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Biomedical subjects

Javier Llorca

Publications and source records attributed to Javier Llorca.

At least 19 recordsLinked to original sources
PubMed2006

Weekday but not weekend alcohol consumption before pregnancy influences alcohol cessation during pregnancy.

BACKGROUND: Cantabria has the highest prevalence of alcohol consumption among women in Spain. Patterns of alcohol consumption before pregnancy were assessed as a determinant of alcohol cessation in pregnant women in Cantabria. METHODS: Survey on a random sample of women delivering for the period 1998-2002 (n = 1510). Information was obtained from personal interview (data on alcohol consumption), clinical charts and prenatal care records. Relative risks (RR) and 95% confidence intervals (CI) were estimated. Multivariable analyses were carried out using logistic regression. RESULTS: Nearly half (49.5%) of the women drank regularly before pregnancy and 22.7% during pregnancy. Sociodemographic variables favouring alcohol cessation were: high education level and smoking cessation, whereas high social class, advanced maternal age and employment outside of home decreased the rate of alcohol cessation. Cessation decreased with the amount of alcohol consumed on weekdays (P < 0.001), but not with intake during weekends only. In women with alcohol use only during weekends, only the consumption of spirits increased the rate of alcohol cessation (adjusted RR = 1.40, 95% CI: 1.13-1.60). Pre-pregnancy binge drinking (> or =4 drinks on one occasion) decreased alcohol cessation in pregnancy (adjusted RR = 0.66, 95% CI: 0.40-0.97). CONCLUSIONS: Drinking patterns influenced the rate of alcohol cessation: the heavier the alcohol consumption on weekdays, the lower the rate of alcohol cessation.

Adult↗
PubMed2006

Cardiovascular disease in rheumatoid arthritis.

Epidemiological studies have disclosed an increased mortality due to cardiovascular (CV) complications in patients with rheumatoid arthritis (RA). Patients with this disease have an increased risk of left ventricular diastolic dysfunction and congestive heart failure that is unrelated to the presence of traditional atherosclerosis risk factors or ischemic heart disease. Endothelial dysfunction, an early step in the atherogenesis process, is observed in both early and long-standing actively treated patients with RA. High-resolution B-mode ultrasound studies of the common carotid artery have shown the presence of subclinical atherosclerosis, manifested by increased carotid intima-media thickness and carotid plaques, in patients with RA. Association between HLA-DRB1*04 shared epitope alleles, in particular with HLA-DRB1*0404, and endothelial dysfunction and CV mortality has also been observed in these patients. Chronic inflammation plays a pivotal role in the mechanisms associated with atherogenesis in RA. Tumor necrosis factor (TNF)-alpha is a potent proinflammatory cytokine implicated in the initiation and progression of inflammation as well as in the mechanisms associated with accelerated atherosclerosis in this disease. Anti-TNF-alpha therapy has proved to be clinically effective in patients with severe RA. Recent studies have also emphasized the positive effect of anti-TNF-alpha blockade in improving endothelial dysfunction in RA patients. However, this effect seems to be transient and in line with the persistence of chronic inflammation.

Adalimumab↗
PubMed2006

No association between low density lipoprotein receptor genetic variants and Alzheimer's disease risk.

A number of studies suggest that brain cholesterol metabolism may play a role in Alzheimer's disease (AD) development, probably through modulation of amyloid beta production. The discovery that apolipoprotein E (APOE) epsilon4 allele is a risk factor for sporadic AD raises the possibility that the receptors to which APOE binds on the surface of neurons are also involved in the neurodegenerative process. To evaluate the relationship between low density lipoprotein receptor (LDLR) genetic variant and AD, independently or in concert with the APOE epsilon4 allele, we examined three LDLR polymorphisms located in exons 8 (rs 11669576), 10 (rs 5930), and 13 (rs 5925), in a large group of 322 Spanish AD patients and 314 controls. The current study does not demonstrate an association between LDLR genotypes or haplotypes and AD, neither in the total sample nor when the populations were stratified for the presence or absence of the APOE epsilon4 allele.

Aged↗
PubMed2006

Case-control study of vascular endothelial growth factor (VEGF) genetic variability in Alzheimer's disease.

Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis and blood vessel function. Recent evidence indicates that VEGF facilitates memory and learning through stimulating angiogenesis and neurogenesis in the rat hippocampal dendate gyrus. Abnormal regulation of VEGF expression has been reported in the pathogenesis of both atherosclerosis and motoneuron degeneration in amyotrophic lateral sclerosis, with low VEGF-producing polymorphisms (-2578 allele A and -634 allele G) conferring increased susceptibility for the development of the disorders. We tested whether these polymorphisms downregulating expression of VEGF might increase the risk of developing Alzheimer's disease (AD). So, we performed a case-control study in 362 Spanish AD patients and 428 healthy controls. The current study does not demonstrate an association between VEGF (-2578) and VEGF (-634) genotypes or haplotypes and AD.

