Incidence and mortality of myocardial infarction among Catalonian older adults with and without underlying risk conditions: The CAPAMIS study.

BACKGROUND: Population-based data about the epidemiology of acute myocardial infarction is limited. This study investigated incidence and mortality of acute myocardial infarction in older adults with specific underlying chronic conditions and evaluated the influence of these conditions in developing acute myocardial infarction. DESIGN AND METHODS: This was a population-based cohort study involving 27,204 individuals ≥ 60 years of age in Tarragona (Catalonia, Spain). Data on all cases of hospitalised acute myocardial infarction were collected from 1 December 2008-30 November 2011. Incidence rates and 30-day mortality were estimated according to age, sex, chronic illnesses and underlying conditions. Multivariable Cox regression analysis was used to calculate hazard ratios and to estimate the association between baseline conditions and risk of developing acute myocardial infarction. RESULTS: The incidence of acute myocardial infarction was 475 per 100,000 person-years. Maximum rates appeared among individuals with history of coronary artery disease (2839 per 100,000), chronic severe nephropathy (1407 per 100,000), atrial fibrillation (1226 per 100,000), chronic heart disease (1149 per 100,000), history of stroke (1147 per 100,000) and diabetes mellitus (914 per 100,000). Thirty-day mortality was 15.3% overall, reaching 31.6% among patients over 80 years. In the multivariable analysis, history of coronary artery disease, age > 70 years, sex male, chronic heart disease, history of stroke, atrial fibrillation, diabetes mellitus and hypertension emerged as significantly associated with an increased risk of acute myocardial infarction. CONCLUSIONS: The incidence and mortality of acute myocardial infarction remain considerable in our setting. Considering classical major risk factors, diabetes mellitus and hypertension were the underlying conditions most strongly associated with an increased risk in our study population.

Incidence and risk conditions of ischemic stroke in older adults.

OBJECTIVE: The objective of this study was to investigate incidence and mortality from ischemic stroke in older adults with specific underlying chronic conditions, evaluating the influence of these conditions in developing stroke. MATERIALS & METHODS: Population-based cohort study involving 27,204 individuals ≥60 years old in Southern Catalonia, Spain. All cases of hospitalization from ischemic stroke (confirmed by neuro-imaging) were collected from 01/12/2008 until 30/11/2011. Incidence rates and 30-day mortality were estimated according to age, sex, chronic illnesses, and underlying conditions. Multivariable Cox regression analysis was used to calculate Hazards Ratio (HR) and estimate the association between baseline conditions and risk of developing stroke. RESULTS: Mean incidence rate reached 453 cases per 100,000 person-years. Maximum rates appeared among individuals with history of prior stroke (2926 per 100,000), atrial fibrillation (1815 per 100,000), coronary artery disease (1104 per 100,000), nursing-home residence (1014 per 100,000), and advanced age ≥80 years (1006 per 100,000). Thirty-day mortality was 13% overall, reaching 21% among patients over 80 years. Age [HR: 1.06; 95% confidence interval (CI): 1.04-1.07], history of prior stroke (HR: 5.08; 95% CI: 3.96-6.51), history of coronary artery disease (HR: 1.65; 95% CI: 1.21-2.25), atrial fibrillation (HR: 2.96; 95% CI: 2.30-3.81), diabetes mellitus (HR: 1.55; 95% CI: 1.23-1.95), and smoking (HR: 1.64; 95% CI: 1.15-2.34) emerged independently associated with an increased risk of ischemic stroke. CONCLUSION: Incidence and mortality from ischemic stroke remains considerable. Apart from age and history of atherosclerosis (prior stroke or coronary artery disease), atrial fibrillation, diabetes, and smoking were the underlying conditions most strongly associated with an increased risk.

