Does Consumption of Ultra-Processed Foods Matter for Liver Health? Prospective Analysis among Older Adults with Metabolic Syndrome.

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been sufficiently assessed. We aimed to investigate the prospective association between UPF consumption and liver health biomarkers. Methods: We followed for 1 year 5867 older participants with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus trial. A validated 143-item semi-quantitative food frequency questionnaire was used to evaluate consumption of UPF at baseline, 6, and 12 months. The degree of processing for foods and beverages (g/day) was established according to the NOVA classification system. The non-invasive fatty liver index (FLI) and hepatic steatosis index (HSI) were used to evaluate liver health at three points in time. The associations between changes in UPF consumption (percentage of total daily dietary intake (g)) and liver biomarkers were assessed using mixed-effects linear models with repeated measurements. Results: In this cohort, UPF consumption at baseline was 8.19% (SD 6.95%) of total daily dietary intake in grams. In multivariable models, each 10% daily increment in UPF consumption in 1 year was associated with significantly greater FLI (ß 1.60 points, 95% CI 1.24;1.96 points) and HSI (0.43, 0.29; 0.57) scores (all p-values < 0.001). These associations persisted statistically significant after adjusting for potential dietary confounders and NAFLD risk factors. Conclusions: A higher UPF consumption was associated with higher levels of NAFLD-related biomarkers in older adults with overweight/obesity and MetS.

Validation of a modified version of the Spanish Geriatric Oral Health Assessment Index (GOHAI-SP) for adults and elder people.

BACKGROUND: The Geriatric Oral Health Assessment Index (GOHAI) was developed and validated in 1990 and translated into Spanish in 1999. Since then, the original version has been used in numerous studies, but it has not been re-evaluated in terms of language in the new generations of older adults. The purpose of this study is to confirm the validity of the Spanish version of the Geriatric Oral Health Assessment Index (GOHAI-SP) after three decades to be used as part of an ongoing field trial. METHODS: The GOHAI-SP was pilot tested in a focus group to confirm linguistic comprehension. A version with minor language changes was administered to individuals with metabolic syndrome aged 55-75 years from one health care district in southern Spain as part of an ongoing field trial (PREDIMED-Plus). Clinical evaluation included assessment of dental and periodontal status. The psychometric properties of the GOHAI-SP were evaluated through stability and internal consistency measures, and concurrent and discriminant validity were assessed. RESULTS: The new version of the GOHAI-SP was administered to 100 individuals. The application time was reduced by 7 min. The alpha value for reliability was 0.87. The item-scale correlation coefficients ranged from 0.54 to 0.75, and the test-re-test correlation for the total score was 0.75. There were inverse correlations between GOHAI-SP scores and the number of lost teeth and the decayed-missing-filled teeth index (p < 0.001). CONCLUSIONS: The GOHAI-SP questionnaire remains a valid and useful tool to assess oral health-related quality of life in primary health care settings. A linguistic update of the questionnaire brought improvements to the instrument application. TRIAL REGISTRATION: The PREDIMED-Plus trial is registered in the ISRCTN registry with reference number ISRCTN89898870. Registration date: 4th July 2014.

Experience of Using an App in HIV Patients Older Than 60 Years: Pilot Program.

