14 research outputs found
Primary care behind the former "Iron Curtain": changes and development of primary healthcare provision in the Eastern part of the European Union
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Development and reliability of questionnaires for the assessment of diet and physical activity behaviors in a multi-country sample in Europe the Feel4Diabetes Study
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Obtaining evidence base for the development of Feel4Diabetes intervention to prevent type 2 diabetes: a narrative literature review
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Conducta suicida no letal en Castellón: un estudio descriptivo y comparativo.
Treball Final de Grau en Medicina. Codi: MD1158. Curs acadèmic: 2018/2019.Background: Due to the suicidal behavior variability regarding the sociocultural values of each
territory, we conducted this study to define the sociodemographic and clinical features of the patients
from Castellon. The objective is to obtain deeper knowledge that facilitate the detection and
implementation of effective interventions. In addition, we carried out a comparative analysis between
non-lethal suicide cases (our sample) and completed suicide cases.
Methods: Our sample includes every person assisted for non-lethal suicidal behavior in the Psychiatric
Emergency room at Castellon’s Provincial Hospital from January 19th to February 15th, performing an
8 year follow-up. Our completed suicide sample was taken from a previous study conducted in 2018.2
Results: Our sample showed an average age of 39, with a majority of women (56.1%) and psychiatric
pathology diagnosis (74.2%, mainly anxiety-depressive disorders). Most of them were being followed
by a health service (81.2%, generally their GP). The most frequent suicide method was drug overdose
(94.4%). After the suicide episode, only 27 patients (40.9%) attended the healthcare service they were
referred to, what may explain the persistance of the suicidal behavior during the follow-up (7.7%
suicidal threats and 34.5% attempts)
Conclusions: Non-lethal suicidal behavior in Castellon is more frequent among young, women, and
those with psychiatric disorders, using as main suicidal method drug overdose. Most of them don’t
attend the health care service responsible for their follow-up.
Moreover, it was found that the completed suicide profile differs from the non-lethal; it is therefore
required to develop different therapeutical and preventive strategies for each one.Introducción: Dada la variabilidad en la conducta suicida según los valores socioculturales de cada
territorio, realizamos este estudio para definir las características sociodemográficas y clínicas de los
pacientes con comportamiento suicida no letal de nuestra provincia. Pretendemos ampliar nuestro
conocimiento para facilitar la detección de individuos en riesgo e implantar intervenciones efectivas.
Además, realizamos una comparativa entre las características de nuestra muestra con las de suicidio
consumado.
Material y métodos: La muestra incluye toda conducta suicida no letal registrada en el Hospital
Provincial de Castellón entre el 19 de enero y 15 de febrero de 2009, realizándose un seguimiento hasta
febrero de 2017. La muestra de suicidio consumado es tomada de un proyecto previo de 2018.
Resultados: La muestra la integran mayormente individuos jóvenes (media de 39 años), de sexo
femenino (56.1%), con patología psiquiátrica (74.2%, principalmente trastornos ansioso-depresivos) y
en seguimiento sanitario (81.2%, predominantemente MAP (77.3%)). El método de suicidio más
frecuente fue la sobreingesta medicamentosa (94.4%). Sólo 27 pacientes (40.9%) acudieron tras el
episodio a los servicios de salud remitidos, facilitándose así la persistencia de la conducta durante el
seguimiento (7.7% amenazas, 34.5% tentativas).
Conclusiones: La conducta suicida no letal de Castellón predomina entre adultos jóvenes, de sexo
femenino, con trastornos psiquiátricos, que recurren como método a la sobredosis medicamentosa e
incumplen el seguimiento a posteriori.
Además, se comprobó que el perfil del comportamiento suicida letal difiere de los rasgos de la conducta
suicida no letal, evidenciando la necesidad de desarrollar estrategias preventivas y terapéuticas distintas
entre ellos
Repositioning of the global epicentre of non-optimal cholesterol
High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe
Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants
Background
Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories.
Methods
We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.
Findings
The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran.
Interpretation
Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings
Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions
Bőr makrofágok és dendritikus sejtek karakterizálása a melanoma progresszió során
A humán malignus melanomát az egyik legagresszívabb tumor típusként tartják számon. A különböző típusai és megjelenési formái miatt sok esetben csak a késői stádiumokban kerül diagnosztizálásra. Jelen vizsgálat célja a bőr makrofágok és dendritikus sejtek karakterizálása és összehasonlítása volt naevusokban és primer malignus melanomákban. A primer melanomák szövetblokkjaiból származó minták elemezése immunhisztokémiai módszerrel történt. Klinikopatológiai adatok alapján rendszereztük a nem áttétes, illetve a metasztatizáló primer tumorokat. A daganathoz mérten intratumorálisan és peritumorálisan elhelyezkedő sejtek festődése mértékének meghatározásához FXIII-A, CD163, CD11c antitesteket alkalmaztunk. A markerek expresszióját vizsgálva arra kerestük a választ, hogy milyen összefüggések mutathatók ki a malignitással kapcsolatosan, valamint az egyes klinikopatológiai adatok alapján milyen különbségek figyelhetők meg a nem metasztatizáló, illetve a haematogén úton áttétet adó primer melanomák csoportjaiban. Elemzéseink alapján a csoportok között klinikopatológiai szempontból a leglényegesebb különbség a tumorvastagság, a nem és az ulceráció paramétereinél volt megfigyelhető. A Breslow-szerinti tumorvastagság bizonyult a legjelentősebb prognosztikai faktornak. A primer tumor mindkét csoportjánál a peritumorális strómában nagyobb mennyiségben makrofágok és kisebb számban dendritikus sejtek foglaltak helyet. Malignus melanomákban a FXIII-A/CD163 pozitív makrofágok denzitásának fokozódása, különösen intratumorális jelenléte, rossz prognózissal társul, illetve a távoli haematogén metasztázisok meglétének valószínűségét növeli.MSc/MAkörnyezet-egészségügyimagyarnappalig