Exposición mantenida a bajas dosis de plomo : un modelo experimental

Tesis Univ. Complutense de MadridEste trabajo de investigación ha querido profundizar en las alteraciones producidas por bajas dosis de plomo, en un modelo Murino. Como célula diana de los mismos se ha escogido al macrófago peritoneal. El número y la composición de las células de la cavidad peritoneal no se afecta por el plomo. Sin embargo, la adherencia, quimiotaxis y la ingestión de c. Albicans disminuye con la exposición al metal.Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEpu

Exposición mantenida a bajas dosis de plomo : un modelo experimental

Este trabajo de investigación ha querido profundizar en las alteraciones producidas por bajas dosis de plomo, en un modelo Murino. Como célula diana de los mismos se ha escogido al macrófago peritoneal. El número y la composición de las células de la cavidad peritoneal no se afecta por el plomo. Sin embargo, la adherencia, quimiotaxis y la ingestión de c. Albicans disminuye con la exposición al metal

Curso on-line de apoyo metodológico a la realización del Trabajo Final de Grado y Master (TFGM) de Medicina

Depto. de Salud Pública y Materno - InfantilFac. de MedicinaFALSEsubmitte

Sports facilities, socio-economic context and overweight among the childhood population in two southern European cities: a cross sectional study

Background: To evaluate relationship between socio-economic environment and overweight in Madrid and Barcelona, adjusting for possible confounding factors. Methods: We obtained three indicators which reflected socio-economic context, namely, unemployment rate, percentage of population with tertiary education, and percentage with a second home. The design is a cross sectional study. The association with overweight was estimated using odds ratios by multilevel logistic regression. The statistical analysis, data synthesis, or model creation was performed from the 2017. In all, 707 children from 21 districts of Madrid and 474 children from 10 districts of Barcelona were analysed. Results: In Madrid, standardised ORs for personal and family characteristics were 1.17, 1.53 and 1.57 by reference to unemployment rate and percentages of population with a university education and second home. After adjustment, only the OR obtained with unemployment rate decreased, specifically by 58%. In Barcelona, the following ORs were obtained: 1.80 with unemployment rate; 1.80 with population having a university education; and 1.86 with population having a second home. After being standardised, these ORs decreased by 14% in the case of unemployment rate, 10% in the case of population with a university education, and 9% in the case of population with a second home. Conclusions: Overweight displayed a risk gradient in Madrid and Barcelona alike. This risk of overweight is not accounted for by physical inactivity and could, in part, be due to the availability of sports facilities.Ministerio de Ciencia e InnovaciónDepto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEpu

Asthma Is Associated with Back Pain and Migraine-Results of Population-Based Case-Control Study

Background: Worldwide, asthma, back pain, and migraine are major public health problems due to their high prevalence, effect on the quality of life, and huge economic costs. The association of asthma with an increased risk of these types of pain has been suggested; however, no conclusive results have been obtained to date. The aims of our study were (1) to describe and compare the prevalence of three types of pain localization, namely migraine or frequent headaches (MFH), chronic neck pain (CNP), and chronic low back pain (CLBP), in adults with and without asthma in Spain during the years 2014 and 2020 and (2) to identify which variables were associated with the presence of these types of pain in adults with asthma. (2) Methods: A cross-sectional study and a case-control study were conducted. The 2014 and 2020 European Health Interview Surveys for Spain were used as the data source. (3) Results: A total of 2463 individuals were interviewed and had self-reported asthma. In this group, the prevalence of pain was high, with CLBP (30.9%) being the most common, followed by CNP (26.7%) and MFH (13.3%). All types of pain remained stable from 2014 to 2020. In both surveys, the women with asthma reported a remarkably higher prevalence of all the types of pain analyzed than the men with asthma. After matching by age and sex, the prevalence of all pain types was significantly higher in the patients with asthma than in the matched individuals without asthma. Multivariable adjustment showed that asthma increased the likelihood of CNP by 1.45 times (OR 1.45; 95% CI 1.19-1.76), that of CLBP by 1.37 times (OR 1.37; 95% CI 1.11-1.64), and that of MFH by 1.19 times (OR 1.19; 95% CI 1.02-1.51). The three types of pain analyzed were associated with the female sex and worse self-rated health. (4) Conclusions: Among the men and women with asthma, the prevalence of all the pain types was high and remained stable over time. The prevalence was higher and the severity was greater among the women with asthma than among the men with asthma. The prevalence of any pain was significantly higher in people with asthma than in the sex-age-matched individuals without asthma. Multivariable analysis showed that the variables associated with the reporting of the three types of pain in people with asthma were female sex, worse self-reported health, and self-reported mental illness.Comunidad Autónoma de MadridUniversidad Complutense de MadridDepto. de Inmunología, Oftalmología y ORLFac. de MedicinaTRUEpu

