19 research outputs found
Predictive Factors of Pulmonary Embolism in Older Patients with SARS-CoV-2: The OCTA-COVID-19 Study
Background: The risk of pulmonary embolism (PE) has not been studied in older patients affected by COVID-19. We aimed to assess PE incidence and risk factors in a population of older patients infected with SARS-CoV-2. Methods: An ambispective, observational cohort study. A total of 305 patients >= 75 years old had the SARS-CoV-2 infection from March to May 2020. The incidence rate of PE was estimated as the proportion of new cases within the whole sample. Youden's index was used to assess the cutoff point of D-dimer. To select factors associated with the risk of PE, time-to-event analyses were performed using cause-specific hazard models. Results: In total, 305 patients with a median age of 87 years (62.3% female) were studied; 67.9% were referred from nursing homes and 90.4% received any type of anticoagulation. A total of 64.9% showed frailty and 44% presented with dementia. The PE incidence was 5.6%. The cutoff value of a D-dimer level over 2.59 mg/L showed a sensitivity of 82.4% and specificity of 73.8% in discriminating a PE diagnosis. In the multivariate analysis, the factors associated with PE were previous oncological events and D-dimer levels. Conclusions: The PE incidence was 5.6%, and major risk factors for PE were oncological antecedents and increased plasma D-dimer levels.This work was partially supported by grants (to M.Q.-F., J.G.-P.) from the "New announcement for extraordinary initiative fund UAX-Santander COVID-19," Alfonso X el Sabio University
Chikungunya virus infections among travellers returning to Spain, 2008 to 2014
Since the first documented autochthonous transmission of
chikungunya virus in the Caribbean island of Saint Martin in
2013, the infection has been reported within the Caribbean
region as well as North, Central and South America. The risk of
autochthonous transmission of chikungunya virus becoming
established in Spain may be elevated due to the large numbers of
travellers returning to Spain from countries affected by the
2013 epidemic in the Caribbean and South America, as well as the
existence of the Aedes albopictus vector in certain parts of
Spain. We retrospectively analysed the laboratory diagnostic
database of the National Centre for Microbiology, Institute of
Health Carlos III (CNM-ISCIII) from 2008 to 2014. During the
study period, 264 confirmed cases, of 1,371 suspected cases,
were diagnosed at the CNM-ISCIII. In 2014 alone, there were 234
confirmed cases. The highest number of confirmed cases were
reported from the Dominican Republic (n = 136), Venezuela (n =
30) and Haiti (n = 11). Six cases were viraemic in areas of
Spain where the vector is present. This report highlights the
need for integrated active case and vector surveillance in Spain
and other parts of Europe where chikungunya virus may be
introduced by returning travellers
Effect of a nutritional intervention based on an energy-reduced Mediterranean diet on environmental impact
[EN]To estimate the environmental impact of a dietary intervention based on an energy-reduced Mediterranean diet (MedDiet) after one year of follow-up.
Methods
Baseline and 1-year follow-up data were used for 5800 participants aged 55–75 years with metabolic syndrome in the PREDIMED-Plus study. Food intake was estimated through a validated semiquantitative food consumption frequency questionnaire, and adherence to the MedDiet was estimated through the Diet Score. Using the EAT-Lancet Commission tables we assessed the influence of dietary intake on environmental impact (through five indicators: greenhouse gas emissions (GHG), land use, energy used, acidification and potential eutrophication). Using multivariable linear regression models, the association between the intervention and changes in each of the environmental factors was assessed. Mediation analyses were carried out to estimate to what extent changes in each of 2 components of the intervention, namely adherence to the MedDiet and caloric reduction, were responsible for the observed reductions in environmental impact.
Results
We observed a significant reduction in the intervention group compared to the control group in acidification levels (−13.3 vs. -9.9 g SO2-eq), eutrophication (−5.4 vs. -4.0 g PO4-eq) and land use (−2.7 vs. -1.8 m2).
