Mortality and cardiovascular disease burden of uncontrolled diabetes in a registry-based cohort: the ESCARVAL-risk study

BACKGROUND: Despite the epidemiological evidence about the relationship between diabetes, mortality and cardiovascular disease, information about the population impact of uncontrolled diabetes is scarce. We aimed to estimate the attributable risk associated with HbA1c levels for all-cause mortality and cardiovascular hospitalization. METHODS: Prospective study of subjects with diabetes mellitus using electronic health records from the universal public health system in the Valencian Community, Spain 2008-2012. We included 19,140 men and women aged 30 years or older with diabetes who underwent routine health examinations in primary care. RESULTS: A total of 11,003 (57%) patients had uncontrolled diabetes defined as HbA1c ≥6.5%, and, among those, 5325 participants had HbA1c ≥7.5%. During an average follow-up time of 3.3 years, 499 deaths, 912 hospitalizations for coronary heart disease (CHD) and 786 hospitalizations for stroke were recorded. We observed a linear and increasingly positive dose-response of HbA1c levels and CHD hospitalization. The relative risk for all-cause mortality and CHD and stroke hospitalization comparing patients with and without uncontrolled diabetes was 1.29 (95 CI 1.08,1.55), 1.38 (95 CI 1.20,1.59) and 1.05 (95 CI 0.91, 1.21), respectively. The population attributable risk (PAR) associated with uncontrolled diabetes was 13.6% (95% CI; 4.0-23.9) for all-cause mortality, 17.9% (95% CI; 10.5-25.2) for CHD and 2.7% (95% CI; - 5.5-10.8) for stroke hospitalization. CONCLUSIONS: In a large general-practice cohort of patients with diabetes, uncontrolled glucose levels were associated with a substantial mortality and cardiovascular disease burden

Alternativas de comercialización de aguacate Hass en el Valle del Cauca

Ilustraciones (principalmente a color), diagramas, figuras, fotografías, mapasComo resultado del proyecto de regalías Incremento de la competitividad sostenible en la agricultura de ladera en todo el departamento del Valle del Cauca, Occidente, en el cual participaron la Universidad Nacional, la Universidad del Valle y el Centro Internacional de Agricultura Tropical (CIAT), en esta cartilla se presentan dos formas de comercialización de guacate Hass: Aguacate en fresco y aguacate procesado. Se espera que la información aquí consignada sirva de guía a productores, comercializadores y procesadores para agregar valor al producto, como fruta fresca durante la exportación o como aceite después de procesarla, minimizando, de esta manera, las altas pérdidas poscosecha del aguacate. (Texto tomado de la fuente)1° ed

Association of breast and gut microbiota dysbiosis and the risk of breast cancer: a case-control clinical study

We would like to thank M Luisa Puertas-Martin and Isabel Manzano-Jimenez, nurses at the Unit of Mammary Pathology, General Surgery Service, San Cecilio University Hospital (Granada), without whose enthusiasm the enrolment of participants in Granada would still be stalled. We are indebted to all the women taking part in the study.The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Trial registration ClinicalTrials.gov NCT03885648, 03/25/2019. Retrospectively registered.Background Breast cancer ranks first in women, and is the second cause of death in this gender. In addition to genetics, the environment contributes to the development of the disease, although the factors involved are not well known. Among the latter is the influence of microorganisms and, therefore, attention is recently being paid to the mammary microbiota. We hypothesize that the risk of breast cancer could be associated with the composition and functionality of the mammary/gut microbiota, and that exposure to environmental contaminants (endocrine disruptors, EDCs) might contribute to alter these microbiota. Methods We describe a case-control clinical study that will be performed in women between 25 and 70 years of age. Cases will be women diagnosed and surgically intervened of breast cancer (stages I and II). Women with antecedents of cancer or advanced tumor stage (metastasis), or who have received antibiotic treatment within a period of 3 months prior to recruitment, or any neoadjuvant therapy, will be excluded. Controls will be women surgically intervened of breast augmentation or reduction. Women with oncological, gynecological or endocrine history, and those who have received antibiotic treatment within a period of 3 months prior to recruitment will also be excluded. Blood, urine, breast tissue and stool samples will be collected. Data regarding anthropometric, sociodemographic, reproductive history, tumor features and dietary habits will be gathered. Metabolomic studies will be carried out in stool and breast tissue samples. Metagenomic studies will also be performed in stool and breast tissue samples to ascertain the viral, fungal, bacterial and archaea populations of the microbiota. Quantitation of estrogens, estrogen metabolites and EDCs in samples of serum, urine and breast tissue will also be performed. Discussion: This is the first time that the contribution of bacteria, archaea, viruses and fungi together with their alteration by environmental contaminants to the risk of breast cancer will be evaluated in the same study. Results obtained could contribute to elucidate risk factors, improve the prognosis, as well as to propose novel intervention studies in this disease.This work is funded by grants PI-0538-2017 (Junta de Andalucía, Spain, to LF) and Biomedical Research Networking Center-CIBER de Epidemiología y Salud Pública (CIBERESP) of the Institute of Health Carlos III -supported by European Regional Development Fund/FEDER (FIS-PI16/01812) (to MFF)

