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Biomedical subjects

F Santolaria

Publications and source records attributed to F Santolaria.

At least 19 recordsLinked to original sources
PubMed2001

Prognostic value of cytokines in SIRS general medical patients.

We studied 174 patients with SIRS criteria, 45 with sepsis, eight with severe sepsis and 13 with septic shock. Serum TNF-alpha, IL-6, IL-8 and IL-10 levels were raised in SIRS patients, even in those cases in which an infection could not be documented, and more intensely in severe sepsis and in patients who died (11%). The slope of the regression line between IL-10 and TNF-alpha was sharper in patients with severe sepsis and in those who died; an imbalance between pro- and anti-inflammatory cytokines may be related to poor prognosis. Increased IL-6 and IL-10, decreased muscle mass, raised BUN and low body temperature were all independently related to prognosis.

Age Factors↗
PubMed2001

High prevalence of hyperhomocysteinemia in chronic alcoholism: the importance of the thermolabile form of the enzyme methylenetetrahydrofolate reductase (MTHFR).

Alcoholism is related to malnutrition and low levels of several vitamins that take part in the metabolism of homocysteine. The objective of the study was to analyze the prevalence of hyperhomocysteinemia in patients with heavy alcohol intake and the factors on which it depends. Included in the study were 103 hospitalized heavy drinkers (i.e., patients with an intake of alcohol greater than 80 g per day). Serum homocysteine, folate, and vitamin B(12) levels, plasma vitamin B(6) levels, and CT677 polymorphisms of methylenetetrahydrofolate reductase (MTHFR) were determined. We also recorded the intensity of alcoholism, the status of nutrition, and the existence of liver cirrhosis. Determination of biochemical data was repeated after 15 days of withdrawal. Serum homocysteine levels were found to be significantly elevated, whereas serum folate and plasma B(6) levels were significantly decreased. Serum homocysteine levels were significantly higher in those heavy drinkers who showed the TT polymorphism of MTHFR, with a prevalence of hyperhomocysteinemia of 84.2% in the homozygote TT, 54.3% in the heterozygote CT, and 31.6% in the normal CC genotype. Serum homocysteine inversely correlated with serum folate, serum B(12), and plasma B(6) levels. We did not find any relation between serum homocysteine and intensity of alcoholism, nutritional status, or liver cirrhosis. Serum folate levels were significantly decreased in heavy drinkers, mainly depending on irregular feeding and malnutrition. After 15 days of withdrawal, serum homocysteine levels significantly decreased, whereas folate, B(12), and B(6) levels significantly increased. The conclusion is that heavy drinkers show a high prevalence of hyperhomocysteinemia related to low levels of folate, B(6), and B(12) and to the TT polymorphism of MTHFR.

Adult↗
PubMed2000

Nutritional assessment in alcoholic patients. Its relationship with alcoholic intake, feeding habits, organic complications and social problems.

To establish their ability to predict malnutrition, irregular feeding, alcoholic intake, derangement of social and familial links and organic complications (liver cirrhosis) were assessed in 181 hospitalized male alcoholic. BMI was under 18.5 kg/m(2) in 8.9%, between 18.5-20 kg/m(2) in 8.9%, 20-25 kg/m(2) in 42%, 25-30 kg/m(2) in 32.2% and over 30 kg/m(2) in 8.2% of patients. Malnutrition was related to the intensity of ethanol intake, development of social or familial problems, irregularity of feeding habits and cirrhosis with ascites. Irregularity of feeding habits was also related to heavy drinking and to social or familial derangement. By logistic regression analysis, the only variables which independently predict malnutrition were irregular feeding habits and liver cirrhosis with ascites. In a second step, irregular feeding was dependent on social or familial troubles and daily intake of ethanol. So, malnutrition related to alcoholism seems multifactorial in its pathogenesis.

Adult↗
PubMed2000

Osteopenia assessed by body composition analysis is related to malnutrition in alcoholic patients.

