Relación de los índices de adiposidad visceral (VAI) y disfuncional (DAI) con parámetros de obesidad / Visceral adiposity index (VAI) and dysfunctional adiposity index (DAI). Relationship with obesity parameters

Introducción La obesidad es una pandemia mundial con repercusión en morbilidad y mortalidad crecientes. Valoramos la fortaleza asociativa del índice de adiposidad visceral (VAI) y del índice de adiposidad disfuncional (DAI) en obesidad y riesgo asociado utilizando diversos métodos. Material y métodos Estudio transversal en 418.343 trabajadores de diferentes comunidades autónomas en España, estimando prevalencia de obesidad con: perímetro de cintura, Índice cintura/altura, IMC, CUN-BAE, ECORE-BF, RFM, Palafolls, IMG, METS-VF calculados ajustándose a sus fórmulas específicas. Se realizó análisis descriptivo de las variables categóricas y fortaleza asociativa de VAI y DAI para obesidad con curvas ROC considerando riesgo elevado cuando el valor AUC.0,8 y moderado con AUC.0,7 y.0,8. Se utilizó SPSS 27.0, considerando significación estadística p.0,05. Resultados La prevalencia de obesidad varía según el método utilizado, siendo alta con Palafolls (72,92% en mujeres y 86,98% en hombres) y baja con METS-VF (1,31% en mujeres y 8,54% en hombres). Los valores medios de VAI y DAI son siempre superiores en hombres. El AUC de la curva ROC para VAI fue alta con METS-VF: en mujeres 0,836 (intervalo de confianza del 95% [IC 95%] 0,829-0,843), en hombres 0,848 (IC 95% 0,845-0,850) y con perímetro de cintura en hombres: 0,819 (IC 95% 0,816-0,822). DAI fue alto para METS-VF en mujeres: 0,809 (IC 95% 0,801-0,817). Conclusiones La prevalencia de obesidad y riesgo relacionado difiere según el método de valoración utilizado. VAI muestra alta fortaleza asociativa en obesidad y masa grasa para METS-VF en ambos sexos y con perímetro de cintura en hombres; DAI para METS-VF en mujeres (AU)

Introduction Obesity is a global pandemic with a growing impact on morbidity and mortality. We assessed the associative strength of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) in obesity and associated risk using different methods. Material and methods Cross-sectional study in 418 343 workers from different autonomous communities in Spain, estimating prevalence of obesity with: waist circumference, waist/height index, BMI, CUN-BAE, ECORE-BF, RFM, PALAFOLLS, IMG, METS-VF calculated according to their specific formulas. Descriptive analysis of categorical variables and associative strength of VAI and DAI for obesity was performed with ROC curves considering high risk when the AUC value.0.8 and moderate with AUC.0.7 and.0.8. SPSS 27.0 was used, considering statistical significance p.0.05. Results The prevalence of obesity varied according to the method used, being high with Palafolls (72.92% in women and 86.98% in men) and low with METS-VF (1.31% in women and 8.54% in men). The mean values of VAI and DAI are always higher in men. The AUC of the ROC curve for VAI was high with METS-VF: in women 0.836 (95%CI 0.829-0.843), in men 0.848 (95%CI 0.845-0.850) and with waist circumference in men: 0.819 (95%CI 0.816-0.822). DAI was high for METS-FV in women: 0.809 (95%CI 0.801-0.817). Conclusions The prevalence of obesity and related risk differs according to the assessment method used. VAI shows high strength of association with obesity and fat mass for METS-VF in both sexes and with waist circumference in men; DAI for METS-VF in women (AU)

[Visceral adiposity index (VAI) and dysfunctional adiposity index (DAI). Relationship with obesity parameters]. / Relación de los índices de adiposidad visceral (VAI) y disfuncional (DAI) con parámetros de obesidad.

