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Ruiz Molina Y, Aguilera Quitzke SA, Pabas Dotes AB, Tirado Reyes LM, Valdivielso P. Role of weight lost in breast cancer-related lymph. Rehabilitacion (Madr) 2022; 57:100763. [PMID: 36372588 DOI: 10.1016/j.rh.2022.10.002] [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] [Received: 05/19/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Analysis of data collected in routine clinical practice of the combined impact of both physical activity and decrease in body mass index (BMI) on a minor prevalence of lymphedema in post-breast cancer patients. METHODS Analysis of data obtained by the specialized rehabilitation unit, from 99 female patients for 18 months, after a specific diet, sports program and complete decongestive therapy (CDT) was indicated. Personal data, affected organ volume, weight, physical activity level and Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer (FACT-B+4) were collected in follow-up visits. RESULTS Although the average of body-mass index showed no change during the assessment period, about 13% of patients in the second follow-up visit and 30% in the third one had lost weight. Women experiencing weight-loss in the third follow-up visit presented a reduced volume of the affected organ [-50 (-248 to 141) ml vs. 130 (-148 to 355) ml, p<0.05] as compared to weight-gaining patients. No relationship was established between physical activity and lymphedema volume changes. CONCLUSIONS Apart from the conventional treatment with orthotics and manual lymph drainage, BCRL prevention and treatment needs to focus - right from the start - on weight management or weight-loss in obese patients.
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Affiliation(s)
- Y Ruiz Molina
- Department of Physical Medicine and Rehabilitation, Hospital Regional Universitario, Malaga, Spain.
| | - S A Aguilera Quitzke
- Department of Physical Medicine and Rehabilitation, Hospital Regional Universitario, Malaga, Spain
| | - A B Pabas Dotes
- Department of Physical Medicine and Rehabilitation, Hospital Regional Universitario, Malaga, Spain
| | - L M Tirado Reyes
- Department of Physical Medicine and Rehabilitation, Hospital Regional Universitario, Malaga, Spain
| | - P Valdivielso
- Department of Medicine and Dermatology, University of Malaga and The Biomedical Research Institute of Malaga (IBIMA), Spain
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Ruilope LM, Calvo-Bonacho E, Quevedo-Aguado L, Catalina-Romero C, Valdivielso P, Sanchez-Chaparro MA, Fernandez-Labandera C. P3403Clinical utility of the integration of Life Simple 7 designed by the American Heart Association and the model for cardiovascular risk prediction IberScore. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Practice guidelines are agreed on the importance of lifestyle advice for cardiovascular risk reduction as well as cardiovascular risk prediction in planning preventive strategies.
Purpose
To assess the clinical usefulness of the application of the predictive model of cardiovascular risk (CVR) IberScore combined with the recommendations of “Life's Simple 7” (LS7) of the American Heart Association (AHA) in a working population.
Methods
IberScore model is a predictive function for fatal and non-fatal cardiovascular (CV) events derived from a cohort of 774,404 workers (70.4% of the target population) between 16–65 years (average of 35.7 (SD = 10.7)) without CV disease at admission, which was followed for a period of 10 years. Age, sex, total cholesterol, HDL, SBP, glycemia, obesity and a history of dyslipidemia, hypertension and diabetes were used as factors of CVR. Using this model, patients were classified into 4 risk levels. It was also assessed the ideal health status according to the recommendations of “Life's Simple 7” (which includes healthy diet, physical activity, smoking cessation, BMI <25 kg/m2, total cholesterol without treatment <200mg/dl, blood pressure without treatment <120/80 mmHg and basal glycemia <100 mg/dl). Finally, these classifications were compared with the appearance of CV events in a 10-year follow-up.
Results
The results showed a high sensitivity (given that the predictive capacity reached 82% of the cardiovascular events) by using the IberScore, a logistic flexible parametric model to predict 10-year cardiovascular risk. Likewise, the clinical usefulness of the “Life's Simple 7” recommendations could be verified in order to reduce the incidence of total CV events (fatal and non-fatal).
Conclusions
The integration of the predictive model IberScore with the preventive recommendations “Life's simple 7” of the AHA applied to the working population would allow a more efficient cardiovascular prevention.
Acknowledgement/Funding
This project received a research grant from the Carlos III Health Institute (Ministry of Science, Innovation and Universities, Spain). Ref. PI18/01809
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Affiliation(s)
- L M Ruilope
- University Hospital 12 de Octubre, Hypertensive Unit, Research Institute Imas12, Madrid, Spain
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3
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Villena García AC, Cardo AG, Hidalgo CM, Palomo L, Lillo E, Espíldora J, Trigo JM, Chaparro MÁS, Valdivielso P. 18FDG PET/CT & arterial inflammation: predicting cardiovascular events in lung cancer. QJM 2019; 112:401-407. [PMID: 30715503 DOI: 10.1093/qjmed/hcz036] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/25/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND 18F-FDG PET/CT predicts cardiovascular disease. To analyze the predictive value of cardiovascular events from inflammation and arterial calcification in patients who underwent an 18F-FDG PET/CT for lung cancer. METHODS A retrospective study of 274 patients with primary lung neoplasia. We determined: (i) TBR (target-to-background ratio), and (ii) the calcium score, at eight common arterial segments. We took as arteriosclerosis, a TBR ≥1.6 and ≥15 Calcium Score sum. We registered cardiovascular risk factors, comorbidities, histology, stage, treatment, status at the last clinical review, cause of death and cardiovascular event during the follow-up. RESULTS The territory presenting the greatest uptake of 18F-FDG, was the thoracic aorta with an average of 1.77 (± 0.27 TBR) in the aortic arch, while the greatest degree of calcification was obtained in the abdominal aorta (52% with a Calcium Score ≥ 3). 24% of the patients presented a sum Calcium Score ≥15, and 17% a TBR ≥1.6. Patients with high TBR, (17%), had not a higher frequency of cardiovascular comorbidities beforehand, nor did they in the follow-up. However, those with a sum Calcium Score ≥15 (24%), were older, had more cardiovascular risk factors and ischemic events during follow-up. The calcium score, but not the TBR, predicted the emergence of a cardiovascular event (HR 4.9 IC95% 2.1-9.1, P < 0.05). CONCLUSION In our cohort, a high Calcium Score was an independent predictor for developing cardiovascular events.