Incidencia y mortalidad por infarto agudo de miocardio en la población mayor de 60 años del área de Tarragona / Incidence and mortality of ischaemic stroke among people 60 years or older in the región of Tarragona, Spain

Fundamentos. La información procedente de datos de base poblacional sobre la epidemiología del infarto agudo de miocardio es limitada. Este estudio analizó la incidencia y mortalidad por infarto en la población general mayor de 60 años del área sanitaria de Tarragona. Métodos. Estudio de cohortes que incluyó a 27.204 personas ≥60 años adscritas a 9 Áreas Básicas de Salud en la comarca del Tarragonés. Se realizó un seguimiento prospectivo durante 3 años, en los que se registraron todos los episodios de infarto diagnosticados entre los miembros de la cohorte desde 01/12/2008 a 30/11/2011. Se incluyeron exclusivamente los episodios con diagnóstico validado tras revisión de la historia clínica, se excluyeron los casos sin confirmación electrocardiográfica y por biomarcadores. Resultados: Hubo un total de 359 episodios confirmados de infarto, lo cual supuso una incidencia de 475 episodios por 100.000 personas-año (IC 95%: 428-527). La incidencia en hombres fue de 681 por 100.000 y en mujeres de 311 (p<0,001). Por edad fue 277 en el grupo de 60-69, 632 en el de 70-79 y 690 por 100.000 en los sujetos de ≥80 años (p<0,001). La incidencia en las personas con diagnóstico previo de cardiopatía isquémica fue de 2.844 casos por 100.000 personas-año. La mortalidad a los 30 días tras el diagnóstico alcanzó el 15,3%, en hombres 14,9% y en mujeres 16,0% (p=0,776). Conclusiones: La incidencia fue 2,2 veces mayor en hombres que en mujeres y aumentó considerablemente con la edad. También fue superior entre las personas con diagnóstico previo de cardiopatía isquémica. La mortalidad fue ligeramente más baja en hombres que en mujeres (AU)

Background: Population-based data available about the epidemiology of acute myocardial infarction is limited. This study investigated incidence and mortality from infarction among the general population over 60 years in Tarragona. Methods: Cohort study that included 27,204 individuals ≥60 years assigned to nine Primary Care Centers in the Tarragones county (Catalonia, Spain), who were prospectively followed between 01/12/2008 and 30/11/2011. During follow-up, all presumptive episodes of infarction were recruited among cohort members, but only confirmed cases (electrocardiogram and biomarkers confirmation) were included. Results: There were an amount of 359 confirmed episodes of infarction, which means a global incidence rate of 475 episodes per 100,000 person-years (95% CI: 428-527). Incidence was 681 in men and 311in women (p<0.001). According to age, incidence was 277 in 60-69, 632 in 70-79 and 690 per 100,000 in ≥80 years (p<0.001). Incidence was 2,844 cases per 100,000 person-years among those persons whom had history of prior coronary artery disease. Overall 30-day mortality rate was 15.3%, in male 14.9% and in female 16.0% (p=0.776). Conclusion: Incidence was 2.2 times higher in men than in woman and increased considerable by age. It was greater among patients with prior history of coronary artery disease. Mortality was slightly lower in men than in women (AU)

[Incidence and mortality of ischaemic stroke among people 60 years or older in the region of Tarragona, Spain]. / Incidencia y mortalidad por infarto agudo de miocardio en la población mayor de 60 años del área de Tarragona.

BACKGROUND: Population-based data available about the epidemiology of acute myocardial infarction is limited. This study investigated incidence and mortality from infarction among the general population over 60 years in Tarragona. METHODS: Cohort study that included 27,204 individuals ≥60 years assigned to nine Primary Care Centers in the Tarragones county (Catalonia, Spain), who were prospectively followed between 01/12/2008 and 30/11/2011. During follow-up, all presumptive episodes of infarction were recruited among cohort members, but only confirmed cases (electrocardiogram and biomarkers confirmation) were included. RESULTS: There were an amount of 359 confirmed episodes of infarction, which means a global incidence rate of 475 episodes per 100,000 person-years (95% CI: 428-527). Incidence was 681 in men and 311in women (p<0.001). According to age, incidence was 277 in 60-69, 632 in 70-79 and 690 per 100,000 in ≥80 years (p<0.001). Incidence was 2,844 cases per 100,000 person-years among those persons whom had history of prior coronary artery disease. Overall 30-day mortality rate was 15.3%, in male 14.9% and in female 16.0% (p=0.776). CONCLUSION: Incidence was 2.2 times higher in men than in woman and increased considerable by age. It was greater among patients with prior history of coronary artery disease. Mortality was slightly lower in men than in women.

