Background: The purpose of this study was to determine the prevalence and epidemiologic behavior ... more Background: The purpose of this study was to determine the prevalence and epidemiologic behavior of Hypertension (HT) in the Maracaibo Municipality, Zulia state, Venezuela. Materials and Methods: This was a cross-sectional descriptive study, where 2,230 subjects from both genders were randomly selected as part of the Maracaibo city Metabolic Syndrome Prevalence Study (MMSPS). Complete medical examination, laboratory workup and anthropometry measurements were taken. The quantitative variables were expressed as mean±SD, and comparisons were calculated using t Student test. The qualitative variables were represented as absolute and relative frequencies, and comparisons were obtained using Z test for proportions and associations with c2 test. Results: The prevalence of HT was 19.42% (20.92% in women and 17.75% in men). The prevalence of newly diagnosed individuals was 12.0%, with 8.71% in women and 16.90% in men. The overall percentage of HT was 32.02%, being 29.63% in women and 34.65% ...
Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in th... more Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in the evaluation of insulin resistance (IR). The purpose of this study was to estimate the optimal cut-off point for Homeostasis Model Assessment-2 Insulin Resistance (HOMA2-IR) in an adult population of Maracaibo, Venezuela. Methods. Descriptive, cross-sectional study with randomized, multistaged sampling included 2,026 adult individuals. IR was evaluated through HOMA2-IR calculation in 602 metabolically healthy individuals. For cut-off point estimation, two approaches were applied: HOMA2-IR percentile distribution and construction of ROC curves using sensitivity and specificity for selection. Results. HOMA2-IR arithmetic mean for the general population was 2.21±1.42, with 2.18±1.37 for women and 2.23±1.47 for men (P=0.466). When calculating HOMA2-IR for the healthy reference population, the resulting p75 was 2.00. Using ROC curves, the selected cut-off point was 1.95, with an area under th...
Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 ... more Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH- or FH+) and their allelic characterization of ApoE ɛ4 (ApoE ɛ4- or ApoE ɛ4+) and considering cardiovascular risk factors (hypercholesterolemia, hypertension, and diabetes mellitus). In addition, we analyzed the choroidal thickness by OCT and the area of the foveal avascular zone with OCTA. We did not find a relationship between a family history of AD or any of the ApoE isoforms and the presence or absence o...
En imagenología cardiaca 3–D, la tomografía computarizada multica... more En imagenología cardiaca 3–D, la tomografía computarizada multicapa (MSCT) se destaca por su utilidad clínica para generar información relativa a la morfología del corazón. Típicamente, mediante MSCT se producen imágenes cardiacas con resoluciones espaciales sub–milimétricas las cuales exhiben ciertos problemas vinculados con ruido, artefactos y bajo contraste que afectan tanto la identificación adecuada de las diversas estructuras anatómicas, de interés para los cardiólogos, como la evaluación de la función cardiaca. Debido a que el análisis de la función cardiaca puede verse afectado por los mencionados problemas, diversas técnicas de preprocesamiento han sido propuestas para abordarlos. En este sentido, para reducir el efecto del ruido y de los artefactos se recurre a técnicas de filtrado; mientras que para sortear el problema del bajo contraste se consideran técnicas que permiten definir regiones de interés (ROI). La mayoría de estas técnicas están orientadas hacia la disminución del impacto negativo, en la calidad de tales imágenes, del ruido y de los artefactos producidos por movimientos (voluntarios e involuntarios) del paciente y aquellos generados por objetos localizados en su cuerpo. Sin embargo a pesar de los esfuerzos, de los desarrolladores de software y de las casas fabricantes de tomógrafos, para corregir tal impacto aún persisten ciertos factores que habilitan su generación y, por ende, su aparición notoria en las imágenes de MSCT afectando la información presente en ellas. Por ello, en el presente trabajo, se analizan tanto los problemas que afectan las imágenes de MSCT cardiaca como los fundamentos teóricos de las técnicas de preprocesamiento (filtrado + definición de ROI) más utilizadas en el área médica para afrontar los mencionados problemas
Background: As a syndrome of physiological vulnerability and multifactorial progressive decline t... more Background: As a syndrome of physiological vulnerability and multifactorial progressive decline tightly related to age, frailty has been associated with several illnesses, and in particular cardiovascular disease. Objective: To assess the factors associated with the frailty syndrome in older adults evaluated in the outpatient clinic of a tertiary hospital from Maracaibo city, Venezuela. Materials and Methods: An observational, analytical, cross-sectional study was performed on subjects of both genders, over 60 years old that went to the Internal Medicine outpatient clinic of the Hospital General del Sur “Dr. Pedro Iturbe” from Maracaibo city, Venezuela. Sampling was performed via a non-probabilistic, intentional method. For each subject with frailty or pre-frailty, a control subject was selected in a 1:1 ratio according to gender; several risk factors were interrogated. The state of frailty was determined through the FRAIL scale. Results: Of the 201 assessed patients, 49.3% (n=99) w...
