ABSTRACT
OBJECTIVES: The aim of this longitudinal, open-label, comparative, multicenter study was to assess cognitive function in hypertensive patients receiving mid-term treatment with lercanidipine. METHODS: Hypertensive patients aged 40 years or older were treated with lercanidipine (10 mg daily) after 7-10 days washout period. The duration of the study was 6 months. Blood pressure (BP) was measured every 4 weeks (JNC 6th report). In patients with inadequate BP control, doxazosin was added and up-titrated. At baseline and after 6 months of treatment, cognitive function was evaluated using the Spanish validated version of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT). RESULTS: In the study population of 467 patients, BP decreased from 154.4/95.3 mmHg at baseline to 134.8/80.7 mmHg at 6 months. At the end of the study, 98% of patients were receiving lercanidipine, 20% an angiotensin-converting enzyme inhibitor, and 6% doxazosin. Adequate BP control was obtained in 68% of patients. The mean (standard deviation) MMSE scores improved from 32.35 (2.59) to 33.25 (2.36) (p < 0.0001). Patients with good BP control scored significantly better than those with inadequate BP control (p < 0.05), which was already observed at the first month. CONCLUSIONS: The third-generation calcium channel antagonist, lercanidipine, improved cognitive function after 6 months of treatment especially in patients with good BP control, suggesting that improvements in cognitive function may be associated with a decrease in BP.
Subject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Calcium Channel Blockers/therapeutic use , Cognition/drug effects , Dihydropyridines/therapeutic use , Hypertension/drug therapy , Adrenergic alpha-Antagonists , Adult , Aged , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents/adverse effects , Calcium Channel Blockers/adverse effects , Dihydropyridines/adverse effects , Doxazosin/therapeutic use , Drug Therapy, Combination , Female , Heart Rate/drug effects , Humans , Hypertension/physiopathology , Hypertension/psychology , Longitudinal Studies , Male , Middle Aged , Psychiatric Status Rating Scales , Psychomotor Performance/drug effects , Spain , Time Factors , Treatment OutcomeABSTRACT
El derrame pericárdico es un problema clínico, sobre todo por la dificultad que entraña su diagnóstico etiológico, sin llegar a determinarse su causa en gran número de casos. Presentamos el caso de una paciente con taponamiento cardíaco in causa filiada, con empeoramiento clínico que precisó pericardiocentesis, y a la que se le administró con tuberculostáticos, de forma empírica, con mejoría y resolución del cuadro. Revisamos la frecuencia del derrame pericárdico de origen tuberculoso y sus técnicas diagnósticas (AU)
Subject(s)
Aged , Female , Humans , Pericardial Effusion/etiology , Pericardial Effusion/surgery , Tuberculosis, Pulmonary/complicationsABSTRACT
El pseudoxantoma elástico es una rara alteración congénita, displásica y hereditaria del tejido conjuntivo, caracterizada por una calcificación distrófica aberrante y una anormal mineralización progresiva de los tejidos elásticos y del colágeno. Este proceso afecta a los tejidos ricos en fibras elásticas y a múltiples sistemas del organismo, siendo las manifestaciones más características las dermatológicas, oftalmológicas y vasculares. Se va manifestando según progresa este trastorno a lo largo de la vida de la persona afectada, pudiendo en ocasiones afectar a la cavidad oral. Estas manifestaciones orales se localizan frecuentemente en la mucosa de la cara interna del labio inferior, en forma de placas o pápulas amarillentas. Estas alteraciones han sido objetivadas en pacientes con afectación cutánea severa. Se presentan cuatro casos de pacientes pertenecientes a una misma familia y diagnosticados de PXE, con diferentes grados de evolución y, por tanto, de afectación a nivel de la cavidad oral. Se describe la clínica de dichas manifestaciones, siendo ésta de localización y evolución variables (AU)
Subject(s)
Adult , Female , Male , Middle Aged , Humans , Pseudoxanthoma Elasticum/complications , Mouth Diseases/etiology , Mouth Diseases/geneticsABSTRACT
