.

Arterial Hypertension (HT) is a frequent risk factor for cardiovascular diseases. Elevated blood pressure (BP) can seriously affect health. Objective: To determine the prevalence of elevated BP in the adult population of Córdoba, Argentina, during 2020-2022. Observational, population-based, cross-sectional study in 797 adults aged ≥18 years in Córdoba city. The presence/absence of self-reported HT was analyzed, and BP was assessed by averaging two measurements using a validated instrument. BP was classified (normal:<130 and/or <85mmHg, borderline: ≥130 and/or ≥85mmHg and <140 and/or <90mmHg, elevated ≥140 and/or ≥90mmHg) according to the Consenso Argentino de Hipertensión Arterial-2018. Descriptive analyses were performed, 95% confidence intervals were constructed, and a logistic regression model (LRM) was fitted to assess elevated BP associations, adjusting for sex, age, body mass index (BMI) and socioeconomic level (SEL). A total of 797 adults (54.2% women) whose average age was 42±17 years, were studied. A 17.6% had HT according to self-report, and among them, at the time of measurements, 55.7% had elevated BP values. Among those who reported not having HT at the time of the measures, 18.8% had borderline BP and 20.2% had elevated BP, with age ranges (95%CI) of 35 to 41 years and 43 to 49 years, respectively. When evaluating elevated BP and its association with the variables of interest (LRM), it was observed that the higher the age and BMI, the greater the possibility of presenting elevated BP (OR 1.04;p<0.001 and OR 1.09;p<0.001, respectively). In turn, men presented a greater chance of elevated BP than women (OR 1.66;p=0.006). The low SEL also presented a greater possibility of elevated AT, compared to the high SEL (OR 1.90;p=0.011). A high percentage of the population presented elevated BP and this could indicate the need for greater follow-up of it.La hipertensión arterial (HTA) es un factor de riesgo frecuente de enfermedades cardiovasculares. La tensión arterial (TA) elevada puede afectar gravemente la salud. Objetivo: Conocer la prevalencia de TA elevada en población adulta de Córdoba, Argentina, durante 2020-2022. Estudio observacional de base poblacional y transversal en 797 adultos ≥18 años de la ciudad de Córdoba. Se analizó la presencia/ausencia de HTA autoreportada, y se evaluó TA, realizando promedio de dos mediciones realizadas mediante instrumento validado. Se clasificó la TA (normal:<130 y/o <85mmHg, limítrofe: ≥130 y/o ≥85mmHg y <140 y/o <90mmHg, elevada ≥140 y/o ≥90mmHg) según Consenso Argentino de Hipertensión Arterial-2018. Se realizaron análisis descriptivos, se construyeron intervalos de confianza del 95%, y modelo regresion logistica (MRL) de TA elevada, ajustando por sexo, edad, indice de masa corporal (IMC) y nivel socio economico (NSE). Se estudiaron 797 adultos (54,2% mujeres), cuya edad promedio fue 42±17 años. El 17,6% tenía HTA según autoreporte, y entre ellos, al momento de las mediciones, un 55,7% presentó valores de TA elevada. Entre quienes reportaron no tener HTA, al momento de las mediciones, un 18,8% presentó TA en valores limítrofes y 20,2% TA elevada, siendo sus intervalos de edad (IC 95%) 35 a 41 años y 43 a 49 años, respectivamente. Al evaluar la TA elevada y su asociación con las variables de interés (MRL), se observó que a mayor edad e IMC existen más posibilidades de presentar la TA elevada (OR 1,04;p<0,001 y OR 1,09;p<0,001, respectivamente). A su vez, el sexo masculino presentó mayor chance de TA elevada en relación al femenino (OR 1,66;p=0,006). El NSE bajo también presentó mayor posibilidad de TA elevada, con respecto al NSE alto (OR 1,90;p=0,011). Existe un alto porcentaje de la población que presenta TA elevada, lo que indicaría la necesidad de un mayor seguimiento de la misma.