BACKGROUND: New technologies can promote knowledge of HIV infection among patients suffering from this disease. Older patients with HIV infection represent an increasingly large group that could benefit from the use of specific apps. OBJECTIVE: The aim of the study was to observe the acceptability and use of a mobile app on HIV infection in patients at least 60 years old and offer them the possibility of anonymously establishing contact with their peers. METHODS: A series of clinical and psychosocial parameters were studied in 30 HIV-infected patients of over 60 years. The patients must be at least 60 years old, with a follow-up in the outpatient clinic for at least 1 year and without pathologies that limit his or her life expectancy to less than a year. They must know how to read and write. To be part of the group assigned to the app, they had to have their own smartphone and confirm that they were connected to the internet from that device. Overall, 15 of them were randomized to use an app and 15 were in the control group. All tests were repeated after 6 months. RESULTS: The median age of patients was 66.5 years. Among them, 29 patients had an undetectable viral load at baseline. The median number of comorbid diseases was 2. Overall, 11 of them lived with their partners and 19 lived alone. They spent an average of 5 hours a day sitting down, and 56% (17/30) of them referred high physical activity. They scored 4 out of 5 for general quality of life perception. Moreover, 80% (24/30) presented high adherence to their treatment, and the average number of concomitant medications was 5. In the 6-min walking test, they covered a distance of 400 meters, and 3 of them desaturated during the test. The 15 patients made frequent use of the app, with 2407 sessions and an average of 7 min and 56 seconds time of use with a total of 13,143 screen views. During the 6 months of the trial, 3 non-AIDS events took place. There were no significant modifications to body mass index, blood pressure measurements, lipid profile, or immuno-virology information data. There were no differences in the questionnaire scores for perception of quality of life, confessed physical activity, or antiretroviral treatment (ART) and non-ART treatment adherence. CONCLUSIONS: Significant differences between studied parameters were not objectified in these patients, possibly because this trial has significant limitations, such as a small sample size and only a brief follow-up period. However, patients did use the app frequently, making this a possible intervention to be proposed in future subsequent studies.

Relación de la inteligencia emocional y la calidad de vida profesional con la consecución de objetivos laborales en el distrito de atención primaria Costa del Sol / Relationship between perceived emotional intelligence and professional quality of life with the achievement of occupational objectives in the costa del sol primary health care district

OBJETIVO: Explorar la relación existente entre «calidad de vida profesional» e «inteligencia emocional percibida», y la relación de ambas con el grado de consecución de objetivos laborales en el Distrito de Atención Primaria Costa del Sol. DISEÑO: Estudio observacional descriptivo transversal multicéntrico. Emplazamiento: Distrito Sanitario Costa del Sol en la Provincia de Málaga. PARTICIPANTES: Muestra de profesionales de todas las categorías, fijos y contratados, de las Unidades de Gestión del Distrito Costa del Sol (n = 303). Respondieron 247 (81,5%). MEDICIONES PRINCIPALES: Se recogieron los datos de porcentaje de consecución de objetivos del año 2010 y los datos sociodemográficos de los participantes; para ello se utilizaron cuestionarios autoadministrados diseñados ad hoc. Para medir la «inteligencia emocional percibida» y «calidad de vida profesional percibida», se utilizaron los cuestionarios TMMS-24 que mide las dimensiones: percepción, comprensión y regulación emocional y CVP-35 que mide las dimensiones: apoyo directivo, demanda de trabajo y motivación intrínseca. RESULTADOS: Se observaron correlaciones significativas entre calidad de vida profesional e inteligencia emocional en las categorías de regulación (p < 0,01) y comprensión (p < 0,05). También existían correlaciones significativas entre la profesión y tipo de contrato con la consecución de objetivos, (p < 0,005) y entre calidad de vida profesional y tipo de contrato (p < 0,05). CONCLUSIONES: La calidad de vida profesional percibida se relaciona con la percepción y la regulación como dimensiones de la inteligencia emocional. Desde los órganos de gestión se debe promover el conocimiento de métodos del manejo de las emociones en todos sus profesional

