Papers by Jose Antonio Clavo Jauregui
International urology and nephrology, Jan 29, 2016
Chronically reduced glomerular filtration rate (GFR) in old people does not always mean that they... more Chronically reduced glomerular filtration rate (GFR) in old people does not always mean that they suffer from chronic kidney disease (CKD) since their GFR can just be reduced by aging. The HUGE equation has been recently described and validated in Spain for screening CKD without taking into account the patient's GFR value. This equation is based on patient's hematocrit, plasma urea levels and gender. The present study documented that the HUGE equation had and acceptable performance for screening CKD in elderly Argentine patients.
Part 1 The neural computer and the emotional system: the emotional system the neural computer bio... more Part 1 The neural computer and the emotional system: the emotional system the neural computer biosocial laws human society. Part 2 Emotional control of the body: emotional control of the digestive system emotional control of entries to the body emotional control of fatigue and danger. Part 3 Emotional control of society: emotional laws of laughter and language emotional laws of crying, shame, and smiling emotional laws of anger and revenge emotional laws of the ethical system emotional laws of the religious system.
Viref Revista De Educacion Fisica, Oct 21, 2014
Objetivo: analizar el lanzamiento pull en Ultimate Frisbee, para identificar sus fases y las var... more Objetivo: analizar el lanzamiento pull en Ultimate Frisbee, para identificar sus fases y las variables cinematicas del gesto tecnico. Metodo: estudio piloto de tipo descriptivo transversal para el cual se selecciono un deportista masculino de alto rendimiento. La accion tecnica de un intento efectivo de pull se describio por fases mediante video analisis. El analisis descriptivo se hizo con el software Kinovea 8.15. Resultados : el analisis permitio establecer 6 fases, con una descripcion especifica de los movimientos que ejecuta el deportista para realizar el lanzamiento de forma efectiva. Con respecto a las variables cinematicas, y en contraste con la teoria revisada, se encontraron valores parecidos al angulo de salida del frisbee. Conclusion : la ensenanza de la tecnica deportiva se debe soportar en evidencias obtenidas mediante investigacion. Este estudio contribuye a la discusion metodologica sobre la ensenanza de la tecnica, en este caso del lanzamiento pull.
El Aula Inteligente Nuevas Perspectivas 2003 Isbn 84 670 1115 7 Pags 185 198, 2003
Como Funciona El Cerebro 1998 Isbn 84 7762 776 2 Pags 37 57, 1998
International Urology and Nephrology, 2016
for HUGE equation validation patient’s evaluation by two nephrologists blind between them, as gol... more for HUGE equation validation patient’s evaluation by two nephrologists blind between them, as gold standard for renal health status, was used [3–5]. CKD is an entity frequently diagnosed in cirrhotic patients, and this kidney–liver alteration may be caused by diseases that can affect both organs (e.g., chronic virus C infection with cryoglobulinemia), or renal conditions induced by cirrhosis (e.g., Ig A nephropathy or pre-renal insufficiency induced by an increased vasomotor tone on renal circulation [6]. An equation like HUGE could be useful for screening CKD in cirrhotic patients, but this equation is based on serum parameters that can be altered by cirrhosis: Hematocrit may be low due to erythropoietin resistance (chronic disease anemia), and serum urea values may be lower because of a reduced urea biosynthesis (reduced hepatic conversion of ammonium to urea) [7, 8]. Thus, we decided to originally evaluate whether HUGE equation could be an accurate tool for detecting CKD in stable cirrhotic patients despite the influence that this condition can have on its constituents. With this objective, we performed a retrospective observational study to assess the operational characteristics of HUGE equation for screening CKD in 75 patients suffering from stable liver cirrhosis (Child–Pugh A) mostly secondary to hepatitis C (43 %), selected from a population of 750 cirrhotic patients who were on follow-up during 1 year (January 2014–January 2015) by the Hepatology and Transplantation Section of the Internal Medicine Division in the Hospital Italiano de Buenos Aires (Argentina). Inclusion criteria were as follows: to have information, every 4 months, during the year of the study (2014–2015) regarding patients’ serum and urine electrolytes, urea, creatinine, uric acid, hematocrit, hemoglobin, glucose, intact parathyroid hormone, urinalysis, and renal ultrasound. Editor,
International Urology and Nephrology, 2016
Additionally, GFR measurement is crucial for adjusting pharmacological prescriptions, particularl... more Additionally, GFR measurement is crucial for adjusting pharmacological prescriptions, particularly in healthy elderly people and renal patients [2, 3]. Because of the importance of evaluating patients' GFR in daily medical care, and the serious difficulties in obtaining a reliable GFR measurement by applying a simple method, compared to complicated GFR gold-standard methods such as: inulin, creatinine aided with cimetidine or iothalamate clearance , there has been along decades an enormous effort for developing accurate and reliable GFR equations [2, 3]. In the present review article, we have analyzed each of the mainly described GFR equations (following a temporal line) and the features of the individuals analyzed for their creation, and finally we performed a comparison among them. Jelliffe's equation (1971) Jelliffe et al. described an equation in 15 kidney transplant patients, which reasonably approaches the creatinine clearance calculated by computer when the patient is around 1.75 m tall and weighs 68 kg. Additionally, this equation also agrees well with the nomogram for estimating creatinine clearance developed by Siersback-Nielsen et al. [4, 5]. Jelliffe's equation is (Table 1): Kampmann's equation (1974) Kampmann et al. studied patients from three different hospitals in Copenhagen (range of age between 20 and 99 years). This population included 368 subjects with serum creatinine <1.4 mg/dl (149 men, and 219 women) eGFR = 98 − [0.8 × (Age − 20)]/serum creatinine × (BSA/1.73) × [0.9 if female] BSA : body surface area.
