Análisis de meriendas escolares: estudio piloto en educación infantil / School meals analysis: pilot study in early childhood education

Fundamentos: La escuela puede ser un contexto favorecedor para prevenir la obesidad infantil, por lo que pautar meriendas escolares puede contribuir a adoptar hábitos saludables. El objetivo de este estudio fue doble: a) analizar el grado de cumplimiento de las meriendas pautadas; b) comparar las características de las meriendas según si eran o no pautadas. Métodos: Estudio transversal donde han participado centros escolares de las ciudades de Vigo y Pontevedra. Para el análisis comparativo se clasificó y categorizó cada una de las meriendas de los centros con y sin pauta. Asimismo, se comparó la composición de las meriendas establecidas, dependiendo si habían cumplido o no la pauta. Resultados: Se analizaron 1259 meriendas establecidas y 1363 sin pauta. El 81,2% de las meriendas recogidas cumplían con los requisitos pautados. Las meriendas no establecidas incluyeron un número de alimentos significativamente superior (p<0,001), así como un mayor porcentaje de alimentos ultraprocesados. En los centros con pauta, los niños cumplidores incluían más fruta y embutido, mientras que los no cumplidores llevaban más ultraprocesados. Conclusiones: Pautar meriendas escolares en educación infantil es una estrategia efectiva para asegurar una nutrición variada y una menor ingesta de alimentos ultraprocesados. (AU)

Background: The school can be a favorable context to prevent childhood obesity, so that the pattern of school snacks can contribute to the adoption of healthy habits. The aim of this study was twofold: a) to analyze the degree of compliance with the prescribed snacks; b) to compare the characteristics of the snacks according to whether they were prescribed or not. Methods: Cross-sectional study in which schools in the cities of Vigo and Pontevedra participated. For the comparative analysis, we classified and categorized each of the snacks in the schools with and without guidelines. Likewise, the composition of the established snacks was compared, depending on whether or not they had complied with the guideline. Results: A total of 1259 established snacks and 1363 without guidelines were analyzed. Of the snacks collected, 81.2% complied with the requirements established. The non-established snacks included a significantly higher number of foods (p<0.001), as well as a higher percentage of ultra-processed foods. In guideline centers, compliant children included more fruit and sausage, while non-compliant children had more ultra-processed foods. Conclusions: The school snack program in early childhood education is an effective strategy to ensure avaried nutrition and a lower intake of ultra-processed foods. (AU)

Immediate effect of the use of toe separators on dynamic balance and ankle range of motion: a pilot study.

BACKGROUND AND OBJECTIVES: Injuries involving ankle stability and range of motion are among the most frequent in athletes and in the general population. In response, this study aimed to assess the immediate effects of toe separators on dynamic stability and ankle range of motion in healthy young individuals. METHODS: Among the 68 eligible participants, 50 healthy and active subjects completed all trials. The impact of the intervention was evaluated using the Weight Bearing Lunge Test and Y-Test. The control condition performed the tests without toe separators, while the experimental condition performed the tests with toe separators. All participants performed both conditions with a wash-out period of at least 7 days between trials. RESULTS: Statistical analysis revealed no significant differences in dynamic balance (p > 0.05) and range of motion (p > 0.05) between the two conditions. Additionally, no asymmetries were detected between the lower limbs in both tests (p > 0.05). CONCLUSIONS: The results of this pilot study indicate that using toe separators does not have an immediate effect on ankle range of motion and dynamic balance in young, healthy individuals. Future research should consider evaluating intervention programs of longer duration and exploring different populations.

