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Biomedical subjects

R Madero

Publications and source records attributed to R Madero.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Variations of angiotensin converting enzyme in chronic obstructive pulmonary disease and chronic respiratory insufficiency].

UNLABELLED: Maintained hypoxia has been reported to induce inactivation of the Angiotensin Converting Enzyme (ACE). Variations have also been observed in patients with chronic obstructive pulmonary disease (COPD) who have chronic hypoxemia and loss of the vascular endothelium. OBJECTIVES: 1) to determine serum ACE activity in patients with COPD treated with and without continuous ambulatory oxygen therapy (CAOT); 2) to verify whether there is a correlation between ACE and any hematological, spirometric or gasometric parameter. METHODS: fifty-eight patients fulfilling clinical and spirometric parameters of COPD were studied. Patients were assigned to two groups of therapy: A) Group A, without Continuous Ambulatory Oxygen Therapy (CAOT): 31 males and 1 female (mean age: 64.8 +/- 6.52). B) Group B (with CAOT): 23 males and 3 females (mean age years: 63.76 +/- 8 years). The following procedures were performed: spirometry, gasometry, blood chemistry, and serum ACE measurements by means of a radioenzymatic assay. The Student "t" test with the Bonferroni correction and Pearson regression analysis were used for the statistical analysis. RESULTS: significant differences were observed for ACE values between Group A and Group B: 42.81 +/- 11.30 vs. 33.40 +/- 9.43 mumol/min/l, with a p value of 0.001, and also between Group B and reference values: 33.40 +/- 9.43 vs. 39.70 +/- 9.65 mumol/min/l, with a p value of 0.002. No differences were observed between Group A and reference values. No correlations wer found between ACE and any of the variables studied. CONCLUSIONS: ACE was not decreased in all patients with COPD. ACE was decreased only in patients with COPD and respiratory insufficiency requiring CAOT and with advanced disease. This results can be correlated with changes in vascular endothelium, pulmonary parenchyma and metabolism. It could be a marker of poor prognosis or advanced disease.

Aged↗
PubMed1993

Urinary solute transport by ileal segments. I. Effects of nicotinic acid.

This study was conducted to quantify urinary solute transport by the ileum, using an in vivo human model, and to determine the effect of nicotinic acid on this process. Patients were studied under both basal conditions and niacin therapy. The rates of solute transport were established by analysis of excretion indexes for each solute. Potassium and ammonium were absorbed by the ileum, while phosphorus, sodium and bicarbonate were secreted. The percentage excretion index of sodium and bicarbonate increased by approximately 100 and 600% respectively, causing a significant rise in urinary pH. Although not statistically significant, there was a tendency for chloride to be absorbed and for water to pass into the bowel lumen. Nicotinic acid 3 g/day had no significant effect on urinary solute transport.

Ammonia↗
PubMed1993

[The descriptive and analytical epidemiology of traumatic spinal cord lesions occurring in Spain during 1984 and 1985].

Descriptive and analytic epidemiology of traumatic spinal cord injury (Traumatic-SCI) in Spain, with a sample of 33% of all incidental cases between 1984 and 1985, underlining the traffic accidents as the origin of those lesions. OR was obtained next of different variables of T-SCI, after controlling possible confusing factors through logistic regression and taking as "control group" Non Traumatic-SCI. OR in Traumatic-SCI decreases with age and in females. These Traumatic-SCI produce especially "cervical" lesions (OR = 3) and "complete" (OR = 4) with higher dependence on second persons. In the rest of variables there are no significative differences.

Adolescent↗
PubMed1992

Frequency and prophylaxis of upper gastrointestinal hemorrhage in critically ill children: a prospective study comparing the efficacy of almagate, ranitidine, and sucralfate. The Gastrointestinal Hemorrhage Study Group.

