Inhibition of corrosion on API 5L X52 pipeline steel in acid media by Tradescantia spathacea.

The concentration effect of Tradescantia spathacea (T. spathacea) as corrosion inhibitor of API 5L X52 steel in 0.5 M of H2SO4 was studied here through electrochemical and gravimetric techniques. To achieve it, samples of the material were prepared to be submitted to each of the tests. Results from electrochemical impedance spectroscopy (EIS) showed that there was an optimum concentration of the inhibitor in which is reached the maximum inhibition efficiency, displaying the best inhibition characteristics for this system with a maximum inhibition of 89% by using 400 ppm. However, the efficiency decreased until 40% when the temperature was increased to 60°C. Potentiodynamic polarization curves (PDP) revealed that some of the present compounds of T. spathacea may affect anodic and cathodic process, so it can be classified as a mix-type corrosion inhibitor for API 5L X52 in sulfuric acid. Also, this compound followed an adsorption mechanism; this can be described through a Frumkin isotherm with an adsorption standard free energy difference (ΔG°) of -56.59 kJmol-1. Metal surface was studied through scanning electron microscope, results revealed that by adding inhibitor, the metal surface is protected; also, they evidenced low damages compared with the surface with no inhibitor. Finally, Tradescantia spathacea inhibited the corrosion process with 82% efficiency.

Macronutrient Intake, Sleep Quality, Anxiety, Adherence to a Mediterranean Diet and Emotional Eating among Female Health Science Undergraduate Students.

INTRODUCTION: COVID-19 provoked a myriad of challenges for people's health, poor life satisfaction and an unhealthy diet that could be associated with serious negative health outcomes and behaviours. University is a stressful environment that is associated with unhealthy changes in the eating behaviours of students. The association between diet and mental health is complex and bidirectional, depending on the motivation to eat; emotional eaters regulate their emotions through the increased consumption of comfort foods. OBJECTIVE: The aim of this study was to compare the nutritional habits, alcohol consumption, anxiety and sleep quality of female health science college students. MATERIAL AND METHODS: A cross-sectional study of 191 female undergraduate students in Madrid was used. Their body mass index and waist hip ratio were measured. The questionnaires used included the Mediterranean Diet Adherence test, AUDIT, Emotional Eater Questionnaire, Pittsburgh Sleep Quality Index, and Food Addiction, Perceived Stress Scale and STAI questionnaires. RESULTS: We observed a high intake of protein, fat, saturated fatty acids and cholesterol. Overall, 9.5% never had breakfast, and 66.5% consciously reduced their food intake. According to Pittsburgh Sleep Quality Index, they mainly slept 6-7 h, and 82% presented with a poor sleep quality; 13.5% presented moderate-high food addiction, and 35% had moderate Mediterranean Diet Adherence score. CONCLUSION: Female students' macronutrient imbalances were noted, with a high-level protein and fat intake diet and a low proportion of carbohydrates and fibre. A high proportion of them need alcohol education and, depending on the social context, they mainly drank beer and spirits.

hTERT and IGF-1R Proteins Expression in Response to Treatment in Patients with HPV Alpha 9-Positive Cervical Cancer.

Human papillomavirus (HPV) infection is strongly associated with cervical cancer (CC). Genomic alterations caused by viral infection and subsequent dysregulation of cellular metabolism under hypoxic conditions could influence the response to treatment. We studied a possible influence of IGF-1Rb, hTERT, HIF1a, GLUT1 protein expression, HPV species presence and relevant clinical parameters on the response to treatment. In 21 patients, HPV infection and protein expression were detected using GP5+/GP6+PCR-RLB and immunohistochemistry, respectively. The worse response was associated with radiotherapy alone compared with chemoradiotherapy (CTX-RT), anemia and HIF1a expression. HPV16 type was the most frequent (57.1%) followed by HPV-58 (14.2%) and HPV-56 (9.5%). The HPV alpha 9 species was the most frequent (76.1%) followed by alpha 6 and alpha 7. IGF-1Rb (85.7%), HIF1a (61.9%), GLUT1 (52.3%), and hTERT expression [cytoplasm and nucleus (90.4%)] were detected. The MCA factorial map showed different relationships, standing out, expression of hTERT and alpha 9 species HPV, expression of hTERT and IGF-1Rb expression [Fisher's exact test (P = 0.04)]. A slight trend of association was observed between, GLUT1 and HIF1 a expression, hTERT and GLUT1 expression. A noteworthy finding was the subcellular localization of hTERT in the nucleus and cytoplasm of CC cells and its possible interaction with IGF-1R in presence of HPV alpha 9 species. Our findings suggest that the expression of HIF1a, hTERT, IGF-1Rb and GLUT1 proteins that interact with some HPV species may contribute to cervical cancer development, and the modu lation of treatment response.

