Delamination of 2D coordination polymers: The role of solvent and ultrasound.

Two novel cadmium-based 2D coordination polymers have been synthesized and characterized. Experimental results evidence that the best delamination processes occurs when weak interactions dominate the cohesion between layers and solvent molecules are occluded within the crystalline network. In this case, the delamination of the crystals occurs spontaneously in water. On top of that, and thanks to the high stability of the resulting (flake) colloidal dispersions, we have completed a detailed study of the sonication assisted delamination impact by: I) comparison of two different sonication approaches (bath vs. tip sonication) and II) optimization of final flake morphology and yield by controlling solvent and sonication time. Our results definitely pave the way for the fabrication and implementation of 2D coordination polymers using ultrasound.

Dual T1/ T2 Nanoscale Coordination Polymers as Novel Contrast Agents for MRI: A Preclinical Study for Brain Tumor.

In the last years, extensive attention has been paid on designing and developing functional imaging contrast agents for providing accurate noninvasive evaluation of pathology in vivo. However, the issue of false-positives or ambiguous imaging and the lack of a robust strategy for simultaneous dual-mode imaging remain to be fully addressed. One effective strategy for improving it is to rationally design magnetic resonance imaging (MRI) contrast agents (CAs) with intrinsic T1/ T2 dual-mode imaging features. In this work, the development and characterization of one-pot synthesized nanostructured coordination polymers (NCPs) which exhibit dual mode T1/ T2 MRI contrast behavior is described. The resulting material comprises the combination of different paramagnetic ions (Fe3+, Gd3+, Mn2+) with selected organic ligands able to induce the polymerization process and nanostructure stabilization. Among them, the Fe-based NCPs showed the best features in terms of colloidal stability, low toxicity, and dual T1/ T2 MRI contrast performance overcoming the main drawbacks of reported CAs. The dual-mode CA capability was evaluated by different means: in vitro phantoms, ex vivo and in vivo MRI, using a preclinical model of murine glioblastoma. Interestingly, the in vivo MRI of Fe-NCPs show T1 and T2 high contrast potential, allowing simultaneous recording of positive and negative contrast images in a very short period of time while being safer for the mouse. Moreover, the biodistribution assays reveals the persistence of the nanoparticles in the tumor and subsequent gradual clearance denoting their biodegradability. After a comparative study with commercial CAs, the results suggest these nanoplatforms as promising candidates for the development of dual-mode MRI CAs with clear advantages.

Grape seed proanthocyanidin supplementation reduces adipocyte size and increases adipocyte number in obese rats.

OBJECTIVES: White adipose tissue (WAT) expands through hypertrophy (increased adipocyte size) and/or hyperplasia (increased adipocyte number). Hypertrophy has been associated with insulin resistance and dyslipidemia independently of body composition and fat distribution. In contrast, hyperplasia protects against metabolic alterations. Proanthocyanidins, which are the most abundant flavonoids in the human diet, improve metabolic disturbances associated with diet-induced obesity without reducing body weight or adiposity. The aim of this study was to determine whether grape seed proanthocyanidin extract (GSPE) can modulate WAT expandability. Because GSPE also contains gallic acid, we also studied the capacity of gallic acid to remodel WAT. DESIGN: Male Wistar rats were fed a standard chow diet (n=6) or a cafeteria diet (CAF) for 11 weeks. After 8 weeks, the CAF-fed animals were supplemented with 25 mg GSPE/kg body weight (n=6), 7 mg gallic acid/kg body weight (n=6) or the vehicle (n=6) for 3 weeks. Histological analyses were performed in the retroperitoneal (rWAT) and inguinal (iWAT) WAT to determine adipocyte size and number. Specific markers for adipogenesis and WAT functionality were analysed in rWAT using quantitative RT-PCR. RESULTS: GSPE or gallic acid supplementation did not reduce weight gain or reverse and adiposity. However, GSPE reduced adipocyte size significantly in rWAT and moderately in iWAT and tripled the adipocyte number in rWAT. Gallic acid slightly reduced adipocyte size in rWAT and iWAT and doubled the adipocyte number in both WATs. In accordance with this adipogenic activity, Pref-1 and PPARγ tended to be overexpressed in rWAT of rats supplemented with GSPE. Moreover, GSPE supplementation increased Plin1 and Fabp4 expression and restored adiponectin expression completely, indicating a better functionality of visceral WAT. CONCLUSIONS: GSPE supplementation has anti-hypertrophic and hyperplasic activities in rats with established obesity, mainly in visceral WAT inducing a healthier expansion of WAT to match the surplus energy provided by the cafeteria diet.