OBJECTIVE: To examine the relationship between "Quality of Professional Life" and "Perceived Emotional Intelligence" and the relationship of both of these with the level of achievement of occupational objectives in the Costa del Sol Primary Health Care District. DESIGN: Multicentre descriptive cross-sectional observational study. LOCATION: The Costa del Sol Primary Health Care District in the province of Málaga. PARTICIPANTS: Sample of Employees of all categories in fixed and contracted employment in the Management Units of the Costa del Sol District. (N = 303). Respondents 247 (81.5%). Principal Measurements: The data collected was that of the percentage of achievement of objectives in 2010 and the socio-demographic data of the participants, using ad hoc designed self-report questionnaires. The TMMS -24 questionnaire was used to measure the "Perceived Emotional Intelligence", with the following dimensions: Perception, comprehension, and emotional control, and the CVP-35 measuring: management support, work demands, and intrinsic motivation. RESULTS: Significant correlationas were observed between Quality of Professional Life and Emotional Intelligence in the Regulation (p< .01) and Comprehension categories (p < 0.05). There were also significant correlations between the profession and the type of contract in the achievement of objectives (p< .005), and quality of professional life and type of contract (p< .05). CONCLUSIONS: The perceived quality of professional life is related to perception and regulation dimensions of Emotional Intelligence. Knowledge of emotion management methods should be promoted by management organisations for all employees

[Relationship between perceived emotional intelligence and professional quality of life with the achievement of occupational objectives in the costa del sol primary health care district]. / Relación de la inteligencia emocional y la calidad de vida profesional con la consecución de objetivos laborales en el distrito de atención primaria Costa del Sol.

OBJECTIVE: To examine the relationship between "Quality of Professional Life" and "Perceived Emotional Intelligence" and the relationship of both of these with the level of achievement of occupational objectives in the Costa del Sol Primary Health Care District. DESIGN: Multicentre descriptive cross-sectional observational study. LOCATION: The Costa del Sol Primary Health Care District in the province of Málaga. PARTICIPANTS: Sample of Employees of all categories in fixed and contracted employment in the Management Units of the Costa del Sol District. (N=303). Respondents 247 (81.5%) PRINCIPAL MEASUREMENTS: The data collected was that of the percentage of achievement of objectives in 2010 and the socio-demographic data of the participants, using ad hoc designed self-report questionnaires. The TMMS -24 questionnaire was used to measure the "Perceived Emotional Intelligence", with the following dimensions: Perception, comprehension, and emotional control, and the CVP-35 measuring: management support, work demands, and intrinsic motivation. RESULTS: Significant correlationas were observed between Quality of Professional Life and Emotional Intelligence in the Regulation (p<.01) and Comprehension categories (p<0.05). There were also significant correlations between the profession and the type of contract in the achievement of objectives (p<.005), and quality of professional life and type of contract (p<.05). CONCLUSIONS: The perceived quality of professional life is related to perception and regulation dimensions of Emotional Intelligence. Knowledge of emotion management methods should be promoted by management organisations for all employees.

Factores que influyen en la liberación de células endoteliales progenitoras y citocinas angiogénicas tras un infarto de miocardio extenso / Factors influencing mobilisation of endothelial progenitor cells and angiogenic cytokines after an extensive acute myocardial infarction

Fundamento y objetivo: Tras un infarto de miocardio (IM), las células progenitoras endoteliales (CPE) procedentes de la médula ósea son movilizadas hacia sangre periférica. El objetivo de nuestro trabajo fue estudiar los factores que influyen en dicha movilización celular espontánea. Pacientes y metodo: En este estudio se han analizado en 47 pacientes con IM extenso (definido por una fracción de eyección ventricular izquierda [FEVI] <50% por ecocardiografía en la primera semana post-IM), las poblaciones de CPE en sangre periférica (porcentaje sobre células mononucleares periféricas) que expresaban CD133+, CD34+, KDR+, CXCR4+, así como las citoquinas vascular endothelial growth factor (VEGF, «factor de crecimiento vascular endotelial»), stromal cell-derived factor 1 (SDF-1, «factor derivado del estroma tipo 1» y trombospondina 1, determinadas en el día 5±2,5 tras el IM. Resultados: La extensión del IM se correlacionó con el número de células movilizadas (r=040; p=0,011 entre pico de CPK y CD133+). Los pacientes que no recibieron reperfusión en fase aguda (fibrinólisis/angioplastia) (34%) presentaron más células CD34+CXCR4+ (mediana [rango intercuartílico]: 2.401 [498-7.004] frente a 999 [100-1.600]; p=0,048), así como una fuerte correlación entre VEGF y CD133+CD34+KDR+ (r=0,84; p<0,01), entre SDF-1 y CD34+CXCR4+ (r=0,67; p<0,01), y entre ambas citoquinas (r=0,57; p=0,01). En los pacientes reperfundidos, la correlación VEGF y CD133+CD34+KDR+ fue menor (r=0,38; p=0,03) y desapareció la correlación de SDF-1 con CD34+CXCR4+ y con VEGF. Tras el análisis multivariante, la presencia de VEGF>7pg/ml (p<0,01) fue predictora de la movilización de CD133+CD34+KDR+, mientras que la hipertensión (p=0,055) mostró una tendencia. La diabetes (p=0,045) lo fue sobre el número de CD34+CXCR4+, presentando el tratamiento de reperfusión (p=0,054) una tendencia sobre esta subpoblación (AU)

