Vinyoles E.,European University at Madrid
Journal of Hypertension | Year: 2017
OBJECTIVE:: The European Guidelines on Hypertension define an office pulse pressure (PP) at least 60?mmHg in the elderly patient as asymptomatic organ damage. Our objective was to estimate the cutoff point of 24-h PP that best predicts office PP associated with higher cardiovascular risk (≥60?mmHg) in hypertensive older patients. METHODS:: We studied all hypertensive patients at least 60 years with a first valid ambulatory blood pressure monitoring drawn from the Spanish ambulatory blood pressure monitoring registry. Receiver operating characteristic curves were used to estimate the best 24-h PP cutoff predictor of office PP at least 60?mmHg that maximized the sum of sensitivity and specificity. RESULTS:: We included 52?246 hypertensive patients [52.4%, female; mean age (SD) 69.0 (7.0) years]. From these, 34?530 (66.1%) patients had an office PP at least 60?mmHg. The value of 24-h PP that best predicts higher risk clinic PP is 54.9?mmHg [sensitivity: 69.2%; specificity: 70.3%; area under the receiver operating characteristic curve of 0.761 (95% confidence interval 0.756–0.765)]. Mean clinic and 24-h PPs were progressively higher as the study participants were classified at higher cardiovascular risk group. Some 20.5% of patients presented isolated office high PP and 10% a masked high 24-h PP. CONCLUSION:: In a large clinical sample of older hypertensive patients, the cutoff point of 24-h PP that best predicts office PP at least 60?mmHg is 55?mmHg. In 30.5% of cases, there is a discrepancy between office PP and ambulatory 24-h PP. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Hidalgo-Figueroa M.,University of Seville |
Bonilla S.,European University at Madrid |
Gutierrez F.,University of Seville |
Pascual A.,University of Seville |
Lopez-Barneo J.,University of Seville
Journal of Neuroscience | Year: 2012
Glial cell line-derived neurotrophic factor (GDNF) is absolutely required for survival of dopaminergic (DA) nigrostriatal neurons and protect them from toxic insults. Hence, it is a promising, albeit experimental, therapy for Parkinson's disease (PD). However, the source of striatal GDNF is not well known. GDNF seems to be normally synthesized in neurons, but numerous reports suggest GDNF production in glial cells, particularly in the injured brain. We have studied in detail striatal GDNF production in normal mouse and after damage of DA neurons with MPTP. Striatal GDNF mRNA was present in neonates but markedly increased during the first 2-3 postnatal weeks. Cellular identification of GDNF by unequivocal histochemical methods demonstrated that in normal or injured adult animals GDNF is expressed by striatal neurons and is not synthesized in significant amounts by astrocytes or microglial cells.GDNFmRNAexpression was not higher in reactive astrocytes than in normal ones. Approximately 95% of identified neostriatal GDNF-expressing cells in normal and injured animals are parvalbumin-positive (PV+) interneurons, which only represent~0.7% of all striatal neurons. The remaining5%of GDNF+cells are cholinergic and somatostatin+interneurons. Surprisingly, medium spiny projection neurons (MSNs), the vast majority of striatal neurons that receive a strong DA innervation, do not express GDNF. PV+interneurons constitute an oscillatory functional ensemble of electrically connected cells that control MSNs' firing. Production of GDNF in the PV+ neurons might be advantageous to supply synchronous activity-dependent release ofGDNFin broad areas of the striatum. Stimulation of the GDNF-producing striatal PV+ ensemble in PD patients could have therapeutic effects. © 2012 the authors.
Pomeda A.R.,European University at Madrid
Eye and Contact Lens | Year: 2017
OBJECTIVES:: Recent research has shown that concentric contact lenses (CLs) can be a way to control the progression of myopia. The purpose of the current study was to compare vision-related quality-of-life measures in children wearing distance single-vision (SV) spectacles versus MiSight CLs, a specific concentric design for myopia control. METHODS:: Subjects aged 8 to 12 with myopia from −0.75 to −4.00 diopters (D) of sphere and astigmatism less than 1.00 D of cylinder were allocated to the lenses study group (MiSight) or control group (SV). A Pediatric Refractive Error Profile (PREP) questionnaire was administered at 12- and 24-month intervals to evaluate childrenʼs perceptions in overall vision, near vision, far distance vision, symptoms, appearance, satisfaction, activities, academic performance, handling, and peer perceptions. The mean score of all items was calculated as the overall score. RESULTS:: In total, 74 children completed the study: n=41 in the MiSight group and n=33 in the SV group. In the MiSight group, the ratings at 12 and 24 months for appearance, satisfaction, effect on activities, handling, and peer perceptions were significantly better than those given by children in the SV group (P<0.001), as was the overall score. However, near vision was significantly better in the SV group at both 12 and 24 months (P<0.001). CONCLUSIONS:: MiSight CL wear for controlling myopia improves vision-related quality of life in children when compared with spectacle wear. © 2017 Contact Lens Association of Ophthalmologists, Inc.
Cosio F.G.,European University at Madrid
Arrhythmia and Electrophysiology Review | Year: 2017
Clinical electrophysiology has made the traditional classification of rapid atrial rhythms into flutter and tachycardia of little clinical use. Electrophysiological studies have defined multiple mechanisms of tachycardia, both re-entrant and focal, with varying ECG morphologies and rates, authenticated by the results of catheter ablation of the focal triggers or critical isthmuses of re-entry circuits. In patients without a history of heart disease, cardiac surgery or catheter ablation, typical flutter ECG remains predictive of a right atrial re-entry circuit dependent on the inferior vena cava-tricuspid isthmus that can be very effectively treated by ablation, although late incidence of atrial fibrillation remains a problem. Secondary prevention, based on the treatment of associated atrial fibrillation risk factors, is emerging as a therapeutic option. In patients subjected to cardiac surgery or catheter ablation for the treatment of atrial fibrillation or showing atypical ECG patterns, macro-re-entrant and focal tachycardia mechanisms can be very complex and electrophysiological studies are necessary to guide ablation treatment in poorly tolerated cases. © RADCLIFFE CARDIOLOGY 2017.
de la Sierra A.,European University at Madrid
Journal of Hypertension | Year: 2017
BACKGROUND AND AIM:: The prevalence and associated risks of white-coat hypertension (WCH) are still a matter of debate. We aimed to assess differences in prevalence and associated conditions of WCH defined on the basis of the normality of all daytime, night-time, and 24-h blood pressure (BP), only daytime, or only 24-h BP. METHODS:: We selected 115?708 patients (45?020 untreated and 70?688 treated) from the Spanish Ambulatory BP Monitoring Registry. WCH was estimated in patients with elevated office BP (≥140 and/or 90?mmHg) by using normal daytime (<135/85) BP, normal 24-h BP (<130/80), or normal daytime, night-time (<120/70) and 24-h BP. Demographic and clinical data (associated risk factors and organ damage) were compared among groups. RESULTS:: Prevalence of WCH was 41.3, 35.2, and 26.1% in untreated, and 45.8, 38.9, and 27.2% in treated patients with elevated office BP, by using the criteria of daytime, 24-h, or all ambulatory periods. Compared with the normotensive group, WCH defined by normal daytime, night-time, and 24-h BP did not significantly differ in terms of other cardiovascular risk factors or organ damage. In contrast, patients from other groups (either only normal daytime BP or 24-h BP) had significantly more prevalence of diabetes, dyslipidaemia, microalbuminuria, left ventricular hypertrophy, reduced renal function, and previous history of cardiovascular disease. CONCLUSION:: Prevalence of WCH is dependent on definition criteria. Only diagnostic criteria which considers the normality of all ambulatory periods identifies patients with cardiovascular risk similar to normotensive patients. These results support using such criteria for a more accurate definition of WCH. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Clemente-Suarez V.J.,European University at Madrid
Applied Physiology, Nutrition and Metabolism | Year: 2015
Many studies have researched the psychophysiological response and energy balance of athletes in numerous ultraendurance probes, but none has investigated an ultraendurance mountain running event. The current study aims to analyze changes in blood lactate concentration, rating of perceived exertion, heart rate, heart rate variability, and energy balance after the performance of an ultraendurance mountain running event. The parameters in the 6 participants who finished the event were analyzed (age, 30.8 ± 3.1 years; height, 176.2 ± 8.6 cm; body mass, 69.2 ± 3.7 kg). The race covered 54 km, with 6441 m of altitude change, 3556 m downhill and 2885 m uphill. The athletes completed together the race in 14 h and 6 min. After the ultraendurance event, the athletes presented a negative energy balance of 4732 kcal, a blood lactate concentration of 2.8 ± 0.3 mmol/L, a heart rate mean/heart rate maximum ratio of 0.64, a heart rate mean of 111.4 ± 5.9 beats/min, a decrease in vagal modulation, and an increase in sympathetic modulation, and recorded 19.5 ± 1.5 points on the 6–20 rating of perceived exertion scale. The event was a stressful stimulus for the athletes despite the low intensity measured by blood lactate concentration and heart rate. The results obtained may be used by coaches as a reference parameter of heart rate, heart rate variability, rating of perceived exertion, and lactate concentration to develop specific training programs. In addition, the energy balance data obtained in this research may improve nutritional intake strategies. ©, 2006 National Research Council of Canada. All rights reserved.
