36 research outputs found

    Relationship between intima-media thickness of the common carotid artery and arterial stiffness in subjects with and without type 2 diabetes: a case-series report

    Get PDF
    Background: We examined the relationship between the intima-media thickness of the common carotid artery (CCA-IMT) and arterial stiffness, assessed by pulse wave velocity (PWV), the ambulatory arterial stiffness index (AASI) and the augmentation index (AIx) in subjects with and without type 2 diabetes. Methods: A case-series study was made in 366 patients (105 diabetics and 261-non-diabetics). Ambulatory blood pressure monitoring was performed on a day of standard activity with the SpaceLabs 90207 system. AASI was calculated as "1-slope" from the within-person regression of diastolic-on-systolic ambulatory blood pressure readings. PWV and AIx were measured with the SphygmoCor system, and a Sonosite Micromax ultrasound unit was used for automatic measurements of CCA-IMT. Results: PWV, AASI and CCA-IMT were found to be greater in diabetic patients, while no differences in AIx were observed between the two groups. CCA-IMT was independently correlated to the three measures of arterial stiffness in both groups. We found an increase in CCA-IMT of 0.40, 0.24 and 0.36 mm in diabetics, and of 0.48, 0.17 and 0.55 mm in non-diabetics for each unit increase in AASI, AIx and PWV. The variability of CCA-IMT was explained mainly by AASI, AIx and gender in diabetic patients, and by age, gender, AASI and PWV in non-diabetic patients. Conclusions: CCA-IMT showed a positive correlation to PWV, AASI and AIx in subjects with and without type 2 diabetes. However, when adjusting for age, gender and heart rate, the association to PWV was lost in diabetic patients, in the same way as the association to Alx in non-diabetic patients. The present study demonstrates that the three measures taken to assess arterial stiffness in clinical practice are not interchangeable, nor do they behave equally in all subjects

    EVIDENT 3 study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application study protocol

    Get PDF
    FUNDAMENTOS: La tecnología móvil, cuando se incluye dentro de las intervenciones de componentes múltiples, podría contribuir a una pérdida de peso más efectiva. El objetivo de este proyecto es evaluar el impacto de añadir el uso de la aplicación EVIDENT 3, diseñada para promover la salud a los hábitos de vida, a las estrategias de modificación tradicionales empleadas para la pérdida de peso. También se evaluarán otras conductas específicas (caminar, ingesta de calorías, tiempo sentado) y resultados (calidad de vida, marcadores inflamatorios, mediciones del envejecimiento arterial). MÉTODOS: Ensayo clínico aleatorio y multicéntrico con 2 grupos paralelos. El estudio se llevará a cabo en el ámbito de la atención primaria e incluirá 700 sujetos de 20 a 65 años, con un índice de masa corporal (27,5-40kg/m2), que están clínicamente clasificados como sedentarios. El resultado primario será la pérdida de peso. Los resultados secundarios incluirán cambios en la forma de caminar (pasos/d), el tiempo de permanencia sentado (min/sem), la ingesta calórica (kcal/d), la calidad de vida, el envejecimiento arterial (índice de aumento) y los niveles de marcadores proinflamatorios. Los resultados se medirán en la línea de base, después de 3 meses y después de 1 año. Los participantes serán asignados aleatoriamente al grupo de intervención (IG) o al grupo de control (CG). Ambos grupos recibirán el asesoramiento tradicional de estilo de vida de atención primaria antes de la asignación al azar. A los sujetos del IG se les prestará un teléfono inteligente y una banda inteligente por un período de 3 meses, correspondiente a la duración de la intervención. La aplicación del EVIDENTE 3 integra la información recogida por la banda inteligente sobre la actividad física y la información autodeclarada por los participantes sobre la ingesta diaria de alimentos. Utilizando esta información, la aplicación genera recomendaciones y objetivos personalizados para la pérdida de peso. DISCUSIÓN: Hay una gran diversidad en las aplicaciones utilizadas obteniendo diferentes resultados en la mejora del estilo de vida y la pérdida de peso. Las poblaciones estudiadas no son homogéneas y generan resultados diferentes. Los resultados de este estudio ayudarán a nuestra comprensión de la eficacia de las nuevas tecnologías, combinadas con el asesoramiento tradicional, para reducir la obesidad y permitir estilos de vida más saludables.INTRODUCTION: Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. METHODS: Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5–40kg/m2), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. DISCUSSION: There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles.• Ministerio de Ciencia e Innovación y el Instituto de Salud Carlos III/Europa y Fondo de Desarrollo Regional (FEDER). Proyectos PI16/00101, PI16/00952, PI16/00765, PI16/00659, PI16/00421, PI16/00170 • Junta de Castilla y León. Ayuda GRS 1277/B/16peerReviewe

