Papers by Carlos Fernandez
European Journal of Pain, 2010
Most forms of visceral pain generate intense referred hyperalgesia but the mechanisms of this enh... more Most forms of visceral pain generate intense referred hyperalgesia but the mechanisms of this enhanced visceral hypersensitivity are not known. The on-cells of the rostral ventromedial medulla (RVM) play an important role in descending nociceptive facilitation and can be sensitized to somatic mechanical stimulation following peripheral nerve injury or hindpaw inflammation. Here we have tested the hypothesis that visceral noxious stimulation sensitizes RVM ON-like cells, thus promoting an enhanced descending facilitation that can lead to referred visceral hyperalgesia. Intracolonic capsaicin instillation (ICI) was applied to rats in order to create a hyperalgesic state dependent on noxious visceral stimulation. This instillation produced acute pain-related behaviors and prolonged referred hyperalgesia that were prevented by the RVM microinjection of AP5, an NMDA selective antagonist. In electrophysiological experiments, ON-like RVM neurons showed ongoing spontaneous activity following ICI that lasted for ~20 min and an enhanced responsiveness to von Frey and heat stimulation of the hindpaw and to colorectal distention (CRD) that lasted for at least 50 min post capsaicin administration. Moreover, ON-like cells acquired a novel response to CRD and responded to heat stimulation in the innocuous range. OFF-like neurons responded to capsaicin administration with a brief (<5 min) inhibition of activity followed by an enhanced inhibition to noxious stimulation and a novel inhibition to innocuous stimulation (CRD and heat) at early time points (10 min post capsaicin). These results support the hypothesis that noxious visceral stimulation may cause referred hypersensitivity by promoting long-lasting sensitization of RVM ON-like cells.
Joint, bone, spine : revue du rhumatisme, 2012
Patients with diabetes experience increased cardiovascular risk that is not fully explained by de... more Patients with diabetes experience increased cardiovascular risk that is not fully explained by deficient glycemic control or traditional cardiovascular risk factors such as smoking and hypercholesterolemia. Asymptomatic patients with diabetes show structural and functional vascular damage that includes impaired vasodilation, arterial stiffness, increased intima-media thickness and calcification of the arterial wall. Subclinical vascular injury associated with diabetes predicts subsequent manifestations of cardiovascular disease, such as ischemic heart disease, peripheral artery disease and stroke. Noninvasive detection of subclinical vascular disease is commonly used to estimate cardiovascular risk associated to diabetes. Longitudinal studies in normotensive subjects show that arterial stiffness at baseline is associated with a greater risk for future hypertension independently of established risk factors. In patients with type 2 diabetes, vascular disease begins to develop during the latent phase of insulin resistance, long before the clinical diagnosis of diabetes. In contrast, patients with type 1 diabetes do not manifest vascular injury when they are first diagnosed due to insulin deficiency, as they lack the preceding period of insulin resistance. These findings suggest that insulin resistance plays an important role in the development of early vascular disease associated with diabetes. Cross-sectional and prospective studies confirm that insulin resistance is associated with subclinical vascular injury in patients with diabetes, independently of standard cardiovascular risk factors. Asymptomatic vascular disease associated with diabetes begins to occur early in life having been documented in children and adolescents. Insulin resistance should be considered a therapeutic target in order to prevent the vascular complications associated with diabetes.
American Journal of Ophthalmology, 2003
World Journal of Diabetes, 2019
Montero A contributed to the analysis of data and organization of the article; Funcasta-Calderón ... more Montero A contributed to the analysis of data and organization of the article; Funcasta-Calderón R contributed to the conception and design of the study and ongoing progress; all authors reviewed and approved the final manuscript.
Atención Primaria, 2010
Incluida en MEDLINE, EMBASE, SCOPUS y SCIENCE CITATION INDEX EXPANDED El reto del manejo diario d... more Incluida en MEDLINE, EMBASE, SCOPUS y SCIENCE CITATION INDEX EXPANDED El reto del manejo diario de la diabetes tipo 2 en atención primaria Editores invitados: F.J. García-Soidán y F.J. Ampudia-Blasco Introducción pág. 1 F.J. García-Soidán et al Diagnóstico y control de la diabetes mellitus tipo 2 pág. 2 J. Díez Espino Guías actuales de práctica clínica en la diabetes mellitus tipo 2: ¿cómo aplicarlas en atención primaria? pág. 9 J. Navarro Pérez et al La diabetes mellitus y el riesgo cardiovascular. ¿Es necesario el tratamiento integral de la diabetes mellitus tipo 2 y los factores de riesgo cardiovascular? pág. 16 D. Orozco Beltrán et al Panorama de los tratamientos actuales disponibles para los pacientes con diabetes tipo 2. Algoritmo terapéutico de la ADA/ EASD. Seguridad y tolerabilidad pág. 24 S. Artola Menéndez Actualización sobre la última familia de fármacos orales comercializados para el tratamiento de la diabetes tipo 2: los inhibidores de la DPP-4. Aportaciones respecto a las otras familias de antidiabéticos orales pág. 33 F. Álvarez Guisasola Importancia de la implicación del paciente en el autocontrol de su enfermedad: paciente experto. Importancia de las nuevas tecnologías como soporte al paciente autónomo pág.
Revista EIA, 2010
The objective of the study was to assess the capacity of vegetation to reduce the noise in the Ab... more The objective of the study was to assess the capacity of vegetation to reduce the noise in the Aburrá valley. The methodology comprised two phases: the first was the revision of secondary information related to the role of vegetation and to obtain the conceptual bases for further experimental development. The second phase was the measurement of noise levels 10 m from the sound source (high traffic road) in urban public green zones with different plant coverage (tree, shrub, and a mixture of trees and shrubs) and without vegetation. Results showed no significant differences between the sites with and without vegetation, allowing us to infer that under conditions of the study, characterized by having few individuals of trees and shrubs dispersed, the vegetation does not play a significant role in reducing noise. Therefore, for its control in urban areas measures other than the planting of trees must be taken, or wider, longer, denser, and higher live barriers should be established.
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Papers by Carlos Fernandez