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Biomedical subjects

L Prieto

Publications and source records attributed to L Prieto.

At least 109 records · Page 6Linked to original sources
PubMed1994

Effect of inhaled budesonide on seasonal changes in sensitivity and maximal response to methacholine in pollen-sensitive asthmatic subjects.

The aim of this study was to investigate the effect of inhaled budesonide on modifications of the provocative concentration of agonist causing a 20% fall in forced expiratory volume in one second (FEV1) (PC20) and maximal response plateau to inhaled methacholine during the pollen season in pollen-sensitive subjects with mild asthma. The effects of inhaled budesonide (800 micrograms.day-1) on the threshold value (PC20) and maximal response plateau to inhaled methacholine were studied in 28 pollen-sensitive subjects with mild asthma during a pollen season in a randomized, double-blind, placebo-controlled parallel fashion. They were challenged with methacholine (up to 200 mg.ml-1) in February (preseasonal assessment) and during the middle of the pollen season (in May and again in June). Subjects treated with budesonide (n = 13) were protected from the decrease in PC20 seen in the placebo (n = 15) group (geometric mean PC20 placebo group: preseasonal = 8.51, May = 2.19 and June = 1.78 mg.ml-1; budesonide group: preseasonal = 3.71, May = 3.23 and June = 2.40 mg.ml-1; intergroup differences in doubling concentrations, p < 0.05). Among 10 subjects in the placebo group who reached plateau during the preseasonal assessment, seven lost the plateau in May and six in June. In the budesonide group, among seven subjects who reached plateau during the preseasonal assessment, three lost the plateau in May and four in June. Between-group differences were not significant. We conclude that in pollen-sensitive subjects with mild asthma, inhaled budesonide blocks the effects of natural allergen exposure on the methacholine threshold value.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1994

Airway responsiveness to methacholine and risk of asthma in patients with allergic rhinitis.

To find out whether airway hyperresponsiveness is associated with a greater risk of asthma in subjects with allergic rhinitis, 66 nonasthmatic patients with allergic rhinitis underwent inhalation challenge with methacholine. Each patient was reevaluated prospectively at least once each year and a diagnosis of asthma was accepted if the subject developed episodic wheezing and/or cough plus airway obstruction and at least a 15% increase in FEV1 after inhaled salbutamol. Those subjects who developed asthma and ten individuals who did not develop asthma were rechallenged after the first asthma symptoms or at the end of the followup period, respectively. Risk of developing asthma during the followup period (mean of 43.8 months, range 36 to 70) was similar (P > .05) in those individuals who previously had airway hyperresponsiveness (2 of the 19 patients), when compared with subjects who were previously nonresponders (4 of the 47 patients). Further, in those subjects who developed asthma, geometric mean (range) PC20 decreased from 11.75 (0.40 to 50) during the initial evaluation to 1.66 (0.15 to 11.07) mg/mL after the first asthma symptoms (P < .05). No significant modifications of PC20 were detected in subjects who did not develop asthma. We conclude that a single determination of methacholine PC20 is not a reliable marker of the subsequent development of asthma in patients with allergic rhinitis.

Adolescent↗
PubMed1993

Modifications of PC20 and maximal degree of airway narrowing to methacholine after pollen season in pollen sensitive asthmatic patients.

We examined the effect of cessation of exposure to pollen on non-specific airway responsiveness in 10 grass and/or parietaria pollen sensitive asthmatics. Three methacholine inhalation challenges were performed, the first during pollen season (seasonal period), the second 2 months after the end of season (short time after seasonal period), and the third 5 months after the end of season (long time after seasonal period). The dose-response curves to methacholine were characterized by the PC20 (provocative concentration of methacholine required to produce a 20% fall in FEV1) and maximal response plateau, if possible. A maximal response plateau on the dose-response curve was considered to be present if three or more data points for FEV1 fell within a 5% response range. The challenge was stopped when FEV1 dropped more than 50% or the highest concentration of methacholine (200 mg/ml) was reached. The geometric mean (range) methacholine PC20 increased from 1.08 (0.18-37.22) in the seasonal period to 4.67 (0.71-200) mg/ml during the long time after seasonal period (P < 0.01). On the other hand, in six subjects in whom it was possible to obtain a plateau on at least one challenge, the level of the maximal response decreased from (mean +/- s.e.m.) 44.1 +/- 4.9 in the seasonal period to 30 +/- 4.4 during the long time after seasonal period (P < 0.05). These results suggest that in pollen sensitive asthmatic patients, the cessation of exposure to pollen is associated with a reduction of non-specific bronchial responsiveness (PC20 and maximal degree of airway narrowing to methacholine).

Adolescent↗
PubMed1993

Methacholine inhalation challenge. Practical consequences of using duplicate spirograms after each concentration.