Familial Mediterranean Fever in Spain: Time Trend and Spatial Distribution of the Hospitalizations.

Familial Mediterranean Fever (FMF) is a rare, hereditary, auto-inflammatory disease. The aims of this study were to explore the time trend and geographical distribution of hospitalizations in Spain from 2008 to 2015. We identified hospitalizations of FMF from the Spanish Minimum Basic Data Set at hospital discharge, using ICD-9-CM code 277.31. Age-specific and age-adjusted hospitalization rates were calculated. The time trend and the average percentage change were analyzed using Joinpoint regression. Standardized morbidity ratios were calculated and mapped by province. A total of 960 FMF-related hospitalizations (52% men) were identified across the period 2008-2015, with an increase in hospitalizations of 4.9% per year being detected (p < 0.05). The risk of hospitalization was higher than expected for the national total (SMR > 1) in 13 provinces (5 in the Mediterranean area), and lower (SMR < 1) in 14 provinces (3 in the Mediterranean area). There was an increase in hospitalizations of patients with FMF in Spain throughout the study period, with a risk of hospitalization that was higher, though not exclusively so, in provinces along the Mediterranean coast. These findings contribute to the visibility of FMF and provide useful information for health planning. Further research should take into account new population-based information, in order to continue monitoring this disease.

Efficacy of a transdiagnostic guided internet-delivered intervention for emotional, trauma and stress-related disorders in Mexican population: study protocol for a randomized controlled trial.

BACKGROUND: Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. METHODS: A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. DISCUSSION: The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. TRIAL REGISTRATION: ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.

A population-based study of mortality due to muscular dystrophies across a 36-year period in Spain.

Muscular dystrophies (MD) are a group of rare hereditary degenerative diseases. Our aim was to analyze the mortality pattern in Spain from 1981 to 2016 to assess the temporal trend and discern possible geographic differences using population-based data. Annual deaths related to MD were obtained from the National Statistics Institute with codes 359.1 of the ICD-9 (1981-1998) and G71.0 of the ICD-10 (1999-2016). Age-adjusted mortality rates were calculated and changes in mortality trends were identified. The standardized mortality ratios (SMR) and their respective 95% confidence intervals were calculated by district for 1999-2016. Smoothed SMRs and posterior probability were also assessed and then mapped to look for patterns or geographic distribution. All rates were expressed per 1,000,000 inhabitants. A total of 2,512 deaths (73.8% men) were identified. The age-adjusted mortality rates varied from 0.63 (95% CI 0.40-0.95) in 1981 to 1.51 (95% CI 1.17-1.93) in 2016. MD mortality showed a significant increase of 8.81% per year (95% CI 5.0-12.7) from 1981 to 1990, remaining stable afterwards. Areas with risk of death higher than expected for Spain as a whole were identified, not showing a specific regional pattern. In conclusion, the rising trend in MD mortality might be attributable to advanced improvements in diagnostic techniques leading to a rise in prevalence. Further research on the districts with the highest mortality would be necessary.

Mortalidad atribuida a telangiectasia hemorrágica hereditaria y variabilidad geográfica en España (1981-2016) / Mortality attributed to hereditary haemorrhagic telangiectasia and geographical variability in Spain (1981-2016)

