ABSTRACT
The genus Tubakia is revised on the basis of morphological and phylogenetic data. The phylogenetic affinity of Tubakia to the family Melanconiellaceae (Diaporthales) was recently postulated, but new analyses based on sequences retrieved from material of the type species of Tubakia, T. dryina, support a family of its own, viz. Tubakiaceae fam. nov. Our phylogenetic analyses revealed the heterogeneity of Tubakia s. lat. which is divided into several genera, viz., Tubakia s. str., Apiognomonioides gen. nov. (type species: Apiognomonioides supraseptata), Involutiscutellula gen. nov. (type species: Involutiscutellula rubra), Oblongisporothyrium gen. nov. (type species: Oblongisporothyrium castanopsidis), Paratubakia gen. nov. (type species: Paratubakia subglobosa), Racheliella gen. nov. (type species: Racheliella wingfieldiana sp. nov.), Saprothyrium gen. nov. (type species: Saprothyrium thailandense) and Sphaerosporithyrium gen. nov. (type species: Sphaerosporithyrium mexicanum sp. nov.). Greeneria saprophytica is phylogenetically closely allied to Racheliella wingfieldiana and is therefore reallocated to Racheliella. Particular emphasis is laid on a revision and phylogenetic analyses of Tubakia species described from Japan and North America. Almost all North American collections of this genus were previously referred to as T. dryina s. lat., which is, however, a heterogeneous complex. Several new North American species have recently been described. The new species Sphaerosporithyrium mexicanum, Tubakia melnikiana and T. sierrafriensis, causing leaf spots on several oak species found in the North-Central Mexican state Aguascalientes and the North-Eastern Mexican state Nuevo León, are described, illustrated, and compared with similar species. Several additional new species are introduced, including Tubakia californica based on Californian collections on various species of the genera Chrysolepis, Notholithocarpus and Quercus, and T. dryinoides, T. oblongispora, T. paradryinoides, and Paratubakia subglobosoides described on the basis of Japanese collections. Tubakia suttoniana nom. nov., based on Dicarpella dryina, is a species closely allied to T. californica and currently only known from Europe. Tubakia dryina, type species of Tubakia, is epitypified, and the phylogenetic position and circumscription of Tubakia are clarified. A revised, supplemented key to the species of Tubakia and allied genera on the basis of conidiomata is provided.
ABSTRACT
El planteamiento del marco analítico, y su representación gráfica, forma parte del abordaje integral para la realización de las revisiones sistemáticas que el US Preventive Services Task Force utiliza en el proceso de elaboración de sus recomendaciones. Se incluye como parte de la metodología para el desarrollo del plan de trabajo. Junto a las preguntas clave, establecen los pasos necesarios en la lógica clínica que deben ser demostrados para evaluar la eficacia y los daños de un servicio preventivo en Atención Primaria. El objetivo de un marco analítico es presentar clara y esquemáticamente las preguntas específicas que relacionan intervenciones y resultados y que deben ser contestadas por la revisión bibliográfica. Se describe una convención para su diseño respecto a los ítems, enlaces, símbolos y representación gráfica (AU)
The analytic framework and its graphic representation, takes part of the integral approach in the systematic reviews that the US Preventive Services Task Force develop in the process of developing their recommendations. It is included as part of the methodology for the process of the working plan. Together with the key questions, the analytic framework establishes the needed steps in the logical process that should be demonstrated in order to assess the efficacy and the harms of a preventive service in primary care. The objective of an analytic framework is to present clearly and schematically the specific questions that relate interventions and results and that should be answered through the bibliographic review. A convention for its design, items, links, symbols and graphic representation is described (AU)
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Consensus , Preventive Health Services/methods , Preventive Health Services/organization & administration , Preventive Health Services/standards , Health Promotion/standards , Preventive Health Services/legislation & jurisprudence , Preventive Health Services/trends , Preventive Health ServicesABSTRACT
