The prevalence of diabetes-related complications and multimorbidity in the population with type 2 diabetes mellitus in the Basque Country

Background: Type 2 diabetes mellitus is associated with a diverse range of pathologies. The aim of the study was to determine the incidence of diabetes-related complications, the prevalence of coexistent chronic conditions and to report multimorbidity in people with type 2 diabetes living in the Basque Country. Methods: Administrative databases, in four cross sections (annually from 2007 to 2011) were consulted to analyse 149,015 individual records from patients aged >= 35 years with type 2 diabetes mellitus. The data observed were: age, sex, diabetes-related complications (annual rates of acute myocardial infarction, major amputations and avoidable hospitalisations), diabetes-related pathologies (prevalence of ischaemic heart disease, renal failure, stroke, heart failure, peripheral neuropathy, foot ulcers and diabetic retinopathy) and other unrelated pathologies (44 diseases). Results: The annual incidence for each condition progressively decreased during the four-year period: acute myocardial infarction (0.47 to 0.40%), major amputations (0.10 to 0.08%), and avoidable hospitalisations (5.85 to 5.5%). The prevalence for diabetes-related chronic pathologies was: ischaemic heart disease (11.5%), renal failure (8.4%), stroke (7.0%), heart failure (4.3%), peripheral neuropathy (1.3%), foot ulcers (2.0%) and diabetic retinopathy (7.2%). The prevalence of multimorbidity was 90.4%. The highest prevalence for other chronic conditions was 73.7% for hypertension, 13.8% for dyspepsia and 12.7% for anxiety. Conclusions: In the type 2 diabetes mellitus population living in the Basque Country, incidence rates of diabetes complications are not as high as in other places. However, they present a high prevalence of diabetes related and unrelated diseases. Multimorbidity is very common in this group, and is a factor to be taken into account to ensure correct clinical management.

The Interplay between Natural Selection and Susceptibility to Melanoma on Allele 374F of SLC45A2 Gene in a South European Population

We aimed to study the selective pressures interacting on SLC45A2 to investigate the interplay between selection and susceptibility to disease. Thus, we enrolled 500 volunteers from a geographically limited population (Basques from the North of Spain) and by resequencing the whole coding region and intron 5 of the 34 most and the 34 least pigmented individuals according to the reflectance distribution, we observed that the polymorphism Leu374Phe (L374F, rs16891982) was statistically associated with skin color variability within this sample. In particular, allele 374F was significantly more frequent among the individuals with lighter skin. Further genotyping an independent set of 558 individuals of a geographically wider population with known ancestry in the Spanish population also revealed that the frequency of L374F was significantly correlated with the incident UV radiation intensity. Selection tests suggest that allele 374F is being positively selected in South Europeans, thus indicating that depigmentation is an adaptive process. Interestingly, by genotyping 119 melanoma samples, we show that this variant is also associated with an increased susceptibility to melanoma in our populations. The ultimate driving force for this adaptation is unknown, but it is compatible with the vitamin D hypothesis. This shows that molecular evolution analysis can be used as a useful technology to predict phenotypic and biomedical consequences in humans.

Identification of the main allergen sensitizers in an Iran asthmatic population by molecular diagnosis

Background: There has been a significant growth in the prevalence of allergy, mainly associated to IgE-mediated disorders such as asthma and rhinitis. The identification of atopy in asthmatic patients through the measurement of specific IgE can help to identify risk factors that cause asthmatic symptoms in patients. The development and use of individualized allergen-based tests by the Component Resolved Diagnosis has been a crucial advance in the accurate diagnosis and control of allergic patients. The objective of this work was to assess the usefulness of molecular diagnosis to identify environmental allergens as possible factors influencing the development and manifestation of asthma in a group of asthmatic patients from Iran. Methods: Studied population: 202 adult asthmatic patients treated at the Loghman Hakim Hospital and Pasteur Institute of Teheran (Iran) from 2011 to 2012. Specific IgE determined by the ImmunoCAP system were used to both evaluate the patients' atopic condition and the molecules involved in the allergic sensitization. SDS-PAGE IgE-immunoblotting associated with mass spectrometry was carried out to study the cockroach IgE-binding sensitizing proteins. Results: Forty-five percent of all patients could be considered atopic individuals. Eighty-two percent of atopic patients were sensitized to pollen allergens. The Salsola kali (Sal k 1) and the Phleum pratense (rPhl p 1 and/or rPhl p 5) major allergens were the most common sensitizers among pollens (71% and 18%, respectively). Thirty-five percent of the atopic population was sensitized to cockroach. Four different allergens, including a previously unknown alpha-amylase, were identified in the cockroach extract. No significant associations could be demonstrated between the severity of asthma and the specific IgE levels in the atopic population. Statistical analysis identified the Sal k 1 as the main protein allergen influencing the development and expression of asthma in the studied population. Conclusions: Pollen and cockroach were the most relevant allergen sources in the asthmatic population. The Salsola kali major allergen was the main cause for sensitization in the atopic patients suffering asthma. Using the Component Resolved Diagnosis, it was possible to identify a new Blattella germanica cockroach allergen (Blattella alpha amylase 53 kDa) that could sensitize a relevant percentage of this population.

