Mortality, Functional Status, and Quality of Life after 5 Years of Patients Admitted to Critical Care for Spontaneous Intracerebral Hemorrhage.

BACKGROUND: The objective of this study was to assess long-term outcome in patients with spontaneous intracerebral hemorrhage admitted to the intensive care unit. METHODS: Mortality and Glasgow Outcome Scale, Barthel Index, and 5-level EQ-5D version (EQ-5D-5L) scores were analyzed in a multicenter cohort study of three Spanish hospitals (336 patients). Mortality was also analyzed in the Medical Information Mart for Intensive Care III (MIMIC-III) database. RESULTS: The median (25th percentile-75th percentile) age was 62 (50-70) years, the median Glasgow Coma Score was 7 (4-11) points, and the median Acute Physiology and Chronic Health disease Classification System II (APACHE-II) score was 21 (15-26) points. Hospital mortality was 54.17%, mortality at 90 days was 56%, mortality at 1 year was 59.2%, and mortality at 5 years was 66.4%. In the Glasgow Outcome Scale, a normal or disabled self-sufficient situation was recorded in 21.5% of patients at 6 months, in 25.5% of patients after 1 year, and in 22.1% of patients after 5 years of follow-up (4.5% missing). The Barthel Index score of survivors improved over time: 50 (25-80) points at 6 months, 70 (35-95) points at 1 year, and 90 (40-100) points at 5 years (p < 0.001). Quality of life evaluated with the EQ-5D-5L at 1 year and 5 years indicated that greater than 50% of patients had no problems or slight problems in all items (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). In the MIMIC-III study (N = 1354), hospital mortality was 31.83% and was 40.5% at 90 days and 56.2% after 5 years. CONCLUSIONS: In patients admitted to the intensive care unit with a diagnosis of nontraumatic intracerebral hemorrhage, hospital mortality up to 90 days after admission is very high. Between 90 days and 5 years after admission, mortality is not high. A large percentage of survivors presented a significant deficit in quality of life and functional status, although with progressive improvement over time. Five years after the hemorrhagic stroke, a survival of 30% was observed, with a good functional status seen in 20% of patients who had been admitted to the hospital.

Long noncoding RNA Malat1 protects against osteoporosis and bone metastasis.

MALAT1, one of the few highly conserved nuclear long noncoding RNAs (lncRNAs), is abundantly expressed in normal tissues. Previously, targeted inactivation and genetic rescue experiments identified MALAT1 as a suppressor of breast cancer lung metastasis. On the other hand, Malat1-knockout mice are viable and develop normally. On a quest to discover the fundamental roles of MALAT1 in physiological and pathological processes, we find that this lncRNA is downregulated during osteoclastogenesis in humans and mice. Remarkably, Malat1 deficiency in mice promotes osteoporosis and bone metastasis of melanoma and mammary tumor cells, which can be rescued by genetic add-back of Malat1. Mechanistically, Malat1 binds to Tead3 protein, a macrophage-osteoclast-specific Tead family member, blocking Tead3 from binding and activating Nfatc1, a master regulator of osteoclastogenesis, which results in the inhibition of Nfatc1-mediated gene transcription and osteoclast differentiation. Notably, single-cell transcriptome analysis of clinical bone samples reveals that reduced MALAT1 expression in pre-osteoclasts and osteoclasts is associated with osteoporosis and metastatic bone lesions. Altogether, these findings identify Malat1 as a lncRNA that protects against osteoporosis and bone metastasis.

Adhesión a la dieta mediterránea y conducta alimentaria en escolares españoles / Adherence to the Mediterranean diet and eating behaviour in Spanish schoolchildren

Introducción: las conductas alimentarias pueden modular o influir en la calidad de la dieta y el grado de adherencia a la dieta mediterráneade niños y adolescentes.Objetivos: investigar la asociación entre la calidad de la dieta y el comportamiento alimentario en un grupo de escolares españoles.Métodos: se trata de un estudio transversal descriptivo en una muestra de 283 escolares españoles de seis a 16 años. Cada sujeto fue evaluadomediante el cuestionario KIDMED de adherencia a la dieta mediterránea y el cuestionario Children’s Eating Behaviour Questionnaire (CEBQ) paraevaluar el comportamiento alimentario.Resultados: un 12,80 % de la muestra presentó baja adherencia a la dieta mediterránea; un 59,80 %, adherencia mejorable; y un 27,40 %,adherencia alta. Al relacionar las conductas alimentarias con la calidad dietética, los escolares con mayor disfrute por los alimentos y menosexigencia con la comida presentan el doble de adherencia a la dieta mediterránea, por un consumo de casi el doble de vegetales, frutos secoso pescado, así como menor ingesta de procesados de baja calidad (golosinas y dulces). La respuesta a la saciedad y la velocidad de ingestatambién tuvieron un papel importante en las elecciones alimentarias.Conclusiones: las conductas alimentarias pueden tener un importante papel en la calidad de la dieta de los escolares, destacando el disfrute y laaceptación o rechazo por los alimentos. Dada la naturaleza bidireccional de los efectos entre las conductas alimentarias y la calidad de la dieta, elanálisis conjunto puede ser la base de futuras investigaciones con el objetivo de un mejor abordaje nutricional desde las edades más tempranas.(AU)

Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children andadolescents.Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren.Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED question-naire for adherence to the Mediterranean diet and the Children’s Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior.Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoymentof food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables,nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played animportant role in food choices.Conclusions: eating behaviors may play an essential role in the quality of school children’s diets highlighting the enjoyment and acceptance orrejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis forfuture research with the aim of a better nutritional approach from the earliest ages.(AU)

[Adherence to the Mediterranean diet and eating behaviour in Spanish schoolchildren]. / Adhesión a la dieta mediterránea y conducta alimentaria en escolares españoles.

Introduction: Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children and adolescents. Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren. Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED questionnaire for adherence to the Mediterranean diet and the Children's Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior. Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and 27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoyment of food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables, nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played an important role in food choices. Conclusions: eating behaviors may play an essential role in the quality of school children's diets highlighting the enjoyment and acceptance or rejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis for future research with the aim of a better nutritional approach from the earliest ages.

Introducción: Introducción: las conductas alimentarias pueden modular o influir en la calidad de la dieta y el grado de adherencia a la dieta mediterránea de niños y adolescentes. Objetivos: investigar la asociación entre la calidad de la dieta y el comportamiento alimentario en un grupo de escolares españoles. Métodos: se trata de un estudio transversal descriptivo en una muestra de 283 escolares españoles de seis a 16 años. Cada sujeto fue evaluado mediante el cuestionario KIDMED de adherencia a la dieta mediterránea y el cuestionario Children's Eating Behaviour Questionnaire (CEBQ) para evaluar el comportamiento alimentario. Resultados: un 12,80 % de la muestra presentó baja adherencia a la dieta mediterránea; un 59,80 %, adherencia mejorable; y un 27,40 %, adherencia alta. Al relacionar las conductas alimentarias con la calidad dietética, los escolares con mayor disfrute por los alimentos y menos exigencia con la comida presentan el doble de adherencia a la dieta mediterránea, por un consumo de casi el doble de vegetales, frutos secos o pescado, así como menor ingesta de procesados de baja calidad (golosinas y dulces). La respuesta a la saciedad y la velocidad de ingesta también tuvieron un papel importante en las elecciones alimentarias. Conclusiones: las conductas alimentarias pueden tener un importante papel en la calidad de la dieta de los escolares, destacando el disfrute y la aceptación o rechazo por los alimentos. Dada la naturaleza bidireccional de los efectos entre las conductas alimentarias y la calidad de la dieta, el análisis conjunto puede ser la base de futuras investigaciones con el objetivo de un mejor abordaje nutricional desde las edades más tempranas.

Influence of the cellulose purification process on the properties of aerogels obtained from rice straw.

Cellulose aerogels were obtained from purified rice straw cellulose fibres (CF) by applying different extraction methods: the conventional alkaline treatment (ALK) and alternative aqueous extraction based on the ultrasound combined with reflux heating (USHT) and subcritical water extraction (SWE) (160 and 180 °C). The composition and properties of the CFs were significantly affected by the purification process. The USHT treatment was as efficient as the ALK at eliminating the silica content, but the fibres maintained a notable ratio of hemicellulose (∼16 %). The SWE treatments were not so effective at removing silica (15 %) but greatly promoted the selective extraction of hemicellulose, especially at 180 °C (3 %). The CF compositional differences affected their hydrogel formation capacity and the properties of aerogels. A higher hemicellulose content in the CF led to better-structured hydrogels with better water-holding capacity, while the aerogels exhibited a more cohesive structure with thicker walls, higher porosity (99 %) and water vapour sorption capacity, but lower liquid water retention capacity (0.2 g/g). The residual silica content also interfered with the hydrogel and aerogel formation, giving rise to less structured hydrogels and more fibrous aerogels, with lower porosity (97-98 %).

Long noncoding RNA Malat1 inhibits Tead3-Nfatc1-mediated osteoclastogenesis to suppress osteoporosis and bone metastasis.