Trends in the Use and Outcomes of Mechanical Ventilation among Patients Hospitalized with Acute Exacerbations of COPD in Spain, 2001 to 2015

(1) Background: We examine trends (2001–2015) in the use of non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV) among patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). (2) Methods: Observational retrospective epidemiological study, using the Spanish National Hospital Discharge Database. (3) Results: We included 1,431,935 hospitalizations (aged ≥40 years) with an AE-COPD. NIV use increased significantly, from 1.82% in 2001–2003 to 8.52% in 2013–2015, while IMV utilization decreased significantly, from 1.39% in 2001–2003 to 0.67% in 2013–2015. The use of NIV + invasive mechanical ventilation (IMV) rose significantly over time (from 0.17% to 0.42%). Despite the worsening of clinical profile of patients, length of stay decreased significantly over time in all types of ventilation. Patients who received only IMV had the highest in-hospital mortality (IHM) (32.63%). IHM decreased significantly in patients with NIV + IMV, but it remained stable in those receiving isolated NIV and isolated IMV. Factors associated with use of any type of ventilatory support included female sex, lower age, and higher comorbidity. (4) Conclusions: We found an increase in NIV use and a decline in IMV utilization to treat AE-COPD among hospitalized patients. The IHM decreased significantly over time in patients who received NIV + IMV, but it remained stable in patients who received NIV or IMV in isolation

Are there sex differences in the effect of type 2 diabetes in the incidence and outcomes of myocardial infarction? A matched‑pair analysis using hospital discharge data

Background To analyze incidence, use of therapeutic procedures, and in-hospital outcomes in patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to the presence of type 2 diabetes (T2DM) in Spain (2016–2018) and to investigate sex differences. Methods Using the Spanish National Hospital Discharge Database, we estimated the incidence of myocardial infarctions (MI) in men and women with and without T2DM aged ≥ 40 years. We analyzed comorbidity, procedures, and outcomes. We matched each man and woman with T2DM with a non-T2DM man and woman of identical age, MI code, and year of hospitalization. Propensity score matching was used to compare men and women with T2DM. Results MI was coded in 109,759 men and 44,589 women (30.47% with T2DM). The adjusted incidence of STEMI (IRR 2.32; 95% CI 2.28–2.36) and NSTEMI (IRR 2.91; 95% CI 2.88–2.94) was higher in T2DM than non-T2DM patients, with higher IRRs for NSTEMI in both sexes. The incidence of STEMI and NSTEMI was higher in men with T2DM than in women with T2DM. After matching, percutaneous coronary intervention (PCI) was less frequent among T2DM men than non-T2DM men who had STEMI and NSTEMI. Women with T2DM and STEMI less frequently had a code for PCI that matched that of non-T2DM women. In-hospital mortality (IHM) was higher among T2DM women with STEMI and NSTEMI than in matched non-T2DM women. In men, IHM was higher only for NSTEMI. Propensity score matching showed higher use of PCI and coronary artery bypass graft and lower IHM among men with T2DM than women with T2DM for both STEMI and NSTEMI. Conclusions T2DM is associated with a higher incidence of STEMI and NSTEMI in both sexes. Men with T2DM had higher incidence rates of STEMI and NSTEMI than women with T2DM. Having T2DM increased the risk of IHM after STEMI and NSTEMI among women and among men only for NSTEMI. PCI appears to be less frequently used in T2DM patients After STEMI and NSTEMI, women with T2DM less frequently undergo revascularization procedures and have a higher mortality risk than T2DM men.Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEpu