Health-Related Quality of Life and Injuries in Physical Education Students: A Multi-Group Model According to the Degree of Adherence to the Mediterranean Diet.

The Mediterranean diet is considered a healthy eating pattern. It has been shown to improve people's quality of life. When a person suffers injuries, their quality of life suffers. This research aims to accomplish the following: (a) to study the differences in the effect of the health-related quality of life on injuries according to the degree of adherence to the Mediterranean diet, (b) to analyse the existing differences in the variables that make up the health-related quality of life according to the degree of adherence to the Mediterranean diet, and (c) to analyse the degree of adherence to the Mediterranean diet according to whether the participants have suffered any injury. The study was descriptive, cross-sectional, and exploratory in a sample of 556 physical education students. The PREDIMED questionnaire, the SF-36 questionnaire, and a self-administered questionnaire were used. The results showed that high adherence to the Mediterranean diet was associated with higher quality of life and lower injury rates. It was also observed that high adherence to the Mediterranean diet improved the effect of the quality of life on injuries. In conclusion, the Mediterranean diet is beneficial for the quality of life of young university students.

Differentiation of acanthamoeba keratitis from other non-acanthamoeba keratitis: Risk factors and clinical features.

INTRODUCTION: Infectious Keratitis is one of the most common ocular emergencies seen by ophthalmologists. Our aim is to identify the risk factors and clinical features of Acanthamoeba Keratitis (AK). METHODS: This retrospective chart review study was conducted at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, and included all the microbial keratitis cases, male and female patients of all ages. The main outcome is the differentiation between various microbial keratitis types. RESULTS: We included 134 consecutive eyes of 126 persons. We had 24 cases of acanthamoeba keratitis, 22 bacterial keratitis, 24 fungal keratitis, 32 herpetic keratitis, and 32 bacterial co-infection. Contact lens wear was found in 33 eyes (24.6%). Among acanthamoeba keratitis patients, 73% were ≤ 39 years of age, and 73% were females (P <0.001). Also, in AK cases, epithelial defect was found in all cases (100%), endothelial plaques were found in 18 eyes (69.2%), 12 cases had radial keratoneuritis (46.2%), and ring infiltrate was found in 53.8% of AK cases. CONCLUSIONS: We determined the factors that increase the risk of acanthamoeba infection and the clinical characteristics that help distinguish it from other types of microbial keratitis. Our findings suggest that younger females and patients who wear contact lenses are more likely to develop acanthamoeba keratitis. The occurrence of epitheliopathy, ring infiltrate, radial keratoneuritis, and endothelial plaques indicate the possibility of acanthamoeba infection. Promoting education on wearing contact lenses is essential to reduce the risk of acanthamoeba infection, as it is the most significant risk factor for this infection.

Niveles de Actividad Física y aspectos saludables en niños de 4 a 6 años de Granada / Physical Activity Levels and health aspects in children from 4 to 6 years old of Granada

El sedentarismo, la inactividad física, así como el sobrepeso y obesidad son los principales problemas de salud física y mental de la población infantil y juvenil, al igual que de adultos. Este tipo de problemática puede deberse principalmente a la alimentación y la cantidad de actividad física realizada desde edades muy tempranas. Hoy en día, los niños y niñas desde muy pequeños se alimentan a diario de comida basura, además de dulces ultra procesados, añadiéndole a esto, la no realización de actividad física y el sedentarismo debido principalmente a las nuevas tecnologías, creando así malos hábitos. El objetivo central de este estudio es relacionar y analizar la Adherencia a la Dieta Mediterránea y el nivel de actividad física de niños de edades comprendidas entre 4 y 6 años, enfocándose para ello en las diferencias existentes entre el género y la edad. Para ello, se ha utilizado un estudio de corte transversal y tipo descriptivo, contando con una muestra de 243 participantes de la provincia de Granada, quienes completaron el test KIDMED. Como resultados se obtuvo que, son los chicos quienes realizan mayor cantidad de actividad física, así como mejor adherencia a la Dieta Mediterránea. Además, cabe destacar que 7 de cada 10 de los participantes necesitan mejorar o poseen una dieta de baja calidad (AU)

A sedentary behaviour, physical inactivity, as well as overweight and obesity are the main physical and mental health problems of children and young people and adults. These problems may be due principally to diet and physical activity from a very early age. Today, children from a very early age are fed daily with junk food, as well as ultra-processed sweets, adding to this, the lack of physical activity and sedentary lifestyles, mainly due to new technologies, thus creating bad habits. The aim of this study is to relate and analyse the adherence to the Mediterranean Diet and the level of physical activity of children aged between 4 and 6 years, focusing on the existing differences between gender and age. A descriptive cross-sectional study was used, with a sample of 243 participants from the city of Granada, completing the KIDMED test. The results showed that boys are the ones who do more physical activity, as well as better adherence to the Mediterranean Diet. In addition, it is worth noting that 7 out of 10 of the participants need to improve or have a poor quality diet (AU)

Stress, Resilience, Burnout and Study Hours in Physical Education Pre-Service Teachers-An Explanatory Model about Gender.

The process of becoming a public teacher in Spain requires a long period of preparation. This long period of preparation has an impact on the psychosocial environment of the candidates. Differences have been observed in the psychosocial area according to gender in pre-service teachers. This research aims to study the relationship between the study hours per day, stress, burnout syndrome and resilience according to gender and to study the differences in the effects according to gender using multigroup equation modeling. A multigroup structural equation analysis has been proposed according to the gender of the participants. Parametric tests were used for the descriptive analysis of the results. The sample consists of 4117 participants, 1363 males and 2754 females. The instruments used to collect the data were a self-made questionnaire, Perceived Stress Questionnaire, Connor-Davidson Resilience Scale and Maslach Burnout Inventory. All the instruments have been validated and adapted to the sample. The data reveal that there are variations in the effects of the variables according to the gender of the participants. In conclusion, it is affirmed that gender is a very important factor in coping with the competitive examination process for state-public-teaching institutions, as well as in avoiding the appearance of disruptive states generated by this preparation process.

Relationship between Physical Activity, Mediterranean Diet and Emotional Intelligence in Spanish Primary Education Students.

There is an international social concern about the low levels of physical activity among young people. It is essential to know what factors influence the practice of physical activity in order to design effective proposals for health promotion. The study aims to: (1) classify primary school students according to their levels of out-of-school physical activity, Mediterranean diet, emotional attention, emotional clarity and emotional repair; (2) analyse descriptively and correlationally the adolescents' profiles of out-of-school physical activity, Mediterranean diet and emotional attention, clarity and repair. The study design was cross-sectional and descriptive-correlational. The sample consisted of 293 children aged 10-12 years in Granada (Spain). An ad hoc socio-academic questionnaire, the KIDMED test and the Trait Meta-Mood Scale (TMMS-24) were used for data collection. Four clusters were identified by the Ward's method and participants were classified using the K-means method. Subsequently, cluster classification was validated through the MANOVA test (F (861) = 106.12; p ≤ 0.001; f = 1.95). The strongest correlation was obtained in cluster 1 between emotional clarity and emotional repair (r = 0.56; p ≤ 0.01). In conclusion, the mean values of time spent in out-of-school physical activity, Mediterranean diet, emotional attention, emotional clarity and emotional repair of students are adequate and vary according to sex. There are significant differences among the physical activity levels of all clusters, as well as among the emotional variables of attention, clarity and repair. In addition, the correlations between the variables studied vary in each cluster.

Associations of Mediterranean Diet, Psychological Wellbeing and Media Pressure on Physical Complexion and Effect of Weekly Physical Activity Engagement in Higher Education.

Nowadays, the media has the power to encourage active and healthy lifestyles; however, it can have a negative impact on body image and psychological wellbeing. The present research aims to analyze Mediterranean diet adherence, media pressure, slim and athletic build ideals and psychological wellbeing as a function of weekly physical activity engagement. A further aim is to examine the effect of Mediterranean diet adherence, media pressure and psychological wellbeing on the perceived pressure to have an athletic and slim build. The present non-experimental study included a sample of 634 university students. Validated instruments adapted by the scientific community were used for data collection. Gathered data reveal that young people who engage in more than 300 min of physical activity per week are more likely to adhere to a Mediterranean diet, have better psychological wellbeing and feel more pressure to obtain an athletic build. In conclusion, weekly physical activity engagement impacts the variables under study.

