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The study of the 15M social movement, and then its transition into a political party like Podemos is of particular interest in different fields such as sociology, politics and also journalism. This is also the case regarding the emergence of Ciudadanos into the political and media arena, or the consolidation of a local political force like Compromís in Valencia. In this context, a study has been made of the media-opinion coverage of these political parties and other traditional parties in Valencia during the election campaign for the 2015 Regional Elections, which led to a change in government after twenty years with the Partido Popular in power. This study has been carried out within the framework of the national R+D Mediaflows project (Ministry of Economy and Competitiveness) and focuses on influence: who influences who, in what way and what are its effects. We focus on the flows that information circulates on, because this enables us to see how messages are translated and how agendas are combined in their attempt to influence the public. We aim to find out which are the most influential and which direction or directions the transmission of information flows in. The methodology includes two methods - quantitative and qualitative. The quantitative aspect is carried out using the framing theory to analyze speeches and contexts, and the qualitative aspect basically uses focus group tools and in-depth interviews. The main objective is to analyze the regional leadership of these parties in the traditional local press in this Community: in the province of Castellón, the newspaper Mediterráneo, from the Zeta group; in Alicante, the newspaper Información, from Prensa Ibérica group; and in the province of Valencia, the newspaper Las Provincias from Vocento group. This research serves as a means of comparing regional leaders' presence and the analysis of their speeches in these local newspapers. Some are leaders of consolidated parties with years of experience in government, or they are members of the opposition parties; others are newcomers, but they are backed by vigorous political brands with high profile leaders like Pablo Iglesias or Albert Rivera. [ABSTRACT FROM AUTHOR]

The application of next-generation sequencing (NGS) to non-invasive samples is one of the most promising methods in conservation genomics, but these types of samples present significant challenges for NGS. The European mink ( Mustela lutreola ) is critically endangered throughout its range. However, important aspects such as census size and inbreeding remain still unknown in many populations, so it is crucial to develop new methods to monitor this species. In this work, we placed hair tubes along riverbanks in a border area of the Iberian population, which allowed the genetic identification of 76 European mink hair samples. We then applied a reduced representation genomic sequencing (ddRAD) technique to a subset of these samples to test whether we could extract sufficient genomic information from them. We show that several problems with the DNA, including contamination, fragmentation, oxidation, and possibly sample mixing, affected the samples. Using various bioinformatic techniques to reduce these problems, we were able to unambiguously genotype 19 hair samples belonging to six individuals. This small number of individuals showed that the demographic status of the species in this peripheral population is worse than expected. The data obtained also allowed us to perform preliminary analyses of relatedness and inbreeding. Although further improvements in sampling and analysis are needed, the application of the ddRAD technique to non-invasively obtained hairs represents a significant advance in the genomic study of endangered species., Competing Interests: None declared., (© 2023 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Traditionally, researchers have assessed diet selection by comparing consumed versus available taxa. However, taxonomic assignment is probably irrelevant for predators, who likely base their selection on characteristics including prey size, habitat, or behavior. Here, we use an aquatic insectivore, the threatened Pyrenean Desman ( Galemys pyrenaicus ), as a model species to assess whether biological traits help unravel the criteria driving food and habitat preferences. We reanalyzed data from a previous taxonomy-based study of prey selection in two contrasting streams, one with excellent conservation status and the other affected by diversion for hydropower and forestry. Available and consumed prey were characterized according to nine biological traits, and diet selection was estimated by comparing availability-measured from Surber net samples, and consumption-analyzed by metabarcoding desman feces. Traits offered a biologically coherent image of diet and almost identical selection patterns in both streams, depicting a highly specialized rheophilic predator. Desmans positively selected prey with a preference for fast flow and boulder substrate, indicating their preferred riffle habitat. On the other hand, they positively selected prey with larger but not the largest potential size, living in the water column or the litter, and not inside sediments. They also chose agile prey, swimmers or prey attached to the substrate, prey with high body flexibility, and prey living exposed and clustered in groups. Overall, our results offer a picture of desman diet preference and point to biological traits as being better than taxonomic identity to describe the diet preference of consumers., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Society of Mammalogists.)

