Attitudes Toward Organ Donation: Differences Between Medical and Nursing Andalusian Students.

INTRODUCTION: A favorable attitude toward organ donation and transplantation (ODT) is fundamental among health professionals at the time of transplant promotion. In this sense, the training and awareness of professionals are fundamental. OBJECTIVE: To analyze the differences in the attitude toward ODT and the factors that condition it among Andalusian medical and nursing students. METHODS AND DESIGN: The study is a sociologic, multicenter, observational study. The population includes medical and nursing students in Andalusian universities. Database of the Collaborative International Donor Project is used and data are stratified by geographic area and academic course. The instrument of measurement was a validated questionnaire (PCID-DTO-RIOS) that was handed out to every student in a compulsory session. Completion of the questionnaire was anonymous and self-administered. The sample included Andalusian medical and nursing students (99% confidence and precision of ±1%) stratified by geographic area and year of study. RESULTS: There was a completion rate of 91%; 79% (n = 2879) of Andalusian students were in favor of donation and 21% were not in favor. The attitude toward ODT is more favorable in medical compared with nursing students (80% vs 77%; P = .021). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): knowing a transplant patient, having received information about the subject, attitude toward family donation, and having discussed transplantation with family and friends. CONCLUSION: Andalusian medical students favored organ donation more than Andalusian nursing students, and the favorable attitude is associated with having an awareness of the subject.

Student nurses at Spanish universities and their attitude toward xenotransplantation.

INTRODUCTION: Recent immunological and transgenic advances are a promising alternative using limited materials of human origin for transplantation. However, it is essential to achieve social acceptance of this therapy. OBJECTIVE: To analyze the attitude of nursing students from Spanish universities toward organ xenotransplantation (XTx) and to determine the factors affecting their attitude. MATERIALS AND METHODS: Type of study: A sociological, multicentre, and observational study. STUDY POPULATION: Nursing students enrolled in Spain (n = 28,000). SAMPLE SIZE: A sample of 10 566 students estimating a proportion of 76% (99% confidence and precision of ±1%), stratified by geographical area and year of study. Instrument of measurement: A validated questionnaire (PCID-XenoTx-RIOS) was handed out to every student in a compulsory session. This survey was self-administered and self-completed voluntarily and anonymously by each student in a period of 5-10 min. STATISTICAL ANALYSIS: descriptive analysis, Student's t test, the chi-square test, and a logistic regression analysis. RESULTS: A completion rate: 84% (n = 8913) was obtained. If the results of XTx were as good as in human donation, 74% (n = 6564) would be in favor and 22% (n = 1946) would have doubts. The following variables affected this attitude: age (P < 0.001); sex (P < 0.001); geographical location (P < 0.001); academic year of study (P < 0.001); attitude toward organ donation (P < 0.001); belief in the possibility of needing a transplant (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); and the opinion of one's partner (P < 0.001). The following variables persisted in the multivariate analysis: being a male (OR = 1.436; P < 0.001); geographical location (OR = 1.937; P < 0.001); an attitude in favor of donation (OR = 1.519; P < 0.001); belief in the possibility of needing a transplant (OR = 1.497; P = 0.036); and having spoken about the issue with family (OR = 1.351; P < 0.001) or friends (OR = 1.240; P = 0.001). CONCLUSIONS: The attitude of nursing students toward organ XTx is favorable and is associated with factors of general knowledge about organ donation and transplantation and social interaction.

Efecto de un programa de actividad física en el medio acuático sobre las constantes hemodinámicas en mujeres embarazadas / Effect of a physical activity programme in the aquatic environment on haemodynamic constants in pregnant women

OBJETIVO: Evaluar el efecto de un programa de actividad física en el medio acuático con inmersión hasta el cuello, de seis semanas de duración, sobre las constantes hemodinámicas en mujeres gestantes. MÉTODO: Se llevó a cabo un programa de actividad física en el medio acuático, de seis semanas de duración a un total de 46 mujeres embarazadas, que fueron distribuidas en grupo experimental que participó en el programa (n=18) y grupo control (n=28) que desarrolló los cuidados habituales. En los dos grupos se valoraron diferentes medidas hemodinámicas antes y después del programa. RESULTADOS: Al inicio del programa el promedio de presión arterial sistólica era similar en ambos grupos pero la presión arterial diastólica era ligeramente mayor en el grupo experimental. Cuando se contrastan las medidas en la última sesión, resultan significativamente mayores las presiones arteriales (sistólica, diastólica y media), en el grupo control (p< 0,050). De forma similar, los valores iniciales de volumen plasmático no diferían en ambos grupos, pero tras la intervención las mujeres del grupo control evidencian un mayor promedio (p< 0,010). La fracción de excreción de sodio (FENa) aumenta significativamente en el grupo experimental, tras la realización del programa, cuyo promedio se triplica (p< 0,050). Los niveles plasmáticos de aldosterona no muestran diferencias significativas entre ambos grupos en las distintas mediciones. CONCLUSIÓN: Un programa de ejercicios de natación e inmersión, en mujeres gestantes, contribuye al equilibrio hidrosalino, previniendo el aumento excesivo de volumen plasmático habitual en el embarazo, y en la actividad del eje renina-aldosterona