Several studies have shown that during bronchial provocation tests with pharmacologic agents, a prior deep inspiration causes transient bronchodilatation in normal subjects and patients with allergic rhinitis. We investigated the influence of using two consecutive spirograms after each methacholine concentration on the results of methacholine inhalation challenge. Methacholine inhalation challenge was performed in 70 nonsmoking subjects (26 with current asthma, 23 asymptomatic asthmatic patients and 21 patients with allergic rhinitis). The aerosols (PBS, followed by twofold increasing concentrations of methacholine from 0.095 to 50 mg/mL) were inhaled by tidal breathing for two minutes; after two minutes of aerosol inhalation, the subject performed two forced vital capacity maneuvers, 30 to 40 seconds apart. Separate dose-response curves were constructed from FEV1 values of the first and second spirogram. The PC20FEV1 (provocative concentration of methacholine required to produce a 20% fall in FEV1) was calculated from the log dose-response curves (first and second spirogram). The PC20 values obtained from the first (PC20-1) and second (PC20-2) spirogram were not significantly different in patients with current asthma, but the PC20-2 values were higher than the PC20-1 values in asymptomatic asthmatic patients (P < .01) as well as in patients with allergic rhinitis (P < .01). On the other hand, the PC20-2 values were one doubling concentration of PC20-1 values in one current asthmatic patient, one asymptomatic asthmatic patient and five patients with allergic rhinitis. We conclude that the choice of the first or second FEV1 obtained after each methacholine concentration significantly modifies the PC20 in asymptomatic asthmatic patients and patients with allergic rhinitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[High pressure filling bladder].

A complete urodynamic study was carried out on 41 consecutive patients presenting in the cystomanometry a vesical filling pressure at maximum capacity higher than 30 cm H2O. Two groups were evident: group I with neurogenic etiology, and group II without an obvious neurogenic etiology. From its results it can be seen that a diminished vesical accommodation is not a urodynamic fact restricted to vesicourethral neurogenic dysfunction, but it happens in several non-neurogenic conditions. Within the neurogenic group, the urodynamic element most frequently associated to a diminished vesical accommodation was an inferior motor neuron-like vesicourethral dysfunction. An increased vesical filling pressure was not enough to produce urinary incontinence, being also necessary an added factor to prompt involuntary loss of urine.

Adolescent↗
PubMed1992

Experimental cardiac tamponade with a myocardial wound: the effect of rapid intravenous infusion of saline.

In order to demonstrate that the evolution of cardiac tamponade from a ventricular wound is different from that without myocardial wounding, the effects of a rapid infusion of saline solution on hemodynamic behavior and pericardial pressure (PP) were evaluated in dogs with cardiac tamponade caused by ventricular perforation (group C), animals without cardiac tamponade (group A), and animals with cardiac tamponade induced by infusion of saline into the pericardium (group B). We found that blood pressure (BP) increased from 107.5 +/- 15.5 mm Hg to 126 +/- 4 mm Hg in group A; increased from 64.5 +/- 17.9 mm Hg to 117.5 +/- 22.17 mm Hg in group B; and increased from 60.75 +/- 46.5 mm Hg to 76 +/- 14.4 mm Hg in group C. Central venous pressure (CVP) increased from 3.75 +/- 0.96 cm H2O to 9.5 +/- 3.3 cm H2O in group A; increased from 8 +/- 2.4 cm H2O to 16.25 +/- 3.1 cm H2O in group B; and rose from 7.75 +/- 2.6 cm H2O to 20.66 +/- 5.03 cm H2O in group C. Cardiac output (CO) increased from 3.9 +/- 1.2 L/min to 18.93 +/- 3.96 L/min in group A; increased from 1.23 +/- 0.3 L/min to 5.4 +/- 1.7 L/min in group B; and increased from 1.8 +/- 0.66 L/min to 3.53 +/- 1.31 L/min in group C.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Urinary incontinence in the elderly: clinical and urodynamic review of 195 cases].

One hundred ninety-five male and female patients over 65 years old presenting with urinary incontinence were evaluated by clinical and urodynamics. Urinary incontinence was in the form of urgency-incontinence in 68% of the cases, incontinence at cough in 26%, and urinary incontinence which the patient referred to no specific situation in 6%. Among the different urodynamics data, bladder instability was the most common (73%). Urinary stress incontinence was observed in 35% of the cases. Bladder instability was demonstrated in 77% of the cases with urgency-incontinence and in 69% of the cases with incontinence not referred to a specific situation. All the male patients with lower urinary tract obstruction had urgency-incontinence. Stress incontinence was demonstrated in 60% of the cases with incontinence at cough. Stress incontinence was not observed in male patients without associated diseases. The associated neurological disorder was accompanied by bladder hyperreflexia in 90% of the cases. A prior adenomectomy or hysterectomy was associated with a greater number of cases with stress urinary incontinence, accounting for 62% in both males and females.

Age Factors↗
PubMed1990

[Xanthogranulomatous pyelonephritis. Retrospective study].

The incidence of PGX in our setting is low (0.67%). Middle-aged women comprise most of our cases. This disease process is usually unilateral; 53.2% of the present series had right-sided renal involvement. Over the past 17 years, 135 cases of histopathologically-documented XGP have been recorded at our hospital. Sixty-three cases were studied retrospectively. Patient history, symptoms and signs, and data gleaned from physical examination are presented. Similarly, patient outstanding pathogenetic features are described. Preoperative diagnosis of XGP is difficult. The availability of high resolution imaging techniques has enhanced diagnostic accuracy. Urinary cytology permits preoperative diagnosis with an accuracy rate of 80%. The postoperative prognosis is excellent.

