Estevez-Gonzalez M.D.,University of Las Palmas de Gran Canaria |
Cebrero-Garcia E.,Universitario Insular Materno Infantil |
Pena-Quintana L.,University of Las Palmas de Gran Canaria
Annals of Nutrition and Metabolism | Year: 2010
Background: This study aimed to examine the changes in serum lipids in children with mild hypercholesterolemia after the use of skim milk or olive-oil-enriched skim milk in their diet and the modulation of lipid levels by the Taq 1B polymorphism in the cholesteryl-ester transfer protein gene. Methods: Thirty-six prepubertal children with mild hypercholesterolemia were randomly assigned in a crossover design into 2 groups of 16 and 20 individuals. Both groups received, in sequential inverse order, the 2 types of milk for 2 periods of 6 weeks. Results: Carriers of at least 1 B2 allele had an adjusted basal HDL cholesterol level significantly higher than children with the B1B1 genotype (1.291 mmol/l, 95% CI: 1.184-1.397, vs. 1.082 mmol/l, 95% CI: 0.931-1.233; p = 0.027). In contrast, there were no significant differences in the adjusted basal levels of apolipoprotein A-I (B2 carriers: 1.292 g/l, 95% CI: 1.218-1.367; B1B1 genotype: 1.215 g/l, 95% CI: 1.109-1.320; p = 0.223). The intake of olive-oil-enriched skim milk caused significant increases in HDL cholesterol and apolipoprotein A-I, both in B2 (0.089 mmol/l, 95% CI: 0.032-0.146, p = 0.005; 0.55 g/l, 95% CI: 0.012-0.098; p = 0.018) and in B1B1 carriers (0.179 mmol/l, 95% CI: 0.096-0.262; p < 0.001; and 0.095 g/l, 95% CI: 0.032-0.157; p = 0.003). This increase in HDL cholesterol was significantly higher in the B1B1 group (p = 0.049). Conclusion: The consumption of skim milk enriched with olive oil increases the HDL cholesterol and apolipoprotein A-I levels in children with hypercholesterolemia, this effect being more intense in carriers of the B1B1 genotype. © 2010 S. Karger AG, Basel.
Martinez-Quintana E.,Universitario Insular Materno Infantil |
Rodriguez-Gonzalez F.,University of Las Palmas de Gran Canaria
Cardiology in the Young | Year: 2015
Introduction: Subclinical hypothyroidism or mild thyroid failure is a common problem in patients without known thyroid disease. Methods: Demographic and analytical data were collected in 309, of which 181 were Male and 128 were feMale, congenital heart disease (CHD) patients. CHD patients with thyroid-stimulating hormone above 5.5 mIU/L were also followed up from an analytical point of view to determine changes in serum glucose, cholesterol, N-terminal pro b-type natriuretic peptide, and C-reactive protein concentrations. Results: Of the CHD patients, 35 (11.3%) showed thyroid-stimulating hormone concentration above 5.5 mIU/L. Of them, 27 were followed up during 2.4±1.2 years - 10 were under thyroid hormone replacement treatment, and 17 were not. Of the 27 patients (25.9%), 7 with subclinical hypothyroidism had positive anti-thyroid peroxidase, and 3 of them (42.8%) with positive anti-thyroid peroxidase had Down syndrome. Down syndrome and hypoxaemic CHD patients showed higher thyroid-stimulating hormone concentrations than the rest of the congenital patients (p<0.001). No significant differences were observed in serum thyroxine, creatinine, uric acid, lipids, C-reactive protein, or N-terminal pro b-type natriuretic peptide concentrations before and after the follow-up in those CHD patients with thyroid-stimulating hormone above 5.5 mIU/L whether or not they received levothyroxine therapy. Conclusions: CHD patients with subclinical hypothyroidism showed no significant changes in serum thyroxine, cholesterol, C-reactive protein, or N-terminal pro b-type natriuretic peptide concentrations whether or not they were treated with thyroid hormone replacement therapy. © © Cambridge University Press 2014.
Martinez-Quintana E.,Universitario Insular Materno Infantil |
Rodriguez-Gonzalez F.,Universitario Insular Materno Infantil |
Nieto-Lago V.,Universitario Insular Materno Infantil |
Novoa F.J.,Universitario Insular Materno Infantil |
And 2 more authors.
Metabolism: Clinical and Experimental | Year: 2010
Atherosclerosis has been correlated with known cardiovascular risk factors such as serum glucose or lipid levels. Because congenital heart disease patients tend to survive until adulthood, atherosclerosis has also become a matter of concern in these patients. One hundred fifty-eight congenital heart disease patients and 152 patients selected at random from the population were studied and compared to determine serum glucose, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, and triglycerides levels. Both groups had similar socioeconomic status levels and the same environmental influences. Significant differences were seen between congenital heart disease patients and the control group, after sex, age, and body mass index adjustment, in fasting plasma glucose (97.7 [94.2-101.2] vs 86.9 [83.2-90.7], P < .001), total cholesterol (171.5 [165.7-177.3] vs 199.8 [90.7-206.0], P < .001), LDL cholesterol (103.9 [98.8-108.8] vs 123.8 [118.5-129.1], P < .001), and high-density lipoprotein cholesterol (48.1 [46.2-50.0] vs 54.2 [52.1-56.2], P < .001) levels. Nonsignificant differences were seen in triglycerides concentrations. Those patients with ventricular septal defect, coarctation of the aorta, and cyanosis had the lowest total cholesterol and LDL cholesterol concentrations. Congenital heart disease patients have lower plasma cholesterol concentrations and higher serum glucose levels than noncongenital ones. © 2010 Elsevier Inc.
