Factores de riesgo cardiovascular en pacientes adultos que asisten a una Institución universitaria de salud de la ciudad de Córdoba / Cardiovascular risk factors in adult patients attending a university health institution in the city of Córdoba

INTRODUCCIÓN: Las enfermedades crónicas son la principal causa de mortalidad a nivel mundial y representan uno de los mayores desafíos para el siglo XXI tanto para la salud como para el desarrollo. La diabetes mellitus y la hipertensión arterial representan enfermedades crónicas con gran impacto socio-sanitario, no solo por su alta prevalencia, sino también por las complicaciones crónicas que produce y la elevada tasa de mortalidad que tiene. El IMC, la glucemia y la presión arterial elevada junto a la inactividad física y hábitos alimentarios inadecuados constituyen factores predictivos de desarrollo de enfermedad cardiovascular, obesidad, hipertensión arterial y diabetes. OBJETIVO: Relacionar el estado nutricional con la presión arterial y la glucemia en pacientes adultos que asisten a una Institución universitaria de salud de la ciudad de córdoba durante el año 2015. MATERIAL Y MÉTODO: Se realizó un estudio observacional de tipo correlacional en el marco de una intervención "Campaña del Día Mundial de la Diabetes y del Día Nacional de la Lucha contra la Obesidad", tomando una muestra de 68 pacientes adultos sanos de ambos sexos, sin patología asociada. Se valoró la presión arterial sistólica (PAS) y diastólica (PAD) elevada >140mg/dl y > 90 mg/dl respectivamente; así como también la glucemia postprandial. Se evaluó la presencia de sobrepeso/obesidad según IMC, frecuencia de consumo de frutas, verduras y cereales integrales, actividad física y circunferencia de cintura elevada (>80 cm en mujeres y >94 cm en varones). Se utilizó como instrumento el Test Findrisk: instrumento validado para detectar el riesgo de desarrollar Diabetes tipo II y de identificar personas con diabetes no diagnosticados. Se realizó Test T de diferencias de medias de la circunferencia de cintura según sexo; de la circunferencia de cintura según actividad física diaria, de la frecuencia de consumo de alimentos según presión arterial y glucemia y un análisis de regresión lineal entre IMC con PAS, PAD y glucemia. Se trabajó con un 95% de confianza. RESULTADOS: El 44% presentó un IMC >30 kg/m2 (obesidad) y el 48% presentó circunferencia de cintura elevada, cuyo valor promedio en mujeres fue de 91,90cm y en hombres 105,31 cm. El valor promedio de glucemia postprandial en hombres y mujeres fue de 117,71 mg± 44,14 mg% y 105,72 ± 33,11mg% respectivamente. El 62% presento PAS elevada y un 22% PAD elevada. El 57% refirió no realizar actividad física diariamente. Según el test Findrisk, el 22% de los pacientes presenta un riesgo alto de desarrollar diabetes tipo II. Se encontró diferencia entre circunferencia de cintura y sexo (p=0, 0012) y entre circunferencia de cintura y actividad física. Se halló diferencia entre personas sin realización de actividad física y circunferencia de cintura (p= 0,0200) y entre personas con actividad física y circunferencia de cintura (p=0,004), siendo la media de circunferencia de cintura en mujeres y hombres sin actividad de 96,70cm y 109,45 cm respectivamente y para las personas con actividad, la media de la circunferencia de cintura fue de 84,19cm en mujeres y 100,75 cm en hombres. Se encontró relación fuerte positiva entre bajo consumo de frutas, verduras y cereales integrales y PAS (p=0,008). Las variables IMC y PAS (p<0,001) presentaron relación positiva. No se encontró relación entre IMC y glucemia (p= 0,176). CONCLUSION: La proporción de adultos con IMC elevado, Presión Arterial sistólica elevada, circunferencia de cintura elevada y baja realización de actividad diaria, y la asociación observada entre tales variables, refuerza la necesidad de una prevención de enfermedades crónicas temprana, promoviendo estilos de vida saludables. (AU)

