Grado de conocimiento, tratamiento y control de la hipertensión arterial, hipercolesterolemia y diabetes mellitus en la población general adulta

ObjetivosEstimar la prevalencia de los principales factores de riesgo cardiovascular (FRCV) tras la confirmación diagnóstica con el criterio clínico. Analizar el grado de su conocimiento y control, y evaluar la asociación de los FRCV entre sí, estimando qué población es susceptible de intervención.DiseñoEstudio observacional, descriptivo,transversal.EmplazamientoEstudio poblacional realizado en el Área de Salud número 20 de la Comunidad Valenciana (comarca de la Vega Baja del río Segura)PacientesPersonas con ≥ 20 años residentes en dicha área. Muestreo aleatorio polietápico proporcional con definición de cuotas muestrales según el tipo de residencia. Tamaño muestral: 2.550 personas (falta de respuesta en la primera fase en el 26%). Segunda fase del estudio: se realiza la confirmación clínica de los 374 casos detectados de hipertensión arterial (HTA), los 126 de hipercolesterolemia (HCOL) y los 33 de diabetes mellitus (DM).MedicionesSe realiza una entrevista a los pacientes detectados para las tomas de presión arterial a los hipertensos y para practicar la extracción sanguínea a hipercolesterolémicos y diabéticos. Se han utilizado los criterios diagnósticos preconizados por los últimos consensos.ResultadosParticipan 1.886 personas (78,1%). Prevalencias halladas: HTA total, 42 ± 2,2%; diagnosticada, 11,7 ± 1,4%; HCOL total, 26,6 ± 2%; DM total, 9,5 ± 1,3%; tabaquismo: 33,6 ± 2,1% y obesidad: 31,6 ± 2,1%. Grado de control: HTA, 8,6%; HCOL, 21,7%; DM, 56,1%. Asociación de FRCV: el 25,5% no presenta hipertensión, hipercolesterolemia ni fuma.ConclusionesElevada prevalencia FRCV en nuestra área frente a los resultados publicados de ámbito nacional. El tabaquismo resulta menos frecuente que en el resto del país. El grado de control es escaso y la asociación de los FRCV principales para cardiopatía isquémica reflejan que cerca del 75% de la población debe ser intervenida.ObjectivesTo calculate the prevalence of the main cardiovascular risk factors (CVRF) after diagnostic confirmation using clinical criteria. To analyse the degree of understanding and monitoring of these factors and to evaluate the association of CVRF with each other, so estimating who is susceptible to intervention.DesignCross-sectional, descriptive, observational study.SettingPopulation study conducted in Health Area 20 of the Community of Valencia (county of the Low Plain of the River Segura). Patients. People who had lived in this Area for ³20 years. Proportional, multi-stage randomised sampling with definition of sample quotas according to type of residence. Sample size: 2550 people (no reply in first stage: 26%). The second stage involved the clinical confirmation of those identified as suffering from hypertension (HT) (374), hypercholesterolaemia (HCOL) (126), and diabetes (DM) (33).MeasurementsPatients identified were interviewed for taking blood pressure in the case of those with HT, and blood samples in the case of those with HCOL and DM. The diagnostic criteria recommended by the latest consensus were used.Results1886 people (78.1%) took part. Prevalences found: total HT 42±2.2%, diagnosed: 11.7±1.4; total HCOL 26.6±2%; total DM 9.5±1.3%.Tobacco dependency was 33.6±2.1% and Obesity: 31.6±2.1%. Degree of control: HT, 8.6%; HCOL, 21.7%; DM, 56.1%. Association of CVR factors with each other: 25.5% had neither HT nor HCOL and did not smoke.ConclusionsHigh prevalence of CVRF in our area, compared with published national findings.Tobacco dependency is less common than at national level. The degree of control is very low and the association of the main CVRF factors for ischaemic cardiopathy reflect that nearly 75% of the population requires a preventive intervention

Relationship of Weather Types on the Seasonal and Spatial Variability of Rainfall, Runoff, and Sediment Yield in the Western Mediterranean Basin

