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Martinez Diaz-Guerra G.,Servicio de Endocrinologia | Jodar Gimeno E.,Hospital Universitario Quiron Madrid | Reyes Garcia R.,Hospital General Universitario Rafael Mendez | Gomez Saez J.M.,Hospital Universitario Of Bellvitge | Munoz-Torres M.,Hospital Universitario San Cecilio
Endocrinologia y Nutricion | Year: 2013

Objective: To provide practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. Participants: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Methods: A systematic search was made in MEDLINE (PubMed), using the terms normocalcemic primary hyperparathyroidism and primary hyperparathyroidism, for articles in English published before 22 November 2012. Literature was reviewed by 2 members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, and after development of recommendations, the manuscript was reviewed by all other members of the Group, and their suggestions were incorporated. Conclusions: The document provides practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. There is however little evidence available about different aspects of this disease, mainly progression rate and clinical impact. More data are therefore needed before definite recommendations may be made. © 2012 SEEN. Source


Jodar Gimeno E.,Hospital Universitario Quiron | Reyes Garcia R.,Hospital General Universitario Rafael Mendez | Carpintero P.,Hospital Universitario Reina Sofia | Casado J.L.,Servicio de Enfermedades Infecciosas | And 6 more authors.
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2014

Objective To provide practical recommendations for the evaluation and treatment of metabolic bone disease in human immunodeficiency virus (HIV) patients. Participants Members of scientific societies related to bone metabolism and HIV: Grupo de Estudio de Sida (GeSIDA), Sociedad Española de Endocrinología y Nutrición (SEEN), Sociedad Española de Investigación Ósea y del Metabolismo Mineral (SEIOMM), and Sociedad Española de Fractura Osteoporótica (SEFRAOS). Methods A systematic search was carried out in PubMed, and papers in English and Spanish with a publication date before 28 May 2013 were included. Recommendations were formulated according to GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) setting both their strength and the quality of supporting evidence. Working groups were established for each major part, and the final resulting document was later discussed in a face-to-face meeting. All the authors reviewed the final written document and agreed with its content. Conclusions The document provides evidence-based practical recommendations on the detection and treatment of bone disease in HIV-infected patients. © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Todos los derechos reservados. Source


Reyes-Garcia R.,Hospital General Universitario Rafael Mendez | Moreno-Perez T.,Hospital General Universitario Of Alicante | Munoz-Torres M.,Hospital Universitario San Cecilio | Merino-Torres J.F.,Polytechnic University of Valencia | And 10 more authors.
Endocrinologia y Nutricion | Year: 2013

Objective: To provide practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Participants: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition. Methods: Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (PubMed). Papers in English and Spanish with publication date before 15 February 2013 were included. For recommendations about drugs only those approved by the European Medicines Agency were included. After formulation of recommendations, they were discussed by the Working Group. Conclusions: The document provides evidence-based practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. © 2013 SEEN. Source


Reyes-Garcia R.,Servicio de Endocrinologia | Reyes-Garcia R.,Hospital General Universitario Rafael Mendez | Moreno-Perez O.,University Miguel Hernandez | Escalada-San Martin J.,University of Navarra | And 2 more authors.
Diabetes Therapy | Year: 2015

Introduction: A limitation with randomized controlled trials is that, while they provide unbiased evidence of the efficacy of interventions, they do so under unreal conditions and in a very limited and highly selected patient population. Our aim was to provide data about the effectiveness of liraglutide treatment in a real-world and clinical practice setting. Methods: In a retrospective and observational study, data from 753 patients with type 2 diabetes were recorded through an online tool (eDiabetes-Monitor). Results: Mean baseline glycated hemoglobin (HbA1c) was 8.4 ± 1.4% and mean body mass index (BMI) was 38.6 ± 5.4 kg/m2. After 3–6 months of treatment with liraglutide, we observed a change in HbA1c of −1.1 ± 1.2%, −4.6 ± 5.3 kg in weight and −1.7 ± 2.0 kg/m2 in BMI (p < 0.001 for all). Compared to baseline, there was a significant reduction in systolic blood pressure (−5.9 mmHg, p < 0.001), diastolic blood pressure (−3.2 mmHg, p < 0.001), LDL cholesterol (−0.189 mmol/l, p < 0.001) and triglycerides (−0.09 mmol/l, p = 0.021). In patients switched from DPP-4 inhibitors, liraglutide induced a decrease of −1.0% in HbA1c (p < 0.001) and a reduction in weight (−4.5 kg, p < 0.001). In patients treated with liraglutide as an add-on therapy to insulin a decrease of −1.08% in HbA1c (p < 0.001) and a weight reduction of −4.15 kg (p < 0.001) were observed. Conclusion: Our study confirms the effectiveness of liraglutide in a real-life and clinical practice setting. Funding: Spanish Society of Endocrinology and Nutrition. © 2015, The Author(s). Source


Garcia-Fontana B.,Hospital Universitario San Cecilio | Reyes-Garcia R.,Hospital Universitario San Cecilio | Reyes-Garcia R.,Hospital General Universitario Rafael Mendez | Morales-Santana S.,Hospital Universitario San Cecilio | And 4 more authors.
Endocrine | Year: 2015

Myostatin and irisin are two myokines related to energy metabolism, acting on skeletal muscle and recently suggested on adipose tissue in mice. However, the exact role of these myokines in humans has not been fully established. Our aim was to evaluate the relationship between serum levels of myostatin and irisin in type 2 diabetes mellitus patients and non-diabetic controls and to explore its links with metabolic parameters. Case–control study including 73 type 2 diabetes mellitus patients and 55 non-diabetic subjects as control group. Circulating myostatin and irisin levels were measured by enzyme-linked immunosorbent assays. Type 2 diabetes mellitus patients showed significantly lower myostatin levels (p = 0.001) and higher irisin levels (p = 0.036) than controls. An inverse relationship was observed between myostatin and irisin levels (p = 0.002). Moreover, in type 2 diabetes mellitus patients, after adjusting by confounder factors, myostatin was negatively related to fasting plasma glucose (p = 0.005) and to triglyceride levels (p = 0.028) while irisin showed a positive association with these variables (p = 0.017 and p = 0.006 respectively). A linear regression analysis showed that irisin and fasting plasma glucose levels were independently associated to myostatin levels and that myostatin and triglyceride levels were independently associated to irisin concentrations in type 2 diabetes mellitus patients. Our results suggest that serum levels of myostatin and irisin are related in patients with type 2 diabetes. Triglyceride and glucose levels could modulate myostatin and irisin concentrations as a compensatory mechanism to improve the metabolic state in these patients although further studies are needed to elucidate whether the action of these myokines represents an adaptative response. © 2015 Springer Science+Business Media New York Source

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