Recent advances in the management of pulmonary arterial hypertension: lessons from the upfront combination of ambrisentan and tadalafil.

INTRODUCTION: The sixth World Symposium of Pulmonary Hypertension (sixth WSPH) brought to the forefront for the first time the value of earlier, aggressive management with an upfront oral combination in patients with pulmonary arterial hypertension (PAH) of low or intermediate risk. This was prompted by results from the AMBITION study (ambrisentan + tadalafil). A literature search was conducted to collect all evidence provided by upfront treatment with this combination, as well as other combinations under investigation at the time the manuscript was prepared. AREAS COVERED: The value of an upfront oral combination with ambrisentan and tadalafil is reviewed on the basis of topics discussed at the sixth WSPH, such as evidence in different PAH etiologies, according to risk stratification and in so-called 'atypical' patients where monotherapy is still recommended. Evidence in clinical practice is also reviewed. New evidence about the value of the upfront oral combination is also commented. Finally, tendencies in primary endpoints to assess the effect of PAH-targeted therapies (time to clinical worsening and hemodynamics) and their value are also reviewed. EXPERT OPINION: All above-mentioned aspects are put into perspective with regard to the impact of new advances on improving PAH management in clinical practice.

Impact of parenteral nutrition standardization on costs and quality in adult patients.

BACKGROUND: Parenteral nutrition (PN) is a costly therapy that can also be associated with serious complications. Therefore, efforts are focusing on reducing rate of complications, and costs related to PN. OBJECTIVE: The aim was to analyze the effect of the implementation of PN standardization on costs and quality criteria. Secondary aim was to assess the use of individualized PN based on patient's clinical condition. METHODS: We compare the use of PN before and after the implementation of PN standardization. Demographic, clinical and PN characteristics were collected. Costs analysis was performed to study the costs associated to the two different periods. Quality criteria included were: 1) PN administration; 2) nutrition assessment (energy intake between 20-35 kcal/kg/day; protein contribution according to nitrogen balance); 3) safety and complications (hyperglycemia, hypertriglyceridemia, hepatic complications, catheter-related infection); 4) global efficacy (as serum albumin increase). Chi-square test was used to compare percentages; logistic regression analysis was performed to evaluate the use of customized PN. RESULTS: 296 patients were included with a total of 3,167 PN compounded. During the first period standardized PN use was 47.5% vs 85.7% within the second period (p < 0.05). No differences were found in the quality criteria tested. Use of individualized PN was related to critical care patients, hypertriglyceridemia, renal damage, and long-term PN. Mean costs of the PN decreased a 19.5%. Annual costs savings would be € 86,700. CONCLUSIONS: The use of customized or standard PN has shown to be efficient and flexible to specific demands; however customized PN was significantly more expensive.

Introducción: La nutrición parenteral (NP) es una terapia costosa asociada a serias complicaciones. De manera que muchos de los esfuerzos se centran en reducir éstas complicaciones, así como los costes asociados. Objetivos: Analizar el efecto de la estandarización de la NP en los costes y en indicadores de calidad. El objetivo secundario es estudiar la utilización de NP individualizadas en función de las condiciones clínicas de los pacientes. Métodos: Se compara la utilización de NP antes y después de la estandarización de la NP. Se recogen los datos demográficos, clínicos y características de la NP. Se realiza un análisis de costes asociados a los dos periodos de estudio. Se incluyen los siguientes indicadores de calidad: 1) Administración de NP; 2) Valoración nutricional (aporte calórico 20-35 kcal/kg/día; aporte proteico en función del balance nitrogenado); 3) seguridad y complicaciones (hiperglicemia, hipertrigliceridemia, complicaciones hepáticas, infección de catéter); eficacia global (aumento albúmina sérica). Se utiliza test de chi-cuadrado para comparación de porcentajes, y regresión logística para evaluar la utilización de NP individualizada. Resultados: Se incluyeron 296 pacientes para un total de 3,167 NP. Durante el primer período el uso de NP estandarizada fue del 47,5% frente 85,7% en el segundo (p < 0,05). No se encontraron diferencias en los indicadores de calidad estudiados. La utilización de NP individualizada fue relacionada con pacientes críticos, hipertrigliceridemia y NP de larga duración. El coste medio de NP disminuyó en un 19,5%; pudiendo resultar un ahorro anual de 86,700 . Conclusiones: La utilización de NP individualizadas o estándar ha mostrado ser eficiente y flexible; aunque el coste de la individualizada fue significativamente mayor.

