Prevención de la enfermedad cardiovascular en atención primaria: comparación de la función SCORE para países europeos de bajo riesgo con la tabla calibrada para España / Prevention of cardiovascular disease in primary care: a comparison of the function SCORE for low risk European countries with the calibrated SCORE for Spain

Introducción. Estudio comparativo de 2 ecuaciones de valoración del riesgo de mortalidad cardiovascular (RCV): función SCORE para países europeos de bajo riesgo y función SCORE calibrada para España, para conocer el perfil de riesgo de los pacientes de nuestro centro de salud y valorar las diferencias entre ambos métodos. Material y métodos. Estudio descriptivo transversal, de un cupo de pacientes de un centro de salud, seleccionándose los de edades comprendidas entre los 35-74 años y sin evento cardiovascular (n=398 pacientes). Se calculó el RCV mediante las 2 ecuaciones, se evaluaron las diferencias de clasificación obtenidas con ambas tablas de manera continua y la distribución de pacientes en cada grupo de riesgo. Resultados. La muestra estudiada presenta un perfil global de RCV bajo. Ambos métodos de estimación de riesgo presentaron una buena correlación (coeficiente de Pearson de 0,975, p<0,001). El RCV promedio estimado por la función SCORE calibrada para España fue superior al RCV estimado por la función SCORE europea (2,04 frente a 1,46%, p<0,001). El SCORE calibrado para España clasificó con un riesgo alto (mortalidad ≥ 5% en 10 años) al 12,9% de los pacientes (frente al 7% del SCORE europeo de países de bajo riesgo). Conclusiones. Aunque ambos métodos de estimación de RCV presentan buena correlación, el SCORE calibrado para España clasifica a los pacientes con un RCV un 28% superior al SCORE europeo. Deben realizarse más estudios de poblaciones locales para una correcta estimación del RCV (AU)

Introduction. This is a comparative Study of two cardiovascular risk (CVR) functions; the SCORE for European countries of low risk and the calibrated SCORE for Spain and the objective is to determine the risk profile and evaluate the differences between both methods. Material and methods. This is a descriptive cross-sectional study of a group of patients in our healthcare area. We selected those with ages between 35-74 years and without any previous cardiovascular event (n=398 patients). The CVR was calculated by both equations, evaluating the differences of classification obtained with both methods. Results. The studied sample had a low CVR profile. Both methods of estimation of risk correlated well (Pearson's coefficient of 0.975, P<.001). The average CVR estimated by the function SCORE calibrated for Spain was higher than the CVR estimated by the European SCORE (2.04 vs. 1.46%, P<.001). The Spanish calibrated SCORE predicted a high risk (mortality risk ≥5% in 10 years) for 12.9% of the patients (vs. 7% of the European SCORE). Conclusions. Although both methods of CVR estimation had a good correlation, the calibrated SCORE for Spain obtained a CVR 28% higher than the European SCORE. More studies of local populations must be performed for a correct estimation of the CVR (AU)

Proliferation and differentiation of human adipocyte precursor cells: differences between the preperitoneal and subcutaneous compartments.

Human adipocyte precursor cells (APC) have been characterized in their proliferation and differentiation potential from subcutaneous, omental, and mesenteric depots, mostly from morbidly obese patients. Cells from the preperitoneal adipose compartment have not been characterized yet, least of all when obtained from normal weight subjects. The aim was to compare proliferation and differentiation of subcutaneous (SC) and preperitoneal (PP) APC derived from adipose tissue in healthy subjects with different body mass. SC and PP adipose tissue was obtained during surgery of inguinal hernias in five healthy non-obese subjects and three obese otherwise healthy men. APC, obtained by collagenase digestion, were cultured. Proliferation was assayed by cell counting and differentiation by oil red O staining and flow cytometry using Nile Red staining. Proliferation of SC was higher than PP APC. Such differences between both compartments were even higher in APC obtained from obese patients. Conversely PP APC differentiated earlier in vitro compared with SC cells. These results agree with published data on fat cell proliferation. However regarding differentiation, our data show that APC from deeper depots (in this case PP) differentiate earlier than subcutaneous APC. This is different to previous studies performed in mesenteric or omental adipose tissue.

Un ensayo psicofarmacológico comparado en pacientes esquizofrénicos no respondedores / A psychopharmacologic compared trial in non responding schizophrenic patients

Fundamento: Los pacientes esquizofrénicos no respondedores al tratamiento constituyen un grave problema clínico. Por ello, se desea evaluar la respuesta terapéutica de unas pautas psicofarmacológicas alternativas a los neurolépticos típicos. Método: Una muestra de pacientes esquizofrénicos no respondedores fue asignada aleatoriamente, en diseño doble ciego, a dos grupos terapéuticos: experimental y control. El primero incluía 4 fases: 1) si existen síntomas afectivos asociados: haloperidol y carbamacepina o litio; 2) clozapina; 3) megadosis de haloperidol, y 4) tioridazina y valproato sódico. El grupo control incluía 3 fases: 1) haloperidol; 2) clorpromazina, y 3) clozapina. Se avanza de fase si no hay respuesta terapéutica tras 4 semanas de tratamiento. La evaluación semanal se realizó mediante las siguientes escalas: clínica (BPRS); síntomas positivos (SAPS); síntomas negativos (SANS); ajuste psicosocial (GAF), y efectos secundarios (UKU). Resultados: Diecinueve pacientes han completado al menos una fase del protocolo. Entre los 2 grupos hubo un total de 13 pacientes respondedores: seis con clozapina, tres con haloperidol y cuatro con haloperidol más carbamazepina. El grupo respondedor presentó entre las evaluaciones inicial y final disminuciones medias superiores al 50 por ciento en las escalas BPRS y SAPS (p 40 por ciento en todas las escalas (AU)

[A critical study of the influence of negative symptoms on the therapeutic response in schizophrenia]. / Estudio crítico de la influencia de los síntomas negativos en la respuesta terapeútica de la esquizofrenia.

INTRODUCTION: The schizophrenia is considered an heterogeneous disorder which phenomenological differences could to point to etiopathogenic differences. Negative symptoms are associated with poor treatment response. In the last year different operative criteria of the "refractory treatment" concept has been developed. The association between negative schizophrenic symptoms and neuroleptic treatment response is studied. METHOD: An open cross-sectioned design is made. 50 schizophrenics (DSM III-R criteria) inpatients are divided into 2 groups: one of 25 treatment-refractory schizophrenics (defined as Kane criteria, modified), and a second group of 25 treatments-responders schizophrenics. Negative symptoms are evaluated by the SANS into the five days before the hospital discharge. RESULTS: The two groups showed differences in the number of hospital income and total length of stay (p < 0.01). There were no differences in the subscales: "alogia", "affective flattening" and "attention impairments", although differences were found in "anhedonia-asociality" and "avolition-apathy" subscales (p < 0.05). DISCUSSION: Association between negative symptoms-poor outcome is issued. Possible relation between "anhedonia-asociality" and "avolition-apathy" added to social dimension with refractoriness to treatment is suggested.