Astrochemical relevance of VUV ionization of large PAH cations.

CONTEXT: As a part of interstellar dust, polycyclic aromatic hydrocarbons (PAHs) are processed by the interaction with vacuum ultra-violet (VUV) photons that are emitted by hot young stars. This interaction leads to the emission of the well-known aromatic infrared bands but also of electrons, which can significantly contribute to the heating of the interstellar gas. AIMS: Our aim is to investigate the impact of molecular size on the photoionization properties of cationic PAHs. METHODS: Trapped PAH cations of sizes between 30 and 48 carbon atoms were submitted to VUV photons in the range of 9 to 20 eV from the DESIRS beamline at the synchrotron SOLEIL. All resulting photoproducts including dications and fragment cations were mass-analyzed and recorded as a function of photon energy. RESULTS: Photoionization is found to be predominant over dissociation at all energies, which differs from an earlier study on smaller PAHs. The photoionization branching ratio reaches 0.98 at 20 eV for the largest studied PAH. The photoionization threshold is observed to be between 9.1 and 10.2 eV, in agreement with the evolution of the ionization potential with size. Ionization cross sections were indirectly obtained and photoionization yields extracted from their ratio with theoretical photoabsorption cross sections, which were calculated using time-dependent density functional theory. An analytical function was derived to calculate this yield for a given molecular size. CONCLUSIONS: Large PAH cations could be efficiently ionized in H i regions and provide a contribution to the heating of the gas by photoelectric effect. Also, at the border of or in H ii regions, PAHs could be exposed to photons of energy higher than 13.6 eV. Our work provides recipes to be used in astronomical models to quantify these points.

Overwhelming genetic heterogeneity and exhausting molecular diagnostic process in chronic and progressive ataxias: facing it up with an algorithm, a gene, a panel at a time.

Ataxias are one of the most frequent complaints in Neurogenetics units worldwide. Currently, more than 50 subtypes of spinocerebellar ataxias and more than 60 recessive ataxias are recognized. We conducted an 11-year prospective, observational, analytical study in order to estimate the frequency of pediatric and adult genetic ataxias in Argentina, to describe the phenotypes of this cohort and evaluate the diagnostic yield of the algorithm used in our unit. We included 334 ataxic patients. Our diagnostic approach was successful in one-third of the cohort. A final molecular diagnosis was reached in 113 subjects. This rate is significantly higher in the subgroup of patients with a positive family history, where the diagnostic yield increased to 55%. The most prevalent dominant and recessive ataxias in Argentina were SCA-2 (36% of dominant ataxias) and FA (62% of recessive ataxias), respectively. Next generation sequencing-based assays were diagnostic in the 65% of the patients requiring these tests. These results provide relevant epidemiological information, bringing a comprehensive knowledge of the most prevalent subtypes of genetic ataxias and their phenotypes in our territory and laying the groundwork for rationally implementing genetic diagnostic programs for these disorders in our country.

Control of the mobilization of arsenic and other natural pollutants in groundwater by calcium carbonate concretions in the Pampean Aquifer, southeast of the Buenos Aires province, Argentina.

The water supply for human consumption in the Chaco-Pampean region in Argentina is restricted by the low quality of groundwater due to elevated concentrations of arsenic and other trace elements. Previous studies indicated a complex concurrence of factors and processes that are believed responsible to control the distribution of arsenic in groundwater. For a better understanding of the origin of trace elements in the Pampean aquifer, flow-through experiments with loess and calcrete samples representative of the sediments that constitute the aquifer were carried out in continuous flow reactors. The aqueous solutions were collected and the concentrations of SiO2(aq), Ca2+, SO42-, Na+, Cl-, F- and trace elements (Ba, Sr, V, and As) were measured by inductively coupled plasma atomic emission spectroscopy (ICP-AES), high performance liquid chromatography (HPLC) and capillary electrophoresis. The experiments showed differences in the release rate of elements to the solution according to the type of sediment. The highest concentrations of V, Ba, and As were measured in experiments conducted with loess, and these elements were released quickly to the solution in the first minute of the test. In the case of loess, V and As are suggested to be adsorbed on the solid particles surface. Conversely, the experiments conducted with calcrete showed a lower but continuous release of those elements. This last result may indicate that the trace elements were coprecipitated in the calcite. In addition, it was demonstrated that F did not come from the dissolution of minerals such as fluorapatite, but both desorption from solid surface and dissolution from calcite minerals account for the release of F. This study support that both dissolution and adsorption-desorption processes can control the mobility of trace elements, with an emphasis on the role of calcrete in the retention and the mobilization of trace elements in the Pampean aquifer.