OBJETIVO: Conocer la mortalidad directamente atribuida a la telangiectasia hemorrágica hereditaria (THH) en España, su tendencia temporal y la posible variabilidad geográfica. MÉTODO: El total de los fallecidos por THH de base poblacional se obtuvo del Instituto Nacional de Estadística, seleccionando los códigos 448.0 (CIE 9-MC, 1981-1998) y I78.0 (CIE 10, 1999-2016) como causa básica de defunción. Se calcularon las tasas de mortalidad específicas y ajustadas por edad para cada sexo, las razones de mortalidad estandarizadas (RME) por provincia y comarca, y las RME suavizadas. RESULTADOS: Se identificaron 327 fallecimientos por THH (el 49,5% eran mujeres), siendo la mortalidad más alta a los 80-84 años en los hombres (0,220 por 100.000 habitantes) y a los 75-79 años en las mujeres (0,147 por 100.000 habitantes). No se detectaron cambios temporales entre 1981 y 2016. Las provincias de Navarra, Cantabria, Guipúzcoa, Pontevedra y Las Palmas presentaron un riesgo significativamente superior con respecto a lo esperado para el total nacional, así como las comarcas de Monte Sur (Ciudad Real) y Ripollès (Girona). CONCLUSIONES: Este trabajo ha permitido identificar algunas regiones con mayor riesgo de defunción por THH, si bien se desconoce si estas diferencias se asocian a la distribución de los tipos THH1 y THH2, por lo que son necesarios estudios posteriores para profundizar en las causas de la variabilidad geográfica. Estos hallazgos complementan la información proporcionada por otros estudios y registros, además de ser útiles para la planificación sanitaria

OBJECTIVE: To identify the mortality directly attributed to hereditary haemorrhagic telangiectasia (HHT) in Spain, and to analyze its time trends and geographic variability. METHOD: Population-based deaths due to HHT were selected from the Spanish National Statistics Institute: codes 448.0 (ICD-9, 1981-1998) and I78.0 (ICD-10, 1999-2016) as the basic cause of death. Specific and age-adjusted mortality rates were calculated by sex, as well as standardized mortality ratios (SMR) by province and district, and smoothed SMR. RESULTS: We identified 327 deaths attributed to HHT (49.5% women), with the highest mortality at 80-84 years in men (0.220 per 100,000 inhabitants) and at 75-79 years in women (0.147 per 100,000 inhabitants). Age-adjusted mortality rates did not show any significant time trend between 1981 and 2016 in Spain. The provinces of Navarra, Cantabria, Guipúzcoa, Pontevedra and Las Palmas had higher than expected mortality, as well as the regions of Monte Sur (Ciudad Real) and Ripollès (Girona). CONCLUSIONS: This study has identified some regions with higher risk of death due to HHT in Spain. It is unknown whether these differences are associated with the distribution of types HHT1 and HHT2, and further studies will be necessary to know the determinants of this geographical variability. These findings are useful to complement the information provided by other studies and registries, and for health planning

[Mortality attributed to hereditary haemorrhagic telangiectasia and geographical variability in Spain (1981-2016)]. / Mortalidad atribuida a telangiectasia hemorrágica hereditaria y variabilidad geográfica en España (1981-2016).

OBJECTIVE: To identify the mortality directly attributed to hereditary haemorrhagic telangiectasia (HHT) in Spain, and to analyze its time trends and geographic variability. METHOD: Population-based deaths due to HHT were selected from the Spanish National Statistics Institute: codes 448.0 (ICD-9, 1981-1998) and I78.0 (ICD-10, 1999-2016) as the basic cause of death. Specific and age-adjusted mortality rates were calculated by sex, as well as standardized mortality ratios (SMR) by province and district, and smoothed SMR. RESULTS: We identified 327 deaths attributed to HHT (49.5% women), with the highest mortality at 80-84 years in men (0.220 per 100,000 inhabitants) and at 75-79 years in women (0.147 per 100,000 inhabitants). Age-adjusted mortality rates did not show any significant time trend between 1981 and 2016 in Spain. The provinces of Navarra, Cantabria, Guipúzcoa, Pontevedra and Las Palmas had higher than expected mortality, as well as the regions of Monte Sur (Ciudad Real) and Ripollès (Girona). CONCLUSIONS: This study has identified some regions with higher risk of death due to HHT in Spain. It is unknown whether these differences are associated with the distribution of types HHT1 and HHT2, and further studies will be necessary to know the determinants of this geographical variability. These findings are useful to complement the information provided by other studies and registries, and for health planning.

Validation of a Rubric to Evaluate Open Educational Resources for Learning.

Open Educational Resources (OERs) include different web formats, such as audio, video, images and text that can be modified, redistributed and used for learning about a specific topic, however, it became pertinent to create an OER evaluation tool with content validity. The present work gives an account of the content validation process using a 41-criteria rubric, each one with three performance levels, developed from a documentary search on relevant aspects to be included in a learning object. Six expert judges were contacted and decided whether each criterion was essential, useful but not essential or not necessary. Based on this, the Content Validity Reason (CVR) was calculated, obtaining 32 validated criteria. Among some conclusions, it can be mentioned that the validation process of contents allowed the identification of those criteria that require modifications or, if necessary, can be discarded to increase the validity of the heading in its whole.

Tetralogy of Fallot in Spain: a nationwide registry-based mortality study across 36 years.

BACKGROUND: Tetralogy of Fallot (TOF) is the most frequent cyanotic congenital heart defect. TOF mortality has fallen remarkably in recent years due to therapeutic advances. Accordingly, the aim of this study was to assess temporal and spatial variability in TOF-related mortality in Spain across the period 1981-2016, using data drawn from the nationwide population-based registry. METHODS: Annual deaths due to TOF were sourced from the Spanish National Institute of Statistics database by reference to International Classification of Diseases (ICD), 9th and 10th Revision codes, namely, ICD-9 code 745.2 (period 1981-1998) and ICD-10 code Q21.3 (period 1999-2016). Age-specific and age-adjusted mortality rates were calculated, as were standardised mortality ratios (SMRs) by province, district and municipality for the period 1999-2016. RESULTS: A total of 1035 deaths were attributed to TOF (57.78% of them were men and 42.22% were women). The age-adjusted mortality rate ranged from 0.75 per 1,000,000 inhabitants (95% confidence interval [CI]: 0-1.36) in 1981 to 0.03 per 1,000,000 (95% CI: 0.01-0.06) in 2016 for both sexes. In 2011, there was a change in the mortality trend, with a significant decrease of 49.22% per year (p < 0.001). In terms of geographical analysis, some areas with a significantly higher risk of TOF mortality were identified in the south of Spain, though no specific spatial pattern was in evidence. CONCLUSION: The decrease in TOF mortality may be related to improvements in diagnostic and treatment techniques. More studies are needed to analyse regions with a higher mortality risk, in order to improve medical planning and resource allocation, and identify risk factors and preventive measures.

Temporal and Cartographic Analyses of the Distribution within Spain of Mortality Due to Granulomatosis with Polyangiitis (1984⁻2016).

The aim is to conduct a descriptive, population-based study in order to assess temporal and spatial changes in mortality due to granulomatosis with polyangiitis (GPA) in Spain from 1984 to 2016. Mortality data were obtained from the Spanish Annual Death Registry. Deaths in which GPA was the underlying cause were selected using the 446.4 and M31.3 codes from the International Classification of Diseases, 9th and 10th revision. Annual average age at death and age-adjusted mortality rates were calculated. Geographic analysis was performed at municipality and district level. Variations in mortality according to the type of municipality (urban, agro-urban or rural), district and geographic location (degrees of latitude) were assessed using standardized mortality ratios (SMRs) and smoothed-SMRs. Over the whole period, 620 deaths due to GPA were identified. Age at death increased at an average annual rate of 0.78% over the period 1987-2016 (p < 0.05). Age-adjusted mortality rates increased by an annual average of 20.58% from 1984 to 1992, after which they fell by 1.91% a year (p < 0.05). The agro-urban category had the highest percentage (4.57%) of municipalities with a significantly higher GPA mortality rate than expected. Geographic analysis revealed four districts with a higher risk of death due to GPA, two in the North of Spain and two in the South. This population-based study revealed an increase in the age at death attributed to GPA. Age-adjusted mortality rates went up sharply until 1992, after which they started to decline until the end of the study period. Geographic differences in mortality risk were identified but further studies will be necessary to ascertain the reasons for the distribution of GPA disease.

Mortality Due to Cystic Fibrosis over a 36-Year Period in Spain: Time Trends and Geographic Variations.

The aim of this study is to analyze population-based mortality attributed to cystic fibrosis (CF) over 36 years in Spain. CF deaths were obtained from the National Statistics Institute, using codes 277.0 from the International Classification of Diseases (ICD) ninth revision (ICD9-CM) and E84 from the tenth revision (ICD10) to determine the underlying cause of death. We calculated age-specific and age-adjusted mortality rates, and time trends were assessed using joinpoint regression. The geographic analysis by district was performed by standardized mortality ratios (SMRs) and smoothed-SMRs. A total of 1002 deaths due to CF were identified (50.5% women). Age-adjusted mortality rates fell by -0.95% per year between 1981 and 2016. The average age of death from CF increased due to the annual fall in the mortality of under-25s (-3.77% males, -2.37% females) and an increase in over-75s (3.49%). We identified districts with higher than expected death risks in the south (Andalusia), the Mediterranean coast (Murcia, Valencia, Catalonia), the West (Extremadura), and the Canary Islands. In conclusion, in this study we monitored the population-based mortality attributed to CF over a long period and found geographic differences in the risk of dying from this disease. These findings complement the information provided in other studies and registries and will be useful for health planning.

