Población y metodología del estudio SIMETAP: Prevalencia de factores de riesgo cardiovascular, enfermedades cardiovasculares y enfermedades metabólicas relacionadas / Population and methodology of the SIMETAP study: Prevalence of cardiovascular risk factors, cardiovascular diseases, and related metabolic diseases

La prevención de la enfermedad cardiovascular se fundamenta en la detección y control de los factores de riesgo cardiovascular (FRCV). En España existen importantes diferencias territoriales tanto en la prevalencia como en el grado de control de los FRCV. En la última década ha habido una mejora del control de la hipertensión y la dislipidemia, pero un empeoramiento de los factores de riesgo cardiometabólicos relacionados con la obesidad y la diabetes. El estudio SIMETAP es un estudio observacional descriptivo transversal realizado en 64 centros de atención primaria de la Comunidad de Madrid. El objetivo principal es determinar las tasas de prevalencia de FRCV, de las enfermedades cardiovasculares y de las enfermedades metabólicas relacionadas con el riesgo cardiovascular. El presente artículo informa sobre las características basales de la población, la metodología del estudio, y las definiciones de los parámetros y enfermedades en estudio. Se seleccionaron 6.631 sujetos de estudio mediante una muestra aleatoria base poblacional. Se determinaron variables antropométricas, estilos de vida, presión arterial, parámetros bioquímicos, y tratamientos farmacológicos. Las prevalencias crudas más elevadas se detectaron en tabaquismo, inactividad física, obesidad, prediabetes, diabetes, hipertensión, dislipidemias y síndrome metabólico. Para valorar la verdadera dimensión epidemiológica de estas enfermedades y FRCV, es necesario realizar un análisis pormenorizado de tasas de prevalencia estratificadas por grupos etarios y de las tasas de prevalencia ajustadas por edad y sexo

The prevention of cardiovascular disease is based on the detection and control of cardiovascular risk factors (CVRF). In Spain there are important geographical differences both in the prevalence and in the level of control of the CVRF. In the last decade there has been an improvement in the control of hypertension and dyslipidaemia, but a worsening of cardio-metabolic risk factors related to obesity and diabetes. The SIMETAP study is a cross-sectional descriptive, observational study being conducted in 64 Primary Care Centres located at the Community of Madrid. The main objective is to determine the prevalence rates of CVRF, cardiovascular diseases, and metabolic diseases related to cardiovascular risk. A report is presented on the baseline characteristics of the population, the study methodology, and the definitions of the parameters and diseases under study. A total of 6,631 study subjects were selected using a population-based random sample. The anthropometric variables, lifestyles, blood pressure, biochemical parameters, and pharmacological treatments were determined. The highest crude prevalences were detected in smoking, physical inactivity, obesity, prediabetes, diabetes, hypertension, dyslipidaemias, and metabolic syndrome. A detailed analysis needs to be performed on the prevalence rates, stratified by age groups, and prevalence rates adjusted for age and sex to assess the true epidemiological dimension of these CVRF and diseases

Population and methodology of the SIMETAP study: Prevalence of cardiovascular risk factors, cardiovascular diseases, and related metabolic diseases. / Población y metodología del estudio SIMETAP: Prevalencia de factores de riesgo cardiovascular, enfermedades cardiovasculares y enfermedades metabólicas relacionadas.

The prevention of cardiovascular disease is based on the detection and control of cardiovascular risk factors (CVRF). In Spain there are important geographical differences both in the prevalence and in the level of control of the CVRF. In the last decade there has been an improvement in the control of hypertension and dyslipidaemia, but a worsening of cardio-metabolic risk factors related to obesity and diabetes. The SIMETAP study is a cross-sectional descriptive, observational study being conducted in 64 Primary Care Centres located at the Community of Madrid. The main objective is to determine the prevalence rates of CVRF, cardiovascular diseases, and metabolic diseases related to cardiovascular risk. A report is presented on the baseline characteristics of the population, the study methodology, and the definitions of the parameters and diseases under study. A total of 6,631 study subjects were selected using a population-based random sample. The anthropometric variables, lifestyles, blood pressure, biochemical parameters, and pharmacological treatments were determined. The highest crude prevalences were detected in smoking, physical inactivity, obesity, prediabetes, diabetes, hypertension, dyslipidaemias, and metabolic syndrome. A detailed analysis needs to be performed on the prevalence rates, stratified by age groups, and prevalence rates adjusted for age and sex to assess the true epidemiological dimension of these CVRF and diseases.

Effect of process technology on the nutritional, functional, and physical quality of grapefruit powder.

The health properties of fruit are widely known. Powdered fruit may be a practical format to be offered to the consumer. Nevertheless, the process used to obtain the powder must ensure the maximum retention of the bioactive compounds and the functional value of the fruit while retaining adequate physical properties. The aim of this study was to compare freeze-drying and spray drying as the drying technologies to obtain grapefruit powder. The obtained results allow freeze-drying to be proposed as a better technology than spray drying in order to obtain a product with a higher content of vitamin C and total carotenoids. Moreover, all of the edible part of the fruit is used in this case, so a greater quantity of healthy compounds is preserved and by-product generation is avoided. Adding about 6 g water, 4 g Arabic gum and 0.6 g bamboo fibre/100 g grapefruit pulp is recommended before freeze-drying.

Stability of micronutrients and phytochemicals of grapefruit jam as affected by the obtention process.

Fruits are widely revered for their micronutrient properties. They serve as a primary source of vitamins and minerals as well as of natural phytonutrients with antioxidant properties. Jam constitutes an interesting way to preserve fruit. Traditionally, this product is obtained by intense heat treatment that may cause irreversible loss of these bioactive compounds responsible for the health-related properties of fruits. In this work, different grapefruit jams obtained by conventional, osmotic dehydration (OD) without thermal treatment and/or microwave (MW) techniques were compared in terms of their vitamin, organic acid and phytochemical content and their stability through three months of storage. If compared with heating, osmotic treatments lead to a greater loss of organic acids and vitamin C during both processing and storage. MW treatments permit jam to be obtained which has a similar nutritional and functional value than that obtained when using a conventional heating method, but in a much shorter time.

Aneurismas supraclinoideos bilaterales asociados de déficit visual progresivo / Bilateral supraclinoid aneurysms associated with progressive visual impairment

No disponible

Estudio observacional multicéntrico español de primeros episodios sugestivos de esclerosis múltiple: cohorte PREM / Spanish multi-centre observational study of the fi rst attacks suggestive of multiple sclerosis: the PREM cohort

Introducción. Estudios recientes han demostrado la necesidad de optimizar el manejo de los pacientes tras un primer brote sugerente de esclerosis múltiple (EM). Nuestro objetivo es comprobar si los resultados de seguimiento de estos estudios son reproducibles en un contexto multicéntrico español. Pacientes y métodos. El estudio PREM (estudio multicéntrico español prospectivo observacional a 24 meses) incluyó a pacientes en los tres primeros meses tras un primer brote sugerente de EM con al menos dos lesiones típicas en una resonancia magnética. Se obtuvo la Expanded Disability Status Scale (EDSS) y se valoró la presencia de brotes basalmente y a los 3, 6, 9, 12, 18 y 24 meses; se realizó una resonancia magnética basalmente y a los 6 y 24 meses, para el cálculo del volumen cerebral y de volúmenes lesionales (T1, T2 y T1 tras la administración de gadolinio). Se valoraron los criterios de McDonald y Poser durante el seguimiento. Un subgrupo de pacientes fue seguido hasta completar cuatro años. Resultados. Se incluyó a 110 pacientes (un 67% mujeres) de edad media de 30,2 años; 22 pacientes abandonaron prematuramente el estudio. Un 19% y un 45% de pacientes cumplían criterios de Poser a los 6 meses y 24 meses, respectivamente; un 63% y un 71% en el caso de los criterios de McDonald. La EDSS descendió signifi cativamente (–0,94; p < 0,001) y se observó desarrollo de atrofi a (–1,2%; p < 0,001) a los 24 meses. Conclusión. Los resultados de seguimiento de pacientes con primeros brotes sugerentes de EM en un contexto multicéntrico español son superponibles a los de los ensayos clínicos internacionales realizados en estos pacientes (AU)

Introduction. Recent studies have shown the need to optimise the management of patients after a fi rst attack suggestive of multiple sclerosis (MS). Our aim is to determine whether the results from follow-ups in these studies are reproducible within a Spanish multi-centre context. Patients and methods. The PREM study (observational prospective Spanish multi-centre study at 24 months) included patients in the fi rst three months following a fi rst event suggestive of MS with at least two typical lesions in a magnetic resonance scan. The Expanded Disability Status Scale (EDSS) was obtained and the presence of attacks was evaluated basally and at 3, 6, 9, 12, 18 and 24 months; a magnetic resonance scan was performed basally and at 6 and 24 months so as to be able to calculate the brain volume and the volumes of the lesions (T1, T2 and T1 after administering gadolinium). McDonald and Poser criteria were evaluated during the follow-up. A subgroup of patients was followed up for a total eriod of four years. Results. Altogether 110 patients (67% females) with a mean age of 30.2 years were included in the study; 22 patients dropped out of the study before it fi nished. Poser criteria were met by 19% and 45% of patients at 6 months and 24 months, respectively; 63% and 71% satisfi ed McDonald criteria. The EDSS decreased signifi cantly (–0.94; p < 0.001) and development of atrophy was observed (–1.2%; p < 0.001) at 24 months. Conclusions. Results of the follow-up of patients with fi rst attacks suggestive of MS within a Spanish multi-centre context are wholly comparable with those from international clinical trials performed in these patients (AU)

[Pulmonary artery malformations]. / Pulmonale arteriovenöse Malformationen.

We report on two patients with pulmonary arteriovenous malformations (PAVM). An almost asymptomatic young man and an elderly woman with severe dyspnoea illustrate paradigmatically various aspects of the clinical manifestation, diagnostic approach and treatment of this rare disorder. New aspects with respect to genetics, diagnosis and therapy are discussed. PAVM are often manifestations of hereditary teleangiectasia, which also affect blood vessels of the skin, mucous membranes, brain and liver. Transcatheter embolotherapy is a safe, effective and minimally invasive treatment option, which seems to be replacing surgical resection as first-line therapy in many cases.