Prevalencia de EPOC entre la población fumadora de Colloto (Asturias) / Prevalence of COPD among the smoker population of Colloto (Asturias)

Objetivos. Conocer la prevalencia total y no conocida de EPOC en la población fumadora y ex-fumadora de 40 a 75 años en el área urbano-rural de Colloto, Asturias, y las diferencias según las distintas variables sociodemográficas. Pacientes y método. Estudio descriptivo transversal sobre 364 fumadores y ex-fumadores de ambos sexos de 40 a 75 años que acudían al consultorio de Colloto. Se realizó una historia clínica del hábito y examen físico detallados, y un estudio espirométrico completo para el diagnóstico y estadiaje. Resultados. La prevalencia de EPOC fue del 15,1% (IC 95% 11,7-19,4), sin diferencias entre sexos. Los factores asociados fueron la edad (pasando del 8,1 al 24,8% del primer al tercer terciles de edad) y el índice tabáquico (pasando del 8,4 al 24,8% del primer al tercer terciles del mismo), y como factor protector el índice de masa corporal. El hábito actual de consumo de tabaco no presentaba diferencias. El 48% de los diagnosticados por espirometría fueron nuevos diagnósticos. De los diagnosticados previamente de EPOC, en el 52% no se confirma el diagnóstico en la espirometría. El 14,8% de los EPOC se clasificaron como grave o muy grave. Conclusiones. La prevalencia obtenida es similar a la de otros estudios, siendo la mitad de los casos desconocidos. Deben estudiarse espirométricamente de rutina todos los fumadores, al menos desde 15 paquetesaño a partir de los 40 años, y en todos los pacientes que hayan sido fumadores a partir de los 65 años (AU)

Objectives. To know the total and unknown prevalence of COPD in the smoker and ex-smoker population of 40 to 75 years in the urban -rural area of Colloto, Asturias, and the differences according to the different sociodemographic variables. Patients and method. A descriptive cross-sectional study on 364 smokers and ex-smokers of both genders, 40 to 75 years old, who came to the medical facility of Colloto. A detailed clinical history on the habit and physical examination was obtained, as well as a complete spirometric study for the diagnosis and staging. Results. COPD prevalence was 15.1% (95% CI 11.7- 19.4), without differences between genders. Associated factors were age (going from 8.1 to 24.8% from its first to third terciles of age) and the smoking habit index (going from 8.4 to 24.8% from its first to the third terciles) and as protective factor, the body mass index. The current smoking consumption habit showed no differences. A total of 48% of those diagnosed by spirometry were new diagnoses. Of those previously diagnosed of COPD, the diagnosis was not confirmed in the spirometry in 52% and 14.8% of the COPD were classified as severe or very severe. Conclusions. The prevalence obtained is similar to that of other studies, half of the cases being unknown. All smokers should undergo routine spirometric studies, at least those smoking from 15 packs a year after the age of 40 and in all of those patients who have been smokers after the age of 65 (AU)

[Identification of individuals with insulin resistance by means of clinical measurements and routine biochemical markers. Construction of an individual risk index]. / Identificación de individuos con resistencia a la insulina mediante mediciones clínicas y marcadores bioquímicos de rutina. Construcción de un índice de riesgo individual.

INTRODUCTION: This study aimed to know the markers and routine biochemical measures that are associated to the insulin resistance (IR) and to develop an index of individual IR risk from them. SUBJECTS AND METHODS: Cross-sectional study made in Primary Health Care population of both genders between 40 and 74 years (n = 2,143). A representative sample was obtained by simple random sampling of 305 patients after excluding the diabetic subjects. Sociodemographic variables, background, examinations, routine analyses as well as fasting insulin levels were obtained. IR was considered if HOMA was higher than 2.9. A step by step logistic regression was done to obtain the best variables to predict IR. A logistic equation, categorical scale and simple additive scale from the beta coefficients was then constructed and was compared with other instruments designed to predict IR. RESULTS: IR prevalence was 25.2%. There were no differences between genders or by age. The four variables that entered the model were fasting plasma glucose, BMI, HDL cholesterol and diastolic blood pressure. The logistic model had good adjustment. The logistic equation was: IR = 1/ 1 + exp (-[-21.011) - [0.119 * fasting plasma glucose] - [0.231 * BMI] - [-0.046 * HDL cholesterol] - [0.048 * diastolic blood pressure]). The scale constructed assesses each subject between -1 and 7 points; cutoff to predict IR was established at 3.5 points, obtaining a sensitivity and specificity similar to the McAuley index and better than the triglycerides/HDL cholesterol ratio, the first model of Stern and the diagnosis of metabolic syndrome according to ATP-III. DISCUSSION: A very easy-to-use instrument has been obtained to predict IR by means of exploratory measures and routine biochemical measures, which makes it possible to select the patients at the greatest risk in order to intensify preventive actions in them.

Identificación de individuos con resistencia a la insulina mediante mediciones clínicas y marcadores bioquímicos de rutina. Construcción de un índice de riesgo individual / Identification of individuals with insulin resistance by means of clinical measurements and routine biochemical markers. Construction of an individual risk index

Introducción. El objetivo del estudio fue conocer los marcadores bioquímicos y las medidas clínicas de rutina que se asocian a la resistencia a la insulina (RI), y desarrollar a partir de ellos un índice de riesgo individual de RI. Sujetos y métodos. Estudio transversal sobre población general de ambos sexos entre 40 y 70 años (n = 2.143); se obtuvo una muestra aleatoria simple de 305 pacientes tras excluir a los diabéticos. Se recogieron variables sociodemográficas, antecedentes, exploración y analítica de rutina más insulinemia. Se consideró RI un HOMA (homeostasis model assessment) ≥ 2,9. Se practicó una regresión logística por pasos hacia adelante para obtener las mejores variables para predecir la RI, posteriormente se construyó una ecuación logística, una escala categórica y una escala aditiva simple a partir de los coeficientes beta, y se comparó ésta con otros instrumentos diseñados para predecir la RI. Resultados. La prevalencia de RI fue del 25,2%. No hubo diferencias por sexos ni por edad. Las variables que entraron en el modelo fueron: glucemia, índice de masa corporal (IMC), colesterol ligado a lipoproteínas de alta densidad (c-HDL) y presión arterial diastólica (PAD). El modelo logístico presentó un buen ajuste. La ecuación logística fue: probabilidad de RI = 1/ 1 + exp (-[-21,011] ­ [0,119 * glucemia] ­ [0,231 * IMC] ­ [-0,046 * c-HDL] ­ [0,048 * PAD]. La escala construida valora a cada sujeto entre -1 y 7 puntos; el punto de corte para predecir la RI se estableció en > 3,5 puntos, obteniéndose una sensibilidad y especificidad similares al índice de McAuley y mejores que la razón triglicéridos/c-HDL, el modelo de Stern y el diagnóstico de síndrome metabólico (SM) según el Adult Treatment Panel III (ATP-III). Discusión. Se ha obtenido un instrumento de gran sencillez de uso para predecir la RI mediante la exploración y analítica de rutina, que permite seleccionar a los pacientes de mayor riesgo para intensificar intervenciones preventiva (AU)

Introduction. This study aimed to know the markers and routine biochemical measures that are associated to the insulin resistance (IR) and to develop an index of individual IR risk from them. Subjects and methods. Cross-sectional study made in Primary Health Care population of both genders between 40 and 74 years (n = 2,143). A representative sample was obtained by simple random sampling of 305 patients after excluding the diabetic subjects. Sociodemographic variables, background, examinations, routine analyses as well as fasting insulin levels were obtained. IR was considered if HOMA was higher than 2.9. A step by step logistic regression was done to obtain the best variables to predict IR. A logistic equation, categorical scale and simple additive scale from the beta coefficients was then constructed and was compared with other instruments designed to predict IR. Results. IR prevalence was 25.2%. There were no differences between genders or by age. The four variables that entered the model were fasting plasma glucose, BMI, HDL cholesterol and diastolic blood pressure. The logistic model had good adjustment. The logistic equation was: IR = 1/ 1 + exp (-[-21.011) ­ [0.119 * fasting plasma glucose] ­ [0.231 * BMI] ­ [-0.046 * HDL cholesterol] ­ [0.048 * diastolic blood pressure]). The scale constructed assesses each subject between -1 and 7 points; cutoff to predict IR was established at 3.5 points, obtaining a sensitivity and specificity similar to the McAuley index and better than the triglycerides/HDL cholesterol ratio, the first model of Stern and the diagnosis of metabolic syndrome according to ATP-III. Discussion. A very easy-to-use instrument has been obtained to predict IR by means of exploratory measures and routine biochemical measures, which makes it possible to select the patients at the greatest risk in order to intensify preventive actions in them (AU)

