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Gamero-Sánchez MDC, Barreto I, Arévalo-Lorido JC, Vázquez-Jarén E, Maese-Calvo J, Mayoral-Testón N, Carretero-Gómez J, Fernández-Bergés D. Multidimensional frailty connection in older patients with diabetes mellitus. Rev Clin Esp 2024:S2254-8874(24)00054-7. [PMID: 38608730 DOI: 10.1016/j.rceng.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND AND OBJECTIVE Patients with diabetes mellitus (DM) experience accelerated aging and, thus, a high prevalence of frailty. Our aim is to outline the type of frailty and prefrailty from a multidimensional perspective and the interaction of these dimensions in this scenery. MATERIAL AND METHODS Observational study of patients with DM over 60 years-old. Variables related to nutrition, cognitive and emotional status, physical and instrumental functional capacity and social resources were collected. They were divided into three groups (robust, prefrail and frail) according to the Fried scale. Each of the variables in the groups were compared and a correspondence analysis was carried out to see the influence of some dimensions with others in each stage of frailty. RESULTS 188 patients (mean age 72.6 + 7.5) were analysed. Of them, 105 patients had prefrailty and 66 were frail. With the exception of social resources, the rest of the variables had an increasing prevalence depending on the stage of frailty. However, in the correspondence analysis (with 22.9% of variation explained by two dimensions) it was only patients with frailty who were associated with worse functional capacity, cognitive and emotional situation and mild to moderate social incapacity. CONCLUSIONS In our sample there was a high prevalence of prefrailty, and frailty associated with an increase in the prevalence of other different dimensions except social resources. However, the interaction between these dimensions was only evident in the case of patients with frailty.
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Affiliation(s)
- M Del Carmen Gamero-Sánchez
- UCSP Moura (Unidad de Cuidados de Salud Personalizados de Moura), Unidade Local de Saúde do Baixo Alentejo, Rua Dr. António Fernando Covas Lima, 7801-849 Beja, Portugal; Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - I Barreto
- UCSP Moura (Unidad de Cuidados de Salud Personalizados de Moura), Unidade Local de Saúde do Baixo Alentejo, Rua Dr. António Fernando Covas Lima, 7801-849 Beja, Portugal; Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - J C Arévalo-Lorido
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain; Servicio de Medicina Interna, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz, Spain.
| | - E Vázquez-Jarén
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - J Maese-Calvo
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - N Mayoral-Testón
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - J Carretero-Gómez
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz, Spain
| | - D Fernández-Bergés
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
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Leme Galvão LP, Menezes FE, Mendonca C, Barreto I, Alvim-Pereira C, Alvim-Pereira F, Gurgel R. Analysis of association of clinical aspects and IL1B tagSNPs with severe preeclampsia. Hypertens Pregnancy 2016; 35:112-22. [PMID: 26909468 DOI: 10.3109/10641955.2015.1116554] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study investigates the association between IL1B genotypes using a tag SNP (single polymorphism) approach, maternal and environmental factors in Brazilian women with severe preeclampsia. METHODS A case-control study with a total of 456 patients (169 preeclamptic women and 287 controls) was conducted in the two reference maternity hospitals of Sergipe state, Northeast Brazil. A questionnaire was administered and DNA was extracted to genotype the population for four tag SNPs of the IL1Beta: rs 1143643, rs 1143633, rs 1143634 and rs 1143630. Haplotype association analysis and p-values were calculated using the THESIAS test. Odds ratio (OR) estimation, confidence interval (CI) and multivariate logistic regression were performed. RESULTS High pregestational body mass index (pre-BMI), first gestation, cesarean section, more than six medical visits, low level of consciousness on admission and TC and TT genotype in rs1143630 of IL1Beta showed association with the preeclamptic group in univariate analysis. After multivariate logistic regression pre-BMI, first gestation and low level of consciousness on admission remained associated. CONCLUSION We identified an association between clinical variables and preeclampsia. Univariate analysis suggested that inflammatory process-related genes, such as IL1B, may be involved and should be targeted in further studies. The identification of the genetic background involved in preeclampsia host response modulation is mandatory in order to understand the preeclampsia process.
