Low-fat dairy products and blood pressure: follow-up of 2290 older persons at high cardiovascular risk participating in the PREDIMED study

High blood pressure (BP) has been ranked as the most important risk factor worldwide regarding attributable deaths. Dietary habits are major determinants of BP. Among them, frequent intake of low-fat dairy products may protect against hypertension. Our aim was to assess the relationship between low-fat dairy product intake and BP levels and their changes after 12 month follow-up in a cohort of asymptomatic older persons at high cardiovascular risk recruited into a large-scale trial assessing the effects of Mediterranean diets on cardiovascular outcomes. Data from 2290 participants, including 1845 with hypertension, were available for analyses. Dairy products were not a specific part of the intervention; thus, data were analysed as an observational cohort. Dietary information was collected with validated semi-quantitative FFQ and trained personnel measured BP. To assess BP changes, we undertook cross-sectional analyses at baseline and at the end of follow-up and longitudinal analyses. A statistically significant inverse association between low-fat dairy product intake and systolic BP was observed for the 12-month longitudinal analysis. In the longitudinal analysis, the adjusted systolic and diastolic BP were significantly lower in the highest quintile of low-fat dairy product intake ( 2 4·2 (95% CI 2 6·9, 2 1·4) and 2 1·8 (95% CI 2 3·2, 2 0·4) mmHg respectively), whereas the point estimates for the difference in diastolic BP indicated a modest non-significant inverse association. Intake of low-fat dairy products was inversely associated with BP in an older population at high cardiovascular risk, suggesting a possible protective effect against hypertension.

Onicomicosis distales versus onicomicosis tanto discal como totales. Agentes etiológicos

En el trabajo que se presenta se ha tratado de obtener muestras clínicas de onicomicosis distales única mente, para posteriormente hacerlo de onicomicosis con afectación tanto distal como total, en pacientes de la Clínica de Podología de la Universitat de Barcelona. A partir de estas muestras se procedió a aislar los hongos presentes y determinar las especies fúngicas que los afectan. Finalmente se realizó una comparación de las diferentes especies fúngicas aisladas entre las onicomicosis distales y las totales

Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation

BACKGROUND: Several recently developed therapies targeting motor disabilities in stroke sufferers have shown to be more effective than standard neurorehabilitation approaches. In this context, several basic studies demonstrated that music training produces rapid neuroplastic changes in motor-related brain areas. Music-supported therapy has been recently developed as a new motor rehabilitation intervention. METHODS AND RESULTS: In order to explore the plasticity effects of music-supported therapy, this therapeutic intervention was applied to twenty chronic stroke patients. Before and after the music-supported therapy, transcranial magnetic stimulation was applied for the assessment of excitability changes in the motor cortex and a 3D movement analyzer was used for the assessment of motor performance parameters such as velocity, acceleration and smoothness in a set of diadochokinetic movement tasks. Our results suggest that the music-supported therapy produces changes in cortical plasticity leading the improvement of the subjects' motor performance. CONCLUSION: Our findings represent the first evidence of the neurophysiological changes induced by this therapy in chronic stroke patients, and their link with the amelioration of motor performance. Further studies are needed to confirm our observations.

Alateraciones de la memoria implícita y explícita en el envejecimiento natural y en la demencia tipo Alzheimer

L’esperança de vida ha millorat en aquest darrer segle, al mateix temps, han augmentat les malalties neurodegeneratives, sent l’Alzheimer el seu màxim exponent, caracteritzant-se per una important pèrdua de memòria. Davant d’aquesta realitat, l’objectiu últim d’aquest treball, és corroborar que les alteracions de memòria (explícita i implícita) no formen part del procés d’envelliment natural. Per a tal propòsit, després d’assentar els aspectes generals sobre la memòria, ens centrarem amb l’anàlisi de les alteracions que es produeixen en la memòria explícita i implícita, tant durant el procés d’envelliment natural, com en el patològic, particularment en el cas de la malaltia d’Alzheimer. Per arribar a una conclusió fefaent, s'efectuarà un minuciós i crític estudi, revisant la literatura específica i científica existent.

Ultrastructure of the spermatozoon of the digenean Lecithocladium excisum (Rudolphi, 1819) (Hemiuroidea: Hemiuridae), a parasite of marine teleosts in Senegal

The present study describes the ultrastructure of the mature spermatozoon of Lecithocladium excisum (Rudolphi, 1819) (Digenea: Hemiuroidea: Hemiuridae) from the stomach of the marine teleost Scomber japonicus Houttuyn (Scombridae) captured in the Atlantic Ocean, off Dakar (Senegal). The ultrastructural organization of the spermatozoon of L. excisum follows the general model described in most digeneans. It presents two axonemes of the 9+'1' pattern of the Trepaxonemata, nucleus, mitochondrion and parallel cortical microtubules, among other characters. However, some particularities of the spermatozoon of L. excisum are (i) the presence of a membranous ornamentation not associated with cortical microtubules in its anterior extremity, (ii) the presence of a very reduced number of cortical microtubules located only in the ventral side of the spermatozoon and (iii) the absence of several structures described in most digeneans such as spine-like bodies and cytoplasmic expansions.

