42 research outputs found
The Mediterranean diet and incidence of hypertension: the Seguimiento Universidad de Navarra (SUN) Study
The Mediterranean diet is receiving increasing attention in cardiovascular epidemiology. The association of
adherence to the Mediterranean diet with the incidence of hypertension was evaluated among 9,408 men and
women enrolled in a dynamic Spanish prospective cohort study during 1999â2005. Dietary intake was assessed at
baseline with a validated semiquantitative food frequency questionnaire, and a 9-point Mediterranean diet score
was constructed. During a median follow-up period of 4.2 years (range, 1.9â7.9), 501 incident cases of hypertension
were identified. After adjustment for major hypertension risk factors and nutritional covariates, adherence to
the Mediterranean diet was not associated with hypertension (the hazard ratio was 1.10 (95% confidence interval
(CI): 0.81, 1.41) for moderate adherence and 1.12 (95% CI: 0.79, 1.60) for high adherence). However, it was
associated with reduced changes in mean levels of systolic blood pressure (moderate adherence, 2.4 mm Hg
(95% CI: 4.0, 0.8); high adherence, 3.1 mm Hg (95% CI: 5.4, 0.8)) and diastolic blood pressure (moderate
adherence, 1.3 mm Hg (95% CI: 2.5, 0.1); high adherence, 1.9 mm Hg (95% CI: 3.6, 0.1)) after 6 years of
follow-up. These results suggest that adhering to a Mediterranean-type diet could contribute to the prevention of
age-related changes in blood pressure
Aspirin, non-aspirin analgesics and the risk of hypertension in the SUN cohort.
The use of aspirin and non-aspirin analgesics has been associated with changes in blood pressure. The aim of this study was to investigate prospectively the association between the regular use of aspirin and non-aspirin analgesics and the incidence of hypertension.
METHODS:
The SUN project is an ongoing, continuously expanding, prospective cohort of Spanish university graduates initially free of hypertension, cardiovascular disease, diabetes and cancer; 9986 (mean age 36 years) were recruited during 1999-2005 and followed up for a mean of 51 months. Regular aspirin and non-aspirin analgesic use and the presence of other risk factors for hypertension were assessed by questionnaire at baseline, and the incidence of hypertension was assessed using biennial follow-up questionnaires.
RESULTS:
In total, 543 new cases of hypertension were identified during follow-up. Regular aspirin use (i.e. 2 or more days/week) was associated with a higher risk of hypertension (hazard ratio=1.45; 95% confidence interval, 1.02-2.04) after adjustment for various confounding factors. Regular use of non-aspirin analgesic drugs was also associated with a higher risk of hypertension (hazard ratio=1.69; 95% confidence interval, 1.28-2.23).
CONCLUSIONS:
The regular use of aspirin and non-aspirin analgesics were both associated with an increased risk of developing hypertension, independently of other risk factors
Consumo de alcohol e incidencia de hipertensiĂłn en una cohorte mediterrĂĄnea: el estudio SUN
Introduction and objectives. To assess prospectively
the association between alcohol consumption, including
alcoholic beverage preference and days of consumption
per week, and the risk of hypertension in a Mediterranean
cohort.
Methods. We prospectively followed 9,963 Spanish men
and women initially without hypertension. Self-reported
and validated data on diet and hypertension diagnoses
were collected.
Results. During follow-up (median [interquartile range],
4.2 [2.5-6.1] years), 554 incident cases of hypertension
were identified over a total of 43,562 person-years. The
hazard ratio for hypertension among those who consumed
alcohol on â„5 days per week was 1.28 (95% confidence
interval, 0.97-1.7) compared to abstainers. Among those
who drank alcohol â„5 days per week, the hazard ratio for
hypertension associated with consuming â„1 drink per day
was 1.45 (95% confidence interval, 1.06-2) compared
with abstainers. The consumption of beer or spirits,
but not wine, was associated with an increased risk of
hypertension. The hazard ratio associated with consuming
>0.5 drinks of beer or spirits per day was 1.53 (95%
confidence interval, 1.18-1.99) compared with abstainers.
In contrast, there was a nonsignificant inverse association
between red wine intake and the risk of hypertension.
Conclusions. In this Mediterranean population,
the consumption of beer or spirits, but not wine, was
associated with a higher risk of developing hypertension.
