Healthy lifestyle habits are the cornerstone in the management of familial hypercholesterolaemia (FH). Nevertheless, dietary studies on FH-affected populations are scarce. The present study analyses ...dietary habits, adherence to a Mediterranean diet pattern and physical activity in an adult population with FH and compares them with their non-affected relatives.
Cross-sectional study.
Data came from SAFEHEART, a nationwide study in Spain.ParticipantsIndividuals (n 3714) aged ≥18 years with a genetic diagnosis of FH (n2736) and their non-affected relatives (n 978). Food consumption was evaluated using a validated FFQ.
Total energy intake was lower in FH patients v. non-affected relatives (P<0·005). Percentage of energy from fats was also lower in the FH population (35 % in men, 36 % in women) v. those non-affected (38 % in both sexes, P<0·005), due to the lower consumption of saturated fats (12·1 % in FH patients, 13·2 % in non-affected, P<0·005). Consumption of sugars was lower in FH patients v. non-affected relatives (P<0·05). Consumption of vegetables, fish and skimmed milk was higher in the FH population (P<0·005). Patients with FH showed greater adherence to a Mediterranean diet pattern v. non-affected relatives (P<0·005). Active smoking was lower and moderate physical activity was higher in people with FH, especially women (P<0·005).
Adult patients with FH report healthier lifestyles than their non-affected family members. They eat a healthier diet, perform more physical activity and smoke less. However, this patient group's consumption of saturated fats and sugars still exceeds guidelines.
To assess compliance of antibiotic prophylaxis in surgery for acute appendicitis in children and its effect on surgical site infection.
We carried out a prospective cohort study to evaluate ...compliance of antibiotic prophylaxis in appendectomies in children. An assessment of the level of compliance with prophylaxis was made, as well as the causes of non-compliance. The effect of non-compliance of antibiotic prophylaxis on the incidence of surgical site infection was studied with the adjusted relative risk (RR) with a backstep logistic regression model.
The study included a total of 412 patients. Antibiotic prophylaxis was indicated in 348 patients, and administered in 95.7% of cases, with an overall protocol compliance of 90.7%. The principal cause of non-compliance was time of initiation. Cumulative incidence of surgical site infection was 2.7%. No relationship was found between inadequate prophylaxis compliance and infection (RR: 1.01; 95% confidence interval: 0.95-1.11; p = 0.61).
Compliance of antibiotic prophylaxis was high, but could be improved. No relationship was found between prophylaxis compliance and surgical site infection rate.
Maximal doses of potent statins are the basement of treatment of familial hypercholesterolemia (FH). Little is known about the use of different statin regimens in FH.
The objectives of the study were ...to describe the treatment changes and low-density lipoprotein cholesterol (LDL-C) goal achievement with atorvastatin (ATV) and rosuvastatin (RV) in the SAFEHEART cohort, as well as to analyze the incidence of atherosclerotic cardiovascular events (ACVEs) and changes in the cardiovascular risk.
SAFEHEART is a prospective follow-up nationwide cohort study in a molecularly defined FH population. The patients were contacted on a yearly basis to obtain relevant changes in life habits, medication, and ACVEs.
A total of 1939 patients were analyzed. Median follow-up was 6.6 years (5–10). The estimated 10-year risk according the SAFEHEART risk equation was 1.61 (0.67–3.39) and 1.22 (0.54–2.93) at enrollment for ATV and RV, respectively (P < .001). There were no significant differences at the follow-up: 1.29 (0.54–2.82) and 1.22 (0.54–2.76) in the ATV and RV groups, respectively (P = .51). Sixteen percent of patients in primary prevention with ATV and 18% with RV achieved an LDL-C <100 mg/dL and 4% in secondary prevention with ATV and 5% with RV achieved an LDL-C <70 mg/dL. The use of ezetimibe was marginally greater in the RV group. One hundred sixty ACVEs occurred during follow-up, being its incidence rate 1.1 events/100 patient-years in the ATV group and 1.2 in the RV group (P = .58).
ATV and RV are 2 high-potency statins widely used in FH. Although the reduction in LDL-C levels was greater with RV than with ATV, the superiority of RV for reducing ACVEs was not demonstrated.
•This study analyzes event rates of 2 high-potency statins in FH.•LDL-C goal attainment and risk were similar in both groups.•LDL-C reduction was greater with rosuvastatin. Events were similar in both groups.•Event rate was 1.1/100 patient-years with atorvastatin and 1.2 with rosuvastatin.