Programas de prevención de lesiones en la clase de Educación Física. Una revisión sistemática / Injury prevention programmes in the physical education classroom. A systematic review

Las lesiones musculoesqueléticas están relacionadas en gran medida con la práctica de actividad físico-deportiva. En el caso de los niños y adolescentes se vinculan al ejercicio que realizan en el transcurso de las clases de Educación Física o las actividades deportivas extraescolares. En esta revisión sistemática, el objetivo de investigación es conocer la tipología lesional existente en el contexto escolar educativo y los programas de prevención vinculados a la descripción de las lesiones que se producen en él y conocer los programas de prevención que se implementan por docentes de Educación Física en el transcurso de sus clases. Se realizó una búsqueda de literatura científica durante los meses de enero y febrero del año 2023 en las bases de datos Web of Science, SCOPUS y PubMed. Como motores de búsqueda se utilizaron las siguientes palabras clave: "injur*", "prevent*”, “program*" y "physical education"; empleándose el operador boleano “and”. Como conclusión destaca la necesidad de continuar investigando y desarrollando programas efectivos de prevención de lesiones en el ámbito escolar y deportivo con el fin de proteger la salud y seguridad de los estudiantes. (AU)

Musculoskeletal injuries are largely related to the practice of physical-sporting activity. In the case of children and adolescents, they are linked to the exercise they carry out during Physical Education classes or extracurricular sports activities. In this systematic review, the aim of the research is to find out about the types of injuries that exist in the educational school context and the prevention programmes linked to the description of the injuries that occur in it and to find out about the prevention programmes that are implemented by Physical Education teachers in the course of their classes. A search of scientific literature was carried out during the months of January and February 2023 in the Web of Science, SCOPUS and PubMed databases. The following keywords were used as search engines: "injur*", "prevent*", "program*" and "physical education", using the Boolean operator "and". In conclusion, it highlights the need to continue researching and developing effective injury prevention programmes in schools and sports in order to protect the health and safety of students. (AU)

Mediterranean diet adherence on self-concept and anxiety as a function of weekly physical activity: an explanatory model in higher education.

Introduction: Scientific literature has now demonstrated the benefits of an active lifestyle for people's psychological health. Based on the above statement, the aim was to (a) evaluate and adjust a structural equation model containing the variables anxiety, self-concept, and Mediterranean diet adherence and (b) contrast the proposed theoretical model by studying the differences between the variables according to the level of weekly physical activity in a sample of 558 university students. Methods: A non-experimental, exploratory, cross-sectional investigation has been proposed. Instruments such as the PREDIMED Questionnaire, the Beck Anxiety Inventory, the International Physical Activity Questionnaire, and the Form 5 Self-Concept Questionnaire were used to collect data. Results and discussion: The results illustrate that students showing low adherence to the Mediterranean diet had higher levels of anxiety (M = 0.95) than those showing a high degree of adherence (M = 0.75). It is also observed that young people with a high degree of adherence to the Mediterranean diet report higher scores in the different dimensions of self-concept compared to young people with a low degree of adherence. In conclusion, it is affirmed that young people who show a high degree of adherence to this dietary pattern show lower levels of anxiety and greater recognition of the different areas of their self-concept.

Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia.

AIM: To identify the current surgical management of aphakia and the outcomes and complications of each technique. METHODS: This cross-sectional study included ophthalmic surgeons with at least one-year experience in surgery for aphakia. A study questionnaire was formulated to collect data in Saudi Arabia and other regional countries. The questionnaire included 22 questions on demographics, preferred surgical techniques, complications and the factors related to surgeon decision and the choice for managing aphakia. RESULTS: The study included 145 participants (111; 76.6% were males) with mean age of 46.7 ± 11.5 years. The mean duration of cataract surgery experience was 17.6 ± 11.1 years. Most participants (86.2%) were trained in cataract surgery. Scleral fixation of intraocular lens (SFIOL) was the most commonly preferred technique, followed by iris fixation IOL, and anterior chamber IOL (75.2%, 9%, and 15.9%, respectively). The main determinants for selection of a surgical technique were simplicity (56.6%), surgical instrument availability (48.3%), and training on the technique (47.6%). The most frequent postoperative complications were pupil distortion, high intraocular pressure (IOP), pupillary capture of the IOL, and IOL decentration. CONCLUSIONS: SFIOL is the preferred surgical technique for managing aphakia. The decision to choose one technique over another is complex and is based on several factors, including technical difficulty, previous training, anatomical variations, ocular comorbidities, and the potential complications. The most frequent complications after surgical correction of aphakia are pupil distortion, high IOP, pupillary capture of the IOL, and decentered IOLs.

