Evolución de la dieta y la actividad física de los estudiantes universitarios tras la pandemia de COVID-19

Objetivo: valorar la evolución de la adherencia a la dieta mediterránea y el nivel de actividad física de los estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha durante la pandemia de COVID-19 y un año después de la misma. Método: estudio observacional transversal mediante cuestionarios sobre la adherencia a la dieta mediterránea y el nivel de actividad física. Participaron 893 alumnos matriculados en grados de Ciencias de la Salud de la Universidad de Castilla-La Mancha, 575 en la primera encuesta (durante la pandemia) y 318 en la segunda (un año después). Por sexos, 672 mujeres y 221 hombres (en la primera encuesta, el 77,7 % eran mujeres y el 22,3 % hombres, mientras que en la segunda lo eran el 70,8 % y 29,2 %, respectivamente). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario de Prevención con Dieta Mediterránea (PREDIMED), modificado. El nivel de actividad física se valoró con el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: tras un año desde el confinamiento por la COVID-19, el consumo de aceite de oliva casi se ha triplicado. Se ha duplicado también el consumo de frutas diario. De igual modo, se ha duplicado el consumo de vino y bebidas alcohólicas. Por el contrario, se encontró una reducción del consumo de mantequilla y margarina, al igual que de bebidas carbonatadas y azucaradas. Asimismo, aumentó significativamente el porcentaje de estudiantes universitarios con adherencia alta a la dieta mediterránea (del 26 % al 34,3 %). En cuanto al nivel de actividad física, ha aumentado significativamente el porcentaje de estudiantes universitarios que realizan actividad fisica ligera, moderada e incluso intensa de forma irregular. Este aumento no se ha encontrado en el caso de las actividades de fuerza muscular y flexibilidad. Conclusión: los resultados del estudio nos indican que, aunque los niveles de adherencia a la dieta mediterránea y de actividad física han mejorado tras el confinamiento por la COVID-19, la adherencia a la dieta mediterránea y el nivel de actividad física de la población universitaria analizada siguen siendo bajos. Es necesario aplicar estrategias para la consecución o mantenimiento de un estilo de vida saludable en dicha población.Objective: to assess the evolution of adherence to Mediterranean diet and level of physical activity of university students of Health Sciences in Castilla-La Mancha during the COVID-19 lockdown and one year afterwards. Methods: a cross-sectional observational study using questionnaires on adherence to the Mediterranean diet and level of physical activity. A total of 893 students enrolled in Health Sciences degrees at the University of Castilla la Mancha participated, 575 in the first survey (during the lockdown) and 318 in the second (one year later). By sex, 672 women and 221 men (in the first survey 77.7 % were women and 22.3 % men while in the second survey these were 70.8 % and 29.2 %, respectively). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The level of physical activity was assessed with the Rapid Assessment of Physical Activity Scale (RAPA). Results: one year after the COVID-19 confinement, consumption of olive oil has almost tripled. Daily fruit consumption has also doubled. Similarly, the consumption of wine and alcoholic beverages has doubled. Conversely, there was a reduction in the consumption of butter and margarine, as well as of carbonated drinks and sweetened beverages. Likewise, the percentage of university students with high adherence to the Mediterranean diet increased significantly (from 26 % to 34.3 %). Regarding physical activity level, there was a significant increase in the percentage of university students who engaged in light, moderate and even intense physical activity on an irregular basis. This increase was not found in the case of muscular strength and flexibility training activities. Conclusion: the results of the study indicate that, although the levels of adherence to the Mediterranean diet and physical activity have improved after the COVID-19 confinement, adherence to Mediterranean diet and physical activity level among the university population analyzed is still low. It is necessary to implement strategies for the achievement or maintenance of a healthy lifestyle in this population