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Affiliation(s)
- A C Villena García
- Nuclear Medicine, Molecular imaging department, Centro de Investigaciones Médico Sanitarias (CIMES)
| | - A Gutierrez Cardo
- Nuclear Medicine, Molecular imaging department, Centro de Investigaciones Médico Sanitarias (CIMES)
| | - C M Hidalgo
- Department of Medicine and Dermatology, University of Malaga, Málaga, Spain
| | - L Palomo
- Department of Medicine and Dermatology, University of Malaga, Málaga, Spain
| | - E Lillo
- Nuclear Medicine, Molecular imaging department, Centro de Investigaciones Médico Sanitarias (CIMES)
| | | | - J Manuel Trigo
- Oncology, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | - M Á Sánchez Chaparro
- Internal Medicine, Hospital Clínico Universitario Virgen de la Victoria, Department of Medicine and Dermatology, Insituto de Investigaciones Biomédicas de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - P Valdivielso
- Internal Medicine, Hospital Clínico Universitario Virgen de la Victoria, Department of Medicine and Dermatology, Insituto de Investigaciones Biomédicas de Málaga (IBIMA), University of Malaga, Málaga, Spain
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Catalina-Romero C, Sanchez Chaparro MA, Valdivielso P, Quevedo-Aguado L, Brotons C, Ruilope LM, Calvo-Bonacho E. Estimating the impact of obesity and metabolic phenotype on sickness absence. Results from the ICARIA study. Nutr Metab Cardiovasc Dis 2019; 29:383-389. [PMID: 30803866 DOI: 10.1016/j.numecd.2018.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/05/2018] [Accepted: 12/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS To assess the impact of obesity and being overweight on sickness absence (SA) as a function of healthy/unhealthy metabolic phenotype. METHODS AND RESULTS A total of 173 120 healthy workers who underwent a routine check-up, consisting of a structured interview, anthropometric measurements and blood pressure and fasting blood analysis, were included as the study sample (67.1% males; 49.2% manual workers; mean age 40.6 ± 21.9 years). Workers were classified according to their body mass index (BMI) and metabolic phenotype. A metabolically unhealthy phenotype was defined as the presence of three or more of the following criteria: glycaemia ≥110 mg/dL or previously diagnosed type I/II diabetes or treatment for diabetes; triglycerides ≥150 mg/dL or lipid-lowering therapy; HDL <40/50 mg/dL M/F; blood pressure ≥130/85 mmHg or previously diagnosed hypertension or antihypertensive therapy; waist circumference >102/88 cm M/F. A one-year follow-up was conducted to evaluate the incidence of work-related and non-work-related SA (WRSA/NWRSA). The association of BMI with SA was tested using Poisson regression (standard error correction), segmenting on the basis of metabolic phenotype. The overall percentages of workers who were overweight, obese and/or had a metabolically unhealthy phenotype were 37.7%, 16.3% and 8.8%, respectively. BMI was associated with increased incidence of NWRSA in both phenotypes. It was also associated with WRSA in subjects with a BMI in the range of 35-39.99 kg/m2 and in metabolically healthy individuals. WRSA was lower in subjects with a BMI ≥40 kg/m2 and among metabolically unhealthy individuals. CONCLUSION Obesity is associated with health problems that have a significant impact on SA.
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Affiliation(s)
- C Catalina-Romero
- Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
| | - M A Sanchez Chaparro
- Department of Internal Medicine, University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain
| | - P Valdivielso
- Department of Internal Medicine, University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain
| | - L Quevedo-Aguado
- Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
| | - C Brotons
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - L M Ruilope
- Research Institute Hospital 12 de Octubre, Madrid, Spain
| | - E Calvo-Bonacho
- Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
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Gutiérrez-Cardo A, Pérez Duarte A, García-Argüello S, López Lorenzo B, Lillo García M, Valdivielso P. Assessment of 68Ga-PSMA-11 PET positivity predictive factors in prostate cancer. Rev Esp Med Nucl Imagen Mol 2019. [DOI: 10.1016/j.remnie.2018.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ruilope LM, Catalina-Romero C, Sanchez-Chaparro MA, Valdivielso P, Quevedo-Aguado L, Moral I, Brotons C, Calvo-Bonacho E. P5414Dietary habits and sick leave. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L M Ruilope
- University Hospital 12 de Octubre, Hypertension Unit, Madrid, Spain
| | | | | | | | | | - I Moral
- Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau, Research Unit, Barcelona, Spain
| | - C Brotons
- Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau, Research Unit, Barcelona, Spain
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Ruilope LM, Fernandez-Labandera C, Valdivielso P, Sanchez-Chaparro MA, Catalina-Romero C, Quevedo-Aguado L, Martinez-Munoz P, Calvo-Bonacho E. P1536A new efficient and flexible cardiovascular risk model for working population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L M Ruilope
- University Hospital 12 de Octubre, Hypertension Unit, Madrid, Spain
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8
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Sánchez ramos A, Casañas MartineZ M, Ibarretxe D, Tomasini R, Anglada J, Plana N, Brea A, Valdivielso P. Lysosomal acid lipase deficiency (LAL-D) : Report of new four Spanish unrelated cases. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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9