Levels of Physical Activity, Family Functioning and Self-Concept in Elementary and High School Education Students: A Structural Equation Model.

In the adolescent population there is great concern about low levels of physical activity and low levels of family awareness of the benefits of physical exercise on physical and mental health. This study aims to determine the influence of physical activity levels, family functioning and self-concept in primary and secondary school students, as well as to develop a structural equation model as a function of weekly physical activity time. A descriptive, cross-sectional, comparative study was conducted on whether students engage in more than three hours of physical activity per week. To collect the data, instruments validated by the scientific community were used, such as the Adaptability, Partnership, Growth, Affection, and Resolve family questionnaire (APGAR) and the self-concept questionnaire form 5. The results show that those students who engage in more than 3 h of physical activity per week have higher levels of family functioning than those who do not meet this sport criterion. In addition, physically active students show higher scores on all dimensions of self-concept than those who practice less than 3 h of physical activity per week. Finally, as a conclusion, it can be affirmed that the amount of physical activity practice brings benefits to student's mental health.

Physical Activity Time, Alcohol Consumption, Mediterranean Diet, and Anxiety in Education Science Students.

Student lifestyles change during university. This research aimed to classify university students according to their levels of physical activity, alcohol consumption, adherence to the Mediterranean diet, and anxiety and studied the relationships between the variables using a multigroup equation model according to gender. The sample was composed of 549 participants (M = 23.06; S.D. = 6.22), of whom 409 were women and 140 were men. Validated and adapted instruments such as the Beck Anxiety Inventory, the PREDIMED Questionnaire, and the Alcohol Use Disorder Identification Test were used. The data revealed four clusters through Ward's method and the k-means method. Regarding the exploratory model, differences were found in the effects of the variables according to sex. In conclusion, alcohol consumption was positively associated with the Mediterranean diet, and physical activity was negatively associated with the Mediterranean diet and anxiety.

Relationship between Learning and Psychomotor Skills in Early Childhood Education.

Psychomotor skills are, among others, an aspect particularly valuable for structuring the teaching-learning process of infant schoolchildren. For this reason, a study was carried out with the aim of describing and comparing the socio-demographic, psychomotor, and learning levels of schoolchildren in the second stage of infant education. Ninety-five pupils from the second cycle of infant education in the capital of Granada took part in this study. A sociodemographic questionnaire, the movement assessment battery for children-2 (MABC-2), and the preschool learning behaviour scale (PLBS) were used to collect data. The main results show that manual dexterity appears as the main motor factor and similar figures in the three dimensions of learning behaviours. On the other hand, balance and learning behaviours were higher in 6-year-old schoolchildren. In terms of gender, girls obtained higher values for the level of the learning behaviour variables. A positive correlation was found between the dimensions of learning and motor activity.

Emotional Intelligence, Physical Activity Practice and Mediterranean Diet Adherence-An Explanatory Model in Elementary Education School Students.

Currently, there is a global concern with regard to the lifestyles of young people. This study aims to study the association between Mediterranean diet adherence, emotional intelligence and physical activity practice in teenagers in the last cycle of elementary education. In turn, this objective is divided into (a) developing an explanatory model of the practice of physical activity, Mediterranean diet adherence and emotional intelligence; and (b) developing a multi-group model according to the gender of the participants. A descriptive, cross-sectional, comparative study was conducted in a sample of 293 elementary school students (M = 11.45; S.D = 0.31). The instruments used were an ad hoc socio-demographic questionnaire, the Trait Meta Mood Scale-24, the KIDMED questionnaire and the Physical Activity Questionnaire for Older Children. The results show that males show a positive relationship between adherence to the Mediterranean diet and emotional intelligence and between emotional intelligence and physical activity. In contrast, in the case of females, a negative relationship was observed between emotional intelligence and physical activity. In conclusion, it can be seen that gender plays a fundamental role in adolescence, being a key factor influencing an active and healthy lifestyle.