    Office and 24-hour heart rate and target organ damage in hypertensive patients

    Get PDF
    <p>Abstract</p> <p>Background</p> <p>We investigated the association between heart rate and its variability with the parameters that assess vascular, renal and cardiac target organ damage.</p> <p>Methods</p> <p>A cross-sectional study was performed including a consecutive sample of 360 hypertensive patients without heart rate lowering drugs (aged 56 ± 11 years, 64.2% male). Heart rate (HR) and its standard deviation (HRV) in clinical and 24-hour ambulatory monitoring were evaluated. Renal damage was assessed by glomerular filtration rate and albumin/creatinine ratio; vascular damage by carotid intima-media thickness and ankle/brachial index; and cardiac damage by the Cornell voltage-duration product and left ventricular mass index.</p> <p>Results</p> <p>There was a positive correlation between ambulatory, but not clinical, heart rate and its standard deviation with glomerular filtration rate, and a negative correlation with carotid intima-media thickness, and night/day ratio of systolic and diastolic blood pressure. There was no correlation with albumin/creatinine ratio, ankle/brachial index, Cornell voltage-duration product or left ventricular mass index. In the multiple linear regression analysis, after adjusting for age, the association of glomerular filtration rate and intima-media thickness with ambulatory heart rate and its standard deviation was lost. According to the logistic regression analysis, the predictors of any target organ damage were age (OR = 1.034 and 1.033) and night/day systolic blood pressure ratio (OR = 1.425 and 1.512). Neither 24 HR nor 24 HRV reached statistical significance.</p> <p>Conclusions</p> <p>High ambulatory heart rate and its variability, but not clinical HR, are associated with decreased carotid intima-media thickness and a higher glomerular filtration rate, although this is lost after adjusting for age.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01325064">NCT01325064</a></p

    Database of spatial distribution of non indigenous species in Spanish marine waters

    Get PDF
    Research in marine Spanish waters are focused on several actions to achieve an effectively management on protected areas, with the active participation of the stakeholders and research as basic tools for decision-making. Among these actions, there is one about the knowledge and control on NIS. One of its objectives is the creation of NIS factsheets, which are going to be added to the National Marine Biodiversity Geographical System (GIS) providing complementary information about taxonomic classification, common names, taxonomic synonyms, species illustrations, identification morphological characters, habitat in the native and introduced regions, biological and ecological traits, GenBank DNA sequences, world distribution, first record and evolution in the introduced areas, likely pathways of introduction, effects in the habitats and interaction with native species, and potential management measures to apply. The database will also provide data for (1) the European online platforms, (2) the environmental assessment for the Descriptor 2 (D2-NIS) of the EU Marine Strategy Framework Directive (MSFD), as well as (3) supporting decisions made by stakeholders. It is the result of extensive collaboration among scientist, manager’s and citizen science in the Spanish North-Atlantic, South-Atlantic, Gibraltar Strait-Alboran, Levantine-Balearic and Canary Islands marine divisions, providing an updated overview of the spatial distribution of relevant extended and invasive NIS of recent and established NIS introduced by maritime transport and aquaculture pathways, as well as on cryptogenic or native species in expansion due to the climatic water warming trend
    corecore