Background and objectives: Following an acute myocardial infarction (AMI), bone-marrow derived endothelial progenitor cells (EPC) are mobilised into the peripheral blood. Our aim was to examine the factors influencing this spontaneous cell mobilisation.Patients and methods: In this study we analysed 47 patients with extensive AMI (left ventricular ejection fraction [LVEF] <50% by echocardiography during the first week post-AMI); we studied the peripheral blood EPC populations expressing CD133+, CD34+, KDR+, CXCR4+, as well as the cytokines VEGF (vascular endothelial growth factor), SDF-1 (stromal cell-derived factor 1) and TSP-1 (thrombospondin 1), measured on day 5±2.5 after AMI. Results: The extension of AMI (CPK peak) correlated with the number of CD133+ mobilised cells: (r=0.40; P=.011). Patients who did not receive perfusion during the acute phase (34%) had more CD34+CXCR4+ cells with a median (interquartile ranges) of 2,401 (498-7,004) vs. 999 (100-1,600), P=.048, and strong correlations between VEGF and CD133+CD34+KDR+ (r=.84; P<.01) and SDF-1 and CD34+CXCR4+ (r=.67; P<.01), and between these 2 cytokines (r=.57; P=.01). In the reperfused patients, the correlation between VEGF and CD133+CD34+KDR+ was lower (r=.38; P=.03) and the correlation between SDF-1 and CD34+CXCR4+ and VEGF disappeared. Multivariate analysis showed that a VEGF >7pg/mL (P<.01) predicted the mobilisation of CD133+CD34+KDR+, whereas hypertension showed a trend (P=.055). Diabetes (P=.045) predicted the number of CD34+CXCR4+, with reperfusion treatment showing a trend in this subpopulation (P=.054). Conclusions:Mobilisation of progenitor cells after AMI is influenced by factors such as diabetes and the cytokine VEGF. Hypertension and reperfusion therapy during the acute phase also tend to influence the cell response (AU)

[Factors influencing mobilisation of endothelial progenitor cells and angiogenic cytokines after an extensive acute myocardial infarction]. / Factores que influyen en la liberación de células endoteliales progenitoras y citocinas angiogénicas tras un infarto de miocardio extenso.