Population structure of Pacific yellowfin tuna

ENGLISH: The population structure and production of Pacific yellowfin tuna, Thunnus albacares, were examined by studying most of the basic data available on stock assessment, as well as other data, for the period 1965 to 1972. The data were obtained mainly from the Japanese longline fishery in the Pacific Ocean east of about 1200E and from the purse-seine fishery in the eastern Pacific east of about 140oW. Data from genetic studies of subpopulations were not used due to their preliminary nature. It was concluded that the concept of "semi-independent" subpopulations proposed by Kamimura and Honma (1963) and Royce (1964) defines the population structure of Pacific yellowfin. At least three stocks (i.e. western, central and eastern), relatively independent of each other, are thought to exist, but the actual number and location of subpopulations is still unclear. Possible north-south separations, indicated to some extent by genetic studies and tagging, could be neither substantiated nor rejected on the basis of this study. Finally, unless some major change in the fishing technology occurs, it is doubtful if any significant sustainable increase in yellowfin production from the Pacific is possible. The greatest potential for increase, if any, appears to be based on changing the size structure of yellowfin in the catch from the central Pacific. SPANISH: Se examino la estructura de la población y la producción del atún aleta amarilla del Pacifico Thunnus albacares para estudiar la mayoría de los datos básicos que se tenían sobre el avalúo de la población, como también otra información correspondiente al periodo de 1965·1972. Los datos fueron obtenidos principalmente de las pescas palangreros japonesas del Océano Pacifico al este de los 1200 E y de las pescas con redes de cerco del Pacifico oriental, al este de los 140oW. No se emplearon los datos de estudios genéticos de las subpoblaciones porque eran mas bien preliminares. Se concluyo que el concepto propuesto por Kamimura y Honma (1963) y Royce (1964) de subpoblaciones "semiindependientes" define la estructura de la población del aleta amarilla en el Pacifico. Se cree que existen por 10 menos tres existencias (e.d. la occidental, central y oriental), relativamente independientes la una de la otra, pero no se conoce con certeza cuantas subpoblaciones hay y donde se encuentran. La posible separación norte-sur, indicada, hasta cierto punto, por los análisis genéticos y del marcado, no puede ni confirmarse ni rechazarse basados en este estudio. Finalmente, a no ser que ocurra algún gran cambio en la tecnología pesquera es dudoso que sea posible obtener un aumento constante e importante en la producción del aleta amarilla del Pacifico. El potencial mayor de aumento, si es que existe alguno, parece que se basa en el cambio de la estructura de talla en la captura del aleta amarilla del Pacifico central. (PDF contains 169 pages.)

Análisis de la desigualdad económica en los municipios del País Vasco agrupados por tamaño de la población. Economic Inequality in the municipalities of the Basque Country aggregated by population size.

This paper analyses the economic inequality in the municipalities of the Basque Country during the period 1996 and 2010. We have used dates from the Udalmap database mainly the GDP per capita. We have drawn Lorenz Curves and also we have computed Gini indexes to analyse the evolution of inequality during this period. Therefore, we have concluded that there has been an increase of the economic inequality in the municipalities of the Basque Country during this period of time.

Nivel de vida de los pensionistas en España

[ES] La situación socioeconómica actual ha provocado la traslación de una mayor responsabilidad a la población para organizar su ahorro a largo plazo. La planificación financiera será la hoja de ruta de los ciudadanos para, a lo largo de su ciclo vital, destinar los ahorros necesarios para su jubilación. Sin embargo, la planificación no termina una vez alcanzada dicha edad, sino que los ahorros deben seguir gestionándose de forma que garanticen la cobertura de las necesidades de los jubilados hasta su fallecimiento. La elevada tasa de paro, el aumento de la longevidad y el envejecimiento de la población son factores que afectan a las arcas públicas de la Seguridad Social. Por lo tanto, ¿tienen los actuales pensionistas la garantía de recibir una pensión de jubilación que les permita vivir dignamente? Para dar respuesta a esta pregunta, será de vital importancia conocer la acumulación de capital durante su vida de activo para así, combinando la fuente de ingresos públicos, sus gastos y sus ahorros privados, conocer cuál será su nivel de vida durante su etapa como jubilados. Por lo tanto, a lo largo de este informe trataremos de identificar cuáles son los diferentes productos de ahorro en los que ha venido invirtiendo la población española previo a la jubilación, en función de su edad y renta. Para ello analizaremos la Encuesta Financiera de las Familias del año 2011. Con todo este estudio, pretendemos obtener resultados para determinar el nivel de ingresos y gastos de los pensionistas.