Microwave-induced covalent functionalization of few-layer graphene with arynes under solvent-free conditions.

A non-conventional modification of exfoliated few-layer graphene (FLG) with different arynes under microwave (MW) irradiation and solvent-free conditions is reported. The described approach allows reaching fast, efficient and mild covalent functionalization of FLG.

Invasive rainbow trout Oncorhynchus mykiss preying on the endangered naked characin Gymnocharacinus bergii at its thermal limits.

The expansion of the invasive rainbow trout Oncorhynchus mykiss into the thermal headwaters of Valcheta Stream (Patagonia, Argentina) and new predation records on the endangered endemic naked characin Gymnocharacinus bergii are presented here. These findings are discussed in relation to the contemporary evolution and thermal refuges hypothesis. This study has immediate implications for the conservation of G. bergii.

Colonic content in health and its relation to functional gut symptoms.

BACKGROUND: Gut content may be determinant in the generation of digestive symptoms, particularly in patients with impaired gut function and hypersensitivity. Since the relation of intraluminal gas to symptoms is only partial, we hypothesized that non-gaseous component may play a decisive role. METHODS: Abdominal computed tomography scans were evaluated in healthy subjects during fasting and after a meal (n = 15) and in patients with functional gut disorders during basal conditions (when they were feeling well) and during an episode of abdominal distension (n = 15). Colonic content and distribution were measured by an original analysis program. KEY RESULTS: In healthy subjects both gaseous (87 ± 24 mL) and non-gaseous colonic content (714 ± 34 mL) were uniformly distributed along the colon. In the early postprandial period gas volume increased (by 46 ± 23 mL), but non-gaseous content did not, although a partial caudad displacement from the descending to the pelvic colon was observed. No differences in colonic content were detected between patients and healthy subjects. Symptoms were associated with discrete increments in gas volume. However, no consistent differences in non-gaseous content were detected in patients between asymptomatic periods and during episodes of abdominal distension. CONCLUSIONS & INFERENCES: In patients with functional gut disorders, abdominal distension is not related to changes in non-gaseous colonic content. Hence, other factors, such as intestinal hypersensitivity and poor tolerance of small increases in luminal gas may be involved.

Intestinal gas content and distribution in health and in patients with functional gut symptoms.

BACKGROUND: The precise relation of intestinal gas to symptoms, particularly abdominal bloating and distension remains incompletely elucidated. Our aim was to define the normal values of intestinal gas volume and distribution and to identify abnormalities in relation to functional-type symptoms. METHODS: Abdominal computed tomography scans were evaluated in healthy subjects (n = 37) and in patients in three conditions: basal (when they were feeling well; n = 88), during an episode of abdominal distension (n = 82) and after a challenge diet (n = 24). Intestinal gas content and distribution were measured by an original analysis program. Identification of patients outside the normal range was performed by machine learning techniques (one-class classifier). Results are expressed as median (IQR) or mean ± SE, as appropriate. KEY RESULTS: In healthy subjects the gut contained 95 (71, 141) mL gas distributed along the entire lumen. No differences were detected between patients studied under asymptomatic basal conditions and healthy subjects. However, either during a spontaneous bloating episode or once challenged with a flatulogenic diet, luminal gas was found to be increased and/or abnormally distributed in about one-fourth of the patients. These patients detected outside the normal range by the classifier exhibited a significantly greater number of abnormal features than those within the normal range (3.7 ± 0.4 vs 0.4 ± 0.1; p < 0.001). CONCLUSIONS & INFERENCES: The analysis of a large cohort of subjects using original techniques provides unique and heretofore unavailable information on the volume and distribution of intestinal gas in normal conditions and in relation to functional gastrointestinal symptoms.

Comparación de la medición de 25 hidroxivitamina D por tres metodologías en pacientes sin y con suplementación de ergocalciferol, colecalciferol o ambos / Comparison of Three Methods for 25 Hydroxyvitamin D Measurement in Patients with No Supplementation or Supplemented with Ergocalciferol, Cholecalciferol or Both

Introducción: Para la determinación de 25 hidroxivitamina D, (25OHD) existen varias opciones metodológicas. La falta de estandarización entre las mismas puede arrojar resultados disímiles que podría acentuarse en el caso de pacientes suplementados con distintas formas de la vitamina D. Objetivo: comparar tres metodologías para la cuantificación de 25OHD y evaluar los resultados de 25OHD de sujetos sin tratar con los que reciben ergocalciferol (D2), colecalciferol (D3), o ambos. Materiales y métodos: Se analizaron 82 muestras por QLIA de Abbott Diagnostics (Architect i1000), EQLIA de Roche Diagnostics (Cobas 601) y RIA DiaSorin. Las muestras se distribuyeron en cuatro grupos: G1: sin tratamiento previo; G2: tratados con D2; G3: tratados con D3 y G4: tratados con D2 + D3. Resultados: En el total de las muestras se observó una diferencia significativa entre las medias de 25OHD evaluadas por los tres métodos (F: 14,80, p < 0,0001), siendo similares entre RIA y EQLIA, pero menores con QLIA (p < 0,05). En los cuatro grupos estudiados las medias con RIA y EQLIA fueron comparables en presencia o no de tratamiento. En G2 se observó una tendencia significativa a niveles más bajos con QLIA, respecto de los otros dos métodos (p = 0,0003), y en G4 también (p < 0,02). En G3 dicha diferencia, aunque significativa (p < 0,05), fue menos marcada. En los gráficos de diferencias, Bland y Altman, QLIA subestimó las concentraciones medidas en comparación con EQLIA, ? media de RIA: - 5,69 a - 14 ng/mL). Esto no se visualizó en la comparación de EQLIA y RIA (?: - 3,45 a 0,47 ng/mL). Conclusiones: Existen diferencias metodológicas en el diseño y especificidad de los inmunoensayos que reconocen en distinta proporción la 25OHD y sus metabolitos. Se podría clasificar de manera diferente la suficiencia o insuficiencia de vit D, dependiendo de la metodología utilizada. Los resultados sugieren que RIA y EQLIA arrojan mediciones comparables en pacientes sin tratamiento, tratados con vitamina D2, D3 o ambas. Rev Argent Endocrinol Metab 51:15-24, 2014 Los autores declaran no poseer conflictos de interés.

Introduction: There are several methodological options for 25 hydroxyvitamin D (25OHD) measurement. The lack of standardization across methods can lead to discrepant results, which could be accentuated in the case of patients supplemented with different forms of vitamin D. Objective: To compare three methods for 25OHD quantification and to compare the 25OHD results from untreated subjects with those obtained from subjects receiving ergocalciferol (D2), cholecalciferol (D3), or both. Materials and Methods: We analyzed 82 samples by QLIA of Abbott Diagnostics (Architect i1000), EQLIA Roche Diagnostics (Cobas 601) and RIA DiaSorin. Samples were divided into four groups: G1: untreated; G2: treated with D2, G3 treated with D3 and G4: treated with D2 + D3. Results: Considering all samples, there was a significant difference between mean 25OHD results obtained by the three methods (F: 14.80, p < 0.0001), being similar with RIA and EQLIA but lower with QLIA (p < 0.05). In the four groups studied, RIA and EQLIA results were similar in the presence or absence of treatment. In G2, there was a significant trend to lower levels with QLIA, compared to the other two methods (p = 0.0003), and the same trend was observed in G4 (p < 0.02). This difference in G3, albeit significant (p < 0.05), was less marked. Bland and Altman showed that QLIA underestimated the measured concentrations compared with EQLIA, average ? RIA: - 5.69 to - 14 ng/mL). This was not observed when comparing EQLIA vs. RIA (?: - 3.45 to 0.47 ng/mL). Conclusions: There are methodological differences in the design and specificity of immunoassays, which recognize 25OHD and its metabolites in different proportions. Therefore, patients might be classified as 25OHD sufficient or insufficient depending on the methodology used. Results suggest that RIA and EQLIA measurements are comparable in untreated patients and in patients treated with vitamin D2, D3 or both. Rev Argent Endocrinol Metab 51:15-24, 2014 No financial conflicts of interest exist.

Estabilidad cardiovascular en la microcirugía laríngea y recuperación postoperatoria precoz: comparación entre remifentanilo-sevoflurano vs. remifentanilo-propofol / Cardiovascular and emergence characteristics between sevofluraneremifentanil and propofol-remifentanil in microlaryngeal surgery

Introducción: La microcirugía laríngea es un proceso de corta duración que se asocia con un importante estímulo adrenérgico y frecuentemente realizada en cirugía de día. Diferentes técnicas anestésicas han sido empleadas para el control hemodinámico. Sin embargo, ningún estudio previo ha comparado la eficacia de la combinación sevoflurano y remifentanilo frente a propofol y remifentanilo en el control de la respuesta hemodinámica y parámetros de recuperación. Material y métodos: 37 pacientes ASA I-III con edades comprendidas entre 23-77 años y programados para microcirugía laríngea fueron incluidos en el estudio. Los pacientes fueron randomizados en dos grupos: grupo S-R (sevoflurano y remifentanilo); grupo P-R (propofol y remifentanilo). La infusión de remifentanilo se ajustó para mantener los valores hemodinámicos alrededor de un 20 % de los valores basales (dosis de 0,2 a 0,6 µg/kg/min). Se registraron los parámetros hemodinámicos cada 3 minutos desde la inducción y durante la inserción del laringoscopio rígido. Se compararon los tiempos de extubación, de orientación y de dolor postoperatorio entre ambos grupos. Resultados: No hubo diferencias entre ambos grupos en los parámetros basales. No hubo diferencias entre ambos grupos en la evolución de los valores hemodinámicos tras la inducción y durante la inserción (..) (AU)