Background: Depression is a heavily prevalent mental disorder. Symptoms of depression extend beyo... more Background: Depression is a heavily prevalent mental disorder. Symptoms of depression extend beyond mood, cognition, and behavior to include a spectrum of somatic manifestations in all organic systems. Changes in sleep and neuroendocrine rhythms are especially prominent, and disruptions of circadian rhythms have been closely related to the neurobiology of depression. With the advent of increased research in chronobiology, various pathophysiologic mechanisms have been proposed, including anomalies of sleep architecture, the effects of clock gene polymorphisms in monoamine metabolism, and the deleterious impact of social zeitgebers. The identification of these chronodisruptions has propelled the emergence of several chronotherapeutic strategies, both pharmacological and non-pharmacological, with varying degrees of clinical evidence. Methods: The fundamental objective of this review is to integrate current knowledge about the role of chronobiology and depression and to summarize the in...
Arterial hypertension is the most prevalent chronic disease in the adult population of developed ... more Arterial hypertension is the most prevalent chronic disease in the adult population of developed countries and it constitutes a significant risk factor in the development of cardiovascular disease, contributing to the emergence of many comorbidities, among which heart failure excels, a clinical syndrome that nowadays represents a major health problem with uncountable hospitalizations and the indolent course of which progressively worsens until quality of life decreases and lastly death occurs prematurely. In the light of this growing menace, each day more efforts are invested in the field of cardiovascular pharmacology, searching for new therapeutic options that allow us to modulate the physiological systems that appear among these pathologies. Therefore, in the later years, the study of natriuretic peptides has become so relevant, which mediate beneficial effects at the cardiovascular level such as diuresis, natriuresis, and decreasing cardiac remodeling; their metabolism is mediat...
Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of... more Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela. The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined. Of the evaluated population, 55.2% were female, 34.8% had a coronary ri...
Subclinical hypothyroidism (ScH) is an endocrine alteration that is related to cardiovascular ris... more Subclinical hypothyroidism (ScH) is an endocrine alteration that is related to cardiovascular risk factors, including those categorized as components of the Metabolic Syndrome (MS). However, findings in prior reports regarding an association between these alterations are inconsistent. The purpose of this study was to determine the relationship between both entities in adult subjects from Maracaibo City, Venezuela. The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multistage sampling. In this substudy, 391 individuals of both genders were selected and TSH, free T3, and free T4 tests were performed as well as a complete lipid profile, fasting glycaemia, and insulin blood values. ScH was defined according to the National Health and Nutrition Examination Survey (NHANES) criteria: high TSH (≥4.12mUI/L) and normal free T4 (0.9-1,9 ng/dL) in subjects without personal history of thyroid disease. MS components were defined accordin...
Data mining consists of using large database analysis to detect patterns, relationships and model... more Data mining consists of using large database analysis to detect patterns, relationships and models in order to describe (or even predict) the appearance of a future event; to accomplish this, it uses classification methods, rules of association, regression patterns, link and cluster analyses. Recently this approach has been used to propose a new diabetes mellitus classification, using information analysis techniques through which the selection bias minimally influences categorization, this new focus that includes data mining previously implemented to predict, identify biomarkers, complications, therapies, health policies, genetic and environmental effects of this disease; it could be generalized in the field of endocrinology, in the classification of other endocrine diseases.
