José Macarlupú - Academia.edu (original) (raw)

Papers by José Macarlupú

Diagnóstico, Feb 26, 2020

Se establece la relación entre embarazo de alto riesgo obstétrico y patología mental futura en hi... more Se establece la relación entre embarazo de alto riesgo obstétrico y patología mental futura en hijos. Método: Estudio comparativo transversal cualitativo que relaciona los factores de riesgo encontrados en gestantes con los de madres de pacientes psiquiátricos atendidos en el ervicio de siquiatría del Niño y del Adolescente del mismo ospital. Se S P h comparan estos dos grupos y los hallados en madres de pacientes del servicio de pediatría y un grupo control de gestantes con embarazo sin alto riesgo. Conclusión: Existe una concordancia entre gestantes de alto riesgo obstétrico y madres de pacientes con patología psiquiátrica. Recomendaciones, La concordancia entre embarazo de alto riesgo y patología psiquiátrica futura amerita diseñar sistemas de seguimiento, intervención psicoterapéutica y psico-educación en madres gestantes con estas características.

Journal of Clinical Sleep Medicine, Oct 1, 2022

Journal of Clinical Sleep Medicine

info:eu-repo/semantics/publishe

Medicine & Science in Sports & Exercise, 2005

Both training and chronic hypoxia act on the autonomic nervous system. Because trained Andean hig... more Both training and chronic hypoxia act on the autonomic nervous system. Because trained Andean high-altitude natives could perform a high-altitude marathon (4220 m above sea level) in 02:27:23 h, we hypothesized that living in chronic hypoxia does not limit the training-induced benefits on the autonomic modulation of the heart. Trained (N=13) and sedentary (N=11) Andean high-altitude natives performed an active orthostatic test. Eight of the trained subjects repeated the test 6-8 and 20-24 h after the end of a high-altitude marathon. Resting heart rate (HR) and the autonomic modulation of the heart were assessed by time domain and spectral analysis of HR variability (HRV): sympathetic (RR low frequency (LF)) and parasympathetic (RR high frequency (HF)) modulations, and sympathovagal balance (RR-LF:HF ratio). Trained subjects exhibited a higher total power of HRV and a lower resting HR (+30%, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.005) than sedentary subjects secondary to a higher and dominant parasympathetic modulation on sympathetic activity (RR-HF, RR-LF:HF ratio). At 6-8 h after the marathon, total power of HRV decreased (-69%), whereas resting HR increased from basal level (+22%), mainly because of a rise in sympathetic modulation (RR-LF, RR-LF:HF ratio). From 8 to 24 h of recovery, sympathetic modulation fell (RR-LF, RR-LF:HF ratio) and all HRV parameters were restored. Responses to the active standing position did not change between each recording session. Living in chronic hypoxia does not limit the training-induced benefits on the autonomic control of the cardiovascular system in Andean high-altitude natives. The sympathetic predominance on the heart observed 6-8 h after the high-altitude marathon disappeared after 1 d of recovery. Therefore, living at high altitude does not impair the autonomic response to training.

American Journal of Respiratory and Critical Care Medicine, 2008

Physiological Reports, 2021

Permanent living at high altitudes challenges the body to carry out its main functions. As altitu... more Permanent living at high altitudes challenges the body to carry out its main functions. As altitude increases, physiological strategies must develop in order to maintain an adequate level of oxygenation at the cellular level. The main adaptations involve respiratory, cardiovascular, and endo

British Journal of Surgery, 2008

Background Vascular endothelial growth factor (VEGF) promotes events favouring carotid plaque ins... more Background Vascular endothelial growth factor (VEGF) promotes events favouring carotid plaque instability: inflammatory chemoattraction, thrombogenesis, and upregulation of matrix metalloproteinases and cell adhesion molecules. The aim of this study was to assess neovascularization, VEGF and its receptors in high-grade stable and unstable carotid plaques. Methods Immunohistochemical staining for CD34, VEGF, VEGF receptor (VEGFR) 1 and VEGFR2 was performed in 34 intact carotid endarterectomy specimens, and compared in sections demonstrating maximal histological instability (cap rupture/thinning) or, if stable, maximal stenosis. Results VEGF staining was increased in 12 unstable compared with 22 stable plaques (median (interquartile range, i.q.r.) plaque score 4·0 (4·0–4·0) versus 3·0 (2·0–3·0); P = 0·002) with upregulation of VEGFR1 (plaque score 4·0 (2·0–4·0) versus 2·0 (1·0–3·0); P = 0·016). In unstable plaques this was associated with increased microvessel density in the cap (medi...

