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López-Prado A, Miramontes-González P, Martín-Escudero JC, Pérez-Castrillón JL, Dueñas-Laita A, Rollán MJ, Corral-Gudino L. Effectiveness of Twitter Threads to Improve Medical Student Electrocardiogram (ECG) Reading-Skills. The TwittUVa-ECG Non-Randomized Pre-Post Study. Med Sci Educ 2023; 33:1359-1369. [PMID: 38188417 PMCID: PMC10767012 DOI: 10.1007/s40670-023-01885-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 01/09/2024]
Abstract
Introduction social media is increasingly used in medical education, but its real educational effectiveness is unclear. In this study we assess the effectiveness of Twitter threads (TTS) in improving electrocardiogram (ECG) basic reading skills (ECGBRS). Materials and Methods Seven TTS describing ECGBRS were published from October 28, 2021, to November 24, 2021. Tests were used to assess medical students ECGBRS pre and post intervention. All third and sixth-year medical students were invited to participate. Sixty-three students were enrolled (33 third year and 30 sixth year). Nine (14.3%) participants dropped out. Results Sixth year medical students had higher ECGBRS at baseline. The number of correct items increased after the Twitter intervention; median correct pre-test items were 20 out of 56, (interquartile range (IQR) 14-23), and median post-test were 29 out of 56, (IQR 21-36) (p < 0.001). The improvement in sixth year students was greater than for third year students; 10 more correct items (IQR 4-14) vs. 7 (IQR 1-14) items (p = 0.045). The more TTS followed, the greater the improvement in ECGBRS (p = 0.004). The QRS axis calculation was the ECG reading skill with the lowest scores. Most medical students were definitely (35%) or very probably (46%) interested in repeating another on-line learning experience and found the TTS extremely (39%) or very (46%) interesting. Conclusions The use of specifically designed TTS was associated with improvement in medical students' interpretation of ECGs. The effectiveness of the threads was higher in the final years of medical school when basic skills had already been acquired. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01885-x.
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Affiliation(s)
- A. López-Prado
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 47005 Valladolid, Spain
| | - P. Miramontes-González
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 47005 Valladolid, Spain
| | - J. C. Martín-Escudero
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 47005 Valladolid, Spain
| | - J. L. Pérez-Castrillón
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 47005 Valladolid, Spain
| | - A. Dueñas-Laita
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 47005 Valladolid, Spain
| | - M. J. Rollán
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 47005 Valladolid, Spain
| | - L. Corral-Gudino
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 47005 Valladolid, Spain
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Riancho JA, Peris P, González-Macías J, Pérez-Castrillón JL. Executive summary clinical practice guideline of postmenopausal, glucocortcioid-induced and male osteoporosis (2022 update). Spanish Society for Bone and Mineral Metabolism Investigation (SEIOMM). Rev Clin Esp 2022; 222:432-439. [PMID: 35676194 DOI: 10.1016/j.rceng.2021.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/30/2021] [Indexed: 10/18/2022]
Abstract
This updated version of the Spanish Society for Research in Osteoporosis and Mineral Metabolism (SEIOMM) osteoporosis guides incorporate the most relevant information published in the last 7 years, since the 2015 guides, with imaging studies, such as vertebral fracture assessment and bone trabecular score analysis. In addition, therapeutic advances include new anabolic agents, comparative studies of drug efficacy, and sequential and combined therapy. Therefore, therapeutic algorithms are also updated.
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Affiliation(s)
- J A Riancho
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Departamento de Medicina y Psiquiatría, Universidad de Cantabria, IDIVAL, Santander, Spain.
| | - P Peris
- Servicio de Reumatología, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain
| | - J González-Macías
- Departamento de Medicina y Psiquiatría, Universidad de Cantabria, IDIVAL, Santander, Spain
| | - J L Pérez-Castrillón
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Departamento de Medicina, Universidad de Valladolid, Valladolid, Spain
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Riancho JA, Peris P, González-Macías J, Pérez-Castrillón JL. Resumen ejecutivo de las Guías de práctica clínica en la osteoporosis postmenopáusica, glucocorticoidea y del varón (actualización 2022). Rev Osteoporos Metab Miner 2022. [DOI: 10.4321/s1889-836x2022000100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Riancho JA, Peris P, González-Macías J, Pérez-Castrillón JL. Guías de práctica clínica en la osteoporosis postmenopáusica, glucocorticoidea y del varón (actualización 2022). Rev Osteoporos Metab Miner 2022. [DOI: 10.4321/s1889-836x2022000100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Pérez-Castrillón JL. Referente al documento de posición de la SEIOMM sobre COVID-19 y vitamina D. Rev Osteoporos Metab Miner 2021. [DOI: 10.4321/s1889-836x2021000200010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Campillo-Sánchez F, Usategui-Martin R, Gil J, Ruiz de Temiño A, González-Silva Y, Ruiz-Mambrilla M, Dueñas-Laita A, Pérez-Castrillón JL. Predictores del riesgo de fractura en una población de mujeres postmenopáusicas mediante el procedimiento estadístico binario CART. Rev Osteoporos Metab Miner 2020. [DOI: 10.4321/s1889-836x2020000400003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Del Pino J, Pérez-Castrillón JL, Dueñas-Laita A, Hernandez G, Arranz-Gutiérrez P, Chinchilla SP. OP0296 SUPERIOR EFFICACY OF CALCIFEDIOL SOFT GELATIN CAPSULES VS CHOLECALCIFEROL FOR THE MANAGEMENT OF VITAMIN D DEFICIENCY IN POSTMENOPAUSAL WOMEN: A TREATMENT TO BE CONSIDERED IN THERAPEUTIC GUIDELINES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Vitamin D deficiency is a highly prevalent entity worldwide, with relevance in specific diseases and stages of life1. Few guidelines assess the indications and optimal dosing in the general population, and although