Rainfall is the key factor to understand soil erosion processes, mechanisms, and rates. Most research was conducted to determine rainfall characteristics and their relationship with soil erosion (erosivity) but there is little information about how atmospheric patterns control soil losses, and this is important to enable sustainable environmental planning and risk prevention. We investigated the temporal and spatial variability of the relationships of rainfall, runoff, and sediment yield with atmospheric patterns (weather types, WTs) in the western Mediterranean basin. For this purpose, we analyzed a large database of rainfall events collected between 1985 and 2015 in 46 experimental plots and catchments with the aim to: (i) evaluate seasonal differences in the contribution of rainfall, runoff, and sediment yield produced by the WTs; and (ii) to analyze the seasonal efficiency of the different WTs (relation frequency and magnitude) related to rainfall, runoff, and sediment yield. The results indicate two different temporal patterns: the first weather type exhibits (during the cold period: autumn and winter) westerly flows that produce the highest rainfall, runoff, and sediment yield values throughout the territory; the second weather type exhibits easterly flows that predominate during the warm period (spring and summer) and it is located on the Mediterranean coast of the Iberian Peninsula. However, the cyclonic situations present high frequency throughout the whole year with a large influence extended around the western Mediterranean basin. Contrary, the anticyclonic situations, despite of its high frequency, do not contribute significantly to the total rainfall, runoff, and sediment (showing the lowest efficiency) because of atmospheric stability that currently characterize this atmospheric pattern. Our approach helps to better understand the relationship of WTs on the seasonal and spatial variability of rainfall, runoff and sediment yield with a regional scale based on the large dataset and number of soil erosion experimental stations.Spanish Government (Ministry of Economy and Competitiveness, MINECO) and FEDER Projects: CGL2014 52135-C3-3-R, ESP2017-89463-C3-3-R, CGL2014-59946-R, CGL2015-65569-R, CGL2015-64284-C2-2-R, CGL2015-64284-C2-1-R, CGL2016-78075-P, GL2008-02879/BTE, LEDDRA 243857, RECARE-FP7, CGL2017-83866-C3-1-R, and PCIN-2017-061/AEI. Dhais Peña-Angulo received a “Juan de la Cierva” postdoctoral contract (FJCI-2017-33652 Spanish Ministry of Economy and Competitiveness, MEC). Ana Lucia acknowledge the "Brigitte-Schlieben-Lange-Programm". The “Geoenvironmental Processes and Global Change” (E02_17R) was financed by the Aragón Government and the European Social Fund. José Andrés López-Tarazón acknowledges the Secretariat for Universities and Research of the Department of the Economy and Knowledge of the Autonomous Government of Catalonia for supporting the Consolidated Research Group 2014 SGR 645 (RIUS- Fluvial Dynamics Research Group). Artemi Cerdà thank the funding of the OCDE TAD/CRP JA00088807. José Martínez-Fernandez acknowledges the project Unidad de Excelencia CLU-2018-04 co-funded by FEDER and Castilla y León Government. Ane Zabaleta is supported by the Hydro-Environmental Processes consolidated research group (IT1029-16, Basque Government). This paper has the benefit of the Lab and Field Data Pool created within the framework of the COST action CONNECTEUR (ES1306)

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

Relationship of Weather Types on the Seasonal and Spatial Variability of Rainfall, Runoff, and Sediment Yield in the Western Mediterranean Basin

Rainfall is the key factor to understand soil erosion processes, mechanisms, and rates. Most research was conducted to determine rainfall characteristics and their relationship with soil erosion (erosivity) but there is little information about how atmospheric patterns control soil losses, and this is important to enable sustainable environmental planning and risk prevention. We investigated the temporal and spatial variability of the relationships of rainfall, runoff, and sediment yield with atmospheric patterns (weather types, WTs) in the western Mediterranean basin. For this purpose, we analyzed a large database of rainfall events collected between 1985 and 2015 in 46 experimental plots and catchments with the aim to: (i) evaluate seasonal differences in the contribution of rainfall, runoff, and sediment yield produced by the WTs; and (ii) to analyze the seasonal efficiency of the different WTs (relation frequency and magnitude) related to rainfall, runoff, and sediment yield. The results indicate two different temporal patterns: the first weather type exhibits (during the cold period: autumn and winter) westerly flows that produce the highest rainfall, runoff, and sediment yield values throughout the territory; the second weather type exhibits easterly flows that predominate during the warm period (spring and summer) and it is located on the Mediterranean coast of the Iberian Peninsula. However, the cyclonic situations present high frequency throughout the whole year with a large influence extended around the western Mediterranean basin. Contrary, the anticyclonic situations, despite of its high frequency, do not contribute significantly to the total rainfall, runoff, and sediment (showing the lowest efficiency) because of atmospheric stability that currently characterize this atmospheric pattern. Our approach helps to better understand the relationship of WTs on the seasonal and spatial variability of rainfall, runoff and sediment yield with a regional scale based on the large dataset and number of soil erosion experimental stations

