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Biomedical subjects

J Soler

Publications and source records attributed to J Soler.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Familial hypocalciuric hypercalcemia. Report of a new family.

We report a new family with familial hypocalciuric hypercalcemia (FHH) composed by 55 living members. Of 38 studied, 10 have been found to be affected by FHH. Differences between FHH and primary hyperparathyroidism are emphasized; lack of clinical features, relative hypocalciuria for the concomitant hypercalcemia and low phosphate excretion index. The PTH and urinary cAMP are normal. It is noteworthy that the disease is benign. None of our patients have undergone surgery, and all of them are asymptomatic.

Adult↗
PubMedDate not supplied

Trichothiodystrophy associated with urologic malformation and primary hypercalciuria.

Trichothiodystrophy (TTD) is a hair abnormality that may be associated with a large number of alterations affecting the skin phenotype and skin appendages, nervous system, eyes, bones, and immune, gonadal, and endocrine systems. We report the first case of TTD associated with a urologic malformation and primary hypercalciuria. Our patient had congenital ichthyosis, physical and mental retardation, and a dysmorphic facies associated with a complex urologic malformation and primary hypercalciuria. Characteristic features of his hair under microscopic examination (trichoschisis, alternating light and dark bands under polarizing microscopy, and a severely defective cuticle) and low sulfur content by radiographic microanalysis confirmed the diagnosis. We discuss the meaning of this new association in the spectrum of abnormalities related to TTD.

Abnormalities, Multiple↗
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Optimal insulin treatment in syngeneic islet transplantation.

Insulin-induced normoglycemia has shown to have a beneficial effect on the outcome of pancreatic islets transplanted to diabetic recipients. The aim of the study was to identify the insulin treatment that can maximize its beneficial effect on islet transplants. Six groups of streptozotocin diabetic C57Bl/6 mice were transplanted (Tx) with 100 syngeneic islets, an insufficient beta cell mass to restore normoglycemia, and were treated with insulin as follows: group 1 (n = 9): from day 10 before Tx to day 14 after Tx; group 2 (n = 11): from day 6 before Tx to Tx day; group 3 (n = 11): from Tx day to day 6 after Tx; group 4 (n = 7): from Tx day to day 14 after Tx; group 5 (n = 8): from day 10 to day 24 after Tx; group 6 (n = 18): Tx mice were not treated with insulin. Sixty days after Tx, normoglycemia was achieved in 100% of mice in groups 1, 4, and 5, in 73% of mice in group 2, and in only 45% and 33% of mice in groups 3 and 6, respectively (p < 0.01). Intraperitoneal glucose tolerance, determined only in normoglycemic mice, was similar in groups 1, 2, 4, and normal controls. In contrast, normoglycemic mice from groups 3, 5, and 6, exposed to more severe and prolonged hyperglycemia after Tx, showed higher glucose values after glucose injection, suggesting that hyperglycemia had a long-lasting deleterious effect on transplanted beta cell function. The initially transplanted beta cell mass was maintained in the grafts of normoglycemic mice, but was severely reduced in hyperglycemic mice. Transplanted beta cell mass was similar in normoglycemic groups with normal or impaired glucose tolerance, indicating that impaired glucose tolerance was not due to reduced beta cell mass. In summary, the beneficial effect of insulin-induced normoglycemia on transplanted islets was maximal when insulin treatment was maintained the initial 14 days after transplantation. Exposure to sustained hyperglycemia initially after transplantation had a long-lasting deleterious effect on transplanted islets.

Animals↗
PubMedDate not supplied

[Olanzapine and cognitive-behavioural group therapy in borderline personality disorder].