Introduction: Laryngeal microsurgery is a short procedure associated with a huge adrenergic response. Different anaesthetics techniques and drugs have been used to try blunting these haemodynamic changes. No previous investigation has directly compared the combination of sevoflurane and remifentanil with that propofol and remifentanil in laryngeal microsurgery. We aimed to compare the haemodynamic responses and emergence characteristics between this two anaesthetic combinations. Material and methods: 37 patients, ASA status I-III, age 23-77 years, scheduled for elective laryngeal microsurgery were included in the study. They were randomly allocated in two groups: Group S-R (sevoflurane-remifentanil) and group P-R (propofol-remifentanil). Remifentanil infusion was adjusted to maintain haemodynamic values around 20 % of baseline. (From 0.2-0.6 µg.kg-1.min-1). Haemodynamic data were measured every 3 minutes from induction and during insertion of the operating laryngoscope. Extubation times, orientation and pain after surgery were recorded. Results: There were no significant differences during baseline. The haemodynamic parameters were similar between the two groups at induction and during insertion of the operating laryngoscope. Thee were no differences in remifentanil requirements between both groups, and the extubation time was similar. More patients had an Aldrete score of 10 at five minutes after extubation in SR group vs. PR group (100 vs. 67 %, p = 0.018). In PACU a higher (..) (AU)

Mechanisms of abdominal distension in severe intestinal dysmotility: abdomino-thoracic response to gut retention.

BACKGROUND: We previously showed that abdominal distension in patients with functional gut disorders is due to a paradoxical diaphragmatic contraction without major increment in intraabdominal volume. Our aim was to characterize the pattern of gas retention and the abdomino-thoracic mechanics associated with abdominal distension in patients with intestinal dysmotility. METHODS: In 15 patients with manometrically proven intestinal dysmotility, two abdominal CT scans were performed: one during basal conditions and other during an episode of severe abdominal distension. In 15 gender- and age-matched healthy controls, a basal scan was performed. KEY RESULTS: In basal conditions, patients exhibited more abdominal gas than healthy subjects, particularly in the small bowel, and the volume significantly increased during an episode of distension. During episodes of abdominal distension, the increase in abdominal content was associated with increased girth and antero-posterior abdominal diameter, as well as a cephalic displacement of the diaphragm, which reduced the height of the lung. The consequent reduction in the air volume of the lung was attenuated by an increase in the antero-posterior diameter of the chest. CONCLUSIONS & INFERENCES: Abdominal distension in patients with severe intestinal dysfunction is related to marked pooling of gut contents, particularly in the small bowel. This increase in content is accommodated within the abdominal cavity by a global and coordinated abdomino-phreno-thoracic response, involving an accommodative ascent of the diaphragm and a compensatory expansion of the chest wall.

Controlled lateral packing of insulin monolayers influences neuron polarization in solid-supported cultures.

Neurons are highly polarized cells, composed of one axon and several branching dendrites. One important issue in neurobiology is to understand the molecular factors that determine the neuron to develop polarized structures. A particularly early event, in neurons still lacking a discernible axon, is the segregation of IGF-1 (Insulin like Growth Factor-1) receptors in one neurite. This receptor can be activated by insulin in bulk, but, it is not known if changes of insulin organization as a monomolecular film may affect neuron polarization. To this end, in this work we developed solid-supported Langmuir-Blodgett films of insulin with different surface packing density. Hyppocampal pyramidal neurons, in early stage of differentiation, were cultured onto those substrates and polarization was studied after 24 h by confocal microscopy. Also we used surface reflection interference contrast microscopy and confocal microscopy to study attachment patterns and morphology of growth cones. We observed that insulin films packed at 14 mN/m induced polarization in a similar manner to high insulin concentration in bulk, but insulin packed at 44 mN/m did not induce polarization. Our results provide novel evidence that the neuron polarization through IGF-1 receptor activation can be selectively modulated by the lateral packing of insulin organized as a monomolecular surface for cell growth.