INTRODUCTION: Obesity is a global pandemic with a growing impact on morbidity and mortality. We assessed the associative strength of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) in obesity and associated risk using different methods. MATERIAL AND METHODS: Cross-sectional study in 418 343 workers from different autonomous communities in Spain, estimating prevalence of obesity with: waist circumference, waist/height index, BMI, CUN-BAE, ECORE-BF, RFM, PALAFOLLS, IMG, METS-VF calculated according to their specific formulas. Descriptive analysis of categorical variables and associative strength of VAI and DAI for obesity was performed with ROC curves considering high risk when the AUC value.0.8 and moderate with AUC.0.7 and.0.8. SPSS 27.0 was used, considering statistical significance p.0.05. RESULTS: The prevalence of obesity varied according to the method used, being high with Palafolls (72.92% in women and 86.98% in men) and low with METS-VF (1.31% in women and 8.54% in men). The mean values of VAI and DAI are always higher in men. The AUC of the ROC curve for VAI was high with METS-VF: in women 0.836 (95%CI 0.829-0.843), in men 0.848 (95%CI 0.845-0.850) and with waist circumference in men: 0.819 (95%CI 0.816-0.822). DAI was high for METS-FV in women: 0.809 (95%CI 0.801-0.817). CONCLUSIONS: The prevalence of obesity and related risk differs according to the assessment method used. VAI shows high strength of association with obesity and fat mass for METS-VF in both sexes and with waist circumference in men; DAI for METS-VF in women.

Cardiometabolic profile of 15057 elderly Spanish workers: association of sociodemographic variables and tobacco consumption.

BACKGROUND: Aging of the world population is one of the most significant demographic changes of our time. Populations older than 60 years are heterogeneous, and age is an independent cardiovascular risk factor aggravated by frailty, obesity, and diabetes, and influenced by several factors, including sex and socioeconomic status. The objective of this study was to calculate cardiovascular risk in workers of both sexes over 60 years of age and to assess whether there are difference s by sex, social class, smoking, and type of job. METHODS: A cross-sectional study was carried out in 15,057 elderly Spanish workers from different autonomous communities in Spain and with different labor occupations. Anthropometric, sociodemographic, clinical, and laboratory values were determined. People were classified according to age from 60 to 64 years inclusive and from 65 to 69 years, smokers and non-smokers, and both blue-collar and white-collar workers. Subsequently, a multivariate analysis was carried out. RESULTS: Men, blue-collar workers, smokers, and aging were factors that influenced cardiovascular risk: with an OR of 3.27 (95% CI: 2.64-4.05) in people 65 years of age or older versus the younger group, and an OR of 3.15 (95% CI: 2.69-3.69) in smokers versus non-smokers. A stronger independent association was found between smoking, age, and cardiovascular risk. The risk of developing non-alcoholic fatty liver and liver fibrosis was much higher in men than in women, with an OR of 4.06 (95% CI: 3.66-4.50) for the former and an OR of 2.10 (95% CI: 1.95-2.26) for the BARD index. CONCLUSIONS: The highest risk groups were observed in male subjects with a history of smoking and blue-collar workers and, as such, should be considered for cardiovascular risk screening programs.

The CUN-BAE, Deurenberg Fat Mass, and visceral adiposity index as confident anthropometric indices for early detection of metabolic syndrome components in adults.

There is no definition for the metabolic syndrome; visceral obesity, elevated lipids and glucose, and hypertension coexist. The aim of the study is to determine which anthropometric indicators best determine it. Cross-sectional study in 418,343 Spanish workers. Metabolic syndrome was determined using the NCEP-ATPIII, IDF and JIS criteria. The anthropometric variables studied were: body mass index, waist circumference, waist-to-height ratio, CUNBAE, Deuremberg formula, body fat index, body surface index, normalized weight adjusted index, body roundness index, body shape index, visceral adiposity index (VAI), dysfunctional adiposity index, conicity index, metabolic score for visceral fat (METS-VF), waist triglyceride index. In men, the anthropometric indices with the largest areas under the ROC curve are VAI with ATPIII criteria and JIS. If we use the IDF criteria: waist circumference and METS-VF, with the same result. In women, the largest areas under the curve were observed with the Deuremberg formula in both ATPIII and JIS while with the IDF criteria it is METS-VF. The most useful anthropometric indices for identifying metabolic syndrome are CUN-BAE and Deuremberg, followed by the VAI. A single definition of metabolic syndrome should be agreed to determine the best anthropometric index with predictive capacity for its diagnosis.