Tasas de prevalencia de enfermedad renal crónica y su asociación con factores cardiometabólicos y enfermedades cardiovasculares. Estudio SIMETAP-ERC / Prevalence rates of chronic kidney disease and its association with cardiometabolic factors and cardiovascular diseases. SIMETAP-CKD study

Introducción: La enfermedad renal crónica (ERC) constituye un importante problema de salud que contribuye al desarrollo de alteraciones cardiovasculares como la insuficiencia cardíaca y la enfermedad cardiovascular arteriosclerótica (ECVA). Los objetivos de este estudio fueron determinar la prevalencia de ERC y evaluar su asociación con factores de riesgo cardiometabólicos y la ECVA. Métodos: Estudio observacional transversal realizado en el ámbito de atención primaria. Muestra aleatoria de base poblacional: 6.588 personas entre 18 y 102 años (tasa de respuesta: 66%). Se determinaron las tasas de prevalencia brutas y ajustadas por sexo y edad de ERC según KDIGO valorando albuminuria y filtrado glomerular estimado según CKD-EPI, y sus asociaciones con factores cardiometabólicos y ECVA. Resultados: La prevalencia cruda de ERC fue 11,48% (IC95%: 10,72–12,27%), sin diferencia significativa entre hombres (11,64% [IC95%: 10,49–12,86%]) y mujeres (11,35% [IC95%: 10,34–12,41%]). La tasa de prevalencia ajustada por edad y sexo de ERC fue 9,16% (hombres: 8,61%; mujeres: 9,69%). La prevalencia del filtrado glomerular estimado reducido (<60mL/min/1,73m2) y de albuminuria (≥30mg/g) fueron 7,95% (IC95%: 7,30–8,61) y 5,98% (IC95%: 5,41–6,55), respectivamente. Hipertensión, diabetes, prediabetes, índice cintura-talla aumentado, insuficiencia cardíaca, fibrilación auricular y ECVA se asociaban independientemente con ERC (p<0,001). El 77,51% (IC95%: 74,54–80,49) de la población con ERC tenía un riesgo cardiovascular muy alto según SCORE. Conclusiones: La prevalencia ajustada de ERC era del 9,2% (filtrado glomerular estimado reducido: 8%; albuminuria: 6%). La mayoría de los pacientes con ERC tenía riesgo cardiovascular muy alto. Hipertensión, diabetes, prediabetes, índice cintura-talla aumentado y ECVA se asociaban independientemente con la ERC.(AU)

Introduction: Chronic kidney disease (CKD) is a major health problem that contributes to the development of cardiovascular disorders such as heart failure and arteriosclerotic cardiovascular disease (ACVD). The aims of this study were to determine the prevalence of CKD and to assess its association with ACVD and cardiometabolic risk factors. Methods: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 6,588 people between 18 and 102 years old (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of CKD according to KDIGO were determined by assessing albuminuria and estimated glomerular filtration rate according to CKD-EPI, and their associations with cardiometabolic factors and ACVD were determined. Results: The crude prevalence of CKD was 11.48% (95%CI: 10.72–12.27%), without significant difference between men (11.64% [95%CI: 10.49–12.86%]) and women (11.35% [95%CI: 10.34–12.41%]). The age- and sex-adjusted prevalence rate of CKD was 9.16% (men: 8.61%; women: 9.69%). The prevalence of low estimated glomerular filtration rate (<60mL/min/1.73m2) and albuminuria (≥30mg/g) were 7.95% (95%CI: 7.30–8.61) and 5.98% (95%CI: 5.41–6.55), respectively. Hypertension, diabetes, prediabetes, increased waist-to-height ratio, heart failure, atrial fibrillation, and ACVD were independently associated with CKD (P<.001). Very high cardiovascular risk according to SCORE was found in 77.51% (95%CI: 74.54–80.49) of the population with CKD. Conclusions: The adjusted prevalence of CKD was 9.2% (low estimated glomerular filtration rate: 8.0%; albuminuria: 6.0%). Most of the patients with CKD had very high cardiovascular risk. Hypertension, diabetes, prediabetes, increased waist-to-height ratio and ACVD were independently associated with CKD.(AU)

Genetic Alterations in Members of the Proteasome 26S Subunit, AAA-ATPase (PSMC) Gene Family in the Light of Proteasome Inhibitor Resistance in Multiple Myeloma.