Las VI Guías Europeas de Prevención Cardiovascular recomiendan combinar las estrategias poblacional y de alto riesgo, con los cambios de estilo de vida como piedra angular de la prevención, y proponen la función SCORE para cuantificar el riesgo cardiovascular. Esta guía hace más hincapié en las intervenciones específicas de las enfermedades y las condiciones propias de las mujeres, las personas jóvenes y las minorías étnicas. No se recomienda el cribado de aterosclerosis subclínica con técnicas de imagen no invasivas. La guía establece cuatro niveles de riesgo (muy alto, alto, moderado y bajo), con objetivos terapéuticos de control lipídico según el riesgo. La diabetes mellitus confiere un riesgo alto, excepto en sujetos con diabetes tipo 2 con menos de diez años de evolución, sin otros factores de riesgo ni complicaciones, o con diabetes tipo 1 de corta evolución sin complicaciones. La decisión de iniciar el tratamiento farmacológico de la hipertensión arterial dependerá del nivel de presión arterial y del riesgo cardiovascular, teniendo en cuenta la lesión de órganos diana. Siguen sin recomendarse los fármacos antiplaquetarios en prevención primaria por el riesgo de sangrado. La baja adherencia al tratamiento exige simplificar el régimen terapéutico e identificar y combatir sus causas. La guía destaca que los profesionales de la salud pueden ejercer un papel importante en la promoción de intervenciones poblacionales y propone medidas eficaces, tanto a nivel individual como poblacional, para promover una dieta saludable, la práctica de actividad física, el abandono del tabaquismo y la protección contra el abuso de alcohol (AU)
The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions specific to women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than ten years of evolution, with no other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and cardiovascular risk, taking into account the lesion of target organs. The guidelines do not recommend antiplatelet drugs in primary prevention because of the increased risk of bleeding. The low adherence to the medication requires simplified therapeutic regimes and identifying and combating its causes. The guidelines highlight the responsibility of health professionals to play an active role in promoting evidence-based interventions at the population level, and propose effective interventions, both at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse (AU)
Subject(s)
Humans , Male , Female , Cardiovascular Diseases/prevention & control , Life Style , Risk Factors , Alcoholism/prevention & control , Smoking/prevention & control , Diabetes Mellitus/prevention & control , Hypertension/prevention & control , Trans Fatty Acids/administration & dosage , Indicators of Morbidity and Mortality , Arterial Pressure/physiology , Cholesterol/physiology , Biomarkers/analysis , Sedentary Behavior , Motor ActivityABSTRACT
Desde su creación, el Grupo PrevInfad ha trabajado con los objetivos de formular y mantener actualizadas las recomendaciones sobre actividades preventivas a realizar en la población infantil y adolescente española y mejorar la práctica clínica y promover la salud pública en el ámbito de la Atención Primaria. Las recomendaciones de PrevInfad van dirigidas principalmente a los pediatras de Atención Primaria, personal de enfermería y otros profesionales de la salud. En este trabajo presentamos una versión resumida del manual de trabajo del Grupo PrevInfad, que se ha actualizado recientemente. Para mayor detalle recomendamos a las personas interesadas consultar la versión íntegra, que se encuentra en la página web del grupo. Los métodos descritos están destinados a garantizar que las recomendaciones de PrevInfad sean metodológicamente sólidas, científicamente defendibles, reproducibles y bien documentadas (AU)
The working group PrevInfad has faced since its beginning the objectives of formulating and updating recommendations on preventive activities for Spanish children and adolescents, improving clinical practice and promoting public health in Primary Care. Previnfad recommendations address mainly to Primary Care paediatricians, nurses and other health professionals. In this paper, we present a resumed version of PrevInfad procedure manual, recently updated. We recommend to consult the complete version available in PrevInfad web site. The described methods are intended to ensure that the recommendations of PrevInfad are methodologically solid, scientifically defendable, reproducible and well documented (AU)
Subject(s)
