Análisis comparativo del manejo de la insuficiencia cardiaca en 2medios diferentes: rural versus urbano. (Estudio ALBAPIC) / Comparative analysis of heart failure management in two different media rural versus urban. (ALBAPIC Study)

OBJETIVO: Conocer las características epidemiológicas, clínicas y terapéuticas de los pacientes con diagnóstico de IC atendidos en atención primaria de 2 zonas de salud de Albacete, Zona 5 A (características de centro urbano) y Casas Ibáñez (características de centro rural), así como destacar las principales diferencias entre ambos. MÉTODO: Estudio descriptivo y transversal, correspondiente a la primera fase del estudio ALBAPIC. Se han registrado a todos los pacientes de la zona desde el 1 de enero del 2018 hasta el 30 de junio del 2019 que cumplieran el criterio de inclusión: tener diagnóstico de IC en el programa TURRIANO (programa de consulta clínica en Atención Primaria de Castilla-La Mancha). Se registraron las características demográfico-antropométricas y clínicas, los datos analíticos, las exploraciones diagnósticas complementarias, las pautas terapéuticas y las hospitalizaciones durante 12 meses previos a la inclusión. Se realizaron una exploración física y controles electrocardiográficos y bioquímicos en la visita de inclusión. RESULTADOS: Han participado 384 pacientes diagnosticados de IC en ambas zonas de salud (161 en zona urbana y 223 en la rural). Edad media ± desviación estándar 82,24 ± 10,51 años (81,24 ± 9,59 años en zona urbana y 83,37 ± 11 años en rural, con diferencias significativas, p < 0,005. Son mujeres un 54,3% (54% en zona urbana y 54,7% rural). Tenemos una incidencia de IC del 1% en medio urbano y del 1,8% en medio rural. En relación con la prevalencia de factores de riesgo cardiovascular, tenemos que la hipertensión sobre todo y las dislipidemias son los más frecuentes, existiendo diferencias según el medio en el que viven. En el medio rural hay mayores tasas de cardiopatías (principalmente isquémicas y por valvulopatía). Los pacientes con IC tienen número alto de enfermedades crónicas concomitantes, siendo entre 4 y 6 más del 60 % de los casos en el medio urbano y entre 1 y 4 en el medio rural. Aproximadamente, un 14% tiene también una enfermedad oncológica en el medio urbano frente a un 21% en el rural. Según los datos de exploración y analítica, las principales variables se encuentran aceptablemente controladas, estando peor controlados los parámetros lipídicos en el centro rural. La media de fármacos prescritos por cada paciente fue de 6,3 en rural y 7,2 urbano. En cuanto a los tratamientos que están tomando se observa que los diuréticos y las estatinas son los más utilizados tanto en el medio rural como urbano. CONCLUSIONES: Existe un aceptable control de los factores de riesgo cardiovascular en ambos medios, existiendo diferencias en cuanto a los métodos diagnósticos y tratamientos utilizados

OBJECTIVE: To know the epidemiological, clinical and therapeutic characteristics of patients with a diagnosis of HF treated in primary care of 2 Health Areas of Albacete, Zone 5 A (characteristics of the Urban Center) and Casas Ibañez (characteristics of the Rural Center) as well as to highlight The main differences between the two. METHOD: Descriptive and cross-sectional study, corresponding to the first phase of the ALBAPIC study. All patients in the area who met the inclusion criteria have been registered: Having a diagnosis of HF in the TURRIANO program (consultation program in Primary Care of Castilla la Mancha). Demographic-anthropometric and clinical characteristics, analytical data, complementary diagnostic examinations, therapeutic guidelines and hospitalizations were recorded for 12 months prior to inclusion. A physical examination and electrocardiographic and biochemical controls were performed at the inclusion visit. RESULTS: 384 patients diagnosed with HF in both Health Zone (161 in urban areas and 223 in rural areas) have participated. Average age 82.24 ± 10.51 years (81.24 ± 9.59 years in urban areas and 83.37 ± 11 years in rural areas with significant differences P < .005, 54.3% are women (54% in urban areas and 54.7% in rural areas) We have an incidence of CI of 1% in urban areas and 1.8% in rural areas. The prevalence of CVRF has that hypertension above all and dyslipidemia are the most frequent, with differences depending on the environment in which they live. In the rural environment there are higher rates of heart disease. Patients with HF have a high number of concomitant chronic diseases, being between 4 and 6 more than 60% of cases in the urban environment and between 1 and 4 in the rural environment. Approximately 14% also have an oncological disease in the urban environment compared to 21% in the rural. According to the exploration and analytical data, the main variables are acceptably controlled, the lipid parameters in the rural center being worse controlled. The average number of drugs prescribed by each patient was 6.3 in rural and 7.2 urban. As for the treatments they are taking, it is observed that diuretics and statins. CONCLUSIONS: There is an acceptable control of cardiovascular risk factors in both media, there being differences in the diagnostic methods and treatments used

Comparative analysis of heart failure management in two different media rural versus urban. (ALBAPIC Study). / Análisis comparativo del manejo de la insuficiencia cardiaca en 2medios diferentes: rural versus urbano. (Estudio ALBAPIC).

OBJECTIVE: To know the epidemiological, clinical and therapeutic characteristics of patients with a diagnosis of HF treated in primary care of 2Health Areas of Albacete, Zone 5 A (characteristics of the Urban Center) and Casas Ibañez (characteristics of the Rural Center) as well as to highlight The main differences between the two. METHOD: Descriptive and cross-sectional study, corresponding to the first phase of the ALBAPIC study. All patients in the area who met the inclusion criteria have been registered: Having a diagnosis of HF in the TURRIANO program (consultation program in Primary Care of Castilla la Mancha). Demographic-anthropometric and clinical characteristics, analytical data, complementary diagnostic examinations, therapeutic guidelines and hospitalizations were recorded for 12 months prior to inclusion. A physical examination and electrocardiographic and biochemical controls were performed at the inclusion visit. RESULTS: 384 patients diagnosed with HF in both Health Zone (161 in urban areas and 223 in rural areas) have participated. Average age 82.24±10.51 years (81.24±9.59 years in urban areas and 83.37±11 years in rural areas with significant differences P<.005, 54.3% are women (54% in urban areas and 54.7% in rural areas) We have an incidence of CI of 1% in urban areas and 1.8% in rural areas. The prevalence of CVRF has that hypertension above all and dyslipidemia are the most frequent, with differences depending on the environment in which they live. In the rural environment there are higher rates of heart disease. Patients with HF have a high number of concomitant chronic diseases, being between 4 and 6 more than 60% of cases in the urban environment and between 1 and 4 in the rural environment. Approximately 14% also have an oncological disease in the urban environment compared to 21% in the rural. According to the exploration and analytical data, the main variables are acceptably controlled, the lipid parameters in the rural center being worse controlled. The average number of drugs prescribed by each patient was 6.3 in rural and 7.2 urban. As for the treatments they are taking, it is observed that diuretics and statins. CONCLUSIONS: There is an acceptable control of cardiovascular risk factors in both media, there being differences in the diagnostic methods and treatments used.

Aqueous humor levels of hepatocyte growth factor in retinitis pigmentosa.

PURPOSE: To determine the level of hepatocyte growth factor (HGF) in the aqueous humor of patients with retinitis pigmentosa (RP). METHODS: This was a prospective, comparative control study. Aqueous humor samples were collected from the eyes of 15 RP patients. The level of HGF was determined with a commercially available enzyme-linked immunoabsorbent assay kit. The control group was composed of aqueous samples from 15 patients about to undergo cataract surgery with no other ocular or systemic diseases. RESULTS: The concentration of HGF was markedly higher in the aqueous humor of the patients with RP than in that of the control subjects (Mann-Whitney U test, P < 0.001). The level of HGF was 958.75 +/- 271.52 (mean +/- SD) pg/mL in the eyes of the RP patients and 403.52 +/- 116.27 pg/mL in eyes of the control group. CONCLUSIONS: The concentration of HGF in aqueous humor is higher among patients with RP than in non-RP subjects. This finding provides new evidence that should be taken in account when considering HGF as a neuroprotective treatment for patients with RP.