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Affiliation(s)
| | - Filipe Emanuel Menezes
- a Department of Medicine , Federal University of Sergipe , Farolândia , Aracaju , Brazil
| | - Caio Mendonca
- a Department of Medicine , Federal University of Sergipe , Farolândia , Aracaju , Brazil
| | - Ikaro Barreto
- a Department of Medicine , Federal University of Sergipe , Farolândia , Aracaju , Brazil
| | - Claudia Alvim-Pereira
- a Department of Medicine , Federal University of Sergipe , Farolândia , Aracaju , Brazil
| | - Fabiano Alvim-Pereira
- a Department of Medicine , Federal University of Sergipe , Farolândia , Aracaju , Brazil
| | - Ricardo Gurgel
- a Department of Medicine , Federal University of Sergipe , Farolândia , Aracaju , Brazil
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Oliveira-Santos S, Motta-Franco J, Barreto I, Solé D, Gurgel R. Asthma in adolescents--Prevalence trends and associated factors in northeast Brazil. Allergol Immunopathol (Madr) 2015; 43:429-35. [PMID: 25201760 DOI: 10.1016/j.aller.2014.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/21/2014] [Accepted: 05/25/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Asthma is the most common chronic disease affecting children and adolescents (AD). We evaluated the prevalence of asthma and associated factors in adolescents living in a developing region in northeast Brazil using the ISAAC (International Study of Asthma and Allergies in Childhood) methodology. METHODS According to the ISAAC protocol, AD (13-14 year olds, n=3,043 in 2003 and 3,009 in 2011-12) answered the standardised written questionnaire by themselves. In addition, in 2011-12 a random sample of these AD (n=430) also answered a complementary questionnaire (associated factors) and underwent a skin prick test with aeroallergens (Dermatophagoides pteronyssinus, Blomia tropicalis, Blatella germanica, Periplaneta americana, dog dander, cat dander, mixed grass pollen and mixed moulds, including 10mg/mL histamine and negative controls). Data were analysed by univariate and multivariate analysis using Poisson regression. RESULTS The prevalence of asthma in 2011-12 in Aracaju was 12.8%, which is lower than that recorded in 2003 (18.7%). Individuals with a dog outside the home (PR=0.93; 95%CI=0.88-0.98; p=0.018) and those with an older sibling (PR=0.94; 95%CI=0.91-0.98; p=0.005) were identified as protective. The presence of smokers in the residence (PR=1.04; 95%CI=1.00-1.09; p=0.039) was associated with an increased risk of developing asthma. CONCLUSIONS The prevalence of asthma was significantly lower than the last ISAAC figures reported for Aracaju. Tobacco smoking, a preventable factor, continues to be associated with an increase in the occurrence of asthma and other associations may concur with the hygiene hypothesis.
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Affiliation(s)
- S Oliveira-Santos
- Master in Health Science, Federal University of Sergipe, Aracaju, Brazil.
| | - J Motta-Franco
- University Hospital, Federal University of Sergipe, Aracaju, Brazil
| | - I Barreto
- Department of Statistics, Federal University of Sergipe, Aracaju, Brazil
| | - D Solé
- Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - R Gurgel
- Department of Medicine, Federal University of Sergipe, Aracaju, Brazil
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Sans M, Figueiro G, Ackermann E, Barreto I, Egaña A, Bertoni B, Poittevin-Gilmet E, Maytia D, Hidalgo PC. Mitochondrial DNA in Basque descendants from the city of Trinidad, Uruguay: Uruguayan- or Basque-like population? Hum Biol 2011; 83:55-70. [PMID: 21453004 DOI: 10.3378/027.083.0104] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Like other countries in the Americas, during its colonization Uruguay was the recipient of immigrants from several ethnic groups from Europe, as well as of enslaved Africans. After its independence in 1830, Basques were the first group of Europeans to arrive in the country. In this paper, we aim to contribute to the understanding of the process of integration of these migratory waves into the Uruguayan society. For that purpose, individuals of Basque origin from the city of Trinidad, Uruguay, were chosen to participate in this study. Particularly, we wanted to determine if Basque descendants in Uruguay remained relatively isolated or if they mixed with other ethnic groups. Mitochondrial DNA (mtDNA) of 60 self-identified Basque descendants, taken from a larger sample of subjects with Basque ancestors, was analyzed. The origin of mtDNA haplogroups was 77.8% European, 20.4% Amerindian, and 1.8% African, showing similar frequencies to other Uruguayan regions. Very few sequences showed a clear Basque origin, although other sources such as the Canary Islands are likely. Moreover, genetic distances clearly show that Basque descendants are genetically closer to other Uruguayan groups than to European populations, including Basques. It is possible to conclude that Basques and their descendants in the region of Trinidad did not remain isolated and that their marriage behavior was similar to that of other Uruguayan populations. However, to have a more accurate picture of the way Basques intermarried with other populations in Uruguay, new analyses are needed that take into account paternal lineages as well as biparental genetic markers.