OBJECTIVE: To determine the occurrence of upper gastrointestinal hemorrhage in critically ill children, and the efficacy of prophylaxis with almagate (antacid), ranitidine, and sucralfate. DESIGN: Prospective, randomized, controlled trial. SETTING: Pediatric ICU of a tertiary care pediatric hospital. PATIENTS: During a 2-yr study period, 165 patients with one or more upper gastrointestinal hemorrhage risk factors were randomized into one of four groups. Twenty-five patients were excluded because of protocol violations. A total of 140 patients completed the study, with 35 patients in each group. INTERVENTIONS: Patients received no treatment in the control group. The antacid group received almagate 0.25 to 0.5 mL/kg every 2 hrs by nasogastric tube. The ranitidine group received 1.5 mg/kg every 6 hrs iv. The sucralfate group received 0.5 to 1 g every 6 hrs by nasogastric tube. METHODS: Gastric pH and macroscopic bleeding were determined every 2 hrs in all patients until the end of the study. Macroscopic bleeding was classified as nonhemorrhage, slight, or important. Microscopic gastric bleeding was researched with guaiac testing in 72 patients (680 samples). The severity of illness was evaluated by using the Therapeutic Intervention Scoring System, Physiologic Stability Index, and the Multiorgan System Failure scores. The risk of upper gastrointestinal hemorrhage was evaluated by the Zinner and Tryba indices, and was modified for children. MEASUREMENTS AND MAIN RESULTS: The occurrence rate of important upper gastrointestinal hemorrhage was higher (by 20%) in the control group than in the rest of the groups (5.7%), p less than .01. There were no differences between the other groups (almagate 5.7%, ranitidine 8.5%, and sucralfate 2.8%). There was a statistically significant correlation between the occurrence rate of important upper gastrointestinal hemorrhage, the scores of severity of illness indices (Therapeutic Intervention Scoring System, Physiologic Stability Index, and the Multiorgan System Failure scoring system), the risk of upper gastrointestinal hemorrhage indices (Zinner and Tryba), and mortality rate. The Zinner index better classified the patients in relation to the onset of important upper gastrointestinal hemorrhage (sensitivity 76.9%, specificity 85.8%). CONCLUSIONS: Upper gastrointestinal hemorrhage is an important complication in critically ill children. Prophylaxis with almagate, ranitidine, or sucralfate reduces the occurrence rate of clinically important gastrointestinal hemorrhage.

Aluminum Hydroxide↗
PubMed1992

[Transposition of the great arteries. A follow-up of patients operated on with atrial correction].

The late results of 146 patients with transposition of the great arteries (simple: 119, complex: 27) surviving to physiological correction (Mustard: 33, Senning: 113) are analyzed. The mean age at operation was 27 months (1-120), and the mean follow-up was 78 months (6-187). The mean P wave voltage significantly decreased (from 0.3 mV preoperatively to 0.16 mV postoperatively). Frontal mean P wave axis varied from 63.9 degrees to 71.3 degrees. Mean heart rate were significantly lower than those for age-matched normal children. Previous atrioseptectomy had been performed in 36 patients and five of them had arrhythmias before operation. 78 (55%) out of the remaining 141 showed arrhythmias in the surface ECG: sinus node disfunction in 51, tachyarrhythmias in eight, atrioventricular block in eight and several association of arrhythmias in 11. Actuarial survival free of arrhythmias is 81% at the first year, 49% at 5 years and 22% at 15 years. The incidence of arrhythmias in the group of 92 patients with Holter monitoring was higher, with 73 cases having arrhythmias (79%): sinus node disfunction in 47, tachyarrhythmias in ten, atrioventricular block in four and associated in 12. Survival free of arrhythmias by both methods (ECG and Holter) shows a 78% at the first year, 28% at 5 years and 5.6% at 15 years. No significant correlation was found between the incidence of arrhythmias and the type of TGA (simple or complex) or the surgical technique (Mustard or Senning). Permanent pacemakers were implanted in seven to a mean follow-up of 7 years. Five patients were reoperated to a mean follow-up of 46 months. There were 7 late deaths to a mean follow-up of 13 months, four of them being sudden. The actuarial survival rate for the whole group was 93.5% at 15 years. No significant correlation was found between the late mortality and the type of TGA or operation. There was also no correlation with the incidence of arrhythmias. Residual lesions were found in 46 patients, hemodynamically significant in ten. Functional status was class I (NYHA) in 123, and class II in 16. There was correlation between the functional class and the residual lesions.

Age Factors↗
PubMed1991

[Alterations in calcium metabolism in patients with active tuberculosis].