Sialoadhesin expression in intact degenerating retinas and following transplantation.

PURPOSE: Resident microglial cells normally do not express sialoadhesin (Sn; a sialic acid-binding receptor), whereas recruited inflammatory macrophages have been shown to do so. The expression of Sn was examined in the course of photoreceptor cell degeneration and after transplantation. METHODS: Sn expression was analyzed in retinas of rd1 and rds mice. For transplantation studies, neonatal (P2) retinal cells derived from GFP mice were injected intraocularly in adult rd1 mice and control mice. Antibodies recognizing different Sn epitopes, CD11b, and MHC-II were used to identify activated microglial cells in intact retinas and 21 days after transplantation. RESULTS: In rd1 mice, a few CD11b-positive cells were observed in the outer nuclear layer in the central retina at postnatal day (P)11 and in increasing numbers between P12 to P21. In rds mice, CD11b-expressing cells were found from P16 onward. No Sn-expressing cells were observed within the rd1 or rds mouse retinas at any of the ages examined (up to P150). Specific staining was observed only in cells found in the vitreous margin of the retina and in surrounding tissues (sclera, cornea, ciliary body, choroid). After transplantation to normal and rd1 mice, a variable number of Sn-positive cells were detected within the grafts, in the graft-host interface, and in the subretinal space. CONCLUSIONS: The significant activation of microglia/macrophages observed in the various stages of degeneration in rd1 and rds mouse retinas is not accompanied by Sn expression. However, Sn-expressing cells are observed after transplantation. The occurrence of such cells could be of significance for the integration and long-term survival of retinal grafts, as the expression of Sn could facilitate other phagocytic receptors.

Aqueous humor levels of vascular endothelial growth factor in retinitis pigmentosa.

PURPOSE: To determine the level of vascular endothelial growth factor A (VEGF-A) in aqueous humors of patients with retinitis pigmentosa (RP). METHODS: A prospective, comparative control study. Aqueous humor was collected from 16 eyes of 16 patients with RP. The level of VEGF-A was determined with a commercially available enzyme-linked immunosorbent assay kit. The control group comprised 16 aqueous samples from 16 patients about to undergo cataract surgery and without any other ocular or systemic diseases. RESULTS: The concentration of VEGF-A in aqueous humor was markedly lower in patients with RP than in control subjects (Mann-Whitney U test, P < 0.001). The level of VEGF-A was 94.9 +/- 99.8 (mean +/- SD) pg/mL in eyes with RP and 336.5 +/- 116.8 pg/mL in the eyes of the control group. CONCLUSIONS: In patients with RP, the concentration of VEGF-A in aqueous humors is lower than in non-RP subjects. The lack of angiogenic actions attributed to VEGF-A may explain some of the clinical manifestations of this disease, such as narrowing and fibrotic degeneration of retinal blood vessels.

The Drosophila selenoprotein BthD is required for survival and has a role in salivary gland development.

Selenium is implicated in many diseases, including cancer, but its function at the molecular level is poorly understood. BthD is one of three selenoproteins recently identified in Drosophila. To elucidate the function of BthD and the role of selenoproteins in cellular metabolism and health, we analyzed the developmental expression profile of this protein and used inducible RNA interference (RNAi) to ablate function. We find that BthD is dynamically expressed during Drosophila development. bthD mRNA and protein are abundant in the ovaries of female flies and are deposited into the developing oocyte. Maternally contributed protein and RNA persist during early embryonic development but decay by the onset of gastrulation. At later stages of embryogenesis, BthD is expressed highly in the developing salivary gland. We generated transgenic fly lines carrying an inducible gene-silencing construct, in which an inverted bthD genomic-cDNA hybrid is under the control of the Drosophila Gal4 upstream activation sequence system. Duplex RNAi induced from this construct targeted BthD mRNA for destruction and reduced BthD protein levels. We found that loss of BthD compromised salivary gland morphogenesis and reduced animal viability.