INTRODUCTION: Chronic diseases are the leading cause of global mortality and represent one of the greatest challenges for the 21st century for both health and development. Diabetes mellitus and arterial hypertension represent chronic diseases with a big socio-sanitary impact, not only for their high prevalence, but also for the chronic complications it causes and the high mortality rate. The BMI (Body Mass Index), glycemia and high blood pressure together with physical inactivity and inadequate eating habits are predictive factors of cardiovascular disease, obesity, hypertension and diabetes. OBJECTIVE: Relation nutritional status with high blood pressure and glycemia in adult patients attending a private institution in the city of Cordoba during the year 2015. MATERIAL AND METHOD: A correlation-type observational study did as part of a "World Diabetes Day and National Obesity Day Campaign", taking a sample of 68 healthy adult patients of both sexes, with no associated pathology. Systolic (SBP) and diastolic blood pressure (DBP) elevated> 140 mg / dl and> 90 mg / dl respectively; As well as postprandial glycemia. The prevalence of overweight / obesity according to BMI, frequency of consumption of fruits, vegetables and whole grains, physical activity and high waist circumference (> 80 cm in women and> 94 cm in men) was evaluated. The Test Findrisk was used as instrument: instrument validated to detect the risk of developing type II diabetes and to identify people with undiagnosed diabetes. Test T of differences of means of waist circumference according to sex; waist circumference according to daily physical activity, frequency of food consumption according to blood pressure and blood glucose, and a linear regression analysis between BMI with SBP, DBP and glycemia. We worked with 95% confidence. RESULTS: 44% had a BMI> 30 kg / m2 (obesity) and 48% had a high waist circumference, with a mean value in women of 91.90 cm and in men 105.31 cm. The mean value of postprandial glycemia in men and women was 117.71 mg ± 44.14 mg% and 105.72 ± 33.11 mg%, respectively. 62% had high SBP and 22% had high DBP. 57% reported that they didn't realize daily physical activity. According to the Findrisk test, 22% of patients were in high risk for developing type II diabetes. We found difference between waist circumference and sex (p = 0, 0012) and between waist circumference and physical activity. There was a difference between people without physical activity and waist circumference (p= 0.0200) and among people with physical activity and waist circumference (p = 0.004), the mean waist circumference in women and men without activity Of 96.70 cm and 109.45 cm respectively and for those with activity the mean waist circumference was 84.19 cm in women and 100.75 cm in men. A strong positive relationship was found between low intakes of fruits, vegetables and whole grains and SBP (p = 0.008). The variables BMI and SBP (p <0.001) presented positive relation. There was no relationship between BMI and glycemia (p = 0.176). CONCLUSIONS: The proportion of adults with elevated BMI, elevated systolic blood pressure, elevated waist circumference and low daily activity, and the association observed between such variables, reinforces the need for prevention of early chronic diseases, promoting healthy lifestyles. (AU)

[Relationship between menopause and tooth loss]. / Période de la ménopause, mortalité dentaire et facteurs systémiques.

This work proposes to evaluate the relationship between menopause and oral health by a cross-sectional study conducted on 202 menopausal women with or without hormone replacement therapy (HRT) and not menopausal women, with backgrounds socio-economic and socio-cultural variety and aged 42 to 80 years. Two hundred and two patients were the subject of an interrogation and a detailed clinical examination. Relations between menopausal and dental mortality were determined by bi and multi analyses varied. The result notes that the number of missing teeth is lowest among women from backgrounds socio - economic favored (p = 0.015). In addition, the number of missing teeth is highly correlated with dry mouth (p = 0,000). On the other hand, postmenopausal women on hormone replacement therapy have less missing teeth than postmenopausal women without hormone replacement therapy, (p = 0.02). In addition, the number of missing teeth is significantly increased in non-diabetic heart women, (OR = 1,215). This result is essentially the same in heart patient, non-diabetic postmenopausal patients without HRT, (OR = 1,214). Finally, we note a link between stressful events and dental mortality (p = 0.042).

Haemopoietic growth factors in myelodysplastic syndromes: towards patient-oriented therapy?