MALAT1, one of the few highly conserved nuclear long noncoding RNAs (IncRNAs), is abundantly expressed in normal tissues. Previously, targeted inactivation and genetic rescue experiments identified MALAT1 as a suppressor of breast cancer lung metastasis. On the other hand, Malat1-knockout mice are viable and develop normally. On a quest to discover new roles of MALAT1 in physiological and pathological processes, we found that this lncRNA is downregulated during osteoclastogenesis in humans and mice. Notably, Malat1 deficiency in mice promotes osteoporosis and bone metastasis, which can be rescued by genetic add-back of Malat1. Mechanistically, Malat1 binds to Tead3 protein, a macrophage-osteoclast-specific Tead family member, blocking Tead3 from binding and activating Nfatc1, a master regulator of osteoclastogenesis, which results in the inhibition of Nfatc1-mediated gene transcription and osteoclast differentiation. Altogether, these findings identify Malat1 as a lncRNA that suppresses osteoporosis and bone metastasis.

LIFR recruits HGF-producing neutrophils to promote liver injury repair and regeneration.

The molecular links between tissue repair and tumorigenesis remain elusive. Here, we report that loss of the liver tumor suppressor Lifr in mouse hepatocytes impairs the recruitment and activity of reparative neutrophils, resulting in the inhibition of liver regeneration after partial hepatectomy or toxic injuries. On the other hand, overexpression of LIFR promotes liver repair and regeneration after injury. Interestingly, LIFR deficiency or overexpression does not affect hepatocyte proliferation ex vivo or in vitro . In response to physical or chemical damage to the liver, LIFR from hepatocytes promotes the secretion of the neutrophil chemoattractant CXCL1 (which binds CXCR2 to recruit neutrophils) and cholesterol in a STAT3-dependent manner. Cholesterol, in turn, acts on the recruited neutrophils to secrete hepatocyte growth factor (HGF) to accelerate hepatocyte proliferation and regeneration. Altogether, our findings reveal a LIFR-STAT3- CXCL1-CXCR2 axis and a LIFR-STAT3-cholesterol-HGF axis that mediate hepatic damage- induced crosstalk between hepatocytes and neutrophils to repair and regenerate the liver.

Genetic risk score for common obesity and anthropometry in Spanish schoolchildren.

IntroductionCommon or non-syndromic obesity is a complex polygenic trait conditioned by biallelic or single-base polymorphisms called SNPs (Single-Nucleotide Polymorphisms) that present an additive effect and act synergistically. Most genotype-obese phenotype association studies include body mass index (BMI) or waist-to-height ratio (WtHR), and very few introduce a broad anthropometric profile. ObjectiveTo verify whether a genetic risk score (GRS) developed from 10 SNPs is associated with the obesity phenotype assessed from anthropometric measures indicative of excess weight, adiposity and fat distribution. Material and methodsA series of 438 Spanish schoolchildren (6-16 years old) were evaluated anthropometrically (weight, height, waist circumference, skinfold thickness, BMI, WtHR, body fat percentage [%BF]). Ten SNPs were genotyped from saliva samples, generating a GRS for obesity, establishing genotype-phenotype association. ResultsSchoolchildren categorised as obese by BMI, ICT and %BF had higher GRS than their non-obese peers. The prevalence of overweight and adiposity was higher in subjects with a GRS above the median. Similarly, between 11 and 16 years of age, all anthropometric variables presented higher averages. ConclusionsGRS estimated from the 10 SNPs can be a diagnostic tool for the potential risk of obesity in Spanish schoolchildren and could be useful from the preventive perspective.

Eating Behavior and Obesity in a Sample of Spanish Schoolchildren.

From the point of view of prevention, it is convenient to explore the association between eating behavior and the obese phenotype during school and adolescent age. The aim of the present study was to identify eating behavior patterns associated with nutritional status in Spanish schoolchildren. A cross-sectional study of 283 boys and girls (aged 6 to 16 years) was carried out. The sample was evaluated anthropometrically by Body Mass Index (BMI), waist-to-height ratio (WHtR) and body fat percentage (%BF). Eating behavior was analyzed using the CEBQ "Children's Eating Behavior Questionnaire". The subscales of the CEBQ were significantly associated with BMI, WHtR and %BF. Pro-intake subscales (enjoyment of food, food responsiveness, emotional overeating, desire for drinks) were positively related to excess weight by BMI (ß = 0.812 to 0.869; p = 0.002 to <0.001), abdominal obesity (ß = 0.543-0.640; p = 0.02 to <0.009) and high adiposity (ß = 0.508 to 0.595; p = 0.037 to 0.01). Anti-intake subscales (satiety responsiveness, slowness in eating, food fussiness) were negatively related to BMI (ß = -0.661 to -0.719; p = 0.009 to 0.006) and % BF (ß = -0.17 to -0.46; p = 0.042 to p = 0.016).

Using rice straw fractions to develop reinforced, active PLA-starch bilayers for meat preservation.

Bilayers from thermoplastic corn starch (TPS) and PLA were obtained, incorporating or not rice straw (RS) valorised fractions: active extract (es) into PLA and cellulose fibres (cf) into TPS films. The films were obtained by thermoprocessing while the bilayers were obtained by thermocompression of the different monolayers (TPS-PLA, TPScf-PLA, TPS-PLAes and TPScf-PLAes). TPS conferred oxygen barrier capacity to the laminates, which was improved by the cf incorporation. The extract slightly reduced the PLA resistance but improved their oxygen barrier capacity. The tensile and barrier properties of the bilayers revealed changes in the performance of each layer associated with the interlayer compound migration. The TPScf-PLAes bags exhibited noticeable antioxidant capacity when used in meat packaging and reduced microbial counts throughout cold storage. Therefore, these bilayers have considerable potential to extend the shelf-life of meat samples, preserving their quality and safety for longer, while using RS fractions permits its valorisation.

Antioxidant starch composite films containing rice straw extract and cellulose fibres.

Antioxidant aqueous rice straw (RS) extract was obtained by a combined ultrasound-reflux heating process and cellulose fibres (CF) were purified by bleaching the extraction residue. Both fractions were incorporated into corn starch to obtain films by melt blending and compression moulding. CF (at 3 % wt.) greatly increased the elastic modulus (by 200 %) and tensile strength at break (by 100 %) while reducing film stretchability. Films with CF exhibited the greatest barrier capacity to water vapour and oxygen. The incorporation of RS extract (at 4, 6 and 8 % wt.) plasticised the film's amorphous phase, but also reinforced the matrix to a certain extent. The active films showed a high degree of UV absorption and DPPH radical scavenging capacity. Mono-dose sunflower oil bags were obtained with films with CF and RS extracts that, to a great extent, prevent oil oxidation in an accelerated oxidative test under UV radiation throughout 50 days.

A targetable LIFR-NF-κB-LCN2 axis controls liver tumorigenesis and vulnerability to ferroptosis.

The growing knowledge of ferroptosis has suggested the role and therapeutic potential of ferroptosis in cancer, but has not been translated into effective therapy. Liver cancer, primarily hepatocellular carcinoma (HCC), is highly lethal with limited treatment options. LIFR is frequently downregulated in HCC. Here, by studying hepatocyte-specific and inducible Lifr-knockout mice, we show that loss of Lifr promotes liver tumorigenesis and confers resistance to drug-induced ferroptosis. Mechanistically, loss of LIFR activates NF-κB signaling through SHP1, leading to upregulation of the iron-sequestering cytokine LCN2, which depletes iron and renders insensitivity to ferroptosis inducers. Notably, an LCN2-neutralizing antibody enhances the ferroptosis-inducing and anticancer effects of sorafenib on HCC patient-derived xenograft tumors with low LIFR expression and high LCN2 expression. Thus, anti-LCN2 therapy is a promising way to improve liver cancer treatment by targeting ferroptosis.

Glucocorticoid receptor regulates PD-L1 and MHC-I in pancreatic cancer cells to promote immune evasion and immunotherapy resistance.

Despite unprecedented responses of some cancers to immune checkpoint blockade (ICB) therapies, the application of checkpoint inhibitors in pancreatic cancer has been unsuccessful. Glucocorticoids and glucocorticoid receptor (GR) signaling are long thought to suppress immunity by acting on immune cells. Here we demonstrate a previously undescribed tumor cell-intrinsic role for GR in activating PD-L1 expression and repressing the major histocompatibility complex class I (MHC-I) expression in pancreatic ductal adenocarcinoma (PDAC) cells through transcriptional regulation. In mouse models of PDAC, either tumor cell-specific depletion or pharmacologic inhibition of GR leads to PD-L1 downregulation and MHC-I upregulation in tumor cells, which in turn promotes the infiltration and activity of cytotoxic T cells, enhances anti-tumor immunity, and overcomes resistance to ICB therapy. In patients with PDAC, GR expression correlates with high PD-L1 expression, low MHC-I expression, and poor survival. Our results reveal GR signaling in cancer cells as a tumor-intrinsic mechanism of immunosuppression and suggest that therapeutic targeting of GR is a promising way to sensitize pancreatic cancer to immunotherapy.