Recently, populations of various species with very low genetic diversity have been discovered. Some of these persist in the long term, but others could face extinction due to accelerated loss of fitness. In this work, we characterize 45 individuals of one of these populations, belonging to the Iberian desman (Galemys pyrenaicus). For this, we used the ddRADseq technique, which generated 1421 SNPs. The heterozygosity values of the analyzed individuals were among the lowest recorded for mammals, ranging from 26 to 91 SNPs/Mb. Furthermore, the individuals from one of the localities, highly isolated due to strong barriers, presented extremely high inbreeding coefficients, with values above 0.7. Under this scenario of low genetic diversity and elevated inbreeding levels, some individuals appeared to be almost genetically identical. We used different methods and simulations to determine if genetic identification and parentage analysis were possible in this population. Only one of the methods, which does not assume population homogeneity, was able to identify all individuals correctly. Therefore, genetically impoverished populations pose a great methodological challenge for their genetic study. However, these populations are of primary scientific and conservation interest, so it is essential to characterize them genetically and improve genomic methodologies for their research., (© 2022. The Author(s).)

Molecular techniques allow non-invasive dietary studies from faeces, providing an invaluable tool to unveil ecological requirements of endangered or elusive species. They contribute to progress on important issues such as genomics, population genetics, dietary studies or reproductive analyses, essential knowledge for conservation biology. Nevertheless, these techniques require general methods to be tailored to the specific research objectives, as well as to substrate- and species-specific constraints. In this pilot study we test a range of available primers to optimise diet analysis from metabarcoding of faeces of a generalist aquatic insectivore, the endangered Pyrenean desman (Galemys pyrenaicus, É. Geoffroy Saint-Hilaire, 1811, Talpidae), as a step to improve the knowledge of the conservation biology of this species. Twenty-four faeces were collected in the field, DNA was extracted from them, and fragments of the standard barcode region (COI) were PCR amplified by using five primer sets (Brandon-Mong, Gillet, Leray, Meusnier and Zeale). PCR outputs were sequenced on the Illumina MiSeq platform, sequences were processed, clustered into OTUs (Operational Taxonomic Units) using UPARSE algorithm and BLASTed against the NCBI database. Although all primer sets successfully amplified their target fragments, they differed considerably in the amounts of sequence reads, rough OTUs, and taxonomically assigned OTUs. Primer sets consistently identified a few abundant prey taxa, probably representing the staple food of the Pyrenean desman. However, they differed in the less common prey groups. Overall, the combination of Gillet and Zeale primer sets were most cost-effective to identify the widest taxonomic range of prey as well as the desman itself, which could be further improved stepwise by adding sequentially the outputs of Leray, Brandon-Mong and Meusnier primers. These results are relevant for the conservation biology of this endangered species as they allow a better characterization of its food and habitat requirements., Competing Interests: We have the following interests. Jorge González-Esteban is employed by DESMA Estudios Ambientales. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Information about the degree of contemporary dispersal is important when trying to understand how populations interchange individuals and identify the specific barriers that prevent these movements. In the case of endangered species, this can represent crucial information when designing appropriate conservation strategies. Here we analyse relatedness between individuals from different localities and use these data to infer whether dispersal occurred in recent generations. We applied this approach to the Pyrenean desman (Galemys pyrenaicus), a semiaquatic and endangered species endemic to the Iberian Peninsula. We studied this species in four primary rivers in the Iberian Range, where two ancient mitochondrial lineages are separated by a strict contact zone, suggesting the existence of complex dispersal patterns. Using next-generation sequencing, we obtained 912 SNPs from each specimen and estimated relatedness values between them. While relatedness networks were dense within each river, we found surprisingly few relationships between individuals from different rivers despite their close proximity in some cases, indicating much lower dispersal between rivers compared to dispersal within a single river. In agreement with this result, the degree of inbreeding was exceedingly high in most individuals. These data show that relatedness information can be crucial to understand the contemporary dispersal patterns and conservation status of specific populations of endangered species., (© 2017 John Wiley & Sons Ltd.)