Garcia-Benitez S.,European University at Madrid
Journal of child neurology | Year: 2013
Owing to the risk of severe rhabdomyolysis, clinicians advise McArdle disease patients to refrain from strenuous exercise, particularly weight lifting. A 15-year-old male McArdle disease patient performed a 6-week, supervised, light- to moderate-intensity (~65-70% of one-repetition-maximum) resistance (weight lifting) training program (2 sessions/week). Training resulted in ~27% and ~6% increase in one-repetition-maximum bench press and multipower squat performance while inducing no myoglobinuria. The patient changed to a lower disease severity class, that is, he became virtually asymptomatic in terms of exercise limitations. The authors' preliminary data suggest that supervised, light to moderate resistance training is feasible in children with McArdle disease and has potential clinical benefits.
Aliane N.,European University at Madrid
IEEE Transactions on Education | Year: 2010
This paper presents an interactive module for learning both the fundamental and practical issues of servo systems. This module, developed using Simulink in conjunction with the Matlab graphical user interface (Matlab-GUI) tool, is used to supplement conventional lectures in control engineering and robotics subjects. First, the paper introduces the theoretical background of servo systems. Then, the interactive module is presented, with a description of its main features as well some hints on how to integrate Simulink models within Matlab-GUI. Some of the module's capabilities are illustrated through classroom examples. Finally, the experience of putting this into use and student assessment of the tool are also addressed. © 2009 IEEE.
Fernandez-Lucas J.,European University at Madrid
Applied Microbiology and Biotechnology | Year: 2015
Living cells are most perfect synthetic factory. The surprising synthetic efficiency of biological systems is allowed by the combination of multiple processes catalyzed by enzymes working sequentially. In this sense, biocatalysis tries to reproduce nature’s synthetic strategies to perform the synthesis of different organic compounds using natural catalysts such as cells or enzymes. Nowadays, the use of multienzymatic systems in biocatalysis is becoming a habitual strategy for the synthesis of organic compounds that leads to the realization of complex synthetic schemes. By combining several steps in one pot, a significant step economy can be realized and the potential for environmentally benign synthesis is improved. Using this sustainable synthetic system, several work-up steps can be avoided and pure products are ideally isolated after a series of reactions in one single vessel after just one straightforward purification step. In recent years, enzymatic methodology for the preparation of nucleic acid derivatives (NADs) has become a standard technique for the synthesis of a wide variety of natural NADs. Enzymatic methods have been shown to be an efficient alternative for the synthesis of nucleoside and nucleotide analogs to the traditional multistep chemical methods, since chemical glycosylation reactions include several protection–deprotection steps and the use of chemical reagents and organic solvents that are expensive and environmentally harmful. In this minireview, we want to illustrate what we consider the most current relevant examples of in vivo and in vitro multienzymatic systems used for the synthesis of nucleic acid derivatives showing advantages and disadvantages of each methodology. Finally, a detailed perspective about the impact of -omics in multienzymatic systems has been described. © 2015, Springer-Verlag Berlin Heidelberg.
Cabrera P.M.,European University at Madrid
Journal of endourology / Endourological Society | Year: 2013
To present the feasibility of laparoendoscopic single-site (LESS) nephron-sparing surgery (NSS) using new reusable umbilical single-port system and instruments. A prospective study was performed to evaluate operative data and patient outcomes after LESS-NSS with KeyPort®, a tri-channel single-port placed through a 2.5-cm umbilical incision, and specific DuoRotate® instruments. Patient characteristics, operative time, estimated blood loss (EBL), complications, visual analog pain scale (VAPS), and visual analogue wound satisfaction scale (VAWSS) scores were registered. Six consecutive nonselected patients with indication of NSS and normal contralateral kidney were offered LESS-NSS. An accessory 3.5 mm port that facilitated renoraphy and unclamped technique was used in 4 (66.7%) cases each. Median tumor maximum size was 4.0 (1-7.5) cm; age 64 (31-76) years; body mass index 28.4 (22.1-39.3) kg/m(2); operative time 233.5 (140-250) min; EBL 500 (200-500) mL; difference in hemoglobin 2.3 (0.1-4.6) g/dL. VAPS at day 2 was 0.7/10 and the median length of stay 3 (2-4) days. One case (16.7%) needed transfusion. None required conversion to standard laparoscopy or use of other additional ports. Postoperative complications occurred in 3 (50%) and major complications in 1 (16.7%). Incisions were totally hidden in the umbilicus. Pathology revealed angiomyolipoma (3), renal cell carcinoma (2), and chronic inflammation (1). Tumor margins were negative in all cases with malignancy. VAWSS at first month was 9.4 (8.1-10). At a median follow-up of 24 (10-32) weeks, no patient developed complications related to the approach. Umbilical LESS-NSS through a new single-port system of reusable nature, with or without the help of an accessory port and occasionally without clamping, can be effectively and very economically performed with minimum postoperative pain. Good candidates are patients with presumed benign renal masses that appreciate the cosmetic advantage of the approach.