Aplicación Android para la adquisición inalámbrica y visualización de señales biomédicas / Android application for wireless acquisition and visualization of biomedical signals / Aplicativo Android para aquisição sem fio e visualização de sinais biomédicos

RESUMEN Introducción: Los avances tecnológicos experimentados por los teléfonos y tabletas con sistema operativo Android han permitido el desarrollo de innumerables aplicaciones en el área de la medicina. Hasta nuestro conocimiento, en nuestro sistema de salud, no se reporta el uso de un dispositivo portátil que permita al especialista, monitorear a distancia, de forma inalámbrica las señales biomédicas asociadas a un paciente. Objetivo: Desarrollar una aplicación Android (herramienta) que permita adaptarse a múltiples sistemas de monitorización inalámbrica con el fin de capturar, visualizar y almacenar señales biomédicas. Método: Se muestra la arquitectura general del sistema de comunicación inalámbrico que integra a la herramienta y se propone el diseño software de la herramienta y el diagrama de interacción de las cinco actividades que la componen: "Menú", "Pacientes", "Configuración", "Escáner", "Graficar". Resultados: Se mostraron las diferentes pantallas y funcionalidades de la aplicación, para dos dispositivos médicos cubanos (y modos): Sistema de Medición Biomédica para la Exploración Vestibular (Recepción) y Sistema de Monitoreo Electrocardiográfico Inalámbrico para dispositivos Android (opera en modo Transmisión/Recepción). Conclusiones: La aplicación proporciona una interfaz sencilla e intuitiva, lo que facilita la interacción con el usuario. Su evaluación cualitativa mediante pruebas pilotos mostró excelentes resultados en ambos casos.

ABSTRACT Introduction: Technological advances experienced by phones and tablets with Android operating system have enabled the development of countless applications in the field of medicine. As far as we know, there is not reported in our health system the use of a portable device that allows the specialist to wirelessly monitor remotely the biomedical signals associated with the patient. Objective: Development of an Android application (as a tool) that can be adapted to multiple wireless monitoring systems in order to capture, visualize and store biomedical signals. Method: The general architecture of the wireless communication system that integrates the tool is shown and the software design of the tool and the interaction diagram of the five activities that compose it are proposed: "Menu", "Patients", "Configuration", "Scanner", "Graph". Results: Different screens and functionalities of the application were shown, compatibles for two Cuban medical devices (and modes): Biomedical Measurement System for Vestibular Exploration (Reception) and the Wireless Electrocardiographic Monitoring System for Android devices (operates in Transmission/Reception mode). Conclusions: The application provides a simple and intuitive interface, which facilitates interaction with the user. Its qualitative evaluation through rapid tests showed excellent results in both cases.

RESUMO Introdução: Os avanços tecnológicos vivenciados pelos telefones e tablets com sistema operacional Android permitiram o desenvolvimento de inúmeras aplicações na área da Medicina. Até onde sabemos, em nosso sistema de saúde, não foi relatado o uso de um dispositivo portátil que permita ao especialista monitorar remotamente, sem fio, os sinais biomédicos associados a um paciente. Objetivo: Desenvolver um aplicativo Android (ferramenta) que possa ser adaptado a vários sistemas de monitoramento sem fio para capturar, exibir e armazenar sinais biomédicos. Método: Apresenta-se a arquitetura geral do sistema de comunicação sem fio que integra a ferramenta e propõe-se o desenho do software da ferramenta e o diagrama de interação das cinco atividades que a compõem: "Menu", "Pacientes", "Configuração", "Scanner", "Gráfico". Resultados: Foram mostradas as diferentes telas e funcionalidades do aplicativo para dois dispositivos médicos cubanos (e modos): Sistema de Medição Biomédica para Exame Vestibular (Recepção) e Sistema de Monitoramento Eletrocardiográfico Sem Fio para dispositivos Android (opera no modo Transmissão/Transmissão). Conclusões: O aplicativo oferece uma interface simples e intuitiva, o que facilita a interação com o usuário. Sua avaliação qualitativa por meio de testes pilotos apresentou excelentes resultados em ambos os casos.

Asociación de obesidad general y abdominal con hipertensión, dislipemia y presencia de prediabetes en el estudio PREDAPS / Association of general and abdominal obesity with hypertension, dyslipidemia and prediabetes in the PREDAPS study

Introducción y objetivos: Algunas medidas antropométricas muestran mayor capacidad que otras para discriminar la presencia de factores de riesgo cardiovascular. Este trabajo estima la magnitud de la asociación de diversos indicadores antropométricos de obesidad con hipertensión, dislipemia y prediabetes (glucemia basal o glucohemoglobina alteradas). Métodos: Análisis transversal de la información recogida en 2.022 sujetos del estudio PREDAPS (etapa basal). Se definió obesidad general como índice de masa corporal ≥ 30 kg/m2 y obesidad abdominal con 2 criterios: a) perímetro de cintura (PC) ≥ 102 cm en varones/PC ≥ 88 cm en mujeres, y b) índice cintura/estatura (ICE) ≥ 0,55. La magnitud de la asociación se estimó mediante regresión logística. Resultados: La hipertensión arterial mostró la asociación más alta con la obesidad general en mujeres (OR = 3,01; IC95%, 2,24-4,04) y con la obesidad abdominal según el criterio del ICE en varones (OR = 3,65; IC95%, 2,66-5,01). La hipertrigliceridemia y los valores bajos de colesterol unido a lipoproteínas de alta densidad mostraron la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,49; IC95%, 1,68-3,67 y OR = 2,70; IC95%, 1,89-3,86) y la obesidad general en varones (OR = 2,06; IC95%, 1,56-2,73 y OR = 1,68; IC95%, 1,21-2,33). La prediabetes mostró la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,48; IC95%, 1,85-3,33) y con obesidad abdominal según el criterio del PC en varones (OR = 2,33; IC95%, 1,75-3,08). Conclusiones: Los indicadores de obesidad abdominal mostraron la mayor asociación con la presencia de prediabetes. La relación de los indicadores antropométricos con hipertensión y con dislipemia mostró resultados heterogéneos (AU)

Introduction and objectives: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). Methods: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30 kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102 cm in men/WC ≥ 88 cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. Results: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). Conclusions: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results (AU)

Long-term evolution of chronic daily headache with medication overuse in the general population.

OBJECTIVE: To investigate long-term efficiency of an intervention protocol for chronic daily headache with medication overuse (CDHwMO) in the general population. METHODS: The 72 subjects meeting CDHwMO criteria coming from an epidemiological study in the general population (Neurology 2004; 62: 1338-42) were offered follow-up and treatment for 1 year and then discharged to their general practitioner with treatment recommendations. Four years later, they were interviewed again. They filled in a diary for 1 month and the SF-12 test. RESULTS: After 1 year, 46 (64%) did not fulfill MO criteria while 26 (36%) did. After 4 years, 68 subjects were contacted. Of those, 38 (58%) did not have CDHwMO, while 30 (44%) still had MO. Among those 38 subjects without MO criteria, 6 still met CDH criteria. Remission at year 1 was a significant predictor for sustained remission at year 4. Age, gender, civil status, socioeconomic situation, and CDH type were not different in the group with MO vs those without MO. Consumption of nonsteroidal anti-inflammatory drugs and/or triptans was significantly higher in subjects without CDH and MO, while the use of ergotics and/or opioids was significantly higher in those patients who still met CDHwMO criteria. Quality of life (QoL) was significantly better at 4 years for the whole group. CONCLUSIONS: After 4 years, almost 60% of subjects did not fulfill CDHwMO criteria and their QoL was also improved. This justifies public health interventions that should include recommendations on a judicious use of symptomatic medications together with an early use of preventatives.

Multilocus analyses reveal involvement of the ESR1, ESR2, and FSHR genes in migraine.

OBJECTIVE: Female hormone genes have been investigated in migraine in recent years. Research in this field has been controversial, especially in regard to ESR1 gene findings. None of the reports have yet to approach the problem from a multigenic point of view. METHODS: We investigated 5 polymorphisms implicated in female hormone metabolism (FSHR, CYP19A1, ESR1, NRIP1, and ESR2) in a cohort of 730 subjects matched for age and sex. The effect of gene-gene interaction was assessed using the set association approach, and the corresponding haplotypes were studied with PM Plus software. To corroborate initial results, we analyzed the selected markers using a cohort of 134 families in which 168 trios were suitable for transmission-disequilibrium test (TDT) analysis under the migraine with aura (MA) phenotype. RESULTS: A total of 356 consecutive migraine patients (198 with MA [76% females] and 158 migraine without aura [MO, 74% females], and 374 matched controls [71% females]) were genotyped. In the 2-point analyses, the ESR1 and ESR2 polymorphisms showed nominal association under MA/MO phenotype, and this association was higher with the FSHR polymorphism in MA females (P = .004, uncorrected). Using the SUMSTAT program, we observed ESR2-ESR1-FSHR significant gene-gene interaction, suggesting association with the MA/MO phenotype (P = .005; P = .003 in females), and with MA alone (P = .021; P = .030 for females).We corroborated that ESR2-ESR1-FSHR haplotypes interacted for migraine under a model-free hypothesis (empirical P = .010 for the whole sample; P = .001 for females), and the association was stronger for the MA phenotype alone (empirical P = 5.0e-4, under the heterogeneity model; P = .001 for females). These results were corroborated using family-based association approaches. We observed nominal association for ESR2 and ESR1 (P = .031 and .034, respectively) in the TDT study, and significant association for ESR1 using family-based association test statistics. Haplotype-TDT analyses showed further significant gene-gene interaction for ESR1-ESR2 (global P = .009), ESR2-FSHR (global P = .011), and nominally significant interaction for ESR2-ESR1-FSHR genes (global P = .037). CONCLUSION: We found significant association of female hormone metabolism polymorphisms under the perspective of multigene approach.

Lack of association of endothelial nitric oxide synthase polymorphisms and migraine.

OBJECTIVE: The aim of this study was to evaluate if 2 functional endothelial nitric oxide synthase (eNOS) gene polymorphisms might be risk factors for migraine. BACKGROUND: Nitric oxide synthase promotes the synthesis of nitric oxide (NO). NO is a potent vasodilator and mediates several processes involved in migraine pathophysiology. Only one study has suggested an association with migraine with aura. METHODS: We performed a sex- and age-matched case-control study using 2 eNOS polymorphisms (rs1800779 and rs1799983), which are in linkage disequilibrium. Genotypes were obtained with allele-specific probes in a real-time polymerase chain reaction assay. Genotypic and allelic distributions were compared with chi(2) method. We also estimated the reconstructed haplotypes and calculated ORs for individual haplotypes. RESULTS: A total of 337 migraine patients (188 with aura) and 341 healthy controls were recruited. We found no significant differences in the distribution of genotypes and alleles for either polymorphism among clinical subgroups. Neither rs1800779 nor rs1799983 polymorphisms increased the risk for suffering from migraine aura. CONCLUSIONS: As others have previously reported, we failed to demonstrate genetic association of the eNOS gene with migraine.