Effect of proteinuria and glomerular filtration rate on cardiovascular risk in essential hypertension

Effect of proteinuria and glomerular filtration rate on cardiovascular risk in essential hypertension. Changes in renal function related with essential hypertension are associated with an elevated cardiovascular morbidity and mortality. Indices of altered renal function (e.g., microalbuminuria, increased serum creatinine concentrations, decrease in estimated creatinine clearance or GFR, and overt proteinuria) are independent predictors of cardiovascular morbidity and mortality. The Framingham Heart Study documented the relevance of proteinuria for cardiovascular prognosis in the community. The INSIGHT Study assessed the role of proteinuria as a risk factor in essential hypertension. The presence of proteinuria at baseline turned out to be a very potent predictor for the development of cardiovascular events and death in patients with essential hypertension and one or more associated cardiovascular risk factors. Recent data indicate that minor derangements of renal function, including proteinuria, are associated, both in the community and in the hypertensive population, with the clustering of cardiovascular risk factors observed in metabolic syndrome that promote progression of atherosclerosis. Renal function has to be routinely evaluated in every hypertensive patient, and the presence of minor alterations considered in the stratification of cardiovascular risk in hypertensive patients

Prueba de habilidades prácticas CCNA.

El siguiente informe hace referencia a la prueba de habilidades prácticas el cual corresponde a la temática del curso de profundización Cisco, dentro de la cual se revisan elementos y conceptos Enrutamiento Dinámico, OSPF de una sola área, Listas de control de acceso, DHCP y Traducción de direcciones IP para IPv4, estas se realizaron a través de la simulación de Packet Tracer.The following report refers to the practical skills test which corresponds to the topic of the Cisco deepening course, within which items and concepts Dynamic Routing, Single Area OSPF, Access control lists, DHCP and Translation are reviewed. of IP addresses for IPv4, these were made through the Packet Tracer simulation

A friendly notebook on Data Structures and Algorithms

The purpose of this document is to provide study material that can be used for independent study by the students of the subject ’Data Structures and Algorithms’. We have tried to write it in a student-friendly way that encourages students to learn as well as enjoy. The document reviews the main concepts of the subject providing clear examples to help students. Each chapter also proposes a set of exercises to reinforce students’ knowledge

Planes prediales para la adaptación frente a la variabilidad climática en Boyacá- Colombia

Este documento presenta el reporte de la implementación de la metodología de Planes Prediales de Adaptación (PPA) frente a la variabilidad climática en los municipios de Betéitiva, Busbanzá, Corrales y Tasco, en el departamento de Boyacá durante los años 2020 y 2021. Se incluye la sistematización del proceso, la metodología, los pasos y actividades realizadas, resultados y proceso de implementación. Se documenta la estructura de la intervención, la cual se basa en el documento “Manual para la formulación de planes prediales de adaptación a la variabilidad climática” (Ortega, L, & Paz-B, 2014) Adicionalmente, se presentan los resultados del proceso de implementación en campo de tres prácticas priorizadas en los PPA: Cosecha de agua lluvia, instalación de reservorios y tanques para el almacenamiento de agua lluvia, y las huertas caseras. De igual forma, se presenta el portafolio de medidas de adaptación que surgió de los PPA que está compuesto por cuatro grupos: Seguridad alimentaria, producción pecuaria, producción agrícola y sostenibilidad ambiental, y contiene las prácticas priorizadas: Reservorios y tanques, cosecha de agua lluvia, sistemas de riego, huertas caseras, abonos orgánicos, cercas vivas, reforestación, mantenimiento de reservorios, diversificación cultivos, producción forrajes, ensilaje, y diversificación pecuaria

Novedades corológicas destacables para la flora vascular de Andalucía, (sur de España) IV

39 citations of 29 collected taxa in Andalusia are presented, (6 of an indigenous nature and 23 native), of which 5 represent a novelty for the flora of Andalusia, 7 a novelty for the flora of Eastern Andalusia and 27 that represent remarkable chorological or populational innovations and of special interest.Se presentan 39 citas de 29 taxones herborizados en Andalucía (6 de carácter alóctono y 23 autóctono), de las que 5 representan novedad para la flora de Andalucía, 7 novedad para la flora de Andalucía Oriental y 27 que suponen novedades corológicas o poblacionales destacables y de especial interés

Association between high and very high albuminuria and nighttime blood pressure: Influence of diabetes and chronic kidney disease

This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes Care. The American Diabetes Association (ADA), publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes Care 39.10 (2016): 1729-1737 in print and online at http://care.diabetesjournals.orgNighttime blood pressure (BP) and albuminuria are two important and independent predictors of cardiovascularmorbidity andmortality. Here, we examined the quantitative differences in nighttime systolic BP (SBP) across albuminuria levels in patients with and without diabetes and chronic kidney disease. RESEARCH DESIGN AND METHODS A total of 16,546 patients from the Spanish Ambulatory Blood Pressure Monitoring Registry cohort (mean age 59.6 years, 54.9% men) were analyzed. Patients were classified according to estimated glomerular filtration rate (eGFR), as ≥60 or <60 mL/min/1.73 m2 (low eGFR), and urine albumin-to-creatinine ratio, as normoalbuminuria (<30 mg/g), high albuminuria (30-300 mg/g), or very high albuminuria (>300 mg/g). Office and 24-h BP were determined with standardized methods and conditions. RESULTS High albuminuria was associated with a statistically significant and clinically substantial higher nighttime SBP (6.8 mmHg higher than with normoalbuminuria, P < 0.001). This association was particularly striking at very high albuminuria among patients with diabetes and low eGFR (16.5 mmHg, P < 0.001). Generalized linear models showed that after full adjustment for demographic, lifestyles, and clinical characteristics, nighttime SBP was 4.8 mmHg higher in patients with high albuminuria than in those with normoalbuminuria (P < 0.001), and patients with very high albuminuria had a 6.1 mmHg greater nighttime SBP than those with high albuminuria (P < 0.001). These differences were 3.8 and 3.1 mmHg, respectively, among patients without diabetes, and 6.5 and 8 mmHg among patients with diabetes (P < 0.001). CONCLUSIONS Albuminuria in hypertensive patients is accompanied by quantitatively striking higher nighttime SBP, particularly in those with diabetes with very high albuminuria and low eGFRSpecific funding for this study analysis was obtained from FIS grants PI10/01011 PI11/02432, PI13/02321, PIE13/00045, PI14/01841, CP15/0129, and also from Fundación SENEFRO, Fondos FEDER, and by Cátedra UAM de Epidemiología y Control del Riesgo Cardiovascula

