An Efficient Edge Computing-Enabled Network for Used Cooking Oil Collection.

In Portugal, more than 98% of domestic cooking oil is disposed of improperly every day. This avoids recycling/reconverting into another energy. Is also may become a potential harmful contaminant of soil and water. Driven by the utility of recycled cooking oil, and leveraging the exponential growth of ubiquitous computing approaches, we propose an IoT smart solution for domestic used cooking oil (UCO) collection bins. We call this approach SWAN, which stands for Smart Waste Accumulation Network. It is deployed and evaluated in Portugal. It consists of a countrywide network of collection bin units, available in public areas. Two metrics are considered to evaluate the system's success: (i) user engagement, and (ii) used cooking oil collection efficiency. The presented system should (i) perform under scenarios of temporary communication network failures, and (ii) be scalable to accommodate an ever-growing number of installed collection units. Thus, we choose a disruptive approach from the traditional cloud computing paradigm. It relies on edge node infrastructure to process, store, and act upon the locally collected data. The communication appears as a delay-tolerant task, i.e., an edge computing solution. We conduct a comparative analysis revealing the benefits of the edge computing enabled collection bin vs. a cloud computing solution. The studied period considers four years of collected data. An exponential increase in the amount of used cooking oil collected is identified, with the developed solution being responsible for surpassing the national collection totals of previous years. During the same period, we also improved the collection process as we were able to more accurately estimate the optimal collection and system's maintenance intervals.

Advancements in Glaucoma Diagnosis: The Role of AI in Medical Imaging.

The progress of artificial intelligence algorithms in digital image processing and automatic diagnosis studies of the eye disease glaucoma has been growing and presenting essential advances to guarantee better clinical care for the population. Given the context, this article describes the main types of glaucoma, traditional forms of diagnosis, and presents the global epidemiology of the disease. Furthermore, it explores how studies using artificial intelligence algorithms have been investigated as possible tools to aid in the early diagnosis of this pathology through population screening. Therefore, the related work section presents the main studies and methodologies used in the automatic classification of glaucoma from digital fundus images and artificial intelligence algorithms, as well as the main databases containing images labeled for glaucoma and publicly available for the training of machine learning algorithms.

Ultrasound screening for abdominal aortic aneurysm in primary care. / Utilidad de la ecografía en el cribado del aneurisma de aorta abdominal en atención primaria.

INTRODUCTION: Abdominal aortic aneurysm (AAA) constitutes a pathology with high mortality. There is currently no screening program implemented in primary care in Spain. OBJECTIVES: To evaluate the usefulness of ultrasound in the detection of AAA in the at-risk population in primary care. Secondarily, to identify subjects whose vascular risk (VR) should be reclassified and to determine whether AAA is associated with the presence of carotid plaque and other risk factors. MATERIAL AND METHODS: Cross-sectional, descriptive, multicenter, national, descriptive study in primary care. SUBJECTS: A consecutive selection of hypertensive males aged between 65 and 75 who are either smokers or former smokers, or individuals over the age of 50 of both sexes with a family history of AAA. MEASUREMENTS: Diameter of abdominal aorta and iliac arteries; detection of abdominal aortic and carotid atherosclerotic plaque. VR was calculated at the beginning and after testing (SCORE). RESULTS: One hundred and fifty patients were analyzed (age: 68.3±5 years; 89.3% male). Baseline RV was high/very high in 55.3%. AAA was detected in 12 patients (8%; 95% CI: 4-12); aortic ectasia in 13 (8.7%); abdominal aortic plaque in 44% and carotid plaque in 62% of the participants. VR was reclassified in 50% of subjects. The detection of AAA or ectasia was associated with the presence of carotid plaque, current smoking and lipoprotein(a), p<0.01. CONCLUSIONS: The prevalence of AAA in patients with VR is high. Ultrasound in primary care allows detection of AAA and subclinical atherosclerosis and consequently reclassification of the VR, demonstrating its utility in screening for AAA in the at-risk population.