Effects of the Mediterranean diet on the cardiovascular risk factors

Background: Eating habits have been modified, which together with a more sedentary lifestyle has contributed to a significant increase in cardiovascular risk factors and consequently in cardiovascular disease. It is believed that this epidemic could be reduced with a change to a healthier lifestyle and diet, such as the Mediterranean diet. Objetive: To demonstrate the benefit of the Mediterranean diet as a valid dietary pattern for the primary prevention of cardiovascular disease Methods: study of the articles found in bibliographic review of different databases through systematic technique Results: In interventions with Mediterranean diet, a global beneficial effect on blood pressure has been observed with significant reductions in systolic, diastolic or both depending on the study. There is also a positive effect on glucose levels, HbA1c and incidence of type 2 diabetes mellitus with a significant level of significance. Regarding the lipid profile, the results are more variable, although generally it is considered that there is a reduction of total cholesterol, triglycerides, concentration and oxidation of LDL and ApoB and an increase of HDL. Inflammatory markers such as CRP, IL6, IL8, TNF alpha, ICAM, P-selectin, are also reduced in several of the studies analyzed. Likewise, the Mediterranean diet has proven to be an useful tool in the reversal of the metabolic syndrome. Conclusions: After a few decades in which prevention and treatment of cardiovascular diseases focused on the use of low-fat diets, the Mediterranean diet is currently emerging as a healthier alternative since it has shown a greater reduction in blood pressure, glycaemia, lipid profile, markers of inflammation and endothelial damage

Erectile Dysfunction Associated with Cardiovascular Risk Factors

Objectives: (1) Determine erectile dysfunction (ED) prevalence in patients with cardiovascular risk factors (CVRF). (2) Assess ED incidence in relation to the extent of controlling CVRF. Methodology: Patients: Enrolled participants came to the health centres in the study area. In accordance with the incidence of diseases with cardiovascular risks (CVR) in the Basic Health Regions of the study area, sample size was calculated with a 95% confidence interval and an alpha error of 0.005, resulting in a sample of 210 people, of which 30 could not complete the study for various reasons (change of address, death, refused to complete questionnaire, etc.). A full awareness and diffusion campaign was organized with talks and leaflets. Letters: A standard letter was given to patients which explained the importance of sexual health, offering them an appointment with a DUE (Diploma in Nursing) survey taker. The questionnaire was devised by the research group and was given by a fully trained DUE survey taker. Previously, contact was made with all the health centres, physicians and nursing staff to give them information on ED and CVRF and to inform them about the work to be done in their health region. Those patients who did not come to the appointment were telephoned to insist on the importance of attending and completing the questionnaire. Variables analysis: We analysed age, level of education, civil status, height, weight and body mass index (BMI), SBP, DBP, smoking habit, number cigarettes/day, year smoking began, ex‐smoker, year smoking stopped, alcohol consumption, grams alcohol/week, as well as consumption of other drugs, frequency and type. Blood test: glucose, haemoglobin glycated haemoglobin, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, artherogenic index, creatinine, urea, GOT, GPT, gamma‐GT and PSA. Urine test: micro‐albuminuria, proteinuria and creatinine clearance. ECG: Diabetes diagnosed at least 1 year ago and prescribed drugs to treat it. High blood pressure diagnosed at least 1 year ago and prescribed drugs to treat it. Dyslipidaemia (hypercholesterolaemia) diagnosed at least 1 year ago and prescribed drugs to treat it. Concomitant diseases of at least 1 year and drugs (up to 3) SHIM questionnaire and ED according to SHIM. Statistical analysis: an observational, descriptive, analytical, cross‐sectional study. Qualitative variables are presented as exact values and a percentage; quantitative variables as the mean and standard deviation (SD). A means comparison was done with the Student’s t‐test for independent groups, or the Mann‐Whitney U test if normality conditions (using the Kolmogorov‐Smirnoff or Shapiro‐Wilks test) were not fulfilled. The chi‐squared test was used for qualitative variables. Results: Of the 210 selected people, 179 completed the questionnaire (85.2%). The mean age was 64.5 ± 11.6 years. When analysing all the study variables in relation to the main variable, presence or absence of ED, age played an important role in ED appearing as ED incidence rises with age. Blood pressure had no significant relationship with the studied variable, and the same hold for BMI and its subdivision into normal weight and obesity. As regards toxic habits, neither cigarette smoking nor alcohol consumption influenced the presence of ED. The same hold for the sociological‐type variables (civil states, level of education). Regarding the biochemical variables from blood tests, a significant relationship with the atherogenic index and its recoded variable at high and low atherogenic risk (p < 0.04) was noted. In the glycaemic profile, a glycaemia mean of 126 mg/dl was obtained in the ED presence group, which is the cut‐off point proposed by ADA117 (American Diabetes Association) to consider a subject diabetic. Likewise, glycated haemoglobin presented figures in the two groups can be considered an alternation of a practically diabetic glucose metabolism. In our study, the presence of diabetic disease, high blood pressure (HBP) and dyslipidaemia showed no significant relationship with ED presence for each disease. However, in the combination of these diseases, a statistically significant relationship was seen when CVR increases, according to the Framinghan tables. Neither did each disease’s duration show a significant relationship with ED presence nor significant differences for the drugs used to treat the three pathologies were found. The coronary risk calculated according to the Framinghan tables indicated a statistically significant result, as did excessive risk (the difference between the coronary risk and the average assigned per age) for ED presence. The LISAT 8 test suggested that ED affected health‐associated quality of life and was statistically significant in two items of sex life and economic situation and was borderline statistically significant in the general life and working life items. Conclusions: There is a high ED prevalence in patients with high CVR. When ED improves, the better CVRFs are controlled. These patients’ pluripathology implies aggressive polymedication which doctors must consider as it increases the risk of ED