Geriatrics has already described four syndromes of its own: confusional syndrome, incontinence (f... more Geriatrics has already described four syndromes of its own: confusional syndrome, incontinence (fecal and/or urinary), and gait disorders and immobility syndrome, naming them geriatric giants. This name reflects their prevalence and great importance in the elderly. Ageing process induces many changes in renal physiology such as a reduction in glomerular filtration rate (senile hyponatremia), and water and sodium reabsorbtion capability. Besides, there are particular water and salt metabolism alteration characteristics of the geriatric syndromes, such as dehydration and hypernatremia in psychiatric disturbances as well as hyponatremia in patients suffering from immobility syndrome. The geriatric giants and nephrogeriatric physiology changes, are a good example of feed-back between geriatric syndromes, clinical entities characteristics in the elderly that predispose and potentiate each other, leading to catastrophic clinical events.
International Urology and Nephrology, 2015
Reviews in Clinical Gerontology, 2011
SummaryArgentina does not yet have a formal nationwide health programme for older people, so ther... more SummaryArgentina does not yet have a formal nationwide health programme for older people, so there are huge differences in the quality and entitlement of health care for senior citizens. Academic infrastructure is also underdeveloped and this situation slows the advance of geriatrics. Teaching and research in this field is usually unpaid. However, a committed minority of teachers and health professionals are confident that their efforts are worthwhile and a new generation of geriatricians is starting to participate actively in international forums, to publish in recognized medical journals, to participate in Latin American academic forums such as ALMA (Latin American Academy of Senior Adult Medicine) and to foster geriatrics as a speciality.
Introduction: Since between 25-30% bone fractures, and 60% hip fractures in the general populatio... more Introduction: Since between 25-30% bone fractures, and 60% hip fractures in the general population are common in the subgroup which correspond to very old women. This happens due to the high predominance of primary osteoporosis and the incidence of falls which are characteristic of such group; thus, we have decided to investigate, through a systematic revision of the bibliography, the value of strontium in the prevention of bone fractures caused by falls in very old patients who suffer from primary osteoporosis. Material and Method: A systematic revision of the literature was carried out following the recommendations of the Cochrane methodology. Out of the 8 documents initially recovered, only two were included (2 independent reviewers selected, evaluated and extracted the data from the included tests) since such tests were the only ones which complied with the eligibility criteria to be tests performed on a population of very old patients: older than 74 years old, thus reaching a t...
Fragility in Older Adults ABSTRACT The term fragility has evolved over time, as a “risk” of dying... more Fragility in Older Adults ABSTRACT The term fragility has evolved over time, as a “risk” of dying, losing functions or getting sick, associated with weakness, falls, and malnutrition. Different definitions have included physical, cognitive and psychosocial issues. The discussion of the definition focuses on whether or not psychosocial factors should be included. Most agree that it is a condition associated with aging and that despite the clearness of the concept, the biggest challenge is to find causal factors. Linda Fried defined fragility as the presence of 3 of the following 5 criteria: self-reported chronic fatigue, weakness, inactivity, decreased walking speed and weight loss. This model was replicated and was used as the basis to build the modern model with identification of causal factors such as physiological activation of inflammation, and altered immune, endocrine, and musculoskeletal systems. Other comorbidities included as causal factors are diastolic hypertension, strok...
