La Síndrome Plurimetabòlica (Síndrome X) com a factor de risc Cardiovascular a l'atencìò primària.

Introduction: the metabolic syndrome (MS) constitutes an extremely prevalent pathology, that conditions a high cardiovascular risk and therefore, is a cause of potentially avoidable death. Hypothesis and objectives: probably the incidence of cardiovascular disease is superior in those subjects that fulfill MS criteria. Each component of the MS will have an impact determined on the probability of displaying active cardiovascular disease. The objectives were: to determine the prevalence of the MS and the agreement between the criteria diagnoses more accepted universally (the WHO and NCEP-ATP III); the cardiovascular risk of the individuals according to the MS diagnosis; the appearance of cardiovascular events according to the MS; the impact of the characteristics of the MS on the appearance of cardiovascular complications and the time in which these appear; and to compare diverse systems of calculation of the cardiovascular risk. Material and methods: a cross-sectional study were carried out in order to know the prevalence of MS; and a prospective study to analyze the cardiovascular events. Greater patients of 14 years of age were selected, pertaining to two basic areas of health, representative of the general population of Reus. The period of study includes from the 01/01/1998 to the 31/12/2002. The study had the ethical institutional approval and the consent informed from the subjects. Results: 1500 subjects are analyzed (871 women), between which 59 losses of pursuit took place during the 5 years of duration. The prevalence of arterial hypertension was of the 37,4%, the diabetes mellitus of the 15,7%, the intermediate alterations of the metabolism of the glucose of the 24%, obesity of the 32,4%, dyslipidaemias of the 22,9% and active smoking of the 18,7%. Considering the WHO criteria the prevalence of MS was of the 17,4%; and according to the NCEP-ATP III criteria of the 20,3%. The agreement between these two criteria diagnoses have been elevated, with an index kappa weighed of 0.693. The cardiovascular risk measured by the formula of Framingham has been superior in the patients with MS (19.6±11.4) that in the exempt of this condition (9.4±8.5) (pThe cardiovascular complications also differ according to the considered group, thus, the population with MS had a prevalence of the 33,1% of complications during the 5 years, whereas the group without MS underwent only 7,8% of complications (pAnalyzing the evolution of the groups by means of survival curves, it is observed that the group of high risk has a relative risk 16,6 times superior to the group of low risk of undergoing complications. As well as a relative risk 29,7 times superior to develope diabetes, in the 5 years of pursuit, of the group of high risk as opposed to the one of low risk. The multiple logistic regression of the components of the MS sample that the main factor is the arterial hypertension (OR= 8.9), followed of the obesity (OR= 7.3), dyslipidaemia (OR= 6.6) and finally the diabetes (OR= 1.5). Conclusions: these obtained prevalences are similar to those of the countries of our environment, but the incidence of cardiovascular disease in Catalonia is of the lowest of the world. Probably this difference comes given by dietary patterns, physical exercise or by genetic factors. The MS constitutes a problem of first order considering their high prevalence and its cardiovascular prognosis. NCEP-ATP III criterion seems more suitable for its application in primary health care given to its greater simplicity and use of more clinical parameters. The cardiovascular risk measured by the tables of the REGICOR is next to the true incidence of observed cardiovascular disease in this study.A point of great importance is the incorporation of the MS like a risk factor in the list of conditioners and problems of the clinical histories of primary attention.Introducció: la síndrome metabòlica (SM) constitueix una patologia extremadament prevalent, que condiciona un alt risc cardiovascular i per tant, és una causa de mort potencialment evitable. Hipòtesi i objectius: probablement la incidència de malaltia cardiovascular sigui superior als subjectes que compleixin criteris de SM. Cada component de la SM tindrà un impacte determinat sobre la probabilitat de presentar malaltia cardiovascular activa. Com a objectius s'han marcat: determinar la prevalença de la SM i la concordància entre els criteris diagnòstics més acceptats universalment (OMS i NCEP-ATP III); el risc cardiovascular dels individus segons el diagnòstic de SM; l'aparició d'esdeveniments cardiovasculars segons la SM; l'impacte dels trets de la SM sobre l'aparició de complicacions cardiovasculars i el temps en que aquestes es presenten; i comparar diversos sistemes de càlcul del risc cardiovascular. Material i mètodes: es realitza un estudi transversal per conèixer la prevalença de SM; i un estudi prospectiu per analitzar els esdeveniments cardiovasculars. Es varen seleccionar pacients majors de 14 anys d'edat, pertanyents a dues àrees bàsiques de salut, representatius de la població general de Reus. El període d'estudi abarca des de l'01/01/1998 fins el 31/12/2002. Es va comptar amb l'aprovació ètica institucional i el consentiment informat dels subjectes. Resultats: S'analitzen 1500 subjectes (871 dones), dels quals es produeixen 59 pèrdues de seguiment durant els 5 anys de durada. La prevalença d'hipertensió arterial va ser del 37.4%, la diabetis mellitus del 15.7%, les alteracions intermitges del metabolisme glucídic del 24%, obesitat del 32.4%, dislipidèmies del 22.9% i tabaquisme actiu del 18.7%. Considerant els criteris OMS la prevalença de SM ha estat del 17.4%; i segons els criteris NCEP-ATP