OBJECTIVE: To evaluate the effect of a physical activity programme in the aquatic environment with immersion up to the neck, of six weeks duration, on haemodynamic constants in pregnant women. METHODS: A six-week physical activity programme in the aquatic environment was carried out with a total of 46 pregnant women, who were distributed into an experimental group (n = 18), which participated in the programme, and a control group (n = 28), which followed routine care. In both groups different haemodynamic measurements were evaluated before and after the program. RESULTS: At the beginning of the programme the mean systolic blood pressure was similar between groups, but diastolic blood pressure was slightly higher in the experimental group. When the measurements at the last session were compared, arterial pressures (systolic, diastolic and mean) were significantly higher in the control group (p <.050). Similarly, the initial plasma volume values did not differ between groups, but after the intervention, the control group women showed a higher mean (p <.010). The fraction of sodium excretion (FENa) increased significantly in the experimental group, after the programme, with a mean three times higher (p <.050). Aldosterone plasma levels did not show significant differences between the groups in the different measurements. CONCLUSIONS: A programme of swimming and immersion exercises in pregnant women contributes to hydrosaline balance, preventing an excessive increase in usual plasma volume during pregnancy and in the activity of the renin-aldosterone axis

Efectos del ayuno en sujetos que realizan el ramadan sobre la calidad de vida y su relación con la diabetes y la hipertensión / Fasting's effects on people in ramadan about their quality of life and the relationship with diabetes and hypertension

El precepto islámico del Ramadán (R), impone a las personas que lo practican importantes modificaciones fisiológicas debido a las restricciones hídricas y dietéticas a lo largo del día y durante un mes, lo que tiene una especial repercusión física e intelectual de los musulmanes. El objetivo del presente estudio es describir los efectos del ayuno del Ramadán en la calidad de vida, así como, su repercusión en la Diabetes e Hipertensión. Participaron un total de 44 sujetos, 22 hombres y 22 mujeres. Con edades comprendidas entre los 14-80 años residentes en Tetuán y Ceuta. En un diseño de grupo único, creando subgrupos en función del sexo o patología. Las mediciones principales son las 8 escalas que miden los 36 items del cuestionario SF-36. Durante el R se evidencia en hombres y mujeres un mayor deterioro de la función física, siendo también significativa una disminución de la percepción de salud mental en el sexo masculino. En las personas diabéticas la percepción de disminución de la calidad de vida es mayor en relación a los parámetros físicos, así como en la salud mental y salud en general. Los sujetos hipertensos presentaron de forma significativa peores valores en los ítems de salud física y mental. El mes de R, en el conjunto de la población, provoca una menor percepción de la calidad de vida, más pronunciada en el caso de las mujeres. En concreto, los diabéticos y los hipertensos, estudiados, perciben una menor calidad de vida que en condiciones normales en cuanto a función física y rol físico se refiere(AU)

The Islamic precept of Ramadan (R) imposes on individuals who practice it important physiological modifications due to the hydric and dietetic restrictions along a whole month plus a day, all of which have a crucial repercussion over the physical and intellectual performance of Muslim. The objective of this study was todescribe the effects of fasting during R in quality of life and its relationship with pathologies such as diabetes and hypertension. It took part 44 individuals, 22 men and 22 women with an age among 14 and 80 year old, from Tetuan and Ceuta. A model in only one group, making sub-models according to sex and pathology. The main measuring are the eight scales that measure 36 items in the SF-36 survey. During R we can see worst results in both men and women in relation with physical function. We can also observe a decrease in the perception of mental health in male sex the perception is even higher in diabetic people in relation to physical parameters, as in mental health in general. Worst values show individuals suffering of hypertension in their perception of physical and mental health.This month of R in the population as a whole causes a less perception in quality of life which is even worst in the case of women. Being concrete, diabetic and hypertension people receive a less quality of life than in normal conditions talking about physical role and function(AU)

Effect of a physical activity programme in the aquatic environment on haemodynamic constants in pregnant women. / Efecto de un programa de actividad física en el medio acuático sobre las constantes hemodinámicas en mujeres embarazadas.

OBJECTIVE: To evaluate the effect of a physical activity programme in the aquatic environment with immersion up to the neck, of six weeks duration, on haemodynamic constants in pregnant women. METHODS: A six-week physical activity programme in the aquatic environment was carried out with a total of 46 pregnant women, who were distributed into an experimental group (n = 18), which participated in the programme, and a control group (n = 28), which followed routine care. In both groups different haemodynamic measurements were evaluated before and after the program. RESULTS: At the beginning of the programme the mean systolic blood pressure was similar between groups, but diastolic blood pressure was slightly higher in the experimental group. When the measurements at the last session were compared, arterial pressures (systolic, diastolic and mean) were significantly higher in the control group (p <.050). Similarly, the initial plasma volume values did not differ between groups, but after the intervention, the control group women showed a higher mean (p <.010). The fraction of sodium excretion (FENa) increased significantly in the experimental group, after the programme, with a mean three times higher (p <.050). Aldosterone plasma levels did not show significant differences between the groups in the different measurements. CONCLUSION: A programme of swimming and immersion exercises in pregnant women contributes to hydrosaline balance, preventing an excessive increase in usual plasma volume during pregnancy and in the activity of the renin-aldosterone axis.