B65. CAN'T RUN, CAN'T HIDE: THE UBIQUITOUS IMPACT OF SLEEP RELATED BREATHING DISORDERS

The FASEB Journal, Apr 1, 2016

Hypertension, 2020

Millions of people worldwide live at high altitude, being chronically exposed to hypobaric hypoxi... more Millions of people worldwide live at high altitude, being chronically exposed to hypobaric hypoxia. Hypertension is a major cardiovascular risk factor but data on its prevalence and determinants in highlanders are limited, and systematic studies with ambulatory blood pressure monitoring are not available. Aim of this study was to assess the prevalence of clinic and ambulatory hypertension and the associated factors in a sample of Andean highlanders. Hypertension prevalence and phenotypes were assessed with office and ambulatory blood pressure measurement in a sample of adults living in Cerro de Pasco, Peru (altitude 4340 m). Basic clinical data, blood oxygen saturation, hematocrit, and Qinghai Chronic Mountain Sickness score were obtained. Participants were classified according to the presence of excessive erythrocytosis and chronic mountain sickness diagnosis. Data of 289 participants (143 women, 146 men, mean age 38.3 years) were analyzed. Office hypertension was present in 20 (7%...

The FASEB Journal, 2014

Chronic hypoxia decreases fasting glucose and increases glucose utilization in lean and obese rat... more Chronic hypoxia decreases fasting glucose and increases glucose utilization in lean and obese rats. Hypoxia increases insulin sensitivity in obese rats, but insulin resistance remains higher compar...

European Respiratory Journal, 2011

Introduction: Both the membrane (Dm) and the capillary (Vc) component of lung diffusing capacity ... more Introduction: Both the membrane (Dm) and the capillary (Vc) component of lung diffusing capacity (DL) have been shown to be increased in high altitude residents and to remain essentially unchanged in high altitude sojourners. Maximal exercise has been reported to decrease Dm at sea level (Manier 1993). The effects of high altitude exercise on Dm and Vc as evaluated from the DL for carbon monoxide (DLCO) and nitric oxide (DLNO) respectively, are incompletely understood. Methods: Lowlanders (n=10) and highlanders (n=14) were tested at 4380m above sea level (Cerro de Pasco, Peru); lowlanders also underwent tests at sea level. Spirometry, alveolar volume (VA), DLCO, DLNO, Dm and Vc were assessed (Hypercompact Medisoft, Belgium) using the NO/CO transfer technique. Values were corrected for PcapO 2 , Hb and are presented as mean predicted value (Aguilaniu 2008) ±SEM. Measurements took place at rest and after an endurance test at 80% of VO 2 max at heart rate returned to rest values. Resul...

Frontiers in Physiology, 2020

Andean highlanders are challenged by chronic hypoxia and many exhibit elevated hematocrit (Hct) a... more Andean highlanders are challenged by chronic hypoxia and many exhibit elevated hematocrit (Hct) and blunted ventilation compared to other high-altitude populations. While many Andeans develop Chronic Mountain Sickness (CMS) and excessive erythrocytosis, Hct varies markedly within Andean men and women and may be driven by individual differences in ventilatory control and/or sleep events which exacerbate hypoxemia. To test this hypothesis, we quantified relationships between resting ventilation and ventilatory chemoreflexes, sleep desaturation, breathing disturbance, and Hct in Andean men and women. Ventilatory measures were made in 109 individuals (n = 63 men; n = 46 women), and sleep measures in 45 of these participants (n = 22 men; n = 23 women). In both men and women, high Hct was associated with low daytime SpO 2 (p < 0.001 and p < 0.002, respectively) and decreased sleep SpO 2 (mean, nadir, and time <80%; all p < 0.02). In men, high Hct was also associated with increased end-tidal P CO2 (p < 0.009). While ventilatory responses to hypoxia and hypercapnia did not predict Hct, decreased hypoxic ventilatory responses were associated with lower daytime SpO 2 in men (p < 0.01) and women (p < 0.009) and with lower nadir sleep SpO 2 in women (p < 0.02). Decreased ventilatory responses to CO 2 were associated with more time below 80% SpO 2 during sleep in men (p < 0.05). The obstructive apnea index and apnea-hypopnea index also predicted Hct and CMS scores in men after accounting for age, BMI, and SpO 2 during sleep. Finally, heart rate response to hypoxia was lower in men with higher Hct (p < 0.0001). These data support the idea that hypoventilation and decreased ventilatory sensitivity to hypoxia are associated with decreased day time and nighttime SpO 2 levels that may exacerbate the stimulus for erythropoiesis in Andean men and women. However, interventional and longitudinal studies are required to establish the causal relationships between these associations.

Frontiers in Genetics, 2019

Chronic mountain sickness (CMS) is a pathological condition resulting from chronic exposure to hi... more Chronic mountain sickness (CMS) is a pathological condition resulting from chronic exposure to high-altitude hypoxia. While its prevalence is high in native Andeans (>10%), little is known about the genetic architecture of this disease. Here, we performed the largest genome-wide association study (GWAS) of CMS (166 CMS patients and 146 controls living at 4,380 m in Peru) to detect genetic variants associated with CMS. We highlighted four new candidate loci, including the first CMS-associated variant reaching GWAS statistical significance (rs7304081; P = 4.58 × 10 −9). By looking at differentially expressed genes between CMS patients and controls around these four loci, we suggested AEBP2, CAST, and MCTP2 as candidate CMS causal genes. None of the candidate loci were under strong natural selection, consistent with the observation that CMS affects fitness mainly after the reproductive years. Overall, our results reveal new insights on the genetic architecture of CMS and do not provide evidence that CMS-associated variants are linked to a strong ongoing adaptation to high altitude.