Blood pressure and lipid goal attainment in the hypertensive population in the primary care setting in Spain

[Abstract] Although blood pressure (BP) control is crucial in hypertensive patients, clinical practice guidelines agree that the goal of treatment should be aimed at not only decreasing BP but reducing global cardiovascular risk. The aim of this cross-sectional study was to evaluate BP, low-density lipoprotein cholesterol (LDL-C), and composite control rates in a hypertensive population in a primary care setting in Spain. Good BP control was defined as <140/90 mm Hg (<130/80 mm Hg for diabetics).LDL-C control rate was established according to the third report of the National Cholestrol Education Program Adult Treatment Panel criteria. A total of 12,954 patients (49.9% women, aged 62.1±10.7 years) were included. BP was controlled in 24.8% of patients, LDL-C in 26% of patients and, when combined, in only 8.6%. The rates of control were significantly worse in high-risk subgroups, such as high-coronary-risk, diabetic, or metabolic syndrome patients. The BP and LDL-C control rates in the hypertensive population attended to daily in primary care settings in Spain are low

Type 2 Diabetes Mellitus and Alcoholic Liver Disease: a literature review

Introduction Alcoholic liver disease (ALD) and type 2 diabetes mellitus (T2DM) are two important chronic diseases in Australia, both of which are emerging epidemics. As a result, patients presenting with both conditions may become increasingly more common. However, not much is known about how each affects the other in terms of clinical outcomes. &nbsp; Methods Evidence from studies exploring the relationship between T2DM and ALD, including those pertaining to liver function tests (LFT) and hepatocellular carcinoma (HCC), was reviewed and summarised. &nbsp; Results There are studies which show that high alcohol intake and chronic liver disease (CLD) are risk factors of developing T2DM. Conversely, having impaired glucose tolerance has been shown to promote progression of CLD. There is also some evidence of increased risk of HCC in patients with T2DM and who consume alcohol in the context of other liver disease. However, no studies that looked into how T2DM directly affects LFT results in ALD were found. &nbsp; Discussion There seems to be a bidirectional relationship between T2DM and ALD, although it is not explicitly cause-and-effect in nature. Hence, there is a need for a comprehensive management plan that utilises a multidisciplinary approach to minimise the risk of complications for patients with either or both diseases. Currently, this is not available and both diseases are treated as separate entities. Therefore, further research must be done to elucidate the relationship between the two, so that effective strategies to manage co-existing T2DM and ALD can be developed

Desynchronizing effect of high-frequency stimulation in a generic cortical network model

Transcranial Electrical Stimulation (TCES) and Deep Brain Stimulation (DBS) are two different applications of electrical current to the brain used in different areas of medicine. Both have a similar frequency dependence of their efficiency, with the most pronounced effects around 100Hz. We apply superthreshold electrical stimulation, specifically depolarizing DC current, interrupted at different frequencies, to a simple model of a population of cortical neurons which uses phenomenological descriptions of neurons by Izhikevich and synaptic connections on a similar level of sophistication. With this model, we are able to reproduce the optimal desynchronization around 100Hz, as well as to predict the full frequency dependence of the efficiency of desynchronization, and thereby to give a possible explanation for the action mechanism of TCES.Comment: 9 pages, figs included. Accepted for publication in Cognitive Neurodynamic

The effect of post-discharge educational intervention on patients in achieving objectives in modifiable risk factors six months after discharge following an episode of acute coronary syndrome, (CAM-2 Project): a randomized controlled trial

<p>Abstract</p> <p>Objectives</p> <p>We investigated whether an intervention mainly consisting of a signed agreement between patient and physician on the objectives to be reached, improves reaching these secondary prevention objectives in modifiable cardiovascular risk factors six-months after discharge following an acute coronary syndrome.</p> <p>Background</p> <p>There is room to improve mid-term adherence to clinical guidelines' recommendations in coronary heart disease secondary prevention, specially non-pharmacological ones, often neglected.</p> <p>Methods</p> <p>In CAM-2, patients discharged after an acute coronary syndrome were randomly assigned to the intervention or the usual care group. The primary outcome was reaching therapeutic objectives in various secondary prevention variables: smoking, obesity, blood lipids, blood pressure control, exercise and taking of medication.</p> <p>Results</p> <p>1757 patients were recruited in 64 hospitals and 1510 (762 in the intervention and 748 in the control group) attended the six-months follow-up visit. After adjustment for potentially important variables, there were, between the intervention and control group, differences in the mean reduction of body mass index (0.5 vs. 0.2; p < 0.001) and waist circumference (1.6 cm vs. 0.6 cm; p = 0.05), proportion of patients who exercise regularly and those with total cholesterol below 175 mg/dl (64.7% vs. 56.5%; p = 0.001). The reported intake of medications was high in both groups for all the drugs considered with no differences except for statins (98.1% vs. 95.9%; p = 0.029).</p> <p>Conclusions</p> <p>At least in the short term, lifestyle changes among coronary heart disease patients are achievable by intensifying the responsibility of the patient himself by means of a simple and feasible intervention.</p

Sustainability and Corporate Social Responsibility in the Perspective of Social Economy Entities: A Bibliometric Study