Humans , Male , Female , Child , Manuals as Topic , Primary Health Care/methods , Primary Prevention/methods , Societies/prevention & control , Societies/policies , Self-Help Groups/organization & administration , Self-Help Groups/standardsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Child , Anaphylaxis/complications , Anaphylaxis/epidemiology , Anaphylaxis/etiology , Epinephrine/therapeutic use , Albuterol/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Histamine Antagonists/therapeutic use , Anaphylaxis/diagnosis , Anaphylaxis/physiopathology , Anaphylaxis/therapy , Clinical Laboratory Techniques/instrumentation , Clinical Laboratory Techniques/methods , Glucagon/therapeutic useABSTRACT
BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha = 0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma
No disponible
Subject(s)
Humans , Male , Female , Child , Adolescent , Caregivers/psychology , Quality of Life , Asthma/diagnosis , Asthma/prevention & control , Epidemiological Monitoring/trends , Impacts of Polution on Health , Family Health , Psychometrics , Spain/epidemiologyABSTRACT
Hay pruebas de que el cribado universal de la infección tuberculosa latente (ITBL) en zonas de baja incidencia tiene un rendimiento pobre, un número elevado de falsos positivos y no es coste-efectivo. Hay evidencias de que el cribado de la ITBL en los grupos que tienen riesgo elevado de desarrollar una infección tuberculosa activa (ITBA) mejora el rendimiento de las pruebas diagnósticas, el balance beneficio-riesgo y debe formar parte de las estrategias para disminuir el impacto de la tuberculosis. Sobre el dilema de cuál de las tres estrategias (prueba cutánea de la tuberculina [PCT] sola, determinación de la liberación de interferón gamma [IGRA] solo o PCT seguida de IGRA) para el diagnóstico de la ITBL es la que ofrece mejor rendimiento, existe variabilidad tanto en las recomendaciones de las guías de práctica clínica (GPC) y las instituciones como en las conclusiones de los estudios sobre el tema, aunque la mayoría de las recomendaciones van en el mismo sentido que las que proponemos en este documento. La prueba cutánea de la tuberculina sigue siendo el test diagnóstico con mejor rendimiento para realizar el cribado de la infección tuberculosa latente en niños y adolescentes. Recomendaciones de PrevInfad (GRADE): Se recomienda no realizar el cribado universal de la infección tuberculosa latente en los niños y adolescentes de nuestro país. Se recomienda realizar el cribado de la infección tuberculosa latente en los niños y adolescentes que pertenecen a grupos de riesgo. Se sugiere el uso de la prueba cutánea de la tuberculina (PCT) como primera prueba para el cribado de la infección tuberculosa latente en niños y adolescentes de nuestro país. Se sugiere utilizar los IGRA para los niños y adolescentes de cinco o más años con PCT positiva y antecedente de vacunación con bacilo de Calmette-Guérin (BCG) para mejorar la especificidad de la prueba de cribado (AU)
There is evidence that latent tuberculosis infection (LTBI) screening in low incidence areas, has a poor efficiency, many false positives and is not cost-effective. There is evidence that LTBI screening in groups at high risk of developing active tuberculosis infection (ATBI) improves the efficiency of the diagnostic tests as well as the risk-benefit balance and should take part of the strategies to reduce tuberculosis impact. Tuberculin skin test is still the best performing diagnostic test in the screening for latent tuberculosis infection in children and adolescents. PrevInfad recommendations (GRADE): Universal screening of latent tuberculosis infection in children and adolescents of our country is not recommended. Universal screening of latent tuberculosis infection in high risk groups of children and adolescents is recommended. Tuberculin skin test (TST) as the first test for screening of latent tuberculosis infection in children and adolescents of our country is suggested. IGRA for children and adolescents five or more years old with a positive TST and history of BCG vaccination, is suggested in order to improve the screening test specificity (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Tuberculosis/epidemiology , Skin Tests/instrumentation , Skin Tests/methods , Skin Tests , Tuberculin/isolation & purification , Tuberculin Test/methods , Epidemiological Monitoring/standards , Epidemiological Monitoring , Mass Screening/methods , Mass Screening/statistics & numerical data , Tuberculosis/prevention & control , Drug Delivery Systems/methods , Drug Delivery Systems , Epidemiological Monitoring/organization & administration , Epidemiological Monitoring/statistics & numerical data , Risk GroupsABSTRACT
BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha=0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma.
