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Papers by Bonifacio Alvarez Lario
Síndrome doloroso regional complejo. Distrofia simpático-refleja
Acta medico-historica Adriatica, 2017
The Vadinienses were a Cantabrian people who lived between the first and fourth centuries in the ... more The Vadinienses were a Cantabrian people who lived between the first and fourth centuries in the north of the Iberian Peninsula, northeast of the present province of León and the corresponding part of the current territory of Asturias. In this paper we study the possible causes of illness and death of the Vadinienses represented in their gravestones. The analysis of Vadinienses epitaphs shows that two-thirds of the deaths occurred in people between the ages of 20-30, a finding that is not interpreted as representative of the usual age of death at that time. The most likely causes of death are infections and violent deaths in sports competitions or work accidents. Analyzing females independently, almost half of the deceased were under the age of 20, being the main possibilities the deaths related to pregnancy and childbirth at very early ages.
The Journal of Rheumatology, 2018
Fisiopatología del dolor en el síndrome de fibromialgia: en el umbral de su comprensión
Medicina Clinica, May 8, 1999
El libro de la artritis reumatoide: (manual para el paciente)
[Reactive arthritis following Mycoplasma pneumoniae infection]
Medicina clínica, Jan 6, 2002
[Pathophysiology of pain in fibromyalgia syndrome: on the threshold of its understanding]
Medicina clínica, Jan 8, 1999
Nature Reviews Rheumatology, 2014
Medicina Clínica, 2002
reactiva se define generalmente como una sinovitis estéril tras una infección en otro punto del o... more reactiva se define generalmente como una sinovitis estéril tras una infección en otro punto del organismo 1 . Está muy asociada a ciertas especies bacterianas, algunas habituales en el tubo digestivo como Salmonella, Yersinia enterocolitica, Shigella flexneri, Campylobacter jejuni, y otras en las vías urinarias y aparato genital como Chlamydia trachomatis y Ureaplasma urealyticum. En los últimos años, la lista de agentes bacterianos desencadenantes de artritis reactiva ha ido en aumento. Así, se han documentado casos de artritis reactiva inducidos por Chlamydia pneumoniae, Pseudomona aeruginosa, Escherichia coli, Staphylococcus aureus, Giardia lamblia y otros gérmenes 1 . Presentamos un caso de artritis reactiva tras infección por Mycoplasma pneumoniae, asociación inusual, en la que además se detectaron mediante reacción en cadena de polimerasa componentes de este germen en el líquido sinovial.
Clinical Rheumatology, 2013
The adverse effects of anti-tumour necrosis factor alpha (TNFα) drugs include an increase in the ... more The adverse effects of anti-tumour necrosis factor alpha (TNFα) drugs include an increase in the risk of infections, congestive heart failure, lupus-like syndrome, and the onset or worsening of various demyelinating diseases such as, multiple sclerosis, optic neuritis, and Guillain-Barrè syndrome (GBS), among others. We describe the case of a patient who developed GBS while she was on treatment with adalimumab. A 50-year-old woman with rheumatoid arthritis (RA) was admitted to the hospital due to progressive severe bilateral symmetric weakness of the legs, which quickly extended to the upper limbs and to the respiratory muscles. Adalimumab was started 13 months before. GBS was diagnosed and the anti-TNFα therapy discontinued. The serological test for Campylobacter jejuni was positive. She required invasive mechanical ventilatory support for 9 months. Twelve months later, the patient was using a wheelchair following a rehabilitation programme, and at 24 months she was walking a few steps with assistive devices. The relevant literature on the relationship between GBS and anti-TNFα is reviewed. Twenty three cases of GBS occurring during anti-TNFα therapy have been reported so far in the literature. In several cases, there was no clear temporal association, more than half had a possible previous infection, and in two cases the drug was reintroduced without recurrence of GBS. Our case, which is best explained by C. jejuni infection, as well as some of the cases described are probably not a direct result of anti-TNFα treatment, but an accidental coincidence. We also discuss the potential therapeutic options after anti-TNFα discontinuation.