III del 20.3%. La concordància entre aquests dos criteris diagnòstics ha estat elevada, amb un índex kappa ponderat de 0.693. El risc cardiovascular mesurat per la fòrmula de Framingham ha estat superior als pacients amb SM (19.6±11.4) que als exempts d'ella (9.4±8.5) (pLes complicacions cardiovasculars també difereixen segons el grup considerat, així, la població amb SM va tenir una prevalença del 33.1% de complicacions en els 5 anys, mentres que el grup sense SM va patir només un 7.8% de complicacions (pAnalitzant la evolució dels grups mitjançant taules de supervivència, s'observa que el grup d'alt risc té un risc relatiu 16.6 vegades superior al grup de baix risc de patir complicacions. Així com un risc relatiu 29.7 vegades superior de desenvolupar diabetis, en els 5 anys de seguiment, del grup d'alt risc en front del de baix risc. La regressió logística múltipla dels components de la SM mostra que el factor principal és la hipertensió arterial (OR=8.9), seguit de la obesitat (OR=7.3), la dislipidèmia (OR=6.6) i finalment la diabetis (OR=1.5). Conclusions: aquestes prevalences obtingudes són similars als països del nostre entorn, però la incidència de malaltia cardiovascular a Catalunya és de les més baixes del món. Probablement aquesta diferència vingui donada per patrons dietètics, d'exercici físic tant com per factors genètics. La SM constitueix un problema de primer ordre donada la seva elevada prevalença i el seu pronòstic cardiovascular. El criteri NCEP-ATP III sembla més idoni per l'aplicació a l'atenció primària donada la major senzillesa i emprar paràmetres més clínics. El risc cardiovascular mesurat amb les taules del REGICOR és més proper a la veritable incidència de malaltia cardiovascular observada en aquest estudi.Un punt de gran importància és la incorporació de la SM con a factor de risc a la llista de condicionants i problemes de les històries clíniques d'atenció primària.Introducción: el síndrome metabólico (SM) constituye una patología extremadamente prevalente, que condiciona un alto riesgo cardiovascular y por tanto, es una causa de muerte potencialmente evitable. Hipótesis y objetivos: probablemente la incidencia de enfermedad cardiovascular sea superior en aquellos sujetos que cumplan criterios de SM. Cada componente del SM tendrá un impacto determinado sobre la probabilidad de presentar enfermedad cardiovascular activa. Como objetivos se señalaron: determinar la prevalencia del SM y la concordancia entre los criterios diagnósticos más aceptados universalmente (OMS y NCEP-ATP III); el riesgo cardiovascular de los individuos según el diagnóstico de SM; la aparición de eventos cardiovasculares según el SM; el impacteo de los rasgos del SM sobre la aparición de complicaciones cardiovasculares y el tiempo en que éstas se presentan; y comparar diversos sistemas de cálculo del riesgo cardiovascular. Material y métodos: se realiza un estudio transversal para conocer la prevalencia de SM; y un estudio prospectivo para analizar los eventos cardiovasculares. Se seleccionaron pacientes mayores de 14 años de edad, pertenecientes a dos áreas básicas de salud, representativos de la población general de Reus. El período de estudio abarca desde el 01/01/1998 hasta el 31/12/2002. Se contó con la aprobación ética institucional y el consentimiento informado de los sujetos. Resultados: Se analizan 1500 sujetos (871 mujeres), entre los cuales se produjeron 59 pérdidas de seguimiento durante los 5 años de duración. La prevalencia de hipertensión arterial fue del 37.4%, la diabetes mellitus del 15.7%, las alteraciones intermedias del metabolismo glucídico del 24%, obesidad del 32.4%, dislipidemias del 22.9% y tabaquismo activo del 18.7%. Considerando los criterios OMS la prevalencia de SM fue del 17.4%; y según los criterios NCEP-ATP III del 20.3%. La concordancia entre estos dos criterios diagnósticos ha sido elevada, con un índice kappa ponderado de 0.693. El riesgo cardiovascular medido por la fórmula de Framingham ha sido superior en los pacientes con SM (19.6±11.4) que en los exentos del mismo (9.4±8.5) (pLas complicaciones cardiovasculares también difieren según el grupo considerado, así, la población con SM tuvo una prevalencia del 33.1% de complicaciones durante los 5 años, mientras que el grupo sin SM sufrió sólo un 7.8% de complicaciones (pAnalizando la evolución de los grupos mediante curvas de supervivencia, se observa que el grupo de alto riesgo tiene un riesgo relativo 16.6 veces superior al grupo de bajo riesgo de sufrir complicaciones. Así como un riesgo relativo 29.7 veces superior de desarrollar diabetes, en los 5 años de seguimiento, del grupo de alto riesgo frente al de bajo riesgo. La regresión logística múltiple de los componentes del SM muestra que el factor principal es la hipertensión arterial (OR=8.9), seguido de la obesidad (OR=7.3), la dislipidemia (OR=6.6) y finalmente la diabetes (OR=1.5). Conclusiones: estas prevalencias obtenidas son similares a las de los paises de nuestro entorno, pero la incidencia de enfermedad cardiovascular en Cataluña es de las más bajas del mundo. Probablemente esta diferencia venga dada por patrones dietéticos, de ejercicio físico así como por factores genéticos. El SM constituye un problema de primer orden habida cuenta su elevada prevalencia y su pronóstico cardiovascular. El criterio NCEP-ATP III parece más idóneo para su aplicación en atención primaria dada su mayor sencillez y utilización de parámetros más clínicos. El riesgo cardiovascular medido por las tablas del REGICOR es más próximo a la verdadera incidencia de enfermedad cardiovascular observada en este estudio.Un punto de gran importancia es la incorporación del SM como un factor de riesgo en la lista de condicionantes y problemas de las historias clínicas de atención primaria

A bimodal crowdsourcing platform for demographic historical manuscripts

Ponència presentada al First International Conference on Digital Access to Textual Cultural Heritage celebrada del 19 al 20 de maig de 2014 a MadridIn this paper we present a crowdsourcing web-based application for extracting information from demographic handwritten document images. The proposed application integrates two points of view: the semantic information for demographic research, and the ground-truthing for document analysis research. Concretely, the application has the contents view, where the information is recorded into forms, and the labeling view, with the word labels for evaluating document analysis techniques. The crowdsourcing architecture allows to accelerate the information extraction (many users can work simultaneously), validate the information, and easily provide feedback to the users. We finally show how the proposed application can be extended to other kind of demographic historical manuscripts

Metabolic Syndrome as a Cardiovascular Disease Risk Factor: Patients Evaluated in Primary Care

To estimate the prevalence of metabolic syndrome (MS) in a population receiving attention in primary care centers (PCC) we selected a random cohort of ostensibly normal subjects from the registers of 5 basic-health area (BHA) PCC. Diagnosis of MS was with the WHO, NCEP and IDF criteria. Variables recorded were: socio-demographic data, CVD risk factors including lipids, obesity, diabetes, blood pressure and smoking habit and a glucose tolerance test outcome. Of the 720 individuals selected (age 60.3 ± 11.5 years), 431 were female, 352 hypertensive, 142 diabetic, 233 pre-diabetic, 285 obese, 209 dyslipemic and 106 smokers. CVD risk according to the Framingham and REGICOR calculation was 13.8 ± 10% and 8.8 ± 9.8%, respectively. Using the WHO, NCEP and IDF criteria, MS was diagnosed in 166, 210 and 252 subjects, respectively and the relative risk of CVD complications in MS subjects was 2.56. Logistic regression analysis indicated that the MS components (WHO set), the MS components (IDF set) and the female gender had an increased odds ratio for CVD of 3.48 (95CI%: 2.26–5.37), 2.28 (95%CI: 1.84–4.90) and 2.26 (95%CI: 1.48–3.47), respectively. We conclude that MS and concomitant CVD risk is high in ostensibly normal population attending primary care clinics, and this would necessarily impinge on resource allocation in primary care