Subject(s)
Asthma/epidemiology , Caregivers/statistics & numerical data , Quality of Life , Adolescent , Child , Child, Preschool , Female , Humans , Male , Psychometrics/methods , Reproducibility of Results , Spain/epidemiology , Surveys and Questionnaires/standardsABSTRACT
Un ensayo clínico, publicado en 2014, bien diseñado y con poca probabilidad de sesgo, muestra que en niños de alto riesgo de enfermedad celíaca, la ingesta de gluten en pequeñas cantidades no reduce la incidencia de enfermedad celíaca a los tres años de vida; también, que la lactancia materna tampoco tuvo ningún efecto en la incidencia de la enfermedad a los tres años. Estos resultados están en clara contradicción con las recomendaciones emitidas en 2008 por la European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). La conclusión es que se mantiene la recomendación de la lactancia materna exclusiva en los primeros seis meses de vida y que la introducción progresiva del gluten entre los cuatro y los seis meses de edad no reduce la incidencia de enfermedad celíaca (AU)
A well designed clinical trial, with low risk of bias, published in 2014, shows that, in celiac disease high risk infants, small amounts of gluten in the diet dont reduce the incidence of celiac disease at three years of age; moreover, breastfeeding didnt have any effect in the disease incidence at three years of age either. These results are clearly contradictory with the 2008 ESPGHAN recommendations. The conclusion is the adherence to the recommendation of exclusive breastfeeding the first six months of life and that the progressive introduction of gluten between 4 and 6 months of age do not reduce celiac disease incidence (AU)
Subject(s)
Female , Humans , Infant , Male , Glutens/therapeutic use , Celiac Disease/diet therapy , Wheat Hypersensitivity/diet therapy , Wheat Hypersensitivity/epidemiology , Prospective Studies , Double-Blind Method , Breast Feeding/instrumentation , Breast Feeding/methodsABSTRACT
En el presente trabajo se aportan los resultados obtenidos de la revisión del tema del cribado de la escoliosis idiopática del adolescente. No existe acuerdo entre las distintas sociedades científicas implicadas en este problema sobre si se debe o no realizar cribado universal sistemático de esta patología. Tras elaborar un marco analítico donde se encuadran las preguntas clínicas que se tratan de responder, se repasan los conceptos de magnitud del problema e historia natural del proceso. Se valoran los estudios sobre las pruebas de cribado y la eficacia del tratamiento. Se refieren los datos existentes sobre la eficacia de los programas de cribado, su balance riesgo-beneficio y su coste-efectividad. Se informa sobre las recomendaciones de los grupos de expertos a nivel internacional. El grupo PrevInfad considera que los riesgos del cribado universal de la escoliosis idiopática del adolescente son mayores que los beneficios y sugiere no realizar el cribado sistemático (AU)
The present paper provides the results of the review on adolescent idiopathic scoliosis screening. There is no agreement among the different scientific societies involved on the issue of recommending or not the universal systematic screening of this condition. An analytic framework is provided with the involved clinical questions to be answered. The prevalence and natural history are described. The studies on screening tests and treatment effectiveness are appraised. The existent data on effectiveness of screening programs are provided, as well as their risk-benefits balance and cost-effectiveness. The recommendations of international expert groups are reported. The group PrevInfad considers that the risks of universal adolescent idiopathic scoliosis screening outweigh the benefits so we suggest not to do systematic screening (AU)
Subject(s)
Adolescent , Female , Humans , Male , Scoliosis/epidemiology , Scoliosis/prevention & control , Mass Screening/analysis , Mass Screening/methods , Quality of Life , Predictive Value of Tests , Exercise , Risk Assessment/methods , Evaluation of the Efficacy-Effectiveness of Interventions , 50303 , Primary Health Care/methods , Primary Health Care/trends , Surveys and Questionnaires , Natural HistoryABSTRACT
En el presente trabajo se revisan y actualizan las recomendaciones de PrevInfad sobre el cribado de alteraciones visuales en la infancia. Se analizan los beneficios en salud de la detección precoz, la validez y seguridad de las pruebas de cribado, la efectividad del tratamiento y los posibles riesgos de la detección precoz y el tratamiento de los problemas detectados. PrevInfad recomienda incluir la inspección ocular y la prueba del reflejo rojo en las visitas de salud de los primeros seis meses de vida, así como la detección de alteraciones visuales (ambliopía, estrabismo y errores de refracción) a la edad de 3-5 años. La evidencia para evaluar el balance entre los beneficios y los riesgos del cribado de la disminución de la agudeza visual por errores de refracción en niños de 6 a 14 años es insuficiente. Debido a su extensión, el texto se ha divido en dos partes, siendo esta la segunda de ellas (AU)
