Prevalencia de diabetes, utilización de antidiabéticos y grado de control glucémico en la provincia de Cádiz (2014-2016): un estudio de base poblacional / Prevalence of diabetes, use of antidiabetic drugs and degree of glycaemic control in the province of Cadiz (2014-2016): A population-based study

Antecedentes y objetivo: Los objetivos de este estudio fueron evaluar la prevalencia de diabetes mellitus tratada farmacológicamente, analizar los patrones de prescripción de los fármacos antidiabéticos y evaluar el grado de control de la enfermedad en la provincia de Cádiz. Pacientes y métodos: Estudio observacional retrospectivo utilizando las bases de datos del Sistema Público de Salud del Servicio Andaluz de Salud entre los años 2014 a 2016, ambos inclusive. Se consideró persona adulta con diabetes tratada (PADT) aquella persona mayor de 14 años que había consumido al menos un envase de medicación del grupo A10 a lo largo de cada uno de los años correspondientes de estudio. Resultados: La prevalencia de PADT varió entre el 8,65% y el 8,83% de 2014 a 2016, respectivamente. Un 71% de PADT estaban tratadas solo con fármacos no insulínicos, un 11% con insulinas y un 18% con una combinación de ambos. En aproximadamente un tercio de las PADT no se había realizado una determinación de HbA1c a lo largo de cada año. El 69% de las PADT evaluadas tenía en 2016 un adecuado grado de control de acuerdo a los criterios de la RedGDPS (según HbA1c y edad). Conclusión: La prevalencia de diabetes tratada farmacológicamente en la provincia de Cádiz es elevada y parece ir en aumento. Los pacientes presentan un limitado control glucémico, al que puede contribuir de forma predominante el seguimiento inadecuado en casi una tercera parte de los mismos

Background and objective: The aim of the study was to assess the prevalence of diabetes mellitus treated pharmacologically, analyse the prescription patterns of antidiabetic drugs and assess the degree of control over the disease in the province of Cadiz. Patients and methods: An observational retrospective study was conducted with the databases of the public health system of the Andalusian Health Service between 2014 and 2016, inclusive. Adults with treated diabetes (ATD) were considered those older than 14 years who had consumed at least 1 package of medication from the A10 group during the corresponding year covered by the study. Results: The prevalence of ATD varied between 8.65% and 8.83% from 2014 to 2016, respectively. Seventy-one percent of the ATD were treated with only noninsulin drugs, 11% were treated with insulin, and 18% were treated with a combination of both. For approximately one-third of the ATD, an HbA1c reading was not performed during each year. Sixty-nine percent of the assessed ATD in 2016 had an appropriate degree of control according to RedGDPS criteria (based on HbA1c and age). Conclusion: The prevalence of pharmacologically treated diabetes in the province of Cadiz is high and appears to be increasing. The patients presented limited glycaemic control, to which inadequate follow-up in almost a third of the patients could be the major contributor

Prevalencia de la diabetes mellitus en la provincia de Cádiz / Prevalence of diabetes mellitus in the province of Cádiz, Spain

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Relevance of breast cancer subtypes for magnetic resonance imaging response monitoring during neoadjuvant chemotherapy

Changes in magnetic resonance imaging (MRI) during neoadjuvant chemotherapy (NAC) have been reported as predictive of pathology outcome in triple-negative and HER2-positive breast cancer. The purpose of our study was to evaluate the relevance of breast cancer subtype for MRI response in 24 women before and during NAC in our centre. Our results show that a reduction greater than 23% is associated with a pathological complete response (pCR) in Her-2-positive and ER-negative/Her2-negative breast cancer, and suggest a trend correlation between higher ADC values and pCR in these subtypes in comparison with ER-positive/Her2-negative breast cancers. Higher proliferating tumours respond better to chemotherapy and our study suggests that changes in MRI during NAC are predictive of pCR in these breast cancer subtypes (AU)

Prevalencia de la incontinencia urinaria en dos centros de salud urbanos / Prevalence of urinary incontinence in two urban health centres

Introducción. La incontinencia urinaria (IU) tiene importantes repercusiones para la salud y elevados costes sociales y económicos, pero a pesar de ello su prevalencia no está bien establecida y varía en distintos estudios en el mundo desde el 3 al 40% en relación con la edad y el sexo. El objetivo principal de este estudio es determinar la prevalencia global de IU en dos centros de salud urbanos (excluyendo a los pacientes que no pueden acudir a la consulta médica en el centro de salud), así como la prevalencia no conocida por el médico de atención primaria. Material y métodos. El estudio, transversal y descriptivo, se llevó a cabo durante febrero y marzo de 2010 en dos centros de salud urbanos, con pacientes de la consulta de dos médicos de familia. Se realizó un muestreo aleatorio simple, seleccionando 4 pacientes al día del total de los citados, entre los hombres y mujeres de 14 años o mayores no institucionalizados, que acudieron a la consulta por cualquier motivo. Se obtuvo una muestra total de 356 pacientes. Resultados. Se obtuvo una prevalencia global de la IU del 33%. En el 62% de los casos el diagnóstico no era conocido por el médico de atención primaria y en el 79% no había sido valorada por el especialista. El 60% refirió alguna limitación en su calidad de vida. Conclusiones. A pesar del impacto de la incontinencia urinaria, su prevalencia no está bien establecida y varía en los estudios realizados hasta la actualidad; se puede afirmar que se deben realizar nuevas investigaciones con métodos estandarizados de estudio, validados y más fácilmente comparables, así como realizar nuevos estudios estatales de su prevalencia (AU)

Introduction. Urinary incontinence (UI) has significant repercussions for health and has high social and economic costs. In spite of this, its prevalence is not well established and varies, according to different studies around the world, from 3 to 40% depending on age and sex. The principal aim of our study is to determine the prevalence of urine incontinence (UI) in two urban health centres (excluding the patients unable to come to the clinic) as well as the prevalence unknown to the Primary Care doctor. Material and methods. A cross-sectional descriptive study was carried out during February and March, 2010 in two urban health centres, with patients attending two family doctor clinics. Simple random sampling was used, selecting four patients each day during the period of the study, from non- institutionalised males and females age 14years and over, who came to the clinic for another reason. A total sample of 356 patients was obtained. Results. An overall prevalence of UI of 33% was obtained. Of these, 62% of the cases diagnosed were not known by the Primary Care doctor, and 79% had not been assessed by specialist. It caused some limitation in the quality of life in 60% of the cases. Conclusions. In spite of the impact of the urinary incontinence, its prevalence is not well established well and varies in the studies conducted up to the present time. This confirms that further studies should be performed using standardised, validated and easy to compare methods in order to determine its prevalence nationwide (AU)