A systems biology approach reveals a link between systemic cytokines and skeletal muscle energy metabolism in a rodent smoking model and human COPD

BACKGROUND: A relatively large percentage of patients with chronic obstructive pulmonary disease (COPD) develop systemic co-morbidities that affect prognosis, among which muscle wasting is particularly debilitating. Despite significant research effort, the pathophysiology of this important extrapulmonary manifestation is still unclear. A key question that remains unanswered is to what extent systemic inflammatory mediators might play a role in this pathology. Cigarette smoke (CS) is the main risk factor for developing COPD and therefore animal models chronically exposed to CS have been proposed for mechanistic studies and biomarker discovery. Although mice have been successfully used as a pre-clinical in vivo model to study the pulmonary effects of acute and chronic CS exposure, data suggest that they may be inadequate models for studying the effects of CS on peripheral muscle function. In contrast, recent findings indicate that the guinea pig model (Cavia porcellus) may better mimic muscle wasting. METHODS: We have used a systems biology approach to compare the transcriptional profile of hindlimb skeletal muscles from a Guinea pig rodent model exposed to CS and/or chronic hypoxia to COPD patients with muscle wasting. RESULTS: We show that guinea pigs exposed to long-term CS accurately reflect most of the transcriptional changes observed in dysfunctional limb muscle of severe COPD patients when compared to matched controls. Using network inference, we could then show that the expression profile in whole lung of genes encoding for soluble inflammatory mediators is informative of the molecular state of skeletal muscles in the guinea pig smoking model. Finally, we show that CXCL10 and CXCL9, two of the candidate systemic cytokines identified using this pre-clinical model, are indeed detected at significantly higher levels in serum of COPD patients, and that their serum protein level is inversely correlated with the expression of aerobic energy metabolism genes in skeletal muscle. CONCLUSIONS: We conclude that CXCL10 and CXCL9 are promising candidate inflammatory signals linked to the regulation of central metabolism genes in skeletal muscles. On a methodological level, our work also shows that a system level analysis of animal models of diseases can be very effective to generate clinically relevant hypothesis

FoxA and LIPG endothelial lipase control the uptake of extracellular lipids for breast cancer growth

The mechanisms that allow breast cancer (BCa) cells to metabolically sustain rapid growth are poorly understood. Here we report that BCa cells are dependent on a mechanism to supply precursors for intracellular lipid production derived from extracellular sources and that the endothelial lipase (LIPG) fulfils this function. LIPG expression allows the import of lipid precursors, thereby contributing to BCa proliferation. LIPG stands out as an essential component of the lipid metabolic adaptations that BCa cells, and not normal tissue, must undergo to support high proliferation rates. LIPG is ubiquitously and highly expressed under the control of FoxA1 or FoxA2 in all BCa subtypes. The downregulation of either LIPG or FoxA in transformed cells results in decreased proliferation and impaired synthesis of intracellular lipids

Circulating progenitor cells and vascular dysfunction in chronic obstructive pulmonary disease.

BACKGROUND: In chronic obstructive pulmonary disease (COPD), decreased progenitor cells and impairment of systemic vascular function have been suggested to confer higher cardiovascular risk. The origin of these changes and their relationship with alterations in the pulmonary circulation are unknown. OBJECTIVES: To investigate whether changes in the number of circulating hematopoietic progenitor cells are associated with pulmonary hypertension or changes in endothelial function. METHODS: 62 COPD patients and 35 controls (18 non-smokers and 17 smokers) without cardiovascular risk factors other than cigarette smoking were studied. The number of circulating progenitors was measured as CD45(+)CD34(+)CD133(+) labeled cells by flow cytometry. Endothelial function was assessed by flow-mediated dilation. Markers of inflammation and angiogenesis were also measured in all subjects. RESULTS: Compared with controls, the number of circulating progenitor cells was reduced in COPD patients. Progenitor cells did not differ between control smokers and non-smokers. COPD patients with pulmonary hypertension showed greater number of progenitor cells than those without pulmonary hypertension. Systemic endothelial function was worse in both control smokers and COPD patients. Interleukin-6, fibrinogen, high sensitivity C-reactive protein, vascular endothelial growth factor and tumor necrosis factor were increased in COPD. In COPD patients, the number of circulating progenitor cells was inversely related to the flow-mediated dilation of systemic arteries. CONCLUSIONS: Pulmonary and systemic vascular impairment in COPD is associated with cigarette smoking but not with the reduced number of circulating hematopoietic progenitors. The latter appears to be a consequence of the disease itself not related to smoking habit