However, the weekly pattern of alcohol consumption did
not have a significant impact on the risk of hypertension
Clinical utility of intralesional methotrexate to distinguish crateriform keratinocytic tumors before surgery
Clinical utility of intralesional methotrexate to distinguish crateriform keratinocytic tumors before surgeryDear Editors,Keratoacanthoma (KA) and cutaneous squamous cell carci-noma (CSCC) may adopt an identical crateriform morpho-logy. Nowadays, the debate about whether KA is a distinct entity, or a low-grade variant of cutaneous squamous cell carcinoma (CSCC) still persists. Since CSCC is a more ag-gressive neoplasm, misdiagnosing crateriform lesions may have a negative impact on the patient's prognosis. Evaluating a partial biopsy is extremely challenging to confidently dis-tinguish KA from CSCC [1]. No distinctive gene expression profiles have been identified and no pathognomonic criteria to unequivocally differentiate between KA and CSCC exist [2]. Consequently, the surgical approach remains the gold standard in the management of crateriform tumors, especi-ally those arising on the face
Effects of dexmedetomidine on subthalamic local field potentials in parkinson's disease
Background: Dexmedetomidine is frequently used for sedation during deep brain stimulator implantation in patients with Parkinson's disease, but its effect on subthalamic nucleus activity is not well known. The aim of this study was to quantify the effect of increasing doses of dexmedetomidine in this population.
Methods: Controlled clinical trial assessing changes in subthalamic activity with increasing doses of dexmedetomidine (from 0.2 to 0.6 ÎŒg kg-1 h-1) in a non-operating theatre setting. We recorded local field potentials in 12 patients with Parkinson's disease with bilateral deep brain stimulators (24 nuclei) and compared basal activity in the nuclei of each patient and activity recorded with different doses. Plasma levels of dexmedetomidine were obtained and correlated with the dose administered.
Results: With dexmedetomidine infusion, patients became clinically sedated, and at higher doses (0.5-0.6 ÎŒg kg-1 h-1) a significant decrease in the characteristic Parkinsonian subthalamic activity was observed (P<0.05 in beta activity). All subjects awoke to external stimulus over a median of 1 (range: 0-9) min, showing full restoration of subthalamic activity. Dexmedetomidine dose administered and plasma levels showed a positive correlation (repeated measures correlation coefficient=0.504; P<0.001).
Conclusions: Patients needing some degree of sedation throughout subthalamic deep brain stimulator implantation for Parkinson's disease can probably receive dexmedetomidine up to 0.6 ÎŒg kg-1 h-1 without significant alteration of their characteristic subthalamic activity. If patients achieve a 'sedated' state, subthalamic activity decreases, but they can be easily awakened with a non-pharmacological external stimulus and recover baseline subthalamic activity patterns in less than 10 min
Effect of sugammadex on processed EEG parameters in patients undergoing robot-assisted radical prostatectomy
Background: Sugammadex has been associated with increases in the bispectral index (BIS). We evaluated the effects of
sugammadex administration on quantitative electroencephalographic (EEG) and electromyographic (EMG) measures.
Methods: We performed a prospective observational study of adult male patients undergoing robot-assisted radical
prostatectomy. All patients received a sevoflurane-based general anaesthetic and a continuous infusion of rocuronium,
which was reversed with 2 mg kg1 of sugammadex i.v. BIS, EEG, and EMG measures were captured with the BIS Vistaâą
monitor.
Results: Twenty-five patients were included in this study. Compared with baseline, BIS increased at 4e6 min (b coefficient: 3.63; 95% confidence interval [CI]: 2.22e5.04; P<0.001), spectral edge frequency 95 (SEF95) increased at 2e4 min (b
coefficient: 0.29; 95% CI: 0.05e0.52; PŒ0.016) and 4e6 min (b coefficient: 0.71; 95% CI: 0.47e0.94; P<0.001), and EMG
increased at 4e6 min (b coefficient: 1.91; 95% CI: 1.00e2.81; P<0.001) after sugammadex administration. Compared with
baseline, increased beta power was observed at 2e4 min (b coefficient: 93; 95% CI: 1e185; PŒ0.046) and 4e6 min (b coefficient: 208; 95% CI: 116e300; P<0.001), and decreased delta power was observed at 4e6 min (b coefficient: 526.72; 95%
CI: 778 to 276; P<0.001) after sugammadex administration. Neither SEF95 nor frequency band data analysis adjusted
for EMG showed substantial differences. None of the patients showed clinical signs of awakening.
Conclusions: After neuromuscular block reversal with 2 mg kg1 sugammadex, BIS, SEF95, EMG, and beta power showed
small but statistically significant increases over time, while delta power decreased
Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis: long-term follow up of a multicenter randomized controlled clinical trial (phase I/II)
Background: Mesenchymal stromal cells (MSCs) are a promising option to treat knee osteoarthritis (OA). Their safety
and usefulness have been reported in several short-term clinical trials but less information is available on the longterm efects of MSC in patients with osteoarthritis. We have evaluated patients included in our previous randomized
clinical trial (CMM-ART, NCT02123368) to determine their long-term clinical efect.