Background and Aim. Insulin resistance (IR) is a prominent pathophysiologic component in a myriad... more Background and Aim. Insulin resistance (IR) is a prominent pathophysiologic component in a myriad of metabolic disorders, including obesity, prediabetes, and type 2 diabetes mellitus, which are common in our locality. The objective of this study was to determine the prevalence of IR and factors associated with this condition in an adult population from Maracaibo city, Venezuela.Methodology. A cross-sectional, descriptive study with multistaged randomized sampling was carried out in 2026 adults. IR was defined as HOMA2-IR ≥ 2. A multiple logistic regression model was constructed in order to evaluate factors associated with IR.Results. The prevalence of IR was 46.5% (n=943), with 46.7% (n=450) in the general population, 46.4% (n=493) in females, and 47.90% (n=970) in males (p=0.895). IR prevalence tended to increase with age and was significantly greater in subjects aged ≥30 years (χ2=16.726;p=2.33×10-4). Employment, alcohol consumption, obesity, high triacylglycerides, low HDL-C, and...
Cardiovascular disease (CVD) is a global epidemic, currently representing the worldwide leading c... more Cardiovascular disease (CVD) is a global epidemic, currently representing the worldwide leading cause of morbidity and mortality. Atherosclerosis is the fundamental pathophysiologic component of CVD, where the immune system plays an essential role. Monocytes and macrophages are key mediators in this aspect: due to their heterogeneity and plasticity, these cells may act as either pro- or anti-inflammatory mediators. Indeed, monocytes may develop heterogeneous functional phenotypes depending on the predominating pro- or anti-inflammatory microenvironment within the lesion, resulting in classic, intermediate, and non-classic monocytes, each with strikingly differing features. Similarly, macrophages may also adopt heterogeneous profiles being mainly M1 and M2, the former showing a proinflammatory profile while the latter demonstrates anti-inflammatory traits; they are further subdivided in several subtypes with more specialized functions. Furthermore, macrophages may display plasticity ...
Introducción: La automedicación y la polifarmacia son los principales patrones de consumo de medi... more Introducción: La automedicación y la polifarmacia son los principales patrones de consumo de medicamentos dentro del uso irracional de fármacos. Ambas prácticas se han con-vertido en un problema de salud a nivel mundial, constitu-yendo un potencial riesgo para los sujetos que las practican. El objetivo de esta investigación es estimar la frecuencia y describir los principales factores asociados a la automedica-ción y polifarmacia en individuos adultos del sector Dalia de Fernández, municipio San Francisco, estado Zulia. Materiales y Métodos: Se realizó un estudio descriptivo no experimental, aleatorio y transversal en 102 individuos de ambos sexos mayores de 30 años, mediante un muestreo por conglomerados monoetápico. Se excluyeron individuos cuya entrevista fuera aplicada cercano a farmacias y con-sultorios médicos, así como pacientes embarazadas. Para el análisis estadístico las variables cualitativas fueron expre-sadas como frecuencias absolutas y relativas, empleando la prueba C...
Introduction. The purpose of this study was to analyze the influence of metabolic phenotypes duri... more Introduction. The purpose of this study was to analyze the influence of metabolic phenotypes during the construction of ROC curves for waist circumference (WC) cutpoint selection.Materials and Methods. A total of 1,902 subjects of both genders were selected from the Maracaibo City Metabolic Syndrome Prevalence Study database. Two-Step Cluster Analysis (TSCA) was applied to select metabolically healthy and sick men and women. ROC curves were constructed to determine WC cutoff points by gender.Results. Through TSCA, metabolic phenotype predictive variables were selected: HOMA2-IR and HOMA2-βcell for women and HOMA2-IR, HOMA2-βcell, and TAG for men. Subjects were classified as healthy normal weight, metabolically obese normal weight, healthy and metabolically disturbed overweight, and healthy and metabolically disturbed obese. Final WC cutpoints were 91.50 cm for women (93.4% sensitivity, 93.7% specificity) and 98.15 cm for men (96% sensitivity, 99.5% specificity).Conclusions. TSCA in ...
An important etiopathogenic component of cardiovascular disease is atherosclerosis, with inflamma... more An important etiopathogenic component of cardiovascular disease is atherosclerosis, with inflammation being an essential event in the pathophysiology of all clinical pictures it comprises. In recent years, several molecules implicated in this process have been studied in order to assess cardiovascular risk in both primary and secondary prevention. C-reactive protein is a plasmatic protein of the pentraxin family and an acute phase reactant, very useful as a general inflammation marker. Currently, it is one of the most profoundly researched molecules in the cardiovascular field, yet its clinical applicability regarding cardiovascular risk remains an object of discussion, considered by some as a simple marker and by others as a true risk factor. In this sense, numerous studies propose its utilization as a predictor of cardiovascular risk through the use of high-sensitivity quantification methods for the detection of values <1 mg/L, following strict international guidelines. Increas...
Context and Objective. The purpose of this study was to determine optimal waist circumference (WC... more Context and Objective. The purpose of this study was to determine optimal waist circumference (WC) cut-off values for the detection of multiple risk factor aggregation in individuals from Maracaibo, Venezuela.Participants and Methods. A total of 1,902 adult individuals of both genders belonging to MMSPS were included. Complete physical, laboratory, and anthropometric examination were done to evaluate Metabolic Syndrome (MS) components and insulin resistance. ROC curves were plotted for risk factor aggregation in order to assess WC cut-off point. Logistic regression models were constructed to assess risk factors associated with the WC.Results. There were 52.2% females and 47.8% males, with WC of90.7±13.7 cm and98.2±15.9 cm, respectively. ROC curves exhibited a WC cut-off point for women of 90.25 cm (68.4% sensitivity, 65.8% specificity) and 95.15 cm (71.1% sensitivity, 67.4% specificity) for men. HOMA2-IR and high blood pressure were associated with a WC over these cut-off points, as...
Osteoarthritis is a chronic degenerative disorder that currently represents one of the main cause... more Osteoarthritis is a chronic degenerative disorder that currently represents one of the main causes of disability within the elderly population and an important presenting complaint overall. The pathophysiologic basis of osteoarthritis entails a complex group of interactions among biochemical and mechanical factors that have been better characterized in light of a recent spike in research on the subject. This has led to an ongoing search for ideal therapeutic management schemes for these patients, where glucosamine is one of the most frequently used alternatives worldwide due to their chondroprotective properties and their long-term effects. Its use in the treatment of osteoarthritis is well established; yet despite being considered effective by many research groups, controversy surrounds their true effectiveness. This situation stems from several methodological aspects which hinder appropriate data analysis and comparison in this context, particularly regarding objectives and target...
Background: The purpose of this study was to determine the prevalence and epidemiologic behavior ... more Background: The purpose of this study was to determine the prevalence and epidemiologic behavior of Hypertension (HT) in the Maracaibo Municipality, Zulia state, Venezuela. Materials and Methods: This was a cross-sectional descriptive study, where 2,230 subjects from both genders were randomly selected as part of the Maracaibo city Metabolic Syndrome Prevalence Study (MMSPS). Complete medical examination, laboratory workup and anthropometry measurements were taken. The quantitative variables were expressed as mean±SD, and comparisons were calculated using t Student test. The qualitative variables were represented as absolute and relative frequencies, and comparisons were obtained using Z test for proportions and associations with c2 test. Results: The prevalence of HT was 19.42% (20.92% in women and 17.75% in men). The prevalence of newly diagnosed individuals was 12.0%, with 8.71% in women and 16.90% in men. The overall percentage of HT was 32.02%, being 29.63% in women and 34.65% ...
Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in th... more Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in the evaluation of insulin resistance (IR). The purpose of this study was to estimate the optimal cut-off point for Homeostasis Model Assessment-2 Insulin Resistance (HOMA2-IR) in an adult population of Maracaibo, Venezuela. Methods. Descriptive, cross-sectional study with randomized, multistaged sampling included 2,026 adult individuals. IR was evaluated through HOMA2-IR calculation in 602 metabolically healthy individuals. For cut-off point estimation, two approaches were applied: HOMA2-IR percentile distribution and construction of ROC curves using sensitivity and specificity for selection. Results. HOMA2-IR arithmetic mean for the general population was 2.21±1.42, with 2.18±1.37 for women and 2.23±1.47 for men (P=0.466). When calculating HOMA2-IR for the healthy reference population, the resulting p75 was 2.00. Using ROC curves, the selected cut-off point was 1.95, with an area under th...
Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 ... more Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH- or FH+) and their allelic characterization of ApoE ɛ4 (ApoE ɛ4- or ApoE ɛ4+) and considering cardiovascular risk factors (hypercholesterolemia, hypertension, and diabetes mellitus). In addition, we analyzed the choroidal thickness by OCT and the area of the foveal avascular zone with OCTA. We did not find a relationship between a family history of AD or any of the ApoE isoforms and the presence or absence o...
En imagenolog&iacute;a cardiaca 3&ndash;D, la tomograf&iacute;a computarizada multica... more En imagenolog&iacute;a cardiaca 3&ndash;D, la tomograf&iacute;a computarizada multicapa (MSCT) se destaca por su utilidad cl&iacute;nica para generar informaci&oacute;n relativa a la morfolog&iacute;a del coraz&oacute;n. T&iacute;picamente, mediante MSCT se producen im&aacute;genes cardiacas con resoluciones espaciales sub&ndash;milim&eacute;tricas las cuales exhiben ciertos problemas vinculados con ruido, artefactos y bajo contraste que afectan tanto la identificaci&oacute;n adecuada de las diversas estructuras anat&oacute;micas, de inter&eacute;s para los cardi&oacute;logos, como la evaluaci&oacute;n de la funci&oacute;n cardiaca. Debido a que el an&aacute;lisis de la funci&oacute;n cardiaca puede verse afectado por los mencionados problemas, diversas t&eacute;cnicas de preprocesamiento han sido propuestas para abordarlos. En este sentido, para reducir el efecto del ruido y de los artefactos se recurre a t&eacute;cnicas de filtrado; mientras que para sortear el problema del bajo contraste se consideran t&eacute;cnicas que permiten definir regiones de inter&eacute;s (ROI). La mayor&iacute;a de estas t&eacute;cnicas est&aacute;n orientadas hacia la disminuci&oacute;n del impacto negativo, en la calidad de tales im&aacute;genes, del ruido y de los artefactos producidos por movimientos (voluntarios e involuntarios) del paciente y aquellos generados por objetos localizados en su cuerpo. Sin embargo a pesar de los esfuerzos, de los desarrolladores de software y de las casas fabricantes de tom&oacute;grafos, para corregir tal impacto a&uacute;n persisten ciertos factores que habilitan su generaci&oacute;n y, por ende, su aparici&oacute;n notoria en las im&aacute;genes de MSCT afectando la informaci&oacute;n presente en ellas. Por ello, en el presente trabajo, se analizan tanto los problemas que afectan las im&aacute;genes de MSCT cardiaca como los fundamentos te&oacute;ricos de las t&eacute;cnicas de preprocesamiento (filtrado + definici&oacute;n de ROI) m&aacute;s utilizadas en el &aacute;rea m&eacute;dica para afrontar los mencionados problemas
Background: As a syndrome of physiological vulnerability and multifactorial progressive decline t... more Background: As a syndrome of physiological vulnerability and multifactorial progressive decline tightly related to age, frailty has been associated with several illnesses, and in particular cardiovascular disease. Objective: To assess the factors associated with the frailty syndrome in older adults evaluated in the outpatient clinic of a tertiary hospital from Maracaibo city, Venezuela. Materials and Methods: An observational, analytical, cross-sectional study was performed on subjects of both genders, over 60 years old that went to the Internal Medicine outpatient clinic of the Hospital General del Sur “Dr. Pedro Iturbe” from Maracaibo city, Venezuela. Sampling was performed via a non-probabilistic, intentional method. For each subject with frailty or pre-frailty, a control subject was selected in a 1:1 ratio according to gender; several risk factors were interrogated. The state of frailty was determined through the FRAIL scale. Results: Of the 201 assessed patients, 49.3% (n=99) w...
Background: Depression is a heavily prevalent mental disorder. Symptoms of depression extend beyo... more Background: Depression is a heavily prevalent mental disorder. Symptoms of depression extend beyond mood, cognition, and behavior to include a spectrum of somatic manifestations in all organic systems. Changes in sleep and neuroendocrine rhythms are especially prominent, and disruptions of circadian rhythms have been closely related to the neurobiology of depression. With the advent of increased research in chronobiology, various pathophysiologic mechanisms have been proposed, including anomalies of sleep architecture, the effects of clock gene polymorphisms in monoamine metabolism, and the deleterious impact of social zeitgebers. The identification of these chronodisruptions has propelled the emergence of several chronotherapeutic strategies, both pharmacological and non-pharmacological, with varying degrees of clinical evidence. Methods: The fundamental objective of this review is to integrate current knowledge about the role of chronobiology and depression and to summarize the in...