Impact of parenteral nutrition standardization on costs and quality in adult patients / Impacto de la estandarización de la nutrición parenteral en costes y calidad en pacientes adultos

Background: Parenteral nutrition (PN) is a costly therapy that can also be associated with serious complications. Therefore, efforts are focusing on reducing rate of complications, and costs related to PN. Objective: The aim was to analyze the effect of the implementation of PN standardization on costs and quality criteria. Secondary aim was to assess the use of individualized PN based on patient’s clinical condition. Methods: We compare the use of PN before and after the implementation of PN standardization. Demographic, clinical and PN characteristics were collected. Costs analysis was performed to study the costs associated to the two different periods. Quality criteria included were: 1) PN administration; 2) nutrition assessment (energy intake between 20-35 kcal/kg/day; protein contribution according to nitrogen balance); 3) safety and complications (hyperglycemia, hypertriglyceridemia, hepatic complications, catheter-related infection); 4) global efficacy (as serum albumin increase). Chi-square test was used to compare percentages; logistic regression analysis was performed to evaluate the use of customized PN. Results: 296 patients were included with a total of 3,167 PN compounded. During the first period standardized PN use was 47.5% vs 85.7% within the second period (p < 0.05). No differences were found in the quality criteria tested. Use of individualized PN was related to critical care patients, hypertriglyceridemia, renal damage, and long-term PN. Mean costs of the PN decreased a 19.5%. Annual costs savings would be Euros 86,700. Conclusions: The use of customized or standard PN has shown to be efficient and flexible to specific demands; however customized PN was significantly more expensive (AU)

Introducción: La nutrición parenteral (NP) es una terapia costosa asociada a serias complicaciones. De manera que muchos de los esfuerzos se centran en reducir éstas complicaciones, así como los costes asociados. Objetivos: Analizar el efecto de la estandarización de la NP en los costes y en indicadores de calidad. El objetivo secundario es estudiar la utilización de NP individualizadas en función de las condiciones clínicas de los pacientes. Métodos: Se compara la utilización de NP antes y después de la estandarización de la NP. Se recogen los datos demográficos, clínicos y características de la NP. Se realiza un análisis de costes asociados a los dos periodos de estudio. Se incluyen los siguientes indicadores de calidad: 1) Administración de NP; 2) Valoración nutricional (aporte calórico 20-35 kcal/kg/día; aporte proteico en función del balance nitrogenado); 3) seguridad y complicaciones (hiperglicemia, hipertrigliceridemia, complicaciones hepáticas, infección de catéter); eficacia global (aumento albúmina sérica). Se utiliza test de chi-cuadrado para comparación de porcentajes, y regresión logística para evaluar la utilización de NP individualizada. Resultados: Se incluyeron 296 pacientes para un total de 3,167 NP. Durante el primer período el uso de NP estandarizada fue del 47,5% frente 85,7% en el segundo (p < 0,05). No se encontraron diferencias en los indicadores de calidad estudiados. La utilización de NP individualizada fue relacionada con pacientes críticos, hipertrigliceridemia y NP de larga duración. El coste medio de NP disminuyó en un 19,5%; pudiendo resultar un ahorro anual de 86,700 Euros. Conclusiones: La utilización de NP individualizadas o estándar ha mostrado ser eficiente y flexible; aunque el coste de la individualizada fue significativamente mayor (AU)