Classification of Alzheimer's disease stages from magnetic resonance images using deep learning.

Alzheimer's disease (AD) is a progressive type of dementia characterized by loss of memory and other cognitive abilities, including speech. Since AD is a progressive disease, detection in the early stages is essential for the appropriate care of the patient throughout its development, going from asymptomatic to a stage known as mild cognitive impairment (MCI), and then progressing to dementia and severe dementia; is worth mentioning that everyone suffers from cognitive impairment to some degree as we age, but the relevant task here is to identify which people are most likely to develop AD. Along with cognitive tests, evaluation of the brain morphology is the primary tool for AD diagnosis, where atrophy and loss of volume of the frontotemporal lobe are common features in patients who suffer from the disease. Regarding medical imaging techniques, magnetic resonance imaging (MRI) scans are one of the methods used by specialists to assess brain morphology. Recently, with the rise of deep learning (DL) and its successful implementation in medical imaging applications, it is of growing interest in the research community to develop computer-aided diagnosis systems that can help physicians to detect this disease, especially in the early stages where macroscopic changes are not so easily identified. This article presents a DL-based approach to classifying MRI scans in the different stages of AD, using a curated set of images from Alzheimer's Disease Neuroimaging Initiative and Open Access Series of Imaging Studies databases. Our methodology involves image pre-processing using FreeSurfer, spatial data-augmentation operations, such as rotation, flip, and random zoom during training, and state-of-the-art 3D convolutional neural networks such as EfficientNet, DenseNet, and a custom siamese network, as well as the relatively new approach of vision transformer architecture. With this approach, the best detection percentage among all four architectures was around 89% for AD vs. Control, 80% for Late MCI vs. Control, 66% for MCI vs. Control, and 67% for Early MCI vs. Control.

Detection of Glaucoma on Fundus Images Using Deep Learning on a New Image Set Obtained with a Smartphone and Handheld Ophthalmoscope.

Statistics show that an estimated 64 million people worldwide suffer from glaucoma. To aid in the detection of this disease, this paper presents a new public dataset containing eye fundus images that was developed for glaucoma pattern-recognition studies using deep learning (DL). The dataset, denoted Brazil Glaucoma, comprises 2000 images obtained from 1000 volunteers categorized into two groups: those with glaucoma (50%) and those without glaucoma (50%). All images were captured with a smartphone attached to a Welch Allyn panoptic direct ophthalmoscope. Further, a DL approach for the automatic detection of glaucoma was developed using the new dataset as input to a convolutional neural network ensemble model. The accuracy between positive and negative glaucoma detection, sensitivity, and specificity were calculated using five-fold cross-validation to train and refine the classification model. The results showed that the proposed method can identify glaucoma from eye fundus images with an accuracy of 90.0%. Thus, the combination of fundus images obtained using a smartphone attached to a portable panoptic ophthalmoscope and artificial intelligence algorithms yielded satisfactory results in the overall accuracy of glaucoma detection tests. Consequently, the proposed approach can contribute to the development of technologies aimed at massive population screening of the disease.

Cov-caldas: A new COVID-19 chest X-Ray dataset from state of Caldas-Colombia.

The emergence of COVID-19 as a global pandemic forced researchers worldwide in various disciplines to investigate and propose efficient strategies and/or technologies to prevent COVID-19 from further spreading. One of the main challenges to be overcome is the fast and efficient detection of COVID-19 using deep learning approaches and medical images such as Chest Computed Tomography (CT) and Chest X-ray images. In order to contribute to this challenge, a new dataset was collected in collaboration with "S.E.S Hospital Universitario de Caldas" ( https://hospitaldecaldas.com/ ) from Colombia and organized following the Medical Imaging Data Structure (MIDS) format. The dataset contains 7,307 chest X-ray images divided into 3,077 and 4,230 COVID-19 positive and negative images. Images were subjected to a selection and anonymization process to allow the scientific community to use them freely. Finally, different convolutional neural networks were used to perform technical validation. This dataset contributes to the scientific community by tackling significant limitations regarding data quality and availability for the detection of COVID-19.

