DMed - Artículos
https://hdl.handle.net/10481/31037
2024-03-29T02:39:40ZPrimary prevention of hereditary disease and the economic sustainability of public health systems go hand in hand
https://hdl.handle.net/10481/89604
Primary prevention of hereditary disease and the economic sustainability of public health systems go hand in hand
Esteban de la Rosa, Rafael José; Navarro Espigares, José Luis; Morales García, Ana Isabel; Bravo Soto, Juan Antonio
The diagnosis of HEREDITARY DISEASE is clarified thanks to the impulse of Genetics, and its approach from the cost-efficient scenario of the preventive strategy through PGT supports the economic sustainability of PHS. All this should be better known by health professionals.
Utility of transcranial sonography in the diagnosis of drug-induced parkinsonism: a prospective study.
https://hdl.handle.net/10481/86541
Utility of transcranial sonography in the diagnosis of drug-induced parkinsonism: a prospective study.
Barrero Hernández, Francisco Javier
Background and purpose: Drug-induced parkinsonism usually resolves after discontinuation
of the causative agent. However, it persists in some patients, who actually
have subclinical neurodegenerative parkinsonism. Identification of this condition is
important because these patients could benefit from therapeutic measures. The
objective of this study was to prove whether transcranial sonography, a technique
used in the diagnosis of neurodegenerative parkinsonism, can be used for the said
identification.
Methods: In this prospective study, patients with drug-induced parkinsonism were
followed for at least 6 months after discontinuation of the causative drug and performance
of blinded transcranial sonography. Patients were categorized as having
iatrogenic parkinsonism if the clinical presentation had resolved or subclinical drugexacerbated
parkinsonism if it persisted. Once the patient was classified into one of
the two groups, an expert assessed the transcranial sonography findings and their
agreement with the clinical diagnosis.
Results: Twenty patients composed the group for analysis of results. Assessing hyperechogenicity
in the substantia nigra >20 mm2 and/or hyperechogenic lentiform
nucleus, differences were detected between the iatrogenic parkinsonism and the subclinical
drug-exacerbated parkinsonism groups, although they did not reach statistical
significance (Fisher’s exact test 0.09). Joint assessment of sonographic alterations in
both structures had a negative predictive value of 85.7% for diagnosis of drug-induced
parkinsonism, with a negative likelihood ratio of 0.3.
Conclusions: Although in our study statistically significant differences were not found
between the transcranial sonography characteristics of subclinical drug-exacerbated
parkinsonism and iatrogenic parkinsonism patients, we believe that transcranial
sonography is a valid technique for diagnosis of drug-induced parkinsonism.
Short-term effects of manual therapy on heart rate variability, mood state, and pressure pain sensitivity in patients with chronic tension-type headache: a pilot study.
https://hdl.handle.net/10481/86502
Short-term effects of manual therapy on heart rate variability, mood state, and pressure pain sensitivity in patients with chronic tension-type headache: a pilot study.
Barrero Hernández, Francisco Javier
Cardioprotective function of sclerostin by reducing calcium deposition, proliferation, and apoptosis in human vascular smooth muscle cells
https://hdl.handle.net/10481/86344
Cardioprotective function of sclerostin by reducing calcium deposition, proliferation, and apoptosis in human vascular smooth muscle cells
González Salvatierra, Sheila; García Fontana, Cristina; Andújar Vera, Francisco Luis; Martínez Heredia, Luis; Sanabria de la Torre, Raquel; Ferrer Millán, Maria; Moratalla Aranda, Enrique; Muñoz Torres, Manuel Eduardo; García Fontana, Beatriz
Background
Sclerostin is an inhibitor of the Wnt/b-catenin pathway, which regulates bone formation, and can be expressed in vascular smooth muscle cells (VSMCs). Type 2 diabetes (T2D) is associated with an increased risk of cardiovascular disease (CVD) and increased serum and tissue expression of sclerostin. However, whether the role of sclerostin is detrimental or protective in the development of CVD is unknown. Therefore, our aims are to determine the level of sclerostin in T2D patients with/without CVD and in controls, both at serum and vascular tissue, and to analyze the role of sclerostin in VSMCs under calcified environments.