Aula d'Ecologia : cicles de conferències 1999 i 2000

Descripció del recurs: 13 juny 2007Conté: Rafael Argullol, Natura i ciutat en el canvi de mil·lenni ; Antoni Lloret, Energies per al segle XXI ; Jorge Wagensberg, Investigació científica i sostenibilitat: l'experiència amazònica ; Manuel Ludevid, El paper de les empreses en la societat sostenible ; Rafael Grasa, El paper de les ONG en la societat sostenible ; Luis Ángel Fernández Hermana, La comunicació en la transició cap a una societat sostenible ; Frederic Ximeno, Estratègies i eines de planificació territorial cap a una ciutat sostenible ; José Luis Porcuna, Estratègies agroecològiques cap a una agricultura sostenible ; Josep Germain, Estratègia catalana per a la biodiversitat ; Carles Gràcia, Els boscos i el funcionament sostenible del planeta ; Manuel Herce, El territori de la ciutat: criteris de sostenibilitat, ordenació i urbanització ; Josep Enric Llebot, Ciència i política del canvi climàtic ; Àlex Aguilar, L'extinció de les espècies: entre la ignorància i la tolerància ; Josep Olives, La ciutat com a idea d'equilibri ; Anna Cabré, Demografia i migracions al segle XXI: què és raonable preveure? ; Manolis Kogevinas, Càncer i exposicions mediambientals ; Ramon Arandes, L'aprofitament de les aigües del subsòl de Barcelona ; Rafael Simó, L'oceà i l'atmosfera, inseparables davant el canvi climàtic global ; Joan Caylà, Sobre el possible impacte mundial de la sida en la dècada 2000-2010 ; Jordi Serra Raventós, Ocupació del litoral i implicacions sobre el territori ; Joan Manuel Vilaplana, Catàstrofes i societat ; Montserrat Vilà, Causes i conseqüències de les invasions biològiques ; Josep Egozcue, Clonatge humà: tècnica i ètica ; Millán M. Millán, Contaminación fotoquímica en la cuenca mediterránea: revisión de los resultados de proyectos de investigación europeos ; Jaume Terradas i José Ángel Burriel, Mapa ecològic de Barcelona

RTP801 is involved in mutant huntingtin-induced cell death

RTP801 expression is induced by cellular stress and has a pro-apoptotic function in non-proliferating differentiated cells such as neurons. In several neurodegenerative disorders, including Parkinson's disease and Alzheimer's disease, elevated levels of RTP801 have been observed, which suggests a role for RTP801 in neuronal death. Neuronal death is also a pathological hallmark in Huntington's disease (HD), an inherited neurodegenerative disorder caused by a CAG repeat expansion in the huntingtin gene. Currently, the exact mechanisms underlying mutant huntingtin (mhtt)-induced toxicity are still unclear. Here, we investigated whether RTP801 is involved in (mhtt)-induced cell death. Ectopic exon-1 mhtt elevated RTP801 mRNA and protein levels in nerve growth factor (NGF)-differentiated PC12 cells and in rat primary cortical neurons. In neuronal PC12 cells, mhtt also contributed to RTP801 protein elevation by reducing its proteasomal degradation rate, in addition to promoting RTP801 gene expression. Interestingly, silencing RTP801 expression with short hairpin RNAs (shRNAs) blocked mhtt-induced cell death in NGF-differentiated PC12 cells. However, RTP801 protein levels were not altered in the striatum of Hdh(Q7/Q111) and R6/1 mice, two HD models that display motor deficits but not neuronal death. Importantly, RTP801 protein levels were elevated in both neural telencephalic progenitors differentiated from HD patient-derived induced pluripotent stem cells and in the putamen and cerebellum of human HD postmortem brains. Taken together, our results suggest that RTP801 is a novel downstream effector of mhtt-induced toxicity and that it may be relevant to the human disease