there is no international consensus, 800IU/day is associated with benefits in bone metabolism. Calcifediol, a vitamin D analog, is presented as a therapeutic alternative.Objectives:To assess the efficacy of calcifediol in the treatment of vitamin D deficiency, compared with therapeutic guidelines recommendations for cholecalciferol in postmenopausal women.Methods:Phase III-IV, double blind, randomised, controlled, multicentre superiority clinical trial. Postmenopausal women with baseline levels of 25(OH)D < 20 ng/mL were randomised to three arms: 266 mcg of calcifediol/month for 4 or 12 months (standard and test regime), or to cholecalciferol 25000 IU/month for 12 months (as per therapeutic guidelines).Results from an interim analysis - performed upon completion of month 4 visit by 100% of evaluable patients - are presented and reported without unblinding the study treatments. Both calcifediol groups are summarised for analysis.The trial has been approved by the corresponding ethics committees and national competent authorities.Results:298 women were included in the ITT analysis. The average age was 63.4 ± 8.2 years, mean BMI was 29.3 ± 6 Kg/m2, 10.7% had osteoporosis and received treatment. All demographic characteristics and risk factors for osteoporosis were balanced amongst groups.When analysing per treatment group,13.5% and 35% of women in the calcifediol group reached values of 25(OH)D > 30ng/mL at 1 and 4 months when compared to 0% and 8.2% respectively in the cholecalciferol group (p<0.01), achieving target levels in a rapid manner (Figure 1).Figure 1.Regarding baseline levels, 25% of the population had levels <10ng/mL; in this group there were no statistically significant differences between both treatments, possibly due to the limited sample size. In the group with baseline levels from 10 to<20 ng/mL, a statistically significant mean difference was observed at months 1 and 4, with a greater proportion of patients achieving both therapeutic levels in the calcifediol group (Table 1). No relevant safety issues were reported for the present analysis.Table 1.Basal 25(OH)D levels< 10ng/mLNS10 to <20 ng/mL**Calcifediol (n= 54)Cholecalciferol(n= 20)Calcifediol(n= 146)Cholecalciferol(n= 78)Month 1>30 ng/mL2 (3.7%)0 (0%)25 (17.1%)0 (0%)>20 ng/mL12 (22.2%)2 (10%)106 (72.6%)31 (39.7%)Month 4>30 ng/mL8 (14.8%)1 (5%)62 (42.5%)7 (9%)>20 ng/mL27 (50%)8 (40%)135 (92.5%)63 (80.8%)NSp>0.05; **p≤0.01Conclusion:Calcifediol shows a greater efficacy than cholecalciferol regime (as recommended in therapeutic guidelines), for the treatment of vitamin D deficiency in postmenopausal women and in a timely manner, which could impact osteoporosis treatment. Cholecalciferol fails to achieve recommended levels in a significant proportion of this population. Baseline vitamin D levels are to be considered for the supplementation of vitamin D.References:[1]Amrein, K., Scherkl, M., Hoffmann, M.et al.Vitamin D deficiency 2.0: an update on the current status worldwide.Eur J Clin Nutr(2020).Acknowledgments:Osteoferol Study Group principal investigators and their teams: F Cereto, ML Brandi, E Jodar, JM Quesada-Gómez, JM Olmos-Martínez, MA Colmenero-Camacho, R Alhambra, C Gómez-Alonso, B GalarragaDisclosure of Interests:Javier del Pino Grant/research support from: Roche, Bristol, Consultant of: Gedeon, José Luis Pérez-Castrillón Grant/research support from: Farmalider, Pfizer, Consultant of: Farmalider, Faes Farma, Gedeon-Richter, Speakers bureau: Amgen, Lilly, MSD, Faes Farma, Antonio Dueñas-Laita Grant/research support from: Faes Farma, Farmalider, Consultant of: Faes Farma, Speakers bureau: Farmalider, Gonzalo Hernandez Employee of: Faes Farma S.A., Paula Arranz-Gutiérrez Employee of: Faes Farma, Sandra Pamela Chinchilla Employee of: Faes Farma S.A.
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Affiliation(s)
- G Díaz-Soto
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - E Romero
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - J L Pérez-Castrillón
- Servicio de Medicina Interna, Hospital Universitario Rio Hortega, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - O I Jauregui
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - D de Luis Román
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
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Díaz-Soto G, Romero E, Pérez-Castrillón JL, Jauregui OI, de Luis Román D. Parathyroid Hormone Polymorphism RS6254 is Associated with the Development and Severity of Osteoporosis in Asymptomatic but not Normocalcemic Hyperthyroidism. Horm Metab Res 2016; 48:828-833. [PMID: 27756092 DOI: 10.1055/s-0042-117509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Although normocalcemic and asymptomatic hyperparathyroidism (HPT) are becoming more common, they remain only partially understood. Parathyroid hormone (PTH) polymorphisms have been associated with disease severity in classical HPT. The aim of the present study was to evaluate the clinical effect of PTH polymorphism (rs6254) in normocalcemic and asymptomatic HPT. A prospective study of 61 consecutive patients with normocalcemic or asymptomatic HPT was carried out. Secondary causes of HPT were ruled out. All patients were followed for≥1 year. Calcium and phosphorus metabolism parameters were assessed at least twice during the follow-up period to classify as normocalcemic or asymptomatic HPT. Bone mineral density (BMD) and the rs6254 polymorphism genotype were also assessed. Genotype rs6254GG was observed in 23 patients (37.7%) whereas GA and AA genotypes were presented in 29 (47.5%) and 9 (14.8%) patients, respectively. Age, sex and genotype distributions were comparable in both groups. In asymptomatic but not normocalcemic HPT patients, the GG genotype was associated with a significantly higher level of intact PTH [200.2 (SD 76.5) vs. 113.3 (SD 25.9) pg/ml; p<0.01], and significantly lower Z-score densitometry at the femoral neck, proximal femur, and lumbar spine. Both remained significant after adjusting for major confounding factors by multiple linear regression. The present study supports the independent pathogenic effect of rs6254GA polymorphism on the development and severity of BMD complications in patients with asymptomatic but not normocalcemic HPT. Further studies are needed to confirm this finding and to assess the effect of other polymorphisms in normocalcemic and asymptomatic HPT.