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Pérez López C, Almagro F, Brea A, Sánchez-Chaparro M, Muñiz O, Álvarez-Sala L, Ariza M, Valdivielso P. Sequence variants in the GPIHBP1 gene in patients with severe hypertriglyceridemia. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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Mateo-Gallego R, Perez-Calahorra S, Laclaustra M, Plana N, Lahoz C, Pedro-Botet J, Ascaso J, Belmonte AV, Valdivielso P, Brea Á, Civeira F. Two-generation cardiovascular disease prevalence in familial hypercholesterolemia. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Núñez-Cortés JM, Mantilla T, Millán-Pérez J, Ascaso J, Civeira F, Mostaza J, Pintó X, Valdivielso P. Cardiometabolic risk related with the association of hypertriglyceridemia and low HDL cholesterol levels. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Núñez-Cortés JM, Mantilla T, Millan-Perez J, Pinto X, Valdivielso P, Mostaza J, Civeira F, Ascaso J. Metabolic syndrome in patients with clinical phenotype of “hypertriglyceridemic waist”. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Ariza M, Almagro F, Sánchez-Chaparro M, Coca I, Calvo-Bonacho E, Brea A, Mosquera J, González-Santos P, Valdivielso P. Effect of the accumulation of genetic and secondary risk factors on the presence of severe hipertriglyceridemia. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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14
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Valdivielso P, Catalina-Romero C, Sánchez-Chaparro M, González-Santos P, Cabrera M, Calvo-Bonacho E. Association between cardiovascular risk level and the incidence of stroke among Spanish working population: results from the icaria study. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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González-Santos P, Valdivielso P, Cabrera M, Quevedo-Aguado L, Sánchez-Chaparro M, Calvo-Bonacho E. Association of atherogenic dyslipidemia with cardiovascular risk in spanish working population: results from the icaria study. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Díaz Rodríguez A, Murga N, Camafort-Babkowski M, López Peral JC, Ruiz E, Ruiz-Baena J, Valdivielso P. Therapeutic inertia in hypercholesterolaemia is associated with ischaemic events in primary care patients. A case-control study. Int J Clin Pract 2014; 68:1001-9. [PMID: 24667004 DOI: 10.1111/ijcp.12419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The frequency of therapeutic inertia (TI) is very high in the management of vascular risk factors, although its impact on the incidence of ischaemic events is not well-established. Our aim was to investigate the relationship between TI in the treatment of hypercholesterolaemia and the appearance of ischaemic events. METHODS An observational, multicentre, case-control study was conducted in 70 primary care centres in Spain. Case subjects (n = 235) were high-risk hypercholesterolaemic patients (both genders, ≥ 18 years) who had had a first event in the 12 months prior to recruitment. They were matched with 235 controls (by vascular risk, age and gender). The observation period was 18 months prior to the onset of a first event (cases) or to date of recruitment (control subjects). RESULTS The TI in the basal visit (an average of 7.8 months before the event) was slightly higher in cases than in controls (39.7% vs. 34.8%, NS). However, the accumulated TI was similar in both groups (70.7% for cases and 73.95% for controls, NS). The multivariate analysis, taking ischaemic events as the dependent variable, showed that the TI at baseline visit was significantly associated with the development of the event [OR 2.18 (95% CI 1.04-4.51), p < 0.05]. Other variables also associated with the ischaemic event were a family history of premature vascular disease [OR 3.38 (95% CI 1.35-8.49), p < 0.05] and uncontrolled hypertension [OR 2.35 (95% CI 1.02-5.43), p < 0.05]. CONCLUSION The TI in high-risk hypercholesterolaemic patients in primary prevention in Spanish primary care centres doubled the risk of an ischaemic event in the short term.
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Cabrera M, Sánchez-Chaparro MA, Valdivielso P, Quevedo-Aguado L, Catalina-Romero C, Fernández-Labandera C, Ruiz-Moraga M, González-Santos P, Calvo-Bonacho E. Prevalence of atherogenic dyslipidemia: association with risk factors and cardiovascular risk in Spanish working population. "ICARIA" study. Atherosclerosis 2014; 235:562-9. [PMID: 24956529 DOI: 10.1016/j.atherosclerosis.2014.05.960] [Citation(s) in RCA: 18] [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] [Received: 12/03/2013] [Revised: 05/22/2014] [Accepted: 05/30/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of atherogenic dyslipidemia (AD) and the lipid triad (LT) in the working population in Spain, their associated variables and how far they are linked to cardiovascular risk (CVR). METHODS Observational cross-sectional study of 70,609 workers (71.5% male (M), 28.5% female (F), mean age 39.2 ± 10), who attended medical checkups and agreed to participate. Plasma samples were analysed in a central laboratory. AD definition used was: triglycerides ≥150 mg/dl and HDL cholesterol <40 mg/dl (M)/<50 mg/dl (F) and LT when LDL cholesterol > 160 mg/dl is further added. Univariate comparisons in the absence and presence of AD and LT and the probability of AD according to different parameters and their possible association with CVR were assessed. CVR was stratified following the European SCORE model for low risk-population. RESULTS 5.7% (95% CI 4.7-6.9) of the working population have AD and 1.1% (95% CI 1.0-1.2) LT. In univariate analysis, workers with AD and LT had a higher prevalence of obesity, hypertension, smoking and diabetes than those who had not (p < 0.001). In multivariate analysis, BMI, sex, age 40-49, diabetes, tobacco, uric acid, LDL or blood pressure significantly influenced the risk of AD. AD was significantly associated with CVR after adjusting for alcohol and obesity. However, most of the AD subjects (91.8%) were classified as low risk. CONCLUSIONS About 6% of the working population in Spain meets AD criteria. Assuming that these subjects have increased CVR, AD allows to identify additional 5% of subjects with increased CVR to that one the SCORE model detects, helping to improve cardiovascular risk stratification.
