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Biomedical subjects

J Sancho

Publications and source records attributed to J Sancho.

At least 199 records · Page 11Linked to original sources
PubMed1975

Suppression of plasma renin and plasma aldosterone during water immersion in normal man.

Previous studies from this laboratory have demonstrated that the redistribution of blood volume and concomitant relative central hypervolemia induced by water immersion to the neck (NI) results in a significant natriuresis which is quantitative identical to that induced by the acute administration of 2 liters of saline. Since the central hypervolemia induced by NI occurs without concomitant alterations in serum sodium and potassium concentration, the NI model was utilized to assess the role of volume in the regulation of both plasma renin (PRA) and plasma aldosterone (PA) in man. Nine normal subjects were studied on two occasions while in balance on a 10 meq Na, 100 meq K diet; Control and NI. The conditions of seated posture and time of day were identical. Blood for PRA and PA was obtained at 30-min intervals for 6 h. NI produced a profound suppression of PRA as early as 30 min with maximal suppression (62%) by 180 min (P less than 0.001). Recovery from NI was associated with a prompt return to pre-study levels. The changes in PA paralleled those of PRA with regard to both the rapidity and magnitude of the suppression (r = 0.993: P less than 0.001). These data emphasize the importance of central volume per se as a primary determinant of PRA and PA regulation in normal man. Furthermore, the current studies confirm the importance of the renin-angiotensin axis in the control of volume-related changes in PA in normal man. The ability of NI to induce a prompt and parallel suppression of PRA and PA without concomitant alterations in plasma composition, suggests that NI may be a preferred investigative tool for assessing the effects of volume expansion on renin-aldosterone.

Adult↗
PubMed1975

The role of the renin--angiotensin--aldosterone system in cardiovascular homeostasis in normal man.

1. To examine the role of angiotensin II in the maintenance of blood pressure and control of aldosterone secretion, eight normal human subjects were studied on a tilt table in sodium-replete and sodium-depleted states, before and after the administration of an angiotensin converting-enzyme inhibitor (CEI). 2. Administration of CEI was followed by a marked fall in blood pressure on tilting in sodium-depleted, but not in sodium-replete, subjects. CEI administration also resulted in a rise in plasma renin activity in the supine position, in the absence of haemodynamic change. The rise in plasma aldosterone observed both in response to tilting and sodium depletion did not occur after CEI, even though plasma renin activities were higher. 3. These results indicate that: (a) angiotensin II is essential for blood pressure control in the sodium-depleted individual; (b) angiotensin II exerts direct feedback control on renin secretion; (c) angiotensin II is the primary stimulus to aldosterone secretion in response to both sodium depletion and posture.

Adult↗
PubMedDate not supplied

[The validity of the classification criteria of the International Headache Society for migraine, episodic tension headache and chronic tension headache].

INTRODUCTION: We analysed the value of the diagnostic criteria of the International Headache Society (IHS) for the classification of the primary headaches in a headache clinic. PATIENTS AND METHODS: The IHS criteria were applied to classify 208 headaches in 194 patients. Forty-two had migraine, 18 tension type headache and 76 chronic daily headaches (CDH). RESULTS: The value of IHS criteria in order to distinguish migraine from tension type headache have a specificity of 94% and a predictive positive value of 99%. The predictive negative value is 63%. The more specific symptoms for migraine were severity, photophobia, phonofobia and vomits. IHS criteria for chronic tension type headache have a very low sensibility; only the 45% of these headaches meet criteria. If we applied the criteria of Silberstein et al we can see that, without the patient history, symptoms don't distinguish between chronic tension type headache, transformed migraine and new daily persistent headache. The most specific features for distinguishing the transformed migraine were worsening with activity, vomiting and pulsating. A 62% of the CDH have analgesic overuse. CONCLUSIONS: IHS criteria distinguish accurately between migraine and tension type headache. Symptoms do not differenciate the different kinds of CDH.

Chronic Disease↗
PubMedDate not supplied

[Reference values for the central motor conduction time and silent period obtained by the transcranial magnetic stimulation].

INTRODUCTION: Normal values of reference to transcranial magnetic stimulation for the motor central conduction time (CCT) and silent period (SP) is recorded in 30 healthy control subjects over abductor pollicis brevis. MATERIAL AND METHODS: We get for the CCT four measurements: two with low intensity of stimulus, 5% plus the motor threshold, with and without facilitation (CCT1 and CCT1 fac.); and two with high intensities of stimulus, elevating the magnetic stimulation intensity to 1.5 times the threshold (CCT2 and CCT2 fac.). RESULTS AND CONCLUSIONS: The mean and standard deviation of each measurement are: CCT1: 9.34 +/- 1.19, CCT1 fac.: 7.12 +/- 1.1. CCT2: 8.84 +/- 1.05 and CCT2 fac.: 6.57 +/- 1.05. Given that the CCT and SP doesn't follow a normal distribution, the medium and the 5-95% percentiles for the normal values of reference are calculated; there are: CCT1: 7.15-11.32, CCT1 fac: 5.27-9.42. CCT2: 7.05-10.73 and CCT2 fac: 4.91-9.14. For the silent period gets only one measurement employing high intensities. These last measurement were recorded in two localizations: on vertex and on motor area, selecting the greater duration. Given the great individual variability of this period in normal population absolute and ratio for the difference duration of SP between both sides are calculated. The latency of the SP is 50.2 +/- 5.99, 95 percentiles 39.1-64.63, the duration 151 +/- 32.51, 95 percentiles 102.63-239.55. The total SP measured from the discharge of the stimulus to the end of the silent period is 201.71 +/- 33.27; 95 percentiles: 151.39-296.4. The comparison of both hemispheres would give us pathological security for the 99.99% of the population for more than 14.94 ms of absolute difference, and for less of the 79.81% of ratio difference. A summary of the discoveries of the silent period in different pathologies is contributed in the discussion.