Prevalencia de diabesidad en población laboral española: influencia de variables sociodemográficas y consumo de tabaco / Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption

Fundamento. La obesidad predispone a sufrir diabetes tipo 2 con tanta frecuencia que su combinación se denomina diabesidad. El objetivo de este estudio fue determinar la prevalencia de diabesidad en la población trabajadora y analizar las variables con las que se asocia. Material y métodos. Estudio transversal realizado entre enero de 2019 y junio de 2020 en 418.343 trabajadores de 18 a 67 años, de diferentes profesiones y áreas geográficas españolas. Se determinó la prevalencia de diabesidad con seis fórmulas diferentes para obesidad: IMC (índice de masa corporal), CUN BAE (Clínica Universidad de Navarra Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Fórmula Palafolls, IMG (índice de masa grasa) de Deuremberg y RFM (Relative Fat Mass). Se analizó la asociación entre diabesidad y edad, sexo, clase social y tabaco. Resultados. La prevalencia global de diabesidad osciló entre 2,6 % por el IMC y 5,8% por la fórmula Palafolls. La variable más relacionada con la diabesidad fue la edad mayor de 50 años (OR = 5,9; IC95%: 5,7-6,2 para IMC, y OR = 8,1; IC95%: 7,9-8,4 para IMG de Deuremberg). El sexo masculino y la clase social III se relacionaron con la diabesidad estimada con todas las escalas, ser fumador solo con la fórmula Palafolls. Conclusiones. La prevalencia de diabesidad varía en función de la fórmula empleada, con una prevalencia menor entre las mujeres y un aumento con la edad independientemente de la fórmula utilizada. Su prevalencia es mayor en las clases sociales más bajas.(AU)

Background. Obesity predisposes to type 2 diabetes so often that the combination is called diabesity. The aim of this study was to determine the prevalence of diabesity in the working population and to analyze the variables associated with it. Method. Cross-sectional study between January 2019 and June 2020 by 418,343 workers from 18 to 67 year-old, from different professions and Spanish geographic areas. The prevalence of diabesity was determined with six different formulae for obesity: BMI (body mass index), CUN BAE (Clínica Universidad de Navarra-Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Formula Palafolls, FMI (fat mass index) of Deuremberg and RFM (relative fat mass). The association between diabetes and age, sex, social class and tobacco was analyzed. Results. The global prevalence of diabetes ranged from 2.6% for BMI to 5.8% for the Palafolls formula. The variable most related to diabesity was age over 50 years (OR=5.9; 95%CI: 5.7-6.2 for BMI, and OR = 8.1; 95%CI: 7.9-8.4 for FMI of Deuremberg). Male sex and social class III related with diabesity estimated by all formulas, while being a smoker was only related with the Palafolls formula. Conclusion. Diabesity prevalence varies depending on the formula used, with much lower prevalence among women and increased with age independent of the formula used. Its prevalence is higher in the lower social classes.(AU)

[Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption].

BACKGROUND: Obesity predisposes to type 2 diabetes so often that the combination is called diabesity. The aim of this study was to determine the prevalence of diabesity in the working population and to analyze the variables associated with it. METHOD: Cross-sectional study between January 2019 and June 2020 by 418,343 workers from 18 to 67 year-old, from different professions and Spanish geographic areas. The prevalence of diabesity was determined with six different for-mulae for obesity: BMI (body mass index), CUN BAE (Clínica Universidad de Navarra Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Formula Palafolls, FMI (fat mass index) of Deuremberg and RFM (relative fat mass). The association between diabetes and age, sex, social class and tobacco was analyzed. RESULTS: The global prevalence of diabetes ranged from 2.6% for BMI to 5.8% for the Palafolls formula. The variable most related to diabesity was age over 50 years (OR?=?5.9; 95%CI: 5.7-6.2 for BMI, and OR?=?8.1; 95%CI: 7.9-8.4 for FMI of Deuremberg). Male sex and social class III related with diabesity estimated by all formulas, while being a smoker was only related with the Palafolls formula. CONCLUSION: Diabesity prevalence varies depending on the formula used, with much lower prevalence among women and increased with age independent of the formula used. Its prevalence is higher in the lower social classes.

