Javier Jiménez

Effect of apoE genotype on the hypolipidaemic response to pravastatin in an outpatient setting

Abstract. Peña R, Lahoz C, Mostaza JM, Jiménez J, Subirats E, Pintó X, Taboada M, López‐Pastor A, The RAP study group (Hospital Carlos III; Instituto de Salud Carlos III, Madrid; Hospital de Puigcerdá, Gerona; Hospital de Bellvitge, Barcelona; Centro de Salud de Fuencarral; Hospital La Paz, Madrid, Spain). Effect of apoE genotype on the hypolipidaemic response to pravastatin in an outpatient setting. J Intern Med 2002; 251: 518–525.

Apo A-I promoter polymorphism influences basal HDL-cholesterol and its response to pravastatin therapy

Statins decrease cardiovascular morbidity and mortality, essentially, by reducing LDL-cholesterol levels and, additionally, by increasing HDL-cholesterol concentrations. Environmental and genetic factors are known to affect LDL-C response to statins but less is known regarding HDL-C. We have evaluated the lipid and lipoprotein response to 20 mg/day of pravastatin for 16 weeks in relation to the G/A polymorphism in the promoter region of the apo A-I gene in 397 hypercholesterolaemic subjects followed-up on an out-patient basis. In the study population, 61.7% were homozygous for the G allele and 36% were heterozygous. The A allele carriers had an HDL-C 6.5% higher than the G allele homozygotes (P=0.021 in univariate analysis; P=0.009 in multivariate analysis). However, on segregation by gender and smoking status the effect was significant only in non-smoking males. The A allele carriers did not increase their HDL-C concentrations after treatment (-0.3, 95%CI -3.3 to 2.7%) while G allele homozygotes had a 4.9% increase (95%CI 2.5-7.3%). Differences in the response between both groups were significant before (P=0.008) and after adjustment for confounding variables such as age and baseline HDL-C concentration (P=0.046). We conclude that the G/A polymorphism of the apo A-I promoter region affects not only baseline HDL-C concentrations but also its response to pravastatin treatment.

Polimorfismo de la apolipoproteína E y enfermedad coronaria

Fundamento La apolipoproteina E (apo E) desempena un importante papel en el desarrollo de la arteriosclerosis. Esta proteina es polimorfica, habiendose descrito tres alelos codominantes, e2, e3 y e4. En el presente estudio hemos evaluado la asociacion entre el alelo e4 y la presencia de enfermedad coronaria en una muestra de sujetos hipercolesterolemicos procedentes de toda la geografia nacional. Sujetos y metodo Se seleccionaron 389 personas (un 56% de mujeres, con una edad media de 57 anos) con indicacion de tratamiento hipolipemiante tras seguir una dieta pobre en grasas saturadas. La concentracion de lipidos y lipoproteinas y la determinacion del genotipo de apo E fueron realizadas de forma centralizada. Resultados La distribucion por genotipos de la poblacion fue la siguiente: e2/e3, 3%; e3/e3, 75%; e3/e4, 20%; e4/e4, 1%, y e2/e4, 1%. Los sujetos fueron divididos segun poseian (n = 83) o no (n = 303) el alelo e4, siendo excluidos los e2/e4. No existieron diferencias entre ambos grupos en la edad, el sexo, la prevalencia de hipertension arterial o el tabaquismo, ni en la concentracion de lipidos. La prevalencia de enfermedad coronaria fue del 15,7% en los e4 y del 6,9% en los no e4 (OR, 2,49; IC del 95%, 1,19-5,22). En un analisis de regresion logistica multiple, la relacion entre el alelo e4 y la presencia de enfermedad coronaria se mantuvo significativa tras corregir para la edad, el sexo, los factores de riesgo cardiovascular y la concentracion de colesterol total, cHDL y trigliceridos (OR, 2,56; IC del 95%, 1,03-6,39). Conclusion En Espana, los portadores del alelo e4 presentan una prevalencia de enfermedad coronaria mayor que los no e4.

APEINTA: a spanish educational project aiming for inclusive education in and out of the classroom

APEINTA is a Spanish educational project founded by the Spanish Minister of Education and Sciences that aims for inclusive education for every student of all abilities in and out of the classroom. In this work, the APEINTA project is presented

Tablet PC and Head Mounted Display for live closed captioning in education

Automatic Speech Recognition is a powerful tool for inclusive education. Captioning helps disabled students but distract other students. We propose and evaluate the use of Tablets PC and Head Mounted Displays for live closed captioning.

Web educational services for all: the APEINTA project

This paper presents the web-based educational services included in the APEINTA project. The main aim of APEINTA is to avoid barriers among the students and the education. Taking into account the advantage of cloud computing paradigm, the next web-based services are proposed: First, a captioning service, so students with hearing disabilities, for instance, could access to the verbatim speech of the teachers, even in a remote location; Second, a text-to-speech service, so students with speaking problems could participate in the class or in oral discussions or meetings, for instance, just writing in their personal devices; Third, a web-based educational system, so every student can access the pedagogical resources with time and location independency.

Avoiding communication barriers in the classroom: the APEINTA project

Education is a fundamental human right, however unfortunately not everybody has the same learning opportunities. For instance, if a student has hearing impairments, s/he could face communications barriers in the classroom, which could affect his/her learning process. APEINTA is a Spanish educational project that aims for inclusive education for all. This project proposes two main accessible initiatives: (1) real-time captioning and text-to-speech (TTS) services in the classroom and (2) accessible Web-learning platform out of the classroom with accessible digital resources. This paper presents the inclusive initiatives of APEINTA. Also an evaluation of the into-the-classroom initiative (real-time captioning and TTS services) is presented. This evaluation has been conducted during a regular undergraduate course at a university and during a seminar at an integration school for deaf children. Forty-five hearing students, 1 foreign student, 3 experts in captioning, usability and accessibility, and 20 students with hearing impairments evaluated these services in the classroom. Evaluation results show that these initiatives are adequate to be used in the classroom and that students are satisfied with them.

Supporting Teachers to Automatically Build Accessible Pedagogical Resources: The APEINTA Project

Most of the universities in Europe have started their process of adaptation towards a common educational space according to the European Higher Education Area (EHEA). The social dimension of the Bologna Process is a constituent part of the EHEA and it is a necessary condition for the attractiveness and competitiveness of the EHEA. Two of the main features of the social dimension are the equal access for all the students and the lifelong learning. One of the main problems of the adaptation process to the EHEA is that the teachers have no previous references and models to develop new pedagogical experiences accessible to all the students, nevertheless of their abilities, capabilities or accessibility characteristics. The APEINTA project presented in this paper can be used as a helpful tool for teachers in order to cope with the teaching demands of EHEA, helping the teachers to automatically build accessible pedagogical resources even when the teachers are not accessibility experts. This educational project has been successfully used in 2009 in two different degrees at the Carlos III University of Madrid: Computer Science and Library and Information Science.