[Quality of life related to health in a population of healthy pregnant women after a program of physical activity in the aquatic environment.] / Calidad de vida relacionada con la salud en una población de gestantes sanas tras un programa de actividad física en el medio acuático (PAFMAE).

OBJECTIVE: Moderate physical exercise brings benefits to pregnant women during pregnancy. The aim of this research is to evaluate the effect on the quality of life of a six-week aquatic physical activity program in healthy pregnant women. METHODS: A six-week physical activity program was conducted in the aquatic environment, from May to July 2016 in a sports center, to a total of 46 pregnant women, who were distributed in Experimental (n = 18) and Control (n = 28) groups, to which the health-related quality of life questionnaire SF-36 v2 was applied before and after the program. The t-student test for paired samples was statistically applied for intragroup means, and for the differences between groups, the t-student test for independent samples. RESULTS: At the end of the physical activity program, it was clearly established that it acted positively on the following dimensions whose mean values were: perception of Body Pain (BP) before 66.1 and after 68.4 perception of General Health (GH) before 81.3 and then 83.6, Emotional Role (ER) before 89.0 and Then 93.5 and Mental Health (MH) 80.7 before and 84.2 after. CONCLUSIONS: The practice of a program of physical activity in the aquatic environment for pregnant women provides benefits related to the perception of health-related quality of life.

OBJETIVO: El ejercicio físico moderado aporta beneficios a la mujer gestante durante el embarazo. La finalidad de este trabajo fue evaluar el efecto sobre la calidad de vida de un programa de actividad física en el medio acuático, de seis semanas de duración, en mujeres gestantes sanas. METODOS: Se llevó a cabo un programa de actividad física en el medio acuático, desde mayo hasta julio de 2016 en un centro deportivo, de seis semanas de duración a un total de 46 mujeres embarazadas, que fueron distribuidas en grupo Experimental (n=18) y grupo Control (n=28), a las que se le aplicó el cuestionario de calidad de vida relacionada con la salud "SF- 36 v2" antes y después del programa. Estadísticamente se aplicó para medias intragrupo la prueba t-student para muestras pareadas, y para las diferencias entre grupos, la prueba t-student para muestras independientes. RESULTADOS: Al finalizar el programa de actividad física se constató como el mismo actuó positivamente sobre las siguientes dimensiones, cuyos valores de la media fueron: percepción de Dolor Corporal (DC) antes 66,1 y después 68,4 percepción de Salud General (SG) antes 81,3 y después 83,6, Rol Emocional (RE) antes 89,0 y después 93,5 y Salud Mental (SM) 80,7 antes y 84,2 después. CONCLUSIONES: La práctica de un programa de actividad física en el medio acuático para embarazadas sanas brinda beneficios relacionados con la percepción de calidad de vida relacionada con la salud.

Efectividad de un programa de actividad física mediante el método Pilates en el embarazo y en el proceso del parto / Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour

Objetivo: Valorar la eficacia y seguridad de un programa de actividad física por medio del método Pilates de ocho semanas de duración en mujeres gestantes sobre parámetros funcionales, como el peso, la tensión arterial, fuerza, flexibilidad, curvatura de la columna y parámetros en el parto, como tipo de parto, episiotomía, analgesia y peso del recién nacido. Método: Se realizó un ensayo clínico aleatorizado sobre gestantes, consistente en la aplicación de un programa de actividad física mediante el método Pilates, diseñado específicamente para esta población. Se agrupó una muestra compuesta por un total de 105 mujeres gestantes, las cuales estaban divididas en grupo intervención (n=50) (32,87±4,46 años) y grupo control (n=55) (31,52±4,95 años). El grupo intervención asistió a un programa de actividad física por medio del método Pilates, durante 2 sesiones semanales, mientras que el grupo control no realizó el programa. Resultados: Tras finalizar la intervención se observaron mejoras significativas (p<0,05) en la tensión arterial, fuerza de prensión manual, flexibilidad isquiosural y curvatura de la columna y además mejoras en el proceso del parto, disminuyendo el número de cesáreas y de partos distócicos, de episiotomías, de analgesia y del peso del recién nacido. Conclusión: Un programa de actividad física 8 semanas por medio del método Pilates mejora parámetros funcionales en las gestantes y podría beneficiar la finalización del parto (AU)

Objective: To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. Method: A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population. A sample consisting of a total of 105 pregnant women was divided into two groups: intervention group (n=50) (32.87±4.46 years old) and control group (n=55) (31.52±4.95 years old). The intervention group followed a physical activity programme based on the Pilates method, for 2 weekly sessions, whereas the control group did not follow the program. Results: Significant improvements (p<0.05) in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention. Conclusion: A physical activity programme of 8 weeks based on the Pilates method improves functional parameters in pregnant women and benefits delivery (AU)

Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour. / Efectividad de un programa de actividad física mediante el método Pilates en el embarazo y en el proceso del parto.

OBJECTIVE: To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. METHOD: A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population. A sample consisting of a total of 105 pregnant women was divided into two groups: intervention group (n=50) (32.87±4.46 years old) and control group (n=55) (31.52±4.95 years old). The intervention group followed a physical activity programme based on the Pilates method, for 2 weekly sessions, whereas the control group did not follow the program. RESULTS: Significant improvements (p<0.05) in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention. CONCLUSION: A physical activity programme of 8 weeks based on the Pilates method improves functional parameters in pregnant women and benefits delivery.

Calidad de vida relacionada con la salud en una población de gestantes sanas tras un programa de actividad física en el medio acuático (PAFMAE) / Quality of life related to health in a population of healthy pregnant women after a program of physical activity in the aquatic environment

Fundamentos: El ejercicio físico moderado aporta beneficios a la mujer gestante durante el embarazo. La finalidad de este trabajo fue evaluar el efecto sobre la calidad de vida de un programa de actividad física en el medio acuático, de seis semanas de duración, en mujeres gestantes sanas. Métodos: Se llevó a cabo un programa de actividad física en el medio acuático, desde mayo hasta julio de 2016 en un centro deportivo, de seis semanas de duración a un total de 46 mujeres embarazadas, que fueron distribuidas en grupo Experimental (n=18) y grupo Control (n=28), a las que se le aplicó el cuestionario de calidad de vida relacionada con la salud "SF- 36 v2" antes y después del programa. Estadísticamente se aplicó para medias intragrupo la prueba t-student para muestras pareadas, y para las diferencias entre grupos, la prueba t-student para muestras independientes. Resultados: Al finalizar el programa de actividad física se constató como el mismo actuó positivamente sobre las siguientes dimensiones, cuyos valores de la media fueron: percepción de Dolor Corporal (DC) antes 66,1 y después 68,4 percepción de Salud General (SG) antes 81,3 y después 83,6, Rol Emocional (RE) antes 89,0 y después 93,5 y Salud Mental (SM) 80,7 antes y 84,2 después. Conclusión: La práctica de un programa de actividad física en el medio acuático para embarazadas sanas brinda beneficios relacionados con la percepción de calidad de vida relacionada con la salud (AU)

Background: Moderate physical exercise brings benefits to pregnant women during pregnancy. The aim of this research is to evaluate the effect on the quality of life of a six-week aquatic physical activity program in healthy pregnant women Methods: A six-week physical activity program was conducted in the aquatic environment, from May to July 2016 in a sports center, to a total of 46 pregnant women, who were distributed in Experimental (n = 18) and Control (n = 28) groups, to which the health-related quality of life questionnaire "SF-36 v2" was applied before and after the program. The t-student test for paired samples was statistically applied for intragroup means, and for the differences between groups, the t-student test for independent samples. Results: At the end of the physical activity program, it was clearly established that it acted positively on the following dimensions whose mean values were: perception of Body Pain (BP) before 66.1 and after 68.4 perception of General Health (GH) before 81.3 and then 83.6, Emotional Role (ER) before 89.0 and Then 93.5 and Mental Health (MH) 80.7 before and 84.2 after. Conclusion: The practice of a program of physical activity in the aquatic environment for pregnant women provides benefits related to the perception of health-related quality of life (AU)

The Pilates method and cardiorespiratory adaptation to training.

Although all authors report beneficial health changes following training based on the Pilates method, no explicit analysis has been performed of its cardiorespiratory effects. The objective of this study was to evaluate possible changes in cardiorespiratory parameters with the Pilates method. A total of 45 university students aged 18-35 years (77.8% female and 22.2% male), who did not routinely practice physical exercise or sports, volunteered for the study and signed informed consent. The Pilates training was conducted over 10 weeks, with three 1-hour sessions per week. Physiological cardiorespiratory responses were assessed using a MasterScreen CPX apparatus. After the 10-week training, statistically significant improvements were observed in mean heart rate (135.4-124.2 beats/min), respiratory exchange ratio (1.1-0.9) and oxygen equivalent (30.7-27.6) values, among other spirometric parameters, in submaximal aerobic testing. These findings indicate that practice of the Pilates method has a positive influence on cardiorespiratory parameters in healthy adults who do not routinely practice physical exercise activities.

Health-Related Quality of Life, Gender, and Culture of Older People Users of Health Services in the Multicultural Landscape of the City of Ceuta (Spain): A Cross-Sectional Study.