Spermiogenesis and spermatozoon of the liver fluke Mediogonimus jourdanei (Microphalloidea: Prosthogonimidae), a parasite of Myodes glareolus (Rodentia: Cricetidae)

Spermatological characters of the liver fluke Mediogonimus jourdanei Mas-Coma et Rocamora, 1978 were studied by means of transmission and scanning electron microscopy. Spermiogenesis begins with the formation of the differentiation zone containing two centrioles associated with striated rootlets and an intercentriolar body. These two centrioles originate two free flagella that undergo a 90 degrees rotation before fusing with the median cytoplasmic process. Both nuclear and mitochondrial migrations toward the median cytoplasmic process occur before the proximodistal fusion of flagella. Finally, the constriction of the ring of arched membranes gives rise to the young spermatozoon. The mature sperm of M. jourdanei measures about 260 microm and presents two axonemes of different lengths with the typical pattern of the Trepaxonemata, two bundles of parallel cortical microtubules, one mitochondrion, a nucleus and granules of glycogen. An analysis of all the microphalloidean species studied to date emphasised some differences in certain characters found in Maritrema linguilla Jägerskiöld, 1908 and Ganeo tigrinum Mehra et Negi, 1928 in comparison to those in the remaining microphalloideans. The presence and variability of such ultrastructural characters according to family, superfamily or order have led several authors to propose their use in the analysis of trematode relationships and phylogeny. Therefore, apart from producing new data on the family Prosthogonimidae, the present study also compares the spermatological organization of M jourdanei with other available ultrastructural studies focusing on the Microphalloidea.

Ultrastructure of the spermatozoon of the digenean Lecithocladium excisum (Rudolphi, 1819) (Hemiuroidea: Hemiuridae), a parasite of marine teleosts in Senegal

The present study describes the ultrastructure of the mature spermatozoon of Lecithocladium excisum (Rudolphi, 1819) (Digenea: Hemiuroidea: Hemiuridae) from the stomach of the marine teleost Scomber japonicus Houttuyn (Scombridae) captured in the Atlantic Ocean, off Dakar (Senegal). The ultrastructural organization of the spermatozoon of L. excisum follows the general model described in most digeneans. It presents two axonemes of the 9+'1' pattern of the Trepaxonemata, nucleus, mitochondrion and parallel cortical microtubules, among other characters. However, some particularities of the spermatozoon of L. excisum are (i) the presence of a membranous ornamentation not associated with cortical microtubules in its anterior extremity, (ii) the presence of a very reduced number of cortical microtubules located only in the ventral side of the spermatozoon and (iii) the absence of several structures described in most digeneans such as spine-like bodies and cytoplasmic expansions.

Competencia humanística en enfermería

El objetivo central del trabajo es profundizar sobre la importancia de la competencia humanística en la profesión enfermera. El diseño del trabajo ha sido una revisión sistemática de la literatura. Para poder realizarlo, se ha hecho una profunda búsqueda en bases de datos electrónicas, consultas bibliográficas y búsqueda manual. En el desarrollo del trabajo se parte de lo que se ha dicho desde la evidencia científica sobre esta competencia, pasando por la descripción del vocablo cuidar, por el análisis de los valores, las teorías enfermeras y factores que inciden en el desarrollo de esta competencia, para finalizar con una serie de conclusiones y recomendaciones sobre esta competencia para la práctica enfermera.

Association of MMP-2 polymorphisms with severe and very severe COPD: a case control study of MMPs-1, 9 and 12 in a European population.

BACKGROUND: Genetic factors play a role in chronic obstructive pulmonary disease (COPD) but are poorly understood. A number of candidate genes have been proposed on the basis of the pathogenesis of COPD. These include the matrix metalloproteinase (MMP) genes which play a role in tissue remodelling and fit in with the protease--antiprotease imbalance theory for the cause of COPD. Previous genetic studies of MMPs in COPD have had inadequate coverage of the genes, and have reported conflicting associations of both single nucleotide polymorphisms (SNPs) and SNP haplotypes, plausibly due to under-powered studies. METHODS: To address these issues we genotyped 26 SNPs, providing comprehensive coverage of reported SNP variation, in MMPs- 1, 9 and 12 from 977 COPD patients and 876 non-diseased smokers of European descent and evaluated their association with disease singly and in haplotype combinations. We used logistic regression to adjust for age, gender, centre and smoking history. RESULTS: Haplotypes of two SNPs in MMP-12 (rs652438 and rs2276109), showed an association with severe/very severe disease, corresponding to GOLD Stages III and IV. CONCLUSIONS: Those with the common A-A haplotype for these two SNPs were at greater risk of developing severe/very severe disease (p = 0.0039) while possession of the minor G variants at either SNP locus had a protective effect (adjusted odds ratio of 0.76; 95% CI 0.61 - 0.94). The A-A haplotype was also associated with significantly lower predicted FEV1 (42.62% versus 44.79%; p = 0.0129). This implicates haplotypes of MMP-12 as modifiers of disease severity.