The American Journal of Medicine, 1996
Sleep alterations and muscular changes suggesting hypoxia have been reported in fibromyalgia synd... more Sleep alterations and muscular changes suggesting hypoxia have been reported in fibromyalgia syndrome (FS) pathophysiology. We tested the hypothesis that patients with FS show falls in the oxygen saturation of hemoglobin in arterial blood (SaOp%) during sleep.
Evolution of Uric Acid Metabolism in Humans
eLS, 2013
Several evolutionary changes have led to uric acid levels being much higher in humans than in oth... more Several evolutionary changes have led to uric acid levels being much higher in humans than in other mammals. Uric acid is the end product of purine metabolism in hominoids, including humans, due to the genetic loss of uricase activity during the Miocene epoch, and this is the main cause of the increased uric acid in hominoids. Additional factors that have contributed to increased levels of uric acid are the high renal tubular reabsorption of uric acid and the previous loss of the ability to synthesise vitamin C in hominoids. Several hypotheses have been proposed on the evolutionary advantage of increased serum uric acid levels in hominoids, although the biological reasons for this increase remain unclear. The large current increase in uric acid levels in humans in developed countries is mainly influenced by dietary factors and lifestyle changes. Key Concepts: Uric acid (UA) is the end product of purine metabolism in humans due to the loss of uricase activity by various mutations of its gene during the Miocene epoch. Loss of uricase activity led to humans having higher UA levels than other mammals. The high renal tubular reabsorption of UA and the previous loss of the ability to synthesise vitamin C may have also contributed to increased levels of UA in humans. The biological reason for the loss of uricase activity and increased levels of UA in humans and certain primates is unknown. UA is one of the most important antioxidants in human biological fluids. UA probably has neuroprotective activity. The current large increase in UA levels in humans in developed countries is mainly influenced by eating habits and lifestyle changes. Hyperuricaemia can cause gout and uric lithiasis, and is associated with hypertension, metabolic syndrome, renal disease and cardiovascular disease. Keywords: uric acid; gout; hyperuricaemia; uricase; urate oxidase; vitamin C; urate transporter; evolution; neuroprotective effect; diet
Síndrome doloroso regional complejo. Distrofia simpático-refleja
Acta medico-historica Adriatica, 2017
The Vadinienses were a Cantabrian people who lived between the first and fourth centuries in the ... more The Vadinienses were a Cantabrian people who lived between the first and fourth centuries in the north of the Iberian Peninsula, northeast of the present province of León and the corresponding part of the current territory of Asturias. In this paper we study the possible causes of illness and death of the Vadinienses represented in their gravestones. The analysis of Vadinienses epitaphs shows that two-thirds of the deaths occurred in people between the ages of 20-30, a finding that is not interpreted as representative of the usual age of death at that time. The most likely causes of death are infections and violent deaths in sports competitions or work accidents. Analyzing females independently, almost half of the deceased were under the age of 20, being the main possibilities the deaths related to pregnancy and childbirth at very early ages.
The Journal of Rheumatology, 2018
Fisiopatología del dolor en el síndrome de fibromialgia: en el umbral de su comprensión
Medicina Clinica, May 8, 1999
El libro de la artritis reumatoide: (manual para el paciente)
[Reactive arthritis following Mycoplasma pneumoniae infection]
Medicina clínica, Jan 6, 2002
[Pathophysiology of pain in fibromyalgia syndrome: on the threshold of its understanding]
Medicina clínica, Jan 8, 1999
Nature Reviews Rheumatology, 2014
Medicina Clínica, 2002
reactiva se define generalmente como una sinovitis estéril tras una infección en otro punto del o... more reactiva se define generalmente como una sinovitis estéril tras una infección en otro punto del organismo 1 . Está muy asociada a ciertas especies bacterianas, algunas habituales en el tubo digestivo como Salmonella, Yersinia enterocolitica, Shigella flexneri, Campylobacter jejuni, y otras en las vías urinarias y aparato genital como Chlamydia trachomatis y Ureaplasma urealyticum. En los últimos años, la lista de agentes bacterianos desencadenantes de artritis reactiva ha ido en aumento. Así, se han documentado casos de artritis reactiva inducidos por Chlamydia pneumoniae, Pseudomona aeruginosa, Escherichia coli, Staphylococcus aureus, Giardia lamblia y otros gérmenes 1 . Presentamos un caso de artritis reactiva tras infección por Mycoplasma pneumoniae, asociación inusual, en la que además se detectaron mediante reacción en cadena de polimerasa componentes de este germen en el líquido sinovial.
