[Insomnia and quality of sleep among primary care physicians: a gender perspective]. / Insomnio y calidad del sueño en médicos de atención primaria: una perspectiva de género.

AIM: To assess insomnia and sleep quality in primary care physicians from a gender perspective. SUBJECTS AND METHODS: A representative sample of 240 physicians was drawn from 70 medical centers from the Madrid Autonomous region. The participation rate was 71.6%. The questionnaire included sociodemographic data, insomnia symptomatology using DSM-IV criteria and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: 18.8% of the total sample met DSM-IV criteria for insomnia diagnosis, with higher frequency among women (23%) compared to men (9.6%). The same pattern appeared for early morning awakening and daytime impairment. Results of logistic regression analyses showed that, after controlling for sociodemographic variables, this relationship between gender and insomnia remained significant. Furthermore, the results indicate that women scored significantly higher than men on global sleep quality and on its components. A PSQI global score = or > 5 is an optimal cut-off score for distinguishing good sleepers from subjects with clinical sleep problems. Following this criteria, 35.4% of physicians had sleep problems, with a significant higher prevalence among women (40% vs. 25.3%). CONCLUSIONS: The data indicates that the prevalence of sleep disturbances is high among primary care physicians, especially among women.

Immunological properties of a DNA plasmid encoding a chimeric protein of herpes simplex virus type 2 glycoprotein B and glycoprotein D.

A DNA plasmid containing a chimeric sequence encoding both herpes simplex virus type 2 (HSV-2) glycoprotein B (gB) and glycoprotein D (gD) external domains (pcgDB) was used to immunize BALB/c mice against genital HSV-2 infection. To determine the efficacy of this vaccine, groups of mice immunized with the pcgDB plasmid were compared with animals immunized with plasmids corresponding to the individual proteins (pcgBt or pcgDt), administered separately or in combination (pcgBt + pcgDt). We studied the response of the different mouse groups to viral challenge by analyzing clinical disease (vaginitis), serum antibody levels, as well as lymphoproliferative responses and cytokine production by spleen cells. Increased IFN-gamma levels correlated with prolonged survival in mice immunized with the plasmid pcgDB, relative to mice immunized with plasmids coding for the individual proteins alone or in combination. Our results show that immunization with the plasmid encoding the chimeric protein is advantageous over separate proteins. These findings may have important implications for the development of multivalent DNA vaccines against HSV and other complex pathogens.

[Hypertension-related mortality and arterial pressure in Spain]. / Mortalidad relacionada con la hipertensión y la presión arterial en España.

BACKGROUND: Given the high figures of cardiovascular disease and hypertension in Spain, and the continuity of cardiovascular and total mortality risks at any level of blood pressure, mortality related to hypertension and blood pressure is estimated. SUBJECTS AND METHODS: Blood pressure distribution from a representative sample of the 35 to 64 years old Spanish population and the relative risks for death coming from valid and reasonably generalizable international studies (MRFIT, Framingham and Chicago Project) were used. The proportions and absolute numbers of cardiovascular and total deaths related to blood pressure and hypertension (categories of the US Joint National Committee VI [JNC VI]) have been calculated in middle-aged men and women. RESULTS: As many as 42% of the coronary deaths, 46.4% of the stroke deaths and 25.5% of the total deaths are related to hypertension (> or = 140/90 mmHg), most of them in stages 1 and 2. It follows high-normal plus normal blood pressure group (8.3, 10.2 and 6.2% of these deaths, respectively). All together, 17,266 total deaths and 4,502 cardiovascular deaths related to blood pressure took place annually, three-quarters of them in males. Over the last ones, 65.5% are coronary and 34.5% cerebrovascular, prevailing the first ones in both sexes. Eight out of 10 deaths, cardiovascular or total, related to blood pressure are concentrated in the hypertension categories, and two out of 10 in the high-normal or normal blood pressure groups. CONCLUSIONS: One out of 3 total deaths and one out of 2 cardiovascular deaths are related to blood pressure. One out of 4 total deaths and one out of 2.5 cardiovascular deaths are related to hypertension. A substantial part of these deaths come from stages 1 and 2 hypertension and from high-normal and normal blood pressure group.

Blood pressure in Spain: distribution, awareness, control, and benefits of a reduction in average pressure.

Distribution of blood pressure (as per US Joint National Committee VI classification and staging criteria) plus awareness, treatment, and control of hypertension were studied in a representative Spanish population sample of 2021 persons (age range, 35 to 64 years). Pressure was determined in accordance with World Health Organization guidelines. A total of 45.1% of subjects were hypertensive (>/=140/>/=90 mm Hg or undergoing drug therapy); 12% had isolated systolic hypertension, and 8.7% had isolated diastolic hypertension. Pulse pressure was 48.7 mm Hg. Heart rate was 81.4 bpm in untreated hypertensives and 78.9 bpm in normotensives (P<0.05). A substantial proportion of the community burden of blood pressure was attributable to stage 1 (28.3% of subjects), the most frequent category of hypertension, and to the high-normal blood pressure group (17% of subjects). A percentage breakdown showed that among hypertensives, 44.5% were aware of their condition; of these, 71.9% were undergoing drug therapy, and of those being treated, only 15.5% were controlled (5% of hypertensives). Not only are these figures consistent with the fact that Spain has a higher cerebrovascular mortality than other countries such as the United States, but they represent a great potential for improvement, particularly among those groups registering relatively worse data (younger men, rural residents, and unskilled professionals). A decrease of only 1 to 4 mm Hg in average blood pressure could reduce the prevalence of hypertension in Spain by 12.4% to 15.4%.