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Affiliation(s)
- G Díaz-Soto
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - E Romero
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - J L Pérez-Castrillón
- Servicio de Medicina Interna, Hospital Universitario Rio Hortega, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - O I Jauregui
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
| | - D de Luis Román
- Servicio de Endocrinología y Nutrición, Universidad de Valladolid, Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Valladolid, Spain
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Briongos-Figuero LS, Hernanz-Román L, Pineda-Alonso M, Vega-Tejedor G, Gómez-Traveso T, Sañudo-García S, Dueñas-Laita A, Pérez-Castrillón JL. In-hospital mortality due to infectious disease in an Internal Medicine Department. Epidemiology and risk factors. Eur Rev Med Pharmacol Sci 2015; 19:567-572. [PMID: 25753872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Hospital mortality is a leading indicator of quality of healthcare and a valuable tool for planning and management. Infectious diseases represent a substantial part of the activity of internal medicine.Our aim was to describe the characteristics of in-hospital mortality due to infectious diseases and associated risk factors in our environment. MATERIALS AND METHODS A retrospective case-control study was designed. We reviewed deaths during 2012 from an Internal Medicine Department. 187 cases (infectious disease related mortality) and 224 controls were found. Clinical and demographic information was obtained from medical records. Comorbidity was evaluated with Charlson index (CI). Data were analyzed using SPSS 15.0 (p-value < 0.05). RESULTS During 2012, of the 3193 discharge, 187 were exitus due to infectious disease (5.8%). Mean age was 85.7 ± 7.6, higher in women (88 ± 7 vs 83 ± 7.4, p < 0.001), and 55% were aged over 85 years. The CI mean was 4.2 ± 3, higher in younger than 85 years (5.3 ± 3.4 vs 3.6 ± 2.6, p < 0.001). Most frequent causes of death were respiratory sepsis (29%), severe pneumonia (23.5%) and urinary sepsis (16.6%) and risk factors were living in Nursing Home (55.6% vs 34%, p < 0.001), being dependent (73.8% vs. 44.6%, p < 0.001), dementia (59.4% vs 27.2%, p < 0.001) and cerebrovascular disease (25.7% vs 17.4%, p = 0.041). CONCLUSIONS Dementia, cerebrovascular disease, living in Nursing Home and being dependent were risk factors for infectious disease in-hospital mortality in our study, but not comorbidity, age or length of stay. Our series, although limited by retrospective design, is the first qualitative study of in-hospital mortality due to infectious disease in an Internal Medicine Service in our environment. Most frequent cause of death in our setting was respiratory etiology.
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Affiliation(s)
- L S Briongos-Figuero
- Internal Medicine Service, Admission Service, Clinical Pharmacology Service; Rio Hortega University Hospital, Valladolid, Spain.
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Briongos L, Sañudo S, García-Alonso M, Ruiz-Mambrilla M, Dueñas-Laita A, Pérez-Castrillón JL. Treatment of osteoporosis and hip fractures in a Spanish health area. Eur Rev Med Pharmacol Sci 2013; 17:266-268. [PMID: 23377819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The aim of this longitudinal retrospective ecological study was to evaluate the consumption of anti-osteoporotic medications and the evolution of pertrochanteric and femoral neck (FN), subtrochanteric and diaphyseal hip fractures between 2005 and 2010. MATERIALS AND METHODS Data were obtained from our Hospital Admissions Service (absolute number of fractures) and the Technical Directorate of Pharmacy (defined daily dose and absolute number of containers consumed of bisphosphonates (BP), raloxifene and strontium ranelate). RESULTS The overall incidence density of FN in 2005-2010 was 124.8 new cases per 100,000 persons per year. BP consumption increased between 2005 and 2010 to a peak of 70,452 containers consumed in 2010, while consumption of raloxifene declined. The number of subtrochanteric and diaphyseal fractures remained stable, but FN reached a peak in 2008 (N = 350) and fell thereafter (N = 284 in 2010). The percentage reduction in the number of FN in the period studied (2009: -14% and 2010: -11% compared to 2005) corresponds temporally with the increased consumption of BP (2009: +76% and 2010: +84% compared to 2005). CONCLUSIONS We found an inverse temporal association between the annual consumption of BP and the annual number of FN during 2005-2010. This is probably related to the cumulative effect of BP, although, given the limitations of the study design, other studies are needed to confirm our data.
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Affiliation(s)
- L Briongos
- Documentation Unit. Rio Hortega University Hospital, Valladolid, Spain
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Briongos-Figuero LS, Gómez-Traveso T, Bachiller-Luque P, Domínguez-Gil González M, Gómez-Nieto A, Palacios-Martín T, González-Sagrado M, Dueñas-Laita A, Pérez-Castrillón JL. Epidemiology, risk factors and comorbidity for urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing enterobacteria. Int J Clin Pract 2012; 66:891-6. [PMID: 22897466 DOI: 10.1111/j.1742-1241.2012.02991.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
AIM Urinary tract infection (UTI) caused by resistant bacteria is becoming more prevalent. We investigate characteristics and associated risk factors for UTIs resulting from extended-spectrum beta-lactamase (ESBL)-producing enterobacteria. METHODS Retrospective study of urinary tract isolates of ESBL-producing enterobacteria in adults (2009 and 2010). We included 400 patients and 103 controls (UTI caused by non-ESBL Escherichia coli). Clinical and demographic information was obtained from medical records. Comorbidity was evaluated using Charlson Index (CI). Strains were identified using VITEK 2 system. RESULTS A total of 400 isolates were obtained (93%E. coli and 7%Klebsiella spp). In 2009, 6% of cultures were ESBL-producing E. coli and 7% in 2010. 37% of patients were men and 81% were aged ≥60years. CI was 2.3±1.8 (high comorbidity: 42.8%). 41.5% of strains were susceptible to amoxicillin-clavulanate, 85.8% to fosfomycin and 15.5% to ciprofloxacin. The total number of ESBL E. coli positive urine cultures during hospital admission was 97 and, compared with 103 controls, risk factors for UTI caused by ESBL- E. coli strains in hospitalised patients were nursing home residence (p<0.001), diabetes (p=0.032), recurrent UTI (p=0.032) and high comorbidity (p=0.002). In addition, these infections were associated with more symptoms (p<0.001) and longer admission (p=0.004). CONCLUSIONS Urinary tract infection caused by ESBL are a serious problem and identifying risk factors facilitates early detection and improved prognosis. Male sex, hospitalisation, institutionalisation, diabetes, recurrent UTI and comorbidity were risk factors and were associated with more symptoms and longer hospital stay.
