Association of the KDIGO Risk Classification with the Prevalence of Heart Failure in Patients with Type 2 Diabetes

[Abstract] The objectives of this study were to determine the main characteristics associated with the presence of heart failure (HF) in patients with type 2 diabetes (T2DM), and specifically to assess the association of the risk classification proposed by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines with HF. The DIABET-IC study is a multicentre, observational, prospective and analytical study in T2DM patients recruited in Spanish hospitals. This work, which features a cross-sectional design, has been conducted with the data obtained at the inclusion visit. The main dependent variable analysed was the presence of HF. The predictive variables evaluated were the demography, clinic, laboratory testing (including natriuretic peptides) and echocardiography. Patients were classified according to the number of vascular territories with atherosclerotic involvement and the KDIGO risk category. Multivariate logistic regression models were performed to determine the risk posed by the various baseline variables to present HF at the time of study inclusion. The study included 1517 patients from 58 hospitals, with a mean age of 67.3 (standard deviation (SD): 10) years, out of which 33% were women. The mean DM duration was 14 (SD: 11) years. The prevalence of HF was 37%. In a multivariate analysis, the independent predictors of HF were increased age (odds ratio (OR) per 1 year = 1.02; p = 0.006), decreased systolic blood pressure (OR per 1 mmHg = 0.98; p 1 territory = 2.39; p = 0.02 and p < 0.001 respectively) and the KDIGO risk classification (high-risk OR = 2.46 and very high-risk OR = 3.39; p < 0.001 for both). The KDIGO risk classification is useful to screen for the presence of HF in T2DM patients. Therefore, we believe that it is necessary to carry out a systematic screening for HF in the high- and very high-risk KDIGO categories.This research was funded by the Spanish Society of Diabetes (SED) and the Spanish Society of Cardiology (SEC

Associated factors with health-compromising behaviors among patients treated for oral cancer

To improve eradication strategies of health-compromising behaviors between oral cancer survivors, this study aimed to explore the extent of clustering of risk behaviors and to assess possible factors associated. A cross-sectional study was carried out among oral cancer patients at least 6 months after treatment. They completed a questionnaire about smoking, alcohol consumption, oral hygiene habits and dental visits. Presence of clusters was evaluated through pairwise Pearson correlations and principal component analysis. Factors associated with each identified cluster were analyzed with multivariate models. Among 142 patients, 14.8% smoked, 51.7% consumed alcohol, 52.1% performed oral hygiene less than twice a day, and 74.6% visited to dentist when there was a problem or never. There were two distinct clusters: smoking-alcohol consumption (general risk behaviors cluster) and oral hygiene-dental attendance (oral risk behaviors cluster). Multivariate analysis showed significant associations between males and both clustering patterns of health compromising behaviors, patients with clinical stage I or with longer follow-up and the presence of general risk behaviors cluster and worse social class and the presence of oral risk behaviors cluster. A high proportion of patients treated for oral cancer presented health-compromising behaviors occurring in clusters which reinforce the need for health promotion strategies to target multiple behaviors. Factors analyzed suggest that chances of having detrimental behavioral clustering are higher in male, patients with clinical stage I, with lower social class and those with longer follow-up after treatment

Oral and general health-related quality of life in patients treated for oral cancer compared to control group

Background: Health-related quality of life (HRQoL) is gaining importance as a valuable outcome measure in oral cancer area. The aim of this study was to assess the general and oral HRQoL of oral and oropharyngeal cancer patients 6 or more months after treatment and compare them with a population free from this disease.Methods: A cross-sectional study was carried out with patients treated for oral cancer at least 6 months post-treatment and a gender and age group matched control group. HRQoL was measured with the 12-Item Short Form Health Survey (SF-12); oral HRQoL (OHRQoL) was evaluated using the Oral Health Impact Profile (OHIP-14) and the Oral Impacts on Daily Performances (OIDP). Multivariable regression models assessed the association between the outcomes (SF-12, OHIP-14 and OIDP) and the exposure (patients versus controls), adjusting for sex, age, social class, functional tooth units and presence of illness.Results: For patients (n = 142) and controls (n = 142), 64.1% were males. The mean age was 65.2 (standard deviation (sd): 12.9) years in patients and 67.5 (sd: 13.7) years in controls. Patients had worse SF-12 Physical Component Summary scores than controls even in fully the adjusted model [β-coefficient = −0.11 (95% CI: −5.12-(−0.16)]. The differences in SF-12 Mental Component Summary were not statistically significant. Regarding OHRQoL patients had 11.63 (95% CI: 6.77-20.01) higher odds for the OHIP-14 and 21.26 (95% CI: 11.54-39.13) higher odds for OIDP of being in a worse category of OHRQoL compared to controls in the fully adjusted model.Conclusion: At least 6 months after treatment, oral cancer patients had worse OHRQoL, worse physical HRQoL and similar psychological HRQoL than the general population.Rocio Barrios, academic training, is being supported by the postgraduate research fellowship “Programa de Formación del Profesorado Universitario” from the Spanish Ministry of Education, Culture and Sport. This study was also supported by the Andalusian Research Group CTS-503

Relationship between foetal and maternal serum biochemistry in alpacas

El objetivo del estudio fue relacionar los valores bioquímicos séricos fetales y maternales durante los tres tercios de gestación de la alpaca (Vicugna pacos). Se utilizaron 24 alpacas gestantes y sus respectivos fetos para determinar los niveles de glucosa (G), triglicéridos (T), colesterol (C), proteína total (PT), albúmina (A), calcio (Cl), bilirrubina total (BT), bilirrubina directa (BD) y fosfatasa alcalina (FA). El número de animales para el primer, segundo y tercer tercio de la gestación fue de 6, 7 y 11, respectivamente. Las correlaciones materno-fetal fueron de G: 0.81, C: 0.70, T: 0.85, PT: 0.38, A: 0.38, FA: 0.29, Cl: 0.01, BT: 0.15 y BD: -0.05. Los valores bioquímicos séricos siempre fueron significativamente diferentes (a partir de p&lt;0.05) en el último tercio de gestación tanto en fetos como en las madres. Se concluye que los parámetros bioquímicos se incrementaron hacia el término de la gestación y la mayor parte de los perfiles séricos guardan una relación positiva entre las madres y sus fetos

Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study

Background: The aim of this study was to analyze the impact of the presence of heart failure (HF) on the clinical profile and outcomes in patients with atrial fibrillation (AF) anticoagulated with rivaroxaban. Methods: Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before inclusion. Data were analyzed according to baseline HF status. Results: Out of 1,433 patients, 326 (22.7%) had HF at baseline. Compared to patients without HF, HF patients were older (75.3 ± 9.9 vs. 73.8 ± 9.6 years; p = 0.01), had more diabetes (36.5% vs. 24.3%; p < 0.01), coronary artery disease (28.2% vs. 12.9%; p < 0.01), renal insufficiency (31.7% vs. 22.6%; p = 0.01), higher CHA2DS2-VASc (4.5 ± 1.6 vs. 3.2 ± 1.4; p < 0.01) and HAS-BLED (1.8 ± 1.1 vs. 1.5 ± 1.0; p < 0.01). After a median follow-up of 2.5 years, among HF patients, annual rates of stroke/ /systemic embolism/transient ischemic attack, major adverse cardiovascular events (MACE) (non-fatal myocardial infarction, revascularization and cardiovascular death), cardiovascular death, and major bleeding were 1.2%, 3.0%, 2.0%, and 1.4%, respectively. Compared to those patients without HF, HF patients had greater annual rates of MACE (3.0% vs. 0.5%; p < 0.01) and cardiovascular death (2.0% vs. 0.2%; p < 0.01), without significant differences regarding other outcomes, including thromboembolic or bleeding events. Previous HF was an independent predictor of MACE (odds ratio 3.4; 95% confidence interval 1.6–7.3; p = 0.002) but not for thromboembolic events or major bleeding. Conclusions: Among AF patients anticoagulated with rivaroxaban, HF patients had a worse clinical profile and a higher MACE risk and cardiovascular mortality. HF was independently associated with the development of MACE, but not with thromboembolic events or major bleeding. (Cardiol J 2022; 29, 6: 936–947)

