Epidemiología de la anemia en adultos: estudio observacional de base poblacional / Epidemiology of anemia in adults: A population based study

Objetivo Determinar la prevalencia de la anemia y las características definitorias de los individuos que la padecen. Diseño Estudio observacional descriptivo de base poblacional. Variables extraídas de la base de datos informatizada de historias clínicas de atención primaria. Emplazamiento El presente estudio se realizó en la región sanitaria Metropolitana Nord, Barcelona. Participantes Pacientes con anemia evaluada mediante hemoglobina durante el año 2019. Criterios inclusión: mayores de 14 años, con determinaciones de hemoglobina por debajo del valor recomendado por la OMS. Criterio exclusión: no realizar seguimiento por la sanidad pública. Mediciones principales Variables demográficas, variables clínicas (fármacos, diagnóstico de anemia, paciente crónico complejo o enfermedad crónica avanzada. Variables consumo de recursos (número de visitas a atención primaria, número de ingresos hospitalarios y número de consultas a urgencias). Las variables demográficas y clínicas se evaluaron mediante frecuencias y porcentajes, media y desviación estándar para las variables cuantitativas. Las características de los diferentes subgrupos se compararon con la t de Student. Resultados La prevalencia de la anemia fue del 3,78%. Media de edad 64,5 años, el 60,8% mujeres. El 15,8% identificados como pacientes crónicos complejos. La hipertensión arterial presente en el 51,46%. El 50,97% fueron anemias ferropénicas. Consultaron al médico de familia 2,25 veces de media y a la enfermera de familia 1,49 veces. De las personas con criterios analíticos de anemia, solo el 46,57% tenían registrado un diagnóstico de anemia. Conclusiones En el territorio estudiado se ha objetivado un infraregistro del diagnóstico de anemia. Se observan diferencias en la caracterización por género y edad (AU)

Objective To determine the prevalence of anemia and the defining characteristics of the individuals who suffer from it. Design Population-based descriptive observational study. Variables extracted from the computerized database of primary care medical records. Setting This study was conducted in the Metropolitana Nord health region, Barcelona. Participants Patients with anemia evaluated by hemoglobin, during the year 2019. Inclusion criteria: older than 14 years, with hemoglobin determinations below the value recommended by the WHO. Exclusion criteria: no follow-up by public health. Main measurements Demographic variables, clinical variables (drugs, diagnosis of anemia, complex chronic patient or advanced chronic disease. Resource consumption variables (number of visits to primary care, number of hospital admissions, and number of visits to the emergency room). The variables demographic and clinical variables were evaluated using frequencies and percentages, mean and standard deviation for quantitative variables. The characteristics of the different subgroups were compared with Student's t-test. Results The prevalence of anemia was 3.78%. Mean age 64.5 years and 60.8% women. 15.8% identified as complex chronic patients. Arterial hypertension present in 51.46%. 50.97 were iron deficiency anemias. They consulted the family doctor 2.25 times on average and the family nurse 1.49. Of the people with analytical criteria for anemia, only 46.57 had a registered diagnosis of anemia. Conclusions In the territory studied, an under-reporting of the diagnosis of anemia has been observed. Differences are observed in the characterization by gender and age (AU)

[Epidemiology of anemia in adults: A population based study]. / Epidemiología de la anemia en adultos: estudio observacional de base poblacional.

OBJECTIVE: To determine the prevalence of anemia and the defining characteristics of the individuals who suffer from it. DESIGN: Population-based descriptive observational study. Variables extracted from the computerized database of primary care medical records. SETTING: This study was conducted in the Metropolitana Nord health region, Barcelona. PARTICIPANTS: Patients with anemia evaluated by hemoglobin, during the year 2019. INCLUSION CRITERIA: older than 14 years, with hemoglobin determinations below the value recommended by the WHO. EXCLUSION CRITERIA: no follow-up by public health. MAIN MEASUREMENTS: Demographic variables, clinical variables (drugs, diagnosis of anemia, complex chronic patient or advanced chronic disease. Resource consumption variables (number of visits to primary care, number of hospital admissions, and number of visits to the emergency room). The variables demographic and clinical variables were evaluated using frequencies and percentages, mean and standard deviation for quantitative variables. The characteristics of the different subgroups were compared with Student's t-test. RESULTS: The prevalence of anemia was 3.78%. Mean age 64.5 years and 60.8% women. 15.8% identified as complex chronic patients. Arterial hypertension present in 51.46%. 50.97 were iron deficiency anemias. They consulted the family doctor 2.25 times on average and the family nurse 1.49. Of the people with analytical criteria for anemia, only 46.57 had a registered diagnosis of anemia. CONCLUSIONS: In the territory studied, an under-reporting of the diagnosis of anemia has been observed. Differences are observed in the characterization by gender and age.