An Explanatory Model of Sport Motivation, Physical Self-Concept and Anxiety as a Function of the Degree of Adherence to the Mediterranean Diet in Future Physical Education Teachers.

The present research has the objectives of establishing the relationship between motivational climate towards sport, anxiety, and physical self-concept, and identifying the existing relationships between anxiety, motivational climate, and physical self-concept, broken down into (a) developing an explanatory model of the motivational climate towards sport and its relationship with anxiety and physical self-concept, and (b) contrasting the structural model by means of a multi-group analysis according to the degree of adherence to the Mediterranean diet. A quantitative, comparative, non-experimental (ex post facto), cross-sectional study was carried out with a total sample of 556 participants (23.06 ± 6.23). The instruments used were an ad hoc questionnaire and the Spanish versions of the Perceived Motivational Climate in Sport Questionnaire 2, Beck Anxiety Inventory, Self-Concept Form-5, and the PREDIMED questionnaire. The data reveal that participants who show high adherence to the Mediterranean diet attain higher scores on physical self-concept and anxiety, as well as ego-climate. As a conclusion, it is observed that participants who show a high adherence to the Mediterranean diet show higher scores in physical self-concept and anxiety, as well as in all the variables that make up the ego-climate.

Glioblastoma Cells Counteract PARP Inhibition through Pro-Survival Induction of Lipid Droplets Synthesis and Utilization.

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults. Poly (ADP-ribose) polymerase inhibitors (PARPi) represent a new class of anti-neoplastic drugs. In the current study, we have characterized the mechanism by which glioblastoma cells evade the effect of PARPi as anti-tumor agents. We have found that suppression of PARP activity exerts an anti-stemness effect and has a dual impact on autophagy, inducing its activation in the first 24 h (together with down-regulation of the pro-survival mTOR pathway) and preventing autophagosomes fusion to lysosomes at later time-points, in primary glioma cells. In parallel, PARPi triggered the synthesis of lipid droplets (LDs) through ACC-dependent activation of de novo fatty acids (FA) synthesis. Notably, inhibiting ß-oxidation and blocking FA utilization, increased PARPi-induced glioma cell death while treatment with oleic acid (OA) prevented the anti-glioma effect of PARPi. Moreover, LDs fuel glioma cells by inducing pro-survival lipid consumption as confirmed by quantitation of oxygen consumption rates using Seahorse respirometry in presence or absence of OA. In summary, we uncover a novel mechanism by which glioblastoma escapes to anti-tumor agents through metabolic reprogramming, inducing the synthesis and utilization of LDs as a pro-survival strategy in response to PARP inhibition.

Tankyrases as modulators of pro-tumoral functions: molecular insights and therapeutic opportunities.

Tankyrase 1 (TNKS1) and tankyrase 2 (TNKS2) are two homologous proteins that are gaining increasing importance due to their implication in multiple pathways and diseases such as cancer. TNKS1/2 interact with a large variety of substrates through the ankyrin (ANK) domain, which recognizes a sequence present in all the substrates of tankyrase, called Tankyrase Binding Motif (TBM). One of the main functions of tankyrases is the regulation of protein stability through the process of PARylation-dependent ubiquitination (PARdU). Nonetheless, there are other functions less studied that are also essential in order to understand the role of tankyrases in many pathways. In this review, we concentrate in different tankyrase substrates and we analyze in depth the biological consequences derived of their interaction with TNKS1/2. We also examine the concept of both canonical and non-canonical TBMs and finally, we focus on the information about the role of TNKS1/2 in different tumor context, along with the benefits and limitations of the current TNKS inhibitors targeting the catalytic PARP domain and the novel strategies to develop inhibitors against the ankyrin domain. Available data indicates the need for further deepening in the knowledge of tankyrases to elucidate and improve the current view of the role of these PARP family members and get inhibitors with a better therapeutic and safety profile.

