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Biomedical subjects

R Carmena

Publications and source records attributed to R Carmena.

At least 73 records · Page 4Linked to original sources
PubMed1993

Red blood cell aggregation and primary hyperlipoproteinemia.

Erythrocyte aggregation (EA) was determined in a Myrenne aggregometer at stasis (EAMo) and low shear (EAM1) in 102 patients suffering from primary hyperlipoproteinemia (PHLP)-46 with familial hypercholesterolemia (FH); 28 with familial combined hyperlipemia (FCHL); 28 with primary hypertriglyceridemia (PHTG)-and in a control group (CG) of healthy matched subjects. EA was also determined in FH after the autologous plasma had been replaced by a control plasma. The following parameters were also measured: fibrinogen (Fbg), plasmatic lipids, apolipoproteins, glucose, HbA1 c and membrane erythrocyte lipids: cholesterol (C) and phospholipids (PL). An increase in both EAMo and EAM1 was observed in all the studied groups of patients. When erythrocytes of FH were resuspended in control plasma, EA normalized, but only in 75% of them. Fbg was elevated only in FH and FCHL. Membrane C was increased mainly in FH and FCHL. EA correlates with both Fbg and apolipoproteins. In FH, EA also correlates with membrane C/PL. In addition, a high significant correlation exists between EA and HbA1 c in FCHL. The results obtained suggest that not only Fbg and apolipoproteins but also possible changes in erythrocyte membrane could encourage EA in PHLP.

Adolescent↗
PubMed1993

The response to lovastatin treatment in patients with heterozygous familial hypercholesterolemia is modulated by apolipoprotein E polymorphism.

In a retrospective study, we examined the influence of apolipoprotein (apo) E polymorphism and gender on the response to treatment with 80 mg/d lovastatin in a homogeneous population of patients with familial hypercholesterolemia (FH), most of whom were carriers of the 10-kb deletion of the low-density lipoprotein (LDL) receptor gene. Apo E phenotype distribution among the 189 FH patients was not different from that of a normal population sample. The total and LDL cholesterol (LDL-C) response to lovastatin in the overall group (men and women) was significantly lower in the E4 subset compared with E2 and E3 subsets. This finding is in agreement with trends observed in previous reports. On the other hand, the response of LDL-C to lovastatin was significantly lower in E4 men than in E4 women, whereas the high-density lipoprotein cholesterol (HDL-C) concentration in the E4 group increased significantly more in men than in women, suggesting a role of gender in modulating the response to lovastatin. Hence, apo E polymorphism influenced LDL-C (and HDL-C) response to lovastatin in men, but not in women, revealing the existence of a gene-by-gender interaction. These findings were independent of the nature of the LDL receptor defect. We conclude that male FH patients carrying the epsilon 4 allele respond less efficiently to lovastatin than men carrying the epsilon 3 or epsilon 2 allele or women of any apo E phenotype with respect to decreasing total cholesterol and LDL-C levels, but respond more efficiently with respect to increasing HDL-C levels. The full practical implication of these findings remains to be explored.

Adult↗
PubMed1991

[Course of cardiac autonomic neuropathy in diabetic patients++ depending on the degree of metabolic control].

Thirty-one diabetic subjects, 19 males and 12 females, with a mean age of 40.5 +/- 14.0 years, 17 of whom were insulin dependent (IDDM) and 14 non-insulin dependent (NIDDM) treated with insulin and diet, were followed for a period of six months. Patients were diagnosed of diabetic autonomic cardiopathy (without other neuropathy causes, nor use of drugs except for insulin) by the alteration of at least 2 of the 5 cardiovascular tests (tCV) performed. Patients underwent an educational diabetes program and self-control, and after 6 months of treatment they were divided into two groups according to the degree of metabolic control. In group 1, in which there was a good control with mean blood sugar levels of 108 +/- 12 mg/dl (5.9 +/- 0.6 mmol/l) and triglycerides of 101 +/- 21 (1.1 +/- 0.2 mmol/l), an improvement in tCV was observed: Valsalva coefficient of 1.16 +/- 0.13 and 1.22 +/- 0.13 (initial and final respectively) (p less than 0.001), with and improvement in 56% of cases; E/I (expiration/inspiration) ratio increased from 1.13 +/- 0.11 to 1.21 +/- 0.11, improving 53% of cases (p less than 0.001); 30/50 index (RR in 30/RR beat in beat 15 after orthostatism) (n.s.); difference in systolic arterial pressure after standing (p less than 0.001) and increase in diastolic arterial pressure with isometric muscular exercise (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Autonomic Nervous System Diseases↗
PubMed1990

[Protein malnutrition in insulin-dependent or type I diabetes mellitus. Relationship with the degree of metabolic control].