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Affiliation(s)
- M Cabrera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - M A Sánchez-Chaparro
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - P Valdivielso
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - L Quevedo-Aguado
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - C Catalina-Romero
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - C Fernández-Labandera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - M Ruiz-Moraga
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - P González-Santos
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - E Calvo-Bonacho
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
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Gómez-Huelgas R, Pérez-Jiménez F, Serrano-Ríos M, González-Santos P, Román P, Camafort M, Conthe P, García-Alegría J, Guijarro R, López-Miranda J, Tirado-Miranda R, Valdivielso P. Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine. Rev Clin Esp 2014. [DOI: 10.1016/j.rceng.2014.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Gómez-Huelgas R, Pérez-Jiménez F, Serrano-Ríos M, González-Santos P, Román P, Camafort M, Conthe P, García-Alegría J, Guijarro R, López-Miranda J, Tirado-Miranda R, Valdivielso P. Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine. Rev Clin Esp 2014; 214:209-15. [PMID: 24602600 DOI: 10.1016/j.rce.2013.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/27/2013] [Revised: 12/10/2013] [Accepted: 12/15/2013] [Indexed: 01/28/2023]
Abstract
Although the mortality associated to cardiovascular diseases (CVD) has been reduced in the last decades, CVD remains the main cause of mortality in Spain and they are associated with an important morbidity and a huge economic burden. The increasing prevalence of obesity and diabetes could be slowing down the mortality reduction in Spain. Clinicians have often difficulty making clinical decisions due to the multiple clinical guidelines available. Moreover, in the current context of economic crisis it is critical to promote an efficient use of diagnostic and therapeutic proceedings to ensure the viability of public health care systems. The Spanish Society of Internal Medicine (SEMI) has coordinated a consensus document to answer questions of daily practice with the aim of facilitating physicians' decision-making in the management of diabetes and cardiovascular risk factors from a cost-efficiency point of view.
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Affiliation(s)
- R Gómez-Huelgas
- Hospital Regional Universitario de Málaga, Internal Medicine Department, Málaga, Spain.
| | - F Pérez-Jiménez
- Hospital Universitario Reina Sofia, Lipid and Atherosclerosis Unit, IMIBIC/Hospital Universitario Reina Sofia/Universidad de Cordoba, and CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain
| | - M Serrano-Ríos
- Hospital Clínico San Carlos, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Investigacion (IdISSC), Madrid, Spain
| | - P González-Santos
- Hospital Clínico Universitario Virgen de la Victoria, Internal Medicine Service, Malaga, Spain
| | - P Román
- Hospital General de Requena, Internal Medicine Department, Requena, Valencia, Spain
| | - M Camafort
- Hospital Clinic IDIBAPS Universidad de Barcelona, Internal Medicine Department, Barcelona, Spain
| | - P Conthe
- Hospital Gregorio Marañon, Internal Medicine Unit, Spain
| | - J García-Alegría
- Hospital Costa del Sol, Internal Medicine Department, Autovia, Marbella, Málaga, Spain
| | - R Guijarro
- Hospital Regional Universitario Carlos Haya, Internal Medicine Unit, Malaga, Spain
| | - J López-Miranda
- Hospital Universitario Reina Sofia, Lipid and Atherosclerosis Unit, IMIBIC/Hospital Universitario Reina Sofia/Universidad de Cordoba, and CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain
| | - R Tirado-Miranda
- Hospital Infanta Margarita, Internal Medicine Department, Cabra, Cordoba, Spain
| | - P Valdivielso
- Hospital Clínico Universitario Virgen de la Victoria, Internal Medicine Department, Malaga, Spain
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Ramírez-Bueno A, Salazar-Ramírez C, Cota-Delgado F, de la Torre-Prados MV, Valdivielso P. Plasmapheresis as treatment for hyperlipidemic pancreatitis. Eur J Intern Med 2014; 25:160-3. [PMID: 24012324 DOI: 10.1016/j.ejim.2013.08.701] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/13/2013] [Accepted: 08/14/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Severe hypertriglyceridemia with an accumulation of chylomicrons and triglyceride figures >1000 mg/dL can cause acute pancreatitis, a potentially fatal complication. The option of rapid reduction in triglyceride concentrations is attractive and possible with plasmapheresis. METHODS We present the results of an analysis of 11 patients admitted to the intensive care unit with severe hypertriglyceridemic pancreatitis and treated with plasmapheresis. The procedure was repeated until serum triglycerides were below 1000 mg/dL. We recorded anthropometric, clinical data as well as final outcome. RESULTS In eight patients a single plasma exchange was sufficient to reduce triglyceride figures <1000 mg/dL. Only three patients died, all with the worst severity indexes and who experienced the longest delay before the procedure. CONCLUSIONS Our results, together with a review of the literature, confirm the need for a randomized clinical trial to compare conventional treatment vs. plasmapheresis in patients with severe hypertriglyceridemic pancreatitis.
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Affiliation(s)
- A Ramírez-Bueno
- Unidad de Gestión Clínica de Medicina Interna, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Spain
| | - C Salazar-Ramírez
- Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Spain
| | - F Cota-Delgado
- Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Spain
| | - M V de la Torre-Prados
- Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Spain
| | - P Valdivielso
- Unidad de Gestión Clínica de Medicina Interna, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Spain; Departamento de Medicina y Dermatología, Universidad de Malaga, Spain.
