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Biomedical subjects

D A de Luis

Publications and source records attributed to D A de Luis.

At least 19 recordsLinked to original sources
PubMed2002

Implications of estradiol and progesterone in pulmonary vasodilatation in cirrhotic patients.

The derangement of sex hormone serum levels in cirrhotic patients is well-delineated, and increased levels of progesterone and estradiol have been associated to hyperventilation in cirrhotic patients. These hormones have a well-known role in the regulation of vascular tone. The aim of this study was to evaluate whether sex hormone levels contribute to pulmonary vasodilatation (PV) and gas exchange abnormalities in cirrhosis. Contrast transesophageal echocardiography, arterial blood gases, parameters of liver function, pulmonary function test, estradiol and progesterone levels were determined in 45 male cirrhotic patients. Nineteen of 45 patients (42.2%) presented PV. Hyperventilation (pressure arterial of CO2< or =35 mmHg) was correlated to progesterone levels (p<0.05) and pressure arterial of CO2 was high in patients with PV (p<0.005) and Child class B and C (p<0.01). Hypoxemia (pressure arterial of O2<80 mmHg) had inverse correlation with progesterone (p<0.05) and estradiol (p<0.05) levels and pressure arterial of O2 was low in patients with Child class B and C (p<0.05). PV was present in patients with high estradiol levels (p<0.05), high progesterone levels (p<0.005) and Pugh class B and C (p<0.05). Logistic regression analysis identified progesterone as the sole independent factor associated to PV (p<0.0005). Multivariate linear regression showed that PV was the sole independent factor related to both pressure arterial of CO2 (p<0.05) and pressure arterial of O2 (p<0.01) levels. PV was independently associated to gas exchange abnormalities in cirrhosis. Progesterone and estradiol were related with PV in cirrhotic patients.

Carbon Dioxide↗
PubMed2002

Total homocysteine and cognitive deterioration in people with type 2 diabetes.

The aim of this study was to investigate the relationship between total homocysteine levels in people with Type 2 diabetes and cognitive status. Fifty patients from our diabetes unit (30 females/20 males) with diabetes were enrolled. All patients had fasting blood samples taken for measurement of cardiovascular risk factors; total cholesterol and triglyceride concentrations and other lipid fractions (lipoprotein (a), low density lipoprotein (LDL-cholesterol), high density lipoprotein (HDL-cholesterol)), glucose, HbA(1c) and homocysteine. 24-h urine collection was used to measure creatinine clearance and microalbuminuria. Vitamin B-12 and folate were measured to assess vitamin status. All diabetic patients were assessed for late complications and a Mini-Mental State Examination (MMSE) was performed. The patients were 64.6 (49-78) years old with body mass index (BMI) of 29.6 +/- 6.3 kg/m(2), and duration of diabetes of 8.9 +/- 6.7 years. A univariant correlation analysis was performed among cardiovascular risk factors and vitamins with total MMSE score. Total homocysteine was inverse by correlated with MMSE score (r=-0.38; P<0.05) of the other measures of cardiovascular risk, microalbuminuria showed an inverse correlation with MMSE score (r=-0.51:P<0.01). Lipoproteins, glucose control and vitamin status were not correlated MMSE score. In the multiple regression model only microalbuminuria remained in the model, showing a decrease of one point in the MMSE result with each milligram of microalbuminuria, adjusted for confounding factors. Cognitive status in type 2 diabetic was correlated with homocysteine levels and microalbuminuria, this last endothelial damage marker remaining as an independent risk factor of cognitive deterioration.

Aged↗
PubMed2002

Light symptoms following a high-dose intentional L-thyroxine ingestion treated with cholestyramine.

Adult exposure to L-thyroxine has a wide range of presentations: most adults either do not develop symptoms or only become minimally symptomatic. Appropriate treatments after exposure to L-thyroxine have yet to be established. A 26-year-old woman with a suicidal intention was witnessed to ingest approximately 50 L-thyroxine tablets, each containing 0.1 mg L-thyroxine (total dose 5 mg). Cholestyramine was administered (4 g every 8 h p.o.). Vital signs were monitored every 6 h and the hormone levels (L-thyroxine and thyroid-stimulating hormone) every 24 h. The thyroxine levels increased, and the thyroid-stimulating hormone levels decreased, with a normalization of the L-thyroxine level on postingestion day 6. Hypertension, dysrhythmias, and delusions did not appear in our patient. Only distal tremor and diaphoresis appeared on day 1 after ingestion. Cholestyramine has been used in cases of iatrogenic hyperthyroidism, in patients with Graves' disease, and in patients with digoxin intoxications, with good responses in all cases and a low incidence of side effects. This case illustrates the potential utility of cholestyramine to treat L-thyroxine intoxications.

Adult↗
PubMed2002

[Acromegaly, multinodular toxic goiter and papillary carcinoma of the thyroid, potential role of G proteins].