In this paper the recommendations of PrevInfad on visual screening in children are reviewed. The health benefits of early detection, and the validity and safety of the screening tests are analysed as well as treatment effectivity and the potential risks of early diagnosis and treatment of the detected problems. PrevInfad recommends including eye inspection and red reflex test in the health visits of the first 6 month of life, as well as the detection of visual impairments (amblyopia, strabismus and refraction errors) at 3-5 years of age. Evidence to assess the balance between risks and benefits of reduced visual acuity screening in children 6 to 14 years old is insufficient. Due to its extent, the text has been divided into two parts. We present in this paper the second part (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Vision Screening/methods , Vision Disorders/diagnosis , Visual Acuity , Refractive Errors/epidemiology , Refractometry/methods , School Health ServicesABSTRACT
En el presente trabajo se revisan y actualizan las recomendaciones de PrevInfad sobre el cribado de alteraciones visuales en la infancia. Se analizan los beneficios en salud de la detección precoz, la validez y seguridad de las pruebas de cribado, la efectividad del tratamiento y los posibles riesgos de la detección precoz y el tratamiento de los problemas detectados. PrevInfad recomienda incluir la inspección ocular y la prueba del reflejo rojo en las visitas de salud de los primeros seis meses de vida, así como la detección de alteraciones visuales (ambliopía, estrabismo y errores de refracción) a la edad de 3-5 años. La evidencia para evaluar el balance entre los beneficios y los riesgos del cribado de la disminución de la agudeza visual por errores de refracción en niños de 6 a 14 años es insuficiente. Debido a su extensión, el texto se ha divido en dos partes. Presentamos en este artículo la primera de ellas (AU)
In this paper the recommendations of PrevInfad on visual screening in children are reviewed. The health benefits of early detection, and the validity and safety of the screening tests are analyzed as well as treatment effectivity, potential risks of early diagnosis and treatment of the detected problems. PrevInfad recommends including eye inspection and red reflex test in the health visits of the first 6 month of life, as well as the detection of visual impairments (amblyopia, strabismus and refraction errors) at 3-5 years of age. Evidence to assess the balance between risks and benefits of reduced visual acuity screening in children 6 to 14 years old is insufficient. Due to its extent, the text has been divided into two parts. We present in this paper the first of them (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child , Adolescent , Eye Diseases/epidemiology , Eye Diseases/prevention & control , Amblyopia/epidemiology , Amblyopia/prevention & control , Visual Acuity/immunology , Visual Acuity/physiology , Early Diagnosis , Vision Disorders/economics , Mass Screening/methods , Vision Disorders/epidemiology , Vision Disorders/prevention & control , Vision Tests/methods , Evaluation of the Efficacy-Effectiveness of InterventionsABSTRACT
El beneficio de la suplementación con yodo durante la gestación en las áreas con deficiencia grave de yodo está bien establecido. En el año 2004 la Organización Mundial de la Salud incluyó a España entre los países con adecuada ingesta de yodo y varios estudios recientes confirman que la ingesta de yodo es suficiente en la población española. Los profesionales españoles, sin embargo, se han encontrado con recomendaciones contradictorias, lo que ha generado confusión e incertidumbre en la práctica a seguir en cuanto a la suplementación de yodo a la mujer gestante o en periodo de lactancia. A los clínicos e investigadores les preocupa que las situaciones de déficit de yodo leve o moderado puedan relacionarse con un peor desarrollo de los niños, pero la suplementación rutinaria de yodo en la gestación no está exenta de riesgo. PrevInfad considera que, al tratarse de una medida profiláctica que afecta a dos individuos -madre e hijo- y que se aplica al conjunto de una población sana, debe primar el principio de precaución y que no existen pruebas de calidad suficiente para determinar el balance entre los beneficios y los riesgos de la suplementación farmacológica de yodo durante la gestación y la lactancia, por lo que sugiere que no se realice esta intervención (AU)
The benefits of Iodine supplementation in Iodine-deficient areas are well established. The World Health Organization included Spain among the countries with an adequate Iodine intake in 2004 and some recent research papers confirm that Iodine intake is adequate in the Spanish population. Nevertheless, Spanish health professionals have been faced with contradictory recommendations, producing confusion and uncertainty in clinical practice referring to Iodine supplementation in pregnancy and breastfeeding mothers. Clinicians and researchers are concerned that mild or moderate Iodine deficiency could be related to underdevelopment in children, but routine Iodine supplementation in pregnancy is not risk free. The working group PrevInfad (Prevention in Childhood and Adolescence) considers that being a preventive intervention that applies to the total healthy population, the precaution principle must be prioritized, and that there is no evidence on the balance risk-benefit in the pharmacological Iodine supplementation during pregnancy and breastfeeding. For these reasons they suggest not making this intervention
Subject(s)
Humans , Female , Pregnancy , Iodine/administration & dosage , Prenatal Nutrition , Breast Feeding , Maternal Nutrition , Thyroid Diseases/prevention & control , Dietary Supplements , Thyroid Function Tests , Thyroid Hormones/analysisABSTRACT
Broccoli (Brassica oleracea var. italica), cauliflower (B. oleracea var. botrytis), and cabbage (B. oleracea var. capitata) have been grown in central Mexico since 1970, with 21,000 ha cropped in 2001. In contrast, areas grown with oilseed rape (B. napus) are very limited in Mexico (<8,000 ha). Blackleg, a destructive disease of B. napus in most parts of the world, was first observed in Mexico in Zacatecas and Aguascalientes in 1988 on B. oleracea, causing as much as 70% yield loss. A species complex of two closely related Dothideomycete species, Leptosphaeria maculans and L. biglobosa, is associated with this disease of crucifers (1), but leaf symptoms on susceptible plants are different, with L. maculans typically causing >15-mm pale gray lesions with numerous pycnidia, whereas L. biglobosa causes dark and smaller lesions only containing a few pycnidia. Having a similar epidemiology, both species can be present on the same plants at the same time, and symptom confusion can occur as a function of the physiological condition of the plant or expression of plant resistance responses. A total of 209 isolates from symptomatic B. oleracea leaves were collected from three fields in central states of Mexico (58 to 71 isolates per location). All leaves showed similar symptoms, including a 10- to 15-mm tissue collapse with an occasional dark margin. Cotyledons of seven B. napus differentials were inoculated with conidia of all the isolates as described by Dilmaghani et al. (1). Two hundred isolates caused tissue collapse typical of L. maculans. However, nine obtained from white cabbage in a single location in Aguascalientes caused <5-mm dark lesions. When inoculated onto cotyledons of three B. oleracea genotypes commonly grown in Mexico (cvs. Domador, Monaco, and Iron Man), the nine isolates caused a range of symptoms characterized by tissue collapse (maximum 10 to 15 mm), showing the presence of patches of black necrotic spots within the collapse. The occasional presence of a few pycnidia allowed us to reisolate the fungus for molecular identification. ITS1-5.8S-ITS2, (internal transcribed spacers and 5.8S rDNA), actin, and ß-tubulin sequences were obtained as described previously (4). Multiple gene genealogies based on these sequence data showed two subclades of L. biglobosa: L. biglobosa 'occiaustralensis' (one isolate; ITS [AM410082], actin [AM410084], and ß-tubulin [AM410083]) and L. biglobosa 'canadensis' (eight isolates; ITS [AJ550868], actin [AY748956], and ß-tubulin [AY749004]) (3,4), which were previously described on B. napus in the United States, Canada, and Chile. To our knowledge, this is the first report of L. biglobosa in Mexico. Previously, this species has only been reported once on B. oleracea without discrimination into subclades (2). In the Aguascalientes sampling, 24% of the isolates were L. biglobosa, similar to Canadian locations where this species is still common as compared with L. maculans (1). The large proportion of sampled L. biglobosa 'canadensis', highlights the prevalence of this subclade throughout the American continent (1). References: (1) A. Dilmaghani et al. Plant Pathol. 58:1044, 2009. (2) E. Koch et al. Mol. Plant-Microbe Interact. 4:341, 1991. (3) E. Mendes-Pereira et al. Mycol Res. 107:1287, 2003. (4) L. Vincenot et al. Phytopathology 98:321, 2008.
ABSTRACT
We present the Spanish adaptation made by the CEIPC of the European Guidelines on Cardiovascular Disease Prevention (CVD) in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD through the management of its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care medical doctors in promoting a healthy life style, based on increasing physical activity, change dietary habits, and non smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but among patients with diabetes, chronic kidney disease, or definite CVD, the objective is <130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL<130 mg/dl, although among patients with CVD or diabetes, the objective is <100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, to reach body mass index (BMI) guided and waist circumference objectives. In diabetic type 2 patients, the objective is glycated haemoglobin <7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to transfer the recommendations established into the daily clinical practice.