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Pintó X, Valdivielso P, Perez de Juan JM, Plana N, Garcia-Arias C, Fuentes FJ, Hernández-Mijares A, Mostaza JM. Predictive factors of achieving therapeutic goals of hypertriglyceridemia. Curr Med Res Opin 2014; 30:19-26. [PMID: 24083660 DOI: 10.1185/03007995.2013.850069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to ascertain the factors associated with non-achievement of triglyceride (TG) goals in a cohort of hypertriglyceridemic patients attending the lipid clinics of the Spanish Arteriosclerosis Society (LC-SAS). METHODS Patients with high TG levels (>2.2 mmol/L; 200 mg/dL) were included in this multicenter, prospective, observational study and followed up for 1 year. The TG goal was ≤2.2 mmol/L (200 mg/dL). Main limitations of this study are that etiologic diagnosis of hypertriglyceridemia was not done under unified criteria and drug compliance was not evaluated. RESULTS From 1394 patients initially included in the study, 929 (age range: 50 ± 12 years, 26% women) were followed up for 1 year; 523 patients (56%) failed to reach the TG target. These patients were younger, had a higher body mass index (BMI), were more frequently smokers, hypertensive and diabetic and had more severe dyslipidemia. They were also more sedentary, their diet was of poorer quality and they had higher alcohol consumption. The independent predictors of treatment failure were hypertriglyceridemia severity, low high density lipoprotein cholesterol (HDL-C), and high non-HDL-C, alcohol consumption and a raised BMI, while drug treatment had no predictive power. CONCLUSION Independent predictors of failure to achieve hypertriglyceridemia treatment goals are inappropriate lifestyle, evidenced by insufficient weight loss, alcohol consumption and dyslipidemia severity.
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Affiliation(s)
- X Pintó
- Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL, Barcelona University , CIBERobn ISCIII , Spain
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22
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Mancera-Romero J, Rodríguez-Morata A, Angel Sánchez-Chaparro M, Sánchez-Pérez M, Paniagua-Gómez F, Hidalgo-Conde A, Valdivielso P. Role of an intermittent claudication questionnaire for the diagnosis of PAD in ambulatory patients with type 2 diabetes. INT ANGIOL 2013; 32:512-517. [PMID: 23903311] [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: 06/02/2023]
Abstract
AIM In epidemiological studies, peripheral arterial disease is assessed by the measurement of the ankle/brachial index (ABI), thus enabling detection of asymptomatic disease. Our aim was to evaluate the diagnostic accuracy of a validated questionnaire on intermittent claudication for peripheral arterial disease in a clinical setting. METHODS We administered the Edinburgh questionnaire on intermittent claudication and measured ABI using a portable Doppler in 456 outpatients with type 2 diabetes. Subjects with intermittent claudication and an ABI above 0.9 were examined with color Doppler ultrasound imaging. Peripheral arterial disease was considered to be present when the ABI was <0.9 or the color Doppler arterial waveform was monophasic. RESULTS Thirty-five (7.6%) of the 456 patients had intermittent claudication. Of these, 22 (63%) had an ABI <0.9 and the remaining 13 (37%) had an ABI >0.9. Of these latter, 12 were reexamined and 3 (25%) were found to have monophasic waveforms in color Doppler, thus being diagnosed with peripheral arterial disease. The overall accuracy of intermittent claudication for peripheral arterial disease was 75% (95% CI, 71-79). CONCLUSION Among patients with type 2 diabetes, a normal ABI does not rule out peripheral arterial disease; the use of an intermittent claudication questionnaire is able to identify correctly the disease in 3 out of 4 patients with diabetes. Our results suggest incorporating the intermittent claudication questionnaire into the general consultation instead of the general screening of the ABI.
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Affiliation(s)
- J Mancera-Romero
- Centro de Salud Ciudad Jardín, Servicio Andaluz de Salud, Málaga, Spain
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23
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Martín-Morales R, García-Díaz JD, Tarugi P, González-Santos P, Saavedra-Vallejo P, Magnolo L, Mesa-Latorre JM, di Leo E, Valdivielso P. Familial hypobetalipoproteinemia: analysis of three Spanish cases with two new mutations in the APOB gene. Gene 2013; 531:92-6. [PMID: 24001780 DOI: 10.1016/j.gene.2013.08.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 04/28/2013] [Revised: 08/13/2013] [Accepted: 08/14/2013] [Indexed: 01/25/2023]
Abstract
Extremely low LDL-cholesterol concentrations are very unusual and generally related with comorbidities accompanying malnutrition. Less frequently low LDL-cholesterol levels result from mutations in the APOB, PCSK9, ANGPTL3, SAR1B and MTTP genes (primary hypobetalipoproteinemia). We investigated three patients with plasma LDL-cholesterol levels below the fifth percentile of the Spanish population. We recorded data on demographic and anthropometric characteristics, life style habits, physical examination, liver ultrasound and lipid and lipoprotein levels, in the probands and their first-degree relatives. Secondary causes of hypocholesterolemia were ruled out by clinical study, complementary tests and follow-up. The APOB, MTTP and SAR1B genes were sequenced. Patients were found to be heterozygotes for point mutations located in the exon 26 of the APOB gene. One patient, with fatty liver, carried a previously described mutation (c.7600C>T) (Arg2507X), causing the formation of truncated Apo B-55.25. The other two mutations producing truncations are new. One asymptomatic patient carried the Arg3672X (Apo B-80.93) and the other with fatty liver and steatorrhea carried the Ser2184fsVal2193X (Apo B-48.32). Our study reinforces the concept that in the heterozygous carriers of truncated Apo Bs, the clinical manifestations of FHBL are dependent on the size of the truncations.
