Search PubMed⌕ Search

Biomedical subjects

M Serrano Ríos

Publications and source records attributed to M Serrano Ríos.

At least 19 recordsLinked to original sources

Effect of the Pro12Ala polymorphism of the peroxisome proliferator-activated receptor gamma-2 gene on adiposity, insulin sensitivity and lipid profile in the Spanish population.

OBJECTIVE: To investigate the role of the Pro12Ala peroxisome proliferator-activated receptor (PPAR) gamma-2 polymorphism in the susceptibility to the insulin resistance syndrome and its metabolic complications in a population-based nationwide multicenter study in Spain. DESIGN: 464 unrelated adults (45.3% men and 54.7% women) aged between 35 and 64 years were randomly chosen from a nationwide population-based survey of obesity and related conditions including insulin resistance and cardiovascular risk factors. METHODS: Anthropometric determinations included: body mass index (BMI), waist-to-hip ratio, sagittal abdominal diameter; biochemical determinations included: fasting plasma glucose concentration and concentration 2 h after an oral glucose tolerance test (OGTT), total cholesterol, high and low density lipoprotein-cholesterol, triglycerides, leptin and insulin. Systolic and diastolic blood pressure were also measured. Genotyping of the PPARgamma-2 Pro12Ala polymorphism was determined by polymerase chain reaction and single strand conformation polymorphism analysis. RESULTS: The Ala12 allele frequency was higher in obese men than in lean men (0.15 vs 0.08, P=0.03). Men carriers of the Ala12 allele had a higher BMI than non-carriers (38.9% vs 21.3%; adjusted odds ratio 2.36, 95% confidence interval 1.10-5.05, P=0.03). However, despite higher BMI obese men carriers of the Ala12 allele had lower sagittal abdominal diameter than Pro12 homozygotes (24.1+/-3.2 vs 26.3+/-2.5 cm, P=0.01). The Ala12 allele was associated with lower total triglycerides levels in the overall population and it was also associated with lower fasting insulin levels and a higher insulin sensitivity by homeostasis model assessment (HOMA) in women. CONCLUSIONS: Our results suggest that the Pro12Ala polymorphism of the PPARgamma-2 gene promotes peripheral deposition of adipose tissue and increased insulin sensitivity for a given BMI. The results in women might be due to their different adipose tissue distribution.

Adipose Tissue↗

[Late diagnosis of Turner syndrome: therapeutic implications].

We report the case of a patient with Turner's syndrome, whose special peculiarity is that its clinical signs have gone unnoticed despite the presence of several morphological features and functional disorders which must have induced it precociously. It's about a 58 years old patient with an aortic metalic valve in treatment with dicumarinics, who came to emergencies with a severe anemic syndrome because of a peptic ulcer propitiated by the hypoprotrombinaemia. In the physical examination some typical signs of the syndrome were detected. The karyotype verified the existance of Turner (45X0). We insist on the need of an early diagnosis, in order to prevent the short stature and to offer a satisfactory sexual development, and we include an actualization of the different approachments in the therapy and management of the disease.

Female↗

[Tuberculosis as cause of death].

Despite the availability of an effective treatment for most cases, tuberculosis (TB) is still a cause of death in our environment. The necropsic sections of patients died because of TB during the 1987-1996 period at Hospital Clínico de San Carlos, Madrid, were reviewed. The investigated data from each patient included age, gender, chronology of suggestive symptoms of TB, degree of histological involvement, radiological pattern in chest X-ray, delay in initiating therapy, concomitant diseases and other alternative diagnosed considered. The delay in diagnosis was the main cause for TB mortality. Advanced age, delay in seeking medical care and the presence of atypical clinical and radiological patterns contributed to the fatal end. Other factors included alcoholism and immunodeficiency.

Adult↗

[Prevalence of Helicobacter pylori infection in symptomatic adults].

AIM: To study the prevalence of Helicobacter pylori infection in different gastroduodenal entities in a wide group of symptomatic patients of our area. MATERIALS AND METHODS: 796 (493 females) patients referred to our Hospital for upper gastrointestinal endoscopy were studied. Mean age was 51.1 +/- 16.6 yrs. In all patients biopsies samples were taken from the gastric antrum for histological and microbiological (urease test) studies. A patient was considered Helicobacter pylori negative when its presence was not proved by microbiological and histological methods. RESULTS: 70.9% (73.8% males and 64.7% females) were Helicobacter pylori positive. The great majority of patients belong to 4. and 5. decade. Endoscopic diagnosis were: normal endoscopy 47.4%; antral gastritis 79.9%; pangastritis 68%; gastric ulcer 75.9%; duodenal ulcer 98.2%; pyloric ulcer 94.7%; endoscopic duodenitis 95.7%; gastric cancer 31.9%; operated stomachs 45.6%; and esophagitis 33.3%. CONCLUSIONS: The urease test had a high specificity (100%) and sensitivity (90%). Global results of H. pylori infection and its distribution among different gastroduodenal entities was similar to those described in other publications in our setting, although the prevalence was lower when compared with those countries with a lower socioeconomic status. H. pylori infection age-distribution suggests that this infection is acquired throughout life.