Thyroid as a target of adjuvant autoimmunity/inflammatory syndrome due to mRNA-based SARS-CoV2 vaccination: from Graves' disease to silent thyroiditis.

BACKGROUND: As COVID-19 became a pandemic, the urgent need to find an effective treatment vaccine has been a major objective. Vaccines contain adjuvants which are not exempt from adverse effects and can trigger the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). There is very little information about autoimmune endocrine disease and the ASIA after the use of mRNA-based SARS-CoV2 vaccination. CASE SERIES: We report three cases and also review the literature showing that the thyroid gland can be involved in the ASIA induced by the mRNA-based SARS-CoV2 vaccination. We present the first case to date of silent thyroiditis described in the context of SARS-CoV2 vaccination with Pfizer/BioNTech. Also, we discuss the first subacute thyroiditis in the context of SARS-CoV2 vaccination with the Moderna's vaccine. Finally, we provide another case to be added to existing evidence on Graves' disease occurring post-vaccination with the Pfizer/BioNTech vaccine. DISCUSSION: Adjuvants play an important role in vaccines. Their ability to increase the immunogenicity of the active ingredient is necessary to achieve the desired immune response. Both the Moderna and the Pfizer/BioNTech vaccines use mRNA coding for the SARS-CoV2 S protein enhanced by adjuvants. In addition, the cross-reactivity between SARS-CoV2 and thyroid antigens has been reported. This would explain, at least, some of the autoimmune/inflammatory reactions produced during and after SARS-CoV2 infection and vaccination. CONCLUSION: The autoimmune/inflammatory syndrome induced by adjuvants involving the thyroid could be an adverse effect of SARS-CoV2 vaccination and could be underdiagnosed.

Relación entre el consumo de alcohol y el riesgo de diabetes tipo 2 en los trabajadores / Relationship Between Alcohol Consumption and Risk Of Diabetes Type 2 in Workers

Introducción. El consumo de alcohol daña la mayoría de los órganos y sistemas de nuestro organismo, con un efecto nocivo sobre la diabetes tipo 2. En nuestro país, el consumo de alcohol es tolerado y socialmente bien considerado, lo que provoca que una parte importante de la población tenga una ingesta excesiva de alcohol. Por tanto, quisimos evaluar el efecto de la ingesta excesiva de alcohol en la población trabajadora y su efecto sobre el riesgo de desarrollar diabetes tipo 2. Métodos. Estudio descriptivo y transversal en 55.147 trabajadores españoles en el que se evaluó el efecto del consumo excesivo de alcohol sobre el riesgo de desarrollar diabetes tipo 2. El riesgo de diabetes se evaluó con las escalas Findrisk y QDScore. El consumo de alcohol se evalúa con la unidad de bebida estándar, equivalente a 10 g de alcohol. Se considera consumo excesivo cuando se superan semanalmente 35 unidades de bebida estándar en hombres y 20 en mujeres. Resultados. El consumo excesivo de alcohol en comparación con no beber, beber poco o moderadamente aumenta el riesgo de diabetes tipo 2 en ambas escalas de riesgo. La razón de probabilidades es 12,22 (IC 95 11,51-12,99) para la escala Findrisk y 13,36 (IC 95% 12,04-14,69) para el riesgo relativo con QDScore. Conclusión. El consumo excesivo de alcohol aumenta el riesgo de diabetes tipo 2 con las escalas Findrisk y QDScore en la población laboral española

