ABSTRACT
No disponible
Subject(s)
Humans , Critical Care Outcomes , Patient Reported Outcome Measures , Patient Outcome Assessment , Measures of Association, Exposure, Risk or Outcome , Quality of Life/psychology , Sickness Impact ProfileABSTRACT
BACKGROUND: Identifying patients at risk of developing diabetic peripheral neuropathy (DPN) is of paramount importance in those with type 2 diabetes mellitus (T2DM) to provide and anticipate secondary prevention measures as well as intensify action on risk factors, particularly so in primary care. Noteworthy, the incidence of DPN remains unknown in our environment. AIMS: (i) To analyze a single angiotensin-converting enzyme (ACE) gene polymorphism (D/I) as a genetic marker of risk of developing DPN, and (ii) to determine the incidence of DPN in our environment. RESEARCH DESIGN AND METHODS: Longitudinal study with annual follow-up for 3years involving a group of T2DM (N=283) randomly selected. ACE gene polymorphism distribution (I=insertion; D=deletion) was determined. DPN was diagnosed using clinical and neurophysiology evaluation. RESULTS: Baseline DPN prevalence was 28.97% (95% CI, 23.65-34.20). ACE polymorphism heterozygous genotype D/I presence was 60.77% (95% CI, 55.05-66.5) and was independently associated with a decreased risk of DPN (RR, 0.51; 95% CI, 0.30-0.86). DPN correlated with age (P<0.001) but not with gender (P=0.466) or time of evolution of T2DM (P=0.555). Regarding end point, DPN prevalence was 36.4% (95% CI, 30.76-42.04), and accumulated incidence was 10.4% 3years thereafter. In the final Poisson regression analysis, the presence of heterozygous genotype remained independently associated with a decreased risk of DPN (RR, 0.71; (95% CI, 0.53-0.96). DPN presence remained correlated with age (P=0.002), but not with gender (P=0.490) or time of evolution (P=0.630). CONCLUSIONS: In our series, heterozygous ACE polymorphism (D/I) stands as a protective factor for DPN development. Accumulated incidence of DPN was relevant. Further prospective studies are warranted.
Subject(s)
Diabetic Neuropathies/genetics , Peptidyl-Dipeptidase A/genetics , Polymorphism, Single Nucleotide , Aged , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Diabetic Neuropathies/epidemiology , Female , Genetic Markers , Humans , Incidence , Longitudinal Studies , Male , Middle Aged , Mutation , Polymorphism, Genetic , Prevalence , Prospective StudiesABSTRACT
OBJECTIVE: To identify dietary patterns and nutritional status of the population between 18-44 years visited at a health center (HC) and explore the associated factors. METHODS: Cross-sectional study conducted in an urban HC in a random sample of 201 people. Were analyzed socio-demographic data, anthropometric measurements, 24 hours latest reminder intake, weekly food frequency questionnaire. RESULTS: The mean age of participants was 32.81 years (standard deviation 6.72). 63.68% (128) were women and 62.69% (126) immigrants. 45.27% (91) expressed no exercise. About 60% of participants related a deficit in consumption milk, fruits, meat and farinaceous and 80% vegetables, 58% related excessive fat. 44.4% (56) of immigrants was 20.3% with respect to obese (15) of native (P = 0.001). The proportion of people with "waist-risk" was higher among immigrants as compared to the native (19.0% vs 6.8%, P = 0.017) and among those who did not exercise with respect to each other (17.6% vs 8.1%, P = 0.049). Immigrants perform less physical activity related to the native (42.1% vs 62.7%, P = 0.013). Being an immigrant was the variable explaining of distribution acceptable daily macronutrient intake (Odds Ratio 4.7, Confidence Interval 95% 2.02-11.03). DISCUSSION: The participants related excessive consumption of fats and deficient in the rest of food groups. Obesity and the "risk waist" were more common among immigrants and sedentary population. Immigrants talked of a better distribution of nutrients in your daily diet.