Objectives: This study aimed to investigate the knowledge and attitudes of Argentine women 65 yea... more Objectives: This study aimed to investigate the knowledge and attitudes of Argentine women 65 years of age and older regarding urinary incontinence (UI). Methods: A cross-sectional study of 238 community-dwelling Argentine women 65 years of age and older was conducted in San Justo, Argentina. Data were collected by in-person interviews. Results: Regarding knowledge, 232 (97.5%) of the women surveyed were familiar with the term urinary incontinence, but 152 (63.9%) falsely believed that UI is a normal part of aging and 163 (68.5%) did not know about pelvic exercises or a surgical option to treat UI. A total of 106 (44.5%) women reported symptoms of UI. Discussion: Older Argentine women are misinformed about UI. Interventions are necessary to increase their knowledge and healthcare seeking behaviors.
Geriatric orthopaedic surgery & rehabilitation, 2014
This study aimed to determine the dislocation and reoperation rate, functional outcomes, and the ... more This study aimed to determine the dislocation and reoperation rate, functional outcomes, and the survival rate of the unique subset of very old but lucid and independent patients with hip fractures following a total hip arthroplasty (THA) and geriatric team-coordinated perioperative care. Between 2000 and 2006, previously independent ambulatory patients ≥80 years old presenting with an intracapsular hip fracture were given THAs under the care of an integrated orthopedic surgery-geriatric service. Their fracture-related complications, ambulation, mental status, and survival were followed for 5 to 11 years postinjury. Five years postinjury, 57 (61.3%) patients of the original study group were living. In all, 3 (3.2%) patients had postoperative hip dislocations (and 2 patients had dislocation twice) and 2 reoperations were needed within the first postoperative month. There were no hip dislocations or reoperations after the first year. Radiographs obtained on 88% of the surviving patien...
World Journal of Nephrology, 2012
Renal physiology in the healthy oldest old has the following characteristics, in comparison with ... more Renal physiology in the healthy oldest old has the following characteristics, in comparison with the renal physiology in the young: a reduced creatinine clearance, tubular pattern of creatinine back-filtration, preserved proximal tubule sodium reabsorption and uric acid secretion, reduced sodium reabsorption in the thick ascending loop of Henle, reduced free water clearance, increased urea excretion, presence of medulla hypotonicity, reduced urinary dilution and concentration capabilities, and finally a reduced collecting tubules response to furosemide which expresses a reduced potassium excretion in this segment due to a sort of aldosterone resistance. All physiological changes of the aged kidney are the same in both genders.
Expert Review of Endocrinology & Metabolism, 2014
Human senescence induces changes in the renin-angiotensin-aldosterone system (RAAS) which consist... more Human senescence induces changes in the renin-angiotensin-aldosterone system (RAAS) which consists of a substantial decrease in its plasma activity. Consequently, the distal tubule´s capability of handling sodium and potassium is significantly reduced in the elderly, while distal tubule acidification is slightly delayed but preserved in this age group. Several studies in animal models support the hypothesis that senile renal structural changes could be induced by the local production of angiotensin II, and also that enalapril significantly decreases senile mesangial expansion, glomerulosclerosis and peritubular and medullar interstitial sclerosis. The same applies to several highly prevalent diseases in the elderly, such as hypertension, obesity, cardiac insufficiency, chronic nephropathy and dementia. In conclusion, the relationship between the RAAS and senescence is complex, since not only does aging cause many changes on this hormonal system, but also RAAS overactivity seems to be one of the main inducing mechanisms for normal senescence, and for many prevalent diseases in the elderly.
International urology and nephrology, Jan 5, 2014
The overall number of very elderly patients (>79 years of age) requiring renal replacement the... more The overall number of very elderly patients (>79 years of age) requiring renal replacement therapy is rising in the Western societies, with a choice for managing advanced chronic renal disease among hemodialysis, peritoneal dialysis, kidney transplant, conservative, or palliative care. The selection of the most adequate alternatives should be tailored to meet individual needs, considering variables such as patient's choice, clinical status, and social context, analyzed from a geriatric perspective, aiming not only to prolong patient's life expectancy, but also to improve the patient's quality of life. Frailty and sarcopenia are highly prevalent comorbidities found in very elderly population, particularly in the end-stage chronic renal disease population. Both comorbidities have a strong negative impact on health general status, and specific treatment should be provided in conjunction with the selected management for renal replacement, except when a palliative care has...
Uploads
Papers by Jose Antonio Clavo Jauregui