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Pérez-Castrillón JL, De Luis D, Inglada L, Olmos Martínez JM, Pinacho F, Conde R, González-Sagrado M, Dueñas-Laita A. [Telmisartan effect's on remodelling bone markers in hypertensive patients]. NUTR HOSP 2012; 27:276-80. [PMID: 22566334 DOI: 10.1590/s0212-16112012000100037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 07/23/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The telmisartan is an angiotensin II receptor blocker (ARB) with a few own characteristics that it allows us to obtain a few additional benefits. It displays the ability to act as a partial agonist of PPARgamma. On the other hand, PPAR gamma intervenes in the control of bone remodelling though with not concordant results. The objective of this study to value the effect of telmisartan on bone markers in hypertensive patients. SUBJECTS A sample of 31 hypertensive patients with hypertension were included. The dose of telmisartan was of 80 mg/24 h and the period of follow-up was 12 weeks. The control group included 32 hypertensive patients treated before with IECA (enalapril-20 mg/24 h - or quinapril - 40 mg/24 hours). The following parameters were determined P1NP, β-CTX, 25OHD and PTH , osteocalcin, insulin and adiponectin. RESULTS The patients treated with Telmisartan shown a significantly decrease in systolic blood pressure (156 ± 19 mmHg vs 133 ± 15 mmHg, p = 0.001) and diastolic blood pressure (92 ± 9 mmHg vs 82 ± 6 mmHg, p = 0.01) . Changes were not observed in other parameter, PTHi (48 ± 22 pg/ml vs 45 ± 22 pg/ml, p > 0.05) and 25-vitamin D (21 ± 10 ng/ml vs 25 ± 8 ng/ml, p > 0.05), CTX (0.195 ± 0.12 ng/ml vs 0.221 ± 0.13 ng/ml, p > 0.05), PINP (39 ± 20 ng/ml vs 40 ± 19 ng/ml, p > 0.05), osteocalcin (11 ± 9 ng/ml vs 11 ± 5 ng/ml, p > 0.05), glucose, adiponectin, insulin and HOMA. When the patients divided in two groups depending on the levels of vitamin D (insufficient and not insufficient), with a cut of 20 ng/ml, there was changes on bone markers but a decrease of the glucose was observed in patients with levels of vitamin D over 20 ng/ml (135 ± 53 mg/dl vs 119 ± 39 mg/dl, p = 0.01). The patients treated with IECAS decreases the systolic blood pressure but the diastolic blood pressure values of arterial systolic does not show changes. CONCLUSIONS Telmisartan has a neutral effect to level of the bone markers of bone remodelling.
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Pérez-Castrillón JL, De Luis DA, Duenas-Laita A. Are beta-blockers useful in the prevention of osteoporotic fractures? Eur Rev Med Pharmacol Sci 2009; 13:157-162. [PMID: 19673165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Atherosclerosis and osteoporosis are highly prevalent chronic diseases that affect populations of similar ages who are clinically asymptomatic until complications appear. Therefore, research into new drugs that are useful for both processes and may improve therapeutic compliance appears to be reasonable. beta-blockers are widely used in the treatment of hypertension and its complications, ischemic heart disease and heart failure. Their use has been associated with a decrease in cardiovascular mortality. Experimental data have demonstrated that the sympathetic nervous system inhibits bone formation and increases resorption due to the binding of catecholamines to receptors located in osteoblasts. This produces a decrease in bone mineral density and a higher risk of fractures. The effect is eliminated by the administration of beta-blockers. Retrospective case-control and cohort studies have shown a beneficial effect of beta-blockers on fractures reduction, with a protective effect being observed in eight studies and no effect being found in two studies. The aim of this paper is review these data and the possible role of beta-blockers in the prevention of osteoporotic fractures in patients with cardiovascular disease.
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Affiliation(s)
- J L Pérez-Castrillón
- Internal Medicine Department, Rio Hortega University Hospital, Faculty of Medicine, Valladolid, Spain.
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Burillo-Putze G, Nogué-Xarau S, Pérez-Castrillón JL, Dueñas-Laita A. [Cyanide and carbon monoxide in intoxication by smoke in a fire]. Rev Neurol 2009; 48:335-336. [PMID: 19291665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Valero C, Pérez-Castrillón JL, Zarrabeitia MT, Hernández JL, Alonso MA, del Pino-Montes J, Olmos JM, González-Macías J, Riancho JA. Association of aromatase and estrogen receptor gene polymorphisms with hip fractures. Osteoporos Int 2008; 19:787-92. [PMID: 17962916 DOI: 10.1007/s00198-007-0491-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Accepted: 10/03/2007] [Indexed: 11/29/2022]
Abstract
UNLABELLED Two polymorphisms of the aromatase and estrogen receptor genes appeared to interact to influence the risk of hip fractures in women. INTRODUCTION Allelic variants of the aromatase gene have been associated with bone mineral density and vertebral fractures. Our objective was to analyze the relationship between two polymorphisms of the aromatase and estrogen receptor genes and hip fractures. METHODS We studied 498 women with hip fractures and 356 controls. A C/G polymorphism of the aromatase gene and a T/C polymorphism of the estrogen receptor alpha gene were analyzed using Taqman assays. Aromatase gene expression was determined in 43 femoral neck samples by real-time RT-PCR. RESULTS There were no significant differences in the overall distribution of genotypes between the fracture and control groups. However, among women with a TT genotype of the estrogen receptor, the CC aromatase genotype was more frequent in women with fractures than in controls (39 vs. 23%, p = 0.009). Thus, women homozygous for T alleles of estrogen receptor and C alleles of aromatase were at increased risk of fracture (odds ratio 2.0; 95% confidence interval 1.2-3.4). The aromatase polymorphism was associated with RNA levels in bone tissue, which were three times lower in samples with a CC genotype (p = 0.009). CONCLUSIONS These common polymorphisms of the aromatase and estrogen receptor genes appear to interact, influencing the risk of hip fractures in women.