Prevalencia de tabaquismo en una población general y valoración de la actitud ante el cambio. ¿Están preparados nuestros pacientes para abandonar el hábito? / Prevalence of smoking in a general population and evaluation of patient attitude prior to stopping. Are our patients prepared to stop smoking?

Introducción y objetivos. El modelo teórico de los Estadios del Cambio permite entender los cambios en el grado de disposición del paciente ante un hipotético intento de abandono del tabaquismo. El objetivo del presente trabajo ha sido estudiar la prevalencia del tabaquismo, la dependencia del tabaco y los intentos del abandono del hábito, estudiar la asociación con la historia de tabaquismo en los padres, estudiar a los fumadores en función de la fase de abandono en que se encuentran y conocer si los afectados por enfermedades relacionadas con el tabaco son más proclives al abandono. Pacientes y métodos. Estudio descriptivo transversal en la población mayor de 14 años perteneciente al Consultorio de Colloto (Asturias). Se calculó una muestra de 415 personas, que se seleccionaron de forma aleatoria simple. Los datos se obtuvieron mediante encuesta. Para el análisis estadístico de los datos se utilizó el programa Epi Info (v. 6.04b). Resultados. Se evaluó a 402 individuos, un 51,7% mujeres. La prevalencia de fumadores actuales es del 29,9% (25,5-34,6%); son ex fumadores el 19,1% (15,5-23,4%) y nunca ha fumado el 51,0% (46,0-56,0%). Hay diferencias muy significativas entre sexos en el grupo de más de 64 años. De los que han sido fumadores, el 39,1% (32,3-46,3%) ha dejado el hábito. El abandono del tabaco se incrementa con la edad. Cuando los padres han sido fumadores los sujetos tienen 2 veces más posibilidades de serlo. Sólo el 13% de los fumadores tienen elevada dependencia. Se encuentra en la fase precontemplativa el 46,6% (37,5-55,0%), en la contemplativa el 40,7% (31,8-50,1%), y en la de preparación el 12,7% (7,5-20,4%). Aquellos que estaban en fase precontemplativa presentaban un grado de dependencia (índice de Fageström), una media de cigarrillos/día y de paquetes/año más altos que el resto. El 50,8% de los fumadores han intentado abandonar el tabaco. En los pacientes con enfermedades crónicas relacionadas con el tabaquismo o factores de riesgo vascular el abandono del hábito tabáquico ha sido mayor que en los que no presentaban ninguna enfermedad. Conclusiones. Se sugiere la existencia de un descenso en el número de consumidores activos. No obstante, en los más jóvenes el número de mujeres fumadoras se equipara al de varones. La distribución de los fumadores en función del modelo de los Estadios del Cambio revela un elevado número de pacientes en las fases donde es previsible una mayor eficacia de la intervención. Es notable el grado de abandono existente en pacientes con factores de riesgo cardiovascular y en aquéllos con enfermedad vascular ya presente (AU)