It is well known that non-toxic goiter is not uncommon in acromegaly, but hyperthyroidism only occasionally occurs. In addition, the risk for the development of a malignant process is increased, the most often seen is carcinoma of the colon. Thyroid carcinoma is not frequent, nevertheless the rate in these patients is higher than general population. In this article, a case of hyperthyroidism, papillar carcinoma and acromegaly is presented. We reviewed the literature an discussed the possible pathogenesis.

Acromegaly↗
PubMed2001

Effect of the treatment of Helicobacter pylori infection on gastric emptying and its influence on the glycaemic control in type 1 diabetes mellitus.

Helicobacter pylori (Hp) infection plays a role in gastric emptying (GE) in type 1 diabetic patients and may have implications for glycaemic control. The aim of our study was to investigate this relationship. Gastric emptying was studied in 13 patients with type 1 diabetes and Hp infection. The Hp infection status was assessed by serology and urease breath test (UBT). In addition upper gastrointestinal endoscopy with gastric mucosal biopsy was performed to look for gastritis. A radionuclide-labeled solid meal was used to study GE before and after eradication therapy (amoxicillin, clarithromycin and omeprazole) for Hp infection. All patients were evaluated for autonomic and peripheral neuropathy and were asked for symptoms of gastrointestinal motor dysfunction. Blood glucose levels were determined before the meal and at 30,60,90 and 120 min after the start of the meal. Home blood glucose self-monitoring and HbA(1c) were performed to document glycaemic control during the study. Three months after treatment, five patients were free of Hp infection and were without gastritis (group I: no Hp infection, no gastritis); eight of the patients continued to have gastritis after treatment (group II) and of these eight patients, six had gastritis without Hp infection and two had gastritis plus persistent Hp infection. These last two patients were re-treated with eradication therapy. Patients with gastritis were re-evaluated 6 months after initial treatment; at which time four were now free of gastritis and were added to group I (n=9) while four continual to have gastritis although without Hp infection (group II, n=4). In group I, GE half-time showed an increase (30.6+/-10.3 min vs. 60.2+/-15.4 min; P<0.05) while no change (28.8+/-9.5 vs. 26.9+/-8.7 min; n.s.) was observed in group II. GE half-time was not altered by autonomic and peripheral neuropathy or blood glucose during solid meal test. HbA(1c) did not change significantly after treatment in either groups but the blood glucose levels were more stable in group I compared to group II. A delay in GE was observed with disappearance of gastritis associated to H. pylori infection after eradication treatment in patients with type 1 diabetes. This change in GE could help to stabilise the blood glucose levels in these patients treated with insulin before each meal.

Adult↗
PubMed2001

[Anabolic steroids and gynecomastia. Review of the literature].

Gynaecomastia is a common situation, with a proliferation of glandular component of male breast secondary to an imbalance in sexual hormones in mammary tissue. A main cause of gynaecomastia is anabolic steroids consumption. Few studies have been performed in patients with high consumption of anabolic steroids, showing a high prevalence (52%). In this article we present a case of bilateral gynaecomastia secondary to anabolic steroids intake, with a partial response to tamoxifen. In summary, a patient with sportive habits and gynaecomastia, an early suspicious diagnosis is anabolic steroid intake. After suppression of anabolic steroid intake and treatment with tamoxifen, a high remission rate can be achieved. If gynaecomastia persisted, surgery is a good option.

Adult↗
PubMed2001

[Nutritional status in HIV infected patients].

OBJECTIVES: Nutritional assessment in HIV infected patients must be a main objective in the treatment of this disease. The main objective of our work was to study the nutritional status with biochemical and anthropometrical parameters in a group of HIV infected patients. MATERIAL AND METHODS: A total of 119 patients were evaluated. In all patients the next parameters were assessed: age, sex, treatment with anti-retroviral drugs, performed an anthropometric evaluation (weight, height, tricipital skinfold, arm circumference, arm muscular circumference and body mass index) and biochemical evaluation (albumin, prealbumin, transferrin, total proteins, triglycerides, cholesterol, lymphocytes and count of CD4). RESULTS: Patients had an average age 37.9 +/- 9.9 years, weight 64.5 +/- 13.2 kg and body mass index 22.5 +/- 3.5. The values of total proteins, albumin, prealbumin y transferrin were all normal, only patients with AIDS had low levels of transferrin (262.5 +/- 49.2 mg/dl vs 277.8 +/- 87.5; p < 0.05). Percentil distribution of anthropometric parameters showed a deep depletion in muscular protein compartment, 53.1% of patients had skinfold under P 50, 91.8% had arm circumference under P 50, and 91.8% arm muscular circumference under P 50. High levels of triglycerides were detected in 30.5%, these levels are related with the HIV phase and the number of antiretroviral drugs. CONCLUSION: Nutritional status in HIV infected patients is good in our population, only a deep depletion in muscular proteic compartment was detected. Transferrin was decreased in AIDS patients. High levels of triglycerides were secondary to the number of antiretroviral drug taking by patients.

Adult↗
PubMed1999

Improvement in lipid and haemostasis patterns after Helicobacter pylori infection eradication in type 1 diabetic patients.

