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Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing [SEDEN]), along with the methodological support of the Cochrane Center, has updated the Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain a similar structure, in that they review the evidence without compromising the educational aspects. However, on one hand, they provide an update to methodology development following the guidelines of the GRADE system in order to translate this systematic review of evidence into recommendations that facilitate decision-making in routine clinical practice, and, on the other hand, the guidelines establish quality indicators which make it possible to monitor the quality of healthcare.

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The present results suggest that an anaerobic metabolic state may be favored further to reduce the expression of cytoskeleton-related proteins. The better knowledge of molecular mechanism involved in AAAs may favor development of new clinical strategies.

FXa inhibition by rivaroxaban exerted anti-inflammatory and antioxidative stress properties in human AAA sites, suggesting a role of FXa in these mechanisms associated with the pathogenesis of AAA.

Abstract-Sexual dimorphism in blood pressure (BP) regulation has been observed both in humans and experimental animals, and estrogens have been shown to contribute to this epidemiological observation. A key enzyme in determining estrogen levels is aromatase cytochrome P450. The aim of this study was to evaluate the role of the gene encoding aromatase, CYP19A1, as an independent risk factor for hypertension and its relationship with systolic and diastolic BP measures. We genotyped 2 polymorphisms within the CYP19A1 gene, IVS4 rs11575899 and 3ЈUTR rs10046, in 3448 individuals. In quantitative analysis, we observed significant associations between the 2 polymorphisms and BP values in women, being these associations dependent on BMI and independent of menopause status. The case-control analysis revealed that the most prominent associations were found for nonobese women in diastolic hypertension (DHT) Key Words: essential hypertension Ⅲ body mass index Ⅲ polymorphism Ⅲ genetics Ⅲ estrogens Ⅲ gender E ssential hypertension (EH) is the most common cardiovascular disease, with a prevalence of nearly 27% worldwide. 1 EH is a major risk factor for stroke, heart disease, and end-stage renal disease. High arterial blood pressure is a complex and multifactorial disorder that results from the interaction of multiple genetic and environmental influences. 2 Genetic factors account for 30% to 50% of interindividual variability in blood pressure (BP), [3][4][5] and there is evidence suggesting that each of the polygenes contributing to hypertension has only a modest effect.Sexual dimorphism in the regulation of BP has been demonstrated in several population studies 3,6 and in experimental animal models. 7 Age-adjusted BP is consistently higher in men than women, but these differences are attenuated when women enter menopause. 8 These findings suggest the presence of distinct mechanisms of BP regulation in males and females, emphasizing the importance of the sex hormonal levels in determining BP. Thus, genes involved in testosterone-estradiol shunt are strong candidates to explain, at least in part, the genetic influence on hypertension. The aromatase cytochrome P450 is the enzyme responsible for catalyzing the final step of conversion of androgens into estrogens. 9 The importance of this enzyme in BP regulation has been highlighted in animal studies. Aromatase inhibitors have antihypertensive effects in rats with genetic and experimental hypertension. 10,11 Thus, genetic variations in CYP19A1, the gene encoding aromatase, might contribute to alterations in aromatase expression and enzyme activity,

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