INTRODUCTION: Borderline Personality Disorder (BPD) is considered one of the most difficult psychiatric conditions to treat, neither psychological nor pharmacological treatments have been shown to be particularly effective. We present a proposal for the treatment of patients diagnosed with BPD which uses an atypical neuroleptic, olanzapine, and cognitive-behavioural group therapy aimed at dealing with the following problems: Interpersonal Conflict, Affective Instability, Impulsiveness, and Confused Identity. METHODS: Six patients diagnosed with BPD using the International Personality Disorder Evaluation (IPDE) were treated during 6 months with olanzapine (at dosages of 5-20mg/day) and dialectical behaviour therapy, with weekly 2-hour sessions. RESULTS: All of these patients followed the programme during the first 2 months, and 3 of the 6 completed it, showing an improvement in their behavioural disorder, as indicated by a decrease in parasuicidal episodes (i.e. suicide attempts and self-mutilative acts) and fewer visits to the emergency department. One of the patients dropped out due to side effects. DISCUSSION: The possibility of using a combined therapeutic approach enables us to project controlled clinical trials over a longer period of time, thus making it possible to assess behavioural changes which are difficult to observe in conventional clinical trials.

Adult↗
PubMedDate not supplied

[Clinical evaluation of glipizide. Results of a multicentric study in Spain].

In this study, with the evaluation of 621 diabetics under treatment, it is shown that glipizide is a potent oral sulfonilurea which controlled satisfactorily the blood sugar levels in 83,5% of diabetics without previous treatment, 67% of the cases with positive response to previous anti-diabetic therapy and 51,3% of the patients that had not responded to previous treatments. The most frecuently used dosage was 5 mg daily, with a minimum of 2,5 mg and a maximum of 30 mg. Tolerance and safety observed was excellent.

Administration, Oral↗
PubMedDate not supplied

[Validation of a Spanish version of the Diagnostic Interview for Bordelines-Revised (DIB-R)].

INTRODUCTION: Borderline Personality Disorder (BPD) is the most studied Axis II disorders. However, there are no Spanish versions of specific interviews. The Diagnostic Interview for Borderlines-Revised (DIB-R) is a semistructured interview used to determine the diagnosis and severity of BPD patients. The aim of this study was to validate the DIB-R for use in a Spanish-speaking sample. METHOD: The psychometric characteristics of the DIB-R Spanish version were assessed in a sample of 156 patients with the possible diagnosis of borderline personality disorder. There were 29 men and 127 women with a mean age of 27.6 years (SD: 6.5; range: 18-45). The Spanish adaptation of the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) was used as gold standard. RESULTS: The DIB-R showed good total internal consistency (Cronbach's alpha: 0.89) and high inter-rater reliability (within-class correlation: 0.94). Using logistic regression analyses the best cut-off was judged to be 6 or more, obtaining high sensitivity (0.81), specificity (0.94) and moderate convergent validity of the diagnosis with the SCID-II (kappa: 0.59). CONCLUSIONS: The Spanish version of the DIB-R showed psychometric characteristics similar to those in the original interview and may be useful to determine BPD presence and severity.

Adolescent↗
PubMedDate not supplied

Age, sex and ICA influence on beta-cell secretion during the first year after the diagnosis of type 1 diabetes mellitus.

We studied the independent influence of sex, age and islet-cell antibodies (ICA) on residual beta-cell secretion and metabolic control during the first year after the diagnosis of type 1 diabetes mellitus in 40 consecutive newly diagnosed patients. Glucagon-stimulated C-peptide secretion was measured after 5-10 days and 3, 6 and 12 months of diagnosis. ICA (JDF units) and complement-fixing ICA (CF-ICA) were determined at diagnosis and after 12 months. The influence of sex, age and ICA was analyzed in a multivariate analysis of variance of 3 factors (age, sex and ICA) for repeated measures over time. ICA and CF-ICA were positive in 75.0% and 35.0% of patients at diagnosis and in 48.7% and 20.5% of patients one year later. Persistence of ICA positivity was higher in females (p. less than 0.001) and in CF-ICA+ patients (p less than 0.01), but did not involve a different evolution of C-peptide secretion. Males had a lower C-peptide secretion than females (p = 0.023) during the first year after the diagnosis of type 1 diabetes, independently of the age and ICA status of the patients. Adult patients (greater than or equal to 18 years-old) had lower HbA1 values than younger patients (p = 0.006) and ICA+ patients with a moderate or high value (greater than 10 JDF units) had a lower C-peptide secretion over time (p = 0.031 at 6 months, p = 0.067 at 12 months) and higher HbA1 values (p = 0.056) than younger patients. HbA1 was significantly explained by ICA and C-peptide values in a stepwise multiple regression analysis (p = 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

The influence of insulin antibodies on metabolic deterioration after interruption of continuous subcutaneous insulin infusion.