Osteopenia is frequent among alcoholics. Its pathogenesis seems to be multifactorial, including ethanol intake, hormonal changes, liver cirrhosis, and malnutrition. Our objective is to determine the relative role of malnutrition on bone loss. One hundred and eighty-one male alcoholic patients, drinkers of more than 80 g ethanol/day, were included, recording data on the intensity of alcoholism, liver cirrhosis, nutritional assessment based on feeding habits, body mass index (BMI), midarm anthropometrics, subjective nutritional assessment, lean and fat mass by dual energy X-ray absorptiometry (DEXA), serum proteins and insulin growth factor Type I (IGF-I), calcitropic hormones, parathyroid hormone (PTH), osteocalcin 25OHD3, and bone mass assessed by DEXA, which was also performed in 43 healthy controls. Alcoholics showed decreased serum osteocalcin, PTH, 25OHD3, IGF-I, and bone mass. Alcoholics were frequently malnourished with decreased BMI, lean, and fat mass. The loss of bone mass was not related to the alteration of calcitropic hormones, to the intensity of alcoholism, or to the existence of liver cirrhosis, but to malnutrition. For a similar BMI, bone loss was more intense in alcoholics than in controls, especially in those with irregular feeding habits. Although cross-sectional ones, our data suggest that alcoholic osteopenia may be interpreted as a form of nutritional osteoporosis, notwithstanding the influence of other factors.

Absorptiometry, Photon↗
PubMed2000

Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD.

STUDY OBJECTIVES: To determine the 1-year efficacy of noninvasive positive pressure ventilation (NPPV) added to long-term oxygen therapy (LTOT) in patients with stable severe COPD. PATIENT SELECTION AND METHODS: We prospectively randomized 52 patients with severe COPD (FEV(1) < 45%) to either NPPV plus "standard care" (96% patients with LTOT) or to standard care alone (93% patients with LTOT). The outcomes measured included the following: rate of acute COPD exacerbations; hospital admissions; intubations; and mortality at 3 months, 6 months, and 12 months. The patients were also evaluated at 3 months and 6 months for dyspnea using the Medical Research Council and Borg scales, gas exchange, hematocrit, pulmonary function, cardiac function with echocardiogram, and neuropsychological performance. RESULTS: One-year survival was similar in both groups (78%). The number of acute exacerbations was similar at all time points in patients receiving NPPV, compared with control subjects. The number of hospital admissions was decreased at 3 months in the NPPV group (5% vs 15% of patients, p < 0.05), but this difference was not seen at 6 months (18% vs 19%, respectively). The only beneficial differences were observed in the Borg dyspnea rating, which dropped from 6 to 5 (p < 0.039), and in one of the neuropsychological tests (psychomotor coordination) for the NPPV group at 6 months. CONCLUSIONS: Our study indicates that over 1 year, NPPV does not affect the natural course of the disease and is of marginal benefit in outpatients with severe COPD who are in stable condition.

Acute Disease↗
PubMed1999

Cytokine levels (IL-6 and IFN-gamma), acute phase response and nutritional status as prognostic factors in lung cancer.

Raised serum levels of interleukin 6 (IL-6) have been described in cancer patients. This cytokine mediates the acute phase response and has been also involved in the pathogenesis of cancer cachexia. The objectives of the present study were: (1) to determine the relationships of IL-6 and other cytokines with neoplasia extension, acute phase response and nutritional status, in lung cancer patients; and (2) to establish the prognostic value of serum cytokine levels. A prospective study in which IL-1, IL-2, IL-6, tumour necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) have been determined in 66 newly diagnosed lung cancer patients. Nutritional status was assessed objectively. Serum levels of growth hormone (GH), insulin growth factor 1 (IGF-1) and acute phase reactants as C Reactive Protein, alpha1 antitrypsin and ferritine, were determined. Increased IL-6 levels were related to extensive disease, impaired performance status, enhanced acute phase response and malnutrition. Raised serum IL-6 levels, extensive disease, low Karnofsky index, malnutrition, acute phase response and low IFN-gamma were all related to a shorter survival. When assessed by a multivariate analysis, IL-6 kept its independent prognostic value together with age, disease extension, and decreased IFN-gamma serum levels.IL-6 is increased in lung cancer patients, enhances the acute phase response in them, and is correlated with poor nutritional status, impaired performance status and shorter survival.

Acute-Phase Reaction↗
PubMed1995

Effects of alcohol and liver cirrhosis on the GH-IGF-I axis.