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Affiliation(s)
- M Sans
- Department of Biological Anthropology, Facultad de Humanidades y Ciencias de la Educación, Universidad de la República, 11200 Montevideo, Uruguay
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Lusiardo A, Barreto I, Hidalgo PC, Bonilla C, Bertoni B, Portas M, Sans M. Consanguinity in two Uruguayan cities: historical evolution and characteristics (1800-1994). Ann Hum Biol 2004; 31:513-25. [PMID: 15739381 DOI: 10.1080/03014460412331281737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Information about consanguinity in Uruguay is scarce and limited to the end of the 20th century. AIM To determine the frequency and characteristics of consanguineous marriages, as well as chronological trends, in two Uruguayan cities over almost two centuries. SUBJECTS AND METHODS We analysed 28,393 Roman Catholic Church marriage records and Diocesan consanguinity dispensations belonging to the cities of Melo (Northeast), and Montevideo (South), for the period 1800--1994. RESULTS 633 (2.23%) marriages were consanguineous. Among them, first cousin marriages were the most common (58.8% of all consanguineous marriages, including double consanguineous), especially those where the bride and groom were related through their maternal side. During the first decades of the 19th century both regions showed low levels of consanguinity. Consanguinity reached its maximum during the mid-1800s and decreased significantly throughout the 20th century. The overall mean coefficients of inbreeding were moderate in both cases, being greater in the Northeast (alpha=0.00165) than in the South (alpha = 0.00089). CONCLUSIONS The low level of consanguinity as well as the structure of consanguineous marriages (distribution by degrees) is similar to that found in other southern South American countries. Temporal trends are similar to those found in industrialized regions in Europe, with maximum inbreeding levels during the middle-late 19th century; however, the clear predominance of first cousin unions, differs from most of the data for European countries. Small differences between the two cities can be related to diverse facts, such as socio-economic conditions, ethnic origin, immigration, and sampling.
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Affiliation(s)
- A Lusiardo
- Sección de Antropologia Biológica, Facultad de Humanidades y Ciencias de la Educación, Universidad de la República, Magallanes 1577, 11200 Montevideo, Uruguay.
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Bravi CM, Sans M, Bailliet G, Martínez-Marignac VL, Portas M, Barreto I, Bonilla C, Bianchi NO. Characterization of mitochondrial DNA and Y-chromosome haplotypes in a Uruguayan population of African ancestry. Hum Biol 1997; 69:641-52. [PMID: 9299884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We used a set of informative mtDNA and Y-chromosome-specific markers to determine the origin of maternal and paternal lineages in a sample of 41 Uruguayan black individuals. We found that 20 maternal lineages were African, 13 were Amerindian, and 5 were Caucasian. In three individuals we were unable to determine the ethnic origin of the mtDNA lineages. Of the 22 males analyzed we found 4 Y chromosomes of African origin, 5 of Caucasian origin, and 13 of undetermined ancestry. Our results suggest that mtDNA and Y-chromosome-specific DNA variants may be a useful tool in determining the level of mtDNA and Y chromosome ethnic introgression in a population of a given ethnic origin.
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Gomes I, Melo A, Lucena R, Cunha-Nascimento MH, Ferreira A, Góes J, Barreto I, Jones N, Gaspari V, Embiruçu EK, Veiga M. Prognosis of bacterial meningitis in children. Arq Neuropsiquiatr 1996; 54:407-11. [PMID: 9109984 DOI: 10.1590/s0004-282x1996000300008] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We studied the incidence and prognosis of acute neurologic complications in 281 children under 13 years of age with a diagnosis of acute bacterial meningitis. All the patients were examined daily by the same group of neurologists, using a standardized neurological examination. Patients with signs of encephalic lesions, unsatisfactory response to antibiotics or decreased level of consciousness were submitted to brain computer tomography. The overall lethality rate was 20.3% and cases whose causative agent was identified presented a higher lethality rate (23.7%) than those in which the agent was not found. The most important neurological abnormalities were meningeal signs (88.3%) followed by decreased consciousness (47.7%), irritability (35.2%), seizures (22.4%), fontanel bulging (20.6%) and cranial nerve palsy (14.2%). Seizures, cranial nerve palsy and the absence of meningeal signs were related to higher rates of lethality. Diminished consciousness, seizures, subdural effusion, abscess and hydrocephalus were the most important complications, respectively. We can conclude that acute bacterial meningitis continues to be an important health problem in developing countries and that public health measures will be necessary to minimize the impact of sequelae and reduce the mortality rate in children with that pathology.
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Affiliation(s)
- I Gomes
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brasil
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