Geographic Analysis of Motor Neuron Disease Mortality and Heavy Metals Released to Rivers in Spain.

The etiology of motor neuron disease (MND) is still unknown. The aims of this study were to: (1) analyze MND mortality at a fine-grained level; and (2) explore associations of MND and heavy metals released into Spanish river basins. MND deaths were extracted from the Spanish nationwide mortality registry (2007⁻2016). Standardized mortality ratios (SMRs) for MND were estimated at a municipal level. Sites that emitted quantities of heavy metals above the regulatory thresholds were obtained from the European Pollutant Release and Transfer Register database (2007⁻2015). The relative risks for non-exposed and exposed municipalities (considering a downstream 20 km river section) by type of heavy metal were analyzed using a log-linear model. SMRs were significantly higher in central and northern municipalities. SMRs were 1.14 (1.10⁻1.17) higher in areas exposed to heavy metals than in non-exposed areas: 0.95 (0.92⁻0.96). Considering the different metals, we found the following increased MND death risks in exposed areas: 20.9% higher risk for lead, 20.0% for zinc, 16.7% for arsenic, 15.7% for chromium, 15.4% for cadmium, 12.7% for copper, and 12.4% for mercury. This study provides associations between MND death risk and heavy metals in exposed municipalities. Further studies investigating heavy metal exposure are needed to progress in MND understanding.

Remisión de síndrome metabólico con cirugía bariátrica / Remission of metabolic syndrome with bariatric surgery

Resumen: OBJETIVO Determinar el alivio de comorbilidades en pacientes a los que se les practicó cirugía bariátrica en el Hospital Regional de Alta Especialidad de la Península de Yucatán. MATERIAL Y MÉTODO Estudio retrospectivo observacional efectuado de 2011 a 2014, en el que se incluyeron pacientes con índice de masa corporal ≥ 40 kg/m2o ≥ 35 kg/m2 con comorbilidades a quienes se les efectuó cirugía bariátrica. Los criterios diagnósticos de síndrome metabólico fueron los de la Federación Internacional de Diabetes válidos para población mexicana. RESULTADOS Se incluyeron 67 pacientes a los que se les hizo cirugía bariátrica (bypass gástrico en Y de Roux por laparoscopia); 79% eran mujeres, el rango de edad fue de 19-55 años con media de 36.5 ± 8.2 años. El promedio de peso antes de la cirugía fue de 119.4±20 kg. El promedio del porcentaje de pérdida de peso posoperatorio fue de 19.8, 27.9 y 34.3% a 3, 6 y 12 meses. La media del peso, índice de masa corporal, presión arterial sistólica y diastólica, colesterol total, LDL, HDL y glucosa disminuyeron significativamente (p< 0.001) un año después de la intervención quirúrgica. Los porcentajes de remisión fueron: síndrome metabólico, diabetes mellitus y col-HDL bajo: 100%, hipertensión arterial: 94.1%, hipertrigliceridemia: 60.9%. CONCLUSIÓN A 12 meses de la intervención quirúrgica, las remisiones de síndrome metabólico, diabetes mellitus y HDL bajo fueron del 100% y mayores a 60% en los otros componentes del síndrome metabólico.

Abstract: OBJECTIVE To determine the relief of comorbidities in patients undergoing bariatric surgery of metabolic syndrome in the Regional Hospital of High Specialty of the Yucatan Peninsula, Mexico. MATERIAL AND METHOD A retrospective observational study was done from 2011 to 2014 in patients with a body mass index (BMI) ≥ 40 kg/m2 or ≥ 35 kg/m2 with comorbidities undergoing bariatric surgery. The diagnostic criteria of the metabolic syndrome were those of the International Diabetes Federation applied to the Mexican population. RESULTS A total of 67 patients undergoing bariatric surgery (laparoscopic Roux-en-Y gastric bypass) were included in the study; 79% were women, the age range was 19-55 years with an average of 36.5 ± 8.2 years. The average weight before surgery was 119.4 ± 20 kg. The average percentage of postoperative weight loss was 19.8%, 27.9% and 34.3% at 3, 6 and 12 months, respectively. The mean weight, BMI, systolic and dyastolic blood pressure, total cholesterol, LDL, HDL and glucose decreased significantly (p < 0.001) one year after surgery. The percentages of remission were: metabolic syndrome, diabetes mellitus and low HDL-cholesterol: 100%, arterial hypertension: 94.1%, hypertriglyceridemia: 60.9%. CONCLUSION At twelve months, the remissions of metabolic syndrome, diabetes mellitus and low HDL were 100%, being greater than 60% in the other components of the metabolic syndrome.