Cambios en los parámetros fisiológicos por diarrea neonatal en crías de alpaca

Alpacas in the pre-weaning stage often present neonatal diarrhoea, usually of infectious type, causing high mortality. This study determined the physiological parameters and their changes in animals with diarrhoea. In total, 79 neonate alpacas less than 60 days of age from Pasco and Junín regions, Peru, were used. Of them, 60 had clinical diarrhoea lasting 1 to 3 days, and 19 were healthy (controls). Heart and respiratory rate, peripheral capillary oxygen saturation, body temperature, capillary refill time, and mucous color were determined. A significant increase in heart rate in crias with diarrhea compared to healthy ones was found (p&lt;0.05). Besides, no differences in other physiological parameters between diseased and apparently healthy offspring was found.Las crías de alpaca en la etapa pre-destete cursan con frecuencia con cuadros diarreicos, por lo general de tipo infeccioso, causantes de alta mortalidad. El presente estudio determinó los parámetros fisiológicos y sus cambios en animales con diarrea. Se utilizaron 79 alpacas neonatas menores de 60 días de edad de las zonas de Pasco y Junín, Perú. De ellas, 60 cursaban con cuadros de diarrea entre 1 a 3 días y 19 estaban sanas (controles). Se determinó la frecuencia cardiaca y respiratoria, saturación de la sangre por la presión parcial de oxígeno, temperatura corporal, tiempo de llenado capilar y coloración de las mucosas. Se encontró un aumento significativo de la frecuencia cardiaca (p&lt;0.05) en crías con diarrea en comparación a las sanas, no habiendo diferencias en los demás parámetros fisiológicos entre crías enfermas y aparentemente sanas

Flórula de plantaciones de palma aceitera establecidas en el estado Monagas, Venezuela | Florula of oil palm plantations established in Monagas State, Venezuela

Las plantaciones de palma aceitera (Elaeis guineensis) provocan cambios sucesionales en la vegetación asociada durante las fases de establecimiento, producción y renovación de este cultivo, sin embargo los estudios florísticos y los inventarios de malezas en plantaciones son escasos. Estas plantaciones son agroecosistemas heterogéneos y complejos en los cuales el efecto de las malezas es menos dramático que los ataques de plagas y enfermedades. Este trabajo tuvo como objetivos identificar plantas vasculares asociadas a plantaciones de palma aceitera ubicadas en el estado Monagas y comparar la diversidad de plantas vasculares entre plantaciones. El estudio se realizó en dos plantaciones en establecimiento (El Águila y San Agustín) y en dos plantaciones en producción (Palmaveral y Palorica). Las muestras botánicas fueron colectadas y procesadas de acuerdo a técnicas clásicas de herborización. La identificación se realizó utilizando claves, descripciones e ilustraciones disponibles en la literatura y la determinación en IRBR, MY, UOJ y VEN. La comparación entre plantaciones se realizó a través del Coeficiente de Comunidad (CC). Se identificaron 200 especies de plantas vasculares: 135 especies agrupadas en 39 familias de dicotiledóneas, 60 especies agrupadas en cinco familias de monocotiledóneas y cinco especies agrupadas en cuatro familias de pteridofitas. Las familias con más de diez especies son: Poaceae (37), Fabaceae (24), Asteraceae (20) y Cyperaceae (17). Las plantaciones San Agustín (SAGU), El Águila (AGUI), Palorica (PLRC) y Palmaveral (PALM) presentaron 148, 52, 43 y 27 especies respectivamente. El CC entre plantaciones en establecimiento es superior al de las plantaciones en producción. Palabras clave: Elaeis guineensis, coeficiente de comunidad, angiospermas, pteridofitas, malezas ABSTRACT Plantations of oil palm (Elaeis guineensis) cause successional changes in associated vegetation during phases of establishment, production and renovation of this crop, however, studies of flora and weed inventories are scarce. These plantations are heterogeneous and complex agroecosystems in which the effect of weeds is less dramatic than attacks of pests and diseases. This study aimed to identify vascular plants associated with oil palm plantations located in Monagas State and to compare vascular plant diversity among plantations. The study was conducted in two young plantations (El Águila and San Agustin) and in two productive plantations (Palmaveral and Palorica). Botanical samples were collected and processed according to classical techniques of herborization. Identification was made using keys, descriptions and illustrations available in current literature and determinations at IRBR, MY, UOJ and VEN. Comparison between plantations was conducted through the Community Coefficient (CC). There were identified 200 species of vascular plants: 135 species grouped in 39 families of dicotyledons, 60 species in five families of monocot and 5 species grouped in four families of pteridophytes. Families with more than ten species are Poaceae (37), Fabaceae (24), Asteraceae (20) and Cyperaceae (17). San Agustín (SAGU), El Águila (AGUI), Palorica (PLRC) and Palmaveral (PALM) plantations had 148, 52, 43 and 27 species respectively. CC were higher between young plantations than between productive plantations. Key words: Elaeis guineensis, community coefficient, angiosperms, pteridophytes, weeds

Programación docente y responsabilidad social en la Universidad de la Experiencia. Docencia virtual y presencial desde y para “los márgenes” del Programa

Memoria ID-0162. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2016-201

Cambios en el perfil bioquímico hepático de alpacas positivas a huevos de Fasciola hepática

The aim of this study was to determine changes in the liver biochemical profile in alpacas with presence of F. hepatica eggs. We used serum and feces samples of 35 male alpaca between 2-5 years old, 18 were positives and 17 were negatives in coproparasitologic analysis for F. hepatica eggs. Differences are showed (p&lt;0.05) in the values of ALT, GGT and direct bilirubin between positives y negatives animals. We concluded that there is relationship between presence of F. hepatica eggs and high levels in the liver biochemical profile, maybe due to alterations in the hepatic parenchyma by chronic infection in alpacas.El objetivo del presente estudio fue determinar cambios en el perfil bioquímico hepático en alpacas con presencia de huevos de F. hepatica en heces. Se utilizaron muestras de suero y heces de 35 alpacas machos de entre 2 y 5 años de edad, de los cuales 18 fueron positivos y 17 negativos al examen coproparasitológico (sedimentación) para identificación de huevos de F. hepática. Se observó diferencia significativa (p&lt;0.05) entre los valores de ALT, GGT y bilirrubina directa entre los animales positivos y negativos. Concluimos que la presencia de huevos de Fasciola hepatica guarda relación con la elevación de algunos parámetros del perfil hepática posiblemente por alguna alteración en el parénquima producto de una infección crónica en alpacas

Health‑related quality of life in patients newly diagnosed with prostate cancer: CAPLIFE study

Funding Funding for open access charge: Universidad de Granada / CBUA. This research was funded by Regional Ministry of Health and Families of Andalusia/Consejería de Salud y Familias de la Junta de Andalucía (PI-0514-2016).Purpose To analyse the Health-Related Quality of Life (HRQoL) at diagnosis of patients with prostate cancer (PCa) according to tumour extension and urinary symptomatology and to explore factors associated with HRQoL. Methods 408 Controls and 463 PCa cases were included. Eligibility criteria were a new diagnosis of PCa (cases), 40–80 years of age, and residence in the participating hospitals’ coverage area for ≥ 6 months before recruitment. HRQoL was evaluated using the 12-Item Short-Form Health Survey, Mental (MCS) and Physical Component Summaries (PCS), and urinary symptoms with the International Prostate Symptom Score. HRQoL scores for all PCa cases, according to tumour extension and urinary symptoms, were compared with controls. In addition, information about lifestyles and comorbidities was collected and its association with low HRQoL (lower scores) were explored using logistic regression models. Results Overall cases had similar PCS score, but lower MCS score than controls. The lowest standardised scores for both PCS and MCS were reached by cases with severe urinary symptoms and a metastatic tumour [mean (SD); PCS: 41.9 (11.5), MCS: 42.3 (10.3)]. Having “below” PCS and MCS scores was associated with the presence of three or more comorbidities in the cases [aOR = 2.86 (1.19–6.84) for PCS and aOR = 3.58 (1.37–9.31) for MCS] and with severe urinary symptomatology [aOR = 4.71 (1.84–12.08) for PCS and aOR = 7.63 (2.70–21.58) for MCS]. Conclusion The mental dimension of HRQoL at diagnosis of patients with PCa was lower than in controls, especially for cases with severe urinary symptoms and a metastatic tumour. Comorbidities and urinary symptoms were variables associated with the HRQoL of PCa cases.Funding for open access charge: Universidad de Granada/CBUARegional Ministry of Health and Families of Andalusia/Consejería de Salud y Familias de la Junta de Andalucía (PI-0514-2016