Dobutamine in Paediatric Population: A Systematic Review in Juvenile Animal Models

Objective: Although dobutamine is widely used in neonatal clinical practice, the evidence for its use in this specific population is not clear. We conducted a systematic review of the use of dobutamine in juvenile animals to determine whether the evidence from juvenile animal experiments with dobutamine supported the design of clinical trials in neonatal/ paediatric population. Methods: Studies were identified by searching MEDLINE (1946-2012) and EMBASE (1974-2012). Articles retrieved were independently reviewed by three authors and only those concerning efficacy and safety of the drug in juvenile animals were included. Only original articles published in English and Spanish were included. Results: Following our literature search, 265 articles were retrieved and 24 studies were included in the review: 17 focused on neonatal models and 7 on young animal models. Although the aims and design of these studies, as well as the doses and ages analysed, were quite heterogeneous, the majority of authors agree that dobutamine infusion improves cardiac output in a dose dependent manner. Moreover, the cardiovascular effects of dobutamine are influenced by postnatal age, as well as by the dose used and the duration of the therapy. There is inadequate information about the effects of dobutamine on cerebral perfusion to draw conclusions. Conclusion: There is enough preclinical evidence to ensure that dobutamine improves cardiac output, however to better understand its effects in peripheral organs, such as the brain, more specific and well designed studies are required to provide additional data to support the design of clinical trials in a paediatric population.

Envelhecimento, ciclo de vida e mudanças socioeconômicas: novos desafios para os sistemas de seguridade social

O processo de envelhecimento populacional, ainda que amplamente reconhecido como uma das principais conquistas do século XX engendra o desafio de assegurar que o processo de desenvolvimento ocorra com base em princípios capazes de garantir a dignidade humana e a equidade entre os grupos etários na partilha dos recursos, direitos e responsabilidades sociais. Além dos desafios impostos aos já tradicionais programas constantes dos atuais sistemas de seguridade social, o envelhecimento populacional acrescenta uma nova questão ou risco social: os cuidados de longa duração, demandados pelos idosos com perda de capacidade instrumental e/ou funcional para lidar com as atividades do cotidiano. Por capacidade instrumental pode-se entender a capacidade para a realização de atividades relacionadas a, por exemplo: preparar refeições, fazer compras no mercado, ir ao banco, cuidar da casa etc. Capacidade funcional, por sua vez, refere-se às seguintes atividades: alimentar-se, banhar-se, caminhar distâncias curtas, vestir-se etc. A preocupação com os cuidados de longa duração dos idosos nos países desenvolvidos, onde o processo de envelhecimento populacional já se encontra mais avançado, surgiu como uma necessidade de se separar os custos crescentes com o tratamento dos idosos dos demais gastos com saúde. Os custos, tangíveis ou não, envolvidos na atividade de cuidar/assistir aos idosos tendem a aumentar em função da entrada maciça das mulheres no mercado de trabalho e das mudanças nos contratos de gênero, sugerindo crescentes dificuldades para que as famílias arquem com a responsabilidade pelo cuidado de seus idosos. Em países em desenvolvimento, como o Brasil, essa questão é agravada por se somar a uma ampla lista a ser respondida pelos sistemas de seguridade social, tais como a pobreza, a exclusão de crescentes contingentes da população e o nível de desigualdade vigente. No Brasil, para que se possa avançar no debate sobre os cuidados de longa duração voltados para uma população idosa crescente, faz-se necessário rediscutir e redefinir uma série de parâmetros do atual sistema de seguridade social, em especial, a expressiva parcela de trabalhadores informais alijados do mesmo. O precário equilíbrio, ou resultado, do sistema de seguridade social brasileiro precisa ser revisto e analisado a luz das tendências demográficas, sociais e econômicas que se vislumbram para os próximos 20 ou 30 anos. Somente após o reequacionamento do sistema é possível pensar a incorporação desta nova e latente demanda da sociedade brasileira.