Lumbalgia crónica en la población española. Factores asociados y calidad de vida según la Encuesta Nacional de Salud 2011

Introducción. La lumbalgia es una dolencia frecuente, que tiene repercusión a nivel social, laboral y económico, lo que la convierte en un problema de salud pública, tanto en países industrializados, como en aquellos en vías de desarrollo. Se calcula que la lumbalgia afecta a entre un 80% y un 85% de la población general al menos una vez en su vida y que tiene una prevalencia puntual situada entre el 17-32%. La lumbalgia cursa con dolor, reducción de la movilidad espinal y discapacidad. El dolor y la limitación de la movilidad pueden dificultar actividades tanto de la vida diaria, como laborales. La lumbalgia es la mayor causa de discapacidad e invalidez en el periodo laboral de las personas, lo que genera grandes costes, llegando a ser un componente fundamental del gasto en salud de muchos países. Supone la principal causa de gasto público por conceptos asistenciales y laborales en los países desarrollados. Múltiples estudios han señalado como factores de riesgo de lumbalgia la obesidad, el tabaquismo y el sedentarismo. Además los individuos con lumbalgia tienen un alto nivel de ansiedad y depresión. Hay varios estudios españoles que utilizan la información facilitada por la Encuesta Nacional de Salud para investigar las características epidemiológicas de los individuos que padecen lumbalgia en nuestro país, aunque ninguno estudia la repercusión que tiene el dolor lumbar sobre la calidad de vida de estas personas. La medida de la Calidad de Vida (CV) es, probablemente, la evaluación subjetiva de salud más utilizada en relación con las enfermedades de carácter crónico ya que refleja de forma adecuada la carga de enfermedad. Los indicadores de salud tradicionales no son suficientes cuando se evalúa una condición invalidante o crónica, como es el caso de la lumbalgia..

Eficacia y sobrevida de sellantes dentales: revisión de la literatura

Objetivo: Analizar la literatura respecto a la eficacia y sobrevida de los sellantes de fosas y fisuras. Materiales y métodos: Revisión de la literatura en las bases de datos Pubmed y Lilacs con las palabras claves: dentición permanente, sobrevida, eficacia y sellantes, teniendo en cuenta como criterios de inclusión los artículos en español e inglés, artículos que son revisiones sistemáticas y ensayos clínicos, artículos de libre acceso, con fecha de corte febrero del 2022. En cuanto a los criterios de exclusión artículos que no sean de libre acceso, aquellos que se repitan y los que no tenían concordancia con el tema. Al inicio de la búsqueda se encontraron en Pubmed 30 artículos usando la combinación de palabras clave y en Lilacs 10 artículos, obteniendo un total de 40 artículos de los cuales se descartaron 16, 8 porque no hubo acceso al texto completo, uno se retiró porque no concordaba con el tema y 7 artículos porque se repitieron. Resultados: Los hallazgos encontrados en esta revisión muestran que la eficacia de los sellantes para prevenir la caries dental está relacionada a la retención del material. El ionómero de vidrio es eficaz para prevenir lesiones cariosas gracias a su propiedad de liberar flúor mientras que la resina lo hace por medio de su adhesión al tejido dental, en cuanto a sobrevida, esta depende de la colocación del material de manera correcta, respetando los tiempos operatorios y siguiendo los pasos debidos para cada material, sin embargo el sellante de resina mostró mejores propiedades retentivas debido a que re-quiere grabado ácido y sistemas adhesivos que por el contrario el ionómero de vidrio no necesita.Objective: To analyze the literature regarding the efficacy and survival of pit and fissure sealants. Materials and methods: Review of the literature in the Pubmed and Lilacs databases with the keywords: permanent dentition, survival, efficacy and sealants, taking into account articles in Spa-nish and English as inclusion criteria, articles that are systematic reviews and clinical trials, free ac-cess articles, with a cut-off date of February 2022. Regarding the exclusion criteria, articles that are not free access, those that are repeated and those that did not match the theme. At the beginning of the search, 30 articles were found in Pubmed using the combination of keywords and 10 articles in Lilacs, obtaining a total of 40 articles of which 16 were discarded, 8 because there was no access to the full text, one was withdrawn because there was no agreed with the theme and 7 articles because they were repeated. Results: The findings found in this review show that the efficacy of sealants to prevent dental caries is related to the retention of the material. The glass ionomer is effective in preventing carious lesions thanks to its property of releasing fluoride while the resin does so through its adhesion to the dental tissue, in terms of survival, it depends on the correct placement of the material, respecting the operating times and following the proper steps for each material, however, the resin sealant showed better retentive properties due to the fact that it requires acid etching and adhesive systems that, on the contrary, the glass ionomer does not need.0000-0002-5857-5347OdontólogoCuenc