Introduction. Alcohol consumption damages most of the organs and systems of our organism, with a harmful effect on type 2 diabetes. In our country, alcohol consumption is tolerated and socially well regarded, which causes an important part of the population to have an excessive alcohol intake. Therefore, we want to evaluate the effect of excessive alcohol intake in the working population and its effect on the risk of developing type 2 diabetes. Methods. Descriptive and cross-sectional study in 55,147 Spanish workers in which the effect of excessive alcohol consumption on the risk of developing type 2 diabetes was assessed. Diabetes risk was assessed with the Findrisk and QDScore scales. Alcohol consumption is assessed with the standard drinking unit, equivalent to 10g of alcohol. Excessive consumption is considered when 35 standard drinking unit in men and 20 in women are exceeded weekly. Results. Heavy drinking compared to no, low or moderate drinking increases the risk of type 2 diabetes on both risk scales. The Odds ratio is 12.22 (CI 95 11.51-12.99) for the Findrisk scale and 13.36 (CI 95% 12.04-14.69) for the relative risk with QDScore. Conclusion. Excessive alcohol consumption increases the risk of type 2 diabetes with the Findrisk and QDScore scales in the Spanish working population

Impacto emocional en el camino de aprender a vivir con "la diabetes" / Emotional impact on the way to learn to live with the illness, "la diabetes"

Resumen Objetivo: Describir, interpretar y analizar los sentimientos de las personas con diabetes en el transcurrir de su enfermedad. Método: Estudio cualitativo, fenomenológico; se realizó en el Hospital Chepén (La Libertad, Perú) a 10 personas entre 50 y 70 años, determinado por la saturación del discurso y que cumplieron los criterios de inclusión. Los datos fueron recolectados con entrevista a profundidad. Se consideran tres momentos: descripción, reducción y comprensión, que incluye el análisis ideográfico y nomotético hasta llegar a generalidades. Resultados: Se generaron cuatro unidades de significado principales de acuerdo al mayor número de convergencias: sufrimiento, miedo, resignación y fe en Dios, que se agruparon en dos grandes unidades: "viviendo con sufrimiento y miedo para aceptar mi enfermedad" y" teniendo resignación y fe en Dios para aprender a vivir con mi enfermedad". También expresaron cólera, soledad, autoconfianza, desesperanza, culpabilidad, negación, sensibilidad, envidia y alegría, que indican la develación y comprensión del fenómeno vivenciado por las personas con diabetes. Conclusiones: En la convivencia con una enfermedad crónica todos enfrentan el duelo como proceso natural necesario, que causa principalmente sufrimiento, miedo que culmina con la aceptación, pero cuando dicho proceso no es satisfactorio se opta por la resignación; de ahí la importancia para enfermería de tomar en cuenta el universo emocional del paciente para comprenderlo, poniéndose en su lugar y ayudarlo a que aprenda a vivir con su enfermedad y mejorar su calidad de vida.

Abstract Objective: To describe, interpret and analyze the feelings of people with diabetes in the course of their illness. Method: A qualitative, phenomenological study was conducted at the Chepén Hospital (La Libertad, Peru), on 10 people between 50 and 70 years old, determined by speech saturation and who met the inclusion criteria. The data collected was with an in-depth interview. Three moments are considered: description, reduction and comprehension that includes the ideographic and nomothetic analysis reaching generalities. Results: four main units of meanings were generated according to the greatest number of convergences: suffering, fear, resignation and faith in God, which were grouped into two main units of meanings: "living with suffering and fear to accept my illness" and "having resignation and faith in God to learn to live with my disease". They also expressed anger, loneliness, self-confidence, hopelessness, guilt, denial, sensitivity, envy and joy, indicating the unveiling and understanding of the phenomenon experienced by people with diabetes. Conclusions: In cohabitation with a chronic illness, all face bereavement as a necessary natural process, which causes mainly suffering, fear that culminates with acceptance, but when this process is not satisfactory the person chooses resignation, hence the importance for nursing take into account the emotional universe of the patient to understand it, putting themselves in his place and helping him to learn to live with his illness and improve his quality of life.