For the treatment of Multiple Myeloma, proteasome inhibitors are highly efficient and widely used, but resistance is a major obstacle to successful therapy. Several underlying mechanisms have been proposed but were only reported for a minority of resistant patients. The proteasome is a large and complex machinery. Here, we focus on the AAA ATPases of the 19S proteasome regulator (PSMC1-6) and their implication in PI resistance. As an example of cancer evolution and the acquisition of resistance, we conducted an in-depth analysis of an index patient by applying FISH, WES, and immunoglobulin-rearrangement sequencing in serial samples, starting from MGUS to newly diagnosed Multiple Myeloma to a PI-resistant relapse. The WES analysis uncovered an acquired PSMC2 Y429S mutation at the relapse after intensive bortezomib-containing therapy, which was functionally confirmed to mediate PI resistance. A meta-analysis comprising 1499 newly diagnosed and 447 progressed patients revealed a total of 36 SNVs over all six PSMC genes that were structurally accumulated in regulatory sites for activity such as the ADP/ATP binding pocket. Other alterations impact the interaction between different PSMC subunits or the intrinsic conformation of an individual subunit, consequently affecting the folding and function of the complex. Interestingly, several mutations were clustered in the central channel of the ATPase ring, where the unfolded substrates enter the 20S core. Our results indicate that PSMC SNVs play a role in PI resistance in MM.

Prevalence rates of chronic kidney disease and its association with cardiometabolic factors and cardiovascular diseases. SIMETAP-CKD study. / Tasas de prevalencia de enfermedad renal crónica y su asociación con factores cardiometabólicos y enfermedades cardiovasculares. Estudio SIMETAP-ERC.

INTRODUCTION: Chronic kidney disease (CKD) is a major health problem that contributes to the development of cardiovascular disorders such as heart failure and arteriosclerotic cardiovascular disease (ACVD). The aims of this study were to determine the prevalence of CKD and to assess its association with ACVD and cardiometabolic risk factors. METHODS: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 6,588 people between 18 and 102 years old (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of CKD according to KDIGO were determined by assessing albuminuria and estimated glomerular filtration rate according to CKD-EPI, and their associations with cardiometabolic factors and ACVD were determined. RESULTS: The crude prevalence of CKD was 11.48% (95%CI: 10.72-12.27%), without significant difference between men (11.64% [95%CI: 10.49-12.86%]) and women (11.35% [95%CI: 10.34-12.41%]). The age- and sex-adjusted prevalence rate of CKD was 9.16% (men: 8.61%; women: 9.69%). The prevalence of low estimated glomerular filtration rate (<60mL/min/1.73m2) and albuminuria (≥30mg/g) were 7.95% (95%CI: 7.30-8.61) and 5.98% (95%CI: 5.41-6.55), respectively. Hypertension, diabetes, prediabetes, increased waist-to-height ratio, heart failure, atrial fibrillation, and ACVD were independently associated with CKD (P<.001). Very high cardiovascular risk according to SCORE was found in 77.51% (95%CI: 74.54-80.49) of the population with CKD. CONCLUSIONS: The adjusted prevalence of CKD was 9.2% (low estimated glomerular filtration rate: 8.0%; albuminuria: 6.0%). Most of the patients with CKD had very high cardiovascular risk. Hypertension, diabetes, prediabetes, increased waist-to-height ratio and ACVD were independently associated with CKD.

Tasas de prevalencia de sobrepeso y obesidad y sus asociaciones con factores cardiometabólicos y renales. Estudio SIMETAP-OB / Prevalence rates of overweight and obesity and their associations with cardiometabolic and renal factors. SIMETAP-OB study

Introducción: El exceso de peso constituye un importante problema de salud. Los objetivos del estudio fueron determinar las tasas de prevalencia de sobrepeso y obesidad, y comparar sus asociaciones con factores de riesgo cardiometabólicos y renales entre las poblaciones con y sin obesidad, y entre las poblaciones con y sin sobrepeso. Métodos: Estudio observacional transversal realizado en Atención Primaria. Muestra aleatoria de base poblacional: 6.588 sujetos de estudio entre 18 y 102 años (tasa de respuesta: 66%). Se calcularon las prevalencias brutas y ajustadas por edad y sexo de sobrepeso y obesidad, y se evaluaron sus asociaciones con variables cardiometabólicas y renales mediante análisis bivariado y multivariado. Resultados: Las prevalencias ajustadas por edad y sexo de sobrepeso y obesidad fueron 36,0% (42,1% en hombres; 33,1% en mujeres) y 25,0% (26,2% en hombres; 24,5% en mujeres), respectivamente. Estas prevalencias se incrementaban con la edad, y eran más elevadas en hombres que en mujeres. El 52,0% (IC95%: 50,0-53,9) de la población con sobrepeso y el 62,3% (IC95%: 60,1-64,5) de la población con obesidad tenían un riesgo cardiovascular alto o muy alto. La obesidad abdominal, la inactividad física, la prediabetes, la hipertensión, la hipertrigliceridemia y el c-HDL bajo se asociaban independientemente con ambas entidades. Además, la diabetes se asociaba independientemente con el sobrepeso y la hipercolesterolemia con la obesidad. Conclusiones: La prevalencia de sobrepeso y obesidad era del 61,0% (68,4% en hombres y 59,0% en mujeres). Más de la mitad de la población con sobrepeso y casi dos tercios de la población con obesidad tenían un riesgo cardiovascular elevado. La hiperglucemia, el sedentarismo, la hipertensión, la hipercolesterolemia, el c-HDL bajo y la hipertrigliceridemia se asociaban independientemente con el sobrepeso y la obesidad.(AU)

Introduction: Excess weight is a major health problem. Aims of this study were to determine the prevalence rates of overweight and obesity, and to compare their associations with cardiometabolic and renal risk factors between obese and non-obese populations, and between overweight and non-overweight populations. Methods: Cross-sectional observational study conducted in Primary Care. Population-based random sample: 6,588 study subjects between 18 and 102 years of age (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of overweight and obesity were calculated, and their associations with cardiometabolic and renal variables were assessed by bivariate and multivariate analysis. Results: The age- and sex-adjusted prevalence rates of overweight and obesity were 36.0% (42.1% in men; 33.1% in women) and 25.0% (26.2% in men; 24.5% in women), respectively. These prevalences increased with age, and were higher in men than in women. Fifty-two percent (95%CI: 50.0-53.9) of the overweight population and 62.3% (95%CI: 60.1-64.5) of the obese population had a high or very high cardiovascular risk. Abdominal obesity, physical inactivity, prediabetes, hypertension, hypertriglyceridemia, and low HDL-C were independently associated with both entities. Furthermore, diabetes was independently associated with overweight and hypercholesterolemia with obesity. Conclusions: The prevalence of overweight and obesity was 61.0% (68.4% in men and 59.0% in women). More than half of the overweight population and nearly two-thirds of the obese population had a high cardiovascular risk. Hyperglycemia, physical inactivity, hypertension, hypercholesterolemia, low HDL-C, and hypertriglyceridemia were independently associated with overweight and obesity.(AU)

Prevalencia de prediabetes y asociación con factores cardiometabólicos y renales. Estudio SIMETAP-PRED / Prevalence of prediabetes and association with cardiometabolic and renal factors. SIMETAP-PRED study