Use of probe-based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence

Background Probe-based confocal laser endomicroscopy (pCLE) provides microscopic imaging during an endoscopic procedure. Its introduction as a standard modality in gastroenterology has brought significant progress in management strategies, affecting many aspects of clinical care and requiring standardisation of practice and training. Objective This study aimed to provide guidance on the standardisation of its practice and training in Barrett’s oesophagus, biliary strictures, colorectal lesions and inflammatory bowel diseases. Methods Initial statements were developed by five group leaders, based on the available clinical evidence. These statements were then voted and edited by the 26 participants, using a modified Delphi approach. After two rounds of votes, statements were validated if the threshold of agreement was higher than 75%. Results Twenty-six experts participated and, among a total of 77 statements, 61 were adopted (79%) and 16 were rejected (21%). The adoption of each statement was justified by the grade of evidence. Conclusion pCLE should be used to enhance the diagnostic arsenal in the evaluation of these indications, by providing microscopic information which improves the diagnostic performance of the physician. In order actually to implement this technology in the clinical routine, and to ensure good practice, standardised initial and continuing institutional training programmes should be established

Air pollution and respiratory health of children: the PEACE panel study in Krakow., Poland.

The Krakow panel study was performed as part of the Pollution Effects on Asthmatic Children in Europe (PEACE) project. The aim of the study was to examine the acute effects of short-term changes in air pollution on symptomatic children. Krakow served as the urban area and Rabka, a small health resort 70 km south of Krakow, as the control area. In the first stage, two panels of children (86 from urban and 80 from control area) were selected according to relevant answers to a screening questionnaire. For 12 winter weeks a diary study was performed. Children measured their peak expiratory flow twice a day and made notes on respiratory signs and symptoms, as well as on medication use. Monitoring stations collected data on air pollution in both areas for the same 12 weeks. Multivariate regression models did not show a consistent relationship between air pollution and peak expiratory flow or with respiratory symptom prevalence or incidence. No effect of air pollution could be established

Presencia de obesidad y su asociación con alimentos fuente de fibra y azúcares simples, desde un enfoque de determinantes sociales, en la ciudad de Córdoba durante los años 2020/2021

Obesity is a chronic, heterogeneous and multifactorial disease. Regarding this last concept, the Social Determinants of Health (SDH) become relevant, which influence the development of obesity, such as material and psychosocial circumstances, behavioral factors (including diet), biological factors, social cohesion and the health system. The aim of the present work was to assess the association between intermediate SDH, mainly diet, and obesity in adults residing in Córdoba city in 2020/2021.  A population-based, cross-sectional and analytical study was carried out on adults from Córdoba, who were selected based on a multistage random sampling approach. A total of 919 subjects participated in a validated survey that examines different aspects such as demographic, anthropometric measurements and physical activity, and intake through a food frequency questionnaire. The nutritional status was analyzed according to the presence of obesity (through the Body Mass Index). 95 % confidence intervals were estimated to evaluate the prevalence of the disease and models of logistic regression were built to assess the correlation between obesity and SDH of interest, stratifying by sex. The prevalence of obesity was 21,96% (CI95% 0,1929-0,2481). Foods source of simple sugars (g/day) were positively associated with the presence of obesity (OR:1,0008; CI95%1,00003-1,00159). When stratifying by sex, this correlation was significant only in women (OR:1,0012; CI95%1,0001-1,0023). In relation to the intake of food sources of fiber, an inverse correlation between obesity and the quantified consumption per g/day was found. This correlation was significant only in men (OR:0,9958; CI95%0,9921-0,9994). In addition, the weekly intake of this food group was inversely associated with the presence of obesity (OR: 0,9747; CI95% 0,9574-0,9924), being significant only in men (OR: 0,9474; IC95% 0,9101-0,9861). Furthermore, the socio-economic conditions, physical activity, access to a health care system, the presence of comorbidities and exposure to pollutants at work, were linked to the presence of obesity. Considering the SDH approach, a diet with a low fiber and high simple sugar intake has a negative impact on health, being associated with the presence of obesity.La obesidad es una enfermedad crónica, heterogénea y multifactorial. En este último concepto adquieren relevancia los Determinantes Sociales de la Salud (DSS), los cuales influyen en el desarrollo de la obesidad, como las circunstancias materiales, psicosociales, factores conductuales (entre ellos la alimentación), factores biológicos, cohesión social y el sistema de salud. El objetivo del presente trabajo fue valorar la asociación entre los DSS intermedios, principalmente la alimentación, y la obesidad en adultos que residen en la ciudad de Córdoba en 2020/2021. Estudio de base poblacional, transversal y analítico en adultos de la ciudad de Córdoba seleccionados por muestreo aleatorio multietápico. 919 personas respondieron una encuesta validada que indagó sobre aspectos sociodemográficos, medidas antropométricas y actividad física, e ingesta mediante un cuestionario de frecuencia alimentaria. Se analizó el estado nutricional según presencia de obesidad (mediante el índice de masa corporal). Se estimaron intervalos de confianza al 95% para la prevalencia de enfermedad y se construyeron modelos de regresión logística múltiple para evaluar la asociación entre obesidad y los DSS de interés, estratificando según sexo. La prevalencia de obesidad fue del 21,96% (IC95% 0,1929 - 0,2481). Los alimentos fuente de azúcares simples (g/día) se asociaron positivamente con la presencia de obesidad (OR:1,0008; IC95%1,00003-1,00159). Al estratificar por sexo, esta asociación solo fue significativa en mujeres (OR:1,0012; IC95%1,0001-1,0023). En cuanto a la ingesta de alimentos fuente de fibra, se evidenció una asociación inversa con la presencia de obesidad en el consumo cuantificado en g/día, siendo significativo sólo en hombres (OR:0,9958; IC95%0,9921-0,9994). También se demostró que el consumo en veces/semana de estos alimentos se asoció inversamente con la presencia de obesidad (OR: 0,9747; IC95% 0,9574-0,9924), observándose sólo en varones (OR: 0,9474; IC95% 0,9101-0,9861). El nivel socio económico, la actividad física, tener obra social, la presencia de comorbilidades y exposición a contaminantes en trabajo también mostraron asociación con la obesidad. Considerando el enfoque de DSS, una alimentación con un bajo consumo de fibra y elevado en azúcares simples impacta negativamente en la salud, asociándose a la presencia de obesidad

Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project.

The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of particles with a 50% cut-off aerodynamic diameter of 10 μm (PM10), black smoke (BS), sulphur dioxide (SO2) and nitrogen dioxide (NO2) on the respiratory health of children with chronic respiratory symptoms. The study was conducted in the winter of 1993/1994 by 14 research centres in Europe. A total of 2,010 children, divided over 28 panels in urban and suburban locations, was followed for at least 2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by daily peak expiratory flow (PEF) measurements and a symptom diary. The association between respiratory health and air pollution levels was calculated with time series analysis. Combined effect estimates of air pollution on PEF or the daily prevalence of respiratory symptoms and bronchodilator use were calculated from the panel-specific effect estimates. Fixed effect models were used and, in cases of heterogeneity, random effect models. No clear associations between PM10, BS, SO2 or NO2 and morning PEF, evening PEF, prevalence of respiratory symptoms or bronchodilator use could be detected. Only previous day PM10 was negatively associated with evening PEF, but only in locations where BS was high compared to PM10 concentrations. There were no consistent differences in effect estimates between subgroups based on urban versus suburban, geographical location or mean levels of PM10, BS, SO2 and NO2. The lack of association could not be attributed to a lack of statistical power, low levels of exposure or incorrect trend specifications. In conclusion, the PEACE project did not show effects of particles with a 50% cutoff aerodynamic diameter of 10 μm, black smoke, sulphur dioxide or nitrogen dioxide on morning or evening peak expiratory flow or the daily prevalence of respiratory symptoms and bronchodilator use

Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project

The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre studs of the acute effects of particles with a 50% rut-off aerodynamic diameter of 10 mu m (PM10), black smoke (BS), sulphur dioxide (SOL) and nitrogen dioxide (NO2) on the respiratory health of children with chronic respiratory symptoms, The study was conducted in the winter of 1993/1994 by 14 research centres in Europe. A total of 2,010 children, divided over 28 panels in urban and suburban locations, was followed For at least 2 months. Exposure to air pollution was monitored on a daily basis, Health status was monitored hy daily peak expiratory how (PEF) measurements and a symptom diary. The association between respiratory health and air pollution levels was calculated with time series analysis. Combined effect estimates of air pollution on PEI: or the daily prevalence of respiratory symptoms and bronchodilator use were calculated from the panel-specific effect estimates, Fixed effect models were used and, in cases of heterogeneity, random effect models. No clear associations between PM10, BS, SO2 or NO2 and morning PEF, evening PEI, prevalence of respiratory symptoms or bronchodilator use could be detected. Only previous day PM10 was negatively associated with evening PEF, but only in locations where BS was high compared to PM10 concentrations. There were no consistent differences in effect estimates between subgroups based on urban versus suburban, geographical location or mean levels of PM10, BS, SO2 and NO2. The lack of association could not be attributed to a lack of statistical power, low levels of exposure or incorrect trend specifications, In conclusion, the PEACE project did not show effects of particles with a 50% cutoff aerodynamic diameter of IO pm, black smoke, sulphur dioxide or nitrogen dioxide on morning or evening peak expiratory how or the daily prevalence of respiratory symptoms and bronchodilator use