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Affiliation(s)
- R Martín-Morales
- Unidad de Lípidos, Unidad de Gestión Clínica de Medicina Interna, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Malaga, Spain
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Manrique-Arija S, Fernandez-Nebro A, Lopez-Lasanta MA, Espiño-Lorenzo P, Rioja J, Jimenez-Nuñez F, Ureña I, Cano L, Romero-Barco CM, Rodriguez-García V, Nieves L, Irigoyen MV, Valdivielso P. SAT0080 Early Rheumatoid Arthritis Patients without Treatment: Baseline Asessment of Insulin Resistance and Cytokines. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Mancera-Romero J, Sánchez-Chaparro MA, Rioja J, Ariza MJ, Olivecrona G, González-Santos P, Valdivielso P. Fasting apolipoprotein B48 is a marker for peripheral arterial disease in type 2 diabetes. Acta Diabetol 2013; 50:383-9. [PMID: 23053881 DOI: 10.1007/s00592-012-0434-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 09/23/2012] [Indexed: 02/06/2023]
Abstract
An earlier study showed that fasting and postprandial concentrations of apolipoprotein B48 were raised in patients with type 2 diabetes (DM2) and peripheral arterial disease (PAD) as compared with persons without DM2 or persons with DM2 but not PAD. The aim of this study was to confirm the association of PAD and B48 in a larger group of patients with DM2 and the relation of B48 with the preheparin lipoprotein lipase (LPL) mass. We studied 456 patients with DM2. PAD was defined as an ankle-brachial index (ABI) <0.9. Apolipoprotein B48 was quantified by ELISA. Apo B48 was significantly higher in the group with an ABI <0.9 than the groups with ABI of 0.9-1.3 and >1.3 (10.7 ± 6.28 vs. 9.24 ± 5.5 vs. 9.17 ± 8.8 mg/L, ANOVA test, p < 0.05). B48 was independently associated with an ABI <0.9 (OR 1.053; 95 % CI, 1.013-1.094; p < 0.05), together with smoking and duration of diabetes. The preheparin LPL mass was similar in the patients with and without PAD. In conclusion, we confirmed that fasting B48 is an independent marker of PAD in patients with DM2, unrelated to the preheparin LPL mass, statin therapy or glucose lowering treatment.
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Affiliation(s)
- J Mancera-Romero
- Centro de Salud Ciudad Jardín, Servicio Andaluz de Salud, Málaga, Spain
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26
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Catalina-Romero C, Calvo E, Sánchez-Chaparro MA, Valdivielso P, Sainz JC, Cabrera M, González-Quintela A, Román J. The relationship between job stress and dyslipidemia. Scand J Public Health 2013; 41:142-9. [DOI: 10.1177/1403494812470400] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: To investigate whether there is an association between job stress, lipid profile and dyslipidemia diagnosis. Methods: This study used a questionnaire to evaluate job stress and lifestyle variables in 91,593 workers undergoing periodic checkups. Serum lipid levels were measured in all cases. Results: The prevalence of job stress was 8.7% (95% CI, 8.5–8.8%). In bivariate analyses, job stress was significantly associated with previous dyslipidemia diagnosis ( p < 0.001), lipid-lowering therapy ( p < 0.001), and altered total-cholesterol ( p = 0.001), HDL-cholesterol ( p < 0.001) and LDL-cholesterol levels ( p = 0.025). After adjusting for potential confounding variables, job stress was still associated with current dyslipidemia diagnosis (OR = 1.10; 95% CI, 1.04–1.17), high LDL-cholesterol (OR = 1.14; 95% CI, 1.05–1.23), low HDL-cholesterol (OR 1.08; 95% CI, 1.01–1.15), high total cholesterol/HDL-cholesterol ratio (OR 1.13; 95% CI, 1.05–1.23) and high LDL-cholesterol/HDL-cholesterol ratio (OR 1.11; 95% CI, 1.04–1.19). Conclusion: These results support the hypothesis of an association between job stress and lipid disturbances.
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Affiliation(s)
- C. Catalina-Romero
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
| | - E. Calvo
- Hospital Virgen de la Victoria, University of Malaga, Madrid, Spain
| | | | - P. Valdivielso
- Hospital Virgen de la Victoria, University of Malaga, Madrid, Spain
| | - J. C. Sainz
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
| | - M. Cabrera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
| | | | - J. Román
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
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Coca-Prieto I, Kroupa O, Gonzalez-Santos P, Magne J, Olivecrona G, Ehrenborg E, Valdivielso P. Childhood-onset chylomicronaemia with reduced plasma lipoprotein lipase activity and mass: identification of a novel GPIHBP1 mutation. J Intern Med 2011; 270:224-8. [PMID: 21314738 DOI: 10.1111/j.1365-2796.2011.02361.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Deficiency in the catabolism of triglyceride-rich lipoproteins is the main cause of childhood-onset chylomicronaemia syndrome. Missense mutations in lipoprotein lipase (LPL) or in proteins influencing LPL activity or stability have been shown to be critical determinants of chylomicronaemia syndrome. The main objective of this study was to assess the primary deficiency in five cases of childhood-onset chylomicronaemia syndrome. SETTING Lipid clinic at a university hospital, SUBJECTS Subjects presenting with severe hypertriglyceridaemia and chylomicronaemia syndrome in which reduced LPL activity and mass were observed. INTERVENTIONS Analysis of LPL and GPIHBP1 genes. RESULTS Amongst the five patients, one novel homozygous missense mutation (p.C68Y) in exon 3 of GPIHBP1 was identified. The other four patients were homozygous for the common LPL mutation p.G188E. CONCLUSION These findings provide further evidence that GPIHBP1 is involved in the catabolism of triglyceride-rich lipoproteins and plays a role in childhood-onset chylomicronaemia.