ResumenIntroducciónLa prevalencia del embarazo múltiple está experimentando un ascenso en los últimos años, lo que conlleva un aumento de la morbimortalidad fetal y de la morbilidad materna. El ...objetivo de este estudio es analizar la evolución de los partos múltiples en Castilla y León durante 13 años y sus implicaciones maternas y fetales. Material y métodosEstudio de asociación cruzada, sobre el conjunto mínimo básico de datos (CMBD), de altas hospitalarias de la red Sanidad de Castilla y León (SACYL) entre 2001 y 2013. Se realizó un análisis de tendencias mediante regresión lineal de joinpoint, un análisis ritmométrico y un análisis multivariante mediante regresión logística binaria. ResultadosA lo largo de los 13 años de estudio se observa una tendencia creciente en la proporción de partos múltiples, en contraste con los únicos, con un porcentaje anual de cambio del 3,4% (IC del 95%: 2,5-4,4%). Se encontró asociación estadística entre la edad materna, la tolerancia anormal a la glucosa, el parto operatorio, la macrosomía fetal, el parto prematuro, la muerte fetal, las malposiciones fetales, la fecundación in vitro y los estados hipertensivos maternos y el parto gemelar, destacando que la fecundación in vitro se asocia con un exceso de riesgo de 9,3 veces de parto múltiple (IC del 95%: 7,4-11,5), así como la edad de la madre se asocia con un exceso de riesgo del 5% por cada año de edad (OR: 1,05; IC 95%: 1,04-1,05). No se evidenció estacionalidad en los partos múltiples en contraposición con los únicos. ConclusionesLos partos múltiples experimentaron un continuo ascenso, sin seguir un ritmo estacional, asociados a la extensión del uso de las técnicas de reproducción asistida y al retraso en la edad de la maternidad, lo que conlleva mayor morbimortalidad fetal y materna.
INTRODUCTIONMultiple pregnancy has increased in prevalence in the last few years, which could lead to more foetal and maternal morbidity issues. The aim of this study is to describe the trend of ...multiple pregnancy deliveries in Castilla y León during the last 13years and the subsequent impact on foetal and maternal health. MATERIAL AND METHODSData was collected from the hospital discharge reports registered in the Regional Health-care database (SACYL: Health care in Castilla y León) between 2001 and 2013. A cross sectional descriptive study was conducted, including trend analysis with log-linear joint point model, a rhythm metric study, as well as a risk assessment with multivariate analysis. RESULTSA pronounced upward trend was observed in the proportion of multiple deliveries in this time period, compared to single ones, with an annual percentage change of 3.4% (95% CI: 2.5-4.4). Multiple pregnancy was significantly correlated with advanced maternal age, abnormal glucose tolerance, dystocia and caesarean section delivery, premature birth, foetal malposition, foetal macrosomia, stillbirth, in vitro fertilisation, and hypertensive episodes of pregnancy. In vitro fertilization showed a 9.3 fold increased risk in multiple pregnancy (95% CI: 7.4-11.5), with maternal age increasing the risk up to 5% per year of age (OR: 1.05: 95%CI: 1.04-1.05). No seasonal rhythm was observed in multiple deliveries compared with single ones. CONCLUSIONMultiple pregnancy has experienced a continuous increase, with no seasonal trend, and is associated with the increase in assisted reproductive technology and advanced maternal age. This involves more problems regarding foetal and maternal morbidity and mortality.
The current work introduces a study about the knowledge obtained by the proffesionals in the educational areas of detection, indetification and notification of child abuse situations. For that ...matter, a questionnaire about detection of child abuse has been designed and distributed amongst Early Childhood and Primary Education teachers in three schools throughout San Fernando (Cádiz). The results denote the existence of a widespread ignorance from the teachers about how to detect, notify and act when a child abuse case appears, and so with the action protocol about child abuse and the most popular notification tools. Likewise, there is an evidence that points to the uncertainty of these teachers, among which we can highlight the process to follow when there is a suspicion of an abuse situation and their rol when they have to intervene in the way parents educate their children. On the other hand, a higher number of years of teaching experience doesn
Influenza virus infection can contribute to cardiovascular morbidity and mortality. The purpose of this study is to confirm if the increase in seasonal influenza rates is associated with a growth in ...hospitalisation and mortality rates for acute cardiovascular diseases (ACVD).