Introducción: La prediabetes constituye un importante problema de salud pública. Los objetivos del estudio fueron determinar la prevalencia de prediabetes según dos criterios diagnósticos, y comparar la asociación de factores de riesgo cardiometabólicos y renales entre las poblaciones con y sin prediabetes. Métodos: Estudio observacional transversal realizado en el ámbito de Atención Primaria. Muestra aleatoria de base poblacional: 6.588 sujetos de estudio (tasa de respuesta: 66%). Se utilizaron dos criterios diagnósticos: 1) prediabetes según la Sociedad Española de Diabetes (PRED-SED): glucosa plasmática en ayunas 110–125mg/dL o HbA1c 6,0%–6,4%; 2) prediabetes según la Asociación Americana de Diabetes (PRED-ADA): glucosa plasmática en ayunas 100–125mg/dL o HbA1c 5,7%–6,4%. Se evaluaron las prevalencias crudas y ajustadas por edad y sexo, y las variables cardiometabólicas y renales asociadas con prediabetes. Resultados: Las prevalencias crudas de PRED-SED y PRED-ADA fueron 7,9% (IC95% 7,3–8,6%), y 22,0% (IC95% 21,0–23,0%) respectivamente, y sus prevalencias ajustadas fueron 6,6% y 19,1% respectivamente. El riesgo cardiovascular alto o muy alto de las poblaciones PRED-SED y PRED-ADA fueron 68,6% (IC95% 64,5–72,6%) y 61,7% (IC95% 59,1–64,1%) respectivamente. La hipertensión, hipertrigliceridemia, sobrepeso, obesidad y el índice cintura-talla aumentado se asociaban independientemente con PRED-SED. Además de estos factores, el filtrado glomerular bajo y la hipercolesterolemia también se asociaban independientemente con PRED-ADA. Conclusiones: La prevalencia de PRED-ADA triplica a la PRED-SED. Dos tercios de la población con prediabetes tenían un riesgo cardiovascular elevado. Varios factores de riesgo cardiometabólicos y renales se asociaban con la prediabetes. En comparación con los criterios de la SED, los criterios de la ADA facilitan más el diagnóstico de la prediabetes. (AU)

Introduction: Prediabetes is a major public health problem. The aims of the SIMETAP-PRED study were to determine the prevalence rates of prediabetes according to two diagnostic criteria, and to compare the association of cardiometabolic and renal risk factors between populations with and without prediabetes. Methods: Cross-sectional observational study conducted in Primary Care. Based random sample: 6,588 study subjects (response rate: 66%). Two diagnostic criteria for prediabetes were used: 1) prediabetes according to the Spanish Diabetes Society (PRED-SDS): Fasting plasma glucose (FPG) 110–125mg/dL or HbA1c 6.0% –6.4%; 2) prediabetes according to the American Diabetes Association (PRED-ADA): FPG 100–125mg/dL or HbA1c 5.7%–6.4%. The crude and sex- and age-adjusted prevalence rates, and cardiometabolic and renal variables associated with prediabetes were assessed. Results: The crude prevalence rates of PRED-SDS and PRED-ADA were 7.9% (95% CI 7.3–8.6%), and 22.0% (95% CI 21.0–23.0%) respectively, their age-adjusted prevalence rates were 6.6% and 19.1 respectively. The high or very high cardiovascular risk of the PRED-SDS or PRED-ADA populations were 68.6% (95%CI 64.5–72.6%) and 61.7% (95%CI 59.1–64.1%) respectively. Hypertension, hypertriglyceridemia, overweight, obesity, and increased waist-to-height ratio were independently associated with PRED-SDS. In addition to these factors, low glomerular filtration rate and hypercholesterolemia were also independently associated with PRED-ADA. Conclusions: The prevalence of PRED-ADA triples that of PRED-SDS. Two thirds of the population with prediabetes had a high cardiovascular risk. Several cardiometabolic and renal risk factors were associated with prediabetes. Compared to the SDS criteria, the ADA criteria make the diagnosis of prediabetes easier. (AU)

Prevalence rates of overweight and obesity and their associations with cardiometabolic and renal factors. SIMETAP-OB study. / Tasas de prevalencia de sobrepeso y obesidad y sus asociaciones con factores cardiometabólicos y renales. Estudio SIMETAP-OB.