The role of population change in the increased economic differences in mortality: a study of premature death from all causes and major groups of causes of death in Spain, 1980-2010

Background: An increase has been observed in differences in mortality between the richest and poorest areas of rich countries. This study assesses whether one of the proposed explanations, i.e., population change, might be responsible for this increase in Spain. Methods: Observational study based on average income, population change and mortality at provincial level. The premature mortality rate (ages 0-74 years) was estimated for all causes and for cancer, cardiovascular disease and external causes across the period 1980-2010. In the years analysed, provinces were grouped into tertiles based on provincial income, with the mortality rate ratio (MMR) being estimated by taking the tertile of highest-income provinces as reference. Population change was then controlled for to ascertain whether it would modify the rate ratio. Results: In all-cause mortality, the magnitude of the MRR for provinces in the poorest versus the richest tertile was 1.01 in 1980 and 1.12 in 2010; in cardiovascular mortality, the MMRs for these same years were 1.08 and 1.31 respectively; and in the case of cancer and external-cause mortality, MMR magnitude was similar in 1980 and 2010. The magnitude of the MMR remained unchanged in response to adjustment for population change, with the single exception of 1980, when it increased in all-cause and cardiovascular mortality. Conclusion: The increase in the difference in premature mortality between the richest and poorest areas in Spain is due to the increased difference in cardiovascular mortality. This increase is not accounted for by population change. In rich countries, more empirical evidence is thus needed to test other alternative explanations for the increase in economic differences in mortality.This study was conducted thanks to support from the Research Project PI12/01459 “Population change and geographical inequalities in mortality” financed by the Ministry of Science and Innovation

A polymorphic enhancer near GREM1 influences bowel cancer risk through differential CDX2 and TCF7L2 binding

Under a Creative Commons license.-- et al.A rare germline duplication upstream of the bone morphogenetic protein antagonist GREM1 causes aMendelian-dominant predisposition to colorectal cancer (CRC). The underlying disease mechanism is strong, ectopic GREM1 overexpression in the intestinal epithelium. Here, we confirm that a common GREM1 polymorphism, rs16969681, is also associated with CRC susceptibility, conferring ~20% differential risk in the general population. We hypothesized the underlying cause to be moderate differences inGREM1 expression. We showed that rs16969681 lies in a region of active chromatin with allele- and tissue-specific enhancer activity. The CRC high-risk allele was associated with stronger gene expression, and higher Grem1 mRNA levels increased the intestinal tumor burden in ApcMin mice. The intestine-specific transcription factor CDX2 and Wnt effector TCF7L2 bound near rs16969681, with significantly higher affinity for the risk allele, and CDX2 overexpression in CDX2/GREM1-negative cells caused re-expression of GREM1. rs16969681 influences CRC risk through effects on Wnt-driven GREM1 expression in colorectal tumors. © 2014 The Authors.Funding was provided from Cancer Research UK grant A/16459, an EU FP7 SYSCOL Consortium grant, and the EU COST colorectal cancer initiative. Core funding to the Wellcome Trust Centre for Human Genetics was provided from the Wellcome Trust (090532/Z/09/Z). J.L.G.-S. and J.J.C. were supported by the Spanish/FEDER government grants BFU2010-14839 and BFU2011-2292.Open Access funded by Wellcome Trust.Peer Reviewe

Adherencia a las recomendaciones nutricionales entre adolescentes Españoles e inmigrantes residentes en España: Estudio AFINOS

Objectives: This study compares the adherence of immigrant and Spanish adolescents residing in the Madrid region (Spain) to national dietary recommendations. The factors compared were the consumption of items from the eight basic food groups (vegetables, fruits, bread/cereals, meat, eggs, fish, legumes and milk/dairy products), including the excessive or deficient consumption of eggs, meat and fish. In addition, the evaluation of excessive sweet foods or soft drinks in the diet was also considered. Subsequently, the influence of length of residence on dietary habits was examined. Materials and methods: Self-reported data were co - llected in a cross-sectional survey conducted over the period November 2007 to February 2008. The study participants were a representative sample of adolescents aged 13 to 17 years (n = 2,081, 1,055 girls) living in the Madrid region. Participants were recruited from secondary schools (grades 7th to 10th) randomly selected according to the geographic distribution of adolescents in the region. Results: Immigrant adolescents showed a greater likelihood of not fulfilling recommendations for the consumption of meat, fish, eggs, legumes, bread/cereals, and milk/dairy products. Their diets were also more likely to lack sufficient fish and they also consumed more eggs and more sweet foods and soft drinks than their native counterparts. Spanish adolescents were more likely not to meet recommendations for the intake of vegetables. Length of residence weakly affected dietary habits, with both negative and positive effects observed. Conclusion: The likelihood of not fulfilling dietary recommendations was higher among the immigrant adolescents with the exception of the intake of fruits and vegetables.Objetivos: Este estudio compara la adherencia a las recomendaciones nutricionales de adolescentes inmigrantes y españoles residentes en la Comunidad de Madrid, España. Se comparó el consumo de ocho grupos principales de alimentos (verduras, frutas, pan/cereales, carne, huevos, pescado, legumbres, leche/derivados lácteos) incluyendo el consumo excesivo y deficiente de huevos, carne y pescado. También fue valorado el consumo excesivo de dulces y bebidas azucaradas. Posteriormente se analizó la influencia del tiempo de residencia en España sobre los mencionados hábitos de dieta. Material y método: Se llevó a cabo un estudio transversal en el que fueron recogidos datos auto-reportados durante el periodo comprendido entre noviembre 2007 y febrero 2008. Se obtuvo una muestra representativa de adolescentes con edades comprendidas entre 13 y 17 años (n = 2.081, 1.055 mujeres) residentes en la Comunidad de Madrid. Los participantes pertenecían a centros de enseñanza secundaria seleccionados aleatoriamente según la distribución geográfica de los adolescentes en la región. Resultados: Los inmigrantes adolescentes presentaron una mayor probabilidad de no cumplir las recomendaciones nutricionales para el consume de carne, pescado, legumbres, pan/cereales y leche/derivados, de consumir una cantidad insuficiente de pescado y más dulces y bebidas azucaradas que sus compañeros españoles. Los adolescentes españoles mostraron una mayor probabilidad de no cumplir con la recomendación establecida para verduras. El tiempo de residencia afectó débilmente los hábitos de dieta, asociando aspectos tanto positivos como negativos. Conclusiones: La probabilidad de no cumplir las recomendaciones nutricionales fue mayor entre los adolescentes inmigrantes con excepción del consumo de frutas y verduras.The AFINOS Study was supported by grant DEP2006- 56184-C03-01-02-03/PREV from the Spanish Ministry of Education and Science and co-funded by FEDER funds from the European Unio

Inequalities in total mortality and by cause of death according to the level of education in Navarra: findings from a longitudinal study from 2001 to 2008

Fundamentos: Dada la ausencia de evidencia científica, el objetivo fue mostrar las desigualdades en mortalidad según el nivel de estudios en Navarra y la contribución de las principales causas de defunción a la magnitud de desigualdades en la mortalidad por todas las causas de muerte. Métodos: Todos los ciudadanos de 25 años y mayores residentes en Navarra en 2001 fueron seguidos durante 7 años para conocer su estado vital. El indicador de posición socioeconómica utilizado fue el nivel de estudios. Se estimaron las tasas de mortalidad general y por causa de muerte ajustadas por edad según la educación. Posteriormente, se calcularon la diferencia relativa (razón) y la diferencia absoluta de tasas entre las categorías más baja y más alta de nivel de estudios y la contribución de las principales causas de muerte a la diferencia absoluta. Resultados: La razón de tasas por todas las causas de muerte fue 1,37 en hombres y 1,23 en mujeres. El virus de la inmunodeficiencia humana (VIH) (25,84) y los accidentes no intencionales (3,78) presentaron las razones de tasas más altas en los hombres y la diabetes mellitus (4,92) y el VIH (4,38) en las mujeres. Las enfermedades cardiovasculares constituyeron la causa de muerte que más contribuyó a la diferencia absoluta en mortalidad: 26% en hombres y 48% en mujeres. Conclusiones: La tasa de mortalidad en la población navarra muestra un gradiente inverso con el nivel educativo, a excepción de algunas localizaciones de cáncer. Las enfermedades cardiovasculares son la causa de muerte que más contribuye a las desigualdades absolutas en mortalidad, mientras que otras causas de muerte que muestran importantes desigualdades relativas contribuyen poco a las desigualdades absolutas.Background: Due to the lack of evidence, the objective was to show the inequalities in mortality by educational level in Navarra and the contribution of the main causes of death to the magnitude of inequalities in mortality from all causes of death. Methods: All citizens aged 25 years and older residing in Spain in 2001 were followed during 7 years to determine their vital status. Level of education was used as socioeconomic status indicator. It was estimated the age-adjusted total mortality rate and mortality rate from cause-specific mortality by educational level. Then it was calculated the relative difference (ratio) and the absolute difference in rates between the lowest and highest levels of education and the contribution of the main causes of death to the absolute difference. Results: The rate ratio for all causes of death was 1.37 in men and 1.23 in women. The human immunodeficiency virus (HIV) (25.84) and unintentional injuries (3.78) are the causes of death with higher rate ratio in men and diabetes (4.92) and HIV (4.38) in women. Cardiovascular diseases were the leading causes of death that contribute most to the absolute difference in mortality: 26% in men and 48% women. Conclusions: The mortality rate in the Navarre population shows an inverse gradient with educational level, except in some cancer sites. Cardiovascular disease is the leading cause of death that contributes most to the absolute inequalities in mortality, while other causes of death that show significant relative inequalities, contribute little to the absolute inequalities.Fundación Caja Navarr

