Sarcoidosis and sacroiliitis, a case report

Producción CientíficaSarcoidosis is amultisystem disorder of unknown etiology characterized by the presence of non-caseating granulomas in the organs affected. Sarcoid arthropathy is a rare manifestation, and sacroiliitis is an unusual first manifestation of the disorde

Cuando comer se convierte en un problema

Diabetic gastroparesis is a complication characterized by the slowing of gastric emptying without mechanical obstruction that affects the morbidity and quality of life of patients. Between 5 and 12% of patients present symptoms suggestive of gastroparesis that are maintained over time. The pathogenic mechanisms are not yet clear but they involve nerve alterations at the level of enteric cells, interstitial cells of Cajal and the vagus nerve. Management must be multidisciplinary, including nutritional status, symptom control and the implementation of glycemic control and gastric emptying with new therapies such as electrostimulation.La  gastroparesia diabética es una complicación caracterizada por el enlentecimiento del vaciamiento gástrico sin obstrucción mecánica que afecta a la morbilidad y calidad de vida de los pacientes. Entre el 5-12% de los pacientes presentan síntomas sugestivos de gastroparesia que se mantienen en el tiempo. Los mecanismos patogénicos aún no están claros pero implican alteraciones nerviosas a nivel de células entéricas, células intersticiales de Cajal y el nervio vago. El manejo debe ser multidisciplinar, incluyendo el estado nutricional, el control de síntomas y la implementación del control glucémico y vaciado gástrico con nuevas terapias como la electroestimulación

Lo que la diabetes esconde

Diabetes mellitus (DM) has been associated with various tumor processes. There are several risk factors for pancreatic cancer and it is estimated that 1% of those over 50 years of age, with a recent diagnosis of DM, will develop a pancreatic neoplasm that is usually advanced. Early diagnosis remains key in the prognosis and it may be cost-effective to perform an abdominal CT scan of early screening in adults newly diagnosed with DM. We present the case of a man with a recent diagnosis of DM and a finding of adenocarcinoma of the pancreas with a narrow temporal presentation between both entities.La diabetes mellitus (DM) se ha asociado a diferentes procesos tumorales. Existen diversos factores de riesgo de cáncer de páncreas y se estima que el 1% de los mayores de 50 años con diagnóstico reciente de DM desarrollará una neoplasia pancreática que habitualmente se encuentra en estadio avanzado. El diagnóstico precoz sigue siendo clave en el pronóstico y puede ser rentable la realización de TAC abdominal de cribado temprano en adultos recién diagnosticados de DM. Presentamos el caso de un varón con diagnóstico reciente de DM y hallazgo de adenocarcinoma de páncreas con una estrecha presentación temporal entre ambas entidades

Depression and health related quality of life among HIV-infected people

Producción CientíficaLittle is known about the impact of comorbid psychiatric symptoms in health related quality of life (HRQL) in patients with HIV infection. The aim of this investigation was to describe depressive symptoms and the impact in HRQL in HIV infected people. A cross-sectional study over 150 HIV-outpatients in a tertiary hospital was designed. Depression data were obtained using the Beck Depression Inventory, Second Edition (BDI-II) inventory. HRQL data were collected by disease-specific questionnaire MOS-HIV. Researchers' team designed a specific template to get rest of the data. Almost three-quarters of the population were men. After adjusting for gender and age, HIV-related symptoms and presence of depression were found to be negatively associated with all the Medical Outcomes Study HIV Health Survey (MOS-HIV) general domains and in the Physical Health Summary score and Mental Health Summary score. Optimization of HRQL is particularly important now that HIV is a chronic disease with the prospect of long-term survival. Quality of life and depression should be monitored in follow-up of HIV infected patients. Comorbid psychiatric conditions may serve as markers for impaired functioning and well-being in persons with HIV

Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain.

PURPOSE: The Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain. PARTICIPANTS: In 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega's catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999-2000 of 495 phase I participants (phase II). In 2001-2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information). FINDINGS TO DATE: The Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort. FUTURE PLANS: In 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations

Healthy lifestyle, metabolomics and incident type 2 diabetes in a population-based cohort from Spain