INTRODUCTION: Excess weight is a major health problem. Aims of this study were to determine the prevalence rates of overweight and obesity, and to compare their associations with cardiometabolic and renal risk factors between obese and non-obese populations, and between overweight and non-overweight populations. METHODS: Cross-sectional observational study conducted in Primary Care. Population-based random sample: 6,588 study subjects between 18 and 102 years of age (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of overweight and obesity were calculated, and their associations with cardiometabolic and renal variables were assessed by bivariate and multivariate analysis. RESULTS: The age- and sex-adjusted prevalence rates of overweight and obesity were 36.0% (42.1% in men; 33.1% in women) and 25.0% (26.2% in men; 24.5% in women), respectively. These prevalences increased with age, and were higher in men than in women. Fifty-two percent (95%CI: 50.0-53.9) of the overweight population and 62.3% (95%CI: 60.1-64.5) of the obese population had a high or very high cardiovascular risk. Abdominal obesity, physical inactivity, prediabetes, hypertension, hypertriglyceridemia, and low HDL-C were independently associated with both entities. Furthermore, diabetes was independently associated with overweight and hypercholesterolemia with obesity. CONCLUSIONS: The prevalence of overweight and obesity was 61.0% (68.4% in men and 59.0% in women). More than half of the overweight population and nearly two-thirds of the obese population had a high cardiovascular risk. Hyperglycemia, physical inactivity, hypertension, hypercholesterolemia, low HDL-C, and hypertriglyceridemia were independently associated with overweight and obesity.

Prevalence of prediabetes and association with cardiometabolic and renal factors. SIMETAP-PRED study. / Prevalencia de prediabetes y asociación con factores cardiometabólicos y renales. Estudio SIMETAP-PRED.

INTRODUCTION: Prediabetes is a major public health problem. The aims of the SIMETAP-PRED study were to determine the prevalence rates of prediabetes according to two diagnostic criteria, and to compare the association of cardiometabolic and renal risk factors between populations with and without prediabetes. METHODS: Cross-sectional observational study conducted in Primary Care. Based random sample: 6,588 study subjects (response rate: 66%). Two diagnostic criteria for prediabetes were used: 1) prediabetes according to the Spanish Diabetes Society (PRED-SDS): Fasting plasma glucose (FPG) 110-125mg/dL or HbA1c 6.0% -6.4%; 2) prediabetes according to the American Diabetes Association (PRED-ADA): FPG 100-125mg/dL or HbA1c 5.7%-6.4%. The crude and sex- and age-adjusted prevalence rates, and cardiometabolic and renal variables associated with prediabetes were assessed. RESULTS: The crude prevalence rates of PRED-SDS and PRED-ADA were 7.9% (95% CI 7.3-8.6%), and 22.0% (95% CI 21.0-23.0%) respectively, their age-adjusted prevalence rates were 6.6% and 19.1 respectively. The high or very high cardiovascular risk of the PRED-SDS or PRED-ADA populations were 68.6% (95%CI 64.5-72.6%) and 61.7% (95%CI 59.1-64.1%) respectively. Hypertension, hypertriglyceridemia, overweight, obesity, and increased waist-to-height ratio were independently associated with PRED-SDS. In addition to these factors, low glomerular filtration rate and hypercholesterolemia were also independently associated with PRED-ADA. CONCLUSIONS: The prevalence of PRED-ADA triples that of PRED-SDS. Two thirds of the population with prediabetes had a high cardiovascular risk. Several cardiometabolic and renal risk factors were associated with prediabetes. Compared to the SDS criteria, the ADA criteria make the diagnosis of prediabetes easier.

Factores cardiometabólicos asociados y prevalencia de concentraciones bajas de colesterol HDL y de dislipidemia aterogénica. Estudio SIMETAP-DA / Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study