Background: Species with strict ecological requirements may provide new insights into the forces that shaped the geographic variation of genetic diversity. The Pyrenean desman, Galemys pyrenaicus, is a small semi-aquatic mammal that inhabits clean streams of the northern half of the Iberian Peninsula and is endangered in most of its geographic range, but its genetic structure is currently unknown. While the stringent ecological demands derived from its aquatic habitat might have caused a partition of the genetic diversity among river basins, Pleistocene glaciations would have generated a genetic pattern related to glacial refugia., Results: To study the relative importance of historical and ecological factors in the genetic structure of G. pyrenaicus, we used mitochondrial and intronic sequences of specimens covering most of the species range. We show, first, that the Pyrenean desman has very low levels of genetic diversity compared to other mammals. In addition, phylogenetic and dating analyses of the mitochondrial sequences reveal a strong phylogeographic structure of a Middle Pleistocene origin, suggesting that the main lineages arose during periods of glacial isolation. Furthermore, both the spatial distribution of nuclear and mitochondrial diversity and the results of species distribution modeling suggest the existence of a major glacial refugium in the northwestern part of the Iberian Peninsula. Finally, the main mitochondrial lineages show a striking parapatric distribution without any apparent exchange of mitochondrial haplotypes between the lineages that came into secondary contact (although with certain permeability to nuclear genes), indicating incomplete mixing after the post-glacial recolonization. On the other hand, when we analyzed the partition of the genetic diversity among river basins, the Pyrenean desman showed a lower than expected genetic differentiation among main rivers., Conclusions: The analysis of mitochondrial and intronic markers in G. pyrenaicus showed the predominant effects of Pleistocene glaciations on the genetic structure of this species, while the distribution of the genetic diversity was not greatly influenced by the main river systems. These results and, particularly, the discovery of a marked phylogeographic structure, may have important implications for the conservation of the Pyrenean desman.

Objective: To assess the prevalence of low serum levels of HDL cholesterol (HDL-C) and its relationship with the presence of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (DM) and arterial hypertension attended in Internal Medicine and Nephrology offices., Methods: Cross-sectional, multicenter study, conducted in diabetic patients with hypertension, aged >/= 55 years old. Demographic, clinical and biochemical data were obtained from the patient's hospital records. Low HDL-C was defined as <40 mg/dl (men) or <46 mg/dl (women). The relationship between low HDL-C and CVD was assessed using logistic regression models., Results: In 2,021 patients (mean age: 68.6 years, 48.9% women, 51.1% with established CVD), the prevalence of low HDL-C was 33.7% (95% CI: 31.5-35.7), it being higher in women (38.0%) than in men (29.6%, p<0.001), and higher in patients with previous CVD (37.3% vs. 29.9% in patients without CVD, p=0.001). In the multivariate analysis that included cardiovascular risk factors, an independent relationship between low HDL-C levels and CVD was observed (OR for CVD in patients with low HDL-C: 1.46 [CI 95%: 1.19-1.79, p<0.001]), compared to patients with normal HDL-C blood levels. A second model which was also adjusted for left ventricular hypertrophy and renal disease showed a similar association (OR 1.55 [1.21-2.00], p=0.001). This association was stronger in women than in men., Conclusions: One out of three patients with diabetes and hypertension examined in Internal Medicine and Nephrology outpatient offices had low serum levels of HDL-C. Low HDL-C showed an independent relationship with a higher prevalence of CVD.

Background and Objective: Data on the prevalence of obesity in elderly population in Spain are scarce. The objective of this work was to describe the prevalence of obesity and the related factors in a random sample of Spanish population aged 60 years-old or more, stratified by autonomous communities., Subjects and Method: We analyzed the PREV-ICTUS study, a population-based study carried out between September and December 2005 in a random sample stratified by autonomous communities according to the census of inhabitants and the habitat in each community. Subjects were classified as with normal weight (body mass index [BMI] < 25 kg), overweight (BMI 25-29.9) and obesity (BMI > or = 30 kg)., Results: In 6,843 subjects -mean age (standard deviation): 71.9 (7.1) years-old; 53.3% women-, prevalence of obesity was 34.5% (95% confidence interval [CI], 33.3-35.5%), higher in women (38.4%; 95% CI, 36.8-39.9%) than in men (30.0%; 95% CI, 28.4-31.6%; p < 0.001), with a tendency to decrease in the older population. In total, 81.7% of the population showed overweight (BMI > or = 25). Prevalence differed among communities from 46.4% to 20.7% (p < 0.001). In the multivariate analysis, obesity was inversely related to age (odds ratio [OR] = 0.98 per each year increment), and directly to female gender (OR = 1.25), rural (OR = 1.50) or semi-urban habitat (OR = 1.38), sedentary lifestyle (OR = 1.86) and non-smoking history (OR = 1.19)., Conclusions: Obesity was present in one out of 3 individuals of this reasonably representative sample of the Spanish population in an age range, 60 years-old or more, which concentrates a high cardiovascular risk. Differences in the prevalence among autonomus communities were detected.

Background and Objectives: To analyze the impact of occult renal failure (ORF) in the individual risk stratification and on the blood pressures (BP) and low-density lipoprotein (LDL) goals in an aged population, according to the ESH/ESC Hypertension Guidelines., Methods: A cross-sectional, population-based study on individuals aged 60 years or more carried out in Primary Care Centers of Spain. Kidney function was estimated from calculated creatinine clearance (eGFR), Cockroft and Gault formula. Ten-year cardiovascular risk was estimated through the ESH/ESC table including or not including the eGFR. Estimates of the modification in BP and LDL-cholesterol (cLDL) goals were calculated., Results: In 6419 subjects, 4242 subjects (66%) had normal renal function, 1971 (31%) had ORF (normal creatinine and low eGFR) and 206 (3%) had insufficient renal function (high creatinine and all of them low eGFR). Inclusion of ORF as target organ damage resulted in an increase in the estimated risk in 10.8% of the total sample, increasing the percentage of high-risk subjects. In the latter case, new BP and cLDL goals (<130/80 mmHg and <100 mg/dl) should be needed in 475 (7.4%) and 413 (6.4%) additional subjects, respectively., Conclusion: Inclusion of the ORF resulted in a significant increase in the percentage of subjects with estimated high cardiovascular risk.

This study was conducted to assess the in vitro activity of ertapenem against clinical bacterial isolates from patients with community-acquired intra-abdominal and lower tract respiratory infections in Spain in 2003. As the study was conducted before the marketing of ertapenem, it was also useful to define a baseline susceptibility pattern for ertapenem in each of the participating hospitals for later surveillance studies. Each partipating site identified a variable number of aerobic and facultative bacteria isolated from patients with community-acquired intra-abdominal infection or pneumonia using standard procedures. E-test strips were used for determining the minimum inhibitory concentration (MIC) of ertapenem, while for other antimicrobials either quantitative dilution techniques or qualitative diffusion procedures were used according to each microbiology laboratory's routine practice. MIC breakpoints for categorization of susceptibility provided by the CLSI were used for interpreting MIC values. A total of 2,901 recent clinical isolates from patients with community-acquired intra-abdominal infection or pneumonia hospitalized in 69 Spanish medical centers were tested. These isolates included 2,039 Gram-negative bacteria (1,646 Enterobacteriaceae, 216 Haemophilus, 123 non-fermenting Gram-negative bacteria [NFGNB] and 54 others) and 862 Gram-positive bacteria (556 pneumococci, 159 staphylococci, 96 streptococci other than S. pneumoniae, 44 enterococci and 7 others). Ertapenem was very active in vitro against Enterobacteriaceae (99.8% susceptible), Haemophilus (96.3% susceptible), pneumococci (99.6% susceptible, of which 31% were penicillin non-susceptible strains), streptococci other than S. pneumoniae (99.0% susceptible) and methicillin-susceptible staphylococci (94.8% susceptible). For other Gram-positive and Gram-negative pathogens for which ertapenem susceptible breakpoints have not been defined, MIC(90) values were 0.38 and 0.064 mg/l, respectively. As expected, ertapenem had minimal activity in vitro against NFGNB, enterococci and methicillin-resistant staphylococci (MIC(90) of >32 mg/l for all three). Ertapenem was highly active in vitro against most bacteria isolated from patients with community-acquired intra-abdominal and lower respiratory tract infections.

Background and Objective: To assess the prevalence of low glomerular filtration rate (GFR < 60 ml/min/1.73 m2) in general population of subjects aged 60 years or older of Spain, and the related factors., Patients and Method: Analysis of PREV-ICTUS, a population-based study carried out in a sample of subjects aged 60 years or more, randomly selected and stratified by Autonomic Communities according to the census of inhabitants and the habitat in each Community. Demographic data, cardiovascular risk factors and diseases were collected. GFR was calculated using the MDRD (Modification of Diet in Renal Disease) equation., Results: In 6,799 subjects (age 71.9 years-old; 53.6% women; 72.9% with arterial hypertension [HT]; 27.0% with diabetes mellitus [DM]; 24.3% with cardiovascular disease), 25.9% had low GFR (95% confidence interval, 24.8-26.9). The prevalence increased linearly, from 16.5% in subjects aged 60-64 years to 46.5% in those aged 85 or more (p < 0.001), and was higher in women (36.1% vs 14.1% in men, p < 0.001). In the multivariate analysis, low GFR was independently related to advanced age (odds ratio [OR] between 1.30 y 4.20), female gender (OR = 5.82), HT older than 7 years (OR = 1.23), uric acid (OR = 1.52 for each increment of 1 mg/dl) and cardiovascular disease (OR = 1.68). The association with DM did not reach statistical significance. In a model without cardiovascular disease, related factors remained the same, increasing the significance of HT older than 7 years (OR = 1.31) and of DM (OR = 1.19)., Conclusion: One out or 4 subjects of this sample showed low GFR. The variables directly associated with low GFR were advanced age, female gender, HT of longer evolution, cardiovascular disease, increased uric acid, and, in one model, DM.