Detección Precoz de los factores de riesgo cardiovasculares en los Centros de Atención Primaria de Cataluña Central

Las enfermedades cardiovasculares son actualmente la principal causa de muerte prematura, por lo que es necesario controlar los factores que podrían reducir el riesgo cardiovascular. El presente estudio se centra en la ejecución de los protocolos de prevención cardiovascular en los Centros de Atención Primaria de Cataluña central, ya que se cree que una prevención adecuada podría reducir significativamente la mortalidad por esta enfermedad. Para lograr este objetivo, se propone utilizar una muestra poblacional de 100 individuos entre 45 y 65 años y realizar un estudio cuantitativo descriptivo. Basándose éste, en el control de las diferentes variables que afectan en poseer factores de riesgo cardiovascular: el alcohol, el tabaco, la obesidad, la inactividad física, la diabetes y el colesterol.

Educación de Enfermería para el autocuidado y control de la Hipertensión Arterial (HTA) en personas con HTA Crónica

La Hipertensión Arterial (HTA) es uno de los principales factores de riesgo de morbilidad y mortalidad cardíaca y cerebrovascular, que afecta mundialmente, por lo que conlleva a un problema de salud pública universal. Es por ello que, el JNC7 recomienda una serie de actividades de autocuidado (AC), que se dividen en el tratamiento farmacológico y no-farmacológico, en el que deberá intervenir el personal sanitario, entre ellos, enfermería, para lograr el control de la enfermedad y evitar complicaciones.

Pathophysiology of muscle dysfunction in COPD

Muscle dysfunction often occurs in patients with chronic obstructive pulmonary disease (COPD) and may involve both respiratory and locomotor (peripheral) muscles. The loss of strength and/or endurance in the former can lead to ventilatory insufficiency, whereas in the latter it limits exercise capacity and activities of daily life. Muscle dysfunction is the consequence of complex interactions between local and systemic factors, frequently coexisting in COPD patients. Pulmonary hyperinflation along with the increase in work of breathing that occur in COPD appear as the main contributing factors to respiratory muscle dysfunction. By contrast, deconditioning seems to play a key role in peripheral muscle dysfunction. However, additional systemic factors, including tobacco smoking, systemic inflammation, exercise, exacerbations, nutritional and gas exchange abnormalities, anabolic insufficiency, comorbidities and drugs, can also influence the function of both respiratory and peripheral muscles, by inducing modifications in their local microenvironment. Under all these circumstances, protein metabolism imbalance, oxidative stress, inflammatory events, as well as muscle injury may occur, determining the final structure and modulating the function of different muscle groups. Respiratory muscles show signs of injury as well as an increase in several elements involved in aerobic metabolism (proportion of type I fibers, capillary density, and aerobic enzyme activity) whereas limb muscles exhibit a loss of the same elements, injury, and a reduction in fiber size. In the present review we examine the current state of the art of the pathophysiology of muscle dysfunction in COPD.

El Sentido de la Vida y el Deseo de Adelantar la Muerte en pacientes con procesos avanzados de enfermedad

El deseo de adelantar la muerte (DAM) no es infrecuente en la población paliativa o con cáncer avanzado. Las evidencias actuales muestran el DAM como una respuesta reactiva al sufrimiento multidimensional propio del paciente en con procesos avanzados de enfermedad. Tras estudiar los factores relacionados con el DAM, se ha observado que la variable sentido de la vida (SV), desempeña un rol importante en relación al desencadenamiento del DAM. Hasta el momento se han publicado diversas intervenciones dirigidas a ayudar a los pacientes en la búsqueda o mejora de SV en el tramo final de sus vidas. Sin embargo no se ha evaluado la eficacia de estas intervenciones sobre el DAM. El objetivo principal del presente estudio es evaluar, en una población de pacientes en cuidados paliativos, la efectividad de una intervención de mejora del SV para disminuir el eventual DAM. El estudio se desarrollará en tres fases. En primer lugar se realizará una revisión sistemática integrativa de las intervenciones publicadas para mejorar el SV y posterior selección de la terapia más adecuada de acuerdo con las evidencias halladas. En segundo lugar se hará la adaptación transcultural y validación de un instrumento de medida de SV, el Meaning in Life Questionnaire (MLQ). Por último se llevará a cabo la implementación de la intervención escogida y evaluación de su efectividad para disminuir el DAM, mediante un estudio de diseño pre-post, en pacientes oncológicos ingresados en la unidad de cuidados paliativos. Este trabajo aportará también los resultados preliminares de la revisión sistemática integrativa de las intervenciones de SV.

Delinqüència estacional a Barcelona : dificultats, reptes i estratègies

Problemàtiques de les comissaries en zones turístiques. Estratègies per fer front càrregues de feina.Turistes víctimes.Tipologia de fets.Estratègies de prevenció.Estratègies d’investigació