Fifty-eight insulin-dependent diabetic (IDDM) patients with a disease duration of more than three years were evaluated and divided in three groups depending on the mean sugar blood levels in a three month follow-up. In the first group sugar blood level was lower than 7.7 mmol/l, in the second group it was between 7.7 and 11.1 mmol/l, and in the third group it was higher than 11.1 mmol/l. The nutritional status was evaluated. Protein malnutrition was found in 50% of the evaluated subjects, with a significant relation between the degree of metabolic control and the prevalence of protein malnutrition. In group I (sugar blood level less than 7.7 mmol/l) the prevalence of malnutrition was 31%, whereas in groups II and III (greater than 7.7 mmol/l) it was 54% and 61%, respectively. We discuss the importance to evaluate the nutritional status in diabetic patients, as protein malnutrition is a significant cause of general morbidity and mortality, which can be added to those attributable to diabetes itself.

Adult↗
PubMed1990

[Hyperplasia of the pancreatic islets or nesidioblastosis in adults? Apropos 2 cases].

Nesidioblastosis is an anatomopathological situation defined as the transformation or the exocrine ductal epithelium into endocrine tissue which can be hormonally active or inactive. In this study we present two cases which to our knowledge fulfil criteria for nesidioblastosis. Both patients were male (73 and 45 years, respectively) who were admitted to our department because they presented hypoglycemia. Blood examination revealed the existence of an hyperinsulinism although axial computerized tomography, pancreatic echocardiography and selective angiography of the celiac arterial trunk failed to demonstrate the presence of the tumor in either of the two cases. Due to the persistence of the clinical picture in the first case and to the intolerance to the diazoxide in the second patient, a subtotal pancreatectomy was performed in both cases. The surgical procedure involved removal of the 80% and 75% of the head and body respectively. Both patients are presently free of symptoms although the first patient in under diazoxide therapy due to persistent hypoglycemia (more spaced crisis).

Aged↗
PubMed1990

[Course of peripheral diabetic neuropathy depending on the metabolic control after 6 months of follow-up].

We evaluated 40 diabetic patients (with a duration of the disease longer than 10 years) with diabetic neuropathy, to assess the effect of a good metabolic control maintained for six months on the nervous conduction velocity. The motor nervous conduction velocity (NCV) and the sensory latency and potentials were evaluated in the median and external popliteal nerves. In the groups of patients with a good metabolic control (mean basal glucose blood levels 109 +/- 12 mg/dl, or 6.04 +/- 0.66 mmol/l) there was a significant clinical improvement with improved test results; the NCV if the external popliteal nerve changed from 40.5 +/- 5.9 m/sec to 43.5 +/- 5.8 m/sec (p less than 0.05). An improvement of motor involvement and sensory potentials were found in 35 and 20%, respectively, of group I patients. The differences with those patients without a good metabolic control, in whom no study parameter improved, were significant. These studies apparently show a good metabolic control may reverse or at least improve diabetic neuropathy. However, wider studies are required to elucidate whether diabetic neuropathy is reversible or not.

Adult↗
PubMed1989

[Insulin and peptide C secretion after food ingestion and the interaction of insulin with its erythrocyte receptor in a family with MODY type diabetes mellitus].

In 12 members of a family with MODY, insulin and C-peptide release after intake of a test breakfast was measured as well as binding of insulin to its erythrocyte receptor. According to serum glucose concentrations, subjects were classified into: diabetic, carbohydrate intolerant, and normal subjects. The two diabetic patients had an insulin release pattern similar to that of non-insulin dependent diabetics. The two patients with carbohydrate intolerance presented hyperinsulinism either at base state and after stimulation. Of the eight normal subjects, three presented high concentrations of serum insulin either at base level and after stimulation; in the remaining five, base insulinemia was normal and the response after food intake was poor. Insulin binding to the receptor was decreased in diabetic patients and this anomaly was more evident in patients with carbohydrate intolerance. In the three patients with increased serum insulin concentration, no disturbances in insulin-receptor binding were detected; in the remaining five patients, insulin-receptor binding was significantly decreased. Our findings prove that these subjects present a disturbance of insulin release and an impairment of insulin-receptor binding with a predominance of one or the other alteration even before hyperglycemia is evident.

Adolescent↗
PubMed1984

Changes in plasma high-density lipoproteins after body weight reduction in obese women.

We investigated effects of a hypocaloric diet of 5023.2 kJ (1200 kcal) on body weight and plasma lipids in 40 obese female subjects in two groups: (1) 20 obese subjects with normal plasma triglycerides at the onset (means = 148.5 mg/dl), and (2) 20 with hypertriglyceridemia (means = 225.3 mg/dl). The hypocaloric diet was instituted for a mean period of nine months and average body weight loss was 15.6 kg for Gp 1 and 14.0 kg for Gp 2. In Gp 1 there were no significant changes in total plasma cholesterol or triglycerides, but HDL-cholesterol rose significantly from a mean value of 42.5 to 53.6 mg/dl (P less than 0.001). Subjects in Gp 2 showed a significant decrease in plasma triglycerides (from 225.3 to 152.3 mg/dl, P less than 0.001) and an elevation in HDL-cholesterol from 41.2 to 48.2 mg/dl, P less than 0.001. Our results show that losing weight is associated with HDL-cholesterol elevation, independently of variation in plasma triglycerides.

Adolescent↗