Aged↗
PubMed2006

Lack of echocardiographic and Doppler abnormalities in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors.

OBJECTIVE: To assess the prevalence of echocardiographic and Doppler abnormalities in psoriatic arthritis (PsA) patients without clinically evident cardiovascular manifestations or classic atherosclerosis risk factors. METHODS: Fifty PsA patients were recruited from Hospital Xeral-Calde, Lugo, Spain. Patients seen during the period of recruitment that had classic cardiovascular risk factors or had suffered cardiovascular or cerebrovascular events were excluded. Fifty healthy matched controls were also studied. Echocardiographic and Doppler studies were performed in all cases and controls. RESULTS: In PsA patients the frequency of aortic and tricuspid (10%) and mitral regurgitation (16%) was not different from that seen in matched controls (10, 4, and 12%). Also, the pulmonary artery systolic pressure was normal in the group of PsA patients (23.4+/-3.9 mm Hg). The prevalence of diastolic dysfunction, in all cases due to impaired relaxation, was similar in PsA patients (28%) and controls (24%) (P=0.65). In addition, no significant echocardiographic and Doppler differences were observed when PsA patients with polyarticular pattern were compared with the remaining PsA patients. CONCLUSIONS: The present study shows that actively treated PsA patients without cardiovascular risk factors or clinically evident cardiovascular disease do not exhibit silent subclinical echocardiographic abnormalities.

Adult↗
PubMed2006

Association between glycogen synthase kinase-3beta genetic polymorphism and late-onset Alzheimer's disease.

Aberrant phosphorylated tau is the major component of the neurofibrillary tangles in Alzheimer's disease (AD) brains. Glycogen synthase kinase-3beta (GSK-3beta) phosphorylates tau protein, and increased GSK-3beta expression has been associated with neurofibrillary tangles. Saitohin (STH) is a recently identified protein that shares tissue expression pattern with tau, and previous evidence in the Spanish population indicated that a polymorphism at codon 7 (Q7R) of the STH gene was associated with late-onset AD. Since both GSK-3beta and STH are related to tau, we examined the association between a polymorphism in the promoter region (-50) of the GSK-3beta gene and AD, either through an independent effect or through interaction with the STH (Q7R) polymorphism, in a well-defined group of 333 sporadic AD patients and 307 control subjects from Spain. The current study reveals that GSK-3beta (-50) TT genotype is associated with an increased risk (OR 1.99, p = 0.003) for late-onset (after the age of 72 years) AD. Our results indicate that both the GSK-3beta (-50) and STH (Q7R) polymorphisms increase the risk of late-onset (subjects >72 years) AD, although they appear to be independent and thus not to interact synergistically.

Age Factors↗
PubMed2006

A practical clinical trial comparing haloperidol, risperidone, and olanzapine for the acute treatment of first-episode nonaffective psychosis.

OBJECTIVE: Randomized controlled drug trials have demonstrated that antipsychotic medication is effective to rapidly improve psychotic symptomatology in first-episode psychosis. However, these results may not be generalizable to routine clinical practice. We evaluated the effectiveness, tolerability, and safety of olanza-pine, risperidone, and haloperidol in individuals with first-episode nonaffective psychosis who are representative of clinical practice and who are treated in routine clinical settings. METHOD: 172 patients participated in a practical clinical trial and were randomly assigned to haloperidol (N = 56), risperidone (N = 61), and olanzapine (N = 55). The mean modal daily doses were 5.4 mg/day for halo-peridol, 4 mg/day for risperidone, and 15.3 mg/day for olanzapine; 98.3% of subjects were drug naive at baseline. Data from clinical measures of treatment response and tolerability and safety data from the 6-week acute phase of a large epidemiologic and longitudinal (February 2001 to February 2005) intervention program of first-episode psychosis (schizophrenia spectrum disorders, DSM-IV criteria) are reported. RESULTS: All 3 treatments showed similar effectiveness in reducing the severity of general, negative, and positive symptomatology after 6 weeks of treatment, as reported by mean change in total Clinical Global Impressions-Severity of Illness scale, Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms, and Scale for the Assessment of Negative Symptoms scores between baseline and 6 weeks. The proportion of study subjects responding, defined as 40% or greater BPRS total score improvement from baseline, was 57.1% (N = 32 of 56) haloperidol, 52.5% (N = 32 of 61) risperidone, and 63.6% (N = 35 of 55) olanzapine, with no statistical differences among groups. The frequency of extrapyramidal symptoms (chi(2) = 24.519; p < .001) and concomitant anticholinergic medication use (chi(2) = 57.842; p < .0001) was greater with haloperidol than olanzapine or risperidone. Olanzapine-treated patients had significantly more weight gain compared with the haloperidol and risperidone groups (p < .001). CONCLUSION: Relatively low doses of haloperidol, risperidone, and olanzapine are equally effective for the acute treatment of first-episode nonaffective psychosis under usual conditions of real clinical practice.