Arterial hypertension is the most prevalent chronic disease in the adult population of developed ... more Arterial hypertension is the most prevalent chronic disease in the adult population of developed countries and it constitutes a significant risk factor in the development of cardiovascular disease, contributing to the emergence of many comorbidities, among which heart failure excels, a clinical syndrome that nowadays represents a major health problem with uncountable hospitalizations and the indolent course of which progressively worsens until quality of life decreases and lastly death occurs prematurely. In the light of this growing menace, each day more efforts are invested in the field of cardiovascular pharmacology, searching for new therapeutic options that allow us to modulate the physiological systems that appear among these pathologies. Therefore, in the later years, the study of natriuretic peptides has become so relevant, which mediate beneficial effects at the cardiovascular level such as diuresis, natriuresis, and decreasing cardiac remodeling; their metabolism is mediat...
Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of... more Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela. The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined. Of the evaluated population, 55.2% were female, 34.8% had a coronary ri...
Subclinical hypothyroidism (ScH) is an endocrine alteration that is related to cardiovascular ris... more Subclinical hypothyroidism (ScH) is an endocrine alteration that is related to cardiovascular risk factors, including those categorized as components of the Metabolic Syndrome (MS). However, findings in prior reports regarding an association between these alterations are inconsistent. The purpose of this study was to determine the relationship between both entities in adult subjects from Maracaibo City, Venezuela. The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multistage sampling. In this substudy, 391 individuals of both genders were selected and TSH, free T3, and free T4 tests were performed as well as a complete lipid profile, fasting glycaemia, and insulin blood values. ScH was defined according to the National Health and Nutrition Examination Survey (NHANES) criteria: high TSH (≥4.12mUI/L) and normal free T4 (0.9-1,9 ng/dL) in subjects without personal history of thyroid disease. MS components were defined accordin...
Data mining consists of using large database analysis to detect patterns, relationships and model... more Data mining consists of using large database analysis to detect patterns, relationships and models in order to describe (or even predict) the appearance of a future event; to accomplish this, it uses classification methods, rules of association, regression patterns, link and cluster analyses. Recently this approach has been used to propose a new diabetes mellitus classification, using information analysis techniques through which the selection bias minimally influences categorization, this new focus that includes data mining previously implemented to predict, identify biomarkers, complications, therapies, health policies, genetic and environmental effects of this disease; it could be generalized in the field of endocrinology, in the classification of other endocrine diseases.
Background and Aim. Insulin resistance (IR) is a prominent pathophysiologic component in a myriad... more Background and Aim. Insulin resistance (IR) is a prominent pathophysiologic component in a myriad of metabolic disorders, including obesity, prediabetes, and type 2 diabetes mellitus, which are common in our locality. The objective of this study was to determine the prevalence of IR and factors associated with this condition in an adult population from Maracaibo city, Venezuela.Methodology. A cross-sectional, descriptive study with multistaged randomized sampling was carried out in 2026 adults. IR was defined as HOMA2-IR ≥ 2. A multiple logistic regression model was constructed in order to evaluate factors associated with IR.Results. The prevalence of IR was 46.5% (n=943), with 46.7% (n=450) in the general population, 46.4% (n=493) in females, and 47.90% (n=970) in males (p=0.895). IR prevalence tended to increase with age and was significantly greater in subjects aged ≥30 years (χ2=16.726;p=2.33×10-4). Employment, alcohol consumption, obesity, high triacylglycerides, low HDL-C, and...
Cardiovascular disease (CVD) is a global epidemic, currently representing the worldwide leading c... more Cardiovascular disease (CVD) is a global epidemic, currently representing the worldwide leading cause of morbidity and mortality. Atherosclerosis is the fundamental pathophysiologic component of CVD, where the immune system plays an essential role. Monocytes and macrophages are key mediators in this aspect: due to their heterogeneity and plasticity, these cells may act as either pro- or anti-inflammatory mediators. Indeed, monocytes may develop heterogeneous functional phenotypes depending on the predominating pro- or anti-inflammatory microenvironment within the lesion, resulting in classic, intermediate, and non-classic monocytes, each with strikingly differing features. Similarly, macrophages may also adopt heterogeneous profiles being mainly M1 and M2, the former showing a proinflammatory profile while the latter demonstrates anti-inflammatory traits; they are further subdivided in several subtypes with more specialized functions. Furthermore, macrophages may display plasticity ...