Retrospective cohort study of hospital discharges due to ACVD (myocardial infarction, unstable angina, heart failure and ischemic stroke) in the Castilla y León (Spain) hospital system between 2001 and 2015. Hospitalisation and hospital mortality rates due to ACVD, and influenza rates in Castilla y León between 2001 and 2015 were studied. To calculate hospitalisation and mortality rates, the hospital discharges database was used; for influenza rates, the weekly reports of the Sentinel System for the surveillance of influenza in Spain (Carlos III Health Institute) were used. A statistical analysis of linear and multivariate logistic regressions was performed.
239,586 ACVD (myocardial infarction: 55,004; unstable angina: 15,406; heart failure: 11,1647; ischemic stroke: 57,529) were studied. Increasing rates of influenza were associated with increased mortality due to ACVD and all the diseases studied, except unstable angina. A linear correlation was observed between influenza rates and hospitalisation (r2=0.03; p=0.02) and mortality (r2=0.14; p<0.001) rates by ACVD. Virtually all influenza rates were associated, as independent variables, to an increase in mortality due to ACVD, being higher in rates>139/100,000 inhabitants (OR: 1.25; p<0.001).
The rates of hospitalisation and in-hospital mortality due to ACVD in the period 2001–2015 increased in relation to infection rates due to the influenza virus.
La infección por virus de la gripe puede contribuir a la morbimortalidad cardiovascular. El objetivo de este estudio es analizar si el incremento en las tasas de gripe estacional se asocia a un crecimiento en las tasas de hospitalización y mortalidad hospitalaria por enfermedades cardiovasculares agudas (ECVA).
Estudio de cohortes retrospectivo sobre altas hospitalarias por ECVA (infarto de miocardio, angina inestable, insuficiencia cardiaca, accidente cerebrovascular isquémico) del sistema hospitalario de Castilla y León durante el periodo 2001-2015. Se analizaron tasas de hospitalización y mortalidad hospitalaria, y tasas de gripe en Castilla y León. Para calcular las tasas de hospitalización y mortalidad se empleó el Conjunto Mínimo Básico de Datos (CMBD); para las tasas de gripe, los informes semanales del Sistema Centinela de Vigilancia de la Gripe en España (Instituto de Salud Carlos III). Se realizó análisis estadístico de regresión lineal y multivariante de regresión logística.
Se estudiaron 239.586 ECVA (infarto, 55.004; angina inestable, 15.406; insuficiencia cardiaca, 11.1647; accidente cerebrovascular, 57.529). Tasas de gripe ascendentes se ajustaron a mortalidad creciente por todas las enfermedades, salvo angina inestable. Se observó una correlación lineal entre tasas de gripe y de hospitalización (r2=0,03; p=0,02) y mortalidad (r2=0,14; p<0,001) por ECVA. Las tasas de gripe se asociaron, como variables independientes, a un aumento de la mortalidad por ECVA, siendo mayor en tasas >139 casos/100.000 habitantes (OR: 1,25; p<0,001).
Las tasas de hospitalización y mortalidad hospitalaria por ECVA en el periodo estudiado aumentaron en relación con las tasas de infección por el virus de la gripe.
Since the discovery of the SARS-CoV-2 virus, the polymerase chain reaction technique (RT-PCR) has become the fundamental method for diagnosing the disease in its acute phase. The objective is to ...describe the demand-based series of RT-PCR determinations received at a Microbiology Service at a third-level reference hospital for a health area for three months spanning from the onset of the epidemic by SARS-CoV-2.
A retrospective analysis of the total of the RT-PCR requested in the Microbiology Service analyzed from 02/25/2020 to 05/26/2020 (90 days) has been carried out. They have been grouped by epidemiological weeks and by the petitioner service. A descriptive analysis was carried out by age, gender and number of requests for each patient. In the tests carried out, a confidence level of 95% (p <0.05) was considered significant.
A total of 27,106 requests was received corresponding to 22,037 patients. Median age 53.7 (RIC 40.9-71.7) years, women: 61.3%. Proportion of patients with any positive RT-PCR: 14%. Of the total requests for RT-PCR, positive 3,710. Week 13 had the highest diagnosis performance (39.0%). The primary care has been the service thar has made the most requests (15,953). Patients with 3 or more RT-PCR: 565, of them, 19 patients had a positive result after previously having a negative one.
Requests have been increasing depending on the evolution of the epidemic. The RT-PCR has a high diagnostic performance in the phases of highest contagiousness and / or transmissibility of the virus.
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