Reliability and Validity of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) in Persons with Arterial Hypertension.

OBJECTIVE: To evaluate the reliability and validity of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) in persons with arterial hypertension undergoing pharmacological treatment, along with its convergent validity with degree of control of blood pressure levels, therapeutic adherence, and tolerability of antihypertensive drugs. METHODS: Observational cross-sectional study conducted on a sample of 484 persons. Treatment satisfaction was evaluated with the SATMED-Q, an instrument consisting of 17 items with six dimensions. Other variables were blood pressure, antihypertensive drugs, adverse effects, therapeutic adherence, and participants' characteristics. RESULTS: Cronbach's alpha was 0.916. Factor analysis revealed six factors that could account for 89.97% of total variance. The test-retest reliability analysis yielded an intraclass correlation coefficient of 0.910 (95% CI = 0.806-0.959). In a possible range of 0 through 100 points, participant satisfaction with treatment ranged from 38.2 to 100 (mean 79.9 (SD = 12.9; 95% CI = 78.8-81.0); median 80.9). SATMED-Q scores were higher among persons who reported experiencing no adverse effects (82.5 ± 11.6 SD vs. 68.7 ± 11.9 SD; p < 0.001). Satisfaction levels were significantly lower among subjects not complying with the treatment (73.2 ± 12.9 vs. 82.1 ± 12.1; p < 0.001), and significantly higher among those presenting with controlled blood pressure levels (82.1 ± 12.1 SD vs. 77.5 ± 13.3 SD; p < 0.001). CONCLUSIONS: The SATMED-Q showed high internal consistency and good stability in the reliability analysis. It is an appropriate instrument for evaluating satisfaction with antihypertensive treatment, both in routine clinical practice and in community pharmacy or clinical research settings.

Osteosarcopenia: del envejecimiento de la unidad óseo-muscular a la enfermedad / Osteosarcopenia: from muscle-bone unit aging to disease

Aunque la masa muscular y la ósea tienen igual origen embriológico, desarrollo y función, por lo que constituyen la unidad hueso-músculo, las enfermedades asociadas al envejecimiento de esta unidad se consideran de manera independiente. Sin embargo, en los últimos años se evidencia el efecto aditivo nocivo que genera la sarcopenia y la osteopenia/osteoporosis en la calidad de vida y la salud del adulto mayor y aparece el concepto de osteosarcopenia. Entre los adultos mayores se reporta la disminución progresiva de la masa y la fuerza musculares, y las caídas accidentales en el hogar (probables por fragilidad) que están entre las principales causas de muerte, lo que sugiere que un grupo de estos adultos mayores pudieran tener osteosarcopenia. Por ello se requiere desarrollar capacidades para su prevención. Se realiza una revisión narrativa para actualizar aspectos del envejecimiento de la unidad óseo-muscular, la importancia de la osteosarcopenia, sus criterios diagnósticos y opciones terapéuticas. Se estudiaron artículos completos, en idioma inglés y español, obtenidos de las bases de datos Pubmed, Scielo Regional y Google Scholar. La infiltración grasa de la unidad músculo-hueso es el evento más importante del envejecimiento, pero no existe uniformidad en el diagnóstico de la sarcopenia. Hasta el presente un aporte proteico de calcio y vitamina D, unido a ejercicios de fuerza, son las principales opciones terapéuticas. No se dispone de fármacos que actúen al unísono sobre las dos entidades que conforman la osteosarcopenia(AU)

Muscle and bone mass have the same embryological origin, development and function constituting the bone-muscle unit. However, the diseases associated with aging of this unit are considered independently. In recent years, the additive effect of sarcopenia and osteopenia / osteoporosis on the quality of life and health of the elderly has been revealed, and thus the concept of Osteosarcopenia emerged. In older adults, reporting a progressive decrease in muscle mass and strength. Along with the above, accidental falls at home (by fragility?) are among its main causes of death, suggesting that a group of these aging people may have undiagnosed Osteosarcopenia. To develop capacities for its prevention the objective of this narrative revision are update aspects related to the aging of muscle. Bone unit and diagnostic criteria and therapeutic options for Osteosarcopenia. Exhaustive review of complete articles, in English and Spanish, downloaded manually and published between 2010 and 2019, obtained from the Pubmed, Scielo Regional and Google Scholar databases. the fatty infiltration of the muscle-bone unit It is the most important event of aging, there is no uniformity in the diagnosis of sarcopenia and adequate protein intake, calcium and D vitamin and strength exercises are principal therapeutic options. There are no drugs with on both entities(AU)

