Differences in circadian rhythmicity in CLOCK 3111T/C genetic variants in moderate obese women as assessed by thermometry, actimetry and body position.

INTRODUCTION: Genetics is behind our circadian machinery. CLOCK (Circadian Locomotor Output Cycles Kaput) 3111T/C single-nucleotide polymorphism (SNP) has been previously related to obesity and weight loss. However, phenotypic association and functionality of CLOCK 3111 locus is still unknown. The aim of this study was to determine, in free-living conditions, if the presence of CLOCK 3111C in overweight women could be related to (a) circadian disorders, and (b) changes in sleep quality, to improve understanding of the previously demonstrated associations with obesity and reduced weight loss of the C carriers. METHODS: Wrist temperature, actimetry and position (TAP) and TAP variables were measured as markers of circadian functionality during 8 consecutive days. A rest-activity and food diary was also completed, whereas sleep quality was determined by domiciliary polysomnography. We recruited 85 women who were overweight with body mass index (BMI) of 28.59±4.30 kg m(-2) and age 43±12 years. From this sample, we found that 43 women were carrying the minor allele (C) for CLOCK 3111T/C SNP and 42 women were TT carriers (major allele carriers). Both groups of patients were matched for number, age, obesity parameters and energy intake. RESULTS: Compared with TT subjects, who showed more robust circadian rhythm profiles, patients with the C allele displayed significant circadian abnormalities: lower amplitude and greater fragmentation of the rhythm, a less stable circadian pattern and a significantly weakened circadian function, as assessed by the circadian function index (CFI). C subjects were also less active, started their activities later in the morning and were sleepier during the day, showing a delayed acrophase that characterizes 'evening-type' subjects. CONCLUSION: C genetic variants in CLOCK 3111T/C display a less robust circadian rhythm than TT and a delayed acrophase that characterizes 'evening-type' subjects. We support the notion that identifying CLOCK genotypes in patients may assist the therapist in characterization of the roots of the metabolic problem.

Hemoptisis: revisión de 70 casos / Hemoptysis: a review of 70 cases

Objetivos: Conocer las características etiológicas de los pacientes ingresados en la sección de Neumología por hemoptisis y su distribución en nuestro medio con relación a otras series. Métodos: Se realizó un estudio retrospectivo revisando las historias clínicas de los pacientes diagnosticados de hemoptisis en el servicio de neumología del Hospital Universitario Virgen de la Arrixaca, durante el año 2002. Resultados: Se estudiaron 70 pacientes, de los cuales 15 (21,4%) eran mujeres, y 55 hombres (78,5%). La edad media fue de 58,7 años. Fumadores y exfumadores de menos de 10 años constituyeron el 48,6%, exfumadores de más de 10 años 17,14%, no fumadores 35,7%. Los diagnósticos obtenidos fueron: bronquiectasias 24,3%, cáncer de pulmón 20%, infecciones respiratorias 12,8%, criptogenéticas 11,4%, bronquitis crónica 8,5%, TBC activa 7,1%, lesiones residuales por TBC 4,3%; abscesos 2,8%; sobredosificación por dicumarínicos 2,8%, malformaciones vasculares 2,8%, aspergiloma 1,4% fibrosis pulmonar 1,4%. Por rangos de edad encontramos diferencias, presentándose como primera causa en pacientes en mayores de 80 años y entre 50-59 años el cáncer de pulmón, entre 60 y 79 años las bronquiectasias y en los menores de 50 las infecciones respiratorias. El cáncer, también supone la primera causa en los pacientes fumadores y exfumadores desde hace menos de 10 años. Entre los exfumadores de más de 10 años destacan las bronquiectasias y en los no fumadores las infecciones respiratorias. En cuanto al diagnóstico la TC es diagnóstica en el 61,1%, la RX tórax en el 44,4% y la broncoscopia en el 11,1%; aunque localiza el sangrado en hasta el 47,2%. Conclusiones: La causa más frecuente de hemoptisis en nuestro medio es la secundaria a bronquiectasias, seguidas del cáncer de pulmón y de las infecciones respiratorias (AU)

Objectives: The aim of this review is know the etiology of hemoptysis in pneumology´s patients and its distribution in ours area compared with others series. Methods: We have made a restrospective and descriptive study about the clinical records of patients with diagnosis of hemoptysis in pneumology section from our hospital during the year 2002. Results: We have studied 70 clinical reports: 15 (21.4%) were women and 55 men (78.5%). The mean age was 58.7 years. Smoker and ex-smoker of less than 10 years were 48.6%, ex-smoker of more than10 years were 17.14% and non-smoker were 35.7%. The result included the following diagnosis: bronchiectasis 24.3%, lung cancer 20%, respiratory infecctions 12.8%, criptogenic 11.4%, chronic bronchitis 8.5%, active TBC 7.1%, residual lesions of TBC 4.3% abscess 2.8%, overdosis of anticoagulants 2.8%, vascular malformation 2.8%, aspergilloma 1.4% pulmonary fibrosis 1.4%. For age intervals we found differences: In the intervals 81-90 years and 51-60 years the main cause were lung cancer, between 61-80 years were bronchyectasis and <50 years respiratory infecitons. The lung cancer were also the most important cause the hemoptysis among the smokers and ex-smokers of less than 10 years. In non-smokers were the bronchiectasis. Conclusion: Bronchiectasis, lung cancer, and respiratory infections are the most common causes of hemoptysis in our area. In the same way that others series, we have found a important descent of impact of tuberculosis, but not in the bronchiectasis, as in others mediterraneans countries, where in their series is the main cause of hemoptysis (AU)