Propuesta de mejora de la asignatura TFG del Grado en Nutrición Humana y Diétetica. Implantación de la prueba ECOE

Depto. de Farmacología y ToxicologíaFac. de MedicinaFALSEsubmitte

Brain and immune system-derived extracellular vesicles mediate regulation of complement system, extracellular matrix remodeling, brain repair and antigen tolerance in Multiple sclerosis

Background: Multiple sclerosis (MS) is an immune-mediated central nervous system disease whose course is unpredictable. Finding biomarkers that help to better comprehend the disease's pathogenesis is crucial for supporting clinical decision-making. Blood extracellular vesicles (EVs) are membrane-bound particles secreted by all cell types that contain information on the disease's pathological processes. Purpose: To identify the immune and nervous system-derived EV profile from blood that could have a specific role as biomarker in MS and assess its possible correlation with disease state. Results: Higher levels of T cell-derived EVs and smaller size of neuron-derived EVs were associated with clinical relapse. The smaller size of the oligodendrocyte-derived EVs was related with motor and cognitive impairment. The proteomic analysis identified mannose-binding lectin serine protease 1 and complement factor H from immune system cell-derived EVs as autoimmune disease-associated proteins. We observed hepatocyte growth factor-like protein in EVs from T cells and inter-alpha-trypsin inhibitor heavy chain 2 from neurons as white matter injury-related proteins. In patients with MS, a specific protein profile was found in the EVs, higher levels of alpha-1-microglobulin and fibrinogen β chain, lower levels of C1S and gelsolin in the immune system-released vesicles, and Talin-1 overexpression in oligodendrocyte EVs. These specific MS-associated proteins, as well as myelin basic protein in oligodendrocyte EVs, correlated with disease activity in the patients with MS. Conclusion: Neural-derived and immune-derived EVs found in blood appear to be good specific biomarkers in MS for reflecting the disease state.This work was sponsored by a grant from Miguel Servet (CP20/00024 to Laura Otero-Ortega), Miguel Servet (CPII20/00002 to María Gutiérrez-Fernández), a predoctoral fellowship (FI18/00026 to Fernando Laso-García), a Río-Hortega grant (CM22/00065 to Gabriel Torres Iglesias and CM20/00047 to Elisa Alonso-López) and by Research Project (PI21/00918) from the Instituto de Salud Carlos III and co-funded by the European Union and by a grant CA1/RSUE/2021-00753 to Dolores Piniella funded by Ministerio de Universidades, Plan de Recuperación, Transformación y Resiliencia y la Universidad Autónoma de Madrid.S

Innovación en la enseñanza virtual de la Medicina Preventiva y Salud Pública en el ámbito clínico

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

Risk of suicide attempt repetition after an index attempt: A systematic review and meta-analysis

Objectives To estimate the risk of suicide attempt repetition among individuals with an index attempt. It also aims to study the role of risk factors and prevention programme in repetition. Methods This systematic review and meta-analysis was conducted in keeping with the PRISMA 2020 guidelines. Studies on attempt repetition (both cohort studies and intervention studies) were searched from inception to 2022. Results A total of 110 studies comprising 248,829 attempters was reviewed. The overall repetition rate was 0.20 (0.17, 0.22). Repetition risk linearly increased over time. A higher risk of attempt repetition was associated with female sex and index attempts in which self-cutting methods were used. Moreover, a mental disorder diagnosis was associated with an increasing repetition risk (OR = 2.02, p < .01). The delivery of a preventive programme reduced the repetition risk, OR = 0.76, p < .05; however, this effect was significant for psychotherapy interventions, OR = 0.38, p < .01. Conclusion One in five suicide attempters will engage in a new suicide attempt. An elevated repetition risk is associated with being female, more severe index methods and psychiatric disorder diagnosis. Preventive programmes, particularly psychotherapy, may contribute to reducing repetition risk and eventually save lives.This study was supported by the Instituto de Salud Carlos III-FIS research grants (PI16/00187, PI19/00236, PI19/00569, PI19/00685, PI19/00941, PI19/00954, PI19/01027, PI19/01256, PI19/01484, PI20/00229), co-funded by the European Regional Development Fund (ERDF) “A Way to Build Europe”; the Government of the Principality of Asturias (grant ref.: PCTI-2018-2022 IDI/2018/235); Secretaria d'Universitats i Recerca from the Departament d'Economia i Coneixement (ref.: 2017SGR1365 and 2017SGR134), and Generalitat de Catalunya (Government of Catalonia), CERCA Programme