Decreased serum insulin-like growth factor (IGF-I) levels have been shown in malnutrition and liver diseases. To analyse which of them is the main cause of GH-IGF-I axis alterations, serum levels of growth hormone (GH), growth-hormone releasing factor (GHRH), IGF-I and its binding protein IGFBP-3 were measured in 85 hospitalized alcoholics (51 without cirrhosis, 15 with compensated cirrhosis and 19 with cirrhosis with ascites) and in 25 healthy controls. Liver function tests and objective nutritional assessment were also performed. Serum IGF-I and IGFBP-3 levels were lower in alcoholics, particularly in those with liver cirrhosis. Serum GH was raised in cirrhotics with ascites but GHRH levels were not significantly altered. Although these patients were frequently malnourished there was no relationship between data derived from GH-IGF-I axis and nutritional parameters. However, there was a significant positive correlation between serum GH concentrations and impaired liver function and a significant negative correlation between serum IGF-I and IGFBP-3 and impaired liver function. This suggests that, in this population, serum IGF-I and IGFBP-3 levels reflect liver dysfunction rather than malnutrition.

Adult↗
PubMed1992

Relative and combined roles of ethanol and protein malnutrition on skeletal muscle.

The aim of the present study is to analyse the relative and combined effect of ethanol and protein malnutrition on muscle changes in ethanol-fed rats. The study was performed in 32 animals divided into four groups, fed with the Lieber-DeCarli control, 36% ethanol, 2% protein, and 36% ethanol/2% protein-containing diets, respectively. Right gastrocnemius muscle was removed two months later, and histochemical-morphometrically studied. Type IIb fibre atrophy was observed both in the alcoholic and protein-deficient animals. The combination of these factors led to a slightly more marked atrophy. Malnutrition led to a decrease in type I fibre diameter; ethanol caused an increase in their size; whereas concurrent administration of ethanol and a protein deficient diet led to type I fibre atrophy. The proportion of type IIb fibre decreased in the three experimental groups with respect to the control group, especially in the alcoholic, protein-deficient animals. Thus, malnutrition potentiates the effect of ethanol except for changes in type I fibre diameter, in which the effects are opposite.

Animals↗
PubMed1991

Alcoholic intake in a small rural village.

Eight hundred and eighteen (400 males and 418 females), randomly selected inhabitants of an economically depressed rural village in the south of Tenerife, have been analysed with respect to their daily alcoholic intake and its relationship to sex, age, marital status, educational and economical level, job, tobacco use and the CAGE and brief MAST tests. Five hundred and four (68.9%) consumed alcoholic beverages, while 254 (31.1%) were teetotal; 12.1% of the subjects aged more than 15 years (23.85% of the males and 1.4% of the females) consumed 'risk' amounts of alcoholic beverages (more than 80 g/day and 40 g/day respectively). Mean ethanol consumption was 37.9 +/- 2.1 g/day for the male sex and 3.9 +/- 0.6 g/day for the female. Maximum mean ethanol consumption (60.9 g/day) was observed among the males aged 55-64 years. The distribution of the population according to the amount of ethanol consumed fits into Lederman's curve, most of the individuals being consumers of small amounts of ethanol. Male sex, middle age, married status, unskilled job, low educational level, and tobacco use were all related to a higher ethanol consumption. CAGE and brief MAST tests detected only 40.5% and 47% respectively of the subjects with 'risk' levels of alcohol consumption.

Adolescent↗
PubMed1988

Evaluation of marrow cellularity in alcoholism and hepatic cirrhosis, by aspiration, biopsy and histomorphometric.

A study of bone marrow cell content was carried out in 23 non-cirrhotic alcoholics, 20 cirrhotic alcoholics and 19 cirrhotic non-alcoholics compared with a control group of 12 healthy subjects, by means of sternal aspiration and bone marrow biopsy with histomorphometric quantification of fat in the latter. Although in the three pathological groups the mean values of fat area were superior to those of the control group, the only statistical differences found were between non-alcoholic cirrhotic and control subjects. The differences disappeared under covariance analysis with age as the correcting factor, showing a correlation between age and bone marrow fat content. To conclude from the biopsy the bone marrow of the cirrhotic is not hypercellular, contrary to the so far accepted findings obtained through sternal aspiration. Moreover, between the subjective global cellularity evaluation by biopsy and aspiration there was an important disagreement in 23.8% and an absolute agreement only 28.6% of cases. The non-existence of a linear correlation between fat content in bone marrow and liver, suggests that the two phenomena do not develop simultaneously.

Adult↗
PubMed1975

[Emergencies in internal medicine. General management in coma situations].

One of the most important aspects of the Emergency Medicine is the coma status as much as intra and extrahospitalary ambient. The interest of om study is based according the hardness of anamnesis, and the severity of symptoms induced by a altered conscience and by the need of a emergency therapy. This work summarized the general semiology of the patient in order to diagnostic, severity and etiology of the coma. The general behaviour therapeutic and some criterions about an irreversibility is also studied.

Coma↗