Prevención cardiovascular y de la osteoporosis con terapia hormonal sustitutiva

Se recomienda actualmente que todo médico -sea cual sea su especialidad- aproveche la oportunidad que supone la atención clínica a cualquier mujer postmenopáusica o que se halle en torno a la menopausia para aconsejarle acerca de los beneficios y riesgos que supone la terapia hormonal sustitutiva (THS) con estrógenos y progesterona. Una vez que sea adecuadamente informada de estos beneficios y riesgos, debe ser la propia mujer quien decida si va a iniciar o no esta terapia, teniendo en cuenta no sólo su propio perfil de riesgo sino también sus preferencias. Los beneficios más claros se refieren a la reducción del riesgo de osteoporosis y de fracturas, así como al control y prevención de algunos síntomas frecuentes en la menopausia. Para prevenir la osteoporosis se requiere un uso continuado de IaTHS. También existen cada vez más argumentos que sugieren una reducción del riesgo de un primer episodio coronario. No obstante, no hay pruebas de que laTHS sea útil en la prevención secundaria de la cardiopatía isquémica o aporte alguna protección frente a los accidentes cerebrovasculares. Las desventajas más importantes de la THS se refieren a un mayor riesgo de hiperplasia de endometrio y de cáncer endometrial cuando se usan estrógenos solos, sin combinarlos con progestágenos. También existe un pequeño incremento del riesgo de cáncer de mama cuando se prolonga la THS, también cuando se asocian progestágenos

Influence of COVID-19 confinement in students’ performance in higher education

Documento procedente de EdArXiv Preprints , se deposita en Biblos-e Archivo versión 2 de 7 Mayo de 2020This study explores the effects of COVID-19 confinement in the students’ performance in higher education. Using a field experiment of 458 students from three different subjects in Universidad Autónoma de Madrid (Spain), we study the differences in assessments by dividing students into two groups. The first group (control) corresponds to academic years 2017/2018 and 2018/2019. The second group (experimental) corresponds to students from 2019/2020, which is the group of students that interrupted their face-to-face activities because of the confinement. The results show that there is a significant positive effect of the COVID-19 confinement on students’ performance. This effect is also significative in activities that did not change their format when performed after the confinement. We find that this effect is significative both in subjects that increased the number of assessment activities and subjects that did not change the workload of students. Additionally, an analysis of students’ learning strategies before confinement shows that students did not study on a continuous basis. Based on these results, we conclude that COVID-19 confinement changed students’ learning strategies to a more continuous habit, improving their efficiency. For these reasons, better scores in students’ assessment are expected due to COVID-19 confinement that can be explained by an improvement in their learning performanceThis work has been financed by the project Erasmus+ 2017-1-ES01-KA203-038266 Project of the European Union: “Advanced Design of e-Learning Applications Personalizing Teaching to Improve Virtual Education

Daily physical activity and macronutrient distribution of low-calorie diets jointly affect body fat reduction in obese women.

Inadequate dietary patterns and sedentary lifestyles are believed to be important factors in predisposing people to obesity. This study analyzed the potential interaction between habitual physical activity and the carbohydrate (CHO)-fat distribution in 2 hypocaloric diets and the impact of such interplay on body composition changes. Forty healthy obese women, 20–50 years old, were randomly assigned to a high- or low-CHO energy-restricted diet, which was low or high in fat, respectively, during 10 weeks. Baseline and final measurements were performed to assess dietary habits, resting metabolic rate, and body composition changes. Physical activity was measured with a triaxial accelerometer and with a questionnaire. There were no significant differences in anthropometric and metabolic variables between both dietary groups at baseline. However, there was a positive correlation between total free-living physical activity and arm muscle preservation after 10 weeks (r = 0.371; p = 0.024). Interestingly, an interaction between macronutrient (CHO–fat distribution) intake and physical activity was found, since less-active subjects with a high-CHO–low-fat diet showed a greater fat loss than those more active with a lower-CHO–high-fat diet, whereas more-active subjects with a high-CHO–low-fat diet showed a smaller fat loss than those receiving a low-CHO–high-fat diet. Physical activity and the macronutrient content of energyrestricted diets, when designed to promote body fat mass reduction, should be considered together to better predict the outcome