To evaluate the influence of insulin antibodies (IA) on metabolic deterioration after interruption of continuous subcutaneous insulin infusion (CSII), we studied two groups of type I diabetic patients without residual insulin secretion: group 1 (5 patients) with insulin-binding antibodies below 10% and group 2 (8 patients) with insulin-binding antibodies above 10%. We investigated the changes in blood glucose, plasma non-esterified fatty acids (NEFA), bicarbonate and glucagon after stopping insulin infusion between 08.00 h. and 14.00 h. Insulin infusion cessation resulted in: 1) a similar increase in blood glucose in both groups after 2 hours of interruption (group 1: 9.45 +/- 1.28 mmol/L versus basal levels of 6.94 +/- 0.96 mmol/L, p less than 0.05; group 2: 8.11 +/- 2.87 mmol/L versus 5.75 +/- 2.17 mmol/L, p less than 0.02) and a greater increase in blood glucose in group 1 than group 2 after 4 hours (p less than 0.05) and after 6 hours (p less than 0.05); 2) a progressive increase in NEFA in group 1 throughout the study period (08.00 h.: 0.51 +/- 0.28 mmol/L; 14.00 h: 1.44 +/- 0.45 mmol/L, p less than 0.05) that was significant after 4 and 6 hours of CSII interruption; there were no changes in NEFA in group 2; 3) plasma level of IA correlated inversely with final glycemia (r = -0.67, p less than 0.01) and final NEFA (r = -0.56, p = 0.02). We conclude that IA may play a role in slowing metabolic deterioration after CSII interruption.

Adult↗
PubMedDate not supplied

[Generalized scleroderma and angioaccesses for hemodialysis].

Considering the manifold difficulties present in renal insufficiency: economical as much as those created by reinterventions in order to keep the angioacceses viable, the use of Quinton's double lumen catheter is proposed in generalized scleroderma, obliteration of several angioaccesses, absence of distal bed in left upper limb, and dry skin in a patient with chronic renal insufficiency.

Catheterization, Central Venous↗
PubMedDate not supplied

Allogeneic stem cell transplantation for advanced low-grade lymphoproliferative disorders: report of six cases.

BACKGROUND: Allogeneic stem cell transplantation is being increasingly used to treat young patients with poor-prognosis low-grade lymphoproliferative disorders. We report our single-center experience. PATIENTS AND METHODS: Six adults (four with advanced chronic lymphocytic leukemia, one follicular center cell lymphoma and one mantle cell lymphoma) underwent allogeneic stem cell transplantation (SCT). Five received bone marrow while one received peripheral blood stem cells. Donors were HLA-identical siblings in five cases and an HLA-haploidentical sibling in one. The conditioning regimen included in five cases cyclophosphamide, TB1 and high-dose chlorambucil, without the latter in the patient with follicular lymphoma. RESULTS: Five patients successfully engrafted, while the patient who received the haploidentical marrow suffered primary graft failure. There were two cases of grade 2 acute GVHD and one limited chronic GVHD. Four patients are alive in complete remission (CR) with a follow-up of 17+ to 118+ months. Additionally, there is no evidence of residual disease by immunologic and molecular techniques in three cases, while one patient has residual disease assessed by molecular methods. CONCLUSIONS: These results suggest that allogeneic SCT can achieve prolonged remissions in advanced chronic lymphoproliferative disorders.

Adult↗