Estudio de prevalencia de factores de riesgo cardiovascular en un área de salud

ObjetivoEstimar la prevalencia de los factores de riesgo cardiovascular: hipertensión arterial (HTA), hipercolesterolemia, diabetes mellitus (DM), obesidad y tabaquismo en el Área de Salud 20 de la Comunidad Valenciana.DiseñoEstudio observacional descriptivo transversal.EmplazamientoEstudio poblacional realizado en el Área de Salud 20 de la Comunidad Valenciana (comarca de la Vega Baja del río Segura).PacientesPersonas 3 20 años de edad residentes en dicha área. Muestreo aleatorio polietápico proporcional con definición de cuotas muestrales según tipo de residencia (urbano, periurbano y rural), según grupos de edad y sexo. Tamaño muestral calculado de 2.550 personas. Se excluyen las embarazadas y las personas diagnosticadas de enfermedad psíquica o física incapacitante (n = 134). Se incluye el resto (n = 2.416).MedicionesMediante entrevista personal se cumplimenta un cuestionario y se realiza una exploración física básica. Posteriormente se practica una extracción sanguínea. Se recogen las siguientes variables: filiación, datos socioeconómicos, enfermedades previas (cardiovasculares, HTA, hipercolesterolemia, DM), hábito tabáquico, índice de masa corporal, presión arterial, hemograma y bioquímica estándar. Se han utilizado los criterios diagnósticos preconizados por el último consenso para cada factor.ResultadosDe las 2.416 personas elegibles, participan 1.886 (78,06%). Prevalencias halladas: HTA conocida: 30,3 ± 2,1% (mujeres: 34,1 ± 2,9%, varones: 25,8 ± 2,9%); hipercolesterolemia conocida: 22,6 ± 1,9%; diabetes conocida: 8,4 ± 1,2%; tabaquismo: 33,6 ± 2,1% (mujeres: 25,4 ± 2,7%; varones: 42,2 ± 3,3%; grupo de edad 20–39 años: 56,9 ± 3,8%), y obesidad: 31,6 ± 2,1% (mujeres: 34,6 ± 2,9%; varones: 28,1 ± 3%; grupo de edad 3 60 años: 46,7 ± 3,9%). Se presentan los datos de detección.ConclusionesSe han encontrado prevalencias elevadas de hipertensión arterial, hipercolesterolemia, diabetes y obesidad, superiores a las halladas en el ámbito nacional. El tabaquismo es menos frecuente, aunque en los jóvenes es muy prevalente. La hipertensión conocida y la obesidad son más prevalentes en mujeres que en varones.ObjectiveTo calculate the prevalence of cardiovascular risk factors: hypertension, hypercholesterolaemia, diabetes mellitus (DM), obesity and tobacco dependency, in Health Area 20 of the Community of Valencia.DesignCross-sectional, descriptive, observational study.SettingPopulation study carried out in Health Area 20 of the Community of Valencia (Vega Baja del río Segura county).Patients≥20 years-old people, living in this area. Multi-stage randomised sample proportional to the definition of sample quotas according to the kind of residence (urban, peri-urban or rural), age groups and sex. Calculated sample size of 2550 people. Pregnant women and people diagnosed with incapacitating psychiatric or physical illnesses (134) were excluded. The rest (2416) were included.MeasurementsA questionnaire was filled out in a face-to-face interview and a basic physical examination was made. A blood sample was taken. The following variables were recorded: personal details, social and economic details, previous illnesses (cardiovascular, hypertension, hypercholesterolaemia, DM), tobacco habit, Body Mass Index, blood pressure, haemogram and standard biochemical test. The most recently agreed and recommended diagnostic criteria were used for each factor.Results1886 people of the 2416 eligible took part (78.06%). Prevalence was as follows: hypertension, 30.3±2.1% (women, 34.1±2.9%; men, 25.8±2.9%); hypercholesterolaemia, 22.6±1.9%; diabetes, 8.4±1.2%; tobacco dependency, 33.6±2.1% (women, 25.4±2.7%; men, 42.2±3.3%; 20–39 years old age-group, 56.9±3.8%), and obesity, 31.6±2.1% (women, 34.6±2.9%; men, 28.1±3%; age group ≥60 years old, 46.7±3.9%). Detection data were shown.ConclusionsHigh presence of hypertension, hypercholesterolaemia, diabetes and obesity, greater than the country-wide level. Tobacco dependency was less common, though very high in young people. Known hypertension and obesity are more common in women than men

Relationship of weather types on the seasonal and spatial variability of rainfall, runoff, and sediment yield in the western Mediterranean basin