Helicobacter pylori has been implicated in the cardiovascular risk of diabetic patients. The aim of our study was to investigate whether the Helicobacter pylori infection plays a role in the lipid and haemostasis patterns of type 1 diabetic patients. Twenty nine patients with type 1 diabetes mellitus and H. pylori infection were enrolled (Chlamydia pneumoniae negative). The H. pylori infection status was assessed by serology and urease breath test. In all patients levels of total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, lipoprotein (a) (Lpa) C reactive protein (CRP), fibrinogen, thrombin/antithrombin III complex (TAT), plasminogen activator inhibitor type 1(PAI-1), tissue plasminogen activator (t-PA) and von Willebrand antigen were measured. All patients were evaluated before and after H. pylori eradicating treatment with amoxicillin, clarithromycin and omeprazole. Twenty two patients were eradicated and seven remained infected. In H. pylori eradicated patients, HDL cholesterol increased (59.7+/-18.9 mg/dl vs 65.2+/-15. 9 mg/dl, P << 0.05), after treatment. After H. pylori eradication, the levels of CRP and TAT decreased (48+/-0.7 ng/l vs 3.3+/-0.4 ng/l;P << 0.05), (27.7+/-44.7 microg/ml vs 2.1+/-1.4 microg/ml, P << 0.05), respectively. The decrease in TAT was higher in the group of H. pylori (+) patients with higher levels of TAT (TAT >> 20 ng/ml, 92.8+/-41.6 ng/ml vs 1.9+/-2.0 ng/ml, P << 0.005; TAT 4Eth 20 ng/ml; 10.1+/-5.2 ng/ml vs 2.2+/-0.6 ng/ml, P << 0.05). These changes did not occur in patients without H. pylori eradication. Eradication of H. pylori infection in type 1 diabetic patients modifies some parameters of lipid and haemostasis patterns, (increase of HDL-cholesterol, reduction of Lpa and decrease of CRP and TAT) and so contributes to improvement of cardiovascular risk factors in these patients.

Adult↗
PubMed1999

Diagnosis of hepatopulmonary syndrome with contrast transesophageal echocardiography: advantages over contrast transthoracic echocardiography.

The aim of this study was to study the prevalence of hepatopulmonary syndrome (HPS) in cirrhotic patients, comparing the results obtained using contrast transthoracic echocardiography (CTTE) and contrast transesophageal echocardiography (CTEE) in the demonstration and grading of pulmonary vasodilatation (PV). We also analyzed the correlation between gas-exchange abnormalities and PV when it was demonstrated with both techniques. The prevalence of PV and HPS with CTEE in the 88 cirrhotic patients was 28% and 22%, respectively, and with CTEE, 42% (P < 0.05) (middle PV: 35% and significant PV: 7%) and 30% (P < 0.05), respectively. Fifty-six percent of patients diagnosed with PV and with CTTE presented with hypoxemia as did 49% using CTEE (83% of patients with significant PV had hypoxaemia). PaCO2 and diffusing capacity of CO were significantly more decreased in patients with PV than in patients without PV when CTEE was employed. We conclude that CTEE is superior to CTTE in the diagnosis and grading of PV in the diagnosis of HPS in cirrhotic patients, being more sensitive and presenting a better correlation with gas-exchange abnormalities. Given its high sensitivity, CTEE should be carried out in all patients with suspicion of HPS and normal or uncertain CTTE.

Aged↗
PubMed1998

Helicobacter pylori infection and insulin-dependent diabetes mellitus.

Helicobacter pylori is associated with different diseases: duodenal ulcer, rosacea, ischaemic heart disease and gastric cancer. Given the abnormal immunological response and the high prevalence of gastrointestinal symptoms in diabetic patients, we conducted a study on H. pylori prevalence among these patients. We designed a case control study of a population-based cohort. Eighty insulin-dependent diabetes mellitus (IDDM) patients with an average age (24.05 +/- 8.3 years), and 100 control subjects (25 +/- 7.1 years) were selected to verify the seroprevalence of Helicobacter pylori in these populations. One serum sample was obtained from each subject for evaluation of antibodies against Helicobacter pylori, parietal cells (APA) and pancreatic islets cells (ICA). The seroprevalence of H. pylori among IDDM patients aged less than 24 years was significantly higher than among control subjects; the corresponding rate among IDDM aged greater than 24 years was significantly lower than among control subjects. Antibodies against parietal cells (APA) and islet cells (ICA) among H. pylori positive diabetic patients were significantly higher than among H. pylori negative diabetic patients. IDDM patients were subdivided on the basis of the evolutive course of diabetes. Seroprevalence of H. pylori as well as prevalence of ICAs decreased with IDDM duration. Nevertheless, no variation in the prevalence of APAs during the course of diabetes was observed. We observed an association between the seroprevalence of Helicobacter pylori and the duration of IDDM. The seroprevalence of H. pylori and ICA decreased with the evolutive course of diabetes mellitus among IDDM. The prevalence of ICA and APA in IDDM H. pylori positive subjects was higher than among controls.

Adolescent↗