Use of a prosthetic mesh to prevent parastomal hernia during laparoscopic abdominoperineal resection: a randomized controlled trial.

PURPOSE: Prevention of parastomal hernia represents an important aim when a permanent stoma is necessary. The objective of this work is to assess whether implantation of a prophylactic prosthetic mesh during laparoscopic abdominoperineal resection contributed to reduce the incidence of parastomal hernia. METHODS: Rectal cancer patients undergoing elective laparoscopic abdominoperineal resection with permanent colostomy were randomized to placement of a large-pore lightweight mesh in the intraperitoneal/onlay position by the laparoscopic approach (study group) or to the control group (no mesh). Parastomal hernia was defined radiologically by a CT scan performed after 12 months of surgery. The usefulness of subcutaneous fat thickness measured by CT to discriminate patients at risk of parastomal hernia was assessed by ROC curve analysis. RESULTS: Thirty-six patients were randomized, 19 to the mesh group and 17 to the control group. Parastomal hernia was detected in 50 % of patients in the mesh group and in 93.8 % of patients in the control group (P = 0.008). The AUC for thickness of the subcutaneous abdominal was 0.819 (P = 0.004) and the optimal threshold 23 mm. Subcutaneous fat thickness ≥23 mm was a significant predictor of parastomal hernia (odds ratio 15.7, P = 0.010), whereas insertion of a mesh was a protective factor (odds ratio 0.06, P = 0.031). CONCLUSIONS: Use of prophylactic large-pore lightweight mesh in the intraperitoneal/onlay position by a purely laparoscopic approach reduced the incidence of parastomal hernia formation. Subcutaneous fat thickness ≥23 mm measured by CT was an independent predictor of parastomal hernia.

Predictive value of small ulcers in the evolution of acute type B intramural hematoma.

OBJECTIVE: To assess the long-term evolution and predictive factors of type B intramural hematoma (IMH). MATERIAL AND METHODS: 34 patients (33 men), mean age: 67 years (47-87) diagnosed with type B IMH by computed tomography (CT) and followed up clinically and by CT yearly. Mean follow-up was 5.9 years (2-13 years). Two evolution patterns were considered: (a) regression and (b) progression. Clinical and imaging variables were analyzed for assessing their predictor values. RESULTS: Evolution at one year was to regression in 56% and to progression in 44% of cases. There were no association among age, sex, other aortic abnormalities, presence of atherosclerotic disease or blood pressure, initial maximum aortic diameter, indexed maximum aortic diameter, IMH thickness or length, presence or absence of mediastinal hematoma and the evolution of type B IMH. Ten patients had small aortic ulcers in the acute phase. The presence of ulcers was related with progression of IMH. No differences were observed in evolution between the control at first year and the last control. CONCLUSIONS: The presence of small ulcers is a strong predictor of evolution in acute type B IMH. In addition, the regression group remains completely stable after the first year of evolution.

Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn's disease.

BACKGROUND: Cross-sectional imaging techniques, including ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI), are increasingly used for evaluation of Crohn's disease (CD). Aim To perform an assessment of the diagnostic accuracy of cross-sectional imaging techniques for diagnosis of CD, evaluation of disease extension and activity and diagnosis of complications, and to provide recommendations for their optimal use. METHODS: Relevant publications were identified by literature search and selected based on predefined quality parameters, including a prospective design, sample size and reference standard. A total of 68 publications were chosen. RESULTS: Ultrasonography is an accurate technique for diagnosis of suspected CD and for evaluation of disease activity (sensitivity 0.84, specificity 0.92), is widely available and non-invasive, but its accuracy is lower for disease proximal to the terminal ileum. MRI has a high diagnostic accuracy for the diagnosis of suspected CD and for evaluation of disease extension and activity (sensitivity 0.93, specificity 0.90), and is less dependent on the examiner and disease location compared with US. CT has a similar accuracy to MRI for assessment of disease extension and activity. The three techniques have a high accuracy for identification of fistulas, abscesses and stenosis (sensitivities and specificities >0.80), although US has false positive results for abscesses. As a result of the lack of radiation, US or MRI should be preferred over CT, particularly in young patients. CONCLUSIONS: Cross-sectional imaging techniques have a high accuracy for evaluation of suspected and established CD, reliably measure disease severity and complications; they may offer the possibility to monitor disease progression.

Faster rate of cognitive decline in essential tremor cases than controls: a prospective study.