Rotura aneurismática aguda en paciente con HSA grave objetivada en AngioTC craneal / Acute aneurysmal rupture in a severe SAH patient seen on head CT angiography scan

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Bayesian network modeling: A case study of an epidemiologic system analysis of cardiovascular risk.

An extensive, in-depth study of cardiovascular risk factors (CVRF) seems to be of crucial importance in the research of cardiovascular disease (CVD) in order to prevent (or reduce) the chance of developing or dying from CVD. The main focus of data analysis is on the use of models able to discover and understand the relationships between different CVRF. In this paper a report on applying Bayesian network (BN) modeling to discover the relationships among thirteen relevant epidemiological features of heart age domain in order to analyze cardiovascular lost years (CVLY), cardiovascular risk score (CVRS), and metabolic syndrome (MetS) is presented. Furthermore, the induced BN was used to make inference taking into account three reasoning patterns: causal reasoning, evidential reasoning, and intercausal reasoning. Application of BN tools has led to discovery of several direct and indirect relationships between different CVRF. The BN analysis showed several interesting results, among them: CVLY was highly influenced by smoking being the group of men the one with highest risk in CVLY; MetS was highly influence by physical activity (PA) being again the group of men the one with highest risk in MetS, and smoking did not show any influence. BNs produce an intuitive, transparent, graphical representation of the relationships between different CVRF. The ability of BNs to predict new scenarios when hypothetical information is introduced makes BN modeling an Artificial Intelligence (AI) tool of special interest in epidemiological studies. As CVD is multifactorial the use of BNs seems to be an adequate modeling tool.

[Pain and workplace. Sociodemographic variables influence in therapeutic response and labor productivity]. / Dolor y trabajo. Influencia de variables sociodemográficas en la respuesta terapéutica y la productividad laboral.

INTRODUCTION: Pain is a major cause of medical consultation. The complexity of managing it is due to its long duration and intensity, and it sometimes requires a combination of multiple drugs. The objective of this study is to assess the use of drugs for pain in workers, the clinical response obtained, its influence on estimating work productivity, its relationship to sociodemographic variables, and the type of drug used. MATERIAL AND METHODS: A cross-sectional study on 1,080 workers, aged 18-65 years, during periodic surveys to monitor their health in companies in the service sector in Spain. Treatments used, clinical efficacy, influence on work productivity and sociodemographic variables (age, gender) are evaluated. The Brief Pain Inventory questionnaire, validated for Spain, was used to assess pain, and the SPSS(®) 20.0 package for the statistical analysis. RESULTS: NSAIDs and simple analgesics have higher percentages of improvement in pain (P=.032 and P<.0001, respectively). Men respond better to NSAIDs, and women to simple analgesics. Improved productivity is higher in men than in women (P=.042). No significant differences were observed for age, pain improvement or productivity, except in those over 55 years. CONCLUSIONS: The analgesic prescription pain conditions must consider the age and gender of the patient, as well as the type of drug. The choice of drug should be based on the aetiology and aspects unrelated to the clinical variables, such as sociodemographic, work or psychosocial.

[Occupational disability in epilepsy. The assessment criteria]. / La incapacidad laboral en epilepsia. Criterios de valoración.

Epilepsy is a chronic disease cursing with recurrent and paroxysmal crises due to anomalies in the electrical activity of brain, and is controllable in most of the patients by using antiepileptic drugs, in single or combination therapy. Probably one of the most complex aspects of epilepsy is the assessment of disability for work of the affected person. For this purpose, multiple factors need to be taken into account for homogeneous decision-making, and according to criteria of approval and within the principle of equity inherent in the granting of Social Security disability benefits. This requires the cooperation of all professionals involved in the different specialties, with reports using common criteria and taking into account the disease itself, as well as the effects of the prescribed treatments, the effects of which can contribute to the limitations in the performance of certain professions of risk.

