Análisis pronóstico del ancho de distribución eritrocitaria en pacientes con insuficiencia cardiaca y función sistólica conservada

La insuficiencia cardiaca con función sistólica conservada, es una entidad de creciente prevalencia, morbimortalidad y gasto sanitario, que precisa de herramientas de manejo clínico-terapéutico. El ancho de distribución eritrocitaria es una medida de la variabilidad del tamaño del hematíe presente en cualquier analítica rutinaria, que se confirma en nuestro trabajo como marcador pronóstico independiente de eventos cardiovasculares, mortalidad global y mortalidad cardiovascular en esta población, permitiendo estimar razones de riesgo de importante valor numérico y un punto de corte claro de evaluación clínica. Además su alteración parece preceder a la aparición de anemia proporcionado una valiosa información para su tratamiento precoz. El ancho de distribución es por tanto un marcador pronóstico asequible, útil y rentable en la población de insuficiencia cardiaca con función sistólica conservada

Social scope of educative intervention to increase the level of knowledge in oral hygiene in pregnant women. Corralillo. Guisa, 2016

Introducción: la salud bucal es parte integrante de la salud en general. La gestación ha estado rodeada de una serie de tabúes y creencias alrededor de la salud bucal de la embarazada que se han transmitido generación tras generación. Objetivo: determinar el nivel de conocimientos sobre la higiene bucal en las gestantes de Corralillo, antes de la intervención y después de aplicada la misma.Método: se realizó una intervención educativa para elevar el nivel de conocimientos, modificar actitudes y hábitos sobre la higiene bucal en gestantes de Corralillo, del municipio de Guisa en el año 2016. El universo estuvo compuesto por el total de 40 gestantes que presentaron algún factor de riesgo.Resultados: antes de la intervención 62,5 % tenían nivel de conocimientos en la categoría de mal. En las necesidades de aprendizaje, 92,5 % correspondió a respuestas incorrectas en la pregunta 2 y 90 % relacionada con las causas que causan el sangrado de encías. En cuanto a la higiene bucal, antes de la intervención en el 85 % era deficiente.Conclusiones: se alcanzó un incremento significativo del nivel de conocimientos de las gestantes después de la intervención desarrollaron sus conocimientos, se incrementó la efectividad de la estrategia propuesta, así como la percepción del riesgo, lo que favoreció un comportamiento adecuado ante la prevención de la enfermedad.Introduction: oral health is an integral part of overall health. Gestation has been surrounded by a series of taboos and beliefs around the oral health of the pregnant woman that have been passed on generation after generation. Objective: to determine the level of knowledge about oral hygiene in pregnant women of Corralillo, before and after the intervention. Method: an educational intervention was carried out to raise the level of knowledge, to modify attitudes and habits about oral hygiene in pregnant women in Corralillo, Guisa municipality, in 2016. The universe was composed of a total of 40 pregnant women who presented some factor risky. Results: before the intervention 62.5 % had level of knowledge in the category of mal. In the learning needs, 92.5 % corresponded to incorrect answers in question 2 and 90 % related to the causes that cause bleeding gums. Regarding oral hygiene, before the intervention in 85 % was deficient. Conclusions: a significant increase in the level of knowledge of pregnant women after the intervention developed their knowledge, increased the effectiveness of the proposed strategy, as well as the perception of risk, which favored an adequate behavior in the prevention of the disease

Alcance social de la intervención educativa para elevar el nivel de conocimientos de la higiene bucal en gestantes. Corralillo. Guisa, 2016

RESUMEN Introducción: la salud bucal es parte integrante de la salud en general. La gestación ha estado rodeada de una serie de tabúes y creencias alrededor de la salud bucal de la embarazada que se han transmitido generación tras generación. Objetivo: determinar el nivel de conocimientos sobre la higiene bucal en las gestantes de Corralillo, antes de la intervención y después de aplicada la misma. Método: se realizó una intervención educativa para elevar el nivel de conocimientos, modificar actitudes y hábitos sobre la higiene bucal en gestantes de Corralillo, del municipio de Guisa en el año 2016. El universo estuvo compuesto por el total de 40 gestantes que presentaron algún factor de riesgo. Resultados: antes de la intervención 62,5 % tenían nivel de conocimientos en la categoría de mal. En las necesidades de aprendizaje, 92,5 % correspondió a respuestas incorrectas en la pregunta 2 y 90 % relacionada con las causas que causan el sangrado de encías. En cuanto a la higiene bucal, antes de la intervención en el 85 % era deficiente. Conclusiones: se alcanzó un incremento significativo del nivel de conocimientos de las gestantes después de la intervención desarrollaron sus conocimientos, se incrementó la efectividad de la estrategia propuesta, así como la percepción del riesgo, lo que favoreció un comportamiento adecuado ante la prevención de la enfermedad. ABSTRACT Introduction: oral health is an integral part of overall health. Gestation has been surrounded by a series of taboos and beliefs around the oral health of the pregnant woman that have been passed on generation after generation. Objective: to determine the level of knowledge about oral hygiene in pregnant women of Corralillo, before and after the intervention. Method: an educational intervention was carried out to raise the level of knowledge, to modify attitudes and habits about oral hygiene in pregnant women in Corralillo, Guisa municipality, in 2016. The universe was composed of a total of 40 pregnant women who presented some factor risky. Results: before the intervention 62.5 % had level of knowledge in the category of mal. In the learning needs, 92.5 % corresponded to incorrect answers in question 2 and 90 % related to the causes that cause bleeding gums. Regarding oral hygiene, before the intervention in 85 % was deficient. Conclusions: a significant increase in the level of knowledge of pregnant women after the intervention developed their knowledge, increased the effectiveness of the proposed strategy, as well as the perception of risk, which favored an adequate behavior in the prevention of the disease

Analysis of functional connectome pipelines for the diagnosis of autism spectrum disorders

This paper explores the effect of using different pipelines to compute connectomes (matrices representing brain connections) and use them to train machine learning models with the goal of diagnosing Autism Spectrum Disorder. Five different pipelines are used to train six different ML models, splitting the data into female, male and all subsets so we can also research the effect of considering male and female patients separately. Our results conclude that pipeline and model choice impact results, along with using general or specific models.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

A bacterial antirepressor with SH3 domain topology mimics operator DNA in sequestering the repressor DNA recognition helix

Direct targeting of critical DNA-binding elements of a repressor by its cognate antirepressor is an effective means to sequester the repressor and remove a transcription initiation block. Structural descriptions for this, though often proposed for bacterial and phage repressor–antirepressor systems, are unavailable. Here, we describe the structural and functional basis of how the Myxococcus xanthus CarS antirepressor recognizes and neutralizes its cognate repressors to turn on a photo-inducible promoter. CarA and CarH repress the carB operon in the dark. CarS, produced in the light, physically interacts with the MerR-type winged-helix DNA-binding domain of these repressors leading to activation of carB. The NMR structure of CarS1, a functional CarS variant, reveals a five-stranded, antiparallel β-sheet fold resembling SH3 domains, protein–protein interaction modules prevalent in eukaryotes but rare in prokaryotes. NMR studies and analysis of site-directed mutants in vivo and in vitro unveil a solvent-exposed hydrophobic pocket lined by acidic residues in CarS, where the CarA DNA recognition helix docks with high affinity in an atypical ligand-recognition mode for SH3 domains. Our findings uncover an unprecedented use of the SH3 domain-like fold for protein–protein recognition whereby an antirepressor mimics operator DNA in sequestering the repressor DNA recognition helix to activate transcription

Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial

CDATA[CDATA[Background: Health promotion is a key process of current health systems Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two 01 more risk behaviours, that is why a multiple intervention might be more effective and efficient The primary objectives are to evaluate the effectiveness, the cost effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. CDATA[CDATA[Methods: This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care It will be carried out in 26 PHC centres in Spam The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in the routine care of PHC practices according to the conceptual framework of the ''5A''s" It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community) Incremental cost per quality adjusted life year gamed measured by the tanffs of the EuioQo! 5D questionnaire will be estimated. The implementation strategy is based on the ''Consolidated Framework for Implementation Research, a set of discrete implementation strategies and an evaluation framework. CDATA[CDATA[Discussion: EIRA study will determine the effectiveness and cost effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation

Neuromyelitis optica spectrum disorders. Comparison according to the phenotype and serostatus

Objective: To (1) determine the value of the recently proposed criteria of neuromyelitis optica (NMO) spectrum disorder (NMOSD) that unify patients with NMO and those with limited forms (NMO/LF) with aquaporin-4 immunoglobulin G (AQP4-IgG) antibodies; and (2) investigate the clinical significance of the serologic status in patients with NMO. Methods: This was a retrospective, multicenter study of 181 patients fulfilling the 2006 NMO criteria (n = 127) or NMO/LF criteria with AQP4-IgG (n = 54). AQP4-IgG and myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) antibodies were tested using cell-based assays. Results: Patients were mainly white (86%) and female (ratio 6.5:1) with median age at onset 39 years (range 10-77). Compared to patients with NMO and AQP4-IgG (n = 94), those with NMO/LF presentedmore often with longitudinally extensive transverse myelitis (LETM) (p<0.001), and had lower relapse rates (p = 0.015), but similar disability outcomes. Nonwhite ethnicity and optic neuritis presentation doubled the risk for developing NMO compared with white race (p = 0.008) or LETM presentation (p = 0.008). Nonwhite race (hazard ratio [HR] 4.3, 95% confidence interval [CI] 1.4-13.6) and older age at onset were associated with worse outcome (for every 10-year increase, HR 1.7, 95% CI 1.3-2.2). Patients with NMO and MOG-IgG (n = 9) had lower female: male ratio (0.8:1) and better disability outcome than AQP4-IgG-seropositive or double-seronegative patients (p<0.001). Conclusions: In patients with AQP4-IgG, the similar outcomes regardless of the clinical phenotype support the unified term NMOSD; nonwhite ethnicity and older age at onset are associated with worse outcome. Double-seronegative and AQP4-IgG-seropositive NMO have a similar clinical outcome. The better prognosis of patients with MOG-IgG and NMO suggests that phenotypic and serologic classification is useful

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Association of a single nucleotide polymorphism combination pattern of the Klotho gene with non-cardiovascular death in patients with chronic kidney disease

Chronic kidney disease (CKD) is associated with an elevated risk of all-cause mortality, with cardiovascular death being extensively investigated. However, non-cardiovascular mortality represents the biggest percentage, showing an evident increase in recent years. Klotho is a gene highly expressed in the kidney, with a clear influence on lifespan. Low levels of Klotho have been linked to CKD progression and adverse outcomes. Single nucleotide polymorphisms (SNPs) of the Klotho gene have been associated with several diseases, but studies investigating the association of Klotho SNPs with noncardiovascular death in CKD populations are lacking. The main aim of this study was to assess whether 11 Klotho SNPs were associated with non-cardiovascular death in a subpopulation of the National Observatory of Atherosclerosis in Nephrology (NEFRONA) study (n ¼ 2185 CKD patients). After 48 months of follow-up, 62 cardiovascular deaths and 108 non-cardiovascular deaths were recorded. We identified a high non-cardiovascular death risk combination of SNPs corresponding to individuals carrying the most frequent allele (G) at rs562020, the rare allele (C) at rs2283368 and homozygotes for the rare allele (G) at rs2320762 (rs562020 GG/AG þ rs2283368 CC/CT þ rs2320762 GG). Among the patients with the three SNPs genotyped (n ¼ 1016), 75 (7.4%) showed this combination. Furthermore, 95 (9.3%) patients showed a low-risk combination carrying all the opposite genotypes (rs562020 AA þ rs2283368 TT þ rs2320762 GT/TT). All the other combinations [n ¼ 846 (83.3%)] were considered as normal risk. Using competing risk regression analysis, we confirmed that the proposed combinations are independently associated with a higher fhazard ratio [HR] 3.28 [confidence interval (CI) 1.51-7.12]g and lower [HR 6 × 10- (95% CI 3.3 × 10--1.1 × 10-)] risk of suffering a non-cardiovascular death in the CKD population of the NEFRONA cohort compared with patients with the normal-risk combination. Determination of three SNPs of the Klotho gene could help in the prediction of non-cardiovascular death in CKD