BACKGROUND: Mild cognitive deficits have been reported in essential tremor (ET). However, these cognitive deficits have been assessed in cross-sectional rather than longitudinal analyses. OBJECTIVE: To determine whether decline in cognitive test scores occurs at a faster rate in ET cases than controls. METHODS: In a population-based study of older people (≥ 65 years) in central Spain (Neurological Disorders in Central Spain, NEDICES), non-demented ET cases and controls were followed prospectively. Participants with baseline or incident Parkinson's disease or dementia were excluded as were participants who developed incident ET. At baseline (1994-1995) and at follow-up (1997-1998), a 37-item version of the mini-mental state examination (37-MMSE) was administered. RESULTS: A total of 2319 participants (72.4 ± 5.8 years) included 135 prevalent ET cases and 2184 controls. At baseline, the mean 37-MMSE in cases was 28.8 ± 5.8 vs. 30.2 ± 4.8 in controls (P = 0.02). During the 3-year follow-up period, the 37-MMSE declined by 0.70 ± 3.2 points in cases vs. 0.11 ± 3.8 points in controls (P = 0.03). In analyses that adjusted for age, education, and other potential confounders, the case-control difference remained robust. DISCUSSION: In this population-based, prospective study of non-demented elders, baseline cognitive test scores were lower in ET cases than controls; moreover, during the 3-year follow-up period, these scores declined at a rate that was seven-times faster in ET cases. This study provides evidence that cognitive deficits in ET are not static, and they appear to be progressing at a faster rate than in elders without this disease.

DNA adsorption measured with ultra-thin film organic field effect transistors.

Organic ultra-thin film field effect transistors (FET) are operated as label-free sensors of deoxyribonucleic acid (DNA) adsorption. Linearized plasmid DNA molecules (4361 base pairs) are deposited from a solution on two monolayers thick pentacene FET. The amount of adsorbed DNA is measured by AFM and correlated to the concentration of the solution. Electrical characteristics on the dried DNA/pentacene FETs were studied as a function of DNA concentration in the solution. Shift of the pinch-off voltage across a wide range of DNA concentration, from very diluted to highly concentrated, is observed. It can be ascribed to additional positive charges in the semiconductor induced by DNA at a rate of one charge for every 200 base pairs. The sensitivity 74 ng/cm(2), corresponding to 650 ng/ml, is limited by the distribution of FET parameters upon repeated cycles, and is subjected to substantial improvement upon standardization. Our work demonstrates the possibility to develop label-free transducers suitable to operate in regimes of high molecular entanglement.

[Relationship between pulse pressure and clinical cardiovascular damage in elderly subjects of EPICARDIAN study]. / Relación entre presión de pulso y antecedente de enfermedad cardiovascular en ancianos de dos poblaciones pertenecientes al estudio EPICARDIAN.

INTRODUCTION: Arterial hypertension and aging are the main cardiovascular risk factors (CVRF) in the elderly population. Aging is associated with an increase in systolic blood pressure (SBP) levels and a decrease of diastolic blood pressure (DBP), due to increased large artery stiffness. Several epidemiological studies have demonstrated that pulse pressure (PP) is an independent risk factor, better than SBP, for overall, cardiovascular mortality, coronary heart disease and cerebrovascular, particularly in the elderly. OBJECTIVES: To determine the association of PP with clinical cardiovascular damage, in a population-based sample of Spanish elders subjects. To quantify the association between PP and the background of clinical cardiovascular damage. To determine which PP, SBP, DBP or mean arterial pressure (MAP) are better associated to the history of clinical cardiovascular damage. PATIENTS AND METHODS: The sample analyzed included individuals from the EPICARDIAN study in the areas of Lista district (Madrid) and Arévalo (Avila). The following CVRF of age, gender, hypertension, diabetes, dyslipidemia, obesity, abdominal obesity and smoking were considered. Clinical cardiovascular damage is defined as the personal background of stroke, myocardial infarction, angina pectoris and/or intermittent claudication. RESULTS: The sample included 2665 individuals, 56% women, mean age: 74 year-old; 74.3% were hypertensive, 55.6% had central obesity and 31.9% hypercholesterolemia. In the multivariate analysis, the PP was the BP parameter associated most to stroke, angina pectoris and intermittent claudication: OR, 1.015, (95% CI: 1.001-1.030), 1.029 (95% CI: 1.006-1.052) and 1.012 (95% CI: 1.002-1.023), respectively. CONCLUSIONS: In the elderly population studied, an elevated PP is the component of arterial pressure with the greatest association to the background of cardiovascular damage.