Adult↗
PubMedDate not supplied

[Vascular hemichorea: clinical-radiological correlation].

INTRODUCTION: Hemichorea is uncommon in acute cerebrovascular accidents. Its appearance is in relation to the contralateral involvement of the basal ganglia, particularly the striate ganglion. With current neuroimaging techniques it is possible to identify the lesions responsible for these abnormal movements. Magnetic resonance (MR) is the technique of choice for detection of small sized lesions. OBJECTIVE: We have analysed our series of patients to try to relate the site of the lesion to the appearance of chorea. PATIENTS AND METHODS: We made a retrospective study of the cases of hemichorea of vascular origin admitted between January 1993 and April 1999. In all cases, cerebral CAT and/or MR had been done to find the site of the lesion. RESULTS: A total of 10 patients with an average age of 72.5 years (range: 55-85) was found. In eight of them (80%) lesions were found in the basal ganglia, half of which were of ischemic type and the other half hemorrhagic. The sites were: caudate nucleus in one case (10%), thalamus in two cases (20%) and capsulo-lenticular lesions in five cases (50%). All lesions were contralateral to the side of the body affected except in one case with a left thalamic haematoma and homolateral hemichorea. CONCLUSIONS: The lesions found were very varied in site. In 20% of the cases they were not detected by conventional neuroimaging techniques. This fact supports the concept of a functional global network of the basal ganglia which may be interrupted at several points and lead to the same clinical findings.

Aged↗
PubMedDate not supplied

[Neonatal screening of glucose-6-phosphate dehydrogenase deficiency in umbilical cord blood].

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most frequent enzyme deficiency. It is a sex-linked genetic disease concerning mostly african, mediterranean and far-eastern populations. The main clinical expression is a hemolytic anemia which can be acute or chronic. During the neonatal period the disease may manifest as neonatal jaundice. We have been asked by the neonate department to set up a blood screening test for this deficiency. We have therefore developed a test using umbilical cord blood. The assay of G6PD has been automatised and red blood cell aspartate-amino-transferase (ASAT) chosen as a reference enzyme to evaluate the age of red blood cells. Normal values of G6PD, ASAT and G6PD/ASAT ratio have been calculated from 235 cord samples. Genetic frequency of this deficiency in 2002 was 6% in male and 1% in female newborns.

Acute Disease↗
PubMedDate not supplied

[Spontaneous non-hypertensive cerebral hematomas].

A retrospective study of 35 non-hypertensive intraparenchymal brain hematomas (NHBH) is made to evaluate their etiopathogenesis and the therapeutic approaches employed. A comparison is made with the hypertensive hematomas seen during the same period. Among the NHBH there were 5 vascular malformations (VM (14%), 5 hematomas secondary to brain tumors (14%), 2 amyloid angiopathies (6%), 2 cases of coagulation dysfunction (6%), 3 hematomas secondary to anticoagulation therapy (9%), and one hematoma in an intravenous drug abuser (3%). No etiological diagnosis was established in the remaining 17 cases (48%). The NHBH were predominantly lobar (43%), and incidence was greater among young patients. Mortality was 20%. All cases were diagnosed by brain CT, the latter suggesting pathology underlying the hematoma in 3 tumoral hematomas, in 2 VM confirmed arteriographically, and in one patient with suspect VM not confirmed by angiography. A total of 22 angiographies were performed: the latter were diagnostic in all VMs and negative in the tumor hematomas, amyloid angiopathies and in those hematomas of unknown etiology where angiography was performed. Fifteen patients were operated on. We recommend that in patients with brain hematomas but without antecedents of arterial hypertension or with an atypically situated hematoma, a careful examination should be carried out to discard all possible causes of brain hemorrhage, together with the early performing of contrasted CT scans and posterior angiography. If the latter prove negative, the patient should undergo a clinico-radiological follow-up, together with an histological study of the blood clot if operated on.

Adolescent↗
PubMedDate not supplied

[Congenital myopathy associated with cutis laxa].

Congenital myopathies have been described in association with systemic and skin anomalies but not with cutis laxa. De Barsey syndrome relates cutis laxa with neurological alterations and muscular hypotonia, but electromyographic nor muscular pathological studies have been made in previously reported cases. We report a case associating two major features: cutis laxa and congenital myopathy, both confirmed by biopsy. We propose the diagnosis of De Barsey syndrome in an incomplete form.

Adolescent↗