Nonalcoholic steatohepatitis and cardiovascular risk factors in primary care

Varias circunstancias motivan el creciente interés por la esteatosis hepática no alcohólica (EHNA): la elevada prevalencia de la enfermedad en el mundo occidental, su capacidad de progresión a formas histológicas más agresivas y su asociación con enfermedades que incrementan el riesgo cardiovascular. Objetivo: analizar la relación de la esteatosis hepática no alcohólica con los factores de riesgo cardiovascular en pacientes con criterios de síndrome metabólico. Método: fue realizado un estudio descriptivo transversal con una muestra de 100 pacientes, con 2 o más factores de riesgo cardiovascular, con nula o baja ingesta de alcohol, que acudían a consulta de atención primaria. A los seleccionados se les solicitó analítica completa e interconsulta para ecografía de abdomen completo. Se evaluó si tenían esteatosis hepática; en caso de ser afirmativo, se estratificaba en 3 grados. Se recogieron las siguientes variables tanto cualitativas (sexo, antecedentes personales y familiares de diabetes, hipertensión arterial, dislipidemia, entre otros) y cuantitativas (edad, peso, talla, índice de masa corporal, tratamiento farmacológico, cifras de distintos parámetros analíticos, cifras de tensión arterial y perímetro abdominal). Resultados: participaron 100 pacientes, 56% de los cuales eran mujeres, con una edad media de 61,84 DE ± 9,5 años. Del total de sujetos del estudio, el 23 % no tenía esteatosis hepática no alcohólica; un 29% tenía esteatosis hepática leve; otro 29%, esteatosis hepática moderada; y el 19% restante, esteatosis hepática severa. En los hombres, el 82% presentó esteatosis hepática. De las mujeres, el 28,57% no presentó hígado graso. Un 22% tenía sobrepeso y un 38% de los pacientes eran obesos. Solo un 22% y un 18% tenían alteradas las cifras tensionales sistólica y diastólica, respectivamente. El 60% tenía una glucemia basal alterada. En cuanto a los parámetros lipídicos, el 36% tenía hipertrigliceridemia; el 41%, hipercolesterolemia, con un 65% de colesterol LDL alto y un 16% de colesterol HDL bajo. El 83% de los pacientes tenía 2 o más criterios de síndrome metabólico. Conclusiones: hay una estrecha relación entre la aparición de esteatosis hepática no alcohólica y los factores de riesgo cardiovascular en pacientes con síndrome metabólico, por lo que se recomienda que, ante la aparición de estos, se analice el hígadoSeveral factors motivate the growing interest in this disease. They include the high prevalence of the disease in the Western world, its ability to progress to more aggressive histological forms, and its association with diseases that increase cardiovascular risk. Objective: The objective of this study was to analyze the relationship of nonalcoholic steatohepatitis (NASH) with cardiovascular risk factors in patients with criteria for metabolic syndrome. Method: This is a descriptive cross-sectional study of 100 patients who had two or more cardiovascular risk factors, who did not consume alcohol or consumed only small amounts of alcohol, and who came to the primary care clinic. The patients selected underwent complete analyses including abdominal ultrasound. They were evaluated for hepatic steatosis, and, if they tested positive, it was stratified into three degrees. Among the qualitative variables used were sex, personal and family history of diabetes, hypertension, dyslipidemia, and the quantitative variables included age, weight, height, body mass index, pharmacological treatment, numbers of different analytical parameters, blood pressure and abdominal perimeter. Results: There were 100 patients, 56% of whom were women. Patients’ mean age was 61.84 SD ± 9.5 years. Of the total number of subjects in the study, 23% did not have NASH, 29% had mild hepatic steatosis, 29% had moderate hepatic steatosis and 19% had severe hepatic steatosis. Of the men in the study, 82% had hepatic steatosis. Of the women, 28.57% did not have fatty livers. 22% were overweight and 38% obese. Only 22% had altered the systolic blood pressure and and 18% had altered diastolic blood pressure. 60% had altered basal glycemia. 36% had hypertriglyceremia, 41% had hypercholesterolemia including 65% with high LDL cholesterol and 16% with low HDL cholesterol. 83% of the patients had two or more criteria for metabolic syndrome.Conclusions: There is a close relationship between the occurrence of NASH and cardiovascular risk factors in patients with metabolic syndrome, and it is advisable that the liver be analyzedEstudio financiado en parte por la Comisión de Investigación de la Gerencia Integrada de Albacet

