND: To evaluate the zinc organic concentration in the chronic obstructive pulmonary disease (COPD) in relation to a control group. Also, to analyze if the serum zinc levels are related with zinc concentration in erythrocyte, nail and hair. PATIENTS AND METHODS: Forty patients of COPD have been studied, all males, average age 62 +/- 7 years and body mass index (BMI) of 27 +/- 4. Forty patients were included in the control group, with average age 57 +/- 9 years and BMI of 24 +/- 5. The patients with concomitant disease or booth treatment that could increase the zinc excretion were excluded. In all patients clinical history and examination, hematology and biochemistry tests, hepatic and lipid parameters, and nail, plasma, hair and erythrocyte zinc levels by atomic absorption spectrophotometry were done. Variance analysis and Pearson test were done. RESULTS: Blood, intraerythrocyte and nail zinc were similar in healthy subjects and patients; however, the median concentration of zinc in hair was significantly lower in patients (156 +/- 46 micrograms/g versus control group (185 +/- 64 micrograms/g) (p < 0.05). No differences were found between smokers and no smokers, and drinkers and no drinkers in relation with body concentration of zinc. CONCLUSION: The zinc concentration in hair can be a good method to evaluate the chronic deficiency in the human body. The COPD patients could be susceptible to develop zinc deficiency; the situation increases the possibility of infection diseases.

Alcohol Drinking↗
PubMed1999

[The behavior of atherogenic indices under the effect of growth hormone in postoperative disease].

OBJECTIVE: It has been studied the effect of the growth hormone (GH) in the atherogenic indexes, during the postoperative period in 28 patients, operated for digestive surgery. METHOD: Patients were divided in: I) control group, patients without treatment, and II) treatment group, patients treated with 8 U.I. of GH during five days after the intervention. RESULTS: Results show that, while in the control group the atherogenic values increased to pathologic levels, in the treatment group, these values stabilized in the physiological limits. CONCLUSIONS: Thus, these results let conclude to the beneficial antiatherogenic effect of growth hormone in the postoperative disease.

Adult↗
PubMed1998

[Clinical and sociological reflections before death].

The objective of this paper was to determine wether the clinical and sociological factors are implicated on the social rejection against the death. This is an inmutable phenomenon it is also changing and it has historicity. On the western countries it has become a peculiar phenomenon the dying patients and the death has shifted from home to hospital. Death on the hospital has been deshumaniced. Also, the physical and social death are differentiated and social and historical factors and social attitude changer are analyzed.

Adult↗
PubMed1997

[Risk factors in the elderly. A study of 143 patients].

UNLABELLED: Growing old is a process of natural diminish with decrease of biological answer to extrinsic and intrinsic factors and a bigger risk of presenting cardiovascular and metabolic processes. The aim of this study has been to analyse the incidence of cardiovascular factors in an aged population from Almería. PATIENTS AND METHODS: The group is by 172 patients (29 gave up); average global age 72.6 +/- 6.1 (85 women and 58 men). In all cases history and a whole clinic exam have been undertaken; general analytical study (glucose, creatinine, hepatic function cholesterol, HDL-c, LDL-c, trigliceride fibrinogen, microalbuminuria, etc.); blood pressure. STATISTICS: T Students, varianza analysis, Kolmogorov-Smirnov test. RESULTS: With regard to overweight, this was bigger in women (32.1 +/- 4.8 Kg/m2) in relation to men (27.9 +/- 4 Kg/m2). The most frequent risk factor has been hypertension (50.3%) followed by over weight-obesity (46.8%) and hypercholesterolemia (45.4%), only 11.2% did not present any risk factor; shile three factors appeared in 29.5%. Hypertension patients have more risk factors (increase of cholesterol and triglicerids, obesity, diabetes) than normotensive old patients; also diabetic patients have a bigger cardiovascular and lipid risk than non diabetic patients. The ingestion of estatinas or fibrates improves the lipid profile of old patients. In summarizing, conventional therapy can improve the cardiologic and metabolic situation, decreasing so the morbidity and mortality of old patients.

Aged↗
PubMed1997

Acute pancreatitis and microcrystals. Importance of the bile collection and biochemical parameters.

For a substantial number of patients with acute pancreatitis, no recognizable causes can be identified and such cases are called "idiopathic". With the introduction of duodenal bile collection for microscopic examination, it became possible to detect minor constituents of the bile, such as cholesterol and/or calcium bilirrubinate crystals. The mechanism by which crystals produce pancreatitis seems to be related to migration of aggregate crystals through the papilla, inducing papillary trauma or temporary impaction which can cause a biliopancreatic reflux. We now report a series of 45 patients with acute pancreatitis idiopathic, 120 with gallstones and 22 alcoholic. Of the patients with idiopathic pancreatitis whom we studied by biliary drainages, 22 were found to have abnormal drainages (MC+) (20 cholesterol crystals and 2 calcium bilirrubinate), 9 patients had more than 10 crystals per slide. The microcrystals positive (MC+) group had significantly higher values for AST (69.8 +/- 1.7) (mean +/- SEM), ALT (123.3 +/- 28.1), FA (252 +/- 28.1), G-GT (144.6 +/- 26.7) and BT (1.83 +/- 0.37) than the microcrystals negative group: AST (19.6 +/- 2.5), ALT (28.3 +/- 5.8), FA (170.5 +/- 15.1), G-GT (54.3 +/- 10.7) and BT (0.76 +/- 0.09). The more 10 crystals group had higher values (AST: 82.0 +/- 29.1, ALT: 143.1 +/- 43.5, FA: 294.8 +/- 57.2, G-GT: 171.8 +/- 38.4, BT: 2.61 +/- 0.82) than in the microcrystals negative group. We concluded that in the absence of other overt causes, the presence of crystals in bile of patients with pancreatitis justifies etiology. The number is not important.

Acute Disease↗
PubMed1996

[Lymphoblastic stimulation in cirrhotic and non-cirrhotic chronic alcoholics].

OBJECTIVE: To study whether there exists a functional change in lymphocytes in chronic alcoholic patients compared with chronic alcoholic cirrhotic patients. An open, prospective study was performed of the in vitro proliferative response (lymphoblastic transformation) of lymphocytes to phytohemagglutinin, mitogen pokeweed, and concanavalin A. PATIENTS: 73 males (51.4 +/- 12 years) divided on the basis of alcoholic intake and/or chronic liver disease in: social drinkers (< 80 g ethanol/day), 23; excessive drinkers (80-160 g ethanol/day), 14; chronic alcoholics (> 160 g ethanol/day), 21; and cirrhotic patients with no current alcohol consume, 15 cases. RESULTS: In social drinkers, excessive drinkers and cirrhotic patients similar proliferative responses to mitogens were observed, with no significant differences between groups. CONCLUSIONS: Our findings support the concept that chronic alcoholism has immunosuppressive effects which precede the emergence of liver cirrhosis.

Alcoholism↗
PubMed1995

[Does the diuretic effect of calcium inhibitors play an important role in the hypertensive efficacy?].

Calcium ions play an important role in the pathophysiology of hypertension. Calcium antagonists, a group of first line drugs in the treatment of hypertension, reduce the intracellular content of calcium in vascular smooth muscle cells, and decrease the peripheral vascular resistance and blood pressure. These drugs differ from other vasodilators in that they also have natriuretic effects; thus they can affect the kidney on three levels: Renal haemodynamics are affected by increased renal blood flow, and increased glomerular filtration rate. Changes in the renin-angiotensin system can decrease aldosterone secretion. Finally, they affect sodium management by acting directly on the renal tubule, increasing sodium excretion and inhibiting tubular reabsorption of this ion. The natriuretic effect of calcium antagonists is independent of the subject's sodium balance. The vasodilating action of these drugs is therefore accompanied by a natriuretic effect that makes satisfactory control of hypertension possible without placing the patient on a low-salt or salt-free diet.

Calcium↗
PubMed1993

Tumour necrosis factor, interleukin-1 and interleukin-6 in alcoholic cirrhosis.

The existence of a cellular immune deficit in alcoholic cirrhosis, and the alterations described in cytokine synthesis in this disease, led us to compare serum concentrations of tumour necrosis factor-alpha, interleukin-1 beta and interleukin-6 in a group of 33 patients with alcoholic cirrhosis (classified according to the Child-Pugh grade of severity of liver disease) and 43 healthy volunteers. Serum concentrations of tumour necrosis factor-alpha, interleukin-1 beta and interleukin-6 were significantly raised in alcoholic cirrhosis patients, with no significant differences between patients with liver disease of different grades of severity. The results suggest that cirrhosis involves the activation of the monocyte-macrophage system, which may contribute to the progression of the disease and its clinical manifestations.

Cytokines↗
PubMed1992

Metabolic and antihypertensive effects of nifedipine in hypertensive patients.

We studied the effects of nifedipine on blood pressure and on clinical and analytical parameters in hypertensive patients. Seven male and eight female subjects (mean age of 46.27 +/- 5.38 years, range of 41-56 years) with essential arterial hypertension were given nifedipine (20 mg b.i.d.) for 3 months. Before and after treatment, history, blood pressure, and biochemical values were recorded [blood: Na, K, Ca, creatinine, uric acid, triglycerides, cholesterol, HDL cholesterol, antidiuretic hormone (ADH), and aldosterone; urine: Na, K, Ca, creatinine, ADH, aldosterone, and percentage fraction of Na, K, and Ca excreted]. After 3 months of treatment, we found (a) significant decreases in systolic (147 +/- 18 vs. 166 +/- 16 mm Hg, p less than 0.001) and diastolic blood pressure (90 +/- 8 vs. 107 +/- 8 mm Hg, p less than 0.0007), triglycerides (107 +/- 47 vs. 120 +/- 49 mg/dl, p less than 0.0007), and cholesterol (236 +/- 4 vs. 257 +/- 44 mg/dl, p less than 0.00075) in blood, and in K excretion (50 +/- 19 vs. 46 +/- 19 mEq/g of creatinine, p less than 0.0007) and excreted fraction of K (49 +/- 6% vs. 8 +/- 5%, p less than 0.0012) in urine; (b) significant increases in HDL cholesterol (65 +/- 13 vs. 58 +/- 13 mg/dl, p less than 0.001) in blood, and in Na (115 +/- 73 vs. 109 +/- 69 mEq/g of creatinine, p less than 0.0007) in urine; and (c) no significant change in the remaining biochemical parameters, or in heart rate. Secondary effects included flushing (34%), headache (20%), ankle swelling (17%), dizziness (13%), palpitations (4%), and pruritus (4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[The quality of life and cancer].

Quality of life has been one of the main goals of medicine during the past years. With the increase of chronic degenerative diseases and the stability of the life expectancy at birth, we are beginning to think that it is not only important the number of years that we live, but as well the number of years that we live free of discapacities. On the other hand, the increase in the survival rate due to the advance of the biotechnology, as it happens with cancer, lead us to consider several psychosocial aspects neglected a few years ago.

Attitude to Health↗