How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations? : a study in polish primary care

Background: Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women. Methods: A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual’s CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects’ self-care behavior was examined. Results: We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important. Conclusions: Different predictors of acquisition of health behavior are encountered in men and women. Our results suggest that gender-adjusted motivation models influencing the recognition process need to be considered to optimize compliance in patients with CVR

Changes in bread consumption and 4-year changes in adiposity in Spanish subjects at high cardiovascular risk

The effects of bread consumption change over time on anthropometric measures have been scarcely studied. We analysed 2213 participants at high risk for CVD from the PREvención con DIeta MEDiterránea (PREDIMED) trial to assess the association between changes in the consumption of bread and weight and waist circumference gain over time. Dietary habits were assessed with validated FFQ at baseline and repeatedly every year during 4 years of follow-up. Using multivariate models to adjust for covariates, long-term weight and waist circumference changes according to quartiles of change in energy-adjusted white and whole-grain bread consumption were calculated. The present results showed that over 4 years, participants in the highest quartile of change in white bread intake gained 0·76 kg more than those in the lowest quartile (P for trend = 0·003) and 1·28 cm more than those in the lowest quartile (P for trend 2 kg) and gaining waist circumference (>2 cm) during follow-up was not associated with increase in bread consumption, but participants in the highest quartile of changes in white bread intake had a reduction of 33 % in the odds of losing weight (>2 kg) and a reduction of 36 % in the odds of losing waist circumference (>2 cm). The present results suggest that reducing white bread, but not whole-grain bread consumption, within a Mediterranean-style food pattern setting is associated with lower gains in weight and abdominal fat

Impact of biological agents on postsurgical complications in inflammatory bowel disease: A multicentre study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Long daytime napping is associated with increased adiposity and type 2 diabetes in an elderly population with metabolic syndrome

Research examining associations between objectively-measured napping time and type 2 diabetes (T2D) is lacking. This study aimed to evaluate daytime napping in relation to T2D and adiposity measures in elderly individuals from the Mediterranean region. A cross-sectional analysis of baseline data from 2190 elderly participants with overweight/obesity and metabolic syndrome, in the PREDIMED-Plus trial, was carried out. Accelerometer-derived napping was measured. Prevalence ratios (PR) and 95% confidence intervals (CI) for T2D were obtained using multivariable-adjusted Cox regression with constant time. Linear regression models were fitted to examine associations of napping with body mass index (BMI) and waist circumference (WC). Participants napping ≥90 min had a higher prevalence of T2D (PR 1.37 (1.06, 1.78)) compared with those napping 5 to <30 min per day. Significant positive associations with BMI and WC were found in those participants napping ≥30 min as compared to those napping 5 to <30 min per day. The findings of this study suggest that longer daytime napping is associated with higher T2D prevalence and greater adiposity measures in an elderly Spanish population at high cardiovascular risk

Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639

Valoración nutricional de trabajadores sanitarios expuestos a turnicidad en Canarias Nutritional evaluation of health shift workers from the Canary Islands

Objetivo: El trabajo a turnos induce hábitos de vida anómalos, lo cual se asocia al aumento de la morbilidad en los trabajadores. En este estudio se valoró el estado nutricional, los hábitos alimentarios y la actividad física de trabajadores hospitalarios sometidos a turnos. Ámbito: La población de estudio estuvo compuesta por 207 trabajadores con turno fijo de mañana y 210 con turno rotatorio (mañana, tarde y noche) seleccionados aleatoriamente entre 2.100 trabajadores. Intervenciones: La ingesta dietética se determinó mediante cuestionario de frecuencia de consumo de alimentos autoadministrado. También se determinaron índice de masa corporal, parámetros lipídicos (colesterol total, colesterol HDL, colesterol LDL y triglicéridos), actividad física, edad y sexo. Resultados: Los trabajadores sometidos a turnicidad mostraron un mayor consumo de ternera, huevos, zumos y pastas. No se encontraron diferencias significativas en cuanto a niveles lipídicos, estado ponderal ni de actividad física entre los trabajos sometidos y no a turnicidad y no. El 62% de los hombres y el 37,2% de las mujeres mostraron sobrecarga ponderal (obesidad y sobrepeso). El 46% de los individuos de la muestra presentaron sedentarismo. Conclusiones: La turnicidad en los trabajadores hospitalarios influye sólo parcialmente en los hábitos alimentarios de dicho colectivo.Objective: Shift workers are known to have increased morbidity associated to wrong habits. In this study we have evaluated the nutritional status, food habits and physical activity in health shift workers. Subjects: 207 permanent morning-shift workers and 210 shift workers (3-shift system) were randomized selected from the 2,100 workers of the North Area of the Canary Island Sanitary Health System. Methods: Dietary intake was assessed by a self-registered food frequency questionnaire. We also assessed Body Mass Index, blood lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides), physical activity, age and sex. Results: Shift workers shown higher intake of red meat, eggs, fruit juices and pasta. No differences were observed in lipid levels, weight status and physical activity in relation to the shift working status. 62% of men and 37.2% of women were overweight or obese. 46% of the subjects were sedentary. Conclusions: Shift work system seems to have little influence on the food habits of health workers

Avance del estudio geoarqueológico de los depósitos fluviales de la terraza +8M del río Manzanares y del antiguo arroyo Pradolongo en el tramo final del valle medio del Manzanares (Madrid, España)

Durante la ejecución de dos sondeos geoarqueológicos en la Calle Antonio López, nº 241, de Madrid, se localizaron diversas piezas de industria lítica. Una vez comunicado el hallazgo a la Dirección General de Patrimonio de la Comunidad de Madrid, y recibido el correspondiente permiso, se procedió a una excavación en extensión que buscaba definir los niveles geoarqueológicos asociados a la terraza + 8 del río Manzanares en su intersección con el Arroyo Pradolongo. Los resultados obtenidos indican que los niveles estudiados se encuentran en posición derivada, siendo complicado individualizar conjuntos arqueológicos que se correspondan con la cronología asociada a la posición geomorfológica del depósito. Abstract During the execution of the two preliminary surveys required in the permit action undertaken in the plot of the Antonio Lopez street, number 241, several pieces of flint were found. These findings were primarily documented in the lower levels of polling 1. After presenting the respective communication of our findings to the competent authority, and given that the surroundings of this area host one of the richest concentrations of prehistoric sites in Madrid, we decided to conduct a series of systematic geoarchaeological and paleontological works, aimed at getting an in-depth understanding of the site. Obtained results demonstrate that analyzed levels have been reworked, and thus it is complicate to define specific archaeological assemblages corresponding to the geomorphological position of the deposit