Selective modulation by PARP-1 of HIF-1α-recruitment to chromatin during hypoxia is required for tumor adaptation to hypoxic conditions.

BACKGROUND: The adaptation to hypoxia is mainly controlled by the HIF transcription factors. Increased expression/activity of HIF-1α correlates with poor prognosis in cancer patients. PARP-1 inhibitors are used in the clinic to treat BRCAness breast/ovarian cancer and have been shown to regulate the hypoxic response; therefore, their use could be expanded. METHODS: In this work by integrating molecular/cell biology approaches, genome-wide ChIP-seq, and patient samples, we elucidate the extent to which PARP-1 exerts control over HIF-1-regulated genes. RESULTS: In human melanoma, PARP-1 and HIF-1α expression are strongly associated. In response to a hypoxic challenge poly(ADP-ribose) (PAR) is synthesized, HIF-1α is post-transcriptionally modified (PTM) and stabilized by PARylation at specific K/R residues located at its C-terminus. Using an unbiased ChIP-seq approach we demonstrate that PARP-1 dictates hypoxia-dependent HIF-recruitment to chromatin in a range of HIF-regulated genes while analysis of HIF-binding motifs (RCGTG) reveals a restriction on the recognition of hypoxia responsive elements in the absence of PARP-1. Consequently, the cells are poorly adapted to hypoxia, showing a reduced fitness during hypoxic induction. CONCLUSIONS: These data characterize the fine-tuning regulation by PARP-1/PARylation of HIF activation and suggest that PARP inhibitors might have therapeutic potential against cancer types displaying HIF-1α over-activation.

Parp3 promotes astrocytic differentiation through a tight regulation of Nox4-induced ROS and mTorc2 activation.

Parp3 is a member of the Poly(ADP-ribose) polymerase (Parp) family that has been characterized for its functions in strand break repair, chromosomal rearrangements, mitotic segregation and tumor aggressiveness. Yet its physiological implications remain unknown. Here we report a central function of Parp3 in the regulation of redox homeostasis in continuous neurogenesis in mice. We show that the absence of Parp3 provokes Nox4-induced oxidative stress and defective mTorc2 activation leading to inefficient differentiation of post-natal neural stem/progenitor cells to astrocytes. The accumulation of ROS contributes to the decreased activity of mTorc2 as a result of an oxidation-induced and Fbxw7-mediated ubiquitination and degradation of Rictor. In vivo, mTorc2 signaling is compromised in the striatum of naïve post-natal Parp3-deficient mice and 6 h after acute hypoxia-ischemia. These findings reveal a physiological function of Parp3 in the tight regulation of striatal oxidative stress and mTorc2 during astrocytic differentiation and in the acute phase of hypoxia-ischemia.

Características epidemiológicas del hipotiroidismo en un área del sur de España (Sevilla) / Epidemiological characteristics of hypothyroidism in an área in southern Spain (Seville)

OBJETIVO: Determinar la incidencia y prevalencia del hipotiroidismo, estratificándolas por sexo y edad; así como el coste por dosis diaria definida (cDDD) de levotiroxina. DISEÑO: Estudio observacional, descriptivo, longitudinal y retrospectivo. EMPLAZAMIENTO: Área Sanitaria Aljarafe-Sevilla Norte. PARTICIPANTES: Pacientes de cualquier edad y sexo residentes en este Área Sanitaria, que tuvieran prescrita levotiroxina en los años 2015-2017 y al menos dos analíticas consecutivas para el control tiroideo entre 2014-2017. MEDICIONES PRINCIPALES: Se determinaron los valores de tirotropina, tiroxina y anticuerpos antiperoxidasa tiroidea facilitados por la Unidad de Laboratorio del Hospital San Juan de Dios. También los datos de prescripción de levotiroxina y su coste por dosis diaria definida, aportados por la Unidad de Farmacia del Distrito Sanitario Sevilla-Norte. Se consideró el coste del valor medio por dosis diaria definida de levotiroxina. RESULTADOS: Se analizaron 45.224 analíticas tiroideas. El 78,4 % pertenecían a mujeres. La edad media fue 49,04 (DE: 21,24) años. La prevalencia (2017) de hipotiroidismo fue del 5,54 % (IC 95 %: 5,45-5,62), la incidencia acumulada de hipotiroidismo clínico fue 2,67 casos/1.000 personas-año (IC 95 %: 2,67-2,68) y del subclínico 52,04 casos/1.000 personas-año (IC 95 %: 52,01-52,06). El coste medio anual asociado al consumo de levotiroxina fue de 153.081,13 € (DE:12.662,03) (IC 95 %:152.964,43-153.197,83). CONCLUSIONES: El presente estudio establece los primeros datos de incidencia acumulada de hipotiroidismo en un área de España y presenta una prevalencia mayor en comparación con la mayoría de estudios previos. Asimismo, muestra el coste por dosis diaria definida (cDDD) de levotiroxina, que tuvo una tendencia ascendente en el período 2015-2017

