Incremento de la temperatura ambiental y su posible asociaci�n al suicidio en Baja California Sur (BCS) 1985-2008

Introduction: During the last decade we have observed important climate changes, especially in environmental temperatures. There is considerable information linking the increase in hot weather and human health. For example, hot weather is associated with an increased risk of suicide in different countries around the world. Objective: To evaluate the relationship between suicide rates and the environmental temperature in Baja California Sur, Mexico, from 1985 to 2008. Method: Suicide mortality data for Baja California Sur (BCS) were obtained for the years 1985-2008 from the Instituto Nacional de Estad�stica, Geograf�a e Inform�tica (INEGI). The selected codes were: E950-E959 (ICD-9) and X60-X84, Y87.0 (ICD-10) for BCS. The BCS weather data used was the maximum temperature from 1985 to 2008, obtained from the Extractor R�pido de Informaci�n Climatol�gica (ERIC III). Lineal and quadratic models were used to assess the annual rate changes of suicide and generalized lineal models (GLM) to assess the effect of the climatological variables to the suicide rate. The p?0.05 was considered significant. Results: In BCS, 582 suicide deaths were reported from 1985 to 2008. The 9% (53) of the total reported were women with a yearly average rate 1.6/100 000; 91% (529) were men with a yearly average rate 16.3/100 000. Lineal and quadratic models explained the tendency of the annual increment observed in the number of suicides in both seasons. The quadratic model better explained such increment during the warmer months (R2=0.64 p<0.01). The temperature was positively correlated with the rate of suicides in both seasons (p<0.01). Two predictive GLMs were created by season. Discussion: These results suggest a potential link between an increase in environmental temperature and the rates of suicide during 24 years in BCS. This relationship is clear during the hot season; however, a positive trend was found during the cold season, perhaps due to the result of warmer winters

Incremento de la temperatura ambiental y su posible asociación al suicidio en Baja California Sur (BCS) 1985-2008

Introduction: During the last decade we have observed important climate changes, especially in environmental temperatures. There is considerable information linking the increase in hot weather and human health. For example, hot weather is associated with an increased risk of suicide in different countries around the world. Objective: To evaluate the relationship between suicide rates and the environmental temperature in Baja California Sur, Mexico, from 1985 to 2008. Method: Suicide mortality data for Baja California Sur (BCS) were obtained for the years 1985-2008 from the Instituto Nacional de Estadística, Geografía e Informática (INEGI). The selected codes were: E950-E959 (ICD-9) and X60-X84, Y87.0 (ICD-10) for BCS. The BCS weather data used was the maximum temperature from 1985 to 2008, obtained from the Extractor Rápido de Información Climatológica (ERIC III). Lineal and quadratic models were used to assess the annual rate changes of suicide and generalized lineal models (GLM) to assess the effect of the climatological variables to the suicide rate. The p≤0.05 was considered significant. Results: In BCS, 582 suicide deaths were reported from 1985 to 2008. The 9% (53) of the total reported were women with a yearly average rate 1.6/100 000; 91% (529) were men with a yearly average rate 16.3/100 000. Lineal and quadratic models explained the tendency of the annual increment observed in the number of suicides in both seasons. The quadratic model better explained such increment during the warmer months (R2=0.64 p<0.01). The temperature was positively correlated with the rate of suicides in both seasons (p<0.01). Two predictive GLMs were created by season. Discussion: These results suggest a potential link between an increase in environmental temperature and the rates of suicide during 24 years in BCS. This relationship is clear during the hot season; however, a positive trend was found during the cold season, perhaps due to the result of warmer winters

Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background and aims: Management of familial hypercholesterolaemia (FH) may vary across different settings due to factors related to population characteristics, practice, resources and/or policies. We conducted a survey among the worldwide network of EAS FHSC Lead Investigators to provide an overview of FH status in different countries. Methods: Lead Investigators from countries formally involved in the EAS FHSC by mid-May 2018 were invited to provide a brief report on FH status in their countries, including available information, programmes, initiatives, and management. Results: 63 countries provided reports. Data on FH prevalence are lacking in most countries. Where available, data tend to align with recent estimates, suggesting a higher frequency than that traditionally considered. Low rates of FH detection are reported across all regions. National registries and education programmes to improve FH awareness/knowledge are a recognised priority, but funding is often lacking. In most countries, diagnosis primarily relies on the Dutch Lipid Clinics Network criteria. Although available in many countries, genetic testing is not widely implemented (frequent cost issues). There are only a few national official government programmes for FH. Under-treatment is an issue. FH therapy is not universally reimbursed. PCSK9-inhibitors are available in ∼2/3 countries. Lipoprotein-apheresis is offered in ∼60% countries, although access is limited. Conclusions: FH is a recognised public health concern. Management varies widely across countries, with overall suboptimal identification and under-treatment. Efforts and initiatives to improve FH knowledge and management are underway, including development of national registries, but support, particularly from health authorities, and better funding are greatly needed. © 2018 Elsevier B.V

Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background and aims: Management of familial hypercholesterolaemia (FH) may vary across different settings due to factors related to population characteristics, practice, resources and/or policies. We conducted a survey among the worldwide network of EAS FHSC Lead Investigators to provide an overview of FH status in different countries. Methods: Lead Investigators from countries formally involved in the EAS FHSC by mid-May 2018 were invited to provide a brief report on FH status in their countries, including available information, programmes, initiatives, and management. Results: 63 countries provided reports. Data on FH prevalence are lacking in most countries. Where available, data tend to align with recent estimates, suggesting a higher frequency than that traditionally considered. Low rates of FH detection are reported across all regions. National registries and education programmes to improve FH awareness/knowledge are a recognised priority, but funding is often lacking. In most countries, diagnosis primarily relies on the Dutch Lipid Clinics Network criteria. Although available in many countries, genetic testing is not widely implemented (frequent cost issues). There are only a few national official government programmes for FH. Under-treatment is an issue. FH therapy is not universally reimbursed. PCSK9-inhibitors are available in ∼2/3 countries. Lipoprotein-apheresis is offered in ∼60 countries, although access is limited. Conclusions: FH is a recognised public health concern. Management varies widely across countries, with overall suboptimal identification and under-treatment. Efforts and initiatives to improve FH knowledge and management are underway, including development of national registries, but support, particularly from health authorities, and better funding are greatly needed. © 2018 Elsevier B.V

Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. Methods Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. Findings Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53·6%] women) from 56 countries were included in the study. Of these, 31 798 (75·4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84·2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46·2 years (IQR 34·3–58·0); median age at diagnosis of familial hypercholesterolaemia was 44·4 years (32·5–56·5), with 40·2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17·4% (2·1% for stroke and 5·2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81·1%) were receiving statins and 3691 (21·2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5·43 mmol/L (IQR 4·32–6·72) among patients not taking lipid-lowering medications and 4·23 mmol/L (3·20–5·66) among those taking them. Among patients taking lipid-lowering medications, 2·7% had LDL cholesterol lower than 1·8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin–kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1·8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p<0·001). Interpretation Familial hypercholesterolaemia is diagnosed late. Guideline-recommended LDL cholesterol concentrations are infrequently achieved with single-drug therapy. Cardiovascular risk factors and presence of coronary disease were lower among non-index cases, who were diagnosed earlier. Earlier detection and greater use of combination therapies are required to reduce the global burden of familial hypercholesterolaemia. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron