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Marrugat J.,Instituto Municipal Of Investigacion Medica | Vila J.,Instituto Municipal Of Investigacion Medica | Baena-Diez J.M.,Instituto Municipal Of Investigacion Medica | Baena-Diez J.M.,Institute Catala Of La Salut | And 10 more authors.
Revista Espanola de Cardiologia | Year: 2011

Introduction and objectives: Cardiovascular risk screening requires accurate risk functions. The relative validity of the Framingham-based REGICOR adapted function is analyzed and the population distribution of cardiovascular 10-year cardiovascular events is described by risk group. Methods: A population cohort of 3856 participants recruited between 1995 and 2000, aged 35 to 74 years from Girona without symptoms of cardiovascular diseases, was followed between 2006 and 2009. Standardized laboratory and blood pressure measurements, questionnaires, and case definitions were used. The follow-up combined cross-linkage of our databases with our regional mortality registry, reexamination, and telephone contact with participants. Coronary disease endpoints alone were considered. Results: A total of 27 487 person-years were obtained (mean follow-up 7.1 years), and the follow-up was achieved in 97% of participants (120 coronary disease events). Validity was good: the regression coefficients estimated with the cohort data did not differ from those obtained in the original Framingham function. Function calibration was good: the observed incidence of cardiovascular events in the decile groups of risk did not differ from the function prediction (P = .127 in women, and P = .054 in men). The C statistic (discrimination) was 0.82 (95% confidence interval, 0.76-0.88) in women, and 0.78 (95% confidence interval, 0.73-0.83) in men. More than 50% of cardiovascular events occurred in participants whose 10-year risk was 5% to 14.9%. Conclusions: The studied function accurately predicts coronary disease events at 10 years. Risk stratification could be simplified in 4 groups: low (<5%), moderate (5%-9.9%), high (10%-14.9%) and very high (≥15%). © 2010 Sociedad Española de Cardiología. Published by Elsevier España, S.L. All rights reserved. Source


Cabrera De Leon A.,Hospital Universitario Nuestra Senora Of Candelaria | Cabrera De Leon A.,University of La Laguna | Sanz H.,Instituto Municipal Of Investigacion Medica | Elosua R.,Instituto Municipal Of Investigacion Medica | And 11 more authors.
Revista Espanola de Cardiologia | Year: 2012

Introduction and objectives: To update the prevalence of metabolic syndrome and associated coronary risk in Spain, using the harmonized definition and the new World Health Organization proposal (metabolic premorbid syndrome), which excludes diabetes mellitus and cardiovascular disease. Methods: Individual data pooled analysis study of 24 670 individuals from 10 autonomous communities aged 35 to 74 years. Coronary risk was estimated using the REGICOR function. Results: Prevalence of metabolic syndrome was 31% (women 29% [95% confidence interval, 25%-33%], men 32% [95% confidence interval, 29%-35%]). High blood glucose (P=.019) and triglycerides (P<.001) were more frequent in men with metabolic syndrome, but abdominal obesity (P<.001) and low high-density lipoprotein cholesterol (P=.001) predominated in women. Individuals with metabolic syndrome showed moderate coronary risk (8% men, 5% women), although values were higher (P<.001) than in the population without the syndrome (4% men, 2% women). Women and men with metabolic syndrome had 2.5 and 2 times higher levels of coronary risk, respectively (P<.001). Prevalence of metabolic premorbid syndrome was 24% and the increase in coronary risk was also proportionately larger in women than in men (2 vs 1.5, respectively; P<.001). Conclusions: Prevalence of metabolic syndrome is 31%; metabolic premorbid syndrome lowers this prevalence to 24% and delimits the population for primary prevention. The increase in coronary risk is proportionally larger in women, in both metabolic syndrome and metabolic premorbid syndrome. 2011 Sociedad Española de Cardiolog?́a. Published by Elsevier España, S.L. All rights reserved. Source


Comin-Colet J.,Programa de Insuficiencia Cardiaca | Comin-Colet J.,Autonomous University of Barcelona | Comin-Colet J.,Instituto Municipal Of Investigacion Medica | Garin O.,Instituto Municipal Of Investigacion Medica | And 9 more authors.
Revista Espanola de Cardiologia | Year: 2011