Aged↗
PubMed1989

[Dysfunction of the contractile capacity of the detrusor muscle in post-prostatectomy urinary retention].

We report on 23 consecutive patients with urinary retention following prostatectomy for benign prostatic hypertrophy. The patients were clinically and urodynamically evaluated. Urodynamic work-up included flowmetry, cystomanometry, detrusor pressure-micturition flow test, and videocystography. The involvement of detrusor contractility in urinary retention was observed in 60.87% of the cases and was ascribable to lower urinary tract obstruction in 39.19%. These data permitted instituting correct treatment.

Aged↗
PubMed1988

Prevalence of dominant mutations in Spain: effect of changes in maternal age distribution.

We studied the birth prevalence of autosomal dominant mutations in Spain and estimated how a decrease in maternal age distribution may lead to reduction in dominant mutations. The data were collected by the Estudio Colaborativo Español de Malformaciones Congénitas from April, 1976, to December, 1985. Among 553,270 liveborn infants monitored during the period, 66 infants with autosomal dominant conditions were identified. These included Apert, Crouzon, Hay-Wells, Treacher-Collins, Robinow, Stickler, Adams-Oliver, and the blepharophimosis syndromes, achondroplasia, cleidocranial dysostosis, and thanatophoric dysplasia. The overall rate of autosomal dominant conditions was 1.2 per 10,000 liveborn infants. Thirteen (20%) had an affected relative, and 52 (79%) had a negative family history. One case was excluded because of insufficient family data. The rate of autosomal dominant mutations was 0.9 per 10,000 liveborn infants, or 47 per 1 million gametes. A reduction in the maternal age distribution of mothers age 35 years and older from the current 10.8% to 4.9%, as in Atlanta, Georgia, would reduce the rate of Down syndrome in Spain by 33% and through a change in parternal age distribution may lead to a reduction in dominant mutations of about 9.6%. This suggests that a public health campaign to reduce older maternal age distribution in Spain may also lead to a reduction in dominant mutations and emphasizes the potential that a direct campaign for fathers to complete their families before age 35 years may have a small, but measurable, effect in the primary prevention of dominant mutations.

Adult↗
PubMed1984

Epidemiological study of gastroschisis and omphalocele in Spain.

We report an epidemiological study of gastroschisis and omphalocele performed through the Spanish Collaborative Study of Congenital Malformations. Among 264,502 live births analyzed from April 1976 to September 1981, 12 gastroschisis and 40 omphaloceles were identified. The overall incidence of gastroschisis was 0.4 per 10,000 live births and 1.5 for omphalocele. The incidence of gastroschisis showed a significant secular trend with a mean annual increase of 0.38 per 10,000 livebirths. The mean maternal age was 21.42, which is significantly lower than the control group (p less than 0.01). Among isolated omphaloceles the maternal ages showed a U-shape distribution. Maternal vaginal bleeding, gestational age, and birth weight were significantly different between gastroschisis and omphaloceles and the controls. Mortality within the first 3 days of life was significantly higher in gastroschisis, syndromic omphaloceles, and those associated with other malformations when compared to controls. No significant consanguinity or familial cases were observed for either gastroschisis or omphaloceles.

Abdominal Muscles↗
PubMed1984

[Descriptive epidemiologic study of congenital abnormalities of the central nervous system in Spain (1976-1982)].

Authors present an epidemiologic study of the five most frequent congenital birth defects of the central nervous system: anencephaly, spina bifida, encephalocele, hydrocephaly and microcephaly. Over a total of 409 liveborns with some of these anomalies, gathered from 1976 to 1982 in 46 maternities spread all over Spanish geography, they analyze its prevalence at birth, temporary and geographical distribution, sex ratio, gestational age, birth weight and maternal age. To analyze some of these variables they have separated different types of anomalies in three groups depending if they were present as an only defect (isolated), together with other defects in a not syndromic picture (associated), and forming part of a described syndrome (syndromes). This separation is an intention of forming homogeneous ethiopathogenic groups upon which epidemiologic methodology can be applied with assurance to interpret results in a right way.

Anencephaly↗
PubMed1982

Elevation of urinary catecholamines and their metabolites following tyrosine administration in humans.

A single oral dose of tyrosine (100 or 150 mg/kg) caused significant increases in urinary levels of norepinephrine (NE), epinephrine (E), dopamine (DA), 3-methoxy-4-hydroxyphenylglycol (MHPG), vanilmandelic acid (VMA), and homovanillic acid (HVA) during the first 2 hr after its ingestion; water administration failed to produce such changes. The temporal patterns of these increases paralleled those of previously described increases in plasma tyrosine. Since urinary catecholamines derive from peripheral sources, while the catecholamine metabolites in urine may reflect both CNS and peripheral catecholamine turnover, these findings indicate that tyrosine administration may accelerate catecholamine synthesis in and release from cells throughout the human body. Tyrosine may thus constitute a useful agent for treating central or peripheral disorders associated with insufficient release of catecholamines.

Adolescent↗