Abstract BACKGROUND: Whilst it is well known that psychosocial determinants may contribute to cardiovascular diseases (CVD), data from specific groups are scarce. The present study aims to determine ...the contribution of psychosocial determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD, in a high risk adult population. METHODS: Longitudinal prospective study of 7263 patients (57.5% women), mean age 67.0 (SD 6.2) free from CVD but at high risk, with a median follow-up of 4.8 years (from October 2003 to December 2010). The Hazard Ratios (HRs) of cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes) related to educational attainment, diagnosed depression (based on medical records), and low social support (number of people living in the household) were estimated by multivariate Cox regression models. RESULTS: Stroke incidence was associated with low educational level in the whole population (HR: 1.83, 95% CI: 1.09-3.09), and especially in men (HR: 2.11, 95% CI 1.09-4.06). Myocardial infarction and CVD mortality were not associated with any of the psychosocial factors considered. CONCLUSION: Adults with low educational level had a higher risk of stroke. Depression and low social support were not associated with CVD incidence. TRIAL REGISTRATION: Clinical trial registration information unique identifier: ISRCTN35739639.
The objective of this study is to evaluate the antihypertensive effect of bedtime administration of low doses of aspirin in patients with treated hypertension and high cardiovascular risk on low-dose ...aspirin for secondary prevention, in order to optimize their usual treatment and reduce their cardiovascular risk.
This is a prospective phase IV multicentre, randomised, triple-blind, placebo-controlled, cross-over clinical trial. We will include 258 individuals with hypertension treated with low-dose aspirin for secondary prevention. These patients will be randomly recruited, by approximately 40 primary care physicians collaborating in the study, mainly in the Guipúzcoa West, Bilbao and Barcelona areas. The 258 patients will be randomly allocated to treatments to create two comparable groups. In the first period, the intervention group will take aspirin at night and placebo in the morning, while the control group will take their aspirin in the morning and placebo in the evening for 2 months. After a washout period of 15 to 30 days, there will be a second 2-month period for which groups will swap treatments. Participants will undergo ambulatory blood pressure monitoring at baseline, at the end of first period and then again at the beginning and end of the second period. The main outcome measure is the change in mean blood pressure over 24 h, and as secondary outcomes we will also assess changes in systolic and diastolic blood pressure, during the day and night, and the relationship between them. Lastly, we will explore whether non-dipper patients convert into dippers with the intervention.
The goal of this research is to provide the scientific basis for indicating a change in the time of aspirin administration from morning to evening, by primary health practitioners, to improve the patient control of blood pressure and more effectively reduce their cardiovascular risk, by combining this hypotensive effect with the well-known anti-platelet effect of low-dose aspirin.
ClinicalTrials.gov NCT01741922.
We aimed to investigate the prevalence of metabolic syndrome in rural and urban areas in the province of Segovia, Spain, and its relationship to lifestyle habits, cardiovascular risk, and serum ...adiponectin concentrations.
The study had a cross-sectional design and included 888 individual residents in the province of Segovia, Autonomous Community of Castilla-León.
The age/sex standardized prevalence of the metabolic syndrome was by: (1) American Heart Association/National Heart Lung and Blood Institute criteria (AHA/NHLBI), 17%; (2) International Diabetes Federation (IDF), 24.3%; and (3) Consensus Societies/Joint Interim Statement (CS), 27.8%. A high correlation was found between the different criteria. No formal education odds ratio (OR) 6.9 (2.4-20.2) and primary education 6.7 (2.8-15.9) were independently associated with metabolic syndrome. An inverse association with metabolic syndrome was found for subjects doing a high level of exercise during work 0.4 (0.2-0.7) as well as those who were mild drinkers alcohol intake of less than 15 grams/daily, 0.4 (0.3-0.8). Among subjects with low estimated cardiovascular risk, adiponectin levels are higher in those who do not meet criteria of metabolic syndrome. A total of 29.7% of subjects meeting CS criteria had >20% 10-year predicted risk of cardiovascular disease (CVD) by the Framingham risk score criteria 4.5 (2.4-8.5).
Our results show: (1) A higher estimated prevalence of metabolic syndrome according to IDF and CS criteria. (2) Low educational level was independently associated with metabolic syndrome. A high level of physical activity and a daily alcohol intake of less than 15 grams/day were inversely associated with metabolic syndrome. (3) Metabolic syndrome increases the predicted CVD risk. (4) Adiponectin levels are not inversely related to insulin resistance in subjects with high cardiovascular risk and metabolic syndrome.
We carried out a retrospective study to determine the evolution of 23 vertically HIV-1/HCV coinfected children and 30 vertically HIV-1 infected children (control group). Six out of 23 HIV-1/HCV ...coinfected children developed AIDS versus 20 out of 30 HIV-1 children (P < 0.05). HIV-1/HCV children had a good evolution in relation to CD4 and HIV-RNA viral load. They presented higher CD8 counts than HIV-1 children during long periods, and slower progression of HCV liver disease.