Aldehyde dehydrogenases in early stage lung cancer: nuclear expression

PURPOSE: Aldehyde dehydrogenase enzymes are a family of intracellular enzymes that participate in cellular detoxification, differentiation and drug resistance through the oxidation of cellular aldehydes. The isoform 1 (ALDH1) has been proved useful for the identification of cancer stem cells. The ALDH1 cytoplasmatic expression has been associated with poor prognostis in several tumours, such as non-small cell lung cancer. The role of the ALDH1 nuclear expression remains unknown. METHODS: We conducted a historical cohort study in 89 patients diagnosed of stage I non-small cell lung cancer treated with surgery between 2009 and 2004 in the Thoracic Surgery Department in the Universitary Hospital Puerta de Hierro. We selected from this sample those cases with nuclear expression of the ALDH1. RESULTS: Three of the 89 (3.3 %) patients showed a nuclear expression of the ALDH1. The three of them are still alive with a median time of follow up of 73 months (more than 6 years). CONCLUSION: We have identified ALDH1 as a nuclear protein in early stage non-small cell lung cancer. It might have a function in cell cycle control, associating a better prognosis to these patients. More studies are necessary to clarify the role of nuclear expression of ALDH1 (AU)

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Influencia del índice de masa corporal y la forma física de jóvenes universitarios en la capacidad de realizar compresiones torácicas externas de calidad sobre maniquí / Influence of body mass index and physical fitness on university students’ ability to perform high-quality external chest compressions on a mannequin

Objetivos: 1) Analizar las diferencias por sexo en el porcentaje medio de compresiones torácicas externas (CTE) correctas realizadas sobre maniquí por jóvenes universitarios durante 20 minutos por categorías de índice de masa corporal (IMC), capacidad cardiorrespiratoria (CCR) y fuerza muscular; 2) examinar la asociación del IMC y la forma física con la proporción de CTE correctas; y 3) establecer los puntos de corte óptimos de VO2max y fuerza muscular en brazos para realizar CTE correctas. Método: Estudio cuasi-experimental que incluyó 63 estudiantes universitarios. Se determinaron IMC, CCR y fuerza muscular manual. Tras formación previa, realizaron reanimación cardiopulmonar (RCP) en un maniquí durante 20 minutos. Resultados: Los porcentajes medios de CTE correctas y con profundidad adecuada fueron 77,8 (65,1-90,5) y 86,0 (71,7-94,3) en hombres y 41,2 (32,2-50,1) y 43,7 (24,6-52,9) en mujeres (p ≥ 0,001). Las diferencias por género desaparecieron controlando por edad, IMC, CCR y fuerza muscular. El porcentaje medio de CTE correctas fue significativamente mayor en participantes con normopeso/sobrepeso y CCR y fuerza muscular altas. El IMC, la CCR y la fuerza muscular fueron predictores de una adecuada profundidad de compresiones en los modelos de regresión lineal múltiple controlando por edad y sexo. En las curvas ROC, el área bajo la curva para predecir CTE correctas fue 0,862 para VO2 max y 0,872 para la fuerza muscular (puntos de corte de 44,45 ml/Kg/min y de 30,22 Kg respectivamente). Conclusiones: El género, las características antropométricas y la forma física influyen en la realización de CTE correctas. Ello sugiere que una adecuada forma física aumentará la capacidad de los reanimadores para realizar RCP