Introduction and objectives. The theoretical model of the Stages of Change allows us to understand changes in the degree of a patient's willingness in a hypothetical attempt to quit smoking. The aims of this study were to assess the prevalence of smoking, dependence and attempts to stop; study the link with a history of smoking by parents, classify smokers by the degree of desire to stop smoking and to ascertain whether those with smoking-related disesaes are more inclined to quit smoking. Patients and methods. Cross-sectional, descriptive study in the population aged 14 and over in Colloto (a primary care center in Asturias, Spain). The study was focused on a simple, random sample of 415 persons. Data were obtained by means of a survey. The epi-info 6.04b was used for statistical analysis. Results. A sample of 402 patients were evaluated; 51.7% were female. The prevalence of current smokers was 29.9% (25.5-34.6%); 19.1% (15.5-23.4%) had stopped smoking and 51.0% (46.0-56.0%) had never been smokers. Marked differences were observed between sexes in the over-64 age group. Among smokers, 39.1% (32.3-46.3%) had stopped. Quitting had increased with age. When parents had been smokers, the chance of their offspring also being smokers had doubled. Only 13% of smokers had high dependence. 46.6% (37.5-55.0%) were in the "precontemplative" stage, 40.7% (31.8-50.1%) in the contemplative stage and 12.7% (7.5-20.4%) in the readiness stage. Those in the precontemplative stage presented a Fageström score, a number of cigarettes-daily and packs per year consumption higher than the rest. The 50.8% of smokers had made attempts to stop. In patients with chronic tobacco-related illnesses and those at risk for vascular disease, stopping smoking was more prevalent than in those with no such symptoms. Conclusions. A decline in the number of active smokers is suggested; however, in the younger population the number of females approaches that of males. The distribution of smokers according to the Stages of Change model reveals a large number of patients in phases where there should be a high probability of intervention effectiveness. The degree of quitting in patients with higher cardiovascular risk and those who already have vascular diseases is noteworthy (AU)

El caso del hipertenso débil, desorientado y agresivo / Case of the weak, disoriented and aggressive hypertensive patient

Se presenta el caso de un paciente, hipertenso conocido, con repercusión visceral, que presentaba astenia y malestar general y cuya familia refería desorientación y agresividad de reciente aparición, aunque la queja subjetiva inicial era de debilidad muscular y polidipsia, entre otros síntomas. Ante los hallazgos electrocardiográficos se interpretó inicialmente como un cuadro de toxicidad digitálica, probablemente desencadenada por hipopotasemia que resultó ser secundaria a un hiperaldosteronismo primario no conocido previamente (AU)

Prevalencia de la hipertensión arterial sistólica aislada en una población mayor de 60 años / Incidence of isolated systolic arterial hypertension in a population of patients over 60 years old

Objetivos. Conocer la prevalencia de hipertensión arterial y de hipertensión arterial sistólica aislada, factores de riesgo cardiovascular y patología cardiovascular asociada, así como el tratamiento farmacológico utilizado y el grado de control obtenido en una población mayor de 60 años, así como analizar las diferencias entre ambos grupos de hipertensos. Métodos. Se trata de un estudio descriptivo y transversal realizado sobre una muestra aleatoria extraída de la totalidad de personas mayores de 60 años (n = 8.026) de 16 cupos de 6 centros de salud de Asturias. Se analizaron los factores de riesgo clásicos, tratamiento farmacológico y la patología cardiovascular asociada. Resultados. Se estudió una muestra de 342 pacientes. La prevalencia de hipertensión sistodiastólica fue del 40,4 por ciento y la de hipertensión sistólica aislada del 24,6 por ciento (el 38 por ciento de todos los hipertensos) y no eran hipertensos el 35 por ciento. Encontramos que los hipertensos sistólicos aislados presentaban una edad media superior (75 ñ 7 frente a 72 ñ 7 años), una mayor presión arterial sistólica (149 ñ 15 frente a 144 ñ 16 mmHg) y una mayor diferencia de la presión de pulso (70 ñ 14 frente a 61 ñ 13 mmHg), así como una mayor presencia de microalbuminuria (25,6 por ciento frente al 10 por ciento) y de arteriopatía periférica (8,3 por ciento frente al 2,2 por ciento) respecto a los hipertensos sistodiastólicos. En éstos, la diabetes y la obesidad alcanzaron mayor prevalencia (23 por ciento frente al 12 por ciento y 46 por ciento frente al 41 por ciento, respectivamente) que en los hipertensos sistólicos aislados. El tratamiento farmacológico se pautó en el 83 por ciento de los pacientes con hipertensión sistodiastólica y sólo en el 56 por ciento de los del grupo de sistólica aislada, no habiendo diferencias entre los dos grupos en cuanto al uso de fármacos antihipertensivos, salvo en el grupo de los calcioantagonistas (44,7 por ciento frente al 28,1 por ciento en los sistodiastólicos) (AU)