Clinical Rheumatology, 2013
The adverse effects of anti-tumour necrosis factor alpha (TNFα) drugs include an increase in the ... more The adverse effects of anti-tumour necrosis factor alpha (TNFα) drugs include an increase in the risk of infections, congestive heart failure, lupus-like syndrome, and the onset or worsening of various demyelinating diseases such as, multiple sclerosis, optic neuritis, and Guillain-Barrè syndrome (GBS), among others. We describe the case of a patient who developed GBS while she was on treatment with adalimumab. A 50-year-old woman with rheumatoid arthritis (RA) was admitted to the hospital due to progressive severe bilateral symmetric weakness of the legs, which quickly extended to the upper limbs and to the respiratory muscles. Adalimumab was started 13 months before. GBS was diagnosed and the anti-TNFα therapy discontinued. The serological test for Campylobacter jejuni was positive. She required invasive mechanical ventilatory support for 9 months. Twelve months later, the patient was using a wheelchair following a rehabilitation programme, and at 24 months she was walking a few steps with assistive devices. The relevant literature on the relationship between GBS and anti-TNFα is reviewed. Twenty three cases of GBS occurring during anti-TNFα therapy have been reported so far in the literature. In several cases, there was no clear temporal association, more than half had a possible previous infection, and in two cases the drug was reintroduced without recurrence of GBS. Our case, which is best explained by C. jejuni infection, as well as some of the cases described are probably not a direct result of anti-TNFα treatment, but an accidental coincidence. We also discuss the potential therapeutic options after anti-TNFα discontinuation.
The American Journal of Medicine, 1996
Sleep alterations and muscular changes suggesting hypoxia have been reported in fibromyalgia synd... more Sleep alterations and muscular changes suggesting hypoxia have been reported in fibromyalgia syndrome (FS) pathophysiology. We tested the hypothesis that patients with FS show falls in the oxygen saturation of hemoglobin in arterial blood (SaOp%) during sleep.
Evolution of Uric Acid Metabolism in Humans
eLS, 2013
Several evolutionary changes have led to uric acid levels being much higher in humans than in oth... more Several evolutionary changes have led to uric acid levels being much higher in humans than in other mammals. Uric acid is the end product of purine metabolism in hominoids, including humans, due to the genetic loss of uricase activity during the Miocene epoch, and this is the main cause of the increased uric acid in hominoids. Additional factors that have contributed to increased levels of uric acid are the high renal tubular reabsorption of uric acid and the previous loss of the ability to synthesise vitamin C in hominoids. Several hypotheses have been proposed on the evolutionary advantage of increased serum uric acid levels in hominoids, although the biological reasons for this increase remain unclear. The large current increase in uric acid levels in humans in developed countries is mainly influenced by dietary factors and lifestyle changes. Key Concepts: Uric acid (UA) is the end product of purine metabolism in humans due to the loss of uricase activity by various mutations of its gene during the Miocene epoch. Loss of uricase activity led to humans having higher UA levels than other mammals. The high renal tubular reabsorption of UA and the previous loss of the ability to synthesise vitamin C may have also contributed to increased levels of UA in humans. The biological reason for the loss of uricase activity and increased levels of UA in humans and certain primates is unknown. UA is one of the most important antioxidants in human biological fluids. UA probably has neuroprotective activity. The current large increase in UA levels in humans in developed countries is mainly influenced by eating habits and lifestyle changes. Hyperuricaemia can cause gout and uric lithiasis, and is associated with hypertension, metabolic syndrome, renal disease and cardiovascular disease. Keywords: uric acid; gout; hyperuricaemia; uricase; urate oxidase; vitamin C; urate transporter; evolution; neuroprotective effect; diet