Cefalea en urgencias

Headache is among the most frequent neurological symptoms in the Emergency department. Although most of the patients suffer from primary headaches (migraine), an acute headache might be the only symptom of a serious disease, such as subarachnoid haemorrhage. The physician’s task is to make the diagnosis, carry out an appropriate selection of the patients who require further diagnostic evaluation and relieve the pain. An accurate history will identify most of the patients with secondary headaches. Clinicians should suspect secondary causes in sudden onset headache, headache in patients aged over 50 years, and also in those patients with abnormalities on neurological examination

Increased adiposity appraised with cun-bae is highly predictive of incident hypertension. The sun project

Overweight and obesity are growing worldwide and strongly associated with hypertension. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index is proposed as an optimal indicator of body fatness. We aimed to investigate the association of body fat as captured by the CUN-BAE index with incident hypertension in a Mediterranean population. We assessed 15,950 participants of the SUN (Seguimiento Universidad de Navarra) prospective cohort (63.7% women) initially free of hypertension. Participants completed follow-up questionnaires biennially. A validated 136-item food-frequency questionnaire was administered at baseline. We used Cox models adjusted for multiple confounders. Among 12.3 years of median follow-up (interquartile range: 8.3, 15.0 years), 2160 participants reported having received a diagnosis of hypertension. We observed a strong direct association between progressively higher the CUN-BAE index at baseline and incident hypertension during follow-up in multivariable-adjusted models for men and women, even after further adjustment for BMI ≥ 30 kg/m2, showing a significant association also in non-obese participants. For each 2-unit increase in the CUN-BAE index, hypertension risk increased by 27% and 29% in men and women, respectively. The results remained significant when considering longitudinal repeated measures of changes in body fat assessed with the CUN-BAE index among the different biennial follow-up questionnaires. Our results emphasize the importance of reducing and maintaining a low body fat to prevent hypertension

Effect of smoking on body weight: longitudinal analysis of the SUN cohort

Our aim was to investigate prospectively the association between two major cardiovascular risk factors: smoking and weight gain. METHODS: We prospectively evaluated 7565 individuals taking part in a dynamic cohort study over a median follow-up period of 50 months. Self-reported weight and physical activity levels had been validated previously. The adjusted mean difference in weight gain relative to never-smokers (the reference group) was estimated for different levels of tobacco exposure. RESULTS: After adjusting for age, baseline body mass index, sedentary lifestyle, changes in physical activity level, total energy intake, fiber intake, food consumption between meals, and sugary soft drink, fast food and alcohol consumption, it was found that individuals who stopped smoking during follow-up had a greater relative weight gain: men 1.63 kg (95% confidence interval [CI], 1.07-2.19 kg), and women 1.51 kg (95% CI, 1.11-1.91 kg). In addition, active smokers had a greater weight gain than never-smokers: men 0.49 kg (95% CI, 0.11-0.87 kg), and women 0.36 kg (95% CI, 0.07-0.65 kg). CONCLUSIONS: Individuals who stopped smoking during follow-up and active smokers both experienced significantly greater weight gains than never-smokers. This association between cardiovascular risk factors should be taken into account when developing prevention programs

Effect of the Diesel, Inhibitor, and CO 2

In order to determine the diesel contribution in the coadsorption process of the oil-soluble inhibitors, electrochemical impedance spectroscopy measurements have been carried out to study the performance of oil-soluble inhibitors in both presence and absence of diesel and CO2. The results showed that the presence of the oil phase provides some protection to the steel because the water-soluble fractions are capable of being adsorbed on the steel surface thereby reducing the corrosion rate. The oily phase does not contribute to the adsorption process of the inhibitor because the inhibitor is absorbed into the water-soluble fractions. The oil-soluble inhibitors are effective only when the solution is saturated with CO2. CO2 saturation causes a decrease in the pH of the solution causing both an increase of the inhibitor solubility and a better dispersion of the inhibitor into the electrolyte

The Mediterranean diet and incidence of hypertension: the Seguimiento Universidad de Navarra (SUN) Study

The Mediterranean diet is receiving increasing attention in cardiovascular epidemiology. The association of adherence to the Mediterranean diet with the incidence of hypertension was evaluated among 9,408 men and women enrolled in a dynamic Spanish prospective cohort study during 1999–2005. Dietary intake was assessed at baseline with a validated semiquantitative food frequency questionnaire, and a 9-point Mediterranean diet score was constructed. During a median follow-up period of 4.2 years (range, 1.9–7.9), 501 incident cases of hypertension were identified. After adjustment for major hypertension risk factors and nutritional covariates, adherence to the Mediterranean diet was not associated with hypertension (the hazard ratio was 1.10 (95% confidence interval (CI): 0.81, 1.41) for moderate adherence and 1.12 (95% CI: 0.79, 1.60) for high adherence). However, it was associated with reduced changes in mean levels of systolic blood pressure (moderate adherence, 2.4 mm Hg (95% CI: 4.0, 0.8); high adherence, 3.1 mm Hg (95% CI: 5.4, 0.8)) and diastolic blood pressure (moderate adherence, 1.3 mm Hg (95% CI: 2.5, 0.1); high adherence, 1.9 mm Hg (95% CI: 3.6, 0.1)) after 6 years of follow-up. These results suggest that adhering to a Mediterranean-type diet could contribute to the prevention of age-related changes in blood pressure