INTRODUCTION: Perceptions of health-related quality of life (HRQOL) are influenced by sociodemographic variables and by cultural-religious concepts of health, disease, and old age, among others. PURPOSE: To assess the HRQOL of older people in a population with a long history of multiculturalism, the city of Ceuta (Spain), and to compare the results with Spanish reference values. METHOD: A total of 372 individuals (55.4% females) were interviewed using the Spanish version of the Short Form-36 questionnaire. The subjects' mean age was 70.9 (SD = 5) years: 253 were Christians, 93 Muslims, and 26 Jews, representing the proportions in the overall population of these cultural-religious groups. RESULTS: HRQOL differs according to the cultural-religious affiliation, which specifically affects social and psychological dimensions. DISCUSSION AND CONCLUSIONS: All groups obtained lower social function scores than the reference values, especially the Muslim and Jewish groups. IMPLICATIONS FOR PRACTICE: Health care providers may consider integrating culturally sensitive interventions to improve HRQOL.

OVERWEIGHT OBESITY AND CARDIOVASCULAR RISK IN MENOPAUSAL TRANSITION.

INTRODUCTION: the hormonal decline that is characteristic of the menopause, in conjunction with the associated weight gain, is considered a determinant factor of cardiovascular risk. OBJETIVE: to examine weight status in relation to clinical symptoms during the menopausal transition, in women referred from primary care to an endocrinology specialist, to determine potential cardiovascular risk profiles. METHOD: observational analytic cross-sectional study, conducted with data from medical records created at time of referral. STUDY POPULATION: 805 women aged 40 years or older, a sufficient number of subjects and medical records for cardiovascular risk to be estimated. RESULTS: hierarchic cluster analysis distinguished four clusters. The prevalence of obesity in each one exceeded 60%. The highest mean cardiovascular risk was observed in women who were older and presented obesity and hypertension. In younger age groups, the risk was low, rising to levels similar to those of the older women by the age of 65 years. CONCLUSION: these results suggest that preventive and therapeutic monitoring of obesity and modifiable risk factors should be conducted during the menopausal transition, to reduce the risk attributable to these factors, a risk that increases with time.

Introducción: el declive hormonal característico de la menopausia, junto al aumento ponderal añadido, está considerado como un factor determinante de riesgo cardiovascular. Propósito: examinar la situación ponderal en relación con la sintomatología clínica, durante la transición menopáusica, en mujeres derivadas desde atención primaria a la especialidad de endocrinología, para describir los posibles perfiles de riesgo cardiovascular. Método: se realizó un diseño observacional, analítico, de corte transversal, con los datos registrados en las historias clínicas en el momento de la derivación. 805 mujeres con 40 y más años de edad disponían de los registros necesarios para la estimación del riesgo cardiovascular. Resultados: la agrupación jerárquica distingue cuatro grupos. La frecuencia de obesidad en todos ellos superó el 60%, observándose los mayores promedios de riesgo cardiovascular en las mujeres de mayor edad y elevada frecuencia de obesidad e hipertensión arterial. En los grupos de menor edad, la estimación del riesgo fue baja, incrementándose hasta niveles similares a los de mayor edad, al proyectarlo a 65 años. Conclusión: estos resultados sugieren la necesidad de un seguimiento preventivo y terapéutico de la obesidad y los factores de riesgo modificables durante la transición menopáusica, para reducir el riesgo atribuible a dichos factores con el paso de los años.

Overweight obesity and cardiovascular risk in menopausal transition / Sobrepeso, obesidad y riesgo cardiovascular en la transición menopáusica

Introduction: the hormonal decline that is characteristic of the menopause, in conjunction with the associated weight gain, is considered a determinant factor of cardiovascular risk. Objetive: to examine weight status in relation to clinical symptoms during the menopausal transition, in women referred from primary care to an endocrinology specialist, to determine potential cardiovascular risk profiles. Method: observational analytic cross-sectional study, conducted with data from medical records created at time of referral. Study population: 805 women aged 40 years or older, a sufficient number of subjects and medical records for cardiovascular risk to be estimated. Results: hierarchic cluster analysis distinguished four clusters. The prevalence of obesity in each one exceeded 60%. The highest mean cardiovascular risk was observed in women who were older and presented obesity and hypertension. In younger age groups, the risk was low, rising to levels similar to those of the older women by the age of 65 years. Conclusion: these results suggest that preventive and therapeutic monitoring of obesity and modifiable risk factors should be conducted during the menopausal transition, to reduce the risk attributable to these factors, a risk that increases with time (AU)

Introducción: el declive hormonal característico de la menopausia, junto al aumento ponderal añadido, está considerado como un factor determinante de riesgo cardiovascular. Propósito: examinar la situación ponderal en relación con la sintomatología clínica, durante la transición menopáusica, en mujeres derivadas desde atención primaria a la especialidad de endocrinología, para describir los posibles perfiles de riesgo cardiovascular. Método: se realizó un diseño observacional, analítico, de corte transversal, con los datos registrados en las historias clínicas en el momento de la derivación. 805 mujeres con 40 y más años de edad disponían de los registros necesarios para la estimación del riesgo cardiovascular. Resultados: la agrupación jerárquica distingue cuatro grupos. La frecuencia de obesidad en todos ellos superó el 60%, observándose los mayores promedios de riesgo cardiovascular en las mujeres de mayor edad y elevada frecuencia de obesidad e hipertensión arterial. En los grupos de menor edad, la estimación del riesgo fue baja, incrementándose hasta niveles similares a los de mayor edad, al proyectarlo a 65 años. Conclusión: estos resultados sugieren la necesidad de un seguimiento preventivo y terapéutico de la obesidad y los factores de riesgo modificables durante la transición menopáusica, para reducir el riesgo atribuible a dichos factores con el paso de los años (AU)

Should arm span or height be used in calculating the BMI for the older people? Preliminary results.