Subject(s)
Feeding Behavior , Nutritional Status , Primary Health Care/statistics & numerical data , Adolescent , Adult , Anthropometry , Cross-Sectional Studies , Emigrants and Immigrants , Female , Humans , Male , Malnutrition/epidemiology , Motor Activity , Obesity/epidemiology , Risk , Socioeconomic Factors , Spain/epidemiology , Surveys and Questionnaires , Urban Population , Waist Circumference , Young AdultABSTRACT
Introducción: Identificar los hábitos alimentarios y el estado nutricional de la población entre 18-44 años atendida en un centro de salud (CS) y estudiar los factores asociados. Métodos: Estudio transversal realizado en un CS urbano en el que se seleccionó una muestra aleatoria de 201 personas. Se analizaron datos socio-demográficos, medidas antropométricas, recordatorio ingesta últimas 24 horas, cuestionario de frecuencia alimentaria semanal. Resultados: La edad media de los participantes fue de 32,81 años (Desviación Estándar 6,72). El 63,68%(128) eran mujeres y 62,69%(126) inmigrantes. El 45,27%(91) manifestaba no realizar ejercicio. Alrededor del 60% de los participantes refería un consumo deficitario de lácteos, frutas, cárnicos y farináceos y el 80% de verduras; el 58% lo refería excesivo de lípidos. El 44,4%(56) de inmigrantes era obeso respecto al 20,3%(15) de autóctonos (P= 0,001). La proporción de personas con «cintura de riesgo» era superior entre los inmigrantes respecto a los autóctonos (19,0% vs 6,8%; P= 0,017) y entre los que no hacían ejercicio respecto a los que sí (17,6% vs 8,1%; P= 0,049). Los inmigrantes referían realizar menos ejercicio físico que los autóctonos (42,1% vs 62,7%; P= 0,013). Ser inmigrante era la variable más explicativa de la distribución aceptable de macronutrientes en la ingesta diaria (Odds Ratio 4,7; Intervalo de Confianza del 95% 2,02-11,03). Discusión: Los participantes referían un consumo excesivo de lípidos y deficitario del resto de grupos alimentarios. La obesidad y la «cintura de riesgo» eran más frecuentes entre los inmigrantes y los participantes más sedentarios. Los inmigrantes referían una mejor distribución de macronutrientes en su alimentación diaria (AU)
Objective: To identify dietary patterns and nutritional status of the population between 18-44 years visited at a health center (HC) and explore the associated factors. Methods: Cross-sectional study conducted in an urban HC in a random sample of 201 people. Were analyzed socio-demographic data, anthropometric measurements, 24 hours latest reminder intake, weekly food frequency questionnaire. Results: The mean age of participants was 32.81 years (standard deviation 6.72). 63.68% (128) were women and 62.69% (126) immigrants. 45.27% (91) expressed no exercise. About 60% of participants related a deficit in consumption milk, fruits, meat and farinaceous and 80% vegetables, 58% related excessive fat. 44.4% (56) of immigrants was 20.3% with respect to obese (15) of native (P = 0.001). The proportion of people with «waist-risk» was higher among immigrants as compared to the native (19.0% vs 6.8%, P = 0.017) and among those who did not exercise with respect to each other (17.6% vs 8.1%, P = 0.049). Immigrants perform less physical activity related to the native (42.1% vs 62.7%, P = 0.013). Being an immigrant was the variable explaining of distribution acceptable daily macronutrient intake (Odds Ratio 4.7, Confidence Interval 95% 2.02-11.03). Discussion: The participants related excessive consumption of fats and deficient in the rest of food groups. Obesity and the «risk waist» were more common among immigrants and sedentary population. Immigrants talked of a better distribution of nutrients in your daily diet (AU)
Subject(s)
Humans , Male , Female , Adult , Nutrition Assessment , Feeding Behavior , Nutrition Disorders/epidemiology , Primary Health Care/methods , Body Weights and Measures/statistics & numerical data , Human MigrationABSTRACT