Edad de menopausia, condición nutricional y componentes del síndrome metabólico en mujeres españolas / Menopausal age, nutritional status and components of the metabolic syndrome in Spanish women

La enfermedad cardiovascular es la primera causa de morbimortalidad en la mujer, situación que es modulada por los procesos de desarrollo ontogenético, especialmente los relacionados con la transición menopáusica. El objetivo de este trabajo fue asociar la edad de menopausia con la condición nutricional y la presencia de componentes del síndrome metabólico. Participaron 332 mujeres españolas (edad media: 58,17±6,31 años). Se midieron el peso, talla, perímetro de cintura, de cadera y pliegues adiposos subcutáneos, estimándose el Índice de Masa Corporal, cintura-talla, cintura cadera y las variables de composición corporal: porcentaje de grasa, masa grasa y masa libre de grasa total y relativa. Se tomó la presión arterial y los niveles de colesterol y glucosa, obteniéndose la puntuación de riesgo cardiovascular por protocolo Framingham. La edad media de menopausia (50,28±2,91 años) fue estimada por método retrospectivo, se establecieron categorías: temprana (<49,28 años), media (49,28 a 51,28 años) y tardía (>51,28 años). Además, se categorizó según criterio de la Organización Mundial de la Salud, considerándose menopausia temprana (<45 años) o normal (≥45 años). Se aplicaron test T-Student, U Man-Whitney, ANOVA o Kruskal-Wallis para la comparación de medias y Chi-cuadrado para el contraste de proporciones. Las mujeres con menopausia temprana mostraron mayor adiposidad y patrón de acúmulo graso centralizado, mientras que su componente musculoesquelético relativo fue bajo. La presión arterial, los niveles séricos de colesterol y glucosa son superiores en las menopaúsicas tempranas; en consecuencia, estas presentan mayor riesgo cardiovascular. La prevalencia de hipertensión, hipercolesterolemia e hiperglucemia descienden progresivamente entre las menopaúsicas tempranas y tardías

Cardiovascular disease is the leading cause of morbidity and mortality in women, that situation is modulated by ontogenetic development processes, especially those related to the menopausal transition. The aim of this work was to associate the age of menopause with nutritional status and the presence of components of the metabolic syndrome. A total of 332 Spanish women participated (mean age: 58.17±6.31 years). Weight, height, waist circumference, hip circumference and subcutaneous skinfold were measured, estimating Body Mass Index, waist-height, waist-hip and body composition variables: percentage of fat, fat mass and total and relative fat-free mass. Blood pressure, cholesterol and glucose levels were taken, obtaining the cardiovascular risk score by Framingham. The mean age of menopause (50.28±2.91 years) was estimated by retrospective method, categories were established: early (<49.28 years), middle (49.28 to 51.28 years) and late (>51.28 years). In addition, it was categorized according to the World Health Organization, considering early (<45 years) or normal menopause (≥45 years). T-Student, U Man-Whitney, ANOVA or Kruskal-Wallis tests were applied for the comparison of means and Chi-square for the contrast of proportions. Women with early menopause showed higher adiposity and centralized fat accumulation pattern, while their relative musculoskeletal component was low. Blood pressure, serum cholesterol and glucose levels are all higher in early menopause; consequently, early menopause presents greater cardiovascular risk. The prevalence of hypertension, hypercholesterolemia and hypergly cemia decrease progressively between early and late menopause

[Evaluation of satisfaction with pharmacological treatment in people with hypertension]. / Evaluación de la satisfacción con el tratamiento farmacológico en personas con hipertensión arterial.

OBJECTIVE: Medication satisfaction is a patientcentered measure that helps predict the continuity of treatment, correct use and therapeutic compliance. The objective has been to evaluate the satisfaction with the treatment (ST) of subjects with arterial hypertension (HT) and find out if the type of treatment, the state of health and the personal characteristics are related to the satisfaction. METHODS: Observational cross-sectional study conducted in the community pharmacy field. A total of 484 users of antihypertensive medication were evaluated (response rate: 81.6%). The ST was evaluated through the Treatment Satisfaction with Medicines. In the statistical analysis, means comparison and correlation tests were used to verify the existence of associations between the ST level and the different variables, considering a significance level of p<0.05. Likewise, a multiple linear regression model was constructed to identify the associated variables avoiding possible confounding factors. RESULTS: In a range of 0-100 the mean ST value was 79.9 (SD=12.9, 95% CI=78.8-81.0). A weak correlation was observed between perceived health score and ST (r=0.145, p=0.001). ST was higher in subjects with controlled BP (82.1 ±12.1 SD vs 77.5 ±13.3 SD, p<0.001), in treated subjects over 5 years (83.5 ± 12.8 SD vs 78.5 ±12.6 SD; p<0.001), in subjects without adverse effects (82.5 ±11.6 SD vs 68.7 ±11.9 SD; p<0.001) and in lower social classes (81.2 ±12.8 SD vs 78.5 ±12.8 SD, p=0.02). It was lower in the non-compliers with the treatment (73.2 ±12.9 vs 82.1 ±12.1, p<0.001). CONCLUSIONS: The ST level is acceptable, despite insufficient BP control and the high rate of noncompliance. Satisfaction is conditioned both by effectiveness and by therapeutic adherence, although health status, treatment and personal characteristics also intervene.