Resultados de una intervención motivacional con niños obesos o con sobrepeso y sus familias: Estudio Piloto

Introducción: el objetivo fue analizar los resultados de una intervención motivacional con modificación de los hábitos alimentarios, los estilos de vida y los trastornos emocionales en niños obesos de 6 a 12 años y sus familias. Material y métodos: Estudio de intervención con evaluación pre- y posintervención del programa Familias en Movimiento. Se incluyeron 11 niños (10 niñas y 1 niño) de 6 a 12 años tratados con otros programas para la pérdida de peso sin éxito. Se evaluaron al inicio y al final los parámetros: Índice de Masa Corporal (IMC), los resultados de los cuestionarios: de Dieta Mediterránea y ansiedad en niños y el peso y la ansiedad de los adultos tras la intervención. Resultados: El IMC disminuyó de una mediana de 25,2 (Rango intercuartílico de 23,3–28,0) a 23,9 y (22,9–27,6) tras la intervención, cambio no estadísticamente significativo (p<0,086). La mediana de adherencia a la Dieta Mediterránea aumentó significativamente en 2,2 puntos (7,1 a 9,3), debido principalmente a que un mayor número de niños tomaban desayuno (44%) y hubo una disminución del consumo de golosinas y bollería industrial en el desayuno (22,2%). La intervención redujo significativamente en 8,7 puntos la ansiedad en los niños. De los adultos, 9 de ellos participaron en la evaluación inicial, la media de disminución de peso fue de 3,6kg y la disminución de la ansiedad pasó de 45,6 a 27,3 (p=0,02). Conclusiones: La aplicación del programa Familias en Movimiento disminuyó el IMC, aumentó la puntuación en la adherencia a Dieta Mediterránea y disminuyó la ansiedad en los niños, además se redujo el peso y la ansiedad en los adultos que acompañaron en el programa a los niños

Resultados de una intervención motivacional con niños obesos o con sobrepeso y sus familias: Estudio Piloto

Introduction: The objective was to analyze the modification of eating habits, lifestyles and emotional disorders in obese children (6 to 12 years of age) and their families through a motivational intervention.Material and Methods: Intervention study with pre- and post-intervention evaluation through Familias en Movimiento program. This program included 11 children (10 girls and 1 boy) aged 6 to 12 years who had been unsuccessfully treated with other weight loss programs. The following parameters were evaluated at the beginning and at the end: Body Mass Index (BMI), the results of the questionnaires: Mediterranean Diet and anxiety in children, and the weight and anxiety of adults after the intervention.Results: The BMI decreased from a median of 25.2 (interquartile range of 23.3–28.0) to 23.9 and (22.9–27.6) after the intervention, a change not statistically significant (p&lt;0.086). Median adherence to the Mediterranean Diet increased significantly by 2.2 points (7.1 to 9.3), mainly due to the fact that more children ate breakfast (44%) and there was a decrease in the consumption of sweets and pastries industrial breakfast (22.2%). The intervention significantly reduced anxiety in children by 8.7 points. 9 of the adults participated in the initial assessment, the average weight loss was 3.6kg and the decrease in anxiety step from 45.6 to 27.3 (p=0.02). Conclusions: The application of the “Families in movement” program decreased the BMI, increased the score in adherence to the Mediterranean Diet and decreased the anxiety in the children. In addition the weight and anxiety were reduced in the adults who accompanied the program to the children.Introducción: el objetivo fue analizar los resultados de una intervención motivacional con modificación de los hábitos alimentarios, los estilos de vida y los trastornos emocionales en niños obesos de 6 a 12 años y sus familias. Material y métodos: Estudio de intervención con evaluación pre- y posintervención del programa Familias en Movimiento. Se incluyeron 11 niños (10 niñas y 1 niño) de 6 a 12 años tratados con otros programas para la pérdida de peso sin éxito. Se evaluaron al inicio y al final los parámetros: Índice de Masa Corporal (IMC), los resultados de los cuestionarios: de Dieta Mediterránea y ansiedad en niños y el peso y la ansiedad de los adultos tras la intervención.Resultados: El IMC disminuyó de una mediana de 25,2 (Rango intercuartílico de 23,3–28,0) a 23,9 y (22,9–27,6) tras la intervención, cambio no estadísticamente significativo (p&lt;0,086). La mediana de adherencia a la Dieta Mediterránea aumentó significativamente en 2,2 puntos (7,1 a 9,3), debido principalmente a que un mayor número de niños tomaban desayuno (44%) y hubo una disminución del consumo de golosinas y bollería industrial en el desayuno (22,2%). La intervención redujo significativamente en 8,7 puntos la ansiedad en los niños. De los adultos, 9 de ellos participaron en la evaluación inicial, la media de disminución de peso fue de 3,6kg y la disminución de la ansiedad pasó de 45,6 a 27,3 (p=0,02).Conclusiones: La aplicación del programa Familias en Movimiento disminuyó el IMC, aumentó la puntuación en la adherencia a Dieta Mediterránea y disminuyó la ansiedad en los niños, además se redujo el peso y la ansiedad en los adultos que acompañaron en el programa a los niños

Statins: Not all are benefits

Introduction: Dyslipidemia is a group of diseases whose common characteristic is the abnormal concentration of blood lipoproteins. An abnormally high concentration leads to the formation of arteriosclerosis and an increased risk of cardiovascular diseases, the main cause of mortality. Objectives: To evaluate the impact of hypercholesterolemia and to know the effects of the use of statins as treatment in primary and secondary prevention. Method: Systematic review in scientific databases of studies conducted in primary and secondary prevention for the treatment of hypercholesterolemia with statins assessing benefits and harms. Results: The prevalence of hypercholesterolemia is increasing due to the lack of healthy life habits in the population. There are studies that indicate that levels close to normal can be improved with hygienicdietetic measures and when these levels reach a certain value or do not change with these measures, one must move on to pharmacological treatment with statins, always assessing the risks and benefits in each patient. . Conclusions: Hypercholesterolemia requires patient awareness in the problem of arteriosclerosis and its participation in the treatment since, being an asymptomatic disease in the early stages, many of them are not aware of the risks. Statins with their side effects are controversial and research continues on their use as a treatment