Acute Disease↗
PubMed2006

Steroid therapy improves endothelial function in patients with biopsy-proven giant cell arteritis.

OBJECTIVE: Endothelial dysfunction has been found to be present in subjects with both small and medium-size blood vessel vasculitides. We assess whether endothelial dysfunction was also present in patients with biopsy-proven giant cell arteritis (GCA) and whether it might be improved following steroid treatment. METHODS: Endothelial function was determined in cross-sectional and longitudinal studies of 6 patients with biopsy-proven GCA diagnosed between January and May 2002 by measuring flow-mediated endothelial-dependent and independent vasodilatation (EDV and EIV) by brachial ultrasonography. Patients were assessed for endothelial function within 48 hours after the onset of steroid therapy, 4 weeks after the onset of steroid therapy, and 2 years after the disease diagnosis. RESULTS: EDV was significantly impaired in patients with GCA compared with 12 matched controls [mean 2.9%, median 2.45% (range 2.1% to 4.7%) vs mean 6.5%, median 6.6% (range 3.9% to 9.3%) in matched controls; p = 0.002]. However, no significant difference existed between patients and controls in EIV. Significant improvement of EDV after the suppression of inflammation was achieved. At Week 4 after the onset of steroid therapy all 6 patients showed enhanced responses (p = 0.028). This improvement of EDV was still present when steroid treatment was ended, 2 years after diagnosis. CONCLUSION: Endothelial function is significantly impaired in individuals with active biopsy-proven GCA. The results highlight the importance of steroid therapy to improve endothelial function after suppression of the inflammation of GCA.

Aged↗
PubMed2005

Trend in hip fracture epidemiology over a 14-year period in a Spanish population.

Spain lacks detailed data on hip fracture trends despite being the country with the greatest increase in the pensioner-to-provider ratio in Europe. We reproduced a study on hip fracture incidence in a region of northern Spain (Cantabria) carried out 14 years ago to determine whether a secular trend to change is taking place. If such a trend could be found, our objective was to determine whether the effect is solely due to ageing or whether additional variables are involved. We assessed the incidence of hip fracture in patients aged > or =50 years through clinical records from Emergency Units and Orthopedic Surgical Units of all hospitals in the region of Cantabria in 1988 and 2002. A total of 318 new cases of hip fracture were recorded in 1988 and 490 in 2002 (54% increase; p<0.001). No significant changes were noticed following an adjustment for age. Women accounted for the increase in crude hip fracture incidence [246 women and 72 men suffered a hip fracture in 1988 compared to 404 women and 86 men in 2002 (64% increase in women and 19% increase in men; p<0.005 and not significant, respectively)]. The female:male ratio was 3.4 in 1988 versus 4.7 in 2002; following age-adjustment, no significant changes were found (1.8 in 1988 and 1.9 in 2002). The increase in crude hip fracture incidence was greater at cervical (versus trochanteric) sites. Patient residence, time of the year, site of fracture, kind of injury, previous contralateral hip fracture, length of stay, and peri-operative mortality did not differ significantly. In conclusion, a crude hip fracture incidence increase of about 50% in the northern Spanish region of Cantabria has taken place over the last 14 years. This effect does not persist after adjustments have been made for age. The crude rate increase occurred mainly at the expense of women, with a more noticeable rise in cervical fractures as opposed to trochanteric lesions.

Accidental Falls↗
PubMed2005

Pattern of alcohol consumption during pregnancy and risk for low birth weight.

