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Biomedical subjects

M A Valero

Publications and source records attributed to M A Valero.

At least 37 records · Page 2Linked to original sources
PubMed2000

Patient satisfaction with a home televisiting service based on interactive television over a cable network.

Experience shows that high-quality audiovisual contact between remote health carers and patients facilitates a telemedicine service. However, the lack of broadband communication to the home usually prevents domestic televisiting. Deployment of cable networks in Spain has allowed the implementation of a home televisiting service designed for patients with chronic diseases. In a trial, 15 patients received televisits by three specialists and three nurses from the Severo Ochoa Hospital in Madrid. Five patients suffered from chronic pain, five were from the nephrology unit and five had been treated at the intensive-care unit after acute myocardial infarction. Each patient participated in three televisiting sessions, two provided by a specialist and the other by a nurse. The average length of a televisit was 12 min (range 5-21 min). The patients expressed their satisfaction with the service.

Aged↗
PubMed2000

Comparative infectivity of Fasciola hepatica metacercariae from isolates of the main and secondary reservoir animal host species in the Bolivian Altiplano high human endemic region.

Fascioliasis due to Fasciola hepatica (Linnaeus, 1758) is an endemic disease on the Northern Bolivian Altiplano, where human prevalences and intensities are the highest known, sheep and cattle are the main reservoir hosts, and pigs and donkeys the secondary ones. Investigations were carried out to study the viability of metacercariae experimentally obtained from eggs shed by naturally infected Altiplanic sheep, cattle, pigs and donkeys. A total of 157 Wistar rats were infected with doses of 5, 10, 20 and 150 metacercariae. Metacercariae aged for different number of weeks were used to analyse the influence of age on their viability. The number of worms successfully developed in each rat was established by dissection. Results obtained show that metacercarial infectivity is dependent upon storage time, being lower when metacercariae are older. The maximum longevity is 31 weeks using doses of 20 metacercariae per rat and 48 weeks with 150 metacercariae per rat, although in the latter case only a very low percentage of worms is recovered. Age-related infectivity of metacercariae from Altiplanic F. hepatica does not significantly differ from that of the liver fluke in lowlands of other countries. Concerning the influence of the isolate according to host species, results indicate that metacercarial viabilities of pig and donkey isolates are similar to the viabilities of metacercariae of sheep and cattle isolates. Thus, pig and donkey have a high transmission potential capacity concerning this aspect. This fact is of great importance for the control of human and animal fascioliasis in this highly endemic zone.

Age Factors↗
PubMed1999

Comparison of adult liver flukes from highland and lowland populations of Bolivian and Spanish sheep.

A morphological study of adult liver flukes and eggs from sheep in a human fascioliasis endemic zone in the Northern Bolivian Altiplano showed that they belong to the species Fasciola hepatica. An exhaustive morphometric comparison with a F. hepatica population from Spanish sheep was made using image analysis and an allometric model: (y2m-y2)/y2 = c(y1m-y1)/y1[b, where y1 = body surface or body length, y2 = one of the measurements analyzed, y1m, y2m = maximum values towards which y1 and y2 respectively tend, and c, b = constants. Only slight allometric differences in worms were observed despite the geographic distance between both Spanish and Bolivian sheep populations and the very high altitude of the Bolivian Altiplano.

Altitude↗
PubMed1999

Using cable television networks for interactive home telemedicine services.

Most recent cable television network infrastructures can be used to deliver broadband interactive telemedicine services to the home. These facilities allow the provision of social and health services like medical televisiting for elderly, disabled and chronically ill patients; health tele-education; and teleconsultation on demand. Large numbers of patients could benefit from these services. There is also the increasing European tendency to offer customized home-care services. These applications are being developed and validated by a pilot project in Madrid as part of the ATTRACT project of the European Commission. The long-term aim is to develop broadband applications on a large scale to support low-cost interactive home telemedicine services for both patients and institutions.

Aged↗
PubMed1999

Analysis of climatic data and forecast indices for human fascioliasis at very high altitude.

Human infection with Fasciola hepatica has recently been recognized as an important health problem worldwide, and particularly at very high altitudes in South America. The highest prevalences and intensities of human fascioliasis known are those of the northern Bolivian Altiplano, where infected Lymnaea truncatula occur at altitudes of 3800-4100 m. In the present study, the climatic data for this area of the Altiplano, which differ markedly from those of endemic areas in the lowlands, were analysed. There is no marked seasonality in temperature but there are large variations in temperature within a daily, 24-h period. Rainfall is seasonal, with a long dry season, coinciding with the lowest minimum temperatures, and a long wet season. The rate of evapotranspiration is very high, and temporary water bodies dry out very quickly. Solar radiation at ground level is intense, not only because of the altitude but also because of the lack of trees and shrubs. Two climatic indices for forecasting fascioliasis, Mt and Wb-bs, were calculated. Modifications in these forecast indices are proposed, to reflect the environment at high altitude and low latitude. Estimates, based on climadiagrammes, of the durations of the wet and dry seasons were greatly effected by the inclusion of an aridity-index modification. The usefulness of the modified indices was examined using prevalence data for human and cattle fascioliasis collected in the neighbourhoods of the stations providing the meteorological data. Values for both indices indicated that conditions were optimum for transmission between December and March. The results were statistically significant for the modified Wb-bs index when the data for a meteorological station in which no lymnaeids were found were excluded. The modified Mt index did not appear sufficiently accurate to be useful. The values for the modified Wb-bs index permitted the study areas to be designated low-, moderate- or high-risk areas for the transmission of fascioliasis to man and domestic animals.

Altitude↗
PubMed1998

Fasciola hepatica development in the experimentally infected black rat Rattus rattus.

The finding of natural infection of Rattus rattus by Fasciola hepatica on Corsica has stimulated further research into the role of the black rat in the epidemiology of fascioliasis. Corsican black rats were experimentally individually infected with 20 metacercariae from cattle and murine isolates obtained from naturally infected bovines and black rats. The following results were obtained: (a) in R. rattus infected with the cattle isolate, normal adult fluke development took place and infection persisted for a long period, with emission of eggs showing embryogenic capacity; (b) the development of F. hepatica adults paralleled the ontogenetic trajectories observed in other rodent-F. hepatica models; and (c) fluke adults obtained in R. rattus infected with the murine isolate exhibited a similar pattern. These findings strongly suggest that the black rat may be one of the wild reservoirs of F. hepatica and may have contributed to the large geographical extent of the disease on Corsica.

Animals↗
PubMed1996

Clinical management of hyperglycaemic patients receiving total parenteral nutrition.

We evaluated the course of total parenteral nutrition (TPN) therapy in patients with hyperglycaemia. We studied 1) incidence of hyperglycaemia, 2) amount of glucose and insulin provided and 3) incidence of metabolic problems in patients receiving TPN who required insulin to attain metabolic control. The group included 91 patients, 38 women (64 +/- 15 years) and 53 men (64 +/- 12 years), who developed glycaemia higher than 200 mg/dl. Nine patients had a previous diagnosis of IDDM, 36 NIDDM and 46 secondary hyperglycaemia.. Total caloric requirements were initially supplied at 132 +/- 20% the basal energy expenditure (Harris-Benedict formula), and 1.4 +/- 0.3 g/kg of amino-acids. Initially, TPN provided 150-200 g/day of glucose (2.1 mg/kg/min). Regular insulin was added to the bag. The annual incidence of hyperglycaemia was estimated to be 121 per 1000 patients. Mean insulin requirements were 50 U/day (25 to 150 U/day), 0.7 +/- 0.3 U/kg. Comparing with prehospitalization insulin dose, 22% needed similar doses, and 11% lower doses. IDDM patients needed 1.7 times their pre-admission dose (1-4.5 times). The ratio of insulin:glucose in TPN was 0.3 +/- 0.1 U/g (0.1-1.2 U/g). Patients with renal failure had similar insulin requirements (56 +/- 26 U/day) than patients with normal renal function (49 +/- 19 U/day). None of the patients developed glycemic complications. In conclusion, diabetic patients receiving TPN have an acceptable metabolic control if individualized prescriptions and supplemental insulin are used.