Abordaje no farmacológico del dolor en pediatría desde la perspectiva de enfermería: Aplicación de materiales audiovisuales y buzzy®

Objetivo. Evaluacion del abordaje multidisciplinario del dolor pediátrico. Metodo. Revisión sistemática de la bibliografía más actualizada acerca del tema en los buscadores médicos Pubmed, Cuiden, Scielo, Cochrane Library y Cinahl. Aplicando en los motores de búsqueda los términos: “Pain Assessment”, “Pain Measurement” “Pain Management” “Nonpharmacologic treatment”, realizando  una acotación a aquellos artículos escritos en castellano e inglés y con fecha de publicación posterior a enero de 2015. Resultados y Discusión. Se ha tratado la identificación de la intensidad del dolor que requiere de un abordaje complejo y no existe un método de evaluación que se muestre superior a otro. Parece por tanto adecuado la aplicación de la combinación del autoregistro por parte del paciente siempre que sea posible, la familia y la aplicación de escalas de aplicación sistematizada por parte de personal cualificado para ello. Para la aplicación de las escalas parece conveniente la utilización según la validación de estas en determinados grupos de pacientes y lo familiarizado que este el personal encargado de registrarlas. El tratamiento farmacológico está siendo desarrollado amplia y eficazmente como medida complementaria a las formas habituales de tratamiento del dolor. Estas medidas en su mayoría de las veces por su fácil aplicación, escaso coste y casi nulo riesgo de iatrogenia se están implementando en la mayoría de las unidades de atención pediátrica. Esta aplicación de medidas exige de la creatividad y capacitación continua del personal que las lleve a cabo y de una correcta evaluación del dolor en cada momento de la asistencia. Conclusión. El control del dolor y la ansiedad que asocia son un desafío de abordaje multidisciplinar en el que la enfermería cumple un gran papel, desde su posición tanto de realizadora de la gran mayoría de procedimientos que pueden desencadenarlo como desde la aplicación de las medidas no farmacológicas

Active interventions in hypercholeteroloemia patiens with high cardiovascular risk in primary care

