Steno type 1 risk engine and preclinical atherosclerosis in Mediterranean individuals with type 1 diabetes.

BACKGROUND AND AIMS: Tools to detect type 1 diabetes (T1D) individuals at overt cardiovascular disease (CVD) risk are scarce. We aimed to assess the usefulness of the score 'Steno Type 1 Risk Engine' (Steno-Risk) to identify T1D patients with advanced carotid atherosclerosis. MATERIAL AND METHODS: T1D patients without CVD with at least one of the following were included: ≥40 years, diabetic nephropathy, or diabetes duration ≥10 years with ≥1 CVD risk factor. Intima-media thickness (IMT) and plaque presence (IMT ≥1.5 mm) were assessed by standardized B-mode ultrasonography. Steno-Risk was used to estimate 10-year risk (<10% low; 10%-20% moderate; ≥20% high risk). Associations between Steno-Risk and preclinical atherosclerosis were assessed after adjusting for other CVD risk factors. RESULTS: We evaluated 302 patients (55% men, age 47.8 ± 9.8 years, T1D duration 26.3 ± 9.3 years). The prevalence of carotid plaque and ≥2 plaques were 36.4% and 19.2%, respectively; without sex differences. Age (57.4 ± 7.4 vs 37.1 ± 6.2 years), T1D duration (31.3 ± 10.4 vs 21.5 ± 7.1 years), hypertension (52.3% vs 6.3%), nephropathy (25.6% vs 5.1%) and retinopathy (53.5% vs 32.9%) were higher in high-risk (n = 86) vs low-risk participants (n = 79; P < .001 for all). Preclinical atherosclerosis (IMT and plaque) increased in parallel with Steno-Risk (P < .001). In logistic regression analysis, both age ≥40 years and Steno-Risk ≥20% were associated with the presence of plaque (OR 4.22 [1.57-11.36] and 3.79 [1.61-6.80]; respectively), but only high Steno-Risk remained independently associated with ≥2 plaques (OR 3.31 [1.61-6.80]). CONCLUSION: Steno-Risk is independently associated with preclinical atherosclerosis. Further studies are needed to ascertain its usefulness in this high-risk population.

Descripción clínica y epidemiológica de los primeros casos de la gripe nueva A (H1N1) atendidos en España / New influenza virus A (H1N1) infection in Spain: clinical and epidemiologic description

Objetivo: Describir las consultas atendidas en urgencias durante el primer día de brote de gripe nueva A (H1N1), descripción de los primeros casos diagnosticados, su contexto epidemiológico y la organización que se estableció en urgencias durante las 24 horas de la guardia de dicho día. Método: Se revisan las historias clínicas de las consultas recibidas en urgencias el día 26de abril de 2009 en relación al brote de gripe nueva A (H1N1), y a partir de ella se recogen datos clínicos y epidemiológicos. En los casos sospechosos se realizó una analítica general, una radiología de tórax, un frotis nasal y faríngeo para la detección de ácidos nucleicos del nuevo virus de la la gripe A (H1N1) y una extracción de sangre para la determinación de anticuerpos específicos. Además, se han recogido también las principales medidas organizativas que se tomaron durante la guardia. Resultados: Durante la guardia se atendieron un total de 99 pacientes, de los cuales 12(12%) estuvieron relacionados con el brote de nueva gripe en México. Estos 12 pacientes procedían de 6 viajes diferentes, con un tiempo transcurrido desde el vuelo de retorno de entre 3 y 25 días. De los 12 casos, en cuatro de ellos se consideró que no había contexto epidemiológico compatible, por lo que fueron dados de alta sin realizárseles determinación de ácidos nucleicos. De los ocho restantes, cuatro se ingresaron en el hospital (todos ellos en habitaciones individuales que reúnen los requisitos para el aislamiento respiratorio y de contacto) y cuatro fueron dados de alta. De estos 8 pacientes, tres fueron diagnosticados de gripe nueva A (H1N1), uno de ellos por transmisión secundaria doméstica sin haber estado previamente en México. Las características clínicas del cuadro no difieren de la gripe epidémica humana que habitualmente (..) (AU)