El Síndrome de Grönblad-Strandberg es un raro trastorno displásico hereditario congénito del tejido conjuntivo, caracterizado por una anormal mineralización progresiva y una calcificación aberrante distrófica de los tejidos elásticos y del colágeno. Este proceso afecta a los tejidos ricos en fibras elásticas y a múltiples sistemas del organismo, siendo las manifestaciones más típicas las cutáneas, oculares y vasculares. Dichas manifestaciones van progresando a lo largo de la vida de la persona afectada. Se presentan cuatro casos de una misma familia, con una clínica heterogénea y evolución variable (AU)
Subject(s)
Adult , Female , Male , Middle Aged , Humans , Pseudoxanthoma Elasticum , Pedigree , Pseudoxanthoma Elasticum/diagnosisABSTRACT
El síndrome de Grönblad-Strandberg, también conocido como pseudoxantoma elástico, es un infrecuente trastorno displásico hereditario congénito del tejido conjuntivo, caracterizado por una anormal mineralización progresiva y una calcificación aberrante distrófica de los tejidos elásticos y del colágeno (1). El modo de herencia no está claro, si bien se cree que se transmite de manera autosómica recesiva. Este proceso afecta a los tejidos ricos en fibras elásticas y a múltiples sistemas del organismo, siendo las manifestaciones más comunes las cutáneas (pseudoxantoma elástico), oculares (estrías angioides), vasculares (calcificación de vasos) y gastrointestinales. Se va manifestando según progresa el proceso a lo largo de la vida de la persona afectada, siendo heterogéneo tanto en su clínica como en su evolución (AU)
Subject(s)
Humans , Pseudoxanthoma Elasticum/etiology , Pseudoxanthoma Elasticum/diagnosis , Pseudoxanthoma Elasticum/complications , Heart Diseases/etiology , Pseudoxanthoma Elasticum/physiopathology , Pseudoxanthoma Elasticum/therapy , Skin Diseases/etiologyABSTRACT
The Grönblad-Strandberg syndrome is a rare congenital hereditary dysplasic disorder of the connective tissue, characterized by a progressive abnormal mineralization and dystrophic calcification of elastic tissue and collagen. This process affects tissues rich in elastic fibers and multiple systems of the organism, the cutaneous, ocular and vascular being the most common. These findings progress through the life of the affected person. We present 4 cases in the same family, with heterogeneous clinic pattern and evolution.
Subject(s)
Pseudoxanthoma Elasticum/diagnosis , Adult , Female , Humans , Male , Middle Aged , PedigreeABSTRACT
The Grönblad-Strandberg syndrome, also known as pseudoxanthoma elasticum, is a rare congenital dysplasic disorder of the connective tissue, characterized by a progressive abnormal mineralization and dystrophic calcification of elastic tissues and collagen (1). The mode of inheritance is uncertain, but autosomal recessive inheritance can be assumed. This process affects tissues rich in elastic fibres and multiple systems of the organism, being the most common the cutaneous (pseudoxanthoma elasticum), ocular (angioid streaks), vascular (occlusive vascular disease) and gastrointestinal manifestations. These findings progress through the life of the affected person, with variable pattern clinic and evolution.
Subject(s)
Pseudoxanthoma Elasticum , Humans , Pseudoxanthoma Elasticum/diagnosis , Pseudoxanthoma Elasticum/etiology , Pseudoxanthoma Elasticum/physiopathology , Pseudoxanthoma Elasticum/therapySubject(s)
Oxidative Stress , Body Fluids , Endopeptidases/metabolism , Endothelium/cytology , Endothelium/metabolism , Eosinophils/metabolism , Erythrocytes/metabolism , Free Radicals , Humans , Lipid Peroxidation/physiology , Macrophages/metabolism , Neutrophils/metabolism , Oxidative Stress/physiology , Phagocytosis/physiologyABSTRACT
We present a case of multiple symmetric lipomatosis Type I (Madelung's disease) with severe organic affection, hepatic cirrhosis, sever sensitive polyneuropathy and neuropathic ulceration at the left lower limb. A nephrotic syndrome developed in a larval form due to proliferative glomerulonephritis as the result of a metainfectious complications of the infection at the lower limb. We discuss the etiopathogenicity of the organic affection and we highlight the pathogenic links between the disease and its complications.