Introduction: Hypercholesterolemia is a major modifiable risk factors for cardiovascular disease (CVD). Its reduction reduces morbidity and mortality from ischemic heart disease and CVD in general, primary prevention and secondary prevention especially. Objective: To determine whether a notarized and intensive clinical practice can overcome inertia and achieve the therapeutic goal (OT) LDL-C &lt;100 mg &lt;dL in high-risk patients attended in Primary Care (PC) in our country. Methodology: epidemiological, prospective, multicenter study conducted in centers of different ACs By AP consecutive sampling 310 patients at high cardiovascular risk (diabetic or established CVD) previously treated with statins, which did not reach the OT included c-LDL. Results: The study subjects had a mean age of 65.2 years, of which 60.32% were male. The 41.64% had a previous EVC, acute myocardial infarction (20.33%), angina (16.07%), stroke /TIA (9.19%), arthropathy (5.25%), diabetes (70 , 87%), hypertension (71.01%), and abdominal obesity (69.62%). The 43.57% (95% CI: 37,21; 50,08) of patients who performed the 2nd visit (241) got the OT. 62.50% (95% CI: 55.68, 68.98) of those who took the 3rd (216) got the OT. Finally, 77.56% (95% CI: 72.13, 83.08) patients who performed the last visit (205) got the OT. Throughout the study there was a reduction in LDL-C levels from 135.6 mg /dL at baseline, 107.4 mg /dL in the 2nd visit, 97.3 mg /dL in the 3rd visit, up to 90.7 mg /dL at the final visit (p &lt;0.0001) The increase in HDL-C from baseline (50.9 mg /dL) and final (53.6 mg /dL) was also significant (p = 0.013). Conclusions: The reassessment and intensification of treatment in patients at high cardiovascular risk treated in primary care, applying the indications of the guides, achieves the OT in more than three quarters of the previously uncontrolled within half a year. These results should encourage us to overcome the therapeutic inertia in the control of CVD by early and energetic performance against hypercholesterolemia.Introducción: La hipercolesterolemia es uno de los principales factores de riesgo modificables de la enfermedad cardiovascular (ECV). Su reducción disminuye la morbimortalidad por cardiopatía isquémica y ECV en general, en prevención primaria y en prevención secundaria especialmente. Objetivo: Comprobar si una práctica clínica protocolizada e intensiva permite vencer la inercia y alcanzar el objetivo terapéutico (OT) de c-LDL < 100 mg/dL en pacientes de alto riesgo asistidos en Atención Primaria (AP) de nuestro país. Metodología: Estudio epidemiológico, prospectivo, multicentrico, realizado en Centros de AP de diferentes CC.AA. Mediante muestreo consecutivo se incluyeron 310 pacientes de alto riesgo cardiovascular (diabéticos o con ECV establecida), tratados previamente con estatinas, que no alcanzaban el OT de c-LDL. Resultados: Los sujetos del estudio tenían una edad media de 65,2 años, de los que el 60,32% eran varones. El 41,64% presentaba un EVC previo, infarto agudo de miocardio (20,33%), angina (16,07%), ictus/AIT (9,19%), artropatía (5,25%), diabetes (70,87%), hipertensión (71,01%), y obesidad abdominal (69,62%). El 43,57% (IC95%: 37,21; 50,08) de los pacientes que realizaron la 2a visita (241) consiguieron el OT. El 62,50% (IC95%: 55,68; 68,98) de los que realizaron la 3a (216) consiguieron el OT. Finalmente, el 77,56% (IC95%: 72,13; 83,08) de los pacientes que realizaron la última visita (205) consiguieron el OT. A lo largo del estudio hubo una reducción de los niveles de c-LDL desde los 135,6 mg/ dL en la visita basal, 107,4 mg/dL en la 2a visita, 97,3 mg/ dL en la 3a visita, hasta los 90,7 mg/dL en la visita final (p < 0,0001) El incremento de c-HDL entre la visita basal (50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo (p = 0,013). Conclusiones: La reevaluación e intensificación del tratamiento en pacientes de alto riesgo cardiovascular atendidos en Atención Primaria, aplicando las indicaciones de las guías, permite alcanzar el OT en más de las tres cuartas partes de los previamente no controlados en el plazo de medio año. Estos resultados nos deben estimular a superar la inercia terapéutica en el control de la ECV mediante una actuación precoz y enérgica ante la hipercolesterolemi

Bone mass disorders in patients treated with a replacement dose of levothyroxine.

Some thyroid diseases have been associated with osteoporosis due to the effect of thyroid hormones on bone resorption. On this basis, chronic treatment with thyroid hormones, especially suppressive doses, could lead to osteoporosis. Objective: To estimate the prevalence of osteoporosis in patients treated with thyroid hormone in a health center in the city of Albacete. Methods: Cross-sectional study, conducted in patients diagnosed with subclinical hypothyroidism in treatment with levothyroxine in the city of Albacete. Patients were selected by reviewing medical records and laboratory parameters. Physical examination and medical history data were collected. Subsequently they underwent a bone density test and completed a questionnaire. Results: 112 patients were included in the study, with female predominance (88.5%), mean age of 42.5 years and a tendency to be overweight (mean BMI of 25.67 kg/m2, 95% CI: 18,02-35,49) . The average TSH was 6.67 mU / ml (95% CI: 4.31 - 11.15) with normal free T4. Osteoporosis was only found in 14%, with osteopenia prevailing among those where some kind of bone loss was found. Paradoxically, there is a greater bone mass loss in patients with a higher BMI. Although the bone mass deficit has been significantly associated with sex and years of treatment with levothyroxine, it is not related to dose nor to hormone levels detected in blood. Conclusions: The characteristics of our population do not make it particularly susceptible to developing osteoporosis (premenopausal women, overweight, non-smokers) and cases that were found are not doses dependent, but rather time dependent, therefore there must be other factors contributing to this pathology