BACKGROUND AND OBJECTIVES: Following an acute myocardial infarction (AMI), bone-marrow derived endothelial progenitor cells (EPC) are mobilised into the peripheral blood. Our aim was to examine the factors influencing this spontaneous cell mobilisation. PATIENTS AND METHODS: In this study we analysed 47 patients with extensive AMI (left ventricular ejection fraction [LVEF] <50% by echocardiography during the first week post-AMI); we studied the peripheral blood EPC populations expressing CD133(+), CD34(+), KDR(+), CXCR4(+), as well as the cytokines VEGF (vascular endothelial growth factor), SDF-1 (stromal cell-derived factor 1) and TSP-1 (thrombospondin 1), measured on day 5±2.5 after AMI. RESULTS: The extension of AMI (CPK peak) correlated with the number of CD133(+) mobilised cells: (r=0.40; P=.011). Patients who did not receive perfusion during the acute phase (34%) had more CD34(+)CXCR4(+) cells with a median (interquartile ranges) of 2,401 (498-7,004) vs. 999 (100-1,600), P=.048, and strong correlations between VEGF and CD133(+)CD34(+)KDR(+) (r=.84; P<.01) and SDF-1 and CD34(+)CXCR4(+) (r=.67; P<.01), and between these 2 cytokines (r=.57; P=.01). In the reperfused patients, the correlation between VEGF and CD133(+)CD34(+)KDR(+) was lower (r=.38; P=.03) and the correlation between SDF-1 and CD34(+)CXCR4(+) and VEGF disappeared. Multivariate analysis showed that a VEGF >7pg/mL (P<.01) predicted the mobilisation of CD133(+)CD34(+)KDR(+), whereas hypertension showed a trend (P=.055). Diabetes (P=.045) predicted the number of CD34(+)CXCR4(+), with reperfusion treatment showing a trend in this subpopulation (P=.054). CONCLUSIONS: Mobilisation of progenitor cells after AMI is influenced by factors such as diabetes and the cytokine VEGF. Hypertension and reperfusion therapy during the acute phase also tend to influence the cell response.

La extensión de la enfermedad coronaria determina la movilización de las células progenitoras endoteliales y las citocinas tras un primer infarto de miocardio con elevación del ST / Coronary disease extension determines mobilization of endothelial progenitor cells and cytokines after a first myocardial infarction with ST elevation

Introducción y objetivos. La enfermedad coronaria multivaso es un importante factor pronóstico postinfarto a pesar de nuevas formas de reperfusión como la angioplastia primaria. El objetivo del presente estudio es determinar la secuencia de variación de diferentes poblaciones de células progenitoras endoteliales y factores angiogénicos (factor de crecimiento endotelial vascular, factor de crecimiento hepatocitario) según el grado de extensión de la enfermedad coronaria. Métodos. Estudiamos la cinética de liberación en 32 pacientes ingresados por un primer infarto, agrupados según tuvieran enfermedad coronaria monovaso o multivaso y 26 sujetos que constituyen el grupo control. Resultados. Los pacientes presentaban un mayor número de células progenitoras endoteliales y citocinas angiogénicas que los controles en las tres determinaciones realizadas (al ingreso, día 3 y día 7) de las siguientes subpoblaciones: CD34, CD34+CD133+, CD34+KDR+ y CD34+CD133+KDR+CD45+ (débil); este último era mayor el día 7. Los valores de las tres poblaciones analizadas eran mayores en los pacientes con enfermedad coronaria monovaso en las tres determinaciones. Las cifras del factor de crecimiento endotelial vascular subían durante la primera semana y las del factor de crecimiento hepatocitario mostraron un pico precoz al ingreso. No apreciamos diferencias significativas en las variaciones de citocinas según el grado de extensión de la enfermedad coronaria. Conclusiones. Aunque las cinéticas de liberación de diferentes poblaciones de células progenitoras endoteliales en pacientes con un primer infarto agudo de miocardio con enfermedad monovaso con enfermedad multivaso fueron similares, su número fue mayor en los pacientes con enfermedad coronaria monovaso. Las cifras del factor de crecimiento endotelial vascular ascendieron durante la primera semana y las del factor de crecimiento hepatocitario muestran un pico precoz al ingreso (AU)