Subject(s)
Lipomatosis, Multiple Symmetrical/complications , Nephrotic Syndrome/complications , Biopsy , Glomerulonephritis/complications , Glomerulonephritis/etiology , Glomerulonephritis/pathology , Humans , Kidney/pathology , Leg Ulcer/complications , Liver/pathology , Liver Cirrhosis/complications , Liver Cirrhosis/pathology , Male , Middle Aged , Nephrotic Syndrome/pathology , Nervous System Diseases/complicationsSubject(s)
Abscess/microbiology , Brucella melitensis , Brucellosis , Spinal Cord Diseases/microbiology , Adult , Epidural Space , Humans , Male , Middle AgedSubject(s)
Gaucher Disease/therapy , Alleles , Bone Diseases, Metabolic/etiology , Bone Diseases, Metabolic/therapy , Bone Marrow Transplantation , Gaucher Disease/classification , Gaucher Disease/complications , Gaucher Disease/diagnosis , Gaucher Disease/genetics , Genetic Therapy , Glucosylceramidase/deficiency , Glucosylceramidase/therapeutic use , Humans , Leukocytes/enzymology , Splenectomy , Thrombocytopenia/etiology , Thrombocytopenia/therapyABSTRACT
A case of hemispheric medulloblastoma of cerebellum in a 22 male patient is presented. The patient complained of headache and an intracranial hypertension syndrome progressively appeared. Diagnosis was established by CT scan. Treatment consisted of radical surgery associated to radiotherapy and chemotherapy. Present survival with this treatment is 4 years being the patient asymptomatic and without signs of relapse.
Subject(s)
Cerebellar Neoplasms/diagnosis , Medulloblastoma/diagnosis , Adult , Cerebellar Neoplasms/therapy , Combined Modality Therapy , Humans , Male , Medulloblastoma/therapy , Tomography, X-Ray ComputedSubject(s)
Hypertension/etiology , Antioxidants , Cardiomegaly/complications , Cardiomegaly/epidemiology , Cardiomegaly/etiology , Cardiomegaly/metabolism , Cell Membrane Permeability , Free Radicals , Humans , Hypertension/epidemiology , Hypertension/metabolism , Oxidation-Reduction , Oxygen Consumption , Risk FactorsABSTRACT
In this second part, we study in detail the most important cardiological diseases showing the physiopathological consideration to support the importance of the stationary equilibrium between pro-oxidation and anti-oxidation to maintain the cardiovascular health. Ischemic cardiopathy and its risk factors (lipids, smoke, blood hypertension, alcohol, etc.), anti-oxidation, different cardiac diseases (coronary insufficiency, blood hypertension, congestive heart insufficiency, cardiomyopathies), are analyzed, and finally, we make clear certain information related to the onset of nitrites tolerance phenomenon and its treatment with anti-oxidation products.
Subject(s)
Cardiovascular Diseases/metabolism , Oxygen/metabolism , Animals , Antioxidants , Free Radicals , Humans , Oxidation-ReductionABSTRACT
In the first part of this paper, a group of definitions are explained in order to understand the mechanisms groups of the most important enzymes which participate in the formations of free radicals and active species of oxygen in the heart. Furthermore, we focus on chemistry and the production of these different active species of oxygen, rounding of by giving information related to the importance of hypoxia-reoxygenation, as well as the lipidic peroxidation in the formation of oxygen free radicals. All this information provides us with a biochemical baseline to write a second part about the cardiovascular pathology related to the lack of equilibrium between pro-oxidation and anti-oxidation.
Subject(s)
Coronary Disease/etiology , Myocardium/metabolism , Oxygen/metabolism , Biochemical Phenomena , Biochemistry , Cell Hypoxia , Free Radicals/metabolism , Humans , Lipid PeroxidationABSTRACT
A clinical case of Mediterranean Boutonneuse Fever (MBF) with circulating cryoglobulins during the acute phase, with no clinical symptoms is described and considered an epiphenomenon of the infection. The possible relationship between the infection and the cryoglobulinemia are discussed. The patient is also added to the increasing list of patients reported of Boutonneuse Fever in the Mediterranean area during the observation period.