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Affiliation(s)
- I Coca-Prieto
- Lipid Unit, Internal Medicine, Hospital Virgen de la Victoria and Department of Medicine & Dermatology, Malaga University, Malaga, Spain
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Mancera J, Rioja J, Sánchez-Chaparro M, Moreno T, Sánchez-Pérez M, Ariza-Corbo M, González-Santos P, Valdivielso P. 510 PERIPHERAL ARTERIAL DIASESE AND TYPE 2 DIABETES MELLITUS: ROLE OF INFLAMMATORY AND HEMATOLOGICAL PARAMETERS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70511-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Valdivielso P, Catalina-Romero C, González-Quintela A, Sánchez-Chaparro M, Sainz-Gutiérrez J, Sanz-Martín C, Gutiérrez-González F, Calvo E, Ruilope L. 555 THE RELATIONSHIP BETWEEN JOB STRESS AND DYSLIPIDEMIA. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70556-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Maqne J, Coca-Prieto I, Kroupa O, Gonzalez-Santos P, Olivecrona G, Ehrenborg E, Valdivielso P. 622 CHILHOOD-ONSET CHYLOMICRONEMIA WITH REDUCED PLASMA LPL ACTIVITY AND MASS: IDENTIFICATION OF A NOVEL GPIHBP1 MUTATION. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70623-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fanton N, Moreno T, Alférez M, Jiménez M, Coca I, Vianello D, Zambon A, Valdivielso P. 99 OXIDIZED-LDL AND APO B48 IN DIABETIC KIDNEY DISEASE. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70100-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Clemente-Postigo M, Queipo-Ortuño M, Valdivielso P, Tinahones F, Cardona F. Effect of apolipoprotein C3 and apolipoprotein A1 polymorphisms on postprandial response to a fat overload in metabolic syndrome patients. Clin Biochem 2010; 43:1300-4. [DOI: 10.1016/j.clinbiochem.2010.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 07/14/2010] [Accepted: 08/08/2010] [Indexed: 10/19/2022]
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Valdivielso P, Solveig N, Rioja J, Olivecrona G, Mancera J, Ariza M, Sánchez-Chaparro M, Ferro A, González-Santos P. Fasting Apolipoprotein B48, Pre-heparin LPL Mass and Peripheral Arterial Disease in Type 2 Diabetic Patients: Preliminary Report. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/j.atherosclerosissup.2010.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mancera J, Rioja J, Ariza MJ, Paniagua F, Ginel-Mendoza L, Sánchez Chaparro MÁ, González-Santos P, Valdivielso P. MS458 CYSTATIN C AND SUBCLINICAL PERIPHERAL ARTERIAL DISEASE IN PATIENTS WITH TYPE 2 DIABETES. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70959-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Valdivielso P, Puerta S, Rioja J, Alonso I, Ariza MJ, Sánchez-Chaparro MA, Palacios R, González-Santos P. Postprandial apolipoprotein B48 is associated with asymptomatic peripheral arterial disease: a study in patients with type 2 diabetes and controls. Clin Chim Acta 2010; 411:433-7. [PMID: 20059992 DOI: 10.1016/j.cca.2009.12.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 12/20/2009] [Accepted: 12/23/2009] [Indexed: 12/12/2022]
Abstract
BACKGROUND Postprandial hyperlipidemia is a common feature in type 2 diabetes; our aim was to investigate whether there is an association between subclinical peripheral arterial disease (PAD) and the levels of apolipoprotein B48, as a specific marker for postprandial lipidemia. METHODS We enrolled 101 patients with type 2 diabetes and 73 controls free from clinical cardiovascular disease. Main outcome measures were the presence of subclinical PAD, assessed by the ankle-brachial index, and the intestinal particles measured as the concentration of apolipoprotein B48 at fasting and 4h after a mixed breakfast. RESULTS No control had subclinical PAD. Of the 101 diabetic patients, 21 had subclinical PAD. The levels of apo B48, both fasting and postprandial, were only significantly raised in the diabetic patients who had PAD. The diabetic patients without vascular disease had similar concentrations of triglycerides and apo B48 to the controls. In binary logistic regression analyses, only smoking and postprandial B48 levels, in addition to diabetes, were independently associated with PAD. On the other hand, PAD but not diabetes was associated with the fasting and postprandial levels of apo B48. CONCLUSION Our study suggests that apolipoprotein B48 levels might be a marker of occult PAD in patients suffering from type 2 diabetes mellitus. Accordingly, subclinical PAD should be taken into account in studies on postprandial lipidemia involving patients with diabetes.
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Affiliation(s)
- P Valdivielso
- Lipids Unit, Internal Medicine, Hospital Virgen de la Victoria, Malaga, Spain.
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36
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Ariza M, Coca I, García-Arias C, Sánchez-Chaparro M, Román-García J, Rioja J, Hornos A, Calvo-Bonacho E, González-Santos P, Olivecrona G, Valdivielso P. Genetic analysis of patients with severe hypertriglyceridaemia. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/j.atherosclerosissup.2008.09.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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37
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Valdivielso P, Gómez-Doblas JJ, Macias M, Haro-Liger M, Fernández-Nebro A, Sánchez-Chaparro MA, González-Santos P. Lupus-associated endothelial dysfunction, disease activity and arteriosclerosis. Clin Exp Rheumatol 2008; 26:827-833. [PMID: 19032815] [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: 05/27/2023]
Abstract
OBJECTIVE To analyze endothelial function in systemic lupus erythematosus (SLE), and its relationship with disease activity and subclinical arteriosclerosis. METHODS We studied a group of 26 patients with SLE and 21 age- and sex-matched controls. None of the patients or controls had had any ischemic event. Data were recorded on medical history, anthropometrics, prior treatment and the lupus activity index (LAI). Endothelial function was quantified by flow-mediated dilatation in the brachial artery. The presence of subclinical arteriosclerosis was assessed by the average intima-media thickness (IMT) on carotid ultrasound. RESULTS The patients and the controls had a similar degree of carotid IMT (0.58+/-0.08 mm vs. 0.57+/-0.07 mm, NS) and a similar prevalence of carotid plaque (27% vs. 24%, NS). However, the SLE patients had worse endothelial function than the controls (FMD 12.4+/-4.4% vs. 16.9+/-5.5%, p<0.05). This difference remained after adjusting for age, smoking, body mass index, waist circumference, total cholesterol, triglycerides, HDL cholesterol, apolipoproteins A-1 and B100 and postmenopausal status. A significant association was found in the SLE patients between FMD and LAI (Spearman Rho -0.462, p<0.05). CONCLUSION SLE-associated endothelial dysfunction is present in patients who have no prior ischemic events and with the same degree of subclinical arteriosclerosis as controls. The endothelial dysfunction is significantly associated with the degree of disease activity.
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Affiliation(s)
- P Valdivielso
- Lipids Unit, Internal Medicine, Hospital Virgen de la Victoria, Department of Medicine, University of Malaga, Malaga, Spain.