Respuestas del miocardio al estrés biomecánico

El estrés biomecánico del miocardio hace referencia a la situación que se genera cuando, debido a la hipertensión, la hipoxia u otras formas de daño miocárdico, están aumentadas las demandas de trabajo cardíaco y/o se ha perdido miocardio funcionante. Como consecuencia del estrés biomecánico se producen diversas respuestas que afectan a todas las células miocárdicas, en particular a los cardiomiocitos. El resultado final de las mismas son distintas modificaciones fenotípicas que inicialmente son compensadoras (p. ej., hipertrofia), pero que si persiste el estrés pueden mediar la transición de la hipertrofia a la insuficiencia cardíaca (p. ej., apoptosis y fibrosis). Esta revisión se centra en la descripción de las distintas fases de las respuestas miocárdicas al estrés, así como en la consideración de los hallazgos más recientes sobre los mecanismos moleculares implicados en el desarrollo de insuficiencia cardíaca

Validation of metabolic syndrome using medical records in the SUN cohort

The objective of this study was to evaluate the validity of self reported criteria of Metabolic Syndrome (MS) in the SUN (Seguimiento Universidad de Navarra) cohort using their medical records as the gold standard. METHODS: We selected 336 participants and we obtained MS related data according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF). Then we compared information on the self reported diagnosis of MS and MS diagnosed in their medical records. We calculated the proportion of confirmed MS, the proportion of confirmed non-MS and the intraclass correlation coefficients for each component of the MS. RESULTS: From those 336 selected participants, we obtained sufficient data in 172 participants to confirm or reject MS using ATP III criteria. The proportion of confirmed MS was 91.2% (95% CI: 80.7- 97.1) and the proportion of confirmed non-MS was 92.2% (95% CI: 85.7-96.4) using ATP III criteria. The proportion of confirmed MS using IDF criteria was 100% (95% CI: 87.2-100) and the proportion of confirmed non-MS was 97.1% (95% CI: 85.1-99.9). Kappa Index was 0.82 in the group diagnosed by ATP III criteria and 0.97 in the group diagnosed by IDF criteria. Intraclass correlation coefficients for the different component of MS were: 0.93 (IC 95%:0.91- 0.95) for BMI; 0.96 (IC 95%: 0.93-0.98) for waist circumference; 0.75 (IC 95%: 0.66-0.82) for fasting glucose; 0.50 (IC 95%:0.35-0.639) for HDL cholesterol; 0.78 (IC 95%: 0.70-0.84) for triglycerides; 0.49 (IC 95%:0.34-0.61) for systolic blood pressure and 0.55 (IC 95%: 0.41-0.65) for diastolic blood pressure. CONCLUSIONS: Self-reported MS based on self reported components of the SM in a Spanish cohort of university graduates was sufficiently valid as to be used in epidemiological studies

Factores con mayor influencia sobre la elección de alimentos en la población española

Fundamentos: Encuesta poblacional dirigida a conocer los factores que influyen en la elección de los alimentos de la población española. Métodos: Análisis de una muestra de todo el territorio español compuesta por 1009 individuos y seleccionada por un procedimiento aleatorio multietápico. Este estudio corresponde a la participación española en un estudio europeo sobre las actitudes de la población frente a la alimentación, nutrición y salud dirigido por el Instituto Europeo de Estudios Nutricionales de Dublín. Se determinó el porcentaje de individuos que situó a alguno de los cinco factores mencionados con más frecuencia (calidad, precio, dieta sana, condicionantes españoles, sabor) entre las tres primeras influencias en la elección de alimentos. Se ajustó un modelo multivariante para identificar los factores asociados a la elección de una dieta sana como una de las tres primeras influencias en la alimentación.Resultados: El precio influía más en los individuos de mayor edad, en niveles socioeconómicos más bajos y en individuos con menor nivel educativo. Fue mayor el impacto del precio en las mujeres de la zona Norte, Noreste y Noroeste. El sexo, la distribución geográfica, la edad y el nivel educativo presentaron un efecto independiente y significativo sobre la importancia concedida por la población a la elección de una dieta sana. Conclusiones: Los resultados sugieren la necesidad de una mayor educación sobre dieta y salud especialmente en hombre jóvenes, personas con menor nivel educativo y mujeres del Noroeste del país

Increasing trend in the prevalence of morbid obesity in Spain: from 1.8 to 6.1 per thousand in 14 years