Objective: To describe emergency consultations during the first day of the new influenza outbreak. The description covers the first cases of new influenza virus infection diagnosed, the epidemiologic context, and the organization of emergency services during the first 24 hours of care provided on that day. Material and Methods: The medical records for emergency consultations on April 26, 2009 at an urban tertiary care hospital were reviewed to identify cases related to the new influenza virus. Clinical and epidemiologic data were extracted. When the new influenza was suspected, the attending physician ordered a complete laboratory and blood workup, chest x-ray, and nasal swab and throat swab to detect nucleic acids from new influenza virus A (H1N1). Blood was extracted for influenza viral specific antibodies testing. Information on the main organizational measures taken during the 24-hour period were also recorded. Results: Ninety-nine patients were attended over the course of the day. Twelve (12%) had had some contact with cases of the new Mexican flu outbreak. The 12 cases all bore some relationship with 6 different trips (with between 3 and 25 days passing since the return flight). In 4 cases, it was considered that epidemiologic features were not consistent with a diagnosis of the new influenza. Those patients were therefore discharged without viral antigen testing. Four of there maining 8 patients were admitted (all placed in private rooms that allowed for respiratory and contact isolation), and 4 were discharged. Three of the 8 patients were diagnosed with the new influenza. One case was the result of secondary transmission in the home, as the patient (..) (AU)

Development of microsatellite markers in Annona crassiflora Mart., a Brazilian Cerrado fruit tree species.

Annona crassiflora Mart. (Annonaceae) is a native fruit species of the region of Brazilian Cerrado with a high agronomic potential, although without any traces of domestication. A set of 10 microsatellite primer pairs was developed from an enriched genome library (TC13). An average of 19.3 alleles per locus was detected. Observed heterozygosity estimates were consistently lower than those obtained for gene diversity, evidencing a departure from Hardy-Weinberg expected proportions. The reported set of markers showed to be highly informative and constitutes a powerful tool for the development of genetic characterization studies in A. crassiflora.

Protective effects of moderate hypothermia on behavioral deficits but not necrotic cavitation following cortical impact injury in the rat.

A number of experimental studies have reported that moderate hypothermia can produce significant protection against behavioral deficits and/or morphopathological alterations following traumatic brain injury; a Phase 3 clinical trial is currently examining the therapeutic potential for moderate hypothermia (32 degrees C) to improve outcome following severe traumatic brain injury in humans. The current study examined whether hypothermia (32 degrees C) provided behavioral protection following experimental cortical impact injury. The extent of focal cortical contusion was also examined in the same rats. A total of 30 male Sprague-Dawley rats were trained on beam balance and beam walking tasks prior to injury. Under isoflurane anesthesia, cortical impact was produced on the right parietal cortex of 20 rats. Ten rats underwent all surgical procedures but were not impacted (sham-injured rats). Ten of the injured rats were cooled to 32 degrees C (measured in temporalis muscle) beginning 5 min postinjury, maintained for 2 h and rewarmed slowly for 1 h. In the other 10 injured rats, normothermic temperatures (37.5 degrees C) were maintained for the same duration. Beam balance and beam walking performance was assessed daily for 5 days following injury. At 11 days postinjury, rats were assessed for 5 days on acquisition of the Morris water maze task. Following behavioral assessments, rats were perfused and the brain removed. Coronal sections were cut through the site of cortical impact injury and stained with hematoxylin and eosin. Hypothermic treatment resulted in significantly less beam balance and beam walking deficits than observed in normothermic rats. Hypothermia also significantly attenuated spatial memory performance deficits. Quantitative morphometric analyses failed to detect any significant differences in volumes of necrotic tissue cavitation in cortices of hypothermic and normothermic rats. Hypothermic treatment also had no effect on volumes of dorsal hippocampal tissue or numbers of cells in CA1 or CA3 regions of the hippocampus. These data suggest that hypothermia, consistent with the reports of others, can produce significant behavioral protection following cortical impact injury that is not necessarily correlated with changes in focal cortical necrosis within the first 15 days following injury.