BACKGROUND: Abnormalities in phosphocalcic and vitamin D metabolism may develop in patients with active tuberculosis (TB). Their incidence and relationship with the disease is not well known, particularly in our area. We have prospectively evaluated 40 patients with TB [(30 with localized TB (LTB) and 10 with disseminated TB (DTB)]. METHODS: After stabilizing the diet during 4 days, the calcium, phosphorus, magnesium and creatinine balances, blood ionic calcium, plasma intact PTH, 25-hydroxy vitamin D [25(OH)D] and serum 1.25 dihydroxyvitamin D [1.25(OH)2D] were measured. RESULTS: Hypercalcemia was not found in any patient, but 25% had hypercalciuria (HC). The 24-hour urinary excretion of calcium was higher in patients than in controls (3.2 +/- 1.7 mg/kg or 0.10 +/- 0.06 mg/100 ml of GFR vs 2.3 +/- 0.7 mg/kg or 0.08 +/- 0.03 mg/100 ml of GFR, p less than 0.05), basically at the expense of patients with DTB (4.4 +/- 1.8 mg/kg or 0.14 +/- 0.06 mg/10 ml of GFR, p less than 0.005). These had a lower PTH than patients with LTB and controls (12.8 +/- 7.7 vs 18.5 +/- 6.9 vs 19.5 +/- 6.0 pg/ml, p less than 0.05). Independently from the extent of the disease, the patients with HC had a lower PTH (12.6 +/- 6.8 vs 18.5 +/- 6.9 pg/ml, p less than 0.01) and higher serum 1.25(OH)2D (34.5 +/- 10.1 vs 25.0 +/- 7.2 pg/ml, p less than 0.01) than patients without HC. The levels of 25(OH)D were lower in patients with TB than in controls (11.2 +/- 6.0 vs 20.0 +/- 7.0 ng/ml, p less than 0.05), independently from the extent of the disease and the presence or absence of HC. CONCLUSIONS: Patients with tuberculosis may have hypercalcinuria with inadequately high levels of 1.25(OH)2D and low intact PTH. This abnormality appears to be correlated with the extent of the disease.

Adult↗
PubMed1991

Intrapartum chemoprophylaxis of early-onset group B streptococcal disease.

A randomized study in 121 pregnant women carrier of group B streptococci is undertaken in order to assess the administration of 500 mg of intrapartum ampicillin intravenously to interrupt mother-to-fetus group B streptococcal transmission. In the prophylaxis group there was a significant reduction in neonatal colonization (3.7 vs. 42.9%) and in severe neonatal colonization (0 vs. 25%). There was no case of group B streptococcal sepsis in the prophylaxis group compared to 4.6% (3 cases) in the control group (P greater than 0.05). Clinically infected newborns represented 3.3% in the prophylaxis group vs. 13.8% in the control group. When the organism was isolated during delivery in the vagina or amniotic fluid, prophylaxis was quickly followed by second negative cultures. Ampicillin levels in the amniotic fluid were detected early, and they increased significantly till the third hour. Bactericidal levels in the umbilical cord were detected in 60% of newborns. All these findings support the usefulness of ampicillin prophylaxis in the prevention of early-onset group B streptococcal sepsis.

Amniotic Fluid↗
PubMed1991

Maternal colonization by group B streptococci and puerperal infection; analysis of intrapartum chemoprophylaxis.

In a population of 1011 puerperal women, the significance of rectovaginal colonization by group B streptococci during pregnancy with respect to infective puerperal morbidity was analyzed. Patients who were found to be carriers during pregnancy (121) were randomly divided into two groups: women who received ampicillin during delivery (500 mg i.v./6 h) and patients without chemoprophylaxis. Compared with the non-carriers, the carrier patients without prophylaxis had a significant increase in the mild puerperal infective morbidity, when defined as the proportion of women with an index fever greater than or equal to 10 (10.6% vs. 25%). However, the increased incidence among the carrier women of premature rupture of the membranes and of other possible morbidity factors made it impossible to identify the role of group B streptococci. Mild puerperal infective morbidity in the carrier women who received prophylaxis was lower than in those without prophylaxis and very similar to that of non-carrier women. It is concluded that the use of chemoprophylaxis to prevent neonatal sepsis would probably be followed by a reduction in infectious puerperal morbidity.

Ampicillin↗
PubMed1991

Immunological follow-up in children born to HIV-1 infected mothers.

From November 1985 to January 1990 we examined 156 children born to 154 HIV-1 seropositive mothers every 3 months. Eighty-seven infants were over 18 months by January 1990. Six of them met the CDC criteria of HIV-1 infection or died from AIDS; a transmission rate of 7%. Six of the children aged less than 18 months also met the CDC criteria of HIV-1 infection. These 12 infected children were compared with the 81 presumably unifected children. The perinatal findings were similar in both groups. Most of the HIV-1 infected babies showed early abnormalities in humoral and cellular immunity, hypergammaglobulinemia, low percentage of CD4 circulating lymphocytes and increased spontaneous in vitro immunoglobulin production. These changes were persistent in the HIV-1 infected children, but sporadic in those uninfected. Immunological abnormalities were frequently found before clinical symptoms appeared. We conclude that repeated immunological abnormalities in babies born to HIV-1 seropositive mothers are suggestive of HIV-1 infection.

AIDS Serodiagnosis↗
PubMed1990

[Prevalence of hepatitis B virus in a sample of healthy children in Madrid].