OBJETIVO: Determinar las prevalencias ajustadas por edad y sexo de concentraciones bajas de colesterol HDL (cHDL-bajo) y de dislipidemia aterogénica (DA), y valorar sus asociaciones con factores de riesgo cardiovascular, enfermedad renal crónica, enfermedades cardiovasculares y cardiometabólicas. MÉTODOS: Estudio observacional transversal de base poblacional realizado en atención primaria, con sujetos adultos seleccionados aleatoriamente. Se consideró DA si los pacientes tenían hipertrigliceridemia (triglicéridos≥150mg/dL) y cHDL-bajo (<40mg/dL [hombres],<50mg/dL [mujeres]). Se determinaron las tasas de prevalencia crudas y ajustadas por edad y sexo, y se realizó análisis univariado y multivariante para evaluar los factores cardiometabólicos relacionados. RESULTADOS: Población de estudio con 6.588 adultos (55,9% mujeres) con edad media de 55,1 (±17,5) años. Las medias de cHDL fueron 49,2 (±12,6) mg/dL en hombres y 59,2 (±14,7) mg/dL en mujeres. Las prevalencias crudas de cHDL-bajo y de DA fueron 30,8% (IC95%: 29,7-31,9), y 14,3% (IC95%: 13,5-15,2), respectivamente. Las prevalencias ajustadas de cHDL-bajo fueron 28% en hombres y 31% en mujeres, y de DA fueron 16,4% en hombres y 10,6% en mujeres. El 73% de la población con DA tenía riesgo cardiovascular alto o muy alto. Los factores independientes asociados con cHDL-bajo o con DA fueron diabetes, tabaquismo, obesidad abdominal y obesidad. Los principales factores asociados con cHDL-bajo y con DA fueron hipertrigliceridemia y diabetes, respectivamente. CONCLUSIONES: Casi un tercio de la población adulta presentaba cHDL-bajo y la mitad de ellos cumplía criterios de DA. Los factores cardiometabólicos se asociaban con cHDL-bajo y DA, destacando la hipertrigliceridemia con el cHDL-bajo, y la DM con la DA

AIM: To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS: Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS: Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD

Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study. / Factores cardiometabólicos asociados y prevalencia de concentraciones bajas de colesterol HDL y de dislipidemia aterogénica. Estudio SIMETAP-DA.

AIM: To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS: Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS: Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD.

Participation in Everyday Activities of Children with and without Neurodevelopmental Disorders: A Cross-Sectional Study in Spain.

Children with neurodevelopmental disorders (NDDs) often report significant difficulties performing activities of daily living (ADLs), which may restrict their daily participation. The aim of this study was to investigate the differences in ADLs participation between children with NDDs and typically developing (TD) children, and to explore the associations between different daily participation contexts. A cross-sectional study was conducted that included twenty children with a medical diagnosis of an NDD and 26 sex- and age-matched TD controls. The daily participation across home, community, school, and instrumental living activities was measured using the Child and Adolescent Scale of Participation (CASP). The results show that children with NDDs engaged in lower participation in all CASP contexts (Δ = 1.7-5.5, p < 0.001) and had a significantly higher prevalence of moderate or severe restricted participation than their TD peers (OR = 23.4, 95% CI = 3.6-154.2, p < 0.001). Additionally, a strong association was found between the different contexts of participation (r = 0.642-0.856). Overall, the children with NDDs experienced significant participation restrictions on their daily activities. This study adds to the growing evidence showing that intervention strategies in this population should adopt a participation-oriented approach.

Identification of tipifarnib sensitivity biomarkers in T-cell acute lymphoblastic leukemia and T-cell lymphoma.

Patients diagnosed with T-cell leukemias and T-cell lymphomas (TCLs) still have a poor prognosis and an inadequate response to current therapies, highlighting the need for targeted treatments. We have analyzed the potential therapeutic value of the farnesyltransferase inhibitor, tipifarnib, in 25 TCL cell lines through the identification of genomic and/or immunohistochemical markers of tipifarnib sensitivity. More than half of the cell lines (60%) were considered to be sensitive. Tipifarnib reduced cell viability in these T-cell leukemia and TCL cell lines, induced apoptosis and modified the cell cycle. A mutational study showed TP53, NOTCH1 and DNMT3 to be mutated in 84.6%, 69.2% and 30.0% of sensitive cell lines, and in 62.5%, 0% and 0% of resistant cell lines, respectively. An immunohistochemistry study showed that p-ERK and RelB were associated as potential biomarkers of tipifarnib sensitivity and resistance, respectively. Data from RNA-seq show that tipifarnib at IC50 after 72 h downregulated a great variety of pathways, including those controlling cell cycle, metabolism, and ribosomal and mitochondrial activity. This study establishes tipifarnib as a potential therapeutic option in T-cell leukemia and TCL. The mutational state of NOTCH1, p-ERK and RelB could serve as potential biomarkers of tipifarnib sensitivity and resistance.