Recombinant human erythropoietin (r-EPO) has been used in Myelodysplastic Syndrome (MDS) patients with anaemia since the early nineties. In low-risk MDS patients, other haemopoietic growth factors (HGFs) (granulocyte-colony stimulating factor, G-CSF, granulocyte-macrophage-colony stimulating factor, GM-CSF, and interleukin 3, IL-3) have been used to synergise the effects of r-EPO on erythroid growth and to increase neutrophil count in patients with severe neutropenia. In high-risk MDS, or in patients with post-MDS AML, myeloid HGFs have been used to push blasts into the S-phase, thus increasing their sensitivity to antiblastic drugs. Several trials have shown that r-EPO can increase haemoglobin levels and improve QoL in patients with anaemia associated to MDS. The selection of patients with a high probability of response to HGFs is based on the careful consideration of several clinical and biological parameters, i.e., among others, basal EPO and transfusional needs, disease duration, FAB or WHO subtypes, and IPSS score. Treatment of anaemic MDS patients with HGFs should become "patient oriented" and different types, schedules, and duration of treatment have to be designed according to the specific criteria which most likely predict, for each individual patient, the best chance of responding favourably to therapy.

Lymphoplasmacytic lymphoma/immunocytoma: towards a disease-targeted treatment?

Lymphoplasmacytic-lymphoplasmacytoid lymphoma (LPL)/Waldenstrom's macroglobulinemia (WM) or immunocytoma (IMC) consists of diffuse proliferation of small mature B lymphocytes, plasmacytoid lymphocytes, and plasma-cells. The nosographic definition includes the lack of histological, immunophenotypic, cytogenetic, and molecular markers considered specific of other types of lymphoma. The cells show surface Ig (usually IgM), B-cell-associated antigens and display the CD5-, CD23- and CD10- phenotype, which allows for differential diagnosis from B-CLL and mantle cell lymphoma. t(9;14)(p13;q32) chromosomal translocation has been found in 50% of all LPL cases. The cytogenetic rearrangement juxtaposes the PAX-5 gene, which encodes for an essential transcription factor for B-cell proliferation and differention, to the Ig heavy chain gene. The combination of chlorambucil and prednisone holds as the standard treatment and seems to guarantee good control of the disease in most patients. Similar therapeutic results have been described with the combination of cyclophosphamide, vincristine, prednisone with (CHOP) or without doxorubicin (CVP), or with a combination of other alkylating agents and prednisone. Nucleoside analogues, alone or in combination with alkylating agents and anthracyclines, provide good salvage therapy for IMC and being increasingly employed as first line therapy. In a multicentric European trial Foran et al. administered the chimeric anti-CD20-monoclonal antibody (Rituximab) to 28 patients with previously treated IMC. Seven out of 25 evaluable patients (28%) achieved a partial response. Byrd et al. examined the outcome of 7 previously treated WM patients who received weekly infusions of rituximab (375 mg/m2). Therapy was well tolerated by all patients, and there was no decrease in cellular immune function, or significant infectious morbidity. Partial responses were noted in three of these patients, including two with fludarabine-refractory disease. These data suggest that rituximab exerts clinical activity on heavily pre-treated patients with WM. Furthermore, Weide et al. first reported that WM-associated polyneuropathy can be treated effectively with a combination of chemotherapy and the anti-CD20 monoclonal antibody rituximab. Most published trials exploring the efficacy of high dose treatment as salvage therapy for relapsed or refractory low grade non Hodgkin's lymphoma have included prevalently follicular or lymphocytic lymphomas. In selected high risk patients radioimmunotherapy with autologous stem-cell rescue, and myeloablative therapy followed either by autologous stem cell transplantation (SCT) or allogeneic SCT might represent an alternative strategy.

Pyrazole sulfanilamides: nitroderivatives of 1-phenyl-3-sulfanilamidopyrazole. Note XVI.

Synthesis and structural characterization of 3 sulfanilamido-1-phenylpyrazoles bearing on 1-phenyl group nitro substituent o-, m-, p-positioned are reported. All derivatives are analysed through 1H and 13C NMR spectroscopy. The MIC values obtained against Escherichia coli are briefly discussed in terms of structure-activity relationship.

[Partial trisomy 9q: description of a new case]. / Trisomia parziale 9q: descrizione di un nuovo caso.

The authors describe one case of partial 9q trisomy they observed. The malformations they observed are correspondent to the very little amount of existing documented cases. And just because we have only a few observations, we thought useful publishing this case, to better define the clinical features among the alterations of chromosome 9 (trisomy 9 p and 9q). Head, neck, bones, heart and urogenital apparatus seen to be the most frequently involved in the phenotypic expression of the 9q trisomy.