Comparación del rendimiento cognitivo entre pacientes con patrones circadianos anómalos y fisiológicos de presión arterial sistémica en una comunidad rural / Comparison of cognitive performance among patients with abnormal and physiological circadian patterns of systemic blood pressure in a rural community

Resumen: ANTECEDENTES La hipertensión arterial es un proceso crónico degenerativo ampliamente estudiado y relacionado con daños a órganos blanco, entre ellos el cerebro y su función cognitiva. Actualmente se cuenta con dispositivos que realizan mediciones ambulatorias por 24 horas, lo que abre una ventana para el estudio de los patrones circadianos y sus posibles afectaciones orgánicas. OBJETIVO Comparar los resultados del rendimiento cognitivo entre pacientes con patrones circadianos anómalos y fisiológicos de presión arterial sistémica de una comunidad rural en Yucatán. MATERIAL Y MÉTODO Estudio clínico epidemiológico con diseño observacional, analítico, transversal, efectuado de enero a diciembre de 2016. Se realizaron registros de presión arterial de 24 horas a sujetos mayores de 50 años de edad sin diagnóstico previo de hipertensión arterial. Posteriormente se les aplicó una batería de pruebas neurológicas del RBANS (Repeatable Battery for the Assessment of Neuropsychological Status). RESULTADOS Se realizaron 30 registros de presión arterial; al comparar entre el rendimiento cognitivo en los grupos de patrones circadianos anómalos y fisiológicos se encontró diferencia significativa (p = 0.028) con el análisis de X2 de Pearson, mostrando mayor frecuencia de rendimiento cognitivo alto en los que tenían patrones circadianos patológicos. CONCLUSIONES Se obtuvo una relación de mejor rendimiento cognitivo a mayor descenso de la presión arterial nocturna. Esto puede explicarse por la falta de un límite establecido para diferenciar el descenso de la presión arterial media nocturna fisiológica de la patológica en la población adulta media.

Abstract: BACKGROUND Hypertension is a chronic disease widely approached and related with several organic dysfunctions, brain damage and its cognitive performance among them. Nowadays we count with dispositives that can do arterial measures in an ambulatory form for 24 hours, which opens a path to study the circadian patterns and their possible consequences. OBJECTIVE To compare the cognitive performance between patients with physiologic and pathologic arterial circadian patterns in the inhabitants of a rural community in Yucatan. MATERIAL AND METHOD A clinical epidemiologic study, with observational analytic transversal and prospective design was done from January to December 2016. There were performed ambulatory arterial records of 24 hours in patients older than 50 years without previous diagnosis of hypertension. Then the RBANS (Repeatable Battery for the Assessment of Neuropsychological Status) battery was applied to them. RESULTS There were performed 30 ambulatory arterial records. We found a significant difference (p = 0.028) with the Pearson's X2 when contrasting the cognitive performance amount the circadian physiologic and pathologic patterns. It showed a bigger frequency of higher cognitive performance amount the patients with pathologic circadian patterns. CONCLUSIONS Patients seem to have a higher cognitive performance with a higher decline in their night arterial pressure. This could be explainef by the lack of an established limit to differentiate a physiologic arterial pressure decline with the pathologic one among adults in the middle age.

A Nationwide Registry-Based Study on Mortality Due to Rare Congenital Anomalies.