Evaluación de dieta purificada para la obtención de biomodelo de ratas anémicas / Evaluation of a purified diet to obtain a biomodel of anemic rats

Introducción: el desarrollo científico y tecnológico en las ciencias biológicas y biomédicas ha sido posible gracias a la utilización de modelos animales experimentales. La anemia por deficiencia de hierro (Fe), afecta aproximadamente a la tercera parte de la población mundial. La rata recién destetada ha sido el modelo animal más empleado en la obtención de un biomodelo experimental de anemia. Para la obtención de anemia se utiliza el método de depleción de la hemoglobina (Hb), mediante una alimentación basada en una dieta deficiente en Fe. Objetivo: el objetivo de este trabajo fue evaluar la eficacia de una dieta purificada a partir de caseína en la obtención de ratas anémicas. Métodos: se utilizaron 40 ratas Sprague Dawley recién destetadas (21-24 días), la mitad de cada sexo. Se alojaron en grupos de 3 del mismo sexo en cajas de acero inoxidable con piso de rejillas. Durante 8 semanas se les administró agua desionizada y una dieta de caseína al 12,58 por ciento de proteínas y 1,28 mgFe/Kg. Cada dos semanas se midió el peso corporal y a partir de la cuarta semana, la concentración de Hb. Resultados: se obtuvo un incremento significativo del peso corporal sin observarse diferencias entre hembras y machos. Se tomó como criterio de obtención de la anemia aquellos animales cuya Hb disminuyó al menos en un 30 por ciento del valor inicial promedio por grupo. El porcentaje de animales anémicos a las 8 semanas fue superior en las hembras (75 por ciento), mientras que en machos (60 por ciento). La dieta utilizada en este estudio permitió obtener ratas anémicas en el sexo hembras con una eficiencia aceptable, en relación al porcentaje de animales anémicos y al incremento del peso corporal. Conclusiones: la dieta utilizada en este estudio permitió obtener ratas anémicas en el sexo hembras con una eficiencia aceptable, en relación al porcentaje de animales anémicos y al incremento del peso corporal

Introduction: the scientific and technological development of biological and biomedical sciences has been possible due to the use of experimental animal models. Iron- (Fe-) deficiency anemia affects about one third of the world population. Just weaned rats have been the animal model most commonly used to obtain an experimental biomodel of anemia. The disease is obtained by the hemoglobin (Hb) depletion method, feeding the animal an iron-deficient diet. Objective: evaluate the efficacy of a purified diet based on casein to obtain anemic rats. Method: a study was conducted of 40 just weaned (21-24 days) Sprague Dawley rats, 20 of each sex. The animals were housed in groups of 3 rats of the same sex in stainless steel boxes with mesh bottoms. For 8 weeks the animals were administered deionized water and a casein diet of 12.58 percent protein and 1.28 mgFe/kg. Body weight was measured every two weeks. Hb concentration was gauged from the fourth week onwards. Results: a significant increase in body weight was obtained, with no differences between male and female rats. The criterion for anemia was at least a 30 percent decrease in Hb with respect to the average baseline value per group. The percentage of anemic animals at 8 weeks was higher for females (75 percent ) than for males (60 percent ) Conclusions: the diet used for the study made it possible to obtain female anemic rats with acceptable efficiency in relation to the percentage of anemic animals and the increase in body weight

Evaluación de dieta purificada para la obtención de biomodelo de ratas anémicas / Evaluation of a purified diet to obtain a biomodel of anemic rats