In order to determine the prevalence of hepatitis B virus (HBV) markers, we studied 375 healthy children, 242 males and 113 females, with age ranged between 6 to 14 years, from different schools at the Tetuán district (Madrid). We sent a questionnaire to the parents to investigate the presence of risk factor in the children and/or their parents. All children were screened for hepatitis B markers in serum. Our results shown the existence of HBV markers in 22 (5.9%) children. No major incidence of risk factors was found in the children with serologic evidence of HBV infection.

Adolescent↗
PubMed1990

[Fuenlabrada study: lipid and lipoprotein levels in children and adolescents associated with ischemic cardiopathy prevalence among their relatives].

The prevalence of coronary heart disease (CHD) was studied in parents and grandparents of 2,419 children surveyed for lipid levels. Children and their families were divided into 3 groups depending on the level of each lipid and lipoprotein studied in children: high greater than or equal to 95 percentile (p), medium 5-95 p, and low less than 5 p. Total cholesterol (Chol) and triglycerides (TG) were determined by enzymatic techniques in autoanalyzer. C-HDL was determined by precipitation method. C-LDL and C-VLDL were obtained by Friedewald-Fredrickson's equation. The prevalence of CHD in parents and grandparents was ascertained from clinical history. Fathers of children in the high groups of Chol, TG, C-LDL/C-HDL, and low group of C-HDL had increased prevalence of CHD compared with those of the low groups of Chol, TG, C-LDL, C-LDL/C-HDL and high group of C-HDL. The strongest association was with C-HDL. Maternal and paternal grandfathers of children in the high groups of Chol had also increased prevalence of CHD compared with those of low group of Chol. There was no association with any other variable. The association was not significant neither in mothers nor in maternal and paternal grandmothers. Childhood lipid and lipoprotein levels could identify families at elevated risk for CHD.

Adolescent↗
PubMed1990

[The Fuenlabrada study: relationship between anthropometric variables and cardiovascular risk factors].

Anthropometric variables were studied in 2,153 healthy children, 1,115 males and 1,038 females, aged 0 to 18 years, of the Fuenlabrada population, Madrid. Height was measured by an anthropometer and weight by a weighting scale. Tricipital and subscapular skinfold thickness were measured by Holtain caliper. Body mass index (kg/m2) and ponderal index (kg/m3) were calculated from weight and height. In the total population skinfold thickness had the highest correlation with total body fat. But, when only obese children (greater than 95 p) were analyzed, other variables like body mass index and ponderal index had also high correlation. Different fatness trends were observed between sexes, although females always were the fattest. In our population the correlation of skinfold thickness, body mass index and ponderal index with lipids, blood pressure, glycemia and uric acid were significant. Obese children and adolescents had nearly a twofold increase in relative risk of arterial hypertension, hypertriglyceridemia, hyperuricemia and low C-HDL.

Adolescent↗
PubMed1989

[Systemic vasculitis as a cause of fever of unknown origin].

A prospective clinical study (1974-1988) was carried out in 33 patients with several types of systemic vasculitis (SV) presenting as fever of unknown origin (FUO) according to the 1961 Petersdorf and Beeson's criteria. Histological confirmation, either from biopsy or necropsy, was available in all cases. The types of SV with FUO were: panarteritis nodosa (PAN) (14 cases), giant cell arteritis (GCA) (13 cases), and overlapping polyangiitic syndrome (OPS) (6 cases). In PAN, the clinical features associated with fever at the onset of the disease were remarkably nonspecific: constitutional symptoms (85%), arthromyalgia (50%), nonspecific abdominal pain (28%), and irritative cough (28%). In the whole course of the cases of GCA a significantly smaller frequency of presentation of local arterial symptoms and polymyalgia rheumatica (p less than 0.01) was found in the subgroup of patients with FUO than in those without it. As regard laboratory data, a higher increase of serum alkaline phosphatase (p less than 0.05) was found in the cases of PAN and OPS with FUO. Striated muscle biopsy and arteriography were the most useful investigations in the diagnosis of PAN. The study that gave the diagnosis in the cases of GCA was temporal artery biopsy.

Female↗
PubMed1989

[Usefulness of temporal artery biopsy: analysis of 100 cases].