Relación entre presión de pulso y antecedente de enfermedad cardiovascular en ancianos de dos poblaciones pertenecientes al estudio EPICARDIAN / Relationship between pulse pressure and clinical cardiovascular damage in elderly subjects of EPICARDIAN study

Introducción. La hipertensión arterial y la edad son los factores de riesgo cardiovasculares (FRCV) principales en la población anciana. Con la edad existe un incremento en los niveles de presión arterial sistólica (PAS) y un descenso de la presión arterial diastólica (PAD) debido a la rigidez arterial de las grandes arterias. Numerosos estudios epidemiológicos han demostrado que la presión de pulso (PP) es un factor de riesgo independiente, mejor que la PAS, de mortalidad global, cardiovascular, enfermedad coronaria y cerebrovascular, sobre todo en población anciana. Objetivos. Determinar la asociación entre la PP con el antecedente de enfermedad cardiovascular clínica en una muestra poblacional de ancianos españoles. Determinar si la PP se asocia mejor que la PAS, PAD y presión arterial media (PAM) con el antecedente de daño cardiovascular clínico. Pacientes y métodos. Los datos empleados han sido obtenidos de una muestra del proyecto EPICARDIAN pertenecientes al barrio de Lista (Madrid) y Arévalo (Ávila). Se consideraron los siguientes FRCV: edad, sexo, hipertensión, diabetes, hipercolesterolemia, obesidad, obesidad abdominal y tabaquismo. Se definió enfermedad cardiovascular clínica a los antecedentes de accidente cerebrovascular (ACV), infarto agudo de miocardio (IAM), angina y/o claudicación intermitente. Resultados. Se estudiaron 2.665 sujetos (56% mujeres), edad media: 74 años. El 74,3% eran hipertensos, el 55,6% presentaban obesidad central y el 31,9% hipercolesterolemia. De los cuatro componentes de PA, la PP elevada fue el parámetro que más se asoció a ACV, angina y claudicación intermitente: odds ratio en el análisis multivariado de 1,015 (intervalo de confianza del 95% [IC 95%]: 1,001-1,030), 1,029 (IC 95%: 1,006-1,052) y 1,012 (IC 95%: 1,002-1,023), respectivamente. Conclusiones. En la población anciana estudiada la PP es el parámetro de la PA que muestra una mayor asociación con el antecedente de enfermedad cardiovascular (AU)

Introduction. Arterial hypertension and aging are the main cardiovascular risk factors (CVRF) in the elderly population. Aging is associated with an increase in systolic blood pressure (SBP) levels and a decrease of diastolic blood pressure (DBP), due to increased large artery stiffness. Several epidemiological studies have demonstrated that pulse pressure (PP) is an independent risk factor, better than SBP, for overall, cardiovascular mortality, coronary heart disease and cerebrovascular, particularly in the elderly. Objectives. To determine the association of PP with clinical cardiovascular damage, in a population-based sample of Spanish elders subjects. To quantify the association between PP and the background of clinical cardiovascular damage. To determine which PP, SBP, DBP or mean arterial pressure (MAP) are better associated to the history of clinical cardiovascular damage. Patients and methods. The sample analyzed included individuals from the EPICARDIAN study in the areas of Lista district (Madrid) and Arévalo (Avila). The following CVRF of age, gender, hypertension, diabetes, dyslipidemia, obesity, abdominal obesity and smoking were considered. Clinical cardiovascular damage is defined as the personal background of stroke, myocardial infarction, angina pectoris and/or intermittent claudication. Results. The sample included 2665 individuals, 56% women, mean age: 74 year-old; 74.3% were hypertensive, 55.6% had central obesity and 31.9% hypercholesterolemia. In the multivariate analysis, the PP was the BP parameter associated most to stroke, angina pectoris and intermittent claudication: OR, 1.015, (95% CI: 1.001-1.030), 1.029 (95% CI: 1.006-1.052) and 1.012 (95% CI: 1.002-1.023), respectively. Conclusions. In the elderly population studied, an elevated PP is the component of arterial pressure with the greatest association to the background of cardiovascular damage (AU)

[Behavioural disorders in Alzheimer's disease. Data from a populational study]. / Alteraciones del comportamiento en la enfermedad de Alzheimer. Datos de un estudio poblacional.