Martinez-Quintana E.,Universitario Insular Materno Infantil |
Rodriguez-Gonzalez F.,Hospital Universitario Of Gran Canaria Dr Negrin |
Nieto-Lago V.,Universitario Insular Materno Infantil
Pediatric Cardiology | Year: 2013
Subclinical hypothyroidism usually is asymptomatic, but it can be associated with various adverse cardiologic outcomes. With the objective of gaining insight into the role of thyroid-stimulating hormone (TSH) in congenital heart abnormalities, this study measured serum TSH concentrations in different subtypes of grown-up congenital heart disease (GUCHD) patients. Serum TSH (reference range, 0.34-5.6 mIU/L), creatinine, cholesterol, C-reactive protein (CRP), N-terminal proB-type natriuretic peptide (NT-pro-BNP), and 24-h proteinuria were measured in 249 GUCHD patients. Of 24 GUCHD patients (9.6 %) with a TSH level higher than 5.6 mUI/L, nine were cyanotic (37.5 %) and seven (29.1 %) had Down syndrome. The GUCHD patients with serum TSH exceeding 5.6 mIU/L had a significantly higher level of serum NT-pro-BNP (195.1 [0.28; 5,280.3] vs 57.6 [0.00; 929.8]; p = 0.001) and CRP (0.30 [0.06; 1.87] vs 0.16 [0.00; 1.40]; p = 0.011] than those with a TSH level of 5.6 mIU/L or lower. No significant differences were found in serum creatinine, lipids, or 24-h proteinuria between the two groups. The T4 concentrations in the GUCHD patients with TSH exceeding 5.6 mIU/L were within the normal range (0.89 ± 0.23 ng/dL). In the multivariate analysis, cyanosis (odds ratio [OR], 6,399; 95 % confidence interval [CI] 2,296-17,830; p < 0.001), Down syndrome (OR, 6,208; 95 % CI, 1,963-19,636; p = 0.002), and NT-pro-BNP concentrations (OR, 1,001; 95 % CI, 1,000-1,002; p < 0.026) proved to be risk factors for TSH levels higher than 5.6 mIU/L. Because subclinical hypothyroidism entails a cardiovascular risk, the authors postulate that TSH screening should be included in the routine follow-up evaluation of GUCHD patients with cyanosis or Down syndrome. © 2012 Springer Science+Business Media New York.
Learning of percutaneous nephrolithotomy in supine position. An observational multicenter study [El aprendizaje de la nefrolitectomía percutánea en posición supina. Estudio observacional multicéntrico]
Amon J.H.,Hospital Universitario La Paz |
Perez Fentes D.,University of Santiago de Compostela |
Resel L.,Hospital Clinico San Carlos |
Galan J.A.,Hospital Del Vinalopo |
And 9 more authors.
Actas Urologicas Espanolas | Year: 2013
Objective: To prospectively study the post-operative results and complications of percutaneous nephrolithotomy (PNL) in supine position to assess difficulty of learning it and how experience affects the results. To establish a relative comparison with the data published in the literature on the prone position. Material and methods: A prospective observational multicenter study on PNL in Valdivia position or in its Galdakao variant was performed. Demographic variables and specific variables related to the lithiasis were collected. Technical aspects, surgery time, success rate and complications according to the Clavien-Dindo classifications were assessed. Results: A total of 335 PNL in supine position conducted in 13 Spanish centers were registered from September 2008 to June 2011. The man:woman ratio was 1:1.28 and mean age 51.3 + 14.5 years. 211 (63%) cases were performed by urologists with experience in > 50 cases and 124 (37%) by urologists with less experience. Mean operation time was 113.3 ± 46.4 min, 106.6 ± 38.2 for the experienced ones vs. 124.9 ± 56.2 in the novice ones (P <.002). No difference was detected in the mean size of the lithiasis. However, in the experienced group, there was a greater proportion of coraliform cases and multiple lithiasis than in the novice group (P <.001). Success rate evaluated as total absence of lithiasic residuals was 69.6%, without differences between groups (68.2 vs. 71.8%). In 102 (30.6%) patient had residual lithiasis and 60 (17,9%) required complementary treatment. Relative global success rate was 82.1% and complications rate 25.4%, without detecting differences between groups. However, the novel group had more major complications (P >.001). Conclusion: The PNL in supine position is obtaining rapid and consolidated diffusion in our setting and its effectiveness and safety seems to be equivalent to that described in the literature for PNL in prone position. It is possible to obtain good results with a modest learning curve. The rate of greater complications associated to the procedure decreases with experience.© 2012 AEU. Publicado por Elsevier Espana, S.L. Todos los derechos reservados.© 2012 AEU. Publicado por Elsevier Espana, S.L. Todos los derechos reservados.