Rainfall is the key factor to understand soil erosion processes, mechanisms, and rates. Most research was conducted to determine rainfall characteristics and their relationship with soil erosion (erosivity) but there is little information about how atmospheric patterns control soil losses, and this is important to enable sustainable environmental planning and risk prevention. We investigated the temporal and spatial variability of the relationships of rainfall, runoff, and sediment yield with atmospheric patterns (weather types, WTs) in the western Mediterranean basin. For this purpose, we analyzed a large database of rainfall events collected between 1985 and 2015 in 46 experimental plots and catchments with the aim to: (i) evaluate seasonal differences in the contribution of rainfall, runoff, and sediment yield produced by the WTs; and (ii) to analyze the seasonal efficiency of the different WTs (relation frequency and magnitude) related to rainfall, runoff, and sediment yield. The results indicate two different temporal patterns: the first weather type exhibits (during the cold period: autumn and winter) westerly flows that produce the highest rainfall, runoff, and sediment yield values throughout the territory; the second weather type exhibits easterly flows that predominate during the warm period (spring and summer) and it is located on the Mediterranean coast of the Iberian Peninsula. However, the cyclonic situations present high frequency throughout the whole year with a large influence extended around the western Mediterranean basin. Contrary, the anticyclonic situations, despite of its high frequency, do not contribute significantly to the total rainfall, runoff, and sediment (showing the lowest efficiency) because of atmospheric stability that currently characterize this atmospheric pattern. Our approach helps to better understand the relationship of WTs on the seasonal and spatial variability of rainfall, runoff and sediment yield with a regional scale based on the large dataset and number of soil erosion experimental stations.Ministerio de Economía y Competitividad | Ref. CGL2014 52135-C3-3-RMinisterio de Economía y Competitividad | Ref. ESP2017-89463-C3-3-RMinisterio de Economía y Competitividad | Ref. CGL2014-59946-RMinisterio de Economía y Competitividad | Ref. CGL2015-65569-RMinisterio de Economía y Competitividad | Ref. CGL2015-64284-C2-2-RMinisterio de Economía y Competitividad | Ref. CGL2015-64284-C2-1-RMinisterio de Economía y Competitividad | Ref. CGL2016-78075-PMinisterio de Economía y Competitividad | Ref. GL2008-02879/BTEEuropean Commission | Ref. LEDDRA 243857Ministerio de Economía y Competitividad | Ref. CGL2017-83866- C3-1-RMinisterio de Economía y Competitividad | Ref. PCIN-2017-061/AEIMinisterio de Economía y Competitividad | Ref. FJCI-2017-33652Gobierno de Aragón | Ref. E02_17RGeneralitat de Catalunya | Ref. 2014 SGR 645Junta de Castilla y León | Ref. CLU-2018-04Gobierno Vasco | Ref. IT1029-16OECD (Biological Resource Management for Sustainable Agricultural Systems) | Ref. OCDE TAD/CRP JA0008880

Lessons from the "Euro-Lupus Cohort"

The "Euro-Lupus Cohort" is composed by 1,000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium - the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors

Spatial variability of the relationships of runoff and sediment yield with weather types throughout the Mediterranean basin

Soil degradation by water is a serious environmental problem worldwide, with specific climatic factors being the major causes. We investigated the relationships between synoptic atmospheric patterns (i.e. weather types, WTs) and runoff, erosion and sediment yield throughout the Mediterranean basin by analyzing a large database of natural rainfall events at 68 research sites in 9 countries. Principal Component Analysis (PCA) was used to identify spatial relationships of the different WTs including three hydro-sedimentary variables: rainfall, runoff, and sediment yield (SY, used to refer to both soil erosion measured at plot scale and sediment yield registered at catchment scale). The results indicated 4 spatial classes of rainfall and runoff: (a) northern sites dependent on North (N) and North West (NW) flows; (b) eastern sites dependent on E and NE flows; (c) southern sites dependent on S and SE flows; and, finally, (d) western sites dependent on W and SW flows. Conversely, three spatial classes are identified for SY characterized by: (a) N and NE flows in northern sites (b) E flows in eastern sites, and (c) W and SW flows in western sites. Most of the rainfall, runoff and SY occurred during a small number of daily events, and just a few WTs accounted for large percentages of the total. Our results confirm that characterization by WT improves understanding of the general conditions under which runoff and SY occur, and provides useful information for understanding the spatial variability of runoff, and SY throughout the Mediterranean basin. The approach used here could be useful to aid of the design of regional water management and soil conservation measures