Adherence to the MedDiet partially mediated the association between intervention and reduction of acidification by 15 %, eutrophication by 10 % and land use by 10 %. Caloric reduction partially mediated the association with the same factors by 55 %, 51 % and 38 % respectively. In addition, adherence to the MedDiet fully mediated the association between intervention and reduction in GHG emissions by 56 % and energy use by 53 %.SIPublicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL
Circulating carotenoids are associated with favorable lipid and fatty acid profiles in an older population at high cardiovascular risk
Carotenoid intake has been reported to be associated with improved cardiovascular health, but there is little information on actual plasma concentrations of these compounds as biomarkers of cardiometabolic risk. The objective was to investigate the association between circulating plasma carotenoids and different cardiometabolic risk factors and the plasma fatty acid profile. This is a cross-sectional evaluation of baseline data conducted in a subcohort (106 women and 124 men) of an ongoing multi-factorial lifestyle trial for primary cardiovascular prevention. Plasma concentrations of carotenoids were quantified by liquid chromatography coupled to mass spectrometry. The associations between carotenoid concentrations and cardiometabolic risk factors were assessed using regression models adapted for interval-censored variables. Carotenoid concentrations were cross-sectionally inversely associated with serum triglyceride concentrations [-2.79 mg/dl (95% CI: -4.25, -1.34) and -5.15 mg/dl (95% CI: -7.38, -2.93), p-values = 0.0002 and <0.00001 in women and men, respectively], lower levels of plasma saturated fatty acids [-0.09% (95% CI: -0.14, -0.03) and -0.15 % (95% CI: -0.23, -0.08), p-values = 0.001 and 0.0001 in women and men, respectively], and higher levels of plasma polyunsaturated fatty acids [(0.12 % (95% CI: -0.01, 0.25) and 0.39 % (95% CI: 0.19, 0.59), p-values = 0.065 and 0.0001 in women and men, respectively] in the whole population. Plasma carotenoid concentrations were also associated with higher plasma HDL-cholesterol in women [0.47 mg/dl (95% CI: 0.23, 0.72), p-value: 0.0002], and lower fasting plasma glucose in men [-1.35 mg/dl (95% CI: -2.12, -0.59), p-value: 0.001]. Keywords: Mediterranean diet; PREDIMED-plus study; cardiovascular health; liquid chromatography; mass spectrometry; plasma carotenoids
Adopting a High-Polyphenolic Diet Is Associated with an Improved Glucose Profile: Prospective Analysis within the PREDIMED-Plus Trial
Previous studies suggested that dietary polyphenols could reduce the incidence and complications of type-2 diabetes (T2D); although the evidence is still limited and inconsistent. This work analyzes whether changing to a diet with a higher polyphenolic content is associated with an improved glucose profile. At baseline, and at 1 year of follow-up visits, 5921 participants (mean age 65.0 ± 4.9, 48.2% women) who had overweight/obesity and metabolic syndrome filled out a validated 143-item semi-quantitative food frequency questionnaire (FFQ), from which polyphenol intakes were calculated. Energy-adjusted total polyphenols and subclasses were categorized in tertiles of changes. Linear mixed-effect models with random intercepts (the recruitment centers) were used to assess associations between changes in polyphenol subclasses intake and 1-year plasma glucose or glycosylated hemoglobin (HbA1c) levels. Increments in total polyphenol intake and some classes were inversely associated with better glucose levels and HbA1c after one year of follow-up. These associations were modified when the analyses were run considering diabetes status separately. To our knowledge, this is the first study to assess the relationship between changes in the intake of all polyphenolic groups and T2D-related parameters in a senior population with T2D or at high-risk of developing T2
Whether your name is Manuel or María matters: gender biases in recommendations to study engineering
A controlled experiment was conducted to detect gender biases that participants, acting as advisers, may have when providing guidance to teenagers on their career choice. We presented a fictional profile to the study participants – university students from Spain – of a 15-year-old person, called Manuel or María, with two possible levels of academic record. The participants were asked to evaluate the student’s mathematical ability and provide guidance regarding whether or not he or she should study engineering in the future. We assumed that the effect of being a male target on the recommendation to study engineering is partially mediated by the fact that the participants attribute a greater mathematical ability to males. Our results suggest that a significant degree of gender bias in favour of males persists in the recommendation to study engineering. We propose some practical implications for advisers and for equality policies.Ministerio de Ciencia, Innovación y Universidades (España)Depto. de Economía Aplicada, Pública y PolíticaFac. de Estudios estadísticosTRUEpu
Impact of delirium on short‐term outcomes in hip fracture patients under a program of approach to delirium