Introducción: el desarrollo científico y tecnológico en las ciencias biológicas y biomédicas ha sido posible gracias a la utilización de modelos animales experimentales. La anemia por deficiencia de hierro (Fe), afecta aproximadamente a la tercera parte de la población mundial. La rata recién destetada ha sido el modelo animal más empleado en la obtención de un biomodelo experimental de anemia. Para la obtención de anemia se utiliza el método de depleción de la hemoglobina (Hb), mediante una alimentación basada en una dieta deficiente en Fe. Objetivo: el objetivo de este trabajo fue evaluar la eficacia de una dieta purificada a partir de caseína en la obtención de ratas anémicas. Métodos: se utilizaron 40 ratas Sprague Dawley recién destetadas (21-24 días), la mitad de cada sexo. Se alojaron en grupos de 3 del mismo sexo en cajas de acero inoxidable con piso de rejillas. Durante 8 semanas se les administró agua desionizada y una dieta de caseína al 12,58 por ciento de proteínas y 1,28 mgFe/Kg. Cada dos semanas se midió el peso corporal y a partir de la cuarta semana, la concentración de Hb. Resultados: se obtuvo un incremento significativo del peso corporal sin observarse diferencias entre hembras y machos. Se tomó como criterio de obtención de la anemia aquellos animales cuya Hb disminuyó al menos en un 30 por ciento del valor inicial promedio por grupo. El porcentaje de animales anémicos a las 8 semanas fue superior en las hembras (75 por ciento), mientras que en machos (60 por ciento). La dieta utilizada en este estudio permitió obtener ratas anémicas en el sexo hembras con una eficiencia aceptable, en relación al porcentaje de animales anémicos y al incremento del peso corporal. Conclusiones: la dieta utilizada en este estudio permitió obtener ratas anémicas en el sexo hembras con una eficiencia aceptable, en relación al porcentaje de animales anémicos y al incremento del peso corporal(AU)

Introduction: the scientific and technological development of biological and biomedical sciences has been possible due to the use of experimental animal models. Iron- (Fe-) deficiency anemia affects about one third of the world population. Just weaned rats have been the animal model most commonly used to obtain an experimental biomodel of anemia. The disease is obtained by the hemoglobin (Hb) depletion method, feeding the animal an iron-deficient diet. Objective: evaluate the efficacy of a purified diet based on casein to obtain anemic rats. Method: a study was conducted of 40 just weaned (21-24 days) Sprague Dawley rats, 20 of each sex. The animals were housed in groups of 3 rats of the same sex in stainless steel boxes with mesh bottoms. For 8 weeks the animals were administered deionized water and a casein diet of 12.58 percent protein and 1.28 mgFe/kg. Body weight was measured every two weeks. Hb concentration was gauged from the fourth week onwards. Results: a significant increase in body weight was obtained, with no differences between male and female rats. The criterion for anemia was at least a 30 percent decrease in Hb with respect to the average baseline value per group. The percentage of anemic animals at 8 weeks was higher for females (75 percent ) than for males (60 percent ) Conclusions: the diet used for the study made it possible to obtain female anemic rats with acceptable efficiency in relation to the percentage of anemic animals and the increase in body weight(AU)

Resistência a antirretrovirais nas gestantes infectadas pelo HIV: revisão sistemática / Antiretroviral resistance in HIV-infected pregnant women: systematic review

A Aids é uma das doenças mais importantes do mundo, sendo a transmissão vertical um dos problemas mais temidos e combatidos. Com a introdução da terapia antirretroviral, a taxa de transmissão é reduzida para menos de 1%. Alguns estudos dizem que a resistência materna é algo grave, pois o feto nasceria com uma cepa resistente, mas evidências científicas não comprovam isso. Observa-se que cada país tem uma forma padrão utilizada no manejo das gestantes infectadas pelo HIV, levando-se em consideração, por exemplo, a carga viral, período gestacional, ou uso prévio de terapia medicamentosa. Mesmo com recomendações padronizadas a resistência pode aparecer, sendo a resistência à nevirapina a mais comum, por esse motivo inúmeros estudos vêm mostrando medidas alternativas para evitar esse evento que tanto amedronta os clínicos.(AU)

AIDS is one of the most important diseases in the world, and the vertical transmission is the problem more feared and fought. By the introduction of antiretroviral therapy, the vertical transmission rate is reduced to less than 1%. Some studies say the maternal resistance is something serious, because the fetus would be born with a resistant strain, but scientific evidence does not prove it. It is observed that each country has a standard form used in the management of HIV infected pregnant women, taking into consideration, for example, the viral load, pregnancy period or previous use of drug therapy. Even with standardized recommendations, the resistance may appear, and resistance to nevirapine the most common, for this reason many studies have shown alternative measures to prevent this event that both frightens the clinicians.(AU)

A humanized mouse model of HPV-associated pathology driven by E7 expression.

Human papillomavirus (HPV) is the causative agent of human cervical cancer and has been associated with oropharyngeal squamous cell carcinoma development. Although prophylactic vaccines have been developed, there is a need to develop new targeted therapies for individuals affected with malignant infected lesions in these locations, which must be tested in appropriate models. Cutaneous beta HPV types appear to be involved in skin carcinogenesis. Virus oncogenicity is partly achieved by inactivation of retinoblastoma protein family members by the viral E7 gene. Here we show that the E7 protein of cutaneous beta HPV5 binds pRb and promotes its degradation. In addition, we described an in vivo model of HPV-associated disease in which artificial human skin prepared using primary keratinocytes engineered to express the E7 protein is engrafted onto nude mice. Expression of E7 in the transplants was stably maintained for up to 6 months, inducing the appearance of lesions that, in the case of HPV16 E7, histologically resembled human anogenital lesions caused by oncogenic HPVs. Moreover, it was confirmed through biomarker expression analysis via immunodetection and/or quantitative PCR from mRNA and miRNA that the 16E7-modified engrafted skin shares molecular features with human HPV-associated pretumoral and tumoral lesions. Finally, our findings indicate a decrease of the in vitro capacity of HPV5 E7 to reduce pRb levels in vivo, possibly explaining the phenotypical differences when compared with 16E7-grafts. Our model seems to be a valuable platform for basic research into HPV oncogenesis and preclinical testing of HPV-associated antitumor therapies.

Seguridad del paciente en la cirugía refractiva con láser / Safety of the patients in the refractive surgery with laser

Objetivo: Describir aspectos relacionados con la seguridad del paciente en la cirugía refractiva con láser y enumerar las medidas para disminuir el riesgo de complicaciones. Métodos: Se realizó un estudio descriptivo transversal. El universo de estudio y la muestra se conformó por 11 720 ojos correspondientes a 5 955 pacientes que fueron intervenidos de cirugía refractiva con láser de excímeros entre los años 2005 y 2009 en el salón de cirugía refractiva del Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Los datos se presentaron en tablas y gráficos, procesados en el paquete estadístico Statgraph Plus 50. Resultados: El número de ojos operados tuvo un aumento progresivo y su mayor representación en los años 2008 y 2009 (24,5 % y 25,1 %, respectivamente). Las complicaciones representaron 0,74 % del total de ojos intervenidos y con tendencia a la disminución en el tiempo. Conclusión: Existe un aumento en la demanda de la cirugía refractiva por láser en nuestro medio para la corrección de los defectos refractivos. Es necesario cumplir un conjunto de medidas que disminuyen la presencia de complicaciones, así se brinda mayor seguridad al paciente.

Objective: To Identify and to describe aspects of the patient's safety in the refractive surgery with laser, as well as the measures to reduce the risk of complications. Methods: A cross-sectional descriptive study was undertaken. The universe of study was the sample of 11 720 eyes from 5 955 patients who had undergone refractive surgery with excímer laser from 2005 to 2009 in Refractive Surgery service of ¨Ramón Pando Ferrer¨ Cuban Institute of Ophthalmology. Data was processed by Statgraph Plus 50 package and presented in charts and graphics. Results: The number of operated eyes progressively increased and the biggest figure was reached in 2008 and 2009, accounting for 24.5% and 25.1% respectively. The complications occurred in 0.74 % of the total of operated eyes, with a decreasing tendency in the course of time. Conclusion: There is an increase in the demand of refractive surgery with laser for the correction of the refractive defects in our center, where a set of measures that reduce occurrence of complications and offer higher level of safety for patient are implemented.

Gene expression profiling of mouse p53-deficient epidermal carcinoma defines molecular determinants of human cancer malignancy.

BACKGROUND: The epidermal specific ablation of Trp53 gene leads to the spontaneous development of aggressive tumors in mice through a process that is accelerated by the simultaneous ablation of Rb gene. Since alterations of p53-dependent pathway are common hallmarks of aggressive, poor prognostic human cancers, these mouse models can recapitulate the molecular features of some of these human malignancies. RESULTS: To evaluate this possibility, gene expression microarray analysis was performed in mouse samples. The mouse tumors display increased expression of cell cycle and chromosomal instability associated genes. Remarkably, they are also enriched in human embryonic stem cell gene signatures, a characteristic feature of human aggressive tumors. Using cross-species comparison and meta-analytical approaches, we also observed that spontaneous mouse tumors display robust similarities with gene expression profiles of human tumors bearing mutated TP53, or displaying poor prognostic outcome, from multiple body tissues. We have obtained a 20-gene signature whose genes are overexpressed in mouse tumors and can identify human tumors with poor outcome from breast cancer, astrocytoma and multiple myeloma. This signature was consistently overexpressed in additional mouse tumors using microarray analysis. Two of the genes of this signature, AURKA and UBE2C, were validated in human breast and cervical cancer as potential biomarkers of malignancy. CONCLUSIONS: Our analyses demonstrate that these mouse models are promising preclinical tools aimed to search for malignancy biomarkers and to test targeted therapies of prospective use in human aggressive tumors and/or with p53 mutation or inactivation.

A functional role of RB-dependent pathway in the control of quiescence in adult epidermal stem cells revealed by genomic profiling.

Continuous cell renewal in mouse epidermis is at the expense of a pool of pluripotent cells that lie in a well defined niche in the hair follicle known as the bulge. To identify mechanisms controlling hair follicle stem cell homeostasis, we developed a strategy to isolate adult bulge stem cells in mice and to define their transcriptional profile. We observed that a large number of transcripts are underexpressed in hair follicle stem cells when compared to non-stem cells. Importantly, the majority of these downregulated genes are involved in cell cycle. Using bioinformatics tools, we identified the E2F transcription factor family as a potential element involved in the regulation of these transcripts. To determine their functional role, we used engineered mice lacking Rb gene in epidermis, which showed increased expression of most E2F family members and increased E2F transcriptional activity. Experiments designed to analyze epidermal stem cell functionality (i.e.: hair regrowth and wound healing) imply a role of the Rb-E2F axis in the control of stem cell quiescence in epidermis.

Molecular Signature of HPV-Induced Carcinogenesis: pRb, p53 and Gene Expression Profiling.

The infection by mucosal human papillomavirus (HPV) is causally associated with tumor development in cervix and oropharynx. The mechanisms responsible for this oncogenic potential are mainly due to the product activities of two early viral oncogenes: E6 and E7. Although a large number of cellular targets have been described for both oncoproteins, the interaction with tumor suppressors p53 and retinoblastoma protein (pRb) emerged as the key functional activities. E6 degrades tumor suppressor p53, thus inhibiting p53-dependent functions, whereas E7 binds and degrades pRb, allowing the transcription of E2F-dependent genes. Since these two tumor suppressors exert their actions through transcriptional modulation, functional genomics has provided a large body of data that reflects the altered gene expression of HPVinfected cells or tissues. Here we will review the similarities and differences of these findings, and we also compare them with those obtained with transgenic mouse models bearing the deletion of some of the viral oncogene targets. The comparative analysis supports molecular evidences about the role of oncogenes E6 and E7 in the interference with the mentioned cellular functions, and also suggests that the mentioned transgenic mice can be used as models for HPV-associated diseases such as human cervical, oropharynx, and skin carcinomas.

Spontaneous tumor formation in Trp53-deficient epidermis mediated by chromosomal instability and inflammation.