Introduction and Objectives: The aims of this study were to determine the prevalence of atrial fibrillation in individuals aged 60 years or more in Spain using a random sample of the population and to identify associated factors., Methods: An analysis of the PREV-ICTUS study, a randomized cross-sectional population-based study of individuals aged 60 years or more, was carried out. Data on demographic variables, cardiovascular risk factors, and cardiovascular disease were obtained from medical records. The diagnosis of atrial fibrillation was based on the patient's medical history and an electrocardiogram performed during the study., Results: In the 7108 individuals studied (mean age 71.9 [7.1] years, 53.6% female), the prevalence of atrial fibrillation was 8.5% (95% confidence interval [CI] 7.9-9.2%). It was higher in males (9.3% vs 7.9% in females; P=.036) and increased from 4.2% in individuals aged 60-64 years to 16.5% in those aged 85 years or more (chi-squared test for linear trend, P< .001). Multivariate analysis showed that existing cardiovascular disease, hypertension, age, and left ventricular hypertrophy had the strongest associations with atrial fibrillation. Although there was a strong relationship between hypertension and atrial fibrillation (odds ratio 2.53, 95% CI, 1.60-4.01), no association was found between poor blood pressure control and atrial fibrillation. A weak association with diabetes mellitus was found only when arterial pressure was included in the model, but not when a diagnosis of hypertension was included., Conclusions: In this cross-sectional population-based study of elderly individuals, the prevalence of atrial fibrillation was 8.5%, and was strongly associated with existing cardiovascular disease, hypertension, age and left ventricular hypertrophy.

The objective was to assess the stroke risk and prevalence of the cardiovascular risk factors and to analyze their relationship with the specific stroke rates of mortality in each of the autonomic communities of Spain. We conducted a multicenter, cross-sectional study of population >60 years old in Spanish primary care centers. In all of the subjects, clinical, biochemical, and electrocardiographic data were obtained, and the 10-year stroke risk was calculated using the Framingham score. Mortality rates of stroke, age and sex adjusted, were obtained for each of the autonomic communities from the Ministry of Health. A total of 7343 subjects (mean age: 71.6 years, 53.4% women, 34.4% obese, and 27.1% diabetic subjects) were analyzed. A total of 73% were already diagnosed with hypertension. Among hypertensive subjects, 29.1% had blood pressure on therapeutic objective, and, of the total population, 35.7% had blood pressure under control. ECG-left ventricular hypertrophy was present in 12.9% of the subjects. The estimated stroke risk was 19.6%. Stroke mortality rates were significantly related to the estimated 10-year stroke risk (r=0.41; P<0.05) in each autonomic community. Poor hypertension control (P=-0.42; P<0.05) and prevalence of ECG-left ventricular hypertrophy (P=0.52; P<0.05) were the main factors related to the stroke mortality rates after controlling by age, sex, obesity, diabetes, and urban setting. Differences in stroke mortality throughout the autonomic communities of Spain were associated with indexes of worse blood pressure handling, low control rates, and high left-ventricular hypertrophy.

The aim of this study is to assess the relationship among metabolic syndrome (MS), target organ damage (TOD) and established cardiovascular disease (CVD) in non-diabetic hypertensive elderly patients. ERIC-HTA is cross-sectional, multicentre study carried out in primary care, on hypertensive patients aged 55 or older. MS was defined by the NCEP-ATP III criteria, using body mass index (>28.8 kg/m(2)) instead of abdominal perimeter. In 8331 non-diabetic hypertensive patients (3663 men and 4668 women, mean age 67.7 years), the prevalence of MS was 32.6% (men: 29.0%; women: 36.8%). A linear association was observed between a greater number of components of MS and a greater prevalence of left ventricle hypertrophy (LVH) on the electrocardiogram (p<0.001), impaired kidney function (p<0.001) and established CVD (p = 0.001). In a multivariate model, MS in non-diabetic hypertensive patients was related to a greater prevalence of LVH (OR 1.31 [95% CI: 1.15-1.48]), impaired kidney function (OR 1.45 [95% CI: 1.29-1.63]) and established CVD (OR 1.22 [95% CI: 1.08-1.37]). This relationship persisted after stratifying by gender. In conclusion, in this elderly non-diabetic hypertensive population, the presence of MS was independently related to a greater prevalence of hypertensive TOD and established CVD, suggesting a role of MS as a cardiovascular risk marker in hypertension.

