BackgroundChronic obstructive pulmonary disease (COPD) is frequent and often coexists with other diseases. The aim of this study was to quantify the prevalence of COPD and related chronic comorbidity among patients aged over 40 years visiting family practices in an area of Madrid.MethodsAn observational, descriptive, cross-sectional study was conducted in a health area of the Madrid Autonomous Region (Comunidad Autónoma de Madrid). The practice population totalled 198,670 persons attended by 129 Family Physicians (FPs), and the study population was made up of persons over the age of 40 years drawn from this practice population. Patients were deemed to have COPD if this diagnosis appeared on their clinical histories. Prevalence of COPD; prevalence of a further 25 chronic diseases in patients with COPD; and standardised prevalence ratios, were calculated.ResultsPrevalence of COPD in family medicine was 3.2% (95% CI 3.0–3.3) overall, 5.3% among men and 1.4% among women; 90% of patients presented with comorbidity, with a mean of 4 ± 2.04 chronic diseases per patient, with the most prevalent related diseases being arterial hypertension (52%), disorders of lipid metabolism (34%), obesity (25%), diabetes (20%) and arrhythmia (15%). After controlling for age and sex, the observed prevalence of the following ten chronic diseases was higher than expected: heart failure; chronic liver disease; asthma; generalised artherosclerosis; osteoporosis; ischaemic heart disease; thyroid disease; anxiety/depression; arrhythmia; and obesity.ConclusionsPatients with COPD, who are frequent in family practice, have a complex profile and pose a clinical and organisational challenge to FPs.
The ovaries' innervation arrives via the superior ovarian nerve, which originates from the celiac ganglion. Using True Blue as an antidromic marker, the present study analyzed the changes in the anatomical relation between each ovary and the prevertebral celiac-superior mesenteric ganglia during the estrous cycle. The number of labeled neurons increased from the day of diestrus 1 to the day of proestrus. The largest number of labeled cells was observed when tracer was injected into the left ovary on proestrus. The number of labeled cells was significantly higher when the tracer was injected into the left ovary on proestrus than when it was done in the right one. When tracer was injected into the left ovary, the average labeled area of cells increased significantly from diestrus 1 to proestrus, and declined at estrus. In contrast, when True Blue was injected into the right ovary, the average labeled area was similar in diestrus 1 and diestrus 2, and the values increased in proestrus and estrus. The results indicate an apparent asymmetry in the activity of neural connections between ovaries and the prevertebral celiac-superior mesenteric ganglia, and that the number of active neurons of these connections varies during the estrous cycle.
The modulating effects of ovarian innervation reaching the ovary through the suspensory ovarian nerve on the reactivity of the ovaries to gonadotrophins were analysed. Juvenile rats (32 days old), with or without unilateral or bilateral section of the superior ovarian nerve, were injected with 8 iu of pregnant mare serum gonadotrophin (PMSG), 10 iu of human chorionic gonadotrophin (hCG) or with 8 iu of PMSG followed 56 h later with 10 iu of hCG. Treatments were given immediately after surgery or 4 days later, and the rats were killed on the day of first vaginal oestrus. In rats with unilateral section, treatment with PMSG did not induce full ovulatory response by the denervated ovary whether the treatment was applied immediately or 4 days after surgery (0/11 rats treated immediately ovulated vs 5/5 (sham) and 11/12 (control, P<0·05 Fisher's exact probability test), and 4/19 did when treatment was done 4 days after surgery vs 8/10 (sham) and 11/12 (control, P<0·05). The rats with bilateral section receiving the same hormonal treatment, PMSG administration, ovulated. The number of ova shed by the left ovary was similar to those of the control, while the right ovary released fewer ova. Stimulation with hCG immediately after unilateral section did not induce ovulation in normal or denervated ovary. When the treatment was applied 4 days after surgery, ovulation was observed only in the innervated ovary. In the rats with bilateral section, hCG injection induced ovulation in both ovaries. In those rats with unilateral section of the superior ovarian nerve, the treatment with PMSG+hCG given immediately after surgery resulted in a compensatory ovulation by the innervated ovary (the number of ova shed/ovulating animal was significantly higher than those released by control or sham-operated animals: left section, number of ova shed by the right ovary 7·6 0·3 vs 5·5 0·8 and 4·9 1 respectively, P<0·05; right section, number of ova shed by the left ovary 10·2 0·6 vs 4·4 1·1 and 7·0 0·9, P<0·05), while the denervated one showed a lower ovulation rate as well as a smaller number of ova shed than those by the control animals. When the hormonal replacement was given 4 days after surgery, such compensatory ovulation was observed in the left ovary of those rats with a section of the right nerve (14·3 2·6 vs 4·4 1·1 and 6·5 1·1, P<0·05). When the PMSG+hCG treatment was applied to animals with bilateral section of the superior ovarian nerve, the ovulation rate by the right ovary was significantly lower than in control and sham-operated treated animals (2/10 vs 11/11 and 6/7, P<0·05). Because the ovaries receive innervation through the superior ovarian nerve, the ovarian plexus and the vagus nerve, the results obtained in unilateral denervated animals suggest that the innervation of the ovary via the superior ovarian nerve regulates in a stimulatory way the effects of gonadotrophin resulting in ovulation. The ovulation induced by hormonal treatment of rats with bilateral section of the superior ovarian nerve suggests that the ...
Anterior pituitary (AP) glands were removed from adult female rats at different times throughout the estrous cycle, and the isohormones of follicle-stimulating hormone (FSH) present within them were separated by isoelectric focusing in polyacrylamide gels (PAGE-IEF; pH range 3.0-8.0). Gel eluents were analyzed for FSH content by radioimmunoassay (RIA) and radioreceptor assay (RRA). All AP samples exhibited several peaks of FSH immunoactivity within a pH range of 6.2-4.0; the major peak constantly exhibited an isoelectric point (pI) of 4.9-4.5. To quantify differences in the IEF pattern of AP-FSH between the pituitaries collected during the different days of the cycle, each PAGE-IEF profile was divided into 7 regions (pI 7.0-6.3 = Area 1, 6.2-5.5 = Area 2, 5.4-5.0 = Area 3, 4.9-4.5 = Area 4, 4.4-4.0 = Area 5, 3.9-3.5 = Area 6, and less than 3.5 = Area 7), and the amount of FSH present within each was determined. In all APs collected at 0900 h of diestrus 1 (D1) and 2 (D2), proestrus (P), and estrus (E); at 1300 h of D1, D2 and E; at 2200 h of P; and at 0200 h of E, the majority of FSH immunoactivity (37-55% of total FSH on gel) focused within Area 4, whereas Areas 2 and 3 contained minor amounts of FSH activity (11-26% and 14-24%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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