OBJETIVO: La satisfacción con la medicación constituye una medida centrada en el paciente que ayuda a predecir la continuidad del tratamiento, su uso correcto y el cumplimiento terapéutico. El objetivo de este estudio fue evaluar la satisfacción con el tratamiento (ST) de sujetos con hipertensión arterial (HTA), así como averiguar si el tipo de tratamiento, el estado de salud y las características personales guardan relación con el nivel de satisfacción. METODOS: Se elaboró un estudio observacional de carácter transversal, realizado en el ámbito de la farmacia comunitaria. Fueron evaluados 484 consumidores de medicación antihipertensiva (tasa de respuesta del 81,6%). La ST fue evaluada mediante el Treatment Satisfaction with Medicines Questionnaire. Otras variables fueron la presión arterial (PA), los fármacos antihipertensivos, los efectos adversos, otros medicamentos, la comorbilidad, la salud autopercibida, el cumplimiento y las características personales. En el análisis estadístico se utilizaron pruebas de comparación de medias y de correlación para comprobar asociaciones entre el nivel de ST y las diferentes variables, considerando un nivel de significación de p<0,05. Así mismo, se construyó un modelo de regresión lineal múltiple para identificar las variables asociadas, evitando posibles factores de confusión. RESULTADOS: En un rango entre 0 y 100, el valor medio de ST fue de 79,9 (DE=12,9; IC 95%=78,8-81,0). Se observó una débil correlación entre la puntuación en salud percibida y la ST (r=0,145; p=0,001). La ST fue superior en los sujetos con PA controlada (82,1 ±12,1 DE frente a 77,5 ±13,3 DE; p<0,001), en los tratados durante más de 5 años (83,5 ±12,8 DE frente a 78,5 ±12,6 DE; p<0,001), en los sujetos sin efectos adversos (82,5 ±11,6 DE frente a 68,7 ±11,9 DE; p<0,001) y en las clases sociales inferiores (81,2 ±12,8 DE frente a 78,5 ±12,8 DE; p=0,02). Fue inferior en los incumplidores con el tratamiento (73,2 ±12,9 frente a 82,1 ±12,1; p<0,001). CONCLUSIONES: El nivel de ST es aceptable, a pesar del insuficiente control de las cifras de PA y a la elevada proporción de incumplimiento. La satisfacción está condicionada tanto por la efectividad como por la adherencia terapéutica, aunque también intervienen el estado de salud, el tratamiento y las características personales.

Association Study Between Serotonin Transporter Gene and Fluoxetine Response in Mexican Patients With Major Depressive Disorder.

OBJECTIVE: Pharmacogenetic studies have identified genetic variants associated with fluoxetine response in patients with major depression disorder (MDD). The serotonin transporter gene is the principal site of action of selective serotonin reuptake inhibitors. Previous studies analyzing SLC6A4 gene variants are inconsistent and differ among populations. The aim of the present study was to analyze the association between 5-HTTLPR/rs24531 triallelic polymorphism and fluoxetine response in Mexican patients with MDD. METHODS: We analyzed a sample of 150 patients with MDD. Fluoxetine response was assessed according to a reduction in the Hamilton Depression Rating Scale and Montgomery Depression Rating Scale scores of 50% or more at 8 weeks from baseline. In addition, we analyzed the genotype and allele distribution between responder and nonresponder patients in a subgroup of very severe depression patients. RESULTS: We did not find association between fluoxetine responders and 5-HTTLPR/rs25531 variants (P = 0.0637). However, in the analysis of severe depression at baseline (Hamilton Depression Rating Scale ≥ 25), we observed a high frequency of low activity alleles (S/LG) in nonresponders patients (P = 0.0102). CONCLUSIONS: Our findings showed an association between low activity alleles of SLC6A4 gene and fluoxetine nonresponse in patients with severe depression.