Implementación de un Territorio Sostenible y Adaptado al Clima (TeSAC) en Boyacá – Primeros pasos

Este documento presenta los primeros pasos para la implementación de un Territorio Sostenible y Adaptado al Clima, TeSAC, en en los municipios de Corrales, Betéitiva, Busbanzá y Tasco, en el departamento de Boyacá en Colombia durante los años 2019 a 2021. Como parte de la mplementación del TeSAC se llevaron a cabo las metodologías Servicios Integrados Participativos de Clima para la Agricultura (PICSA) ;Planes Prediales de Adaptación (PPA) y la implementación de prácticas para la adaptación al cambio climático. Se presentan en este reporte las metodologías, algunos pasos y actividades realizadas y los resultados. Adicionalmente, se presentan los resultados del proceso de implementación en campo de tres prácticas priorizadas en los PPA: Cosecha de agua lluvia, instalación de reservorios y tanques para el almacenamiento de agua lluvia, y las huertas caseras. De igual forma, se presenta el portafolio de medidas de adaptación que surgió de los PPA que está compuesto por cuatro grupos: Seguridad alimentaria, producción pecuaria, producción agrícola y sostenibilidad ambiental, y contiene las prácticas priorizadas: Reservorios y tanques, cosecha de agua lluvia, sistemas de riego, huertas caseras, abonos orgánicos, cercas vivas, reforestación, mantenimiento de reservorios, diversificación cultivos, producción forrajes, ensilaje, y diversificación pecuaria

Prescription opioid use disorder and heroin use among 12-34 year-olds in the United States from 2002 to 2014

Trend analyses of prescription opioids in the U.S. indicate use, especially use of prescription opioids stronger than morphine, has more than doubled among adults since the early 1990's (Frenk, Porter, & Paulozzi, 2015). Prescription opioids, like Oxycontin®, are effective pharmacological treatments for acute and chronic pain (Fitzcharles and Shir, 2009 ; Gallagher and Rosenthal, 2008). When used as indicated, these medications can be an important component of pain management. However, their high abuse potential presents concerns regarding their nonmedical use, which can be defined as ‘use of a prescription opioid that was not prescribed, or taken for the experience or feeling it caused’ (SAMHSA, 2014). In the United States, nonmedical use of prescription opioids (NMPO) is increasingly recognized as a serious public health problem among adults (Blanco et al., 2007; Han et al., 2015 ; Huang et al., 2006). Nonmedical prescription drug use, specifically nonmedical use of prescription opioids, is also a growing problem in other countries such as Canada (Fischer et al., 2014 ; Fischer et al., 2013) and Australia (Degenhardt et al., 2006 ; Rintoul et al., 2011)

Urinary exosomes reveal protein signatures in hypertensive patients with albuminuria

Albuminuria is an indicator of cardiovascular risk and renal damage in hypertensive individuals. Chronic renin-angiotensin system (RAS) suppression facilitates blood pressure control and prevents development of new-onset-albuminuria. A significant number of patients, however, develop albuminuria despite chronic RAS blockade, and the physiopathological mechanisms are underexplored. Urinary exosomes reflect pathological changes taking place in the kidney. The objective of this work was to examine exosomal protein alterations in hypertensive patients with albuminuria in the presence of chronic RAS suppression, to find novel clues underlying its development. Patients were followed-up for three years and were classified as: a) patients with persistent normoalbuminuria; b) patients developing de novo albuminuria; and c) patients with maintained albuminuria. Exosomal protein alterations between groups were identified by isobaric tag quantitation (iTRAQ). Confirmation was approached by target analysis (SRM). In total, 487 proteins were identified with high confidence. Specifically, 48 proteins showed an altered pattern in response to hypertension and/or albuminuria. Out of them, 21 proteins interact together in three main functional clusters: glycosaminoglycan degradation, coagulation and complement system, and oxidative stress. The identified proteins constitute potential targets for drug development and may help to define therapeutic strategies to evade albuminuria progression in hypertensive patients chronically treated.Instituto de Salud Carlos III, fondos FEDER/FSE (PI11/01401, PI13/01873, PI14/01841, IF08/3667-1, PI11-02239, PI 14/0917, PI11/02432, PI13/01746, PI14/01650, PI16/01334, PT13/0001/0013, CP09/00229, CP15/00129, CPII15/00027), Fundacion SENEFRO, Fundacion Conchita Rabago de Jimenez Diaz, and Redes Tematicas de Investigacion Cooperativa (fondos FEDER/FSE, RD12/0021/0001, RD12/0042/0071). These results are lined up with the Spanish initiative on the Human Proteome Project (SpHPP).S