FUMEPOC: Early detection of chronic obstructive pulmonary disease in smokers

<p>Abstract</p> <p>Background</p> <p>Currently is not feasible using conventional spirometry as a screening method in Primary Care especially among smoking population to detect chronic obstructive pulmonary disease in early stages. Therefore, the FUMEPOC study protocol intends to analyze the validity and reliability of Vitalograph COPD-6 spirometer as simpler tool to aid screening and diagnosis of this disease in early stages in primary care surgery.</p> <p>Methods / Design</p> <p>Study design: An observational, descriptive study of diagnostic tests, undertaken in Primary Care and Pneumology Outpatient Care Centre at San Juan Hospital and Elda Hospital. All smokers attending the primary care surgery and consent to participate in the study will undergo a test with Vitalograph COPD-6 spirometer. Subsequently, a conventional spirometry will be performed in the hospital and the results will be compared with those of the Vitalograph COPD-6 test.</p> <p>Discussion</p> <p>It is difficult to use the spirometry as screening for early diagnose test in real conditions of primary care clinical practice. The use of a simpler tool, Vitalograph COPD-6 spirometer, can help in the early diagnose and therefore, it could improve the clinical management of the disease.</p

Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID)

Background: Renal Cell Carcinoma (RCC) occasionally spreads to the pancreas. The purpose of our study is to evaluate the short and long-term results of a multicenter series in order to determine the effect of surgical treatment on the prognosis of these patients. Methods: Multicenter retrospective study of patients undergoing surgery for RCC pancreatic metastases, from January 2010 to May 2020. Variables related to the primary tumor, demographics, clinical characteristics of metastasis, location in the pancreas, type of pancreatic resection performed and data on short and long-term evolution after pancreatic resection were collected. Results: The study included 116 patients. The mean time between nephrectomy and pancreatic metastases' resection was 87.35 months (ICR: 1.51-332.55). Distal pancreatectomy was the most performed technique employed (50 %). Postoperative morbidity was observed in 60.9 % of cases (Clavien-Dindo greater than IIIa in 14 %). The median follow-up time was 43 months (13-78). Overall survival (OS) rates at 1, 3, and 5 years were 96 %, 88 %, and 83 %, respectively. The disease-free survival (DFS) rate at 1, 3, and 5 years was 73 %, 49 %, and 35 %, respectively. Significant prognostic factors of relapse were a disease free interval of less than 10 years (2.05 [1.13-3.72], p 0.02) and a history of previous extrapancreatic metastasis (2.44 [1.22-4.86], p 0.01). Conclusions: Pancreatic resection if metastatic RCC is found in the pancreas is warranted to achieve higher overall survival and disease-free survival, even if extrapancreatic metastases were previously removed. The existence of intrapancreatic multifocal compromise does not always warrant the performance of a total pancreatectomy in order to improve survival. (C) 2021 The Authors. Published by Elsevier Ltd

Repeated pancreatic resection for pancreatic metastases from renal cell Carcinoma: A Spanish multicenter study (PANMEKID)

Background and objectives: Recurrent isolated pancreatic metastasis from Renal Cell Carcinoma (RCC) after pancreatic resection is rare. The purpose of our study is to describe a series of cases of relapse of pancreatic metastasis from renal cancer in the pancreatic remnant and its surgical treatment with a repeated pancreatic resection, and to analyse the results of both overall and disease -free survival. Methods: Multicenter retrospective study of patients undergoing pancreatic resection for RCC pancreatic metastases, from January 2010 to May 2020. Patients were grouped into two groups depending on whether they received a single pancreatic resection (SPS) or iterative pancreatic resection. Data on short and long-term outcome after pancreatic resection were collected. Results: The study included 131 pancreatic resections performed in 116 patients. Thus, iterative pancreatic surgery (IPS) was performed in 15 patients. The mean length of time between the first pancreatic surgery and the second was 48.9 months (95 % CI: 22.2-56.9). There were no differences in the rate of postoperative complications. The DFS rates at 1, 3 and 5 years were 86 %, 78 % and 78 % vs 75 %, 50 % and 37 % in the IPS and SPS group respectively (p = 0.179). OS rates at 1, 3, 5 and 7 years were 100 %, 100 %, 100 % and 75 % in the IPS group vs 95 %, 85 %, 80 % and 68 % in the SPS group (p = 0.895). Conclusion: Repeated pancreatic resection in case of relapse of pancreatic metastasis of RCC in the pancreatic remnant is justified, since it achieves OS results similar to those obtained after the first resection