Methods
Cross-sectional study including 121 controls and 139 T2D patients with/without CVD (48/91). Sclerostin levels in serum were determined by ELISA, and sclerostin expression was analyzed by RT-qPCR and immunohistochemistry in calcified and non-calcified artery of lower limb from T2D patients (n = 7) and controls (n = 3). In vitro experiments were performed in VSMCs (mock and sclerostin overexpression) under calcifying conditions analyzing the sclerostin function by determination of calcium and phosphate concentrations, and quantification of calcium deposits by Alizarin Red. Proliferation and apoptosis were analyzed by MTT assay and flow cytometry, respectively. The regulation of the expression of genes involved in bone metabolism was determined by RT-qPCR.
Results
A significant increase in serum sclerostin levels in T2D patients with CVD compared to T2D patients without CVD and controls (p < 0.001) was observed. Moreover, higher circulating sclerostin levels were independently associated with CVD in T2D patients. Increased sclerostin expression was observed in calcified arteries of T2D patients compared to non-calcified arteries of controls (p = 0.003). In vitro experiments using VSMCs under calcified conditions, revealed that sclerostin overexpression reduced intracellular calcium (p = 0.001), calcium deposits (p < 0.001), cell proliferation (p < 0.001) and promoted cell survival (p = 0.015). Furthermore, sclerostin overexpression exhibited up-regulation of ALPL (p = 0.009), RUNX2 (p = 0.001) and COX2 (p = 0.003) and down-regulation of inflammatory genes, such as, IL1β (p = 0.005), IL6 (p = 0.001) and IL8 (p = 0.003).
Conclusions
Sclerostin could play a protective role in the development of atherosclerosis in T2D patients by reducing calcium deposits, decreasing proliferation and inflammation, and promoting cell survival in VSMCs under calcifying conditions. Therefore, considering the bone-vascular axis, treatment with anti-sclerostin for bone disease should be used with caution.
This work was supported by Junta de Andalucía grant (PI0268-2019) and Institute of Health Carlos III grants (PI18-00803 and PI18-01235) co-funded by the European Regional Development Fund (FEDER) and by CIBER of Frailty and Healthy Aging (CIBERFES;CB16/10/00475). In addition, S.G-S is funded by predoctoral fellowship (FI19/00118) and C.G-F and B.G-F are funded by postdoctoral fellowships from the Institute of Health Carlos III (CD20/00022; CP22/00022 respectively).
Assessment of Levels of Anxiety and Fear of Covid-19 in a Population of Pregnant Women in Spain
https://hdl.handle.net/10481/86321
Assessment of Levels of Anxiety and Fear of Covid-19 in a Population of Pregnant Women in Spain
Muñoz Vela, Francisco Javier; Fernández Carrasco, Francisco Javier; Vázquez Lara, Juana María; Rodríguez Díaz, Luciano
Objective: The aim of the study was to assess the levels of fear and anxiety in the particularly vulnerable population group of women
during pregnancy.
Methods: Cross-sectional study between March 2022 and July 2022 involving 978 pregnant women aged 16 to 50 years. It was
carried out based on the scale for the assessment of fear and anxiety in pregnant women (AMICO_Pregnant) and the collection of
sociodemographic data. Normality analysis was performed prior to univariate and bivariate statistical analysis.
Results: The sample was composed of a total of 978 pregnant women. The mean of the AMICO_Pregnant scale was intermediate
(5.04 points; SD=2.36). The bivariate analysis showed a statistically significant relationship between the AMICO_Pregnant scale and
the following variables: vaccination schedule status, contact with the disease, weeks of gestation, altered delivery or birth plan.
Conclusion: Women with pregnancies closer to term, with no contact with the disease, without a complete vaccination schedule, or
who had undergone changes in their delivery or birth plans, showed higher levels of fear and anxiety.