Valorization of Prickly Pear [<em>Opuntia ficus-indica</em> (L.) Mill]: Nutritional Composition, Functional Properties and Economic Aspects

Opuntia ficus-indica (L.) Mill, usually named prickly pear or nopal cactus, is the Cactaceae plant with the greatest economic relevance in the world. It is a tropical or subtropical plant, native to tropical and subtropical America, which can grow in arid and semiarid climates. Prickly pear is mainly known by its fruits, popularly named “tunas” or “figs,” but their cladodes are also consumed, principally in Mexico, which is the country with the largest cultivated area and the largest producer. There is ample evidence of the health benefits of prickly pear: it shows high antioxidant activity, it is a source of nutrients and vitamins and it presents medicinal uses, among others. Furthermore, prickly pear presents other uses, including cosmetics, biofuel production, animal nutrition and soil phytoremediation

Effectiveness of a multifactorial intervention, consisting of a self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise, in patients with uncontrolled hypertension taking 2 or more antihypertensive drugs. The MEDICHY study

[eng] Cardiovascular risk and mortality are greater in hypertensive patients who are receiving treatment but have suboptimal control of blood pressure. Methods/Design: This is a multicentre, parallel, 2-arm, single-blind (outcome assessor), controled, cluster-randomized clinical trial. General practitioners and nurses will be randomly allocated to the intervention group (self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise) or the control group (regular clinical practice). A total of 424 patients in primary care centers who use 2 or more antihypertensive drugs and blood pressure of at least 130/80 during 24-hambulatory blood pressure monitoring will be recruited. The primary outcome is systolic blood pressure at 12 months. The secondary outcomes are blood pressure control (<140/90mm Hg); quality of life (EuroQol 5D); direct health care costs; adherence to use of antihypertensive medication; and cardiovascular risk (REGICOR and SCORE scales). Discussion: This trial will be conducted in the primary care setting and will evaluate the impact of a multifactorial intervention consisting of self-management of blood pressure, antihypertensive medications, and lifestyle modifications (hypocaloric and low sodium diet and physical exercise). Abbreviations: ACC = American College of Cardiology, ACE = angiotensin-converting-enzyme, AHA = American Heart Association, ARB = Angiotensin II Receptor Blockers, BMI = body mass index, BP = blood pressure, BPSM = BP self-monitoring, CCB = calcium channel blocker, COPD = chronic obstructive pulmonary disease, CVR = cardiovascular risk, DASH = Dietary Approaches to Stop Hypertension, DBP = dyastolic blood pressure, ESC = European Society of Cardiology, ESH = European Society of Hypertension, FITT of exercise = frequency, intensity, time, and type, GP = general practitioner, IPAQ = International Physical activity Questionnaire, ITT = intention-to-treat, MPR = medication possession ratio, MTD = maximum tolerated dose, NNT = number needed to treat, NSAIDs = non-steroidal anti-inflammatory drugs, SBP = systolic blood pressure, VAS = visual analogue scale. Keywords: blood pressure control, hypertension, low sodium diet, physical exercise, self-management, self-monitorin

Effectiveness of a Multifactorial Intervention, Consisting of Self-Management of Antihypertensive Medication, Self-Measurement of Blood Pressure, Hypocaloric and Low Sodium Diet, and Physical Exercise, in Patients With Uncontrolled Hypertension Taking 2 or More Antihypertensive Drugs: The MEDICHY Study

[eng] Introduction: High blood pressure is the leading modifiable risk factor for cardiovascular disease, and is associated with high morbidity and mortality and with significant health care costs for individuals and society. However, fewer than half of the patients with hypertension receiving pharmacological treatment have adequate blood pressure control. The main reasons for this are therapeutic inertia, lack of adherence to treatment, and unhealthy lifestyle (i.e., excess dietary fat and salt, sedentary lifestyle, and overweight). Cardiovascular risk and mortality are greater in hypertensive patients who are receiving treatment but have suboptimal control of blood pressure. Methods/design: This is a multicentre, parallel, 2-arm, single-blind (outcome assessor), controled, cluster-randomized clinical trial. General practitioners and nurses will be randomly allocated to the intervention group (self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise) or the control group (regular clinical practice). A total of 424 patients in primary care centers who use 2 or more antihypertensive drugs and blood pressure of at least 130/80 during 24-hambulatory blood pressure monitoring will be recruited. The primary outcome is systolic blood pressure at 12 months. The secondary outcomes are blood pressure control (<140/90 mm Hg); quality of life (EuroQol 5D); direct health care costs; adherence to use of antihypertensive medication; and cardiovascular risk (REGICOR and SCORE scales). Discussion: This trial will be conducted in the primary care setting and will evaluate the impact of a multifactorial intervention consisting of self-management of blood pressure, antihypertensive medications, and lifestyle modifications (hypocaloric and low sodium diet and physical exercise)

Analysis of dynamic common factors in the presence of autocorrelated noise-processes

This thesis presents a procedure to build a dynamic factor model in the presence of orthogonal stationary noise-processes. The procedure is based on the Peña-Box model (Peña & Box, 1987), in which the number of observed time series is fixed, and in the extension proposed by Peña & Poncela (2006) to non-stationary common factors, in which the common factors may be integrated processes. As a first result, an alternative for detecting the number of common factors is proposed by extending the statistical test of Peña & Poncela (2006), proposed for the Peña-Box model with a white noise process. Furthermore, in the same context, a statistical test is proposed to identify the number of non-stationary common factors. These proposals are illustrated by simulation and an application with real data, in which some empirical findings related to seasonal factors are also presented. The model is estimated by maximum likelihood, via a state-space model.Esta tesis presenta un procedimiento para construir un modelo de factores comunes dinámicos en presencia de procesos de ruido estacionarios ortogonales. El procedimiento se basa en el modelo de Peña-Box (Peña & Box, 1987), en el cual el número de series de tiempo observadas es fijo, y en la extensión propuesta por Peña & Poncela (2006) a factores comunes no estacionarios, en la cual los factores comunes pueden ser procesos integrados. Como primer resultado, se propone una alternativa para la identificación del número de factores comunes extendiendo la prueba estadística de Peña & Poncela (2006) , propuesta para el modelo Peña-Box con proceso de ruido blanco. Adicionalmente, bajo el mismo contexto, se propone una prueba estadística para identificar el número de factores comunes no estacionarios. Estas propuestas son ilustradas mediante simulación y una aplicación con datos reales, en la cual también se presentan algunos hallazgos empíricos relacionados a factores estacionales. La estimación del modelo se realiza por máxima verosimilitud, vía un modelo espacio de estados.Línea de investigación: Series de TiempoDoctorad