Influence of the degree of adherence to the Mediterranean diet on the cardiometabolic risk in peri and menopausal women. The Flamenco project.

BACKGROUND AND AIMS: The Mediterranean diet (MD) has been associated with reduced morbidity from cardiovascular diseases in the general population. The aim of this study was to assess whether different degrees of adherence to the MD were associated with the cardiometabolic risk in peri and menopausal women. METHODS AND RESULTS: This cross-sectional study included 198 peri and menopausal women participating in the Flamenco project. Validated questionnaires were used to assess menopause health-related quality of life and degree of adherence to the MD (low, medium and high). The following cardiometabolic risk factors were assessed: fat mass percentage, waist circumference, blood pressure and resting heart rate, plasma markers (total cholesterol, high and low-density lipoprotein cholesterol [HDL-C and LDL-C, respectively], total cholesterol/HDL ratio, triglycerides, C-reactive protein and fasting glucose), Physical activity levels and smoking status. The degree of adherence to the MD among the study sample was 27%, 40% and 30% for low, medium and high adherence, respectively. After controlling for potential confounders, women with a high adherence to the MD showed lower plasma total cholesterol (p = 0.025), resting heart rate (p = 0.005), LDL-C (p = 0.019), triglycerides (p = 0.046) and C-reactive protein (p = 0.009) compared to those with a low adherence. Likewise women with high adherence to the MD showed lower total cholesterol/HDL-C ratio (p = 0.020) compared to those with a medium adherence. The high MD adherence group also showed lower clustered cardiometabolic risk (p = 0.004). Moreover, when analysing specific MD components, whole grain cereals, pulses (both p < 0.05) and red wine (p < 0.01) consumption were inversely associated with the clustered cardiometabolic risk. CONCLUSION: The present findings suggest that a high but not medium adherence to the MD is associated with a cardioprotective effect in peri and menopausal women. As a low percentage of the sample showed a high adherence to the MD, future research aimed at increasing the adherence to this dietary pattern for a better cardiometabolic status during peri and menopause is warranted.

[Venous thromboembolism prevention in pregnancy and the postpartum period in Primary and Specialized Care]. / Prevención del tromboembolismo venoso durante el embarazo y el puerperio en Atención Primaria y Especializada.

After noting that there are a number of risk factors for venous thromboembolism disease during pregnancy, it emphasizes primary prevention and treatment of this serious condition during pregnancy and the postpartum period are essential to reduce maternal morbidity and mortality. Low molecular-weight heparins are under the anticoagulant of choice in pregnancy. Your prescription may make both the primary care physician, as the hematologist and obstetrician. As for prescribing terms, an application protocol in both primary and specialized, multidisciplinary care, based on the existing literature on the subject is presented, which indicated that the hypercoagulable disorders associated with some of the risk factors, forced to do thromboprophylaxis with low molecular-weight heparins throughout pregnancy and the postpartum period presented.

[Low back pain during pregnancy. Multidisciplinary approach]. / Lumbalgia durante el embarazo. Abordaje multidisciplinar.

After explaining that low back pain is considered the most common pregnancy complication, its pathogenesis, risk factors and the clinical characteristics of the very painful symptoms of this condition are described. As for its approach, it is stressed that it must be multidisciplinary, introducing very important preventive measures, including proper postural hygiene. For its treatment, the methods may be based on non-surgical or pharmacological interventions of a conservative non-invasive nature. Thus, physiotherapy, osteopathic manipulation, multimodal intervention (exercise and education), exercises performed in water environment, acupuncture, etc., have proven to be effective. Finally, it is emphasised that given the significant impact on their quality of life, different health professionals must be proactive and treat the lumbar disease in pregnant women.

