Stress granules in the viral replication cycle

As intracellular parasites, viruses require a host cell in order to replicate. However, they face a series of cellular responses against infection. One of these responses is the activation of the double-stranded RNA (dsRNA)-activated protein kinase R (PKR). PKR phosphorylates the α subunit of eukaryotic translation initiation factor 2 (eIF2α), which in turn results in global protein synthesis inhibition and formation of stress granules (SGs). Recent studies have shown that SGs can interfere with the replicative cycle of certain viruses. This review addresses how viruses have evolved different control strategies at the SG level to ensure an efficient replication cycle during the cellular stress response triggered by the viral infection.     

Self-rated health and mortality: a follow-up study of a Spanish population

Objectives

Self-rated health (SRH) is known to be a valid indicator for the prediction of health outcomes. The aims of this study were to describe and analyse the associations between SRH and health status, socio-economic and demographic characteristics; and between SRH and mortality in a Spanish population.

Study design

Longitudinal study.

Methods

A sample of 5275 adults (age ≥21 years) residing in the Valencian Community (Spanish Mediterranean region) was surveyed in 2005 and followed for four years. SRH was categorized into good and poor health. The response variable was mortality (dead/alive), obtained from the local mortality register. Logistic regression models were adjusted in order to analyse the associations between SRH and health status, socio-economic and demographic characteristics; odds ratios were calculated to measure the associations. Poisson regression models were adjusted in order to analyse the associations between mortality and explanatory variables; the relative risk of death was calculated to measure the associations.

Results

Poor SRH was reported by 25.9% of respondents, and the mortality rate after four years of follow-up was 3.6%. An association was found between SRH and the presence of chronic disease and disability in men and women. A perception of poor health vs good health led to a mortality risk of 3.0 in men and 2.7 in women. SRH was predictive of mortality, even after adjusting for all other variables. In men and women, the presence of disability provided additional predictive ability.

Conclusions

SRH was predictive of mortality in both men and women, and acted as a mediator between socio-economic, demographic and health conditions and mortality.     

Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure<140/90 mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is<130/80 mmHg. Serum cholesterol should be<200 mg/dl and cLDL<130 mg/dl, although in patients with CVD or diabetes, the objective is<100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin<7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.     

The role of C-reactive protein as a marker for cardiovascular risk associated with antiretroviral therapy in HIV-infected patients

C-reactive protein (CRP) has been associated with prognosis of HIV-infection, but its relationship with cardiovascular disease remains unknown. We aimed to evaluate whether CRP may be a marker of cardiovascular risk in HIV-infected patients, and to determine the influence of antiretroviral therapy (ART) on CRP levels. We conducted a cross-sectional study on 245 consecutive HIV-infected patients during a 2-month period. An extensive workup for cardiovascular risk was performed, including determination of CRP levels measured by an ultrasensitive immunoturbidimetric assay (detection limit, 0.003 mg/dl). Ninety-nine (40.4%) patients had serum CRP concentrations above 0.3 mg/dl, considered to represent individuals at high risk for developing cardiovascular complications. In univariate analysis, CRP levels correlated positively with total cholesterol (p=0.01), LDL cholesterol (p=0.001), triglycerides (p=0.04) and Framingham risk score (p=0.006), and negatively with HDL cholesterol (p=0.004). Concentrations of CRP were higher in males (p=0.05) and smokers (p=0.002). No correlation was found between CRP levels and HIV-viral load or CD4 cell counts. In multivariate analysis, independent factors associated with the highest quartile of serum CRP concentrations (0.49 mg/dl) were LDL-cholesterol (p<0.001), HDL-cholesterol (p=0.001), cigarette smoking (p=0.019) and current ART (p=0.021). Our results show that C-reactive protein is associated with traditional cardiovascular risk factors, and may then be a marker for cardiovascular risk linked to HIV infection and ART.     