Materials: A phase I/II multicenter randomized clinical trial with active control was conducted between 2012 and
2014. Thirty patients diagnosed with knee OA were randomly assigned to Control group, intraarticularly administered
hyaluronic acid alone, or to two treatment groups, hyaluronic acid together with 10Ă106
or 100Ă106
cultured autolâ
ogous bone marrow-derived MSCs (BM-MSCs), and followed up for 12 months. After a follow up of 4 years adverse
efects and clinical evolution, assessed using VAS and WOMAC scorings are reported.
Results: No adverse efects were reported after BM-MSCs administration or during the follow-up. BM-MSCs-adminisâ
tered patients improved according to VAS, median value (IQR) for Control, Low-dose and High-dose groups changed
from 5 (3, 7), 7 (5, 8) and 6 (4, 8) to 7 (6, 7), 2 (2, 5) and 3 (3, 4), respectively at the end of follow up (Low-dose vs Control
group, p=0.01; High-dose vs Control group, p=0.004). Patients receiving BM-MSCs also improved clinically accordâ
ing to WOMAC. Control group showed an increase median value of 4 points (â11;10) while Low-dose and Highdose groups exhibited values of â18 (â28;â9) and â10 (â21;â3) points, respectively (Low-dose vs Control group
p=0.043). No clinical diferences between the BM-MSCs receiving groups were found.
Conclusions: Single intraarticular injection of in vitro expanded autologous BM-MSCs is a safe and feasible proceâ
dure that results in long-term clinical and functional improvement of knee OA
A longitudinal assessment of alcohol intake and incident depression: the sun project
Background: Longitudinal studies assessing the long-term association between alcohol intake and depression are
scarce. The type of beverage may also be important. Therefore we aimed to prospectively evaluate the influence of
alcohol intake on incident depression in a Mediterranean cohort.
Methods: We assessed 13,619 university graduates (mean age: 38 years, 42% men) participating in a Spanish
prospective epidemiological cohort (the SUN Project), initially free of depression. They were recruited between
1999â2008 and biennially followed-up during 2001â2010. At baseline, a 136-item validated foodâfrequency
questionnaire was used to assess alcohol intake. Wine was the preferred beverage. Participants were classified as
incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated
the use of antidepressant drugs. Cox regression and restricted cubic splines analyses were performed over 82,926
person-years.
Results: Only among women, an U-shaped relationship between total alcohol intake and depression risk was found
(P=0.01). Moderate alcohol intake (5â15 g/day) was associated with lower risk (Hazard Ratio: 0.62; 95% Confidence
Interval: 0.43-0.89). No association was apparent for higher intakes of alcohol or for any specific type of alcoholic
beverage.
Conclusions: Moderate alcohol intake might protect against depression among women. Further confirmatory
studies are needed
Reliability of a novel electro-medical device for wheal size measurement in allergy skin testing: An exploratory clinical trial
Skin prick testing (SPT) is the cornerstone of IgE-mediated allergy diagnosis,1 due to its high sensitivity and specificity.2 However, a uniform method for wheal measurement does not exist. Ansotegui et al.2 recommends to measure wheals in millimeters with a ruler, in many centers they are outlined with a pen and transfer by tape to a paper and then measured. Subsequently, the specialist is able to manually measure the maximum (MD) and orthogonal diameter (OD) of the wheal. This procedure is time consuming and makes repro-ducible measurements difficult.2,3 Knowing the wheal's area could help make a more accurate diagnosis.4 Over the last 30 years, many attempts have been made to develop a device to measure the size of SPT.3 Nexkin DSPTÂź (Figure S1A,B) is a novel mechatronic system based on 3D laser technology, that automatically locates allergen's wheal and measures its size (MD, OD and area in square millimeters) (Figure S1C)
Predicting long-term disease control in transplant-ineligible patients with multiple myeloma: impact of an MGUS-like signature
Disease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials (GEM2005MAS65 and GEM2010MAS65), has been analyzed. Among the 435 patients included in this post-hoc study, 18.6% remained alive and progression free after 5 years of treatment initiation. In these patients, overall survival (OS) rate at 10 years was 60.8% as compared with 11.8% for those progressing within the first 5 years. Hemoglobin (Hb) >= 12 g/dl (OR 2.74, p = 0.001) and MGUS-like profile (OR 4.18, p = 0.005) were the two baseline variables associated with long-term disease-free survival. Upon including depth of response (and MRD), Hb >= 12 g/dl (OR 2.27) and MGUS-like signature (OR 7.48) retained their predictive value along with MRD negativity (OR 5.18). This study shows that despite the use of novel agents, the probability of disease control at 5 years is still restricted to a small fraction (18.6%) of elderly MM patients. Since this endpoint is associated with higher rates of OS, this study provides important information about diagnostic and post-treatment biomarkers helpful in predicting the likelihood of disease control at 5 years