AIMS AND OBJECTIVES: To consider using arm span rather than height for calculating the body mass index, as a parameter that offers greater long-term stability, for the nutritional assessment of persons aged over 65 years. BACKGROUND: The body mass index presents certain drawbacks for the nutritional screening of older people suffering malnutrition or at risk of malnutrition, due to the anthropometric changes that occur with increasing age, especially the progressive loss of height. DESIGN: Observational, cross-sectional study, using nonprobabilistic convenience sampling, with anthropometric measurements and nutritional screening in older men and women, divided into two groups: (1) aged 65-75 years and (2) aged over 75 years. METHODOLOGY: Height and arm span were measured to calculate two separate indices of body mass: body mass index (weight/height) and body mass index.1 (weight/arm span). Nutritional screening was conducted using the Mini Nutritional Assessment Short-Form, which includes the body mass index as an anthropometric measure. RESULTS: Our results reveal statistically significant differences between the two indices, for the sample analysed. Body mass index.1 classifies a larger number of older people as suffering malnutrition and fewer as being at nutritional risk. When this new index is used, there is a displacement of the subjects at risk, thus increasing the number considered at risk of malnutrition and in need of appropriate therapeutic intervention. Therefore, the use of body mass index.1 would enable more people suffering malnutrition, who would otherwise remain untreated, to be attended. CONCLUSIONS: As arm span, as an anthropometric measure, remains unchanged over time, it could be used instead of height, as an alternative index (body mass index.1) to the conventional body mass index. Further research is needed to determine the association between body mass index.1 and clinical status parameters to determine optimum cut-off points. RELEVANCE TO CLINICAL PRACTICE: This study describes the greater stability of body mass index.1 with respect to body mass index for nutritional screening, and the resulting benefits for nutritional monitoring and intervention for older people.

[Endocrine-metabolic adjustments during Ramadan fasting in young athletes]. / Ajustes endocrino-metabólicos durante el ayuno de Ramadán en jóvenes deportistas.

The Islamic precept of R implies important physiological modifications due to the hydric and dietetic restrictions along a whole month plus a day, all of which have a crucial repercussion over the physical and intellectual performance of Muslims, particularly in occidental societies, in which there is no hour readjustments for daily activities. Among the imposed modifications by Ramadan in daily habits, intermittent fasting along day and night causes adaptation mechanisms to optimize the energy consumption. The objective of this study was to analyze the metabolic-endocrine changes that happen during daily working hours, along the month of fasting in young subjects who have to continue their usual activities and sport training. Ten young muslim subjects, male, healthy, set to sport training, ages in between 18 and 25 who completed Ramadan. Plasma biochemical and hormonal parameters were analyzed in plasma, a week before Ramadan, in the first and fourth of the fasting month and a week after conclusion. During Ramadan, have been observed a drop of biochemical parameters along daytime, especially those related to glycemia, being these changes stronger in the first week. The concentration of cortisol found to be significantly high during the whole month as a consequence of adaptation to the change of circadian secretion rhythms. Ramadan obliges subject's organisms to readjust their endocrine and metabolic system in order to preserve the energetic efficiency during daytime. This auto control becomes more efficient as long as the month advances due to physiological adaptations.

Ajustes endocrino-metabólicos durante el ayuno de Ramadán en jóvenes deportistas / Endocrine-metabolic adjustments during Ramadan fasting in young athletes

El precepto islámico del Ramadán (R), implica importantes modificaciones fisiológicas debido a las restricciones hídricas y dietéticas a lo largo del día y durante un mes, lo que tiene una especial repercusión física e intelectual de los musulmanes, particularmente en sociedades occidentales, en las que no se producen reajustes horarios para las actividades cotidianas. Entre las modificaciones impuestas por el R, el ayuno intermitente día/noche, desencadena mecanismos de adaptación para rentabilizar el consumo energético. El objetivo del presente estudio ha sido valorar algunos cambios endocrinometabólicos que acontecen a lo largo de la jornada, durante el mes de ayuno, en jóvenes que tienen que continuar con su actividad y entrenamiento deportivo habitual. Diez jóvenes musulmanes, varones, sanos, sometidos a entrenamiento deportivo, con edades entre 18 y 25 años que realizaron el R. Se analizaron parámetros bioquímicos y hormonales en plasma, una semana previa al R, primera y cuarta del periodo de ayuno (mañana y tarde) y semana posterior. Durante el R, se observa un descenso de los parámetros bioquímicos a lo largo del día, especialmente de la glucemia, siendo estos cambios más evidentes en la primera semana. La concentración de cortisol se encuentran significativamente elevada durante todo el mes, como consecuencia del cambio de ritmo circadiano de secreción. El R obliga al organismo a un ajuste endocrino-metabólico con el fin de preservar la eficiencia energética durante la jornada. Este control se vuelve más eficaz conforme avanza el mes de ayuno y la consecuente adaptación fisiológica.