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Affiliation(s)
- C Valero
- Department of Internal Medicine, Hospital U.M. Valdecilla, University of Cantabria, 39008 Santander, Spain
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González-Sagrado M, Luis Román DAD, Conde-Vicente R, Izaola O, Aller R, Pérez-Castrillón JL. [Evaluation of two methods for correcting the impact factor using the investigation done at the "Del Río Hortega" University Hospital (1999-2004) as the data source]. NUTR HOSP 2008; 23:111-118. [PMID: 18449446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Accepted: 07/17/2007] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVE To adjust the Impact Factor (IF) provided by the Institute for Scientific Information (ISI) is necessary for improving bibliometric analysis among the various areas of knowledge. Our objective was to evaluate two parameters (the maximum and the median value of each subject area) for IF adjustment using the original (not corrected) IF as the reference method in a tertiary hospital biomedical investigation model. MATERIAL AND METHOD We retrieved articles from Hospital Universitario "Del Río Hortega" from Valladolid (Spain) for the period 1999-2004 as data source. We have describe the characteristics of the followed IF distributions: IF Corrected by the Maximum value (IFCORMAX), IF Corrected by the Median value (IFCORMED) and IF without adjustments (IF). Besides, we have analyzed both the inter-annual and the inter-subject differences obtained by the three methods. RESULTS The three analyzed IF series shown not normal distributions that are positively skewed. The IF adjusted by the median showed the highest coefficient of variation (CV = 357.3%). The IF adjusted by the Maximum value increased the "weight" of journals with the highest not corrected IF for each subject category. Inter-annual differences were similarly estimated by the three methods. The IF adjusted by the median increased the inter-subject difference from 7.3% to 12.4%. CONCLUSIONS Our results suggests that IF adjusted by the maximum value of each discipline is the best method to correct the ISI-IF values, because journals with the high IF are always rewarded, while IF adjusted by the median infra-estimated most of them.
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Affiliation(s)
- M González-Sagrado
- Unidad de Apoyo a la Investigación, Hospital Universitario Del Río Hortega, Valladolid, Spain.
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Pérez-Castrillón JL, Abad L, Vega G, Sanz-Cantalapiedra A, García-Porrero M, Pinacho F, Dueñas A. Effect of atorvastatin on bone mineral density in patients with acute coronary syndrome. Eur Rev Med Pharmacol Sci 2008; 12:83-88. [PMID: 18575157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The aim of this paper is to evaluate the effect of atorvastatin on bone mineral density in patients with acute ischemic heart disease. MATERIAL AND METHODS Eighty-three patients (52 male and 31 female) with acute coronary syndrome were studied. They received treatment with atorvastatin using low doses (20 mg) and high doses (40 mg-80 mg). Initial and final cholesterol, triglyceride, calcium, phosphorus, 25-hydroxyvitamin D were obtained from every patient. Spine and hip bone mineral density were performed at the beginning and one year later. RESULTS Atorvastatin treatment increases vitamin D (33%, p = 0.007) and decreases the individuals with vitamin D insufficiency. Bone mineral density increased in the spine (1.31%, p = 0.02), but it was significant only in male and patients presenting vitamin D levels higher than 30 nmol/l. CONCLUSION Atorvastatin has a beneficial effect on bone metabolism in patients with acute ischemic heart disease (mainly males) by incrementing bone mineral density in which vitamin D levels are required to be higher than 30 nmol/l for the drug to be effective.
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Pérez-Castrillón JL, Justo I, Sanz A, De Luis D, Dueñas A. Effect of angiotensin converting enzyme inhibitors on 1.25-(OH)2 D levels of hypertensive patients. Relationship with ACE polymorphisms. Horm Metab Res 2006; 38:812-6. [PMID: 17163356 DOI: 10.1055/s-2006-956500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The effect of angiotensin converting enzyme inhibitors (ACEIs) on 1.25-dihydroxyvitamin D [1.25-(OH)2D] levels has not been studied. The purpose of this study is to assess the relationship between 1.25-dihydroxyvitamin D levels and I/D angiotensin-converting enzyme polymorphism (ACE) in hypertensive patients. MATERIALS AND METHODS The study included 60 individuals (31 females and 29 males) with systolic and/or diastolic hypertension. The 25-hydroxyvitamin D levels were measured by HPLC and the 1.25-(OH)2 D was determined by RIA. ACE polymorphism was analyzed by Polymerase Chain Reaction (PCR) using a modification of the original method described by Rigat. RESULTS Treatment with ACEIs produced an increase in total calcium (p=0.003) and a decrease in the 1.25-(OH)2 D (p=0.0001). No relationship between final calcium and 1.25-(OH)2 D (r=-0.171, p=0.198) was observed. When the effects of enalapril and quinapril were analyzed separately, the results were similar. When the patients were divided according to genotype, the decrease in 1.25-(OH)2 D was observed only in patients with D allele, genotype Ins/Del (69+/-23 vs. 48+/-19, p=0.021 ) and in those of genotype Del/Del (64+/-19 vs. 17, p=0.004). CONCLUSION The ACE inhibitors in combination with the presence of the DD genotype decrease the level of 1.25-(OH)2 D. There was no difference between enalapril and quinapril treated groups.
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Affiliation(s)
- J L Pérez-Castrillón
- Departamento de Medicina Interna, Hospital Universitario Río Hortega, Facultad de Medicina de Valladolid, Valladolid, Spain.
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Pérez-Castrillón JL, Martín-Escudero JC, Alvarez Manzanares P, Cortés Sancho R, Iglesias Zamora S, García Alonso M. Hypertension as a risk factor for hip fracture. Am J Hypertens 2005; 18:146-7. [PMID: 15691630 DOI: 10.1016/j.amjhyper.2004.08.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abstract
BACKGROUND The association of lichen planus (LP) with liver diseases is well established. The reported prevalence rates of hepatitis C virus (HCV) antibodies in patients with LP tend to appear quite variable. OBJECTIVE The aim of this study was to assess the prevalence of HCV antibodies in a group of patients with LP and evaluate the clinical characteristics of the subgroup with LP associated with HCV. METHODS We studied 101 patients, 57 (56.4%) women and 44 (43.5%) men with a mean age of 48 years, consecutively diagnosed with cutaneous and/or mucosal LP between January 1992 and December 2000. We used 99 age- and sex-matched controls. RESULTS Anti-HCV antibodies were detected in nine cases (8.9%) of the LP group but only two (2.02%) of the controls. The odds ratio between the subjects with HCV positivity and those with negative HCV virus was 4.74, with a confidence interval at 95%, between 0.999 and 22.545. A statistically significant association was only demonstrated between erosive LP and infection by HCV. CONCLUSIONS The possibility of liver disease caused by HCV should be ruled out in patients with LP, especially in the erosive form.
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Affiliation(s)
- R Gimenez-García
- Dermatology Section, Internal Medicine Service, Hospital del Rio Hortega, Valladolid, Spain.
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Martín-Escudero JC, Dueñas-Laíta A, Pérez-Castrillón JL, Herreros-Fernández V. Olanzapine toxicity in unconjugated hyperbilirubinaemia (Gilbert's syndrome). Br J Psychiatry 2003; 182:267. [PMID: 12611795 DOI: 10.1192/bjp.182.3.267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Pérez-Castrillón JL, Justo I, Silva J, Sanz A, Igea R, Escudero P, Pueyo C, Diaz C, Hernández G, Dueñas A. Bone mass and bone modelling markers in hypertensive postmenopausal women. J Hum Hypertens 2003; 17:107-10. [PMID: 12574788 DOI: 10.1038/sj.jhh.1001520] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Numerous phosphocalcium alterations associated with bone mineral density in hypertension have been described, but very few studies assess them. This study assesses bone mass in hypertensive postmenopausal women and the hypertension influence determining both calcium homeostasis and bone turnover markers. Blood and urine samples were analysed for calcium metabolism-related parameters. Densitometry studies were conducted in the lumbar spine (L2-L4). Hypertensive osteoporotic women--selected from 82 women, with 22% osteoporosis prevalence, similar to the rate for the same age in the Spanish population--had significantly higher levels of body mass index (29+/-4 vs 26+/-4, P=0.019), calciuria (293+/-146 vs 210+/-116 mg/24 h, P=0.023) and calcium/creatinine ratio (0.33+/-0.2 vs 0.22+/-0.1 P=0.003) vs hypertensive nonosteoporotic women. No relation was found between systolic and diastolic blood pressure with bone mass. However, there was a negative osteocalcin correlation (r=-0.386, P=0.0001, and r=-0.242, P=0.033). Calciuria is associated with bone mass decrease in hypertensive women, and there is no relation between bone mass and blood pressure.
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Affiliation(s)
- J L Pérez-Castrillón
- Departamento Medicina Interna, Facultad de Medicina, Hospital Univcersitario Rió Hortega, Cardenal Torquemada s/n, 47010 Valladolid, Spain.
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25
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González-Castañeda C, Pérez-Castrillón JL, Romero-Gómez M, Herreros-Fernández V. Antibodies against Chlamydia pneumoniae and their relation to lymphocyte population levels. Int J Cardiol 2002; 82:293-5. [PMID: 11911918 DOI: 10.1016/s0167-5273(01)00615-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chlamydia pneumoniae infection has long been suspected as a possible cause of atherosclerosis and has been frequently detected in atheromatous plaques of the coronary arteries. Nevertheless, its distribution is not correlated to the severity or extent of the disease, but it would support the hypothesis that the organism may be an active factor in the pathogenesis of atherosclerosis. A group of patients with stable angina were examined as to whether or not the positivity of antibodies against Chlamydia pneumoniae modified cellular populations as mechanisms responsible for the alterations of inflammatory response. We concluded that the presence of IgG anti-C. pneumoniae antibodies do not participate in the activation of inflammatory mechanisms that may intervene in the genesis of atherosclerosis in patients with stable angina.
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Pérez-Castrillón JL, Bachiller-Luque P, Martín-Luquero M, Mena-Martín FJ, Herreros V. Tularemia epidemic in northwestern Spain: clinical description and therapeutic response. Clin Infect Dis 2001; 33:573-6. [PMID: 11462198 DOI: 10.1086/322601] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2000] [Revised: 12/28/2000] [Indexed: 11/04/2022] Open
Abstract
This study describes the clinical characteristics of tularemia in Spain's first epidemic outbreak and the therapeutic response and compares the efficacy of 3 antibiotics (streptomycin, ciprofloxacin, and doxycycline). For 142 cases of tularemia, the therapeutic failure rate was 22.5%; ciprofloxacin was the antibiotic with the lowest percentage of therapeutic failures and with the fewest side effects.
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Affiliation(s)
- J L Pérez-Castrillón
- Department of Internal Medicine, Rio Hortega Hospital, University of Valladolid, Cardenal Torquemada s/n, 47010 Valladolid, Spain.
