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Marin-Iranzo R.,Centro Medico Of Asturias | Riesgo-Garcia A.,Medicina Familiar y Comunitaria | Garcia-Casas J.B.,Servicio de Medicina Preventiva y Salud Publica
Nefrologia | Year: 2012

Objectives: To determine the prevalence of kidney failure in people older than 49 years old with peripheral arterial disease and to analyse its relationship with risk factors and cardiovascular disease. Material and method: Prospective epidemiological study 3 years in duration with selection by simple random sampling in the general population aged over 49 years. Data on demographic, clinical, prevalence of risk factors and cardiovascular disease were registered. We defined peripheral arterial disease (PAD) by ankle-brachial index (ABI) ≤0.9 and chronic kidney disease (CKD) according to estimated glomerular filtration rates by the MDRD <60 ml/min/1.73m 2. Baseline data are presented. Results: 511 people were included. The mean age was 66.6 (9.7) years (SD), 37% were men. The prevalence of PAD was 12.4% (N=63) of the sample, average age 72.6 years, 46% men. The presence of CKD stages 3-5 was 39.7%. Patients with PAD and CKD compared with those with normal renal function were older (75.6 vs. 70.6, p=0.08), predominantly women (64% vs 47.4%, p=ns), and showed higher values for systolic and diastolic blood pressure (159.2 vs 146.1, p=ns and 85.7 vs 80.3 mmHg, p=0.09), CRP (1.23 vs 0.38 mg/dl, p=0.05) and albumin creatinine ratio (90.2 vs 26.4 mg/g, p=ns). In this group, the prevalence of cardiovascular risk factors and associated cardiovascular disease, were significantly higher without reaching statistical significance. Conclusions: Kidney failure is present in 39.7% of patients with PAD and it defines a subgroup of patients with high cardiovascular risk. © 2012 Revista Nefrología.

Vivanco-Allende A.,Hospital Carmen y Severo Ochoa | Garcia-Gonzalez M.,Hospital Carmen y Severo Ochoa | Gonzalez-Jimenez D.,Hospital Carmen y Severo Ochoa | Perez-Guirado A.,Hospital Carmen y Severo Ochoa | And 2 more authors.
Journal of Pediatric Endocrinology and Metabolism | Year: 2012

Central precocious puberty (CPP) is fairly common in girls. In most girls, the etiology for the CPP is unknown. Among the more rare causes of CPP in girls are central nervous system tumors and hamartomas. Osteolipoma of the tuber cinereum, which is the most commonly diagnosed at autopsy, has been reported as a cause of CPP. We describe an 8-year-old girl with central precocious puberty in whom MRI demonstrated a lesion compa tible with osteolipoma. Her symptom was breast development that begun at age 7 years and 9 months. Her case history, laboratory studies and imaging are presented. Her puberty was rapidly progressive. She was treated successfully with a GnRHa (Triptorelin 3.75 mg IM q 4 weeks). Her case brings to the forefront the need to perform an MRI in children with rapidly progressing puberty.

Marcos Mateos V.,Centro Medico Of Asturias | Garcia-Monco J.C.,Servicio de Neurologia | Gomez-Beldarrain M.,Servicio de Neurologia | Armengol-Bertolin S.,Almirall S.A. | Larios C.,Biometria Clinica CRO
Revista de Neurologia | Year: 2011

Introduction. Migraine has recently been associated to certain personality profiles and styles of coping. Aim. To explore the association between personality factors, disability and the therapeutic management of migraine. Patients and methods. We conducted an epidemiological, cross-sectional, multi-centre study with patients with migraine visiting a neurology unit for the first time. Socio-demographic and clinical data were collected about the patients. The NEO-FFI (Neuroticism-Extraversion-Openness Five-Factor Inventory) was used to evaluate personality factors; the degree of disability was evaluated using the Headache Impact Test (HIT-6) and the number of lost workday equivalents (LWDE) was measured. Bivariate logistic regression analyses were also performed. Results. A total of 736 patients were recruited, of whom 700 were suitable for inclusion in the analysis (75.6% females; mean age: 35.5 ± 11.5 years). In all, 68.9% presented migraine without aura, 1-4 seizures/month (66.7%) and of moderate intensity (58.1%). A total of 76.1% of patients had severe disability according to the HIT-6. Of the 554 active patients, the mean number of lost workday equivalents in the previous three months was 6.8 ± 8.2. Patients showed greater emotional instability than the general population and they scored lower on extraversion, openness, agreeableness and conscientiousness. All the patients were being treated for their migraine: 47.3% by means of stepped treatment between seizures; 39.9% intra-seizures, and stratified in only 12.9%. Conclusions. This study confirms the impact of migraine in terms of disability and in terms of loss of labour output, together with its association with personality factors. © 2011 Revista de Neurología.

Ojea B.D.,Seccion de Nefrologia | Marin R.,Centro Medico Of Asturias | Coto E.,Hospital Universitario Central Of Asturias | Vega F.F.,Hospital Universitario Central Of Asturias | And 9 more authors.
Nefrologia | Year: 2010

Background: Hypertensive nephrosclerosis is a chronic kidney disease (CKD) associated to essential hypertension. The lack of correlation between strict control of hypertension and progression of CKD suggests an intrinsic and primary disease. New evidence suggests that MYH9 gene alterations are associated with nephrosclerosis in African Americans. The aim of this study is to investigate whether a polymorphism of MYH9 in Caucasians is linked to the association of essential hypertension and nephrosclerosis. The secondary objective is to identify the clinical risk factors of progression to end-stage renal disease (ESRD). This is a retrospective study that will compare patients with nephrosclerosis versus essential hypertensives without renal disease, and also patients with nephrosclerosis and impaired renal function versus those that are stable. Methods: Between October 2009 and October 2010, 500 patients stages 3-5 CKD attributed to nephrosclerosis according to usual clinical criteria, and 300 essential hypertensives (eGFR > 60 mL/min/1.73m2; microalbuminuria <300 mg/g) will be recruited. 200 healthy controls from general population will also be included for the genetic study. There will be two sections of the study, first and final visit to the clinic (stage 5, the start of replacement therapy will be the end of follow-up). Clinical and laboratory data will be recorded, and blood samples will be collected. Discussion: Our study will seek to determine if there exists a relationship between the diagnosis of nephrosclerosis and MYH9 gene in the Caucasian race, and to study possible risk factors for progression to ESRD, on both clinical and genetic basis. © 2010 Revista Nefrología.

Cadinanos J.,Institute Medicina Oncologica Y Molecular Of Asturias | Llorente J.L.,Hospital Universitario Central Of Asturias | De La Rosa J.,Institute Medicina Oncologica Y Molecular Of Asturias | Villameytide J.A.,Centro Medico Of Asturias | And 4 more authors.
Head and Neck | Year: 2011

Background: Paragangliomas (PGLs) are rare tumors arising either from sympathetic or parasympathetic-associated chromaffin tissue. PGLs can occur either sporadically or as part of a hereditary syndrome. Sympathetic head and neck PGLs are extremely rare tumors and only a few cases have been reported to date. Methods: We report the pedigree of a patient with a head and neck PGL arising from the right sympathetic trunk. SDHD mutation analysis was performed using standard sequencing, multiplex ligation-dependent probe amplification, chromosome 11-specific comparative genome hybridization, and long-range/short-range polymerase chain reaction (PCR) approaches. Results: A previously unreported chromosome 11q deletion encompassing 5 annotated genes (SDHD, DLAT, PIH1D2, C11Orf57, and TIMM8B) was detected in the proband. Conclusion: PGL families considered "mutation-negative" may be attributable to large gene deletions not detectable by standard sequencing Methods: Therefore, deletion analysis should be offered to families or individuals at risk for hereditary PGLs. © 2010 Wiley Periodicals, Inc.

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