Assessment of cognitive function in patients with essential hypertension treated with lercanidipine.

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.

[Gronblad-Strandberg syndrome. Report of four cases in one family]. / Síndrome de Grönblad-Strandberg. A propósito de cuatro casos en una misma familia.

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.

[Gronblad-Strandberg syndrome]. / Síndrome de Grönblad-Strandberg.

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.

[Nephrotic syndrome associated with symmetrical multiple lipomatosis (Madelung's disease)]. / Síndrome nefrótico asociado a la lipomatosis múltiple simétrica. Enfermedad de Madelung.

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.

[Medulloblastoma in the adult: presentation of a new case]. / Meduloblastoma del adulto: presentación de un nuevo caso.

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.

[Cardiac diseases related to free radicals and active oxygen species. Pro-oxidation and anti-oxidation in cardiology (part 2)]. / Enfermedades cardíacas relacionadas con los radicales libres y las especies activas del oxígeno. Pro-oxidación y anti-oxidación en cardiología (2a. parte).

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.

[Cardiac diseases related to free radicals and active species of oxygen. Biochemistry (1)]. / Enfermedades cardíacas relacionadas con los radicales libres y las especies activas del oxígeno. Bioquímica (1a. parte).

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.

[Mixed cryoglobulinemia secondary to Mediterranean boutonneuse fever]. / Crioglobulinemia mixta secundaria a fiebre botonosa mediterránea.

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.