Diaz-Gonzalez C.M.,Universitario Insular Materno Infantil |
Garcia-Alvarez D.,Universitario Nuestra Senora Of La Candelaria |
Bordon-Medina C.D.,Universitario Insular Materno Infantil |
Lobato-Santana A.L.,Universitario Insular Materno Infantil |
Suarez-Garcia M.D.P.,Universitario Insular Materno Infantil
Enfermeria Clinica | Year: 2010
Objective: To find out the wishes of nurses in the Canary Islands in light of the new academic and professional changes, and to identify whether the sociodemographic variables can influence their decisions. Method: We chose a cross-sectional descriptive study using a questionnaire with 5 questions over a period of three months in 2008. Results: A total of 1070 nurses responded to the questionnaire. Of these, 91.9% (n=984) wanted to do their degree in nursing, either voluntarily or obliged to by the academic changes, 71.5% (n=765) wanted to do an official Masters degree, compared to 47.7% (n=510) who wanted to or are doing a PhD. As for career changes, 48.8% (n=522) of the sample wabted access through the Nursing Internal Residency EIR program, and 34.8% (n=372) by the "exceptional route". Conclusions: All sociodemographic variables appeared to influence nurses in continuing their education, particularly showing that, marital status, children, type of contract and Canary Islands residency influence both the academic route as well as work. © 2009 Elsevier España, S.L.
Pena-Quintana L.,University of Las Palmas de Gran Canaria |
Garcia-Luzardo M.R.,Universitario Insular Materno Infantil |
Garcia-Villarreal L.,Universitario Insular Materno Infantil |
Arias-Santos M.D.,Universitario Insular Materno Infantil |
And 6 more authors.
Journal of Pediatric Gastroenterology and Nutrition | Year: 2012
Objective: The aim of the study was to characterize a group of 11 pediatric patients, ages 3 to 13 years, affected by Wilson disease (WD) in the island of Gran Canaria, Spain. Patients and Methods: Genetic, biochemical, and pathological features, together with their response to treatment and clinical evolution, have been analyzed for this group of patients. Results: Genetically, the group was rather homogeneous, with an extremely high prevalence of the L708P mutation (4 homozygotes and 5 heterozygotes). Despite being initially screened because of asymptomatic hypertransaminemia, all of the patients presented with some degree of liver damage that was never accompanied by any neurological manifestation. Hepatic damage was most severe in a compound heterozygote with a novel mutation, G1266W, affecting a motif in the ATP7B polypeptide that is greatly conserved in similar proteins among metazoans. Ceruloplasmin and copper serum levels, together with the determination of hepatic copper content, were found to be of great diagnostic value, whereas urine copper measurements were found to be much less conclusive. All of the patients responded well to treatment with D-penicillamine with no documented adverse reactions. Conclusions: The patients in Gran Canaria constitute, overall, one of the largest groups of patients with WD with a high incidence of a single mutation, allowing us to define the early clinical symptoms and the evolution of the disease in patients carrying the ATP7B L708P mutant allele, and the study of WD in a genetically homogeneous background. Copyright © 2012 by European Society for Pediatric Gastroenterology.
Martinez-Quintana E.,Servicio de Cardiologia |
Rodriguez-Gonzalez F.,Servicio de Medicina Intensiva |
Medina-Gil J.M.,Medico Interno Residente |
Agredo-Munoz J.,Universitario Insular Materno Infantil |
Nieto-Lago V.,Servicio de Cardiologia
Cirugia y Cirujanos | Year: 2010
Background: Long-term complications of Down syndrome patients with congenital heart disease are poorly known. methods: We carried out a retrospective study of Down syndrome patients with congenital heart disease and patients with atrioventricular septal defect with and without Down syndrome. results: Between 2004 and 2008, 317 patients with congenital heart disease were followed-up in the Adult Congenital Heart Disease Unit. Of these patients, 19 (6%) with a mean age of 26.8 ± 8.1 years had Down syndrome. Atrioventricular septal defect was the most frequent congenital heart disease (63%) followed by ventricular septal defect (26%). Ten patients (53%) were operated on during childhood. Three of these patients required reoperation during adulthood (two patients due to left ventricle outflow tract obstruction and one patient due to left atrioventricular valve insufficiency). Four patients (21%) had Eisenmenger syndrome with improvement of functional class in those treated with bosentan, two patients (10.5%) had bacterial endocarditis and two patients (10.5%) died. No significant differences were seen in left atrioventricular valve insufficiency between atrioventricular septal defect in patients with and without Down syndrome (1.5 ± 0.9 vs. 1.7 ± 0.8, p = 0.689). Conclusions: Left atrioventricular valve insufficiency and left ventricle outflow tract obstruction were the most frequent long-term complications requiring surgical reintervention in patients with atrioventricular septal defect.