Adolescent↗

[Aortic dissection: false negative results of aortography and thoracic CAT, report of a case].

Acute dissection of the aorta is a relatively frequent clinical entity, with a poor prognosis and a global mortality of 40% during the first 48 hours. A correct diagnosis and an early surgical treatment may modify the natural course of the dissection of aorta. We present a case of a patient with high clinical suspicion in the aortography, thoraci CAT and transthoracic echocardiogram (TTE). However, it was not possible to establish the diagnosis. The transesophagic echocardiogram (TEE), on the contrary, suggested the presence of dissection of aorta, as was later verified in the necropsis methods, seems to support the TEE as the first election method in the dissection of aorta.

Aged↗

[Diabetes mellitus in the elderly: a study on its clinical presentation, C-peptide reserve, and immunogenetic markers of insulin dependence].

In order to evaluate clinical presentation and to determinate classification criteria of type 1 diabetes in the elderly, we carried out a study in 258 diabetic patients more than 60 years old of which 100 used insulin by failure to oral hypoglycemic agents (OHA). The prevalence of ischemic cardiovascular disease was 36%, peripheral vascular disease 34% and stroke 30%. Non-proliferative retinopathy 47%, nephropathy 16% and peripheral neuropathy 37%. Cardiovascular risk factors as obesity (36%), hypertension (33%) and hypercholesterolemia (12%) were evaluated. The average duration of diabetes was 20 years. Post-glucagon C-Peptide, HLA-DR antigens and islet cell antibodies (ICA), were measured in 75 older diabetic patients on treatment of which 24 used insulin, 11 diet and 40 OHA. Older patients on treatment with insulin had longer duration of disease, less obesity, low level basal of C-Peptide and a low response to post glucagon C-Peptide (0.94 +/- 0.5 pmol/ml) compared with patients on diet (1.8 +/- 0.9 pmol/ml) and OHA (1.8 +/- 0.8 pmol/ml). Older diabetics on insulin therapy had a greater frequency of HLA-DR3 (42%) and HLA-DR4 (21%) than other older diabetics. The ICA was negative in most patients. This study shows the high prevalence of macrovascular and microvascular disease in elderly patients with diabetes mellitus and that the most reliable parameter in classifying type 1 (insulin-dependent) diabetes is the measurement of basal and post-glucagon C-Peptide. HLA-DR specific markers can be used with this parameter because their expression is partly shared. This approach appears useful in the older diabetic patients to help classify diabetes and its management.

Aged↗

Incidence of type 1 (insulin-dependent) diabetes mellitus in subjects 0-14 years of age in the Comunidad of Madrid, Spain.

A retrospective, population-based registry was established in the Comunidad of Madrid, Spain (total population: 4,780,572; under age 15: 1,105,243) to investigate the epidemiology of Type 1 (insulin-dependent) diabetes mellitus. Included were all cases diagnosed with diabetes between 1985 and 1988, with age onset less than 15 years, and using insulin at discharge from hospital. Using the capture-recapture method employing hospital records as the primary source and membership files of the Spanish Diabetic Association as the secondary source, the ascertainment was 90%. The overall annual incidence was estimated to be 11.3/100,000 (Poison 95% confidence interval: 10.3-12.4). There was no temporal increase in incidence, nor was there a significant sex difference in incidence rates, either overall or by year. The seasonal onset pattern showed the highest incidence in winter (December-February) and lowest in summer (June-August) (r = 7.36, p less than 0.05). The age-adjusted (world standard) incidence of 10.9/100,000 was inconsistent with the hypothesis of a north-south gradient in diabetes risk.

Adolescent↗

[Chronic adrenal failure secondary to an isolated deficiency of ACTH. Presentation of 2 new cases].

Chronic adrenal failure due to hypothalamic-hypophyseal disorders is rarely encountered. This can be due to hormonal deficiencies generally related to the presence of a brain tumor or an infiltrating process and sometimes to an isolated deficiency of ACTH. We report on two patients with adrenal failure with low basal cortisol levels and a poor response to short cortisol stimulation test with ACTH. Long cortisol stimulation test with ACTH was normal and ACTH was not stimulated with corticotropin releasing factor. However, other specific dynamic pituitary hormonal tests were normal. The uncommon clinical presentation of the disease, such as severe hypoglycemic crisis and fever of unknown origin (FUO), is underscored.

Adrenal Insufficiency↗