Introducción: La automedicación y la polifarmacia son los principales patrones de consumo de medi... more Introducción: La automedicación y la polifarmacia son los principales patrones de consumo de medicamentos dentro del uso irracional de fármacos. Ambas prácticas se han con-vertido en un problema de salud a nivel mundial, constitu-yendo un potencial riesgo para los sujetos que las practican. El objetivo de esta investigación es estimar la frecuencia y describir los principales factores asociados a la automedica-ción y polifarmacia en individuos adultos del sector Dalia de Fernández, municipio San Francisco, estado Zulia. Materiales y Métodos: Se realizó un estudio descriptivo no experimental, aleatorio y transversal en 102 individuos de ambos sexos mayores de 30 años, mediante un muestreo por conglomerados monoetápico. Se excluyeron individuos cuya entrevista fuera aplicada cercano a farmacias y con-sultorios médicos, así como pacientes embarazadas. Para el análisis estadístico las variables cualitativas fueron expre-sadas como frecuencias absolutas y relativas, empleando la prueba C...
Introduction. The purpose of this study was to analyze the influence of metabolic phenotypes duri... more Introduction. The purpose of this study was to analyze the influence of metabolic phenotypes during the construction of ROC curves for waist circumference (WC) cutpoint selection.Materials and Methods. A total of 1,902 subjects of both genders were selected from the Maracaibo City Metabolic Syndrome Prevalence Study database. Two-Step Cluster Analysis (TSCA) was applied to select metabolically healthy and sick men and women. ROC curves were constructed to determine WC cutoff points by gender.Results. Through TSCA, metabolic phenotype predictive variables were selected: HOMA2-IR and HOMA2-βcell for women and HOMA2-IR, HOMA2-βcell, and TAG for men. Subjects were classified as healthy normal weight, metabolically obese normal weight, healthy and metabolically disturbed overweight, and healthy and metabolically disturbed obese. Final WC cutpoints were 91.50 cm for women (93.4% sensitivity, 93.7% specificity) and 98.15 cm for men (96% sensitivity, 99.5% specificity).Conclusions. TSCA in ...
An important etiopathogenic component of cardiovascular disease is atherosclerosis, with inflamma... more An important etiopathogenic component of cardiovascular disease is atherosclerosis, with inflammation being an essential event in the pathophysiology of all clinical pictures it comprises. In recent years, several molecules implicated in this process have been studied in order to assess cardiovascular risk in both primary and secondary prevention. C-reactive protein is a plasmatic protein of the pentraxin family and an acute phase reactant, very useful as a general inflammation marker. Currently, it is one of the most profoundly researched molecules in the cardiovascular field, yet its clinical applicability regarding cardiovascular risk remains an object of discussion, considered by some as a simple marker and by others as a true risk factor. In this sense, numerous studies propose its utilization as a predictor of cardiovascular risk through the use of high-sensitivity quantification methods for the detection of values <1 mg/L, following strict international guidelines. Increas...
Context and Objective. The purpose of this study was to determine optimal waist circumference (WC... more Context and Objective. The purpose of this study was to determine optimal waist circumference (WC) cut-off values for the detection of multiple risk factor aggregation in individuals from Maracaibo, Venezuela.Participants and Methods. A total of 1,902 adult individuals of both genders belonging to MMSPS were included. Complete physical, laboratory, and anthropometric examination were done to evaluate Metabolic Syndrome (MS) components and insulin resistance. ROC curves were plotted for risk factor aggregation in order to assess WC cut-off point. Logistic regression models were constructed to assess risk factors associated with the WC.Results. There were 52.2% females and 47.8% males, with WC of90.7±13.7 cm and98.2±15.9 cm, respectively. ROC curves exhibited a WC cut-off point for women of 90.25 cm (68.4% sensitivity, 65.8% specificity) and 95.15 cm (71.1% sensitivity, 67.4% specificity) for men. HOMA2-IR and high blood pressure were associated with a WC over these cut-off points, as...
Osteoarthritis is a chronic degenerative disorder that currently represents one of the main cause... more Osteoarthritis is a chronic degenerative disorder that currently represents one of the main causes of disability within the elderly population and an important presenting complaint overall. The pathophysiologic basis of osteoarthritis entails a complex group of interactions among biochemical and mechanical factors that have been better characterized in light of a recent spike in research on the subject. This has led to an ongoing search for ideal therapeutic management schemes for these patients, where glucosamine is one of the most frequently used alternatives worldwide due to their chondroprotective properties and their long-term effects. Its use in the treatment of osteoarthritis is well established; yet despite being considered effective by many research groups, controversy surrounds their true effectiveness. This situation stems from several methodological aspects which hinder appropriate data analysis and comparison in this context, particularly regarding objectives and target...
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