The Islamic precept of R implies important physiological modifications due to the hydric and dietetic restrictions along a whole month plus a day, all of which have a crucial repercussion over the physical and intellectual performance of Muslims, particularly in occidental societies, in which there is no hour readjustments for daily activities. Among the imposed modifications by Ramadan in daily habits, intermittent fasting along day and night causes adaptation mechanisms to optimize the energy consumption. The objective of this study was to analyze the metabolic-endocrine changes that happen during daily working hours, along the month of fasting in young subjects who have to continue their usual activities and sport training. Ten young muslim subjects, male, healthy, set to sport training, ages in between 18 and 25 who completed Ramadan. Plasma biochemical and hormonal parameters were analyzed in plasma, a week before Ramadan, in the first and fourth of the fasting month and a week after conclusion. During Ramadan, have been observed a drop of biochemical parameters along daytime, especially those related to glycemia, being these changes stronger in the first week. The concentration of cortisol found to be significantly high during the whole month as a consequence of adaptation to the change of circadian secretion rhythms. Ramadan obliges subject´s organisms to readjust their endocrine and metabolic system in order to preserve the energetic efficiency during daytime. This auto control becomes more efficient as long as the month advances due to physiological adaptations.

A computer tool for cardiovascular risk estimation according to Framingham and SCORE equations.

Background Currently, we have different scales to estimate the cardiovascular risk of one individual. The most commonly used in clinical practice are the Framingham method and the SCORE project. Both are based on mathematical models that take into account the presence and intensity of various risk factors for cardiovascular morbidity and mortality. Aims and objectives The aim of our study was to develop a measurement system that allows unifying criteria of both models. Thus, we will be able to estimate the cardiovascular risk globally in a cohort of patients instead of individually. Methods The study included a representative subgroup of 50 patients treated at in the Endocrinology Service of Virgen de las Nieves University Hospital, Granada, below 30 years or above 75 years. The equations used in the present study were in strict compliance with the original publications. The reliability and validity of results were tested, comparing them with results obtained using calculation programs developed, available on-line. The degree of similarity was determined by means of the Dice index and the distance between our values and those of the other programs were compared by using the expression: Da-b = √Σ(a - b)(2) Results The results of the present study demonstrated our application to be reliable and valid for cardiovascular risk assessment. Our observations also demonstrated differences in the criteria applied to create cardiovascular risk calculation tools. This may have repercussions on clinical decisions for some patients, suggesting a need to compare and standardize these criteria, ensuring that programs developed for this calculation correctly manage the different risk categories considered. Conclusion The present study validates a computer tool developed for the simultaneous calculation of cardiovascular disease probability by applying Framingham-Anderson and Framingham-Wilson methods, the Spanish adaptations of Regicor and Dorica, and the SCORE project.

Influence of exercise on mood in postmenopausal women.

AIM AND OBJECTIVE: To evaluate the influence of an exercise programme on postmenopausal women with symptoms of anxiety and depression. BACKGROUND: The menopause is a period of hormonal changes when mood variations are probably more severe than at any other period of women's lives. DESIGN: Prospective study with control group and pre- and post-treatment measures, after six months treatment. Conducted at two healthcare clinics, in the province of Granada (Spain). METHODS: A convenience sample of 60 postmenopausal women aged 60-70 years, with symptoms of depression and anxiety, was recruited. The women were randomly divided into two groups: (1) control group, no treatment (n = 30); (2) exercise group, which carried out a programme of mixed physical exercises with musical support (n = 30). All subjects answered questionnaires for the Hamilton Anxiety Scale and the Brink and Yesavage Geriatric Depression Scale before and after treatment. RESULTS: In the exercise group, statistically significant improvements were observed in subjects with moderate and severe depression (18 and 22%, respectively) and in those with symptoms of anxiety. No such changes were observed in the control group. CONCLUSIONS: A controlled programme of physical exercise for postmenopausal women alleviates symptoms of anxiety and depression, and its inclusion in primary healthcare programmes should be considered. RELEVANCE TO CLINICAL PRACTICE: Menopausal women may benefit from physical exercise, which attenuates the effects of the physiological and psychological changes associated with the menopause and prevents pathologic changes.

[The impact of therapy with TNF-blockers on health-related quality of life in rheumatoid arthritis patients. A pilot study]. / Calidad de vida relacionada con la salud tras terapia anti-factor de necrosis tumoral alfa en pacientes con artritis reumatoide. Un estudio piloto.