Endocrinopatías durante el puerperio. Manejo / Endocrinopathies during the postpartum period. Management

Se describen las distintas endocrinopatías que pueden aparecer durante el puerperio. La más importante y frecuente es la diabetes, gestacional y pregestacional, pero también se mencionan otras menos frecuentes, pero muy importantes, como son el hipopituitarismo (síndrome de Sheehan e hipofisitis linfocitaria) y las alteraciones tiroideas, preexistentes (hipertiroidismo e hipotiroidismo) o de aparición durante el posparto (tiroiditis posparto y enfermedad de Graves). Tras describir las características de las mismas, se hace hincapié en el adecuado manejo de estas afecciones endocrinas, algunas de ellas de aparición exclusiva durante el puerperio (AU)

The various endocrinopathies that may occur during the postpartum period are described. The most important and common is gestational and pre-gestational diabetes, but other less common, and also very important ones, are mentioned such as hypopituitarism (Sheehan’s syndrome and lymphocytic hypophysitis) and thyroid disorders, pre-existing (hyperthyroidism and hypothyroidism), or postpartum onset (postpartum thyroiditis and Graves’ disease). After describing their characteristics, the emphasis is placed on the proper management of these endocrine diseases, some of them which exclusively appear during the postpartum period (AU)

[Endocrinopathies during the postpartum period. Management]. / Endocrinopatías durante el puerperio. Manejo.

The various endocrinopathies that may occur during the postpartum period are described. The most important and common is gestational and pre-gestational diabetes, but other less common, and also very important ones, are mentioned such as hypopituitarism (Sheehan's syndrome and lymphocytic hypophysitis) and thyroid disorders, pre-existing (hyperthyroidism and hypothyroidism), or postpartum onset (postpartum thyroiditis and Graves' disease). After describing their characteristics, the emphasis is placed on the proper management of these endocrine diseases, some of them which exclusively appear during the postpartum period.

Día de análisis en Granada de la hipertensiónarterial. Estudio DAGA / The DAGA study: full-day blood pressure analysis in Granada

Objetivo. Conocer el grado de control de la presión arterial (PA) (óptimo<=140/90 mmHg; subóptimo 140/90 mmHg) en hipertensos que acuden a los centros de Atención Primaria en Granada durante el día 24 de noviembre de 1999.Diseño. Estudio observacional, descriptivo y transversal. Ámbito del estudio. Centros de Atención Primaria del área de Granada. Sujetos. Pacientes ambulatorios de ambos sexos, diagnosticados de hipertensión arterial, que acuden a la consulta de Atención Primaria el día 24 de noviembre de 1999.Mediciones. Análisis descriptivo de las diferentes variables del estudio: datos demográficos, motivo de la consulta, anamnesis, exploración física, analítica, tratamientos concomitantes, intervención propuesta tras la visita. Resultados. Se consiguió una muestra de 627 pacientes hipertensos. La edad media fue de 63,8 años (DE ñ 10,6), siendo el rango de edades entre 27 y 90 años. El 37,3 por ciento eran hombres y el 62,7 por ciento mujeres. En la primera medición se obtienen valores medios de PA sistólica (PAS) de 149 mmHg y PA diastólica (PAD) de 85,7 mmHg. En la segunda medición (tras 5 minutos de reposo) la PAS fue de 147 mmHg y la PAD de 84 mmHg, siendo estas diferencias estadísticamente significativas (p<0,001). Distribución del tratamiento antihipertensivo: inhibidores de la enzima de conversión de la angiotensina (IECA), 40,1 por ciento; diuréticos, 6,9 por ciento; calcioantagonistas, 16,5 por ciento; betabloqueantes, 3,4 por ciento; alfabloqueantes, 2,1 por ciento y terapia combinada, 31,1 por ciento. Cumplimiento: el 59,2 por ciento afirmaba seguir correctamente el tratamiento antihipertensivo. Según los valores finales de PA, encontramos un 17,9 por ciento de control óptimo y un 30,3 por ciento de control subóptimo. Conclusiones. Los niveles de control de la PA alcanzado en nuestro estudio concuerdan con los obtenidos en otros estudios, nacionales y no nacionales de características similares (AU)