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Mena-Martín FJ, Pérez-Castrillón JL, Herreros-Fernández V. [Encephalopathy as a sign of Henoch-Schönlein purpura]. Rev Neurol 2001; 33:300. [PMID: 11710331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Dueñas-Laita A, Ruiz-Mambrilla M, Gandía F, Cerdá R, Martín-Escudero JC, Pérez-Castrillón JL, Díaz G. Epidemiology of acute carbon monoxide poisoning in a Spanish region. J Toxicol Clin Toxicol 2001; 39:53-7. [PMID: 11327227 DOI: 10.1081/clt-100102880] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND In Spain, as in most of the world, the incidence of acute carbon monoxide poisoning is probably underestimated. METHODS During an eighteen-month period we studied, by means of a standardized data collection form, all the cases of acute carbon monoxide poisoning that were diagnosed in 2 university hospitals. RESULTS During the study, 154 patients were diagnosed with carbon monoxide poisoning. The mean age was 32.2+/-15.5 years. The two principal exposure sites were the kitchen (43%) and bathroom (23%). The majority of the cases related to malfunction of the water heater (30%) and of the central heating (23%) and 68% occurred in the home. Improper combustion of butane (31%), propane (13%), and natural gas (12%) were most frequent. The most prevalent clinical manifestations were headache (94%), dizziness (56%), nausea (45%), loss of consciousness (38%), and weakness (34%). Five patients died. In 14.4%, symptoms suggested delayed neurological syndrome. The largest number of cases of poisoning occurred during the months of December and January. CONCLUSIONS Compared with previous Spanish series or with the antecedent year, acute carbon monoxide poisoning has a high prevalence in our region. Two factors appear to be essential to the accurate diagnosis of acute carbon monoxide poisoning: 1) the ability of emergency room physicians to recognize the clinical symptoms of carbon monoxide poisoning and 2) access to a carbon monoxide-oximeter.
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Affiliation(s)
- A Dueñas-Laita
- Regional Unit of Clinical Toxicology, Río Hortega University Hospital, University of Valladolid, Spain.
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30
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Justo-Muradas I, Pérez-Suarez M, Saracibar E, Sedano E, Pérez-Castrillón JL. Hypokalemic metabolic alkalosis secondary to giant cell arteritis. Nephron Clin Pract 2000; 86:524-5. [PMID: 11124613 DOI: 10.1159/000045853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Pérez-Castrillón JL, Olmos JM, Gómez JJ, Barrallo A, Riancho JA, Perera L, Valero C, Amado JA, González-Macías J. Expression of opioid receptors in osteoblast-like MG-63 cells, and effects of different opioid agonists on alkaline phosphatase and osteocalcin secretion by these cells. Neuroendocrinology 2000; 72:187-94. [PMID: 11025413 DOI: 10.1159/000054586] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have previously shown that several stressful situations associated with tissue injury determine a decrease in serum osteocalcin concentration. Since reduced osteocalcin production is a marker of decreased osteoblastic activity, this finding could be related to the pathogenesis of osteoporosis secondary to some diseases. Endogenous opioids are involved in stress response. Proenkephalin-derived peptides have been shown to inhibit alkaline phosphatase activity, another marker of bone formation, in the murine cell line ROS-17/2.8. On the other hand, serum osteocalcin has been reported as being low in heroin abusers. We have therefore thought it of interest to study the presence of opioid receptors in the human osteoblast-like cell line MG-63, and to evaluate the effects of different opioid agonists on the secretion of alkaline phosphatase and osteocalcin by these cells. The presence of opioid receptors was studied by means of RT-PCR and immunohistochemistry. RT-PCR studies suggested the presence of specific mRNA for the three types of receptors, and immunohistochemistry clearly showed their occurrence. Osteocalcin synthesis was significantly inhibited by high concentrations of the mu agonists morphine and (D-Ala(2), N-MePhe(4),Gly(5)-ol)-enkephalin although no changes were seen with the delta agonist (D-Ala(2),D-leu(5))-enkephalin. Morphine-induced osteocalcin inhibition was abolished when osteoblastic cells were incubated simultaneously with naloxone, whereas it was potentiated when cells were preincubated with naloxone. None of the opioid agonists modified the secretion of alkaline phosphatase. In conclusion, human osteoblast-like cells MG-63 express the three types of opioid receptors. Endogenous opioids may be involved in the reduction of osteocalcin observed in stressful situations associated with tissue injury.
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Affiliation(s)
- J L Pérez-Castrillón
- Departamento de Medicina Interna, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
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Bellido-Casado J, Pérez-Castrillón JL, Bachiller-Luque P, Martín-Luquero M, Mena-Martín FJ, Herreros-Fernández V. Report on five cases of tularaemic pneumonia in a tularaemia outbreak in Spain. Eur J Clin Microbiol Infect Dis 2000; 19:218-20. [PMID: 10795596 DOI: 10.1007/s100960050462] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A report is given on five cases of atypical tularaemic pneumonia selected from among 140 cases of tularaemic infection in a previously reported outbreak occurring in 1997. Prior to this outbreak no human cases of tularaemia had been reported in Spain. All cases were diagnosed serologically. All five patients reported on here had a mild form of the disease, which was treated successfully with streptomycin in four cases and ciprofloxacin in one case. Tularaemic pneumonia should be considered in the differential diagnosis of atypical pneumonia in Spain, especially in hunters and other persons who handle animal carcasses.