We start from the conceptual interconnection between Sustainability and Corporate Social Responsibility, which, although continuously subject to controversy, both within the scope of its definition and in its performance, advocate, as the ultimate goal, human development and of the society in general, promoting the interests of the Communities on a permanent, long-term basis and without compromising the options of the future generations. In this context, we cannot fail to draw a parallel with the entities that constitute the Social Economy Sector. The activities they carry out are of economic and social nature and must be pursued in the general interest of their members, users and beneficiaries, thus in the general interest of the Community. These institutions also reveal concerns about the sustainability in all the dimensions involved (economic, social and environmental), in which the organizational performance is particularly important, as it becomes imperative to guarantee their continuity, fostering and promoting their social action. We will, therefore, start by framing what is meant by Sustainability, Corporate Social Responsibility and Social Economy, with a particular focus on the current requirements of stakeholders regarding the socially responsible behaviour of the institutions as these, in turn, will entail the adoption of more comprehensive management tools, also more efficient and transparent concerning all dimensions (economic, financial and social). It is within this framework that a project called “TFA—TheoFrameAccountability—Theoretical framework for the promotion of accountability in the social economy sector: The IPSS case” emerges, being promoted by the University of Aveiro, with the participation of National Confederation of Solidarity Institutions (CNIS—acronym in Portuguese), and the Polytechnic Institutes of Coimbra and Porto. This project aims to promote the accountability of the social economy sector (economic, financial and social aspects), in the Private Social Solidarity Institutions (IPSS—acronym in Portuguese), assisting them not only in fulfilling their legal obligations, but also facilitating the reporting of results of activities carried out in a more effective manner and promoting transfer of knowledge (for the IPSS and also for the academic community), thus contributing to the development and sustainability of these institutions. Thus, we develop an exploratory and descriptive analysis, of a quantitative-qualitative nature, in which the procedures of data collection determine the result of the search strategy by the defined descriptors. For this purpose, the analysis will focus on the following variables: number of articles published per year; methodologies used; theories of support; identification by sector/area of activity; countries of origin; more representative institutions; authors who publish more and journals with the largest number of publications. The main results indicate a growing concern about sustainability and a growing publication in this area. This paper presents a bibliometric study to evaluate the main trends of current research on sustainability and on corporate social responsibility, thus contributing to the construction of the theoretical basis underlying the “TFA—TheoFrameAccountability” project.info:eu-repo/semantics/publishedVersio

Genetic analysis of a major international collection of cultivated apple varieties reveals previously unknown historic heteroploid and inbred relationships

Domesticated apple (Malus x domestica Borkh.) is a major global crop and the genetic diversity held within the pool of cultivated varieties is important for the development of future cultivars. The aim of this study was to investigate the diversity held within the domesticated form, through the analysis of a major international germplasm collection of cultivated varieties, the UK National Fruit Collection, consisting of over 2,000 selections of named cultivars and seedling varieties. We utilised Diversity Array Technology (DArT) markers to assess the genetic diversity within the collection. Clustering attempts, using the software STRUCTURE revealed that the accessions formed a complex and historically admixed group for which clear clustering was challenging. Comparison of accessions using the Jaccard similarity coefficient allowed us to identify clonal and duplicate material as well as revealing pairs and groups that appeared more closely related than a standard parent-offspring or full-sibling relations. From further investigation, we were able to propose a number of new pedigrees, which revealed that some historically important cultivars were more closely related than previously documented and that some of them were partially inbred. We were also able to elucidate a number of parent-offspring relationships that had resulted in a number of important polyploid cultivars. This included reuniting polyploid cultivars that in some cases dated as far back as the 18th century, with diploid parents that potentially date back as far as the 13th century

Meniscus tear developed by pulling of the anomalous insertion of medial meniscus on anterior cruciate ligament

There is no report regarding a medial meniscus tear arising from an anomalous insertion of medial meniscus on the ACL, which seemed to be developed by the same mechanism as ACL tear. A case of a combined medial meniscus tear with ACL tear in the presence of an anomalous insertion of the medial meniscus on the ACL is reported

Haplotypes of intron 4 of the estrogen receptor alpha gene and hip fractures: a replication study in Caucasians

<p>Abstract</p> <p>Background</p> <p>Despite their great impact, few genetic association studies have used hip fractures as an endpoint. However, the association of two polymorphisms on intron 4 of estrogen receptor alpha (<it>ESR1</it>) with hip fractures was recently reported in a Chinese population. The aim of this study was to investigate whether such association is also present in Caucasians.</p> <p>Methods</p> <p>We analyzed those two SNPs and another neighbour SNP located on the exon 4 of <it>ESR1 </it>in 787 patients with hip fractures and 953 controls from Spain.</p> <p>Results</p> <p>The allelic frequencies differed markedly from those reported in Asian populations. Nevertheless, haplotypes including the rs3020314 and rs1884051 loci in intron 4 showed a significant association with hip fractures (omnibus test p = 0.006 in the whole group and 0.00005 in women). In the sex-stratified analysis, the association was significant in females, but not in males. In women, the CA haplotype appeared to have a protective influence, being present in 6.5% of the controls, but only in 3% of patients with fractures (odds ratio 0.39; 95% confidence interval 0.26-0.59; estimated population preventive fraction 3.5%). The inclusion of the rs1801132 SNP of exon 4 further increased the statistical significance of the association (odds ratio 0.17; 95% CI 0.08-0.37; p = 0.00001). Each SNP appeared to contribute independently to the association. No genotype-related differences in gene expression were found in 42 femoral bone samples.</p> <p>Conclusions</p> <p>This study confirms the association of some polymorphisms in the region of exon 4/intron 4 of <it>ESR1 </it>and hip fractures in women. However, there are marked differences in allele frequencies between Asian and Caucasian populations.</p