This study aimed to analyse population-based mortality attributed to rare congenital anomalies (CAs) and assess the associated time trends and geographical differences in Spain. Data on CA-related deaths were sourced from annual mortality databases kept by the National Statistics Institute of Spain (1999⁻2013). Based on the ICD-10, only CAs corresponding to rare diseases definition were included in this study. Annual age-adjusted mortality rates were calculated and time trends were evaluated by joinpoint regression analysis. Geographical differences were assessed using standardised mortality ratios and cluster detection. A total of 13,660 rare-CA-related deaths (53.4% males) were identified in the study period. Annual age-adjusted mortality rates decreased by an average of -5.2% (-5.5% males, -4.8% females, p < 0.001). Geographical analysis showed a higher risk of rare-CA-related mortality in regions largely located in the south of the country. Despite their limitations, mortality statistics are essential and useful tools for enhancing knowledge of rare disease epidemiology and, by extension, for designing and targeting public health actions. Monitoring rare-CA-related mortality in Spain has shown a 15-year decline and geographical differences in the risk of death, all of which might well be taken into account by the health authorities in order to ensure equality and equity, and to adopt appropriate preventive measures.

Mortality Statistics and their Contribution to Improving the Knowledge of Rare Diseases Epidemiology: The Example of Hereditary Ataxia in Europe.

Official mortality statistics provide population-based data and serve to improve epidemiological knowledge of rare diseases (RDs), by helping with the description of the natural history of the disease. They are an important complement of registries and estimates of disease burden and costs. At the same time, they heighten both the visibility of these diseases and the interest in their study and the search for treatments that may increase survival. This chapter contains a European analysis of hereditary ataxia mortality, which considers the time trend in different countries and the geographical variability in risk of death. Despite the limitations of applying this data source to RDs, mortality statistics share criteria which facilitate international comparisons and are of great utility for obtaining sufficiently uniform and robust time series for analysis of low-prevalence diseases.

ACTN3 genotype influences exercise-induced muscle damage during a marathon competition.

PURPOSE: Exercise-induced muscle damage has been identified as one of the main causes of the progressive decrease in running and muscular performance in marathoners. The aim of this investigation was to determine the influence of the ACTN3 genotype on exercise-induced muscle damage produced during a marathon. METHODS: Seventy-one experienced runners competed in a marathon race. Before and after the race, a sample of venous blood was obtained and maximal voluntary leg muscle power was measured during a countermovement jump. In the blood samples, the ACTN3 genotype (R577X) and the changes in serum creatine kinase and myoglobin concentrations were measured. Data from RX heterozygotes and XX mutant homozygotes were grouped as X allele carriers and compared to RR homozygotes. RESULTS: At the end of the race, X allele carriers presented higher serum myoglobin (774 ± 852 vs 487 ± 367 U L-1; P = 0.02) and creatine kinase concentrations (508 ± 346 vs 359 ± 170 ng mL-1; P = 0.04) than RR homozygotes. Pre-to-post-race maximal voluntary leg muscle power reduction was more pronounced in X allele carriers than RR homozygotes (-34.4 ± 16.1 vs -27.3 ± 15.4%; P = 0.05). X allele carriers self-reported higher levels of lower limb muscle pain (7 ± 2 vs 6 ± 2 cm; P = 0.02) than RR homozygotes at the end of the race. CONCLUSIONS: In comparison to RR homozygotes, X allele carriers for the R577X polymorphism of the ACTN3 gene presented higher values for typical markers of exercise-induced muscle damage during a competitive marathon. Thus, the absence of a functional α-actinin-3 produced by the X allele might induce higher levels of muscle breakdown during prolonged running events.

Monitoring Huntington's Disease Mortality across a 30-Year Period: Geographic and Temporal Patterns.

BACKGROUND: Huntington's disease (HD) is a progressive neurodegenerative condition characterized by chorea, dystonia, behavioral disturbances and cognitive decline. The aim of this study is to assess temporal and spatial changes on mortality attributable to HD over 30 years in Spain. METHODS: HD data were extracted from the nationwide mortality registry for the period 1984-2013. Annual and 5-year gender- and age-specific rates adjusted for the standard European population were calculated. Geographic analysis was performed by districts from 1999 through 2013, and then estimated standardized mortality ratios (SMRs) and smoothed SMRs. RESULTS: There were 1,556 HD-related deaths across the study period. An increasing trend in age-adjusted HD mortality was in evidence, specifically from 1994 through 1998. On a year-by-year basis, age-adjusted mortality rates increased from 0.076 per 100,000 population in 1984 to 0.157 in 2013. Geographical differences among districts were evident in specific areas and in the southwest of Spain with a significantly higher HD mortality risk. CONCLUSION: HD mortality rising trends in Spain might be attributable to improvements in diagnosis leading to a rise in prevalence. Geographical variability in HD mortality could be related to regional differences in disease prevalence, health-care disparities, or other factors which call for in-depth assessment in future studies.