Journal Article↗
PubMed1995

Calcitonin and bisphosphonates treatment in bone loss after liver transplantation.

Osteopenia is a major complication of orthotopic liver transplantation (OLT). However, no effective therapy for bone disease has been defined. We have studied vertebral bone mineral density (VMD) and fasting serum markers of bone formation [bone gla protein (BGP), procollagen I carboxyterminal peptide (PICP)] and metabolism (serum Ca, P, intact parathyroid hormone (iPTH), 25OHD3 and 1,25(OH)2D3) in 120 patents after OLT. VMD was measured by dual-energy X-ray absorptiometry (DXA) using a Hologic QDR 1000 densitometer on two occasions, 12 months apart. Patients with OLT had a VBD significantly lower compared with age- and sexed-matched Spanish controls (P < 0.05). Prevalence of osteoporosis (Z score below -2 SD) was 35.8%. Serum BGP (8.6 +/- 0.7 ng/ml) and PICP (222.9 +/- 81.9 ng/dl) were higher than those of controls. However, serum calcium, phosphorus, iPTH, 25OHD3, and 1,25(OH)2D3 were within normal range. Patients with osteoporosis were randomly treated with 40 IU/day of calcitonin i.m. (Diatin, Ferrer Int. Laboratories) (n = 17) or 400 mg p.o., 15 days every 3 months, of sodium ethiodronate (Difosfen, Rubio Laboratories) (n = 23). All patients received 500 mg/12 hours of elemental calcium p.o. After 12 months of treatment, a significant increment of vertebral mineral density (VMD) was observed (6.4% and 8.2%, respectively). Serum BGP and PICP values remained elevated without a difference between the two drugs. Our results indicate that antiresorptive drugs may be of benefit in the high turnover osteoporosis of OLT recipients.

Adult↗
PubMed1994

Bone density and turnover in Addison's disease: effect of glucocorticoid treatment.

Osteoporosis is a well-known side-effect of chronic treatment with glucocorticoids. We have studied vertebral bone mineral density (BMD) and biochemical markers of bone metabolism in 30 patients diagnosed of Addison's disease (AD) to determine the effect of long-term replacement treatment with hydrocortisone (30 mg/day) or prednisone (7.5 mg/day). Lumbar bone mineral density was measured with dual energy X-ray absorptiometry in L-1-4 in two occasions, separated by 12 months. BMD in premenopausal women and men with AD was similar to healthy controls and postmenopausal women had slightly lower results. Rate of change of bone density followed up over a period of 12 months was -0.82%. Bone loss was not influenced by duration or type of steroid treatment. Biochemical parameters, serum calcium, alkaline phosphatase, osteocalcin, procollagen type I, PTH and 25(OH)vitamin D were within normal limits. Our results show that in patients with AD, after replacement with low doses of glucocorticoids there is no significative trabecular bone loss neither modifications in bone formation markers.

Absorptiometry, Photon↗
PubMed1994

Bone loss and turnover in patients with liver transplantation.

We have studied bone turnover markers and bone mineral density (BMD) in 82 patients (26 females and 56 males) that underwent orthotopic liver transplantation in our center. Follow-up was for a median of 19.2 months (range 1-60 months). During this period they were treated with prednisone, azathioprine and cyclosporine in accordance with protocols. Spinal bone loss was measured with a dual energy X-ray densitometer (precision 1.3%), and, depending on Z score and BMD values, two groups were distinguished: A) Without osteoporosis: 47 patients, Z = -0.98 +/- 0.09 and BMD 0.899 +/- 0.098 g/cm2, and B) With osteoporosis: 35 patients, Z = -2.71 +/- 0.55 and BMD 0.739 +/- 0.080 g/cm2 (X +/- SD). Serum bone markers such as osteocalcin (BGP) 10.0 +/- 0.8 ng/ml and procollagen-I (pColl-I) 268.1 +/- 32.1 micrograms/ml, were found to be increased. Serum PTH was within the normal range. No significant differences were found between the etiologic subgroups studied with respect to bone loss. Also, no correlation was found between bone loss and duration of follow-up or other factors, such as immunosuppressant drugs or acute rejection. Our study confirms an increased prevalence of bone loss in patients with liver transplantation, which is associated with a high bone turnover, indicating that earlier diagnosis and treatment is necessary to improve survival and quality of life in these patients.