Subject(s)
Cardiovascular Diseases/prevention & control , Clinical Medicine/standards , Age Factors , Biomarkers , Blood Pressure , Body Mass Index , Cardiovascular Diseases/mortality , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/therapy , Cholesterol/blood , Clinical Trials as Topic , Diabetes Mellitus, Type 2/prevention & control , Humans , Life Style , Platelet Aggregation Inhibitors/therapeutic use , Practice Patterns, Physicians' , Risk Factors , SpainABSTRACT
Presentamos la adaptación española realizada por el CEIPC de la Guía Europea de Prevención de las Enfermedades Cardiovasculares (ECV) 2008. Esta guía recomienda el modelo SCORE de bajo riesgo para la valoración del riesgo cardiovascular. El objetivo es prevenir la mortalidad y morbilidad debidas a las ECV mediante el manejo de sus factores de riesgo en la práctica clínica. La guía hace énfasis en la prevención primaria y en el papel del médico y la enfermería de atención primaria en la promoción de un estilo de vida saludable, basado en el incremento de los niveles de actividad física, la adopción de una alimentación saludable y, en los fumadores, el abandono del tabaco. La meta terapéutica para la presión arterial es en general <140/90 mmHg; pero en pacientes con diabetes, enfermedad renal crónica o ECV el objetivo es 130/80 mmHg. El colesterol debe mantenerse por debajo de 200 mg/dl (cLDL<130 mg/dl); en los pacientes con ECV o diabetes el objetivo es cLDL<100 mg/dl (80 mg/dl si factible en sujetos de muy alto riesgo). En diabetes tipo 2 y en pacientes con síndrome metabólico se debe reducir el peso y aumentar la actividad física y en su caso utilizar los fármacos indicados, para alcanzar los objetivos de índice de masa corporal (IMC) y de perímetro de cintura. El objetivo en diabéticos tipo 2 debe ser alcanzar un nivel de hemoglobina glucosilada (HbA1c) <7%. La amplia difusión de las guías y el desarrollo de los programas destinados a favorecer su implantación, identificando barreras y buscando soluciones, son objetivos prioritarios del CEIPC, como uno de los medios fundamentales para trasladar las recomendaciones establecidas a la práctica clínica diaria (AU)
We present the Spanish adaptation made by the CEIPC of the European Guidelines on Cardiovascular Disease Prevention (CVD) in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD through the management of its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care medical doctors in promoting a healthy life style, based on increasing physical activity, change dietary habits, and non smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but among patients with diabetes, chronic kidney disease, or definite CVD, the objective is <130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL<130 mg/dl, although among patients with CVD or diabetes, the objective is <100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, to reach body mass index (BMI) guided and waist circumference objectives. In diabetic type 2 patients, the objective is glycated haemoglobin <7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to transfer the recommendations established into the daily clinical practice (AU)
Subject(s)
Humans , Cardiovascular Diseases/prevention & control , Clinical Medicine/standards , Diabetes Mellitus, Type 2/prevention & control , Platelet Aggregation Inhibitors/therapeutic use , Biomarkers , Blood Pressure , Body Mass Index , Cardiovascular Diseases/mortality , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/therapy , Cholesterol/blood , Clinical Trials as Topic , Life Style , Practice Patterns, Physicians' , Risk Factors , SpainSubject(s)
Humans , Cardiovascular Diseases/prevention & control , Guidelines as Topic , Risk Factors , Genetic Predisposition to Disease , Hyperlipidemias/complications , Renal Insufficiency/complications , Anticoagulants/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Calcium Channel Blockers/therapeutic use , Diuretics/therapeutic use , Antihypertensive Agents/therapeutic useABSTRACT
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Subject(s)
Humans , Cardiovascular Diseases/prevention & control , Risk Adjustment/methods , Diabetes Complications/prevention & control , Risk Factors , Physician-Patient Relations , Smoking/adverse effects , Overweight/prevention & control , Obesity/prevention & control , Hypertension/prevention & control , Life Style , Lipids/blood , Diabetes Mellitus/prevention & control , Metabolic Syndrome/prevention & controlABSTRACT
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