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Affiliation(s)
- J Bellido-Casado
- Department of Internal Medicine, University Hospital Río Hortega, Valladolid, Spain
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Pérez-Castrillón JL, González-Castañeda C, Del Campo F, González JI, Martín-Escudero JC, Herreros V. Cavitary lung lesion in a patient with Sjögren's syndrome. Postgrad Med J 1999; 75:765-6. [PMID: 10567614 PMCID: PMC1741422 DOI: 10.1136/pgmj.75.890.765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- J L Pérez-Castrillón
- Department of Internal Medicine, University Hospital Rio Hortega, University of Valladolid, Valladolid, Spain
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Martín-Luquero M, Marcos LA, Freijanes N, Pérez-Castrillón JL. A focal central nervous system mass in an AIDS patient with tuberculous meningitis. Postgrad Med J 1999; 75:697-8. [PMID: 10621890 PMCID: PMC1741410 DOI: 10.1136/pgmj.75.889.697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- M Martín-Luquero
- Department of Internal Medicine, Hospital Rio Hortega, University of Valladolid, Spain
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Affiliation(s)
- J L Pérez-Castrillón
- Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain
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Pérez-Castrillón JL, Gonzalez-Castâneda C, del Campo-Matias F, Bellido-Casado J, Diaz G. Empyema necessitatis due to Actinomyces odontolyticus. Chest 1997; 111:1144. [PMID: 9106610 DOI: 10.1378/chest.111.4.1144-a] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Carrascosa M, Pascual F, Corrales A, Martínez J, Valle R, Pérez-Castrillón JL. Septic sternoclavicular arthritis caused by group B Streptococcus: case report and review. Clin Infect Dis 1996; 22:579-80. [PMID: 8852988 DOI: 10.1093/clinids/22.3.579] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- M Carrascosa
- Service of Internal Medicine and Laboratory of Microbiology, Hospital of Laredo, Cantabria, Spain
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Napal J, Valle R, Carrascosa M, Pérez-Castrillón JL. [Spontaneous fracture of the sacrum of osteoporotic origin]. Med Clin (Barc) 1995; 104:437-8. [PMID: 7715268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Carrascosa M, Pérez-Castrillón JL, Pascual F, Olalla JI, Valle R. Pernicious anemia presenting with acute generalized thrombocytopenic purpura. Am J Hematol 1995; 48:125. [PMID: 7847326 DOI: 10.1002/ajh.2830480211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M Carrascosa
- Servicio de Medicina Interna, Hospital de Laredo, Spain
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Carrascosa M, Pérez-Castrillón JL, Sampedro I, Valle R, Cillero L, Méndez MA. Lung abscess due to Streptococcus mitis: case report and review. Clin Infect Dis 1994; 19:781-3. [PMID: 7803651 DOI: 10.1093/clinids/19.4.781] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Streptococcus mitis is a bacterium traditionally regarded as a normal commensal of the oropharynx, skin, and intestinal and genital tracts. To our knowledge, we describe the first case of bilateral lung abscesses caused by S. mitis in an immunocompetent host. The abscesses were successfully treated with clindamycin and gentamicin. Our case illustrates that S. mitis should be considered a cause of pulmonary abscesses.
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Affiliation(s)
- M Carrascosa
- Servicio de Medicina Interna, Hospital de Laredo, Cantabria, Spain
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Olmos JM, Pérez-Castrillón JL, García MT, Garrido JC, Amado JA, González-Macías J. Bone densitometry and biochemical bone remodeling markers in type 1 diabetes mellitus. Bone Miner 1994; 26:1-8. [PMID: 7950501 DOI: 10.1016/s0169-6009(08)80157-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Bone mineral density (BMD) at the lumbar spine, quantified by dual energy X-ray absorptiometry, and biochemical bone remodeling markers (serum alkaline phosphatase, osteocalcin, tartrate-resistant acid phosphatase and urinary hydroxyproline) have been studied in 94 patients with diabetes mellitus aged 18-62 years. BMD was normal (1.13 +/- 0.02 g/cm2 in patients vs. 1.16 +/- 0.12 g/cm2 in controls), although it was found to be negatively correlated with HbA1, microalbuminuria, age and the duration of the disease. Serum alkaline phosphatase (188 +/- 75 I.U./l vs. 168 +/- 42 I.U./1; P < 0.03), serum tartrate-resistant acid phosphatase (14.3 +/- 4.3 I.U./l vs. 11.7 +/- 3.7 I.U./l; P < 0.0001) and urinary hydroxyproline (0.018 +/- 0.016 mmol/mmol creatinine vs. 0.011 +/- 0.008 mmol/mmol creatinine; P < 0.001) were higher in diabetics than in controls. Serum osteocalcin was lower (2.5 +/- 1.3 ng/ml vs. 3.4 +/- 1.2 ng/ml; P < 0.0001). No relationship was found between bone remodeling markers and BMD. It is concluded that lumbar BMD is normal in type 1 diabetic patients, although the degree of metabolic control, age and duration of the disease may affect it. In the light of the biochemical markers, bone remodeling may be disturbed in diabetes, but such disturbance seems to be unimportant regarding BMD.
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Affiliation(s)
- J M Olmos
- Departamento de Medicina Interna, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
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Pérez-Castrillón JL, Pérez-Arellano JL, García-Palomo JD, Jiménez-López A, De Castro S. Opioids depress in vitro human monocyte chemotaxis. Immunopharmacology 1992; 23:57-61. [PMID: 1314788 DOI: 10.1016/0162-3109(92)90009-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Intravenous drug abusers (IDA) normally show functional defects in monocyte activity, in particular their chemotactic response. The aim of the present work was to study the action of several opioids on monocyte chemotaxis. To do so, monocytes from healthy individuals were incubated with heroin and morphine at three different concentrations (10(-5) M, 10(-6) M and 10(-7) M), with the finding of a significant depression in monocyte chemotaxis in all cases. This alteration could be due to a receptor effect or, conversely, to a non-specific effect. Accordingly, in the second phase of the study, monocytes from controls were incubated with a selective agonist of mu receptors (DAGO) and a selective agonist of delta receptors (DPDPE). In both cases a decrease in chemotactic function was observed similar to that following incubation with morphine or heroin. Preincubation of the monocytes with naloxone prevented the depression induced by both specific agonists. These findings suggest that opioids play an important role in the depression of monocyte chemotaxis observed in IDA. The results also suggest the presence of mu and delta opiate receptors in the cells of the phagocytic mononuclear system.
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