[Risk factors and stroke among patients of different ages]

Baicalein reduces the invasion of glioma cells via reducing the activity of p38 signaling pathway

Baicalein, one of the major flavonids in Scutellaria baicalensis, has historically been used in anti-inflammatory and anti-cancer therapies. However, the anti-metastatic effect and related mechanism(s) in glioma are still unclear. In this study, we thus utilized glioma cell lines U87MG and U251MG to explore the effect of baicalein. We found that administration of baicalein significantly inhibited migration and invasion of glioma cells. In addition, after treating with baicalein for 24 h, there was a decrease in the levels of matrix metalloproteinase-2 (MMP-2) and MMP-9 expression as well as proteinase activity in glioma cells. Conversely, the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) and TIMP-2 was increased in a dose-dependent manner. Moreover, baicalein treatment significantly decreased the phosphorylated level of p38, but not ERK1/2, JNK1/2 and PI3K/Akt. Combined treatment with a p38 inhibitor (SB203580) and baicalein resulted in the synergistic reduction of MMP-2 and MMP-9 expression and then increase of TIMP-1 and TIMP-2 expression; and the invasive capabilities of U87MG cells were also inhibited. However, p38 chemical activator (anisomycin) could block these effects produced by baicalein, suggesting baicalein directly downregulate the p38 signaling pathway. In conclusion, baicalein inhibits glioma cells invasion and metastasis by reducing cell motility and migration via suppression of p38 signaling pathway, suggesting that baicalein is a potential therapeutic agent for glioma.

[Control of cardiovascular risk factors in patients with stroke attended in primary care in Spain. ICTUSCARE study]

BACKGROUND

The aim of this cross-sectional, multicenter survey was: 1) To investigate the level of control of cardiovascuar risk factors in patients with a previous stroke. 2) To know the pharmacological therapy used to attain the control.

PATIENTS AND METHODS

Data obtained from a total of 955 patients were included in the analysis.. There were evaluated cardiovascular risk factors, parameters related to the degree of control, analytical parameters, antropometric and pharmacological indicated treatment.

RESULTS

The majority (61%) had suffered an ischemic stroke and 97.7% presented at least one associated cardiovascular risk factor, being hypertension (84.8%) and dyslipidemia (61.8%) the most frequent. Other factors were abdominal obesity (42.9%), diabetes mellitus (35.6%) and smoking (25.1%). Only 1.2% of the patients presented an adequate control of all cardiovascular risk factors. Only 17.6% had a well controlled blood pressure and in 29.8% LDL-cholesterol was well controlled. In 50.2% of diabetic patients HbA1c was well controlled. Angiotensin receptor blockers were the most widely used antihypertensive drugs (57.6%) while thiazide diuretics were prescribed in 33.4%. Statins were prescribed in 72.8% of patients and metformin, aspirin and acenocumarol in 30.2%, 57.3%, and 15.0% respectively.

CONCLUSIONS

In conclusion, in patients with a past history of stroke arterial hypertension is the most common cardiovascular risk factor and the control of these factors requires an improvement.

[Quality of records in OMI-AP of the patients with stroke followed in primary care]

OBJECTIVES

1) To determine the level of registration and control of cardiovascular risk factors in stroke patients treated in primary care in Murcia through electronic medical records. 2) To describe the registered drug treatment in patients with stroke.

MATERIAL AND METHODS

Observational descriptive, retrospective, evaluated through the records in OMI (electronic medical records) in all areas of Murcia Health Service. A sample of 407 patients with stroke was analyzed. The analyzed variables were type of stroke, time of evolution, registered cardiovascular risk factors, registered cardiovascular disease, medication and degree of control of modifiable risk factors.

RESULTS

Cardiovascular risk factors recorded were hypertension (81.1%), dyslipemia (72.5%), diabetes (41.3%), abdominal obesity (22.9%) and tobacco (8.8%). Registered cardiovascular diseases were ischemic heart disease (22.1%), atrial fibrillation (13.8%), nephropathy (11.8%), myocardial infarction (5.7%) and left ventricular hypertrophy (3.4%). 2.5% (10) of patients met all criteria for good control. The LDL cholesterol was controlled (<100mg/dl) and recorded in 24.8% of patients and blood pressure in 41.3%. 78.1% of patients were being treated with antihypertensive drugs, 47.4% with lipid-lowering drugs, and 79.1% with antiplatelet or anticoagulant.

CONCLUSIONS

According to data recorded at OMI-AP the patients who have suffered a stroke have poor control of cardiovascular risk factors.

Association of aromatase and estrogen receptor gene polymorphisms with hip fractures

Two polymorphisms of the aromatase and estrogen receptor genes appeared to interact to influence the risk of hip fractures in women.

INTRODUCTION

Allelic variants of the aromatase gene have been associated with bone mineral density and vertebral fractures. Our objective was to analyze the relationship between two polymorphisms of the aromatase and estrogen receptor genes and hip fractures.

METHODS

We studied 498 women with hip fractures and 356 controls. A C/G polymorphism of the aromatase gene and a T/C polymorphism of the estrogen receptor alpha gene were analyzed using Taqman assays. Aromatase gene expression was determined in 43 femoral neck samples by real-time RT-PCR.

RESULTS

There were no significant differences in the overall distribution of genotypes between the fracture and control groups. However, among women with a TT genotype of the estrogen receptor, the CC aromatase genotype was more frequent in women with fractures than in controls (39 vs. 23%, p = 0.009). Thus, women homozygous for T alleles of estrogen receptor and C alleles of aromatase were at increased risk of fracture (odds ratio 2.0; 95% confidence interval 1.2-3.4). The aromatase polymorphism was associated with RNA levels in bone tissue, which were three times lower in samples with a CC genotype (p = 0.009).

CONCLUSIONS

These common polymorphisms of the aromatase and estrogen receptor genes appear to interact, influencing the risk of hip fractures in women.

Similitudes y diferencias entre los pacientes con aterosclerosis sintomática de distintos territorios. Cohorte AIRVAG (Atención Integral al Riesgo VAscular Global)

BACKGROUND AND OBJECTIVE

Even though atherosclerosis is a systemic disease, few prospective studies have evaluated in a thorough and systematic manner the whole vascular tree in patients with clinical damage of different territories.

PATIENTS AND METHOD

Prospective protocolized study of 269 consecutive patients younger than 70, attended because of symptomatic arteriosclerosis of any territory -53% coronary (CHD), 32% cerebrovascular (CVD), 15% peripheral (PVD)-. Patients underwent evaluation of risk factors and their control, systematic non-invasive study of the vascular tree (Doppler-ultrasound) and comparison between groups according to the index territory.

RESULTS

Even though all risk factors were represented in the 3 groups, male sex, smoking and diabetes were more frequent in PVD and dyslipemia was more common in CHD (p < 0.05) Abdominal aortic diameter and carotid intima-media thickness were similar for all groups, while the number of carotid plaques was higher in PVD. CHD patients more often presented left ventricular hypertrophy and reduced ejection fraction. PVD patients showed a marked reduction of the ankle-brachial index as well as increased C-reactive protein and homocysteine (p < 0.05). Severe unsuspected vascular lesions were found in 13% of cases (95% confidence interval, 9.5-17.6%). Risk factor control was better for CHD, followed by CVD and PVD, but was globally poor.

CONCLUSIONS

The systematic evaluation of the vascular tree detects generalized atherosclerotic lesions, in some cases severe and clinically unsuspected. New markers to identify patients at very high risk are necessary. Peripheral vascular disease identifies a group of patients of particular risk. Risk factor control is deficient, particularly among PVD patients.