Complex interactions between nicotine and resveratrol in the Drosophila melanogaster wing spot test.

Nicotine (NIC) and resveratrol (RES) are chemicals in tobacco and wine, respectively, that are widely consumed concurrently worldwide. NIC is an alkaloid known to be toxic, addictive and to produce oxidative stress, while RES is thought of as an antioxidant with putative health benefits. Oxidative stress can induce genotoxic damage, yet few studies have examined whether NIC is genotoxic in vivo. In vitro studies have shown that RES can ameliorate deleterious effects of NIC. However, RES has been reported to have both antioxidant and pro-oxidant effects, and an in vivo study reported that 0.011 mM RES was genotoxic. We used the Drosophila melanogaster wing spot test to determine whether NIC and RES, first individually and then in combination, were genotoxic and/or altered the cell division. We hypothesized that RES would modulate NIC's effects. NIC was genotoxic in the standard (ST) cross in a concentration-independent manner, but not genotoxic in the high bioactivation (HB) cross. RES was not genotoxic in either the ST or HB cross at the concentrations tested. We discovered a complex interaction between NIC and RES. Depending on concentration, RES was protective of NIC's genotoxic damage, RES had no interaction with NIC, or RES had an additive or synergistic effect, increasing NIC's genotoxic damage. Most NIC, RES, and NIC/RES combinations tested altered the cell division in the ST and HB crosses. Because we used the ST and HB crosses, we demonstrated that genotoxicity and cell division alterations were modulated by the xenobiotic metabolism. These results provide evidence of NIC's genotoxicity in vivo at specific concentrations. Moreover, NIC's genotoxicity can be modulated by its interaction with RES in a complex manner, in which their interaction can lead to either increasing NIC's damage or protecting against it.

Lycopene, resveratrol, vitamin C and FeSO4 increase damage produced by pro-oxidant carcinogen 4-nitroquinoline-1-oxide in Drosophila melanogaster: Xenobiotic metabolism implications.

4-nitroquinoline-1-oxide (4-NQO) is a pro-oxidant carcinogen bioactivated by xenobiotic metabolism (XM). We investigated if antioxidants lycopene [0.45, 0.9, 1.8 µM], resveratrol [11, 43, 172 µM], and vitamin C [5.6 mM] added or not with FeSO4 [0.06 mM], modulate the genotoxicity of 4-NQO [2 mM] with the Drosophila wing spot test standard (ST) and high bioactivation (HB) crosses, with inducible and high levels of cytochromes P450, respectively. The genotoxicity of 4-NQO was higher when dissolved in an ethanol - acetone mixture. The antioxidants did not protect against 4-NQO in any of both crosses. In the ST cross, resveratrol [11 µM], vitamin C and FeSO4 resulted in genotoxicity; the three antioxidants and FeSO4 increased the damage of 4-NQO. In the HB cross, none of the antioxidants, neither FeSO4, were genotoxic. Only resveratrol [172 µM] + 4-NQO increased the genotoxic activity in both crosses. We concluded that the effects of the antioxidants, FeSO4 and the modulation of 4-NQO were the result of the difference of Cyp450s levels, between the ST and HB crosses. We propose that the basal levels of the XM's enzymes in the ST cross interacted with a putative pro-oxidant activity of the compounds added to the pro-oxidant effects of 4-NQO.

Interactions of sulforaphane and dimethyl sulfoxide with methyl methanesulfonate, urethane, 4-nitroquinoline-1-oxide and hydrogen peroxide in the Drosophila melanogaster wing spot test.