Introduction and Objectives: Left ventricular hypertrophy (LVH) is the earliest manifestation of cardiac damage in hypertension. Its appearance is associated with a poor cardiovascular prognosis. The objectives of this study were to determine the prevalence of electrocardiographic LVH and to assess the epidemiological characteristics of hypertensive patients receiving primary care., Patients and Method: A cross-sectional multicenter study of hypertensive patients aged 55 years or more was carried out in a primary care setting. Blood pressure was measured using the standard method. Cardiovascular history was determined from medical records and LVH was assessed electrocardiographically using Cornell's criteria., Results: In total, 15 798 patients (mean age 68.0 years, 55.3% women, and 30.4% with diabetes mellitus) were evaluated. Of these, 3207 (20.3%) had electrocardiographic signs of LVH. The prevalence was higher in males, diabetics, smokers, and patients with high blood pressure or renal or cardiovascular disease. Compared to patients without LVH, those with the condition were older, were more often male, and were more likely to have diabetes or renal or cardiovascular disease. Multivariate analysis showed that LVH was independently associated with advanced age, male gender, diabetes, smoking, poor blood pressure control, and the presence of cardiovascular or renal disease. Blood pressure control was poorer in patients with LVH than in those without it., Conclusions: The prevalence of electrocardiographic LVH is high, with affected patients being more likely to have diabetes or renal or cardiovascular disease. Moreover, blood pressure control is poor in these patients, and more aggressive pharmacological management is needed.

Stroke is the leading cause of mortality in women in Spain. RIMHA is a cross-sectional multicenter study in hypertensive women aged 55 or more in primary care to estimate the 10-year risk for a first stroke. Clinical history, cardiovascular risk factors and diseases, electrocardiogram, blood samples and blood pressure (BP) were recorded. Stroke and coronary risk were estimated using the appropriate Framingham scales; 12875 patients were included (mean age 68.0+/-8.5 years, 29.1% with diabetes, 19.7% with cardiovascular disease). Electrocardiographic left ventricular hypertrophy (LVH) was present in 19.2% BP was controlled in 42.9% of non-diabetic (BP<140/90 mmHg) and 9.7% of diabetic patients (BP<130/80 mmHg). The 10-year risk (+/- SD) for a first stroke was estimated as 15.8+/-16.3%, and the coronary risk as 12.0+/-6.3. In the multivariate analysis, the most contributing factors for stroke risk estimation were age, systolic BP, LVH and atrial fibrillation. In conclusion, the 10-year estimated stroke risk for Spanish hypertensive women aged 55 years or more was higher than the estimated coronary risk, in accordance with the high rates of morbidity and mortality due to stroke among women in Spain. The most powerful risk factors were older age, poor BP control, LVH and atrial fibrillation.

Background and Objective: Stroke is a major cause of morbidity and mortality in hypertensive population. The aim of this study is to estimate the 10-year risk of a first stroke in Spanish hypertensive population using the Framingham scale., Patients and Method: Cross-sectional multicenter study in primary care environment, on hypertensive patients aged 55 or more (10 consecutive patients each physician). Blood pressure (BP) was measured according to standardized rules. Stroke and coronary risk were estimated using the Framingham scale., Results: 16,129 patients (mean age 67.7 years; 57.1% women; 30.4% with diabetes mellitus; 26.6% with previous history of cardiovascular disease) were analyzed. 20.3% showed electrocardiographic left ventricular hypertrophy (more prevalent in males, diabetics, with systolic BP > or = 140 mmHg; p < 0.001). The goal of BP control was reached in 30.1% of non-diabetic patients and only in 5.9% of diabetics. The estimated 10-year risk of a first stroke (standard deviation) was estimated to be 19.9% (16.8), and the coronary risk 19.2% (14.0). While males had an estimated risk of coronary disease above the stroke risk, women had an estimated risk of a first stroke greater than the estimated risk of coronary disease., Conclusions: The estimated risk of stroke among Spanish hypertensive population is high, and the main risk factors (age, systolic BP, diabetes and left ventricular hypertrophy) tend to aggregate. In women estimated risk of stroke in greater than estimated coronary risk. The risk of stroke must be taken into account in the assessment and treatment of hypertensive patients.