We have evaluated 100 biopsies of temporal artery carried out in the Hospital La Paz from 1972 to 1986. On the basis of the histological result and the final diagnosis we divided the patients in five groups: I, temporal arteritis/polymyalgia rheumatica with positive biopsy, 11 cases; II, temporal arteritis without polymyalgia symptoms and with positive biopsy, 16 cases; III, temporal arteritis with negative biopsy, 7 cases; IV, polymyalgia with negative biopsy, 14 cases; and V, other diagnoses, 43 cases. The number of diagnoses of temporal arteritis/polymyalgia rheumatica has increased throughout the recent years, although the positive biopsies/overall biopsies ratio has remained constant. Certain symptoms such as claudication, headache, amaurosis and Raynaud's phenomenon have a high predictive value of a positive result, but their sensitivity is low. In the 25 patients with polymyalgia, biopsy was positive in 11, out of which 4 did not have features of temporal arteritis. Biopsy was positive in 4 out of the 9 patients in whom it was repeated in the contralateral side. The diagnostic yield was higher in those cases in whom it was indicated for classical temporal arteritis symptoms, but we emphasize that there was a 19% positive rate in patients who presented with fever of unknown origin, while it was only 5.5% in those in whom a constitutional syndrome was being evaluated. We conclude that the use of temporal biopsy should be more widespread, as its cost is low and it has no side effects; therefore, it can achieve a great benefit for the patient with a shorter and less expensive hospital stay.

Adolescent↗
PubMed1989

[The Fuenlabrada study: a familial aggregation of ischemic cardiopathy and cardiovascular risk factors].

UNLABELLED: Familial aggregation of coronary heart disease (CHD) and coronary risk factors (CRF) were evaluated by clinical history in adult relatives of children surveyed for CRF. Population was divided into two groups: Group I included 2,153 children without parental history of CHD. Group II included 266 children of 112 families with parental history of early CHD (before 56 years). In 105 cases the patients were the fathers and in 7 cases the mothers. All the patients were admitted to a coronary care unit. Familial aggregation of CHD was 9.7 times more frequent in paternal families of group II (p less than or equal to 0.0001) than in group I; there was no differences in maternal families. Higher prevalence of hyperlipidaemia, blood pressure hypertension, smoking habits, diabetes and obesity in fathers of group II was observed. Children in group II showed increased levels of C-LDL and decreased levels of C-HDL compared with those of group I. The prevalence of CRF was also significantly higher in children of group II, although in the 33% of the children of group II no CRF was detected. CONCLUSION: a substantial proportion, but not all cases, of familial aggregation of CHD could be explained by known CRF.

Adolescent↗
PubMed1989

[The Fuenlabrada study: arterial pressure in children and adolescents].

Blood pressure was studied in 2,153 healthy children of both sexes, from 0 to 18 years of age; 1,115 were males and 1,038 females. Systolic and diastolic blood pressures were measured in the sitting position by the auscultatory method on the right arm with a mercury sphygmomanometer using an appropriate cuff size. Systolic blood pressure was measured on the first sound and diastolic blood pressure in the fourth phase of Korotkoff. In children younger than 3 years blood pressure was measured in the decubitus supine position using the Doppler technique. There were no significant differences in mean systolic and diastolic blood pressure in both sexes. But the percentage of systolic blood pressure greater than or equal to 130 mmHg was higher in males than females (p less than or equal to 0.01). 8.4% of the total population had systolic blood pressure greater than or equal to 130 mmHg, and 1.3% had diastolic blood pressure greater than or equal to 90 mmHg. The annual increase rates of systolic and diastolic blood pressure were 2.31/0.94 mmHg in males and 2/0.97 mmHg in females. Children with blood pressure greater than or equal to the 95th percentile had a higher prevalence of hypertriglyceridemia and obesity. 54% of the variation in systolic blood pressure was explained by the association of weight, subscapular skinfold, body mass index and C-HDL. 30% of the variation in diastolic blood pressure was explained by the association of weight, obesity index, subscapular skinfold and C-HDL.

Adolescent↗
PubMed1989

[Cardiovascular risk factors in children and adolescents in Fuenlabrada: objectives, features of the population, design, participation, equipment, laboratory technics, and quality control].

Fuenlabrada is at the present time the most industrialized town placed at the south are of Madrid. This population has some peculiar attractive characteristics from the epidemiologic point of view. Perhaps the most important is that the majority of its inhabitants are immigrant from other depressed rural areas of the country, with a low socio-economic and cultural level. The new conditions of life could have changed the life expectation and the causes of morbidity and mortality of this population. Between 1981 and 1984 we have studied the prevalence of cardiovascular risk factors in children and adolescents of its population, the relationships with cardiovascular risk factors and cardiovascular disease of the family and type of lactancy of the newborn. The variables studied were: height, weight, skin fold, blood pressure, lipids, lipoproteins, glycemia, uric acid and tobacco habit. The laboratory technics were standardized with serums of reference. The index of participation in the study of the required population was approximately of 80%.

Adolescent↗