Objectives: 1) To compare the mean number of external chest compressions (ECCs) performed by male and female university students working on a mannequin for 20 minutes, analyzed according to body mass index (BMI), aerobic capacity, and muscle strength; 2) to analyze the association between BMI and physical fitness and the percentage of high-quality ECCs; and 3) to establish the optimal peak oxygen consumption (VO2 max) and muscle strength cutoffs for performing high-quality ECCs. Methods: Quasi-experimental study of 63 university students. We measured BMI, aerobic capacity, and hand muscle strength. The subjects were trained in cardiopulmonary resuscitation (CPR) and then performed CPR maneuvers on a mannequin for 20 minutes. Results: A mean (95% confidence interval) of 77.8% (65.1%-90.5%) of the ECCs performed by men were technically correct and 86.0% (71.7%-94.3%) were of adequate depth; women performed a mean of 41.2% (32.2%-50.1%) of the ECCs correctly and 43.7% (24.6%-52.9%) were of adequate depth (P ≥.001). After adjustment for age, BMI, aerobic capacity, and muscle strength however, the differences between men and women were no longer significant. Individuals who were of normal weight or overweight and had superior aerobic capacity and muscle strength achieved higher percentages of high-quality ECCs. BMI, aerobic capacity, and hand muscle strength were predictors of ECCs that reached adequate depth according to multiple linear regression models controlling for age and sex. The area under the receiver operating characteristic curve for predicting percentage of correct ECCs was 0.867 for VO2max and 0.872 for hand muscle strength. The cutoffs were 44.45 mL/kg/min for VO2max and 30.22 kg for hand strength. Conclusions: Gender, anthropometric characteristics, and physical fitness affect the ability to perform high-quality ECCs. Our data suggest that maintaining adequate physical fitness would improve individuals' ability to perform CPR

Aldehyde dehydrogenases in early stage lung cancer: nuclear expression.

PURPOSE: Aldehyde dehydrogenase enzymes are a family of intracellular enzymes that participate in cellular detoxification, differentiation and drug resistance through the oxidation of cellular aldehydes. The isoform 1 (ALDH1) has been proved useful for the identification of cancer stem cells. The ALDH1 cytoplasmatic expression has been associated with poor prognostis in several tumours, such as non-small cell lung cancer. The role of the ALDH1 nuclear expression remains unknown. METHODS: We conducted a historical cohort study in 89 patients diagnosed of stage I non-small cell lung cancer treated with surgery between 2009 and 2004 in the Thoracic Surgery Department in the Universitary Hospital Puerta de Hierro. We selected from this sample those cases with nuclear expression of the ALDH1. RESULTS: Three of the 89 (3.3 %) patients showed a nuclear expression of the ALDH1. The three of them are still alive with a median time of follow up of 73 months (more than 6 years). CONCLUSION: We have identified ALDH1 as a nuclear protein in early stage non-small cell lung cancer. It might have a function in cell cycle control, associating a better prognosis to these patients. More studies are necessary to clarify the role of nuclear expression of ALDH1.

[Dry eye syndrome. Occupational risk factors, valuation and prevention]. / Síndrome del ojo seco. Factores de riesgo laboral, valoración y prevención.

Dry eye syndrome in the workplace is associated with new ways of working, with increasing use of screens and electronic devices and environmental conditions encountered in modern office designs and other environments. Also affect occupational exposure to ionizing radiation, chemicals or atmospheric dust with increased ocular dryness. The study of pathophysiological aspects and laboral causality of the dry eye, must be to develop joint task in Occupational Health, Public Health in coordination with and responsible for the national health system, which would involve primary and secondary preventive measures more effective and proper diagnosis, control and monitoring of the disease, A better knowledge of occupational hazards and actions agreed and coordinated between occupational physicians, preventers, primary care physicians and specialist physicians, such as ophthalmology, will get results much more effective when earlier and optimize available resources.

[Chronic migraine and work: occupational risks and prevention]. / Migraña crónica y trabajo. Riesgos laborales y aspectos preventivos.

Chronic migraine is a clinically difficult to manage primary headache which affects the quality of life of the patients. This impact is important in the occupational world, where along with the clinical aspects of the disease, the therapies used for the control of the symptoms or preventive aspects, must be assessed. The side effects of the drugs and the limitations associated with their symptoms are aspects to highlight in occupational health, especially in individual workplaces, where there is a high risk of work-related injuries. The medical officer must assess the occupational risks of particular importance in the progression of this disease, as well as preventive actions, within the ambit of the current Spanish legislation, that may be favorable for both the company and the worker. The coordinated medical intervention and knowledge of these occupational aspects can provide clinically relevant tools, andoccupational and social optimization in the use of available resources.