Aim:We aimed to investigate the impact of delirium on short-term outcomes in hip fracturepatients. Special attention was given to patients with delirium and dementia.Methods:A prospective observational cohort study was carried out in hip fracture patientsaged≥70 years who were admitted to a hospital unit where a multicomponents approach todelirium is established for all patients. Our population was split into delirium (n= 212) andnon-delirium cohort (n= 171) according to the Confusion Assessment Method. Patients witha previous diagnosis of dementia in an outpatient appointment were also assessed within thedelirium cohort. The utility of the rehabilitation was measured with the Absolute FunctionalGain index.Results:A total of 383 patients were entered into the study. The median age was 86 years,and most patients were women (78.8%). Delirium patients were older, presented a lower pre-vious Barthel Index (BI), had higher rates of dementia and came more frequently from nursinghomes. Comparative analysis did not show differences in mortality, complications, length ofstay or walking ability between the cohorts. However, lower BI on discharge, lower AbsoluteFunctional Gain and the presence of nosocomial infections were found more frequently inthe delirium cohort. In multivariate analysis, only the BI on discharge (P= 0.010) was lower indelirium patients. Within the delirium cohort, those suffering from dementia had worse BI ondischarge (P= 0.017) and lower Absolute Functional Gain (P= 0.019).Conclusions:Delirium was not associated with mortality, walking ability, length of stay andclinical complications in hip fracture patients. BI on discharge was the only short-term out-come affected. In the delirium cohort, those suffering from dementia showed worse rehabili-tation results.Sin financiación2.022 JCR (2019) Q2, 14/36 Gerontology0.844 SJR (2019) Q1, 10/41 Gerontology, 55/301 Health (social science)No data IDR 2019UE
Impact of delirium on short-term outcomes in hip fracture patients under a program of approach to delirium
Aim:We aimed to investigate the impact of delirium on short-term outcomes in hip fracturepatients. Special attention was given to patients with delirium and dementia.Methods:A prospective observational cohort study was carried out in hip fracture patientsaged≥70 years who were admitted to a hospital unit where a multicomponents approach todelirium is established for all patients. Our population was split into delirium (n= 212) andnon-delirium cohort (n= 171) according to the Confusion Assessment Method. Patients witha previous diagnosis of dementia in an outpatient appointment were also assessed within thedelirium cohort. The utility of the rehabilitation was measured with the Absolute FunctionalGain index.Results:A total of 383 patients were entered into the study. The median age was 86 years,and most patients were women (78.8%). Delirium patients were older, presented a lower pre-vious Barthel Index (BI), had higher rates of dementia and came more frequently from nursinghomes. Comparative analysis did not show differences in mortality, complications, length ofstay or walking ability between the cohorts. However, lower BI on discharge, lower AbsoluteFunctional Gain and the presence of nosocomial infections were found more frequently inthe delirium cohort. In multivariate analysis, only the BI on discharge (P= 0.010) was lower indelirium patients. Within the delirium cohort, those suffering from dementia had worse BI ondischarge (P= 0.017) and lower Absolute Functional Gain (P= 0.019).Conclusions:Delirium was not associated with mortality, walking ability, length of stay andclinical complications in hip fracture patients. BI on discharge was the only short-term out-come affected. In the delirium cohort, those suffering from dementia showed worse rehabili-tation results.Sin financiación2.730 JCR (2020) Q2, 15/36 Gerontology0.823 SJR (2020) Q1, 10/41 GerontologyNo data IDR 2020UE
Accuracy, feasibility and predictive ability of different frailty instruments in an acute geriatric setting. European geriatric medicine
To analyze the feasibility, accuracy and the ability of different frailty instruments to predict adverse outcomes.
Methods
A prospective cohort study was conducted in patients ≥ 70 years admitted to the acute care setting (ACS). Feasibility and prevalence of frailty were assessed by FRAIL, Clinical Frailty Scale (CFS), hand grip strength (HGS) and the Spanish Frailty-VIG. Receiver operator characteristic (ROC) curves and area under the curve (AUC) were performed to identify frailty according to each instrument, setting VIG as the reference. For each instrument, multiple logistic regressions were used to examine the effect of frailty on primary outcome (i.e., three-month mortality) and secondary outcomes (i.e., in-hospital mortality, length of stay, institutionalization, functional decline and 30-day readmission).
Results
A total of 185 patients were included, with a median age of 89 years. The feasibility of the instruments was 100%, except for HGS (67%). The prevalence of frailty varied from 65.2% (FRAIL) to 86.7% (VIG). AUCs against VIG ranged from 0.69 (95% confidence interval [CI] 0.57–0.81: FRAIL) to 0.77 (95% CI 63.5–90.2: CFS). Frail patients defined by FRAIL were 2.7times more likely to have a prolonged length of stay than non-frail patients (95% CI 1.385–5.416). Three-month mortality occurred more among frail patients, either defined by FRAIL (OR 2.5; 95% CI 1.072–5.881) or CFS (OR 3.7; 95% CI 1.255–10.812), than in non-frail patients.
Conclusion
The four instruments had high feasibility providing variable prevalence of frailty. FRAIL and CFS predicted well for three-month mortality, and FRAIL also for length of stay. However, none of the instruments predicted for the other secondary outcomes of the study.Sin financiación3.269 JCR (2021) Q3, 36/54 Geriatrics & Gerontology0.670 SJR (2021) Q2, 52/110 Geriatrics and GerontologyNo data IDR 2020UE