Two exceptional cases of pancreatic tumor

Pancreatic cancer carries a poor prognosis. The only potentially curative treatment is surgical resection. However, this procedure can only be performed in a few cases due to presentation of the tumor in advanced stages. We present 2 exceptional cases of pancreatic cancer presentation. Case 1: A 59-year-old man presented with recurrent melena despite endoscopic sclerosis of a duodenal ulcer. A computed tomography (CT) scan revealed a 7-cm mass in the head of the pancreas infiltrating the second portion of the duodenum. Duodenal biopsy showed a poorly differentiated carcinoma. Palliative pancreatoduodenectomy was performed. Case 2: A 49-year-old man presented with sporadic pain in the right hypochondrium and a familial history of pancreatic cancer in first and second degree relatives. CT and magnetic resonance imaging revealed a 1-cm cystic lesion in the head of the pancreas. Cytology showed mucoid material and atypia. Given a probable diagnosis of mucinous cystoadenoma, pancreatoduodenectomy was performed.     

The Relationship Between Reproductive Work and Sociodemographic and Psychosocial Factors in Regard to Psychological Distress in Men and Women in Spain

Studies have shown that some sociodemographic factors, such as marital status, employment status or social class, can affect mental health in different ways for each gender. However, up until now, few research projects have tried to ascertain if the role that reproductive work or psychosocial factors play in mental health is different for men and women. The aim of this study is to assess the differences between men and women in terms of how reproductive work, sociodemographic and psychosocial factors are linked to psychological distress in Spain. A cross-sectional study of 29,478 male and female adults using data gathered for the Spanish National Health Survey 2006 was carried out. Psychological distress was measured using the GHQ-12. The independent variables analyzed were: sociodemographic, psychosocial (family functionality and functional social support) and those related to reproductive work (living with or being in charge of different types of people needing care and number of hours devoted to caregiver tasks). Different independent logistic regression models were developed for men and women. In general, with the exception of men who were more prone to psychological distress if they were signed off work for 3 months or more, no major differences were observed regarding the effect of sociodemographic and psychosocial characteristics on psychological distress. With regard to reproductive work, the likelihood of psychological distress doubles in both sexes when the person lives with someone who needs care. In women, a greater number of hours devoted to caring for another person is associated with an increase in distress. Men play a less frequent role in caregiving, but the impact on psychological distress is similar to that in women. Women experienced more psychological distress when they had to live with or be in charge of a disabled person or different types of persons needing care, while men were not affected by this. Major differences have been identified in terms of psychological distress in women and men in several aspects of reproductive work to date unexplored.     

Cardiac asystole during a temporal lobe seizure

The association between temporal lobe seizures and cardiac arrhythmias has been anecdotally reported in the literature. Ictal bradycardia and cardiac asystole are rare, and maybe underestimated. The physiological mechanism is poorly understood. We report a patient with left temporal lobe seizures who developed ictal bradycardia and cardiac asystole during a complex partial seizure and required a subsequent placement of a pacemaker.     

Women's satisfaction with the experience of childbirth: validation of the Mackey Childbirth Satisfaction Rating Scale

Objectives

To determine the reliability and the content and construct validity of the Mackey Childbirth Satisfaction Rating Scale to measure women's satisfaction with labor and delivery.

Methods

The translation-back translation method was used to obtain an adapted version of the scale. For the validation study, a sample of 325 women who had delivered a healthy neonate through the vaginal route was selected. Data collection was performed using a self-administered questionnaire that included the modified scale, childbirth expectations, obstetric variables and sociodemographic characteristics. Reliability was assessed in a subsample of 45 women who completed the scale for the second time 15-30 days later. The factorial structure and internal consistency of the scale were analyzed. Construct validity was evaluated by analyzing the relationship between satisfaction with the experience, fulfillment of expectations and preferences regarding pain management.

Results

In the test-retest study, an intraclass correlation coefficient of 0.93 was obtained for the total scale. Factor analysis identified six factors that explained 69.42% of the variance. Cronbach's alpha coefficient was 0.94 for the total scale, ranging from 0.72 to 0.96 for the subscales. Satisfaction with the experience of childbirth was higher among women whose expectations were met and among those who accessed the pain relief method chosen.

Conclusions

This scale is a useful instrument to measure women's satisfaction with the experience of childbirth, adapted to our context and with good psychometric properties.