Clonal dynamics monitoring during clinical evolution in chronic lymphocytic leukaemia.

Chronic lymphocytic leukaemia is the most prevalent leukaemia in Western countries. It is an incurable disease characterized by a highly variable clinical course. Chronic lymphocytic leukaemia is an ideal model for studying clonal heterogeneity and dynamics during cancer progression, response to therapy and/or relapse because the disease usually develops over several years. Here we report an analysis by deep sequencing of sequential samples taken at different times from the affected organs of two patients with 12- and 7-year disease courses, respectively. One of the patients followed a linear pattern of clonal evolution, acquiring and selecting new mutations in response to salvage therapy and/or allogeneic transplantation, while the other suffered loss of cellular tumoral clones during progression and histological transformation.

Applied diagnostics in liver cancer. Efficient combinations of sorafenib with targeted inhibitors blocking AKT/mTOR.

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. There is increasing interest in developing specific markers to serve as predictors of response to sorafenib and to guide targeted therapy. Using a sequencing platform designed to study somatic mutations in a selection of 112 genes (HepatoExome), we aimed to characterize lesions from HCC patients and cell lines, and to use the data to study the biological and mechanistic effects of case-specific targeted therapies used alone or in combination with sorafenib. We characterized 331 HCC cases in silico and 32 paired samples obtained prospectively from primary tumors of HCC patients. Each case was analyzed in a time compatible with the requirements of the clinic (within 15 days). In 53% of the discovery cohort cases, we detected unique mutational signatures, with up to 34% of them carrying mutated genes with the potential to guide therapy. In a panel of HCC cell lines, each characterized by a specific mutational signature, sorafenib elicited heterogeneous mechanistic and biological responses, whereas targeted therapy provoked the robust inhibition of cell proliferation and DNA synthesis along with the blockage of AKT/mTOR signaling. The combination of sorafenib with targeted therapies exhibited synergistic anti-HCC biological activity concomitantly with highly effective inhibition of MAPK and AKT/mTOR signaling. Thus, somatic mutations may lead to identify case-specific mechanisms of disease in HCC lesions arising from multiple etiologies. Moreover, targeted therapies guided by molecular characterization, used alone or in combination with sorafenib, can effectively block important HCC disease mechanisms.

Molecular basis of targeted therapy in T/NK-cell lymphoma/leukemia: A comprehensive genomic and immunohistochemical analysis of a panel of 33 cell lines.

T and NK-cell lymphoma is a collection of aggressive disorders with unfavorable outcome, in which targeted treatments are still at a preliminary phase. To gain deeper insights into the deregulated mechanisms promoting this disease, we searched a panel of 31 representative T-cell and 2 NK-cell lymphoma/leukemia cell lines for predictive markers of response to targeted therapy. To this end, targeted sequencing was performed alongside the expression of specific biomarkers corresponding to potentially activated survival pathways. The study identified TP53, NOTCH1 and DNMT3A as the most frequently mutated genes. We also found common alterations in JAK/STAT and epigenetic pathways. Immunohistochemical analysis showed nuclear accumulation of MYC (in 85% of the cases), NFKB (62%), p-STAT (44%) and p-MAPK (30%). This panel of cell lines captures the complexity of T/NK-cell lymphoproliferative processes samples, with the partial exception of AITL cases. Integrated mutational and immunohistochemical analysis shows that mutational changes cannot fully explain the activation of key survival pathways and the resulting phenotypes. The combined integration of mutational/expression changes forms a useful tool with which new compounds may be assayed.