Introduction and objectives. Multivessel coronary disease is still a postinfarction prognostic marker despite new forms of reperfusion, such as primary angioplasty. The aim of this study was to determine the time sequence of various sets of endothelial progenitor cells and angiogenic cytokines (vascular endothelial growth factor, hepatocyte growth factor) according to the degree of extension of the postinfarction coronary disease. Methods. We studied the release kinetics in 32 patients admitted for a first myocardial infarction with ST elevation, grouped according to whether they had single or multivessel disease, and 26 controls. Results. The patients had a higher number of endothelial progenitor cells and angiogenic cytokines than the controls at all 3 measurements (admission, day 3, and day 7) of the following subsets: CD34, CD34+CD133+, CD34+KDR+, and CD34+CD133+KDR+CD45+(weak); this latter was higher on day 7. The levels of these cell subsets were all higher in the patients with single-vessel disease and at all 3 measurements. The vascular endothelial growth factor levels were raised during the first week and the hepatocyte growth factor showed an early peak on admission for infarction. No significant differences were seen in the cytokines according to coronary disease extension. Conclusions. Although the release kinetics of different subsets of endothelial progenitor cells in patients with a first acute myocardial infarction with ST elevation was similar in those with single vessel disease to those with multivessel disease, the number of circulating endothelial progenitor cells was greater in the patients with single vessel disease. The vascular endothelial growth factor levels were raised during the first postinfarction week and the hepatocyte growth factor were higher on admission (AU)

[Coronary disease extension determines mobilization of endothelial progenitor cells and cytokines after a first myocardial infarction with ST elevation]. / La extensión de la enfermedad coronaria determina la movilización de las células progenitoras endoteliales y las citocinas tras un primer infarto de miocardio con elevación del ST.

INTRODUCTION AND OBJECTIVES: Multivessel coronary disease is still a postinfarction prognostic marker despite new forms of reperfusion, such as primary angioplasty. The aim of this study was to determine the time sequence of various sets of endothelial progenitor cells and angiogenic cytokines (vascular endothelial growth factor, hepatocyte growth factor) according to the degree of extension of the postinfarction coronary disease. METHODS: We studied the release kinetics in 32 patients admitted for a first myocardial infarction with ST elevation, grouped according to whether they had single or multivessel disease, and 26 controls. RESULTS: The patients had a higher number of endothelial progenitor cells and angiogenic cytokines than the controls at all 3 measurements (admission, day 3, and day 7) of the following subsets: CD34, CD34+CD133+, CD34+KDR+, and CD34+CD133+KDR+CD45+(weak); this latter was higher on day 7. The levels of these cell subsets were all higher in the patients with single-vessel disease and at all 3 measurements. The vascular endothelial growth factor levels were raised during the first week and the hepatocyte growth factor showed an early peak on admission for infarction. No significant differences were seen in the cytokines according to coronary disease extension. CONCLUSIONS: Although the release kinetics of different subsets of endothelial progenitor cells in patients with a first acute myocardial infarction with ST elevation was similar in those with single vessel disease to those with multivessel disease, the number of circulating endothelial progenitor cells was greater in the patients with single vessel disease. The vascular endothelial growth factor levels were raised during the first postinfarction week and the hepatocyte growth factor were higher on admission.

Gonadotropin and steroid receptors as prognostic factors in advanced ovarian cancer: a retrospective study.

INTRODUCTION: Ovarian cancer is a chemosensitive tumour, but two thirds of women have a recurrence during the follow- up, even after an optimal surgical debulking followed by chemotherapy with a platinum and a taxane compound. Cytotoxic drugs are used in a second- or third-line setting but tumour progression is the rule. Also patients with the same histology achieve different outcomes in terms of survival. We decided to study gonadotropin and steroid receptors and to consider if these histological markers could select patients with different prognosis. MATERIALS AND METHODS: In our study we have measured by immunohistochemistry oestrogen, progestin and gonadotropin- releasing hormone receptors (Gn-RHRs) in paraffinembedded ovarian cancer tissue in a sample of 62 consecutive patients with advanced ovarian cancer treated with surgery and adjuvant chemotherapy. Descriptive methods, a survival analysis (Kaplan-Meier) and a Cox regression analysis were done. RESULTS: Oestrogen receptors (ERs) were positive in 65% of patients and the same positivity was obtained for progestin receptors (PRs), with 74% showing some positivity for Gn-RHR receptors. Maximal cytoreduction and ERs, but not gonadotropin receptors, were independently associated with overall survival, with better survival for oestrogennegative tumours. No association was established for progression- free survival. CONCLUSIONS: We can conclude that ER status in our series is an independent prognostic factor for ovarian cancer with better survival for oestrogen-negative receptor tumours. PRs could also have a prognostic role in association with ERs.

Sífilis y embarazo: incidencia y evolución histórica en el área sur de Granada / Syphilis infection in pregnancy. Incidence and changing patterns in the south of Granada (Spain)

Objetivo: Evaluar la prevalencia de la infecciónpor sífilis en el embarazo y los resultados delmanejo de esta afección.Material y métodos: Revisión retrospectiva detodos los casos de sífilis y embarazo diagnosticadoy tratados entre enero de 1996 y diciembre de2006 en el Hospital Universitario San Cecilio deGranada.Resultados: La incidencia global de sífilis duranteel embarazo en nuestro medio en los 11 últimosaños es de 2,42 × 10–04 (7 casos), 3 de ellos en elúltimo año.Conclusiones: En nuestro medio, presentamos unaincidencia de sífilis durante el embarazo superior ala media de los países con nuestro nivelsocioeconómico, como EE.UU. con 1,1/100.000gestaciones, posiblemente debido a un incrementode la población inmigrante

Objective: To evaluate the prevalence of syphilisinfection in pregnancy and the results of themanagement of this disease.Material and methods: We performed aretrospective study of all cases of syphilis infectionin pregnancy diagnosed and treated betweenJanuary 1996 and December 2006 in the SanCecilio University Hospital in Granada.Results: During the 11-year period studied, theoverall incidence of syphilis infection in pregnancywas 2.42 × 10–04 (seven cases), with three casesoccurring in the final year.Conclusions: In our area, the incidence of syphilisin pregnancy was higher than the average reportedin other countries of a similar socioeconomic level(e.g. the USA with 1.1 × 100,000 pregnancies),possibly due to the increase in the immigrantpopulation

Prognostic value of serum angiogenic activity in colorectal cancer patients.

Angiogenesis, resulting from an imbalance between angiogenic activator factors and inhibitors, is required for tumour growth and metastasis. The determination of the circulating concentration of all angiogenic factors (activators and inhibitors) is not feasible at present. We have evaluated diagnostic and prognostic values of the measurement of serum angiogenic activity in colorectal carcinoma (CRC) patients. Serum proliferative activity (PA) on human umbilical vein endothelial cells (HUVEC) in vitro, and serum vascular endothelial growth factor (VEGF) levels were determined by ELISA in 53 patients with primary CRC, 16 subjects with non-neoplastic gastrointestinal disease (SC) and 34 healthy individuals. Data were compared with clinical outcome of the patients. Although serum from CRC patients significantly increased the PA of HUVEC, compared to culture control (HUVEC in medium + 10% foetal bovine serum (FBS); P < 0.001); our results indicate that serum PA in CRC patients was similar to that of SC or healthy individuals. There was no correlation between serum PA and circulating VEGF concentrations. Surgery produced a decrease of PA at 8 hrs after tumour resection in CRC patients compared to pre-surgery values (186 +/- 47 versus 213 +/- 41, P < 0.001). However, an increase in serum VEGF values was observed after surgery (280 [176-450] versus 251 [160-357] pg/ml, P = 0.004). Patients with lower PA values after surgery showed a worse outcome that those with higher PA values. Therefore, this study does not support a diagnostic value for serum angiogenic activity measured by proliferative activity on HUVEC but suggests it could have a prognostic value in CRC patients.