Evaluación de la satisfacción con el tratamiento farmacológico en personas con hipertensión arterial / Evaluation of satisfaction with pharmacological treatment in people with hypertension

OBJETIVO: La satisfacción con la medicación constituye una medida centrada en el paciente que ayuda a predecir la continuidad del tratamiento, su uso correcto y el cumplimiento terapéutico. El objetivo de este estudio fue evaluar la satisfacción con el tratamiento (ST) de sujetos con hipertensión arterial (HTA), así como averiguar si el tipo de tratamiento, el estado de salud y las características personales guardan relación con el nivel de satisfacción. MÉTODOS: Se elaboró un estudio observacional de carácter transversal, realizado en el ámbito de la farmacia comunitaria. Fueron evaluados 484 consumidores de medicación antihipertensiva (tasa de respuesta del 81,6%). La ST fue evaluada mediante el Treatment Satisfaction with Medicines Questionnaire. Otras variables fueron la presión arterial (PA), los fármacos antihipertensivos, los efectos adversos, otros medicamentos, la comorbilidad, la salud autopercibida, el cumplimiento y las características personales. En el análisis estadístico se utilizaron pruebas de comparación de medias y de correlación para comprobar asociaciones entre el nivel de ST y las diferentes variables, considerando un nivel de significación de p < 0,05. Así mismo, se construyó un modelo de regresión lineal múltiple para identificar las variables asociadas, evitando posibles factores de confusión. RESULTADOS: En un rango entre 0 y 100, el valor medio de ST fue de 79,9 (DE=12,9; IC 95%=78,8-81,0). Se observó una débil correlación entre la puntuación en salud percibida y la ST (r=0,145; p = 0,001). La ST fue superior en los sujetos con PA controlada (82,1 +/-12,1 DE frente a 77,5 +/-13,3 DE; p < 0,001), en los tratados durante más de 5 años (83,5 +/-12,8 DE frente a 78,5 +/-12,6 DE; p < 0,001), en los sujetos sin efectos adversos (82,5 +/-11,6 DE frente a 68,7 +/-11,9 DE; p < 0,001) y en las clases sociales inferiores (81,2 +/-12,8 DE frente a 78,5 +/-12,8 DE; p = 0,02). Fue inferior en los incumplidores con el tratamiento (73,2 +/-12,9 frente a 82,1 +/-12,1; p < 0,001). CONCLUSIONES: El nivel de ST es aceptable, a pesar del insuficiente control de las cifras de PA y a la elevada proporción de incumplimiento. La satisfacción está condicionada tanto por la efectividad como por la adherencia terapéutica, aunque también intervienen el estado de salud, el tratamiento y las características personales

OBJECTIVE: Medication satisfaction is a patientcentered measure that helps predict the continuity of treatment, correct use and therapeutic compliance. The objective has been to evaluate the satisfaction with the treatment (ST) of subjects with arterial hypertension (HT) and find out if the type of treatment, the state of health and the personal characteristics are related to the satisfaction. METHODS: Observational cross-sectional study conducted in the community pharmacy field. A total of 484 users of antihypertensive medication were evaluated (response rate: 81.6%). The ST was evaluated through the Treatment Satisfaction with Medicines. In the statistical analysis, means comparison and correlation tests were used to verify the existence of associations between the ST level and the different variables, considering a significance level of p < 0.05. Likewise, a multiple linear regression model was constructed to identify the associated variables avoiding possible confounding factors. RESULTS: In a range of 0-100 the mean ST value was 79.9 (SD=12.9, 95% CI=78.8-81.0). A weak correlation was observed between perceived health score and ST (r=0.145, p = 0.001). ST was higher in subjects with controlled BP (82.1 +/-12.1 SD vs 77.5 +/-13.3 SD, p < 0.001), in treated subjects over 5 years (83.5 +/- 12.8 SD vs 78.5 +/-12.6 SD; p < 0.001), in subjects without adverse effects (82.5 +/-11.6 SD vs 68.7 +/-11.9 SD; p < 0.001) and in lower social classes (81.2 +/-12.8 SD vs 78.5 +/-12.8 SD, p = 0.02). It was lower in the non-compliers with the treatment (73.2 +/-12.9 vs 82.1 +/-12.1, p < 0.001). CONCLUSIONS: The ST level is acceptable, despite insufficient BP control and the high rate of noncompliance. Satisfaction is conditioned both by effectiveness and by therapeutic adherence, although health status, treatment and personal characteristics also intervene