BACKGROUND: The specific ablation of Trp53 gene in mouse epidermis leads to the spontaneous development of aggressive squamous cell carcinoma, a process that is accelerated by the subsequent loss of Rb gene. MATERIALS AND METHODS: The possible mechanisms leading to spontaneous tumor formation in epidermis in the absence of Trp53 were studied focusing on hair cycle defects, inflammation and possible chromosomal instability (CIN). RESULTS: Loss of p53 induces tumorigenesis primarily by mediating early CIN and, to a minor extent, nuclear factor kappaB activation. Notably, CIN occurs not only in p53-deficient skin, but also in epidermis lacking both Rb and Tp53 tumor suppressors, indicating a predominant role of this process in spontaneous tumorigenesis. CONCLUSION: These data identify CIN as a major mechanism in tumorigenesis originated by Trp53 loss in stratified epithelia and imply that therapies aimed to counterbalance CIN might be of relevance for the treatment of human cancer bearing impaired p53 functions.

Estudio comparativo del valor nutritivo de varios coleoptera comestibles de México y pachymerus nucleorum (fabricus 1792)(bruchidae) de Brasil / Comparative survey of the nutritive value of several edible coleoptera from Mexico and pachymerus nucleorum (fabricus 1792)(bruchidae) from Brasil

Por medio de métodos normalizados oficiales se analiza y compara el valor nutritivo de algunas especies de escarabajos comestibles de México y el Pachymerus nucleorum de Brasil. Se concluye que los escarabajos comestibles de México y P. nucleorum poseen un alto valor nutritivo en proteínas, aminoácidos, grasas, calorías y minerales, por lo que su ingestión coadyuva a la nutrición de las poblaciones humanas que hacen acopio de este recurso alimenticio de acuerdo a su abundancia durante las diferentes estaciones del año, en las cuales son encontrados

Diabetes en un centro de salud entre españoles e inmigrantes / Diabetes in a primary care center among Spaniards and immigrants

La diabetes es una enfermedad que tiene prevalencia diferente en distintas poblaciones. Objetivos: El objetivo del presente trabajo es describir los pacientes diabéticos de un centro de salud en función de su origen geográfico. Asimismo, conocer el control de la diabetes en estos pacientes. Métodos: Estudio descriptivo transversal con los datos registrados de diabéticos del centro de atención primaria de Tarrasa Sur en el año 2004. Resultados: Se analizaron datos de 1215 diabéticos con una media edad 65 años, de los que el 51% eran mujeres. En cuanto al país de origen: 97% español, 2% marroquí, 0.8% iberoamericano y 0.2% resto Europa. La HbA1c media fue del 6.9%. En los diabéticos tipo 2 los tratamientos fueron: 46.6% antidiabéticos orales (ADO), 36.5% sólo dieta, 7.9% ADO+insulina y 9% insulina. Entre 30-39 años 0.7% marroquíes tiene diabetes tipo 2 frente 0.5% españoles. 40-49 años: 3.9% marroquíes, 3% españoles, 2.1% iberoamericanos. 50-59 años: 13.5% marroquíes, 10.6% españoles, 7.7% iberoamericanos. 60-69 años: 40% marroquíes, 18.8% españoles, 44.5% iberoamericanos. 70-79 años: 67% marroquíes, 26% españoles, 50% iberoamericanos. HbA1c media en iberoamericanos 6.3%, españoles 6.9% y marroquíes 8.1%. En diabetes tipo 1 la HbA1c en marroquíes es 10.2% y españoles 8%; en DM tipo 2 HbA1c en marroquíes 7.8% y españoles 6.9%. El 6.1% de las españolas tuvieron DG, 10.9% marroquíes y 4.2% iberoamericanas. Conclusiones: Se aprecia una mayor prevalencia diabetes en pacientes de origen magrebí. También aparece un peor control de diabetes en marroquíes (AU)