Absorptiometry, Photon↗
PubMed1986

[Description of Hymenolepis cerberensis n. sp. (Cestoda: Hymenolepididae) and first general considerations on the fauna of cestode parasites of the pygmy shrew Suncus etruscus (Savi, 1822) (Insectivora: Soricidae)].

Description and differentiation of the adult stage of Hymenolepis cerberensis n. sp. (Cestoda: Hymenolepididae), an intestinal parasite of the Pygmy white-toothed shrew, Suncus etruscus (Savi, 1822) (Insectivora: Soricidae: Crocidurinae) in the region of Banyuls-sur-Mer and Cerbère (Oriental Pyrenees, France). The new species is characterized by the size of the gravid specimens and by the presence of 18-21 rostellar hooks of 18.5-20 micron and of filaments around the embryophore. The general composition of the fauna of Cyclophyllidea parasitizing S. etruscus is analysed. There are three less specialised Hymenolepis species with a scolex of the same type and one Pseudhymenolepis species, with the absence of unarmed species lacking a rostrum. The oioxenous character of the Cestodes parasitizing Suncus species sustains the validity of the genus Suncus. The resemblance of the Cestodefaunas suggests a narrow phyletic relationship between the genera Suncus and Crocidura.

Animals↗
PubMedDate not supplied

[A comparison between double-photon absorptiometry (DEXA), impedance and anthropometry in the study of the body composition of obese subjects].

Dual-energy X ray absorptiometry (DEXA) is primarily used in the assessment of bone mineral. However, the transmissions of the two different energy beams in nonbone areas can be processed to calculate the amount of fat and free-fat mass of the soft tissues. We have compared the estimation of body fat mass (FM) by DEXA with data derived from anthropometric (A) (During & Womersley formula) and impedance (BIA) measurements. We have studied 10 subjects, 8 female and 2 male, age 39 +/- 17, weight 97.4 +/- 17.2 kg. The results were: FM 44.4 +/- 8.5 kg (DEXA), 40.6 +/- 6.3 kg (A) and 38.4 +/- 9.8 kg (BIA); FFM 52.1 +/- 14.1 kg (DEXA), 56.8 +/- 13.9 kg (A) and 58.8 +/- 13.6 kg (BIA). The correlation was higher between DEXA and A (r = 0.88, for women r = 0.94). BIA results change depending on the equation used to derive Lean Body Mass (LBM) according to different authors. DEXA measurements are independent from the explorer, whereas A and BIA determinations can change in separate occasions with the same or different observer. Therefore, DEXA method seems more reliable than BIA for the assessment of FM. If DEXA technology is not available, our results support the use of anthropometric over impedance measurements.

Absorptiometry, Photon↗
PubMedDate not supplied

[Comparative study of impedance-based predictive models of body composition].

It was proposed to analyse impedance (BIA) to determine bodily composition: water content, fat-free mass (FFM) and fat mass. Different regression equations were accordingly designed which related impedance obtained by BIA to age, weight, height and sex. We analyzed the result obtained with five different models, already described, in a population comprising 46 persons, 13 men and 33 women, of ages 42.9 +/- 17.7 and 38.6 +/- 15.8 (mean +/- DE) respectively. The results for FFM (Kg) obtained from the different equations were highly spread (43.8 +/- 6.5 to 48.2 +/- 7.6 in women, and 48.7 +/- 10.5 to 59.1 +/- 12.7 in men). The significant coefficients of correlation varied between 0.99 and 0.70 for men and 0.98 and 0.71 in women. In most of the equations, weight is the variable which best correlates with FFM. The results obtained point to the need to seek the predictive equation which best adjusts to the population studied, and to develop more accurate methods for determining body composition.

Adult↗