All-Ireland Health Data Inventory. Part 1: Metadata for key data sources, version 1.0

The All-Ireland Health Data Inventory. Part 1 is a catalogue of key sources of health data in the Republic and Northern Ireland. It includes relevant datasets from the major information reviews, conducted in the North and South, in the past few years. Information is essential for informed decision making and service provision. This inventory draws together information sources to facilitate such decision making. The inventory is intended as a resource for health professionals, researchers and the general public, providing the first phase of a ‘one-stop’ catalogue of health data. The datasets have been catalogued using an expanding numbering system which will allow for the inclusion of future resources. The Institute of Public Health in Ireland is in the process of expanding the Inventory to include further data sources.

Major impact of body position on arterial stiffness indices derived from radial applanation tonometry in pregnant and nonpregnant women.

OBJECTIVE: To evaluate the impact of body position on the arterial stiffness indices provided by radial applanation tonometry in pregnant and nonpregnant women. METHODS: Twenty-four young women (18-30 years) in the third trimester of a normal pregnancy and 20 healthy nonpregnant women of the same age were enrolled. In each, applanation tonometry was carried out in the sitting and supine position. The following stiffness indices were analyzed: systolic augmentation index (sAix), sAix adjusted for heart rate (sAix@75) and diastolic augmentation index (dAix), all expressed in % of central aortic pulse pressure. RESULTS: The sAix was apparently not influenced by body position, but the transition from seated to supine was associated with a substantial decrease in heart rate. When correcting for this confounder by calculating the sAix@75, systolic augmentation was substantially lower when individuals were supine (mean ± SD: nonpregnant 3.0 ± 14.4%, pregnant 8.8 ± 9.7%) than when they were sitting (nonpregnant 5.7 ± 13.0%, pregnant 11.1 ± 83%, P = 0.005 supine vs. seated in both study groups, P > 0.2 for pregnant vs. nonpregnant). The influence of body position on the dAix went in the opposite direction (supine: nonpregnant 9.7 ± 6.6%, pregnant 4.4 ± 3.5%; seated: nonpregnant 7.7 ± 5.8%, pregnant 3.3 ± 2.4%, P < 0.00001 supine vs. seated in both study groups, P = 0.001 for pregnant vs. nonpregnant). CONCLUSION: Body position has a major impact on the pattern of central aortic pressure augmentation by reflected waves in healthy young women examined either during third trimester pregnancy or in the nonpregnant state.

Presión aórtica y rigidez arterial en pacientes con esclerodermia

La Esclerosis Sistémica (ES) es un trastorno generalizado del tejido conectivo caracterizado por el engrosamiento y la fibrosis tanto de la piel como de órganos internos asociándose a daño vascular. Tradicionalmente, la afectación vascular en la ES ha sido considerada principalmente microvascular (1). Sin embargo, existe evidencia reciente que muestra que la ES podría también asociarse a lesión macrovascular (2) debido a la situación de inflamación crónica sostenida que predispondría al incremento de la rigidez de la pared arterial (3) y el desarrollo de arteriosclerosis. No obstante, y a pesar de diversos intentos en estudios realizados en la última década, la fisiopatología completa de los mecanismos subyacentes permanece todavía sin esclarecer. El objetivo de nuestro trabajo ha sido analizar; por un lado, dentro de una población de pacientes con ES, una serie de parámetros para evaluar la prevalencia de enfermedad cardiovascular subclínica y la existencia de factores de riesgo cardiovascular y; por otra parte, comparar esos hallazgos frente a una población sana en busca de diferencias que apoyen la hipótesis existente en la actualidad de que, ciertas enfermedades autoinmunes predisponen al desarrollo de arteriosclerosis precoz (3,4).

Efecto de la deshabituación tabáquica sobre la tensión arterial y los parámetros de rigidez arterial

Los estudios que relacionan el abandono del tabaco con los parámetros de rigidez arterial son escasos. El objetivo de nuestro estudio es analizar el efecto del abandono del tabaco sobre la tensión arterial, la frecuencia cardiaca y los parámetros de rigidez arterial. Realizamos un estudio prospectivo de seguimiento en un grupo de fumadores activos que inician deshabituación tabáquica. A los 3 meses se obtuvo una mejoría en la presión arterial y el Índice de aumento. A los 12 meses de seguimiento el número de pacientes es escaso pero se mantiene una tendencia a la mejoría. En los que continuaron fumando no se observaron cambios.

Características clínicas y evolución de los pacientes con hipertensión arterial refractaria

Un 5-10% de hipertensos no controlan las cifras de TA a pesar de tomar 3 o más fármacos (uno de ellos un diurético), definiendo la HTA refractaria. Estos pacientes presentan un riesgo cardiovascular más elevado. Se trata de un estudio descriptivo y observacional de 101 casos con TA sistólica por MAPA &140 mmHg. El 75% presenta patrón nictemeral alterado. El 54% presentó algún nuevo evento cardiovascular. La HVI es un factor predictor de mortalidad cardiovascular. La causa principal de HTA refractaria es la esencial, siendo la IRC la etiología más prevalente de HTA secundaria.

Experimental peripheral arterial disease: new insights into muscle glucose uptake, macrophage, and T-cell polarization during early and late stages.

Peripheral arterial disease (PAD) is a common disease with increasing prevalence, presenting with impaired walking ability affecting patient's quality of life. PAD epidemiology is known, however, mechanisms underlying functional muscle impairment remain unclear. Using a mouse PAD model, aim of this study was to assess muscle adaptive responses during early (1 week) and late (5 weeks) disease stages. Unilateral hindlimb ischemia was induced in ApoE(-/-) mice by iliac artery ligation. Ischemic limb perfusion and oxygenation (Laser Doppler imaging, transcutaneous oxygen pressure assessments) significantly decreased during early and late stage compared to pre-ischemia, however, values were significantly higher during late versus early phase. Number of arterioles and arteriogenesis-linked gene expression increased at later stage. Walking ability, evaluated by forced and voluntary walking tests, remained significantly decreased both at early and late phase without any significant improvement. Muscle glucose uptake ([18F]fluorodeoxyglucose positron emission tomography) significantly increased during early ischemia decreasing at later stage. Gene expression analysis showed significant shift in muscle M1/M2 macrophages and Th1/Th2 T cells balance toward pro-inflammatory phenotype during early ischemia; later, inflammatory state returned to neutrality. Muscular M1/M2 shift inhibition by a statin prevented impaired walking ability in early ischemia. High-energy phosphate metabolism remained unchanged (31-Phosphorus magnetic resonance spectroscopy). Results show that rapid transient muscular inflammation contributes to impaired walking capacity while increased glucose uptake may be a compensatory mechanisms preserving immediate limb viability during early ischemia in a mouse PAD model. With time, increased ischemic limb perfusion and oxygenation assure muscle viability although not sufficiently to improve walking impairment. Subsequent decreased muscle glucose uptake may partly contribute to chronic walking impairment. Early inflammation inhibition and/or late muscle glucose impairment prevention are promising strategies for PAD management.

Simulium (Psaroniocompsa) tergospinosum new species (Diptera: Simuliidae) in siolii group from the southern part of the State of Amazonas, Brazil

The larva, pupa, male and female of Simulium tergospinosum n. sp. are described and illustrated. The adults of this new species share many characters with species in the subgenus Psaroniocompsa, where it is placed. The larva of this species bears dorsal and lateral triangular tubercles on the abdomen and multiply branched scale-like setae on the body, suggesting that it belongs to the S. siolii species group. S. tergospinosum n.sp. was collected along the Juma River, Apuí county, in the southern part of the State of Amazonas, Brazil. The Juma, a black-water river, is a tributary of the Aripuanã River in the Madeira River hydrographic basin, on the southern part of Amazonas. Females were collected biting humans along the water courses during the sampling period (in the dry season).

The adolescent with a chronic condition. Part II: healthcare provision.

The treatment and management of chronic conditions during adolescence pose specific issues that need to be appropriately handled by health professionals. In this paper, questions related to disclosure of the diagnosis, the management of adherence to therapy, the need for an interdisciplinary network approach, lifestyles' anticipatory guidance and prevention, and the transition into an adult healthcare setting are reviewed. Special areas such as the issue of life threatening diseases and the ethical aspects of the treatment of chronic conditions are also discussed.

Prevalencia de enfermedad arterial periférica en pacientes hipertensos de la población de Paterna mayores de 15 años mediante determinación del índice tobillo-brazo.

Objectius: Conèixer la prevalença de malaltia arterial perifèrica en malalts hipertensos. Material y Métodes. Estudi descriptiu transversal en una mostra de 300 persones hipertenses majors de 15 anys obtingudes al atzar, ateses al centre de Salut de Paterna. Resultats. La prevalença fou d´un 16,7% determinada per un IMB patològic (&0.90). En l´anàlisi multifactorial sols va resultar significativa la variable sexe odds ratio (OR = 2,43) Conclusions. Es necesari prendre conciència de la importància de la MAP per la seua forta capacitat predictora de mal pronòstic a curt-mitjà termini. El IMB es una eina útil, senzilla i barata.

Estudi comparatiu de combinacions de dosis fixes enfront a dosis lliures en el control de la tensió arterial, factors que determinen el seu ús i impacte assistencial sanitari

Es tracta d’un estudi de cohorts prospectiu històric que pretén comparar l’ús de combinacions de dosis lliures enfront a les combinacions de dosis fixes en el control de la tensió arterial pel que fa a eficàcia i assoliment dels objectius terapèutics per al tractament d’aquesta patologia tan prevalent a les societats desenvolupades, així com comparar l’impacte econòmico-sanitari que comporten una i altra pel que fa a número de visites mèdiques, d’infermeria i número d’analítiques que es requereixen en cada estratègia. L’estudi també pretén analitzar els factors que determinen l’ús d’unes o altres en el tractament de la hipertensió arterial.