INTRODUCTION: The aim of this pilot study was to evaluate the initial response to 16 weeks of treatment with infliximab and etanercept of disease activity and quality of life in a cohort of 37 patients with established rheumatoid arthritis. PATIENTS AND METHOD: Patients were selected from the Unit of Rheumatology in Hospital Clínico San Cecilio from Granada, refractory to conventional treatment with disease modifying antirheumatic drugs. To assess the disease activity, Disease activity score (DAS28) was used and the measurement of quality of life was evaluated with the Spanish version of the SF-36 Health Survey (SF-36) and the RA-specific questionnaire QoL Scale (Quality of Life in Rheumatoid Arthritis). RESULTS: Preliminary results show a significant decrease in inflammatory activity of the disease and consequently in HRQL scores. The comparison with the general reference population shows a deviation well below average, especially in the "physical function" dimension with a rising response pattern in all dimensions. The correlation between specific scores (QoL-RA scale) and generic ones (SF-36) for HQ-treatment also showed significance, especially with the physical aggregate. DISCUSSION: An important limitation of the present study is the number of patients and the duration of the treatment; despite this, improvements in functional parameters and quality of life are evident and remain roughly stable since the first weeks of treatment. This allow us to continue the study and increase the number of patients. CONCLUSIONS: The preliminary results obtained with TNF-blockers after 16 weeks of treatment in RA objectively show the effectiveness of these drugs and also the perception by the patients of the effect on their quality of life.

Calidad de vida relacionada con la salud tras terapia anti-factor de necrosis tumoral alfa en pacientes con artritis reumatoide. Un estudio piloto / The impact of therapy with TNF-blockers on health-related quality of life in rheumatoid arthritis patients. A pilot study

Introducción. El objetivo de este estudio piloto ha sido valorar la respuesta inicial tras 16 semanas de tratamiento con infliximab y etanercept sobre la actividad de la enfermedad y la calidad de vida (CV), en una cohorte de 37 pacientes con artritis reumatoide establecida. Pacientes y método. Los pacientes fueron seleccionados en el Servicio de Reumatología del Hospital Clínico San Cecilio de Granada, por ser refractarios al tratamiento convencional con fármacos antirreumáticos modificadores de la enfermedad. Para evaluar la actividad de la enfermedad se utilizó el índice DAS28 (Disease Activity Score) y para CV, la versión española del Cuestionario de Salud SF-36 (Health Survey SF-36) y el cuestionario específico QoL-RA Scale (Quality of Life in Rheumatoid Arthritis). Resultados. Los resultados preliminares muestran una disminución significativa en la actividad inflamatoria y consecuentemente en las puntuaciones de la CV. La comparación con la población general de referencia muestra una desviación muy por debajo de la media, especialmente en la dimensión “función física” con un patrón de respuesta ascendente en todas las dimensiones. La correlación entre puntuaciones específicas (QoL-RA Scale) y genéricas (SF-36) de CV postratamiento, también mostraron significación, especialmente con el agregado físico. Discusión. Consideramos una limitación importante del estudio el número de pacientes y el tiempo de evolución postratamiento. No obstante, las mejorías en los diferentes parámetros funcionales y de CV son objetivables y permanecen prácticamente estables desde las primeras semanas de tratamiento, lo que nos permitirá continuar el estudio y ampliar el número de pacientes. Conclusiones. Los resultados preliminares obtenidos con anti-TNF alfa tras 16 semanas de tratamiento en artritis reumatoide, muestran la efectividad de los fármacos objetivamente y subjetivamente según la percepción del paciente sobre su CV (AU)

Introduction. The aim of this pilot study was to evaluate the initial response to 16 weeks of treatment with infliximab and etanercept of disease activity and quality of life in a cohort of 37 patients with established rheumatoid arthritis. Patients and method. Patients were selected from the Unit of Rheumatology in Hospital Clínico San Cecilio from Granada, refractory to conventional treatment with disease modifying antirheumatic drugs. To assess the disease activity, Disease activity score (DAS28) was used and the measurement of quality of life was evaluated with the Spanish version of the SF-36 Health Survey (SF-36) and the RA-specific questionnaire QoL Scale (Quality of Life in Rheumatoid Arthritis). Results. Preliminary results show a significant decrease in inflammatory activity of the disease and consequently in HRQL scores. The comparison with the general reference population shows a deviation well below average, especially in the “physical function” dimension with a rising response pattern in all dimensions. The correlation between specific scores (QoL-RA scale) and generic ones (SF-36) for HQ-treatment also showed significance, especially with the physical aggregate. Discussion. An important limitation of the present study is the number of patients and the duration of the treatment; despite this, improvements in functional parameters and quality of life are evident and remain roughly stable since the first weeks of treatment. This allow us to continue the study and increase the number of patients. Conclusions. The preliminary results obtained with TNF-blockers after 16 weeks of treatment in RA objectively show the effectiveness of these drugs and also the perception by the patients of the effect on their quality of life (AU)