Voles of the genus Microtus represent one of the most speciose mammalian genera in the Holarctic. We established a molecular phylogeny for Microtus to resolve contentious issues of systematic relationships and evolutionary history in this genus. A total of 81 specimens representing ten Microtus species endemic to Europe as well as eight Eurasian, six Asian and one Holarctic species were sequenced for the entire cytochrome b gene (1140 bp). A further 25 sequences were retrieved from GenBank, providing data on an additional 23, mainly Nearctic, Microtus species. Phylogenetic analysis of these 48 species generated four well-supported monophyletic lineages. The genus Chionomys, snow voles, formed a distinct and well-supported lineage separate from the genus Microtus. The subgenus Microtus formed the strongest supported lineage with two sublineages displaying a close relationship between the arvalis species group (common voles) and the socialis species group (social voles). Monophyly of the Palearctic pitymyid voles, subgenus Terricola, was supported, and this subgenus was also subdivided into two monophyletic species groups. Together, these groupings clarify long-standing taxonomic uncertainties in Microtus. In addition, the "Asian" and the Nearctic lineages reported previously were identified although the latter group was not supported. However, relationships among the main Microtus branches were not resolved, suggesting a rapid and potentially simultaneous radiation of a widespread ancestor early in the history of the genus. This and subsequent radiations discernible in the cytochrome b phylogeny, show the considerable potential of Microtus for analysis of historical and ecological determinants of speciation in small mammals. It is evident that speciation is an ongoing process in the genus and that the molecular data provides a vital insight into current species limits as well as cladogenic events of the past.

Objective: To find a morphologic model of the development of prostate hyperplasia., Methods: Study of the transitional zone in 60 patients (30 with infravesical obstruction, 30 with no obstructive symptoms) and quantification of the involved surface, number of pure stromal and glandular-stromal nodes, node area for each of them, and non-nodular area of the transitional zone, correlating each parameter to age based on clinical status., Results: The greater transitional zone area is seen in patients with obstruction: 1376.83 +/- 408.17 mm2 vs 321.39 +/- 151.49 mm2 in asymptomatic patients, mainly due to a higher number of glandular-stromal nodes (17 vs 2.2) and their size, with a correlation to age (p = 0.03). Moderate increases of non-nodular areas are also found., Conclusions: These findings suggest that onset of prostate hyperplasia may be due to a consistent increase of the transitional area, and that in some patients, probably because of local factors, nodular development occurs as a result of both an increase in nodes number and size.

The introduction and generalization of 24-h ambulatory blood pressure (BP) monitoring has shown the clinical relevance of home BP. The aim of this study was to assess the validity of home-measured BP for monitoring and controlling patients with arterial hypertension while on a homogeneous treatment. An additional objective was to establish the degree of office BP control obtained. This was a prospective, longitudinal, observational and multicenter study in a cohort of 156 patients of both sexes, aged over 18 years and with essential hypertension. All of them received the fixed combination enalapril/HCTZ 20/6 mg as the only hypertensive agent for at least 4 weeks previously. Office BP was the average of three measurements. For home BP, a semi-automated device (OMRON HEM 705 CP) was used. The patients measured their BP twice a day for 2 consecutive days. The average differences between the two measuring methods were low, but significant: 3.99 mmHg for systolic BP (SBP; p < 0.05), 2.02 mmHg for diastolic BP (DBP; p < 0.05). Pearson's regression coefficient between the office and home values was highly significant (p < 0.0001) for SBP, DBP and heart rate. Home BP measurement was highly reproducible as shown by the high within-class correlation coefficient for individual measurements on the first day compared with the second: 0.88 (95% confidence interval, CI 0.82-0.92; p < 0.00001) for SBP and 0.89 for DBP (95% CI 0.83-0.93; p < 0.00001). The percentage of patients with strict office DBP and SBP control (< 140/90 mmHg) was 61.3% and with DBP control (<90 mmHg) 92%. In conclusion, in the ESPADA study, the application of home BP measurement is valid, reproducible and shows a high correlation with office BP.