AIMS: The purpose of this work was to study the characteristics of the behavioural disorders (non-cognitive or neuropsychiatric symptoms) presented by subjects with Alzheimer's disease from a sample of the population together with their relation to the cognitive and functional impairment suffered by these patients. PATIENTS AND METHODS: NEDICES is a longitudinal populational study based on the census of neurological diseases in subjects above the age of 64. In 2001, a study was conducted of the situation of 83 subjects who had started suffering from Alzheimer's disease between 1994 and 1997. Due to death and a number of other reasons, only 32 of them could be examined. Patients were administered a structured interview with scales referring to the cognitive state, functional capacity, severity of the dementia and the presence and severity of neuropsychiatric disorders. RESULTS: All the patients studied presented some non-cognitive symptom. Apathy was the most frequent (93.8%), followed by irritability (81.1%), anxiety (75.0%), dysphoria (71.8%) and agitation-aggressiveness (56.2%). The least frequent were deliria (50.2%), altered nocturnal behaviour and aberrant motor activity (37.6%), altered appetite and eating, and hallucinations (24.9%), disinhibition (21.8%) and euphoria (21.6%). The degree of cognitive impairment and the presence of non-cognitive symptoms exerted a similar and independent effect on functional capacity. Only 56.3% of the patients were treated with some kind of anticholinesterase or psychotropic medication. CONCLUSIONS: Our census-based populational study confirmed the high prevalence rate of non-cognitive symptoms in patients with Alzheimer's disease. These data confirm the notion that these symptoms are intrinsic manifestations of the disease.

Alteraciones del comportamiento en la enfermedad de Alzheimer. Datos de un estudio poblacional / Behavioural disorders in Alzheimer's disease. Data from a populational study

Objetivo. Investigar las características de las alteraciones del comportamiento (síntomas no cognitivos o neuropsiquiátricos) que presentan los sujetos con enfermedad de Alzheimer procedentes de una muestra poblacional y su relación con el deterioro cognitivo y funcional que muestran estos pacientes. Pacientes y métodos. El NEDICES es un estudio poblacional longitudinal basado en el censo sobre enfermedades neurológicas en sujetos mayores de 64 años. En 2001 se estudió la situación de 83 sujetos que habían iniciado una enfermedad de Alzheimer entre 1994 y 1997. Sólo pudieron examinarse 32, debido a fallecimientos y a otras causas. Se realizó una entrevista estructurada con escalas referentes a la situación cognitiva, la capacidad funcional, la gravedad de la demencia y la presencia y gravedad de alteraciones neuropsiquiátricas. Resultados. Todos los pacientes estudiados presentaban algún síntoma no cognitivo. La apatía fue el más frecuente (93,8 por ciento), seguido por la irritabilidad (81,1 por ciento), la ansiedad (75,0 por ciento), la disforia (71,8 por ciento) y la agitación-agresión (56,2 por ciento). Los menos frecuentes fueron los delirios (50,2 por ciento), las alteraciones del comportamiento nocturno y la actividad motora aberrante (37,6 por ciento), las alteraciones del apetito y la alimentación y las alucinaciones (24,9 por ciento), la desinhibición (21,8 por ciento) y la euforia (21,6 por ciento). El grado del deterioro cognitivo y la presencia de síntomas no cognitivos tuvieron una influencia similar e independiente sobre la capacidad funcional. Sólo el 56,3 por ciento de los pacientes se trataban con algún tipo de medicación anticolinesterásica o psicotrópica. Conclusiones. Confirmamos en un estudio poblacional con base en el censo la alta prevalencia de síntomas no cognitivos en los pacientes con enfermedad de Alzheimer; este dato reafirma que estos síntomas son manifestaciones intrínsecas de la enfermedad. (AU)

Aims. The purpose of this work was to study the characteristics of the behavioural disorders (non-cognitive or neuropsychiatric symptoms) presented by subjects with Alzheimer’s disease from a sample of the population together with their relation to the cognitive and functional impairment suffered by these patients. Patients and methods. NEDICES is a longitudinal populational study based on the census of neurological diseases in subjects above the age of 64. In 2001, a study was conducted of the situation of 83 subjects who had started suffering from Alzheimer’s disease between 1994 and 1997. Due to death and a number of other reasons, only 32 of them could be examined. Patients were administered a structured interview with scales referring to the cognitive state, functional capacity, severity of the dementia and the presence and severity of neuropsychiatric disorders. Results. All the patients studied presented some non-cognitive symptom. Apathy was the most frequent (93.8%), followed by irritability (81.1%), anxiety (75.0%), dysphoria (71.8%) and agitation-aggressiveness (56.2%). The least frequent were deliria (50.2%), altered nocturnal behaviour and aberrant motor activity (37.6%), altered appetite and eating, and hallucinations (24.9%), disinhibition (21.8%) and euphoria (21.6%). The degree of cognitive impairment and the presence of non-cognitive symptoms exerted a similar and independent effect on functional capacity. Only 56.3% of the patients were treated with some kind of anticholinesterase or psychotropic medication. Conclusions. Our census-based populational study confirmed the high prevalence rate of non-cognitive symptoms in patients with Alzheimer’s disease. These data confirm the notion that these symptoms are intrinsic manifestations of the disease (AU)