Introduction and objectives: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is specifically designed to evaluate quality of life in patients with chronic heart failure (CHF). The purpose of this study was to assess the reliability, validity, and responsiveness to change of the Spanish version of the KCCQ. Methods: The multicenter study involved 315 patients with CHF. Patients were evaluated at baseline and at weeks 24 and 26. The KCCQ, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Short Form-36 (SF-36) were administered. Reliability was assessed in stable patients (n = 163) by examining test-retest and internal consistency measures between weeks 24 and 26. Validity was evaluated at baseline (n = 315) by determining how KCCQ scores varied with New York Heart Association functional class and by comparing scores with those on similar domains of the MLHFQ and SF-36. Responsiveness to change was assessed in patients who experienced significant clinical improvement between baseline and week 24 (n = 31) by determining the effect size. Results: Reliability coefficients ranged between 0.70 and 0.96 for the different domains. Mean KCCQ scores varied significantly with New York Heart Association functional class (P < .001). Correlations with comparable domains on the other questionnaires were acceptable (e.g. for physical limitation, they were between 0.77 and 0.81). The changes observed at 24 weeks in the majority of KCCQ scores in the subsample that improved corresponded to a moderate effect size (i.e. 0.4-0.6). Conclusions: The Spanish version of the KCCQ has good metric properties (i.e. validity, reliability and responsiveness), which make it suitable for use in evaluating quality of life in Spanish CHF patients. © 2010 Sociedad Española de Cardiología. Publicado por Elsevier España, S.L. Todos los derechos reservados. Source


Alameda F.,Servicio de Patologia | Alameda F.,Autonomous University of Barcelona | Alameda F.,Instituto Municipal Of Investigacion Medica | Mancebo G.,Autonomous University of Barcelona | And 13 more authors.
Revista Espanola de Patologia | Year: 2014

Background: Tyrosine-kinase receptors are frequently activated in malignant human tumours. This activation results in high levels of proliferation, migration, dedifferentiation, dissemination and resistance to apoptosis of the tumour cells. Alterations in the following signalling pathways related to ErbB/HER: RAS-RAF-ERK, PIK3-AKT, MAPK, and NFKB have been described. Studying these signaling pathways could help identify more aggressive tumours and thus provide information about potential changes in therapy. Material and methods: We performed an immunohistochemical study of EGFR, p-EGFR, p38, p-ERK. 1/2, JNK, p-AKT, p65, p50, p52, relB, c-Rel and MAPK-1 in 32 infiltrating squamous cell carcinomas of the uterine cervix using a tissue array. Results: Only p-ERK immunoexpression correlated with the stage of the disease (. P<. .001) and the relapse (. P<. .001). Furthermore, the MKP1 immunoexpression inversely correlated with the immunoexpression of p-JNK (. P= .036) and p-p38 (. P= .011) levels, thereby indicating that MKP1 could exert anti-apoptotic activity. This hypothesis has been further reinforced by the recently reported correlation between MKP detection and poor response to treatment (chemo- and radiotherapy). Conclusions: Our observations indicate that more aggressive tumours show higher p-ERK and MKP1 immunoexpression and lower levels of p-JNK and p-p38 immunoexpression, the latter two favour tumour resistance to chemotherapy. p-ERK and MKP1 immunoexpression could serve as prognostic factors and therapeutic targets for these tumours. © 2013 SEAP y SEC. Source


Quesada R.,Instituto Municipal Of Investigacion Medica | Burdio F.,Servicio de Cirugia | Iglesias M.,Hospital Del Mar | Dorcaratto D.,Instituto Municipal Of Investigacion Medica | And 7 more authors.
Pancreas | Year: 2014

Objective: The aim of this study was to determine whether radiofrequency ablation (RFA) of the pancreas and subsequent transection of the main pancreatic duct may avoid the risk of both necrotizing pancreatitis and postoperative pancreatic fistula (POPF) formation. Methods: Thirty-two rats were subjected to RFA and section of the pancreas over their portal vein. Animals were killed at 3, 7, 15, and 21 days (groups 0-3, respectively). Two additional control groups (sham operation and user manipulation only, respectively) of 15 days of postoperative period were considered. Postoperative complications, histological changes (including morphometric and immunohistochemical analysis), and incidence of POPF were evaluated. Results: A significant increase in serum amylase levels (P < 0.05) on the third postoperative day, which return to baseline levels in the following weeks, was noted in groups 0 to 3. Those groups showed a rapid atrophy of the distal pancreas by apoptosis with no signs of necrotizing pancreatitis or POPF. The distal pancreas in groups 1 to 3 compared with group 0 and control groups showed a significant increase of small islets (<1000 μm). Conclusions: The rapid acinar atrophy of the distal pancreas after RFA and section of the pancreatic ducts in this model does not lead to necrotizing pancreatitis. Copyright © 2014 Lippincott Williams & Wilkins. Source

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