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Valdivielso P, Puerta S, Rioja J, Ariza M, Hornos A, Garcia-Arias C, Sanchez-Chaparro M, Gonzalez-Santos P. FASTING AND POSTPRANDIAL APO-B48 ARE INCREASED IN PATIENTS WITH TYPE 2 DIABETES WITH ATHEROSCLEROSIS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70290-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Valdivielso P, Sanchez Chaparro M, Calvo Bonacho E, Cabrera Sierra M, Sainz Gutierrez J, Fernandez Meseguer A, Fernandez-Labandera C, Ruiz Moraga M, Galvez Moraleda A, Roman Garcia J. HYPERTRIGLYCERIDEMIA, CARDIOVASCULAR RISK FACTORS, AND GLOBAL CARDIOVASCULAR RISK IN THE SPANISH WORKING POPULATION. ICARIA STUDY GROUP. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70062-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rioja J, Pozo A, Ariza M, Gonzalez-Alegre M, Hornos A, Valdivielso P, Gonzalez-Santos P. PO21-672 ADIPONECTIN AND INFLAMMATORY MARKERS IN OBESE NON-DIABETICS AND OBESE TYPE 2 DIABETICS. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71682-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ariza M, Hornos A, Rioja J, Requena G, Roman-Garcia J, Valdivielso P, Sanchez-Chaparro M, Gonzalez-Santos P. PO5-123 ASSOCIATION OF LPL VARIANTS, D9N AND N291S, AND APO E POLYMORPHISMS WITH HYPERTRIGLYCERIDEMIA IN A MEDITERRANEAN SPANISH WORKING POPULATION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Valdivielso P, López-Sánchez J, Garrido A, Sánchez-Carrillo JJ. Metastatic calcifications and severe hypercalcemia in a patient with parathyroid carcinoma. J Endocrinol Invest 2006; 29:641-4. [PMID: 16957413 DOI: 10.1007/bf03344164] [Citation(s) in RCA: 10] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Primary hyperparathyroidism is rarely produced by parathyroid carcinoma. We present the case of a 63-yr-old man who was admitted due to recent onset of constipation, weakness and progressive lethargy. At physical examination, a left cervical mass was palpated. Marked hypercalcemia (serum calcium 25 mg/dl) (6.22 mmol/l) complicated by renal insuficiency (serum creatinine 4.4 mg/dl) (388 micromol/l) was found, but both were unresponsive to conventional therapy and hemofiltration. Autopsy examination showed a carcinoma of the upper left parathyroid gland, multiple foci of metastatic calficications in the vessel walls and parenchyma of both lungs and kidneys, and the myocardium, which contributed to multi-organ failure and death. In addition to describing the clinical presentation, we review the mechanism of metastatic calcifications as well as the role of renal function and hyperphosphatemia, and the basis for therapy of hypercalcemic crisis.
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Affiliation(s)
- P Valdivielso
- Department of Internal Medicine, Universidad de Málaga, Málaga, Spain.
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Ariza M, González-Alegre M, Ulzurrun E, Rioja J, Escalona-Pérez E, Valdivielso P, González-Santos P. Mo-P6:395 Association of the -250G/A promoter polymorphism of the hepatic lipase gene with the risk of peripheral arterial disease in type 2 diabetics. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80525-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rioja J, Escalona F, Ariza M, Gonzalez-Alegre M, Ulzurrun E, Valdivielso P, Gonzalez-Santos P. We-P11:5 Postprandial lipemia and insulin resistance in individuals with and without type 2 diabetes. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81361-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ariza M, Rioja J, Gonzalez-Alegre M, Valdivielso P, Ulzurrun E, Gonzalez-Santos P. W07-P-003 Associations of LPL variants, Hind III and Pvu II, with plasma levels of lipids, lipoproteins, and insulin resistance, in a type 2 diabetic population. ATHEROSCLEROSIS SUPP 2005. [DOI: 10.1016/s1567-5688(05)80104-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Valdivielso P, Hidalgo A, Aguilar I, Escalona F, Rioja P, Ariza M, Gonzalez T, Urrulzun E, González-Santos P. W08-P-034 Lack of association between central obesity and postprandial triglycerides. ATHEROSCLEROSIS SUPP 2005. [DOI: 10.1016/s1567-5688(05)80150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Coronary heart disease is a prevalent condition and a leading cause of death in developed countries. Most cases are due to the cluster of classical risk factors, such as smoking, diabetes, high blood pressure and dyslipidaemia. However, a few patients develop severe and premature arteriosclerosis in spite of absence of common risk factors. Here, we present the clinical, analytical and molecular features of a 36-years-old man who died from advanced ischaemic heart disease as a result of cerebrotendinous xanthomatosis (CTX), a rare condition characterized by elevation in plasma and most tissues of cholestanol and where neurological impairment is the hallmark of this disease. We discuss the relevance of heart disease and the mechanism leading to accelerate arteriosclerosis is CTX.
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Affiliation(s)
- P Valdivielso
- Unidad de Lípidos y Dermatología, Hospital Clínico Universitario 'Virgen de la Victoria', Málaga, Spain.
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de la Vega C, Ruiz Y, Rioja J, Escalona F, Gonzalez T, Ariza M, Valdivielso P, Gonzalez-Santos P. M.499 Risk predicting scores and subclinical atherosclerosis in type 2 diabetics. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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González-Alegre T, Ariza M, Rioja J, Valdivielso P, Pinzón J, Ulzurrum E, González Santos P. M.526 Predictive factors of hypertriglyceridemia in compensated type 2 diabetes mellitus (DM-2). Variations in plasma lipoproteins associated with hypertriglyceridemia (HTG). ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ariza M, González-Alegre M, Ulzurrun E, Rioja J, García-Arias C, Valdivielso P, Gonzaléz-Santos P. W14.346 Genetic polymorphisms in lipid metabolism related genes: Associations with plasma lipoproteins and other biochemical markers in a type 2 diabetic population. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90345-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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