Background: The contribution of metabolomic factors to the association of healthy lifestyle with type 2 diabetes risk is unknown. We assessed the association of a composite measure of lifestyle with plasma metabolite profiles and incident type 2 diabetes, and whether relevant metabolites can explain the prospective association between healthy lifestyle and incident type 2 diabetes. Methods: A Healthy Lifestyle Score (HLS) (5-point scale including diet, physical activity, smoking status, alcohol consumption and BMI) was estimated in 1016 Hortega Study participants, who had targeted plasma metabolomic determinations at baseline examination in 2001-2003, and were followed-up to 2015 to ascertain incident type 2 diabetes. Results: The HLS was cross-sectionally associated with 32 (out of 49) plasma metabolites (2.5% false discovery rate). In the subset of 830 participants without prevalent type 2 diabetes, the rate ratio (RR) and rate difference (RD) of incident type 2 diabetes (n cases = 51) per one-point increase in HLS was, respectively, 0.69 (95% CI, 0.51, 0.93), and - 8.23 (95% CI, - 16.34, - 0.13)/10,000 person-years. In single-metabolite models, most of the HLS-related metabolites were prospectively associated with incident type 2 diabetes. In probit Bayesian Kernel Machine Regression, these prospective associations were mostly driven by medium HDL particle concentration and phenylpropionate, followed by small LDL particle concentration, which jointly accounted for ~ 50% of the HLS-related decrease in incident type 2 diabetes. Conclusions: The HLS showed a strong inverse association with incident type 2 diabetes, which was largely explained by plasma metabolites measured years before the clinical diagnosis.This work was supported by the Strategic Action for Research in Health sciences [PI10/0082, PI13/01848, PI14/00874, PI16/01402, PI11/00726, PI16/609, PI16/1512, PI18/287, PI19/319 and PI20/00896], the GUTMOM Project (JPI-A Healthy Diet for a Healthy Life INTIMIC-085, State Secretary of R + D + I PCIN-2017-117), the Cátedra de Epidemiología y Control del Riesgo Cardiovascular at UAM (#820024), the State Agency for Research (PID2019-108973RB-C21 and C22), the Valencia Government (GRUPOS 03/101; PROMETEO/2009/029 and ACOMP/2013/039), the Castilla-Leon Government (GRS/279/A/08) and European Network of Excellence Ingenious Hypercare (EPSS- 037093) from the European Commission; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN) (CIBER-02-08-2009, CB06/03 and CB12/03/30016). MSP holds a Ramón y Cajal contract (RYC-2018-025069-I) from the Ministry of Science, Innovation and Universities. MDV holds a “Predoctoral Training in Health Research” contract (FI20/00162) from the Carlos III Health Institute. MGP and ADR received the support of a fellowship from “la Caixa” Foundation (ID 100010434, fellowship codes LCF/BQ/IN18/11660001, and LCF/BQ/DR19/11740016, respectively). PO received the support of a Sara Borrell contract from the Carlos III Health Institute (reference CD16/00255). The Strategic Action for Research in Health Sciences, CIBEROBN are initiatives from Carlos III Health Institute Madrid and co-funded by the European Social Fund “The ESF - investing in your future”. The State Agency for Research and Carlos III Health Institute belong to the Spanish Ministry of Science and Innovation. The funding bodies had no role in the study design, data collection and analysis, interpretation of results, manuscript preparation or in the decision to submit this manuscript for publication.S

Urinary metals and metal mixtures and oxidative stress biomarkers in an adult population from Spain: The Hortega Study

INTRODUCTION: Few studies have investigated the role of exposure to metals and metal mixtures on oxidative stress in the general population. OBJECTIVES: We evaluated the cross-sectional association of urinary metal and metal mixtures with urinary oxidative stress biomarkers, including oxidized to reduced glutathione ratio (GSSG/GSH), malondialdehyde (MDA), and 8‑oxo‑7,8‑dihydroguanine (8-oxo-dG), in a representative sample of a general population from Spain (Hortega Study). METHODS: Urine antimony (Sb), barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), molybdenum (Mo), vanadium (V) and zinc (Zn) were measured by ICPMS in 1440 Hortega Study participants. RESULTS: The geometric mean ratios (GMRs) of GSSG/GSH comparing the 80th to the 20th percentiles of metal distributions were 1.15 (95% confidence intervals [95% CI]: 1.03-1.27) for Mo, 1.17 (1.05-1.31) for Ba, 1.23 (1.04-1.46) for Cr and 1.18 (1.00-1.40) for V. For MDA, the corresponding GMRs (95% CI) were 1.13 (1.03-1.24) for Zn and 1.12 (1.02-1.23) for Cd. In 8-oxo-dG models, the corresponding GMR (95% CI) were 1.12 (1.01-1.23) for Zn and 1.09 (0.99-1.20) for Cd. Cr for GSSG/GSH and Zn for MDA and 8-oxo-dG drove most of the observed associations. Principal component (PC) 1 (largely reflecting non-essential metals) was positively associated with GSSG/GSH. The association of PC2 (largely reflecting essential metals) was positive for GSSG/GSH but inverse for MDA. CONCLUSIONS: Urine Ba, Cd, Cr, Mo, V and Zn were positively associated with oxidative stress measures at metal exposure levels relevant for the general population. The potential health consequences of environmental, including nutritional, exposure to these metals warrants further investigation