OBJECTIVE: To determine the incidence and prevalence of hypothyroidism, stratifying by sex and age, as well as the cost per defined daily dose (cDDD) of levothyroxine. DESIGN: Observational, descriptive, longitudinal, retrospective study. SETTING: Aljarafe-Sevilla Norte Health Area. PARTICIPANTS: Patients of any age and either sex living in this Health Area, who were treated with levothyroxine in 2015-2017 and who had at least two consecutive blood tests for thyroid control between 2014-2017. MAIN MEASURES: Levels of thyrotropin, thyroxine, and anti-thyroid peroxidase antibodies were determined, provided by the Laboratory Unit of the Hospital San Juan de Dios. Data on levothyroxine prescription and its cost per defined daily dose were also determined, provided by the Pharmacy Unit of the Distrito Sanitario Sevilla-Norte. We considered the cost of the mean value per defined daily dose of levothyroxine. RESULTS: 45,224 thyroid tests were analysed. 78.4% belonged to women. The average age was 49.04 (SD: 21.24). The prevalence (2017) of hypothyroidism was 5.54% (95% CI: 5.45-5.62), the cumulative incidence of clinical hypothyroidism was 2.67 cases/1000 persons-year (95% CI: 2.67-2.68) and of subclinical hypothyroidism was 52.04 cases/1000 persons-year (95% CI: 52.01-52.06). The annual average cost associated with levothyroxine use was 153,081.13 € (SD: 12,662.03) (95% CI: 152,964.43-153,197.83). CONCLUSIONS: This study establishes the first data on cumulative incidence of hypothyroidism in a Spanish area and presents a higher prevalence compared to most of the previous studies. Likewise, it shows a cost per defined daily dose (cDDD) of levothyroxine which followed an upward trend in the period 2015-2017

Successful surgical management of post-penetrating or deep lamellar keratoplasty Acquired Corneal Sub-Epithelial Hypertrophy (ACSH): A case series.

INTRODUCTION: Acquired Corneal Sub-Epithelial Hypertrophy (ACSH) has been described in patients with peripheral superficial corneal opacities following penetrating keratoplasty and might present similar to Salzmann's nodular degeneration (SND) or peripheral hypertrophic sub-epithelial corneal degeneration (PHSCD). We describe the clinical presentation, topographic findings and the surgical outcome of three cases, which fit the appearance and characteristics of ACSH. PRESENTATION OF CASES: Three patients (3 eyes) with paracentral or peripheral corneal opacification were reviewed to describe their clinical examination (SL), morphology of the opacity (depth, diameter and density) and document their topographic changes before and after surgical intervention by peeling of the epithelium with or without superficial keratectomy under the microscope in addition to brief description of their histopathological examination. DISCUSSION: All 3 cases were secondary to corneal procedures [Penetrating keratoplasty (PKP) in 1 for pseudophakic bullous keratopathy and deep anterior lamellar keratoplasty (DLK) in 2 for advanced keratoconus]. All cases presented with reduced vision, astigmatic changes in topography or manifest refraction. The visual acuity, symptoms, and topographical findings all improved after treatment. Histopathologically, all cases fit the newly described entity of ACSH. CONCLUSION: Careful clinical judgement guided by corneal topography are needed for proper the diagnosis of acquired corneal opacification that results in reduction of vision to identify ACSH from other similar conditions (PHSCD and SND). Peeling of the thickened epithelial and sub-epithelial tissue is curative avoiding the need for corneal re-grafting.