[Anatomical repercussion on the zonular apparatus after a capsular tension ring insertion in swine eyes]. / Estudio experimental sobre la repercusión anatómica de la zónula de Zinn tras la introducción de un anillo endocapsular en ojos de cerdo.

PURPOSE: To carry out an experimental and descriptive study that exhibits the anatomical repercussions on the zonular apparatus after a capsular tension ring (CTR) is inserted. METHODS: CTRs were inserted in five swine eyes (four with forceps, one with an injector). Two additional eyes were left untouched for control purposes. The integrity of the suspensory ligament was examined by scanning electron microscopy. RESULTS: We did not observe alterations in the integrity of the zonular apparatus. The suspensory ligaments adopted a new fold configuration. CONCLUSIONS: CTR insertion is a safe therapeutic tool to maintain the integrity of the lens zonules in elastic, large diameter capsular bags.

Estudio experimental sobre la repercusión anatómica de la zónula de Zinn tras la introducción de un anillo endocapsular en ojos de cerdo / Anatomical repercusion on the zonular apparatus after a capsular tension ring insertion in swine eyes

Objetivos: Valorar experimentalmente la integridad morfológica de los ligamentos suspensorios de la zónula de Zinn (LSZZ) tras la introducción de un anillo de distensión capsular (ADC) mediante un estudio descriptivo. Métodos: Se utilizaron siete ojos de cerdo a los cuales se realizó una extracción extracapsular de cristalino transparente. A cuatro se introdujo un ADC con pinzas y al quinto con inyector. Los otros dos se utilizaron como control. Se examinó la integridad anatómica y la nueva configuración de los LSZZ con un microscopio electrónico de barrido. Resultados: No se observaron alteraciones en la integridad de los LSZZ. Los LSZZ adoptan tras la introducción de un ADC una nueva trayectoria de repliegue consecuencia de la nueva disposición del saco capsular. Conclusiones: En un modelo experimental conojos de cerdo no se encontraron lesiones en los LSZZ por lo que parece que, en cápsulas elásticas y de gran diámetro, la inserción de un ADC no produce roturas en los LSZZ

Purpose: To carry out an experimental and descriptive study that exhibits the anatomical repercussions on the zonular apparatus after a capsular tensionring (CTR) is inserted. Methods: CTRs were inserted in five swine eyes (four with forceps, one with an injector). Two additional eyes were left untouched for control purposes.The integrity of the suspensory ligament was examined by scanning electron microscopy. Results: We did not observe alterations in the integrity of the zonular apparatus. The suspensory ligaments adopted a new fold configuration. Conclusions: CTR insertion is a safe therapeutic tool to maintain the integrity of the lens zonules inelastic, large diameter capsular bags

Effect of distance from the polluting focus on relative concentrations of Bacteroides fragilis phages and coliphages in mussels.

Concentrations of fecal bacteria, somatic and F-specific coliphages, and phages infecting Bacteroides fragilis in naturally occurring black mussels (Mytilus edulis) were determined. Mussels were collected over a 7-month period at four sampling sites with different levels of fecal pollution. Concentrations of both fecal bacteria and bacteriophages in mussel meat paralleled the concentration of fecal bacteria in the overlying waters. Mussels bioaccumulated efficiently, although with different efficiencies, all of the microorganisms studied. Ratios comparing the levels of microorganisms in mussels were determined. These ratios changed in mussels collected at the different sites. They suggest that bacteriophages infecting B. fragilis and somatic coliphages have the lowest decay rates among the microorganisms studied, with the exception of Clostridium perfringens. On the contrary, concentrations of F-specific coliphages showed a greater rate of decay than the other bacteriophages at sites more distant from the focus of contamination. Additionally, levels of enteroviruses were studied in a number of samples, and in these samples, the B. fragilis bacteriophages clearly outnumbered the enteroviruses. The results of this study indicate that, under the environmental conditions studied, the fate of phages infecting B. fragilis released into the marine environment resembles that of human viruses more than any other microorganism examined.