Procesos agroindustriales en piña md2

Ilustraciones (principalmente a color), diagramas, figuras, fotografías,En este documento se incluyen los resultados de los productos y los procesos seleccionados de acuerdo con las brechas identificadas para piña md2, tanto en fresco como procesada, y se realiza un análisis comparativo de dichos resultados. La vigilancia tecnológica se llevó a cabo incluyendo 4 tipos de vigilancias (competitiva, comercial, científico-tecnológica y estratégica). Con base en estas, se seleccionaron los productos y procesos correspondientes a la fruta que fue objeto de este estudio. (Texto tomado de la fuente)1° ed

Procesos agroindustriales en aguacate cv. Hass

Ilustraciones (principalmente a color), diagramas, figuras, fotografías, mapasEste documento se presenta en el marco del proyecto “Incremento de la competitividad sostenible en la agricultura de ladera en todo el departamento del Valle del Cauca, Occidente”, ejecutado por la Universidad Nacional de Colombia, sede Palmira, la Universidad del Valle y el Centro Internacional de Agricultura Tropical (Ciat), con el apoyo económico del Sistema General de Regalías de Colombia (sgr). Este estudio se desarrolló mediante la metodología de vigilancia tecnológica e inteligencia competitiva con el fin de establecer una herramienta que brinde información estratégica para la toma de decisiones de los actores involucrados en el proyecto. Su objetivo principal es identificar a través de la información recopilada, procesada y analizada los productos para desarrollar, tanto frescos como procesados, y la selección de procesos para el aguacate Hass. (Texto tomado de la fuente)1° ed

Procesos agroindustriales en mora de Castilla

Ilustraciones (principalmente a color), diagramas, figuras, fotografías, mapasDentro del proyecto BPIN 2014000100010 “Incremento de la competitividad sostenible en la agricultura de ladera en todo el departamento, Valle del Cauca, Occidente”, la Universidad del Valle propuso la actividad 2: diseñar e implementar procesos agroindustriales que generen, con base en estándares internacionales, valor agregado a los productos seleccionados, así como desarrollar y/o evaluar empaques innovadores apropiados para los productos seleccionados en fresco y procesados. Esta actividad incluye las siguientes acciones específicas: 1) vigilancia tecnológica sobre procesos agroindustriales y productos; 2) selección de productos procesados a desarrollar y 3) selección de los procesos, entre otras. Este documento corresponde al entregable de las actividades específicas 1, 2 y 3. Se incluyen los resultados de los productos y los procesos seleccionados de acuerdo con las brechas identificadas en mora de Castilla, tanto en fresco como procesada, tras un análisis comparativo de los resultados. La vigilancia tecnológica se llevó a cabo incluyendo cuatro tipos de vigilancias (competitiva, comercial, científico-tecnológica y estratégica). Con base en estas, se seleccionaron los productos y procesos correspondientes a la fruta objeto de este estudio. A partir de lo anterior, se evidenció que aumentar la vida útil del producto fresco es un reto para la exportación. En el caso de mora de Castilla, se presentan problemas como el carácter altamente perecedero de esta fruta, con altas pérdidas poscosecha a causa de la escasa tecnología de conservación y transformación en las zonas de producción. El transporte del producto fresco es difícil, debido a que las zonas de producción generalmente están en regiones de ladera con malas vías de comunicación. Para responder a las situaciones presentadas, es necesario buscar alternativas de conservación y transformación que permitan aumentar la productividad y competitividad de los sectores mencionados. Se definieron los siguientes productos y procesos: • Mora fresca: mora refrigerada y congelada. • Mora procesada: mora en polvo obtenida por secado en bandejas.1° ed

Revisar y reescribir textos académicos con herramientas digitales para transformar el conocimiento en la formación del profesorado en la Universidad

La necesidad de proporcionar herramientas digitales para la docencia online eficaz nos lleva a continuar la investigación de la fase de revisión y reescritura de textos, con la finalidad de ofrecer recursos tecnológicos en la plataforma UCM-Redactext