Antecedentes: El deterioro de la función renal se ha asociado con un incremento de la morbimortalidad cardiovascular. El objetivo del estudio fue analizar la asociación del filtrado glomerular (FG) basal, según las fórmulas de Cockcroft-Gault y MDRD, con la incidencia de eventos cardiovasculares (ECV) en una cohorte de personas hipertensas seguida durante 12 años. Métodos: Estudio prospectivo de una muestra aleatoria de 223 hipertensos libres de ECV atendidos en un centro de atención primaria urbano. Se estimó el FG mediante ambas fórmulas. Se consideró ECV la aparición de cardiopatía isquémica, insuficiencia cardíaca, accidente cerebrovascular, vasculopatía periférica o muerte por ECV. Se analizaron los datos mediante el método actuarial y modelos de regresión de Cox. Resultados: La mediana de tiempo de seguimiento fue de 10,7 años (rango intercuartílico,6,5-12,1). El seguimiento fue completo en 191 participantes (85,7%). La supervivencia acumulada fue del 64,7% (intervalo de confianza [IC] del 95%: 57,9-71,6%). La tasa media de incidencia de ECV durante todo el período de seguimiento fue de 3,6 (IC del 95%, 2,7-4,4%) por 100 personas hipertensas/año. El modelo multivariable final mostró que las variables con mayor poder predictivo de ECV en la población de estudio fueron la diabetes y la estimación del FG >60ml/min/1,73 m2mediante fórmula MDRD. Conclusiones: Se observó una relación entre la aparición de ECV y los valores de FG estimados por la fórmula MDRD al inicio del seguimiento superiores a 60 ml/min/1,73 m2, inversa a la eserada. La estimación del FG mediante fórmula de Cockcroft-Gault no se asoció con el riesgo cardiovascular (AU)
Background: Renal function decrease is associated with cardiovascular morbidity and mortality. The aim was to analyze the association of cardiovascular morbidity and mortality with baseline glomerular filtration rate (GFR), according Cockcroft-Gault and MDRD formulas, with incidence of major adverse cardiovascular events (MACEs) in a cohort of hypertensive individuals followed for 12 years. Methods: We performed a prospective study of a random sample of 223 hypertensive patients free of MACEs followed in an urban Primary Care Center. GFR was estimated using both formulas. MACEs were considered the onset of ischemic heart disease, heart failure, stroke, peripheral vascular disease or cardiovascular death. Data were analyzed using the life-table method and Cox regression modeling. Results: Follow-up median was 10.7 (interquartile range, 6.5-12.1) years. Follow-up was complete in 191 participants (85.7%). The cumulative survival was 64.7% (95%Confidence Interval (CI) 57.9%-71.6%). The incidence of MACEs during the follow-up period was 3.6 (95% CI, 2.7-4.4) per 100 subject-years. The final multivariable model showed that the most predictive variables of MACEs in the study population were the presence of diabetes and the estimation of GFR >60 ml/min/1.73 m2by MDRD equation. Conclusions: There was a relationship between the occurrence of MACEs and MDRD formula estimated GFR above60 ml/min/1.73 m2at study entry, inversely to what expected. C-G formula estimated GFR by was not associated with cardiovascular risk (AU)
Subject(s)
Humans , Hypertension/physiopathology , Glomerular Filtration Rate , Renal Dialysis , Renal Insufficiency, Chronic/therapy , Indicators of Morbidity and Mortality , Risk Factors , Cardiovascular Diseases/epidemiology , Primary Health Care/statistics & numerical dataABSTRACT
BACKGROUND: A decrease in renal function is associated with cardiovascular morbidity and mortality. The aim of this study was to analyse the association of cardiovascular morbidity and mortality with baseline glomerular filtration rate (GFR), calculated according to the Cockcroft-Gault and MDRD formulas, with the incidence of major adverse cardiovascular events (MACEs) in a cohort of hypertensive individuals followed for 12 years. METHOD: We performed a prospective study of a random sample of 223 hypertensive patients free of MACEs, who were followed in an urban Primary Care Centre. GFR was estimated using both formulas. MACEs were considered as the onset of ischaemic heart disease, heart failure, heart attacks, peripheral vascular disease or cardiovascular death. Data were analysed using the life-table method and Cox regression modeling. RESULTS: The median follow-up was 10.7 (interquartile range, 6.5-12.1) years. Follow-up was completed in 191 participants (85.7%). The cumulative survival was 64.7% (95% Confidence Interval (CI), 57.9-71.6). The incidence of MACEs during the follow-up period was 3.6 (95% CI, 2.7-4.4) per 100 subject-years. The final multivariable model showed that the most predictive variables of MACEs in the study population were the presence of diabetes mellitus and the estimation of GFR ≥60 ml/min/1.73 m2 by MDRD equation. CONCLUSIONS: There was a relationship between the occurrence of MACEs and an estimated GFR by MDRD above 60 ml/min/1.73 m2 at study entry, inversely to what was expected. GFR estimated by the C-G formula was not associated with cardiovascular risk.