We generated replacement sets for three highly conserved residues, Pro196, Pro197 and His199, that flank the catalytic nucleophile, Cys198. Pro196 and Pro197 have restricted mobility that could be ...important for the structural transitions known to be essential for activity. To test this hypothesis we obtained and characterized 13 amino acid substitutions for Pro196, 14 for Pro197 and 14 for His199. All of the Pro196 and Pro197 variants, except P197R, and four of the His199 variants complemented TS‐deficient Escherichia coli cells, indicating they had at least 1% of wild‐type activity. For all His199 mutations, kcat/Km for substrate and cofactor decreased more than 40‐fold, suggesting that the conserved hydrogen bond network co‐ordinated by His199 is important for catalysis. Pro196 can be substituted with small hydrophilic residues with little loss in kcat, but 15‐ to 23‐fold increases in KmdUMP. Small hydrophobic substitutions for Pro197 were most active, and the most conservative mutant, P197A, had only a 5‐fold lower kcat/KmdUMP than wild‐type TS. Several Pro196 and Pro197 variants were temperature sensitive. The small effects of Pro196 or Pro197 mutations on enzyme kinetics suggest that the conformational restrictions encoded by the Pro–Pro sequence are largely maintained when either member of the pair is mutated.
Este artículo presenta el proyecto desarrollado durante el año 2011 por las unidades y centros de formación de las universidades públicas catalanas. El proyecto se orienta a la mejora de la calidad ...del sistema de educación superior y de la actividad del profesorado universitario mediante planes de formación específicamente diseñados con esta finalidad, centrándose primeramente en la identificación de competencias docentes definidas por la comunidad académica. Partiendo del contexto de implementación del Espacio Europeo de Educación Superior se identifican aquellas competencias propias de la función docente, para que posteriormente puedan ser adquiridas, desarrolladas y evaluadas mediante la formación, identificando modelos, estrategias, instrumentos y recursos que lo permitan. El proceso de identificación de las competencias docentes del profesorado universitario se ha desarrollado partiendo de una revisión bibliográfica del estado del arte, para posteriormente ser modificada y validada por grupos de discusión conformados por expertos en competencias y formación docente. Los resultados de identificación de dichas competencias han sido finalmente refrendados mediante una encuesta respondida por una muestra representativa de la comunidad académica de las ocho universidades públicas catalanas. El objetivo fundamental del proyecto que aquí presentamos no es otro que el de contribuir a una formación de calidad del profesorado universitario, que permita la adquisición, desarrollo y evaluación de las competencias que, como docente, gran parte de la comunidad académica considera que debe poseer para el ejercicio de su labor profesional, definidas como: interpersonal, metodológica, comunicativa, de planificación y gestión de la docencia, de trabajo en equipo y de innovación.
Pratiques hagiographiques II est la continuation de Pratiques hagiographiques dans l’Espagne du Moyen Âge et du Siècle d’Or, paru en 2005. Dans le volume que nous présentons ici sont traitées des ...questions concernant la littérature et l’histoire, l’histoire de l’art, le folklore, la religion et la théologie, au cours d’une longue période mieux caractérisée par son homogénéité que par ses différences internes, qui est celle du Moyen Âge et du Siècle d’Or espagnols. Chacun de ces deux grands moments a privilégié des thèmes et des angles d’approche spécifiques : pour le Moyen Âge, la modélisation héroïque du saint et la réorientation de l’hagiographie vers la narration de miracles spectaculaires ; pour le Siècle d’Or, l’élaboration et le contrôle de l’image de la sainteté dans le contexte de la Contre-Réforme, enjeux qui apparaissent nettement dans la comedia de santos et tout particulièrement dans les figures des saints au travail. Les rencontres scientifiques dont rendent compte ces pages, outre les échanges enrichissants qu’elles ont permis, témoignent de l’importance de l’interdisciplinarité dans ce genre de projet.
The prevalence of hereditary hemochromatosis (HH) (H63D/C282Y) gene variants in Mexico is unknown.
Using amplification refractory mutation system polymerase chain reaction, an analysis of HFE-codon ...63/282 (H63D/C282Y) gene variants was performed in a group of 153 Mexican mestizo blood donors and six individuals with familial iron overload.
In normal blood donors, three heterozygotes for the C282Y mutation (2.0%) were found, whereas 18 heterozygotes and one homozygote for the H63D mutation (11.8% and 0.6%, respectively) were identified; there was one compound heterozygote for the C282Y/H63D mutation. These data resulted in allele frequencies of 0.013 (±0.2%, α = 0.05) and 0.062 (±0.9%, α = 0.05), respectively, for these two mutations, results similar to those found in whites. In the six patients with the HH phenotype, two were found to be heterozygous for C282Y and one heterozygous for H63D; three individuals with HH had no gene mutations. Two heterozygous HH individuals were found to have iron overload associated with other conditions: one heterozygous for C282Y infected with HIV, and another heterozygous for H63D with heterozygous β-thalassemia.
The prevalence of C282Y and H63D HFE gene mutations in Mexican mestizos is similar to that found in other populations. In addition, other gene mutations responsible for HH in the Mexican mestizo population should be investigated, because, in three of six individuals with the HH phenotype, neither of the two mutations was recorded.
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