Background: The development of benign prostatic hyperplasia (BPH) is an androgen-dependent process which may be mediated by a number of locally produced growth factors. One of these, the basic fibroblast growth factor (bFGF or FGF2), has a mitogenic effect on prostatic stroma. High expression levels of bFGF have been reported in BPH. FGFR1 and FGFR2 receptors, that exhibit affinity for bFGF, have been identified in normal and hyperplastic prostate. Finasteride, a 5alpha-reductase inhibitor, is an effective drug in the treatment of BPH, inducing regressive changes in the prostate of treated patients, even though its mechanisms of action are not yet completely elucidated. This study was designed to assess the effects of finasteride on the expression levels of bFGF, FGFR1, and FGFR2 in patients with BPH., Methods: The expression levels of bFGF, FGFR1, and FGFR2 in 9 patients with prostatic hyperplasia treated with finasteride were assessed by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) analysis of mRNA expression and were compared with those of 9 control patients with untreated BPH., Results: Immunohistochemistry showed strong bFGF immunoreactivity in the prostatic stroma of untreated patients, this being somewhat weaker in the epithelium. In treated patients, epithelial immunoreactivity was practically negative, and a considerable reduction in stromal immunoreactivity was seen. These findings were also confirmed by RT-PCR. FGFR1 showed a weak immunoreactivity in the stroma and in basal epithelial cells. FGFR1 showed a weak immunoreactivity in the stroma and in basal epithelial cells. FGFR2 exhibited strong stromal immunoreactivity, becoming weaker in the basal epithelium. No differences were seen in the expression of both receptors between the groups of treated and untreated patients., Conclusions: A marked reduction in bFGF levels is seen in BPH treated with finasteride in comparison to untreated BPH. In our opinion, finasteride may act as a negative regulator of bFGF expression, counteracting the role of bFGF in the development of BPH.

Background: Prostatic atrophy has been documented histologically as a consequence of finasteride action on human hyperplastic prostates. An increase in apoptotic rates has also been reported in androgen-deprived hyperplastic prostates. Transforming growth factor beta (TGF-beta) signaling is implicated in apoptotic cell death. TGF-betas have been detected in normal and diseased human prostate. In the normal prostate, TGF-beta acts as a predominantly negative growth regulator. TGF-beta signaling receptors TbetaRI and TbetaRII have been shown to be negatively regulated by androgens., Methods: We studied the histological changes in 9 selected finasteride-treated patients with benign prostatic hyperplasia (BPH), and analyzed the levels of expression and localization of TGF-beta receptor types TbetaRI and TbetaRII in these patients as compared to selected BPH controls., Results: The prostatic epithelial compartment seemed to be a primary target site for finasteride action, since we observed moderate to severe glandular atrophy after 4-6 months of treatment. TGF-beta receptors were upregulated in treated cases. We assessed a twofold increase in TbetaRII mRNA levels in treated cases as compared to controls. An increase in both TbetaRI and TbetaRII at the protein level by immunostaining was observed, which also provided a helpful means for detecting glands undergoing regression., Conclusions: We conclude that finasteride may modulate the TGF-beta signaling system to promote changes leading to apoptosis of epithelial cells and prostatic glandular atrophy.

The study of the prostate's peripheral area in 32 patients, with age ranging between 48 to 75 years (mean, 61.4 +/- 6.7), demonstrates the frequency of certain morphological changes such as glandular atrophy (46.8%), which are neither related to age (p = 0.8) or the carcinoma (p = 0.8). A very different issue is the prostatic intraepithelial neoplasia, which although not statistically related to age in this series (p = 0.3) (probably due to the absence of young adults), appears to develop in earlier stages than cancer, is associated in 88.8% carcinomas (p = 0.03) and has a close topographic correlation to latent microscopic foci of adenocarcinoma of the prostate's peripheral area, anatomic proximity of both lesions occurring in 55.5% cases.

Purpose: To know the Primary Care Physicians opinion related to their own praxis, background, and needs for a specific medical support in geriatric medicine., Methods: A closed mailed questionnaire, with 22 items. Descriptive analysis of the results. PEOPLE SAMPLE: 559 answers. 77% men. Age: main group (44%) between 35 and 39 years old. 80% of the sample worked in health centers as primary care physicians., Results: a) Praxis: 50% of the physicians attend more than 20 elderly patients every day. 38% of them have specific aged oriented protocols. 74% of them take age into account when decide the appropriate doses of drugs. b) Geriatric background: None at the undergraduate period: 96%. Some sort of postgraduate formation: 42%. Are able to identify at less a geriatric book: 34%. A score of 4.5 (over 10) was the result of their own assessment about their level of geriatric knowledge. 95% of the answers miss a better formation in geriatrics, and 93% of them think that this formation would change their clinical approach to the elderly patient. c) Needs of specialized geriatric support: It would be helpful to them according to a 84% of the answers. It could be as a "Geriatric Inhospital Service" in the opinion of a 44% of the cases (this question had a 18% of abstentions); and with geriatricians working as extrahospitalary consultants according to the answers of the 79% (6% of abstentions)., Conclusions: Primary care physicians have: 1. Many elderly patients, with an acceptable level of attention to them. 2. A poor geriatric formation and awareness of their needs. 3. Need of a specialized support in their daily work.