Search PubMed⌕ Search

Biomedical subjects

W Ricart

Publications and source records attributed to W Ricart.

At least 73 records · Page 4Linked to original sources
PubMed1994

Iron-related damage in acute ischemic stroke.

BACKGROUND AND PURPOSE: Although iron-mediated mechanisms are important in experimental brain injury after carotid occlusion, their clinical role in acute ischemic stroke has not been determined. We evaluated the influence of iron stores, measured as serum ferritin, on the outcome of acute cerebral infarct. METHODS: Admission and fasting glycemia, glycosylated hemoglobin, serum cortisol, serum ferritin, and 24-hour urinary free cortisol levels were measured on the first day of hospitalization in 67 patients admitted with an acute ischemic stroke of less than 24 hours' duration. Patients were classified into two groups according to their Canadian Stroke Scale (CSS) score on day 30: good outcome group (alive and CSS score > 7 points) and poor outcome group (dead or CSS score < or = 7 points). RESULTS: Thirty-three patients (49%) had good outcome and 34 (51%) poor outcome. Fasting glycemia (P = .001), serum cortisol (P < .001), and urinary free cortisol (P = .001) but not admission glycemia and glycosylated hemoglobin had higher levels in patients with poor outcome. Serum ferritin values were greater in the poor outcome group (218 +/- 156 micrograms/L versus 133 +/- 125 micrograms/L; P = .004), and a correlation between ferritin values and degree of worsening or improvement of the CSS score on day 30 was found (P = .002). Serum cortisol (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.7 to 26), fasting glycemia (OR, 5.4; 95% CI, 1.2 to 24), and serum ferritin (OR, 4.6; 95% CI, 1.1 to 19) were independently related to poor outcome in a logistic regression analysis. CONCLUSIONS: High serum ferritin levels within the first 24 hours of hospitalization for an acute ischemic stroke are related to a poor prognosis, independent of the stress response. More research is needed to determine the origin of increased serum ferritin levels and the therapeutic implications.

Acute Disease↗
PubMed1993

[Early diabetic nephropathy in a patient with agenesis of one kidney].

A 24 year old male diagnosed of type II diabetes mellitus of 2 years of known clinical evolution discovered by an episode of hyperglycemic decompensation without ketoacidosis is presented. In the study of possible visceral involvement of the disease agenesis of the left kidney with compensating hypertrophy of the right kidney, increase of glomerular filtrate and proteinuria of 1.8 g/24 hours were observed. Renal histologic study demonstrated the existence of diffuse intercapillar glomerulosclerosis compatible with diabetic glomerulopathy. From these data and review of the literature the possibility of the greater risk of individuals with a single kidney to present nephropathy in the case of coexistence of associated diabetes mellitus.

Adult↗
PubMed1993

[Evaluation of the nutritional status through determination of anthropometric parameters: new charts for the working population of Catalonia. Group for the Evaluation of body composition in the population of Catalonia].

BACKGROUND: Body composition measure by anthropometric parameters permits the detection of populations at risk of developing diseases with greater impact in public health and provides standard values of normality of nutritional state. METHODS: A prospective transversal study was carried out with a randomly selected sample of 6,445 individuals taken from 25,279 workers evaluated in Safety and Hygiene Centers during 1990. Chronically ill patients were excluded with 5,019 healthy individuals between 16 and 65 years of age being selected. The following data were obtained: height, weight, skin fold of the biceps and triceps, subscapular and abdominal and arm perimeter. Calculation of the weight/height, weight/height, weight/height, sum of two and four folds, mid-arm muscle circunference, area fo the arm, muscle area of the arm, adipose area of the arm and muscle adipose index was performed. RESULTS: The tables of the percentiles 1, 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 95, and 99 of the anthropometric parameters according to sex and age are presented. Significant differences were found among the age groups for the fat parameters which were greater from the third decade for the fold of the fat of the trunk in males and from the fourth decade of the fat parameters of the trunk and extremities of females. The muscle parameters successively increased in both sexes and for each age group up to the fourth decade and thereafter remained stable. CONCLUSIONS: The values of the anthropometric parameters may be used as standard patterns of the working population in Catalonia. The differences between sexes and age groups, such as with the values of the Catalan population previously referred and those of the American population, indicate that the anthropometric measurements of body composition must be periodically determined to ensure adequate standards of each population.

Adolescent↗
PubMed1993

Tuberculous Addison's disease. Utility of CT in diagnosis and follow-up.

The computed tomographic (CT) findings in five patients with tuberculous Addison's disease were evaluated. All patients had extra-adrenal tuberculosis. Two patients had enlarged adrenal glands with calcifications at the times of diagnosis. Follow-up CT from 4 to 30 months showed a progressive decrease in the size of adrenal glands from bilateral enlargement to small calcified glands and provides a clue to the etiology of Addison's disease and proper therapy.

Addison Disease↗
PubMed1993

[Hypophyseal apoplexy: clinico-radiologic analysis and clinical course in 18 patients].

The period of time between clinical manifestations and admission of 18 patients with pituitary apoplexy (PA) was of a mean of 6 days with the exception of two cases. Distribution by age and sex, absence of previous endocrinal clinical manifestations in 38.8% of the patients was similar to that of larger series described. Headache constituted an almost constant symptom. The most affected cranial pairs were II (12 patients), III and IV, both in 8 cases. Following decompression surgery, great improvement was observed in visual acuteness in 5 of these patients, and in the ophthalmoplexy in 8. Alterations in the level of consciousness is less and less frequent in the context of PA thanks to the diagnosis of less severe clinical episodes. Similarly, a high rate of clinical suspicion and the use of new imaging techniques (NMR) have contributed notably with the most outstanding findings being resumed. Moreover, a case of PA with associated intracranial aneurysm verified by carotid angiography is described.

Adult↗
PubMed1991

[Pituitary apoplexy: analysis of endocrine function in 17 cases].

BACKGROUND: From a neurological standpoint, pituitary apoplexy (PA) is a well defined syndrome. There are few systematic studies addressing pituitary hormone secretion after a PA episode. The aim of the present study was to assess the frequency and degree of endocrine dysfunction due to PA. METHODS: In 17 consecutive patients, the secretion of growth hormone (GH), the pituitary-adrenal axis status, thyrotropin (TSH), prolactin and gonadotropins (LH, FSH) were evaluated after the administration of insulin, thyrotropin releasing hormone (TRH) and gonadotropin-releasing hormone (LHRH) after an episode of PA. 20-90 days after surgery the measurements were repeated. Antidiuretic hormone (ADH) was measured by plasma/urine osmolality after water deprivation and, in some cases, by administration of hypertonic saline. RESULTS: The most commonly found deficiency was that of GH (84%), which in two cases resulted in cure of acromegaly, followed by that of LH (78%). Pituitary-adrenal dysfunction was improved in two patients after surgery. In all cases except one there was a reduced secretion of at least two hormones. If serum prolactin was reduced, the rest of pituitary function was usually impaired. In one case, permanent diabetes insipidus developed after PA. The prevalence of PA in pituitary adenomas was 9%. CONCLUSIONS: Pituitary hormone secretion after a PA episode is almost invariably impaired. This impairment may be reversed after surgery. Hypoprolactinemia is an indicator of pituitary hypofunction.

Adenoma↗
PubMed1986

Arginine-vasopressin in essential hypernatremia.

Dynamics of AVP secretion in a 14-year-old girl with essential hypernatremia, psychomotor retardation and optic nerve coloboma, are reported. Basal levels of AVP were similar to those of a control population, but disproportionately low in relation with natremies. Hypertonic saline and hydric restriction did not alter the AVP basal values, which were, instead, stimulated with orthostatism. AVP decreased during a water surcharge, but delayed elimination of water was observed. The existence of a moderate volume deficit, not corrigible with a chronic surcharge of water, together with the reversed diurnal pattern of water excretion and the AVP data, suggest--as a physiopathological basis of the syndrome--a severe anomaly of the osmoreceptors, with alteration of thirst and of the osmodependent AVP responses, so that the AVP secretion was regulated exclusively through volumetric mechanisms.

Adolescent↗
PubMedDate not supplied

Ectopic thyroid tissue presenting as a submandibular mass.

BACKGROUND: To our knowledge, only three cases with ectopic submandibular thyroid have been reported. No patient with simultaneous presence of ectopic submandibular thyroid and normal thyroid gland has been reported. Literature on this topic is reviewed. METHODS: A 34-year-old woman with a longstanding asymptomatic right submandibular mass was evaluated by ecography, computer tomography scan, and fine-needle aspiration. Literature review was performed using EBSCO-Medline Results. The mass was hard, nontender, and not movable with swallowing. A fine-needle aspiration revealed hyperplastic thyroid tissue. A second ecographic-guided fine-needle aspiration confirmed cytologically ectopic thyroid tissue. A computer tomography scan showed a calcified mass with cystic areas beneath and medial to the submandibular gland. Rests of thyroid tissue lateral to the trajectory of thyroglossal duct were seen. Thyroid gland was atrophic. No metastatic lymph nodes were noted. Total serum thyroxine and triiodothyronine were normal. Basal and TRH-stimulated serum thyrotropin was suppressed. A 99Tc scintigraphy disclosed a nodular uptake of tracer in the submandibular area, and no uptake by normal thyroid. CONCLUSIONS: We describe the first case, to our knowledge, with lateral multiple aberrant thyroid tissue and hypoplastic thyroid gland.

Adult↗
PubMedDate not supplied

[Prevalence of obesity in the population assisted at primary health care services in Girona, 1995-1999].

OBJECTIVES: To estimate the prevalence of obesity and overweight in the population of Girona (Spain) between 1995 and 1999 and to divide the prevalences in geographical areas according to age and sex. METHODS: Height and weight were directly measures in 24,554 health care consumers older than 14 years (10,595 men and 13,959 women) treated in four primary health care areas: Girona 1, Girona 4, Salt and Camprodon and in one primary health care center in the province of Girona. Body mas index (BMI) was calcuted by dividing weight in kilograms bye height in meters squared. Obesity was defined as grades II and III of Garrow's index (BMI >= 30 kg/m2) and overweight as degree I (25 kg/m2 >= BMI < 30 kg/m2). Because the sample was not randomized, the prevalences were adequately weighted. The comparison between prevalences in two different primary health care areas for each sex (in the same Garrow's index and age group) was carried out using a parametric test of differences in proportions (Student's t-test). A hierarchical logistic regression was used to compare prevalences in the same grade Garrow's index, controlling for age and sex. RESULTS: The prevalence of obesity was estimated as 15.6% in men aged from 20-74 years (from 14.0% in Girona 1 to 22.4% in Camprodon) and 17.5% for women (15.6% in Girona 1, 22.7% in Camprodon). The weighted mean was 16.7%. The prevalence of overweight was 44% in men and 33% in women and the weighted mean was 37.8%. The prevalence of obesity was graduated with statistically significant differences between Girona 1, Salt, Girona 4, Camprodon and Sils. CONCLUSIONS: The estimates of the prevalences of obesity and overweight obtained in this study were closer to those of other studies in similar populations than previously believed. Indeed, the prevalences may be similar to those of the European Union and, in some age groups, to those of the United States.

Adolescent↗
PubMedDate not supplied

[Obesity and inflammation].

The adipose tissue produces a vast number of molecules called adipokines such as leptin, tumoral necrosis factor (TNFalpha), interleukins and adiponectin. Many of the metabolic disturbances associated with obesity and the metabolic syndrome may be due to citokine production by adipocytes. The adipose tissue increases the soluble fractions of TNFalpha leading to a rise in its biological activity. The activation of TNFalpha system causes insulin resistance through different mechanisms such as defects in receptor fosforilation and reduction in insulin-sensitive glucose transporters. TNFalpha is also involved in the pathophysiology of hypertension and dyslipidaemia associated with obesity and insulin resistance. More than one third of interleukin-6 (IL-6) concentrations come from the adipocytes. It has been demonstrated a role for IL-6 in the development of hyperlipidemia, diabetes and hypertension. In contrast to the rest of adipokines, adiponectin is reduced in obesity, diabetes or cardiovascular disease. Adiponectin improves insulin resistance, dyslipidaemia and adhesion to endothelial cells protecting from atherosclerosis development. Thus, adipokines have an important role in the pathophysiology of metabolic syndrome by different mechanisms involving metabolic and vascular effects.

Adipocytes↗