Subject(s)
Algorithms , Cardiovascular Diseases/epidemiology , Glomerular Filtration Rate , Hypertension/complications , Kidney Diseases/diagnosis , Primary Health Care , Aged , Cardiovascular Diseases/etiology , Cardiovascular Diseases/mortality , Cause of Death , Comorbidity , Diabetes Complications/epidemiology , Female , Humans , Hypertension/physiopathology , Incidence , Kaplan-Meier Estimate , Kidney Diseases/blood , Kidney Diseases/complications , Kidney Diseases/physiopathology , Male , Middle Aged , Obesity/epidemiology , Proportional Hazards Models , Prospective Studies , Risk Factors , Sampling Studies , Spain/epidemiology , Survival Rate , Urban PopulationABSTRACT
No disponible
Subject(s)
Male , Humans , Adolescent , Paralysis , Paralysis , Spinal Cord , Arteriovenous Malformations , Acute Disease , Spinal CordABSTRACT
BACKGROUND: Historically the district of Ciutat Vella in Barcelona has a high incidence of tuberculosis (TB) and, more recently, it is home to a considerable proportion of immigrants. OBJECTIVES: To determine the prevalence of tuberculous infection (TI) in a pediatric population from this district and evaluate the impact of immigration. METHODS: Children and adolescents aged < 16 years old were screened using the tuberculin skin test (TST) mainly in visits of the healthy child program. Proportions were compared using the x2 test and adjusted odds ratios were estimated through a logistic regression model. RESULTS: Six hundred ninety-nine children were studied. The overall prevalence of positive TST was 3.4 % (95 % CI: 2.2 %-5.1 %). Prevalence increased with age (P 5 0.009) from 1.9 % in children aged 1-5 years old to 6.4 % in children and adolescents aged 10-15 years. A total of 88.3 % of the immigrants had been vaccinated with BCG compared with 2.5 % of autochthonous children and adolescents (P < 0.001). The prevalence ratio between immigrants and autochthonous children was 2.1 (P 5 0.07). Three cases of TB disease were detected among children, but no index case was found in children with TI. CONCLUSIONS: The high TI prevalence found suggest that living in the district is a risk factor, which justifies routine TST screening of all the children living there. The present criteria for the interpretation of TST in immigrants vaccinated with BCG residing in areas of high incidence are dubious.
Subject(s)
Emigration and Immigration/statistics & numerical data , Tuberculosis/epidemiology , Adolescent , Child , Child, Preschool , Female , Humans , Incidence , Infant , Male , Spain/epidemiologyABSTRACT
Antecedentes: Históricamente, el distrito Ciutat Vella de Barcelona presenta una elevada incidencia de tuberculosis y, más recientemente, alberga una proporción considerable de inmigrantes. Objetivos: Determinar la prevalencia de infección tuberculosa en una población pediátrica de dicho distrito, considerando el impacto de la inmigración. Métodos: Cribado de los niños menores de 16 años mediante la realización de la prueba de la tuberculina, mayoritariamente en las visitas del programa de atención al niño sano. Comparación de proporciones mediante la prueba estadística de la X2 y estimación odds ratio ajustadas mediante modelo de regresión logística. Resultados: Se estudiaron 699 niños. La prevalencia observada de pruebas de la tuberculina positivas fue 3,4 por ciento (intervalo de confianza [IC] 95 por ciento: 2,2-5,1), ésta aumentaba con la edad (p=0,009), desde 1,9 por ciento en niños de 1-5 hasta 6,4 por ciento en los de 10-15 años. Un 88,3 por ciento de los inmigrantes estaba vacunado con bacilo de Calmette-Guérin (BCG) frente al 2,5 por ciento de los autóctonos (p < 0,001). La razón de prevalencias entre los hijos de inmigrantes e inmigrantes y los niños autóctonos fue de 2,1 (p=0,07). Se detectaron 3 casos de tuberculosis en niños; no se encontró el foco en ningún caso entre los niños con infección tuberculosa. Conclusiones: La elevada prevalencia de infección tuberculosa observada sugiere que vivir en el distrito es un factor de riesgo, lo cual justifica realizar pruebas de tuberculina sistemáticas a los niños que residen allí. Los criterios actuales para valorar la prueba de la tuberculina en niños inmigrantes vacunados con BCG residentes en zonas de alta incidencia de tuberculosis, son dudosos (AU)