Consumo de alcohol e incidencia de hipertensión en una cohorte mediterránea: el estudio SUN

Introduction and objectives. To assess prospectively the association between alcohol consumption, including alcoholic beverage preference and days of consumption per week, and the risk of hypertension in a Mediterranean cohort. Methods. We prospectively followed 9,963 Spanish men and women initially without hypertension. Self-reported and validated data on diet and hypertension diagnoses were collected. Results. During follow-up (median [interquartile range], 4.2 [2.5-6.1] years), 554 incident cases of hypertension were identified over a total of 43,562 person-years. The hazard ratio for hypertension among those who consumed alcohol on ≥5 days per week was 1.28 (95% confidence interval, 0.97-1.7) compared to abstainers. Among those who drank alcohol ≥5 days per week, the hazard ratio for hypertension associated with consuming ≥1 drink per day was 1.45 (95% confidence interval, 1.06-2) compared with abstainers. The consumption of beer or spirits, but not wine, was associated with an increased risk of hypertension. The hazard ratio associated with consuming >0.5 drinks of beer or spirits per day was 1.53 (95% confidence interval, 1.18-1.99) compared with abstainers. In contrast, there was a nonsignificant inverse association between red wine intake and the risk of hypertension. Conclusions. In this Mediterranean population, the consumption of beer or spirits, but not wine, was associated with a higher risk of developing hypertension. However, the weekly pattern of alcohol consumption did not have a significant impact on the risk of hypertension

Aspirin, non-aspirin analgesics and the risk of hypertension in the SUN cohort.

The use of aspirin and non-aspirin analgesics has been associated with changes in blood pressure. The aim of this study was to investigate prospectively the association between the regular use of aspirin and non-aspirin analgesics and the incidence of hypertension. METHODS: The SUN project is an ongoing, continuously expanding, prospective cohort of Spanish university graduates initially free of hypertension, cardiovascular disease, diabetes and cancer; 9986 (mean age 36 years) were recruited during 1999-2005 and followed up for a mean of 51 months. Regular aspirin and non-aspirin analgesic use and the presence of other risk factors for hypertension were assessed by questionnaire at baseline, and the incidence of hypertension was assessed using biennial follow-up questionnaires. RESULTS: In total, 543 new cases of hypertension were identified during follow-up. Regular aspirin use (i.e. 2 or more days/week) was associated with a higher risk of hypertension (hazard ratio=1.45; 95% confidence interval, 1.02-2.04) after adjustment for various confounding factors. Regular use of non-aspirin analgesic drugs was also associated with a higher risk of hypertension (hazard ratio=1.69; 95% confidence interval, 1.28-2.23). CONCLUSIONS: The regular use of aspirin and non-aspirin analgesics were both associated with an increased risk of developing hypertension, independently of other risk factors

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

Olive oil and prevention of chronic diseases: summary of an International conference

Olive oil is the foremost source of fat in the Mediterranean area and, among other features, sets the Mediterranean diet apart from other dietary regimens. In January 2018, the International Olive Council convened several worldwide experts at the Robert Mondavi Institute (Davis, CA), to discuss and summarize the available data on the effects of olive oil consumption on human health. In this paper, we critically provide a synthesis of the main reported findings, which underscore how and why consuming this oil as part of a balanced diet and healthful lifestyle improves prognosis and extends life- and health-spans

The HADES RV Programme with HARPS-N at TNG XI. GJ 685 b: a warm super-Earth around an active M dwarf

Small rocky planets seem to be very abundant around low-mass M-type stars. Their actual planetary population is however not yet precisely understood. Currently several surveys aim to expand the statistics with intensive detection campaigns, both photometric and spectroscopic. We analyse 106 spectroscopic HARPS-N observations of the active M0-type star GJ 685 taken over the past five years. We combine these data with photometric measurements from different observatories to accurately model the stellar rotation and disentangle its signals from genuine Doppler planetary signals in the RV data. We run an MCMC analysis on the RV and activity indexes time series to model the planetary and stellar signals present in the data, applying Gaussian Process regression technique to deal with the stellar activity signals. We identify three periodic signals in the RV time series, with periods of 9, 24, and 18 d. Combining the analyses of the photometry of the star with the activity indexes derived from the HARPS-N spectra, we identify the 18 d and 9 d signals as activity-related, corresponding to the stellar rotation period and its first harmonic respectively. The 24 d signals shows no relations with any activity proxy, so we identify it as a genuine planetary signal. We find the best-fit model describing the Doppler signal of the newly-found planet, GJ 685\,b, corresponding to an orbital period $P_b = 24.160^{+0.061}_{-0.047}$ d and a minimum mass $M_P \sin i = 9.0^{+1.7}_{-1.8}$ M$_\oplus$. We also study a sample of 70 RV-detected M-dwarf planets, and present new statistical evidence of a difference in mass distribution between the populations of single- and multi-planet systems, which can shed new light on the formation mechanisms of low-mass planets around late-type stars.Comment: 18 pages, 13 figures, accepted for publication in A&