Obesity, and especiallymorbid obesity, increases the risk of cardiovascular as well as non-cardiovascular diseases. Our objective was to ascertain the trends in morbid obesity in Spain from 1993 to 2006 using representative data from 106,048 participants in the National Health Surveys. An age-adjusted Poisson regression model stratified by sex was fitted using morbid obesity as the dependent variable. An increasing trend in prevalent morbid obesity from 1.8 to 6.1 per thousand participants was found (increase > 200%). Morbid obesity prevalence was higher in women. After adjusting for age, a monotonically increasing prevalence of morbid obesity was apparent for both men and women: the relative increase was 4% per year in women and 12% per year in men. These trends highlight the importance of preventive actions

Limits on Associated Production of Visibly and Invisibly Decaying Higgs Bosons from Z Decays

Many extensions of the standard electroweak model Higgs sector suggest that the main Higgs decay channel is "invisible", for example, $h \to J J$ where $J$ denotes the majoron, a weakly interacting pseudoscalar Goldstone boson associated to the spontaneous violation of lepton number. In many of these models the Higgs boson may also be produced in association to a massive pseudoscalar boson (HA), in addition to the standard Bjorken mechanism (HZ). We describe a general strategy to determine limits from LEP data on the masses and couplings of such Higgs bosons, using the existing data on acoplanar dijet events as well as data on four and six $b$ jet event topologies. For the sake of illustration, we present constraints that can be obtained for the ALEPH data.Comment: FTUV/94-36, IFIC/94-31 TIFR/TH/94--25, 12 pages + 4 figures (included as ps files at the end

Dietary patterns and difficulty conceiving: a nested case–control study

Objective: To investigate potential associations between dietary patterns (defined using factor analysis) and difficulty conceiving. Design: Case–control study nested in a Spanish cohort of university graduates (Seguimiento Universidad de Navarra [SUN] Project). Setting: Female university graduates all over Spain participating in the SUN Project. Patient(s): A total of 485 women, aged 20–45 years, reporting having presented with difficulty getting pregnant, and 1,669 age-matched controls who had at least one child. Intervention(s): None. Main Outcome Measure(s): Reported difficulty getting pregnant. Data were collected from baseline and follow-up questionnaires of the SUN Project. Results: Two dietary patterns were identified. They were labeled as “Mediterranean-type” and “Western-type” patterns. A lower risk of difficulty getting pregnant was apparent in the highest quartile of adherence to the Mediterranean-type pattern compared with the lowest quartile (odds ratio 0.56, 95% confidence interval 0.35–0.95). Greater adherence to the Western-type dietary pattern showed no association with this outcome. Conclusion: A greater adherence to the Mediterranean-type dietary pattern may enhance fertility. Further evidence about the relationship between this dietary pattern and fertility is needed to develop nutritional interventions for women desiring to get pregnant

Abnormalities on 1q and 7q are associated with poor outcome in sporadic Burkitt's lymphoma. A cytogenetic and comparative genomic hybridization study

Comparative genomic hybridization (CGH) studies have demonstrated a high incidence of chromosomal imbalances in non-Hodgkin's lymphoma. However, the information on the genomic imbalances in Burkitt's Lymphoma (BL) is scanty. Conventional cytogenetics was performed in 34 cases, and long-distance PCR for t(8;14) was performed in 18 cases. A total of 170 changes were present with a median of four changes per case (range 1-22). Gains of chromosomal material (143) were more frequent than amplifications (5) or losses (22). The most frequent aberrations were gains on chromosomes 12q (26%), Xq (22%), 22q (20%), 20q (17%) and 9q (15%). Losses predominantly involved chromosomes 13q (17%) and 4q (9%). High-level amplifications were present in the regions 1q23-31 (three cases), 6p12-p25 and 8p22-p23. Upon comparing BL vs Burkitt's cell leukemia (BCL), the latter had more changes (mean 4.3 +/- 2.2) than BL (mean 2.7 +/- 3.2). In addition, BCL cases showed more frequently gains on 8q, 9q, 14q, 20q, and 20q, 9q, 8q and 14q, as well as losses on 13q and 4q. Concerning outcome, the presence of abnormalities on 1q (ascertained either by cytogenetics or by CGH), and imbalances on 7q (P=0.01) were associated with a short survival