PURPOSE: The effects of moderate alcohol drinking on low birth weight are not clear, and conflicting results have been reported. We assessed the influence of different patterns of alcohol drinking during pregnancy on low birth weight. METHODS: A case-control study was carried out at the University of Cantabria Hospital, Spain, from 1998 to 2002. Cases (n = 552) were mothers delivering a single newborn weighing less than 2500 g. Controls (n = 1451) were selected from a random sample of all delivering women. Information was obtained from personal interview, clinical charts, and prenatal care records. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Adjustment for potential confounders was made by means of logistic regression. RESULTS: Alcohol consumption of less than 6 g/day decreased the risk for low birth weight (adjusted OR = 0.64; 95% CI, 0.46-0.88). A similar result was obtained for moderate drinkers (<12 g/day) on weekends only. The opposite relationship was observed between alcohol consumption on weekdays of 12 g/day or greater (adjusted OR = 2.67; 95% CI, 1.39-5.12), not observed in those drinking on weekends only. The interaction between alcohol consumption and tobacco smoking was analyzed. Weekday drinkers of 12 g/day or greater showed an increased risk in smokers. Alcohol consumption on weekends only in nonsmokers was inversely related. The influence of alcohol was greater for small-for-gestational-age (SGA) than non-SGA babies. CONCLUSIONS: Alcohol consumption of 12 g/day or greater increased the risk for low birth weight, whereas lower consumption during weekends showed the opposite effect (mainly in nonsmokers).

Adult↗
PubMed2005

Cervical cancer mortality is increasing in Spanish women younger than 50.

Spanish women seem to have low cervical cancer mortality rates and some studies suggest the trend is stationary; however, this fact remains unclear because a great number of uterine cancer cases are classified as site unspecified. The main goal in this paper is to study mortality trends due to cancer of the cervix in young Spanish women. The percentage of uterus cancer deaths recorded as site unspecified has fallen from 90% in 1965 to 25% in 1995. Mortality by cervical cancer decreases in women aged 25-49 born before 1939-1948 and increases in women born later. This result is shown in each 5-year age group and seems independent from the percentage of unspecified site uterine cancer. In conclusion, Spanish women aged under 50 are suffering an increase in cervix uteri mortality rates; this rise can be related with behavioural changes occurring from 1970-1975 on.

Adult↗
PubMed2005

Prefrontal cognitive functions in stabilized first-episode patients with schizophrenia spectrum disorders: a dissociation between dorsolateral and orbitofrontal functioning.

Specific prefrontal cognitive impairments have been reported in first-episode and chronic schizophrenia. We sought to investigate potential impairments in specific prefrontal cortical cognitive functions among stabilized patients with a first-episode of schizophrenia. A sample of 80 individuals with a first-episode of schizophrenia spectrum disorders and 22 healthy volunteers underwent a neurocognitive battery assessing orbitofrontal (OFC) [The Iowa Gambling Task (GT)], and dorsolateral prefrontal (DLPFC) functions (WAIS III Backward digits, verbal fluency test (FAS), and Trail Making Test). Cognitive data were obtained following stabilization of acute psychotic symptoms. Clinical symptoms after six weeks of treatment were assessed by using the SAPS and SANS scales. While there were no significant group differences in overall scores and in the profile of progress of performance along periods on the GT, patient group showed a significant impairment when performing DLPFC tasks. Only FAS score was correlated to the severity of negative symptomatology. The OFC functions are unimpaired at the early phases of psychosis and in contrast there is a significant deficit in DLPFC functions in first-episode of schizophrenia.

Adult↗
PubMed2005

Interaction between CYP19 aromatase and butyrylcholinesterase genes increases Alzheimer's disease risk.

Biological evidence supports a role of aromatase and butyrilcholinesterase (BCHE) enzymes in the disruption of the cholinergic neurotransmission observed in Alzheimer's disease (AD). Estrogens may reduce the risk of AD through enhancing or preserving cholinergic neurotransmission, and aromatase, the product of the CYP19 gene, is a critical enzyme in the peripheral synthesis of estrogens. BCHE is a hydrolytic enzyme associated with acetylcholine synaptic degradation, and the BCHE K genetic variant confers some protective effect for AD by reducing the activity of the enzyme. We investigated whether a 5'-UTR CYP19 polymorphism and the BCHE K variant might be responsible for susceptibility to AD by studying a clinically well-defined group of 187 sporadic AD patients and 172 control subjects from a Spanish population. We have shown that the CYP19 C/C genotype is overrepresented in AD patients who carry the BCHE non-K allele when compared with controls (OR=1.85, p=0.03). Our findings suggest that the CYP19 and BCHE polymorphisms may interact in determining the risk of AD.

Aged↗
PubMed2005

Interleukin-8, intercellular adhesion molecule-1 and tumour necrosis factor-alpha gene polymorphisms and the risk for multiple system atrophy.

In a case-control study using a clinically well-defined group of 41 multiple system atrophy (MSA) patients and 93 control subjects, the interleukin (IL)-8 (-251) TT genotype was associated with an approximately fourfold increased risk for MSA and, furthermore, this risk increased elevenfold with the simultaneous presence of the intercellular adhesion molecule-1 (ICAM-1: E469K) KK genotype, suggesting a gene-gene interaction. These data support a role for inflammation-related genes in risk for MSA.

Adult↗