Sulforaphane (SF) is an isothiocyanate present in Brassicaceae, vegetables that induce the detoxification of electrophiles and reactive oxygen species. SF has been correlated with chemoprevention mechanisms against degenerative diseases. We tested if the SF had an effect against methyl methanesulfonate (MMS), urethane (URE), 4-NQO and H(2)O(2). SF (>95% purity, 0.14, 0.28, 0.56 mM) was diluted in a DMSO/Tw80/EtOH mixture (DTE) corresponding to 25, 50, 100% of lyophilized broccoli. The SF treatment (0.14 mM) was positive for small spots in the ST cross and negative in the HB cross. In the HB cross, SF (0.28 mM) was genotoxic. In the ST cross, the SF treatments showed a tendency to reduce the genotoxic damage caused by MMS, which could be explained by the radical scavenging action of the DTE mixture. In the ST cross, the frequency of small spots in the SF 0.14 mM/URE treatment was similar to that of Water/URE, which can be explained by a DTE and SF scavenger action. In both crosses, the results for the direct oxidants, 4-NQO and H(2)O(2), were different and must be related to differential modulation of CYPs expression and the SF and DTE scavenger properties.

Sulforaphane modulates the expression of Cyp6a2 and Cyp6g1 in larvae of the ST and HB crosses of the Drosophila wing spot test and is genotoxic in the ST cross.

Constitutive overexpression of Cyp6g1 and Cyp6a2 genes in DDT-resistant line Oregon-flare of the Drosophila melanogaster wing spot test (SMART) has been reported. Cyp6g1 and Cyp6a2 expression levels were compared against the ß-actin gene in the standard (ST) and high bioactivation (HB) crosses of the Somatic Mutation and Recombination test (SMART) treated with sulforaphane or phenobarbital as the control inductor. The CYP450s' enzymatic activity was determined by overall NADH consumption. The expression levels of both genes and the CYP450s activity was higher in the HB cross. The Cyp6g1 levels were higher than those of Cyp6a2 in both crosses, but lower than the expression of ß-actin. Sulforaphane decreased Cyp6g1 in the HB cross and increased it in the ST cross; Cyp6a2 expression was inhibited in the ST cross. Sulforaphane resulted mutagenic in the ST cross, which could be related to the inhibition of Cyp6a2. Phenobarbital did not modify the Cyp6g1 levels but increased the Cyp6a2 and CYP450s basal activity. Although the transcript levels were always higher in the HB cross than in the ST, the expression of Cyp6a2 and Cyp6g1 was not constitutive and was independent one from the other. Sulforaphane modulated both genes in a differential way in each cross and, in contrast to its putative protective effect, it resulted to be mutagenic.

[Multicenter study of Helicobacter pylori infection prevalence in patients with chronic gastroduodenal disease. Various epidemiologic features]. / Estudio multicéntrico de prevalencia de infección por Helicobacter Pylori en pacientes con patología gastroduodenal crónica. Algunos aspectos epidemiológicos.

The aim of this study was to establish the prevalence of H. Pylori infection in patients with chronic gastroduodenal pathology, who were treated in the gastroenterology units of four hospitals located in the Federal Capital and its neighbouring areas. 398 patients were studied by means of clinical assessment and epidemiology data. Upper endoscopy was carried out two biopsies were taken of the gastric antrum for a quick ureasa test and histological assessment of the H. pylori state by means of giemsa's stain. The prevalence of infection on the total of the studied population was 75.6%. In patients with gastric ulcer was 70%; in patients with duodenal ulcer it was 77.2% and 78.5% in patients with chronic gastritis. The prevalence of H. Pylori infection on the population according to age groups was: 61.54% in patients between 21 and 40 years; 76.14% in patients between 41 and 60 years, and 68.22% in patients over 60 year. We have tried to obtain a correlation between the prevalence of the infection and some sanitary characteristic (Running water and sewers) on the studied population. It was seen that 225 patients who lived in dwellings with running water and sewers showed a prevalence of infection of 69.34% and in 129 patients who did not have running water or sewer the rate of prevalence of infection was 83.72; a difference which was statistically significant, (with P < 0.01) for the patients who lived in poor sanitary conditions. These data may be important when the design of therapeutic schemes for the eradication of the bacteria is made.

Estudio multicentrico de prevalencia de infeccion por Helicobacter pylori en pacientes con patologia gastroduodenal cronica: algunos aspectos epidemiologicos / Multicenter study of Helicobacter pylori infection prevalence in patients with chronic gastroduodenal disease: some epidemiologic features

El objetivo de este trabajo fue establecer la prevalencia de infección por H. Pylori en pacientes con patología gastroduodenal crónica, atendidos en las unidades de gastroenterología de cuatro hospitales de Capital Federal y conurbano. Se estudiaron 398 pacientes con evaluación clínica y datos epidemiológicos, se efectuó endoscopía alta con toma de dos biopsias de antro gástrico para test rápido con ureasa y evaluación histológica, con coloración de giemsa, del estado de infección con H. Pylori. La prevalencia de infección en la población total estudiada fue de 75,6 por ciento. En los pacientes con úlcera gástrica la tasa de prevalencia de infección por H.P. fue 70 por ciento en úlcera duodenal 77,2 por ciento y en gastritis crónica fue 78,5 por ciento. La prevalencia de infección por H.P. en la población según grupos etarios para pacientes menores de 20 años fue 61,54 por ciento; entre 21 y 40 años: 80,39 por ciento; entre 41 y 60 años 76,41 por ciento y en mayores de 60 años fue 68,22 por ciento. se ha intentado obtener de una correlación entre prevalencia de la infección y algunas características sanitarias (agua corriente y cloacas) de la población estudiada. Se observó ue 225 pacientes que residen en viviendas con agua corriente y cloacas, tuvieron una prevalencia de infección de 69,345 y en 129 pacientes sin agua corriente ni cloacas se observó una tasa de prevalencia de infección de 83,72 por ciento una diferencia estadísticamente significativa con un p< 0,01 para los pacientes con pobres condicones sanitarias. Estos datos puedem ser importantes cuando se efectua el diseño de los esquemas terapéuticos de erradicación de la bacteria.

Estudio multicentrico de prevalencia de infeccion por Helicobacter pylori en pacientes con patologia gastroduodenal cronica: algunos aspectos epidemiologicos / Multicenter study of Helicobacter pylori infection prevalence in patients with chronic gastroduodenal disease: some epidemiologic features

El objetivo de este trabajo fue establecer la prevalencia de infección por H. Pylori en pacientes con patología gastroduodenal crónica, atendidos en las unidades de gastroenterología de cuatro hospitales de Capital Federal y conurbano. Se estudiaron 398 pacientes con evaluación clínica y datos epidemiológicos, se efectuó endoscopía alta con toma de dos biopsias de antro gástrico para test rápido con ureasa y evaluación histológica, con coloración de giemsa, del estado de infección con H. Pylori. La prevalencia de infección en la población total estudiada fue de 75,6 por ciento. En los pacientes con úlcera gástrica la tasa de prevalencia de infección por H.P. fue 70 por ciento en úlcera duodenal 77,2 por ciento y en gastritis crónica fue 78,5 por ciento. La prevalencia de infección por H.P. en la población según grupos etarios para pacientes menores de 20 años fue 61,54 por ciento; entre 21 y 40 años: 80,39 por ciento; entre 41 y 60 años 76,41 por ciento y en mayores de 60 años fue 68,22 por ciento. se ha intentado obtener de una correlación entre prevalencia de la infección y algunas características sanitarias (agua corriente y cloacas) de la población estudiada. Se observó ue 225 pacientes que residen en viviendas con agua corriente y cloacas, tuvieron una prevalencia de infección de 69,345 y en 129 pacientes sin agua corriente ni cloacas se observó una tasa de prevalencia de infección de 83,72 por ciento una diferencia estadísticamente significativa con un p< 0,01 para los pacientes con pobres condicones sanitarias. Estos datos puedem ser importantes cuando se efectua el diseño de los esquemas terapéuticos de erradicación de la bacteria. (AU)