Diabetes is a disease with different prevalence in different populations. Objectives: The aim of the present study is to describe diabetic patients in a primary care center with regard to their geographic origin, and to determine the status of their disease. Methods: A cross-sectional descriptive study, with data available from clinical records in South Tarrasa primary care center (Barcelona, Spain) in 2004. Results: A total of 1215 diabetic patients with an average age of 65 years, 51% female, were included in the study. Regarding their origin, 97% were from Spain, 2% from Morocco, 0.8% from Latin America, and 0.2% from the rest of Europe. The average Hb1AC was 6.9%. In type 2 diabetic patients, treatment consisted of oral hypoglycemic agents (OHA) for 46.6%, only dietetic restrictions for 36.5%, OHA + insulin for 7.9%, and only insulin for 9%. In the age group 30-39 years, 0.7% of Moroccans suffer from diabetes versus 0.5% of Spaniards. The values in the 40-49 year group are 3.9% of Moroccans, 3% of Spaniards, and 2.1% of Latin Americans. The values in the 50-59 year group are 13.5% of Moroccans, 10.6% of Spaniards, and 7.7% of Latin Americans. The values in the 60-69 year group are 40% of Moroccans, 18.8% of Spaniards, and 44.5% of Latin Americans. The values in the 70-79 year group are 67% of Moroccans, 26% of Spaniards, and 50% of Latin Americans. The average Hb1AC was 6.3% in Latin Americans, 6.9% in Spaniards, and 8.1% in Moroccans. In type 1 diabetic patients, the average Hb1AC was 10.2% in Moroccans and 8% in Spaniards; while in type 2 diabetes, the average Hb1AC was 7.8% in Moroccans and 6.9% in Spaniards. Gestational diabetes was observed in 6.1% of the Spanish, 10.9% of the Moroccan and 4.2% of the Latin American women. Conclusions: A higher prevalence of diabetes was detected in Moroccans than in patients from other countries. These patients present poor control of the disease (AU)

Diabetes in a primary care center among Spaniards and immigrants.

UNLABELLED: Diabetes is a disease with different prevalence in different populations. OBJECTIVES: The aim of the present study is to describe diabetic patients in a primary care center with regard to their geographic origin, and to determine the status of their disease. METHODS: A cross-sectional descriptive study, with data available from clinical records in South Tarrasa primary care center (Barcelona, Spain) in 2004. RESULTS: A total of 1215 diabetic patients with an average age of 65 years, 51% female, were included in the study. Regarding their origin, 97% were from Spain, 2% from Morocco, 0.8% from Latin America, and 0.2% from the rest of Europe. The average Hb1AC was 6.9%. In type 2 diabetic patients, treatment consisted of oral hypoglycemic agents (OHA) for 46.6%, only dietetic restrictions for 36.5%, OHA + insulin for 7.9%, and only insulin for 9%. In the age group 30-39 years, 0.7% of Moroccans suffer from diabetes versus 0.5% of Spaniards. The values in the 40-49 year group are 3.9% of Moroccans, 3% of Spaniards, and 2.1% of Latin Americans. The values in the 50-59 year group are 13.5% of Moroccans, 10.6% of Spaniards, and 7.7% of Latin Americans. The values in the 60-69 year group are 40% of Moroccans, 18.8% of Spaniards, and 44.5% of Latin Americans. The values in the 70-79 year group are 67% of Moroccans, 26% of Spaniards, and 50% of Latin Americans. The average Hb1AC was 6.3% in Latin Americans, 6.9% in Spaniards, and 8.1% in Moroccans. In type 1 diabetic patients, the average Hb1AC was 10.2% in Moroccans and 8% in Spaniards; while in type 2 diabetes, the average Hb1AC was 7.8% in Moroccans and 6.9% in Spaniards. Gestational diabetes was observed in 6.1% of the Spanish, 10.9% of the Moroccan and 4.2% of the Latin American women. CONCLUSIONS: A higher prevalence of diabetes was detected in Moroccans than in patients from other countries. These patients present poor control of the disease.