A Novel In Vivo Model for Multiplexed Analysis of Callosal Connections upon Cortical Damage.

Brain damage is the major cause of permanent disability and it is particularly relevant in the elderly. While most studies focused on the immediate phase of neuronal loss upon injury, much less is known about the process of axonal regeneration after damage. The development of new refined preclinical models to investigate neuronal regeneration and the recovery of brain tissue upon injury is a major unmet challenge. Here, we present a novel experimental paradigm in mice that entails the (i) tracing of cortico-callosal connections, (ii) a mechanical lesion of the motor cortex, (iii) the stereological and histological analysis of the damaged tissue, and (iv) the functional characterization of motor deficits. By combining conventional microscopy with semi-automated 3D reconstruction, this approach allows the analysis of fine subcellular structures, such as axonal terminals, with the tridimensional overview of the connectivity and tissue integrity around the lesioned area. Since this 3D reconstruction is performed in serial sections, multiple labeling can be performed by combining diverse histological markers. We provide an example of how this methodology can be used to study cellular interactions. Namely, we show the correlation between active microglial cells and the perineuronal nets that envelop parvalbumin interneurons. In conclusion, this novel experimental paradigm will contribute to a better understanding of the molecular and cellular interactions underpinning the process of cortical regeneration upon brain damage.

Beyond the Brain: MIDS Extends BIDS to Multiple Modalities and Anatomical Regions.

Brain Imaging Data Structure (BIDS) provides a valuable tool to organise brain imaging data into a clear and easy standard directory structure. Moreover, BIDS is widely supported by the scientific community and has been established as a powerful standard for medical imaging management. Nonetheless, the original BIDS is restricted to magnetic resonance imaging (MRI) of the brain, limiting its implantation to other techniques and anatomical regions. We developed Medical Imaging Data Structure (MIDS), conceived to extend BIDS methodology to other anatomical regions and multiple imaging systems in these areas. The MIDS standard was developed to store and manage medical images as an extension of BIDS. It allows the user to handily save studies of multiple anatomical regions and imaging techniques. Besides, MIDS improves the classification of multiple images within the structure, allowing the possibility to unify them in a single study to apply on them preprocessing or artificial intelligence algorithms. Finally, the results generated are saved in the derivatives folder.

Beyond the Brain: MIDS Extends BIDS to Multiple Modalities and Anatomical Regions.

Brain Imaging Data Structure (BIDS) provides a valuable tool to organise brain imaging data into a clear and easy standard directory structure. Moreover, BIDS is widely supported by the scientific community and has been established as a powerful standard for medical imaging management. Nonetheless, the original BIDS is restricted to magnetic resonance imaging (MRI) of the brain, limiting its implantation to other techniques and anatomical regions. We developed Medical Imaging Data Structure (MIDS), conceived to extend BIDS methodology to other anatomical regions and multiple imaging systems in these areas. The MIDS standard was developed to store and manage medical images as an extension of BIDS. It allows the user to handily save studies of multiple anatomical regions and imaging techniques. Besides, MIDS improves the classification of multiple images within the structure, allowing the possibility to unify them in a single study to apply on them preprocessing or artificial intelligence algorithms. Finally, the results generated are saved in the derivatives folder.

Platos olvidados o de consumo ocasional en la gastronomía española: Madrid / Forgotten dishes or occasional consumption in Spanish gastronomy: Madrid

La gastronomía y comida típica de Madrid se compone de platos compuestos principalmente por productos frescos la región como sus verduras o carnes para los platos de cuchara, guisos o frituras, pero incorpora una amplia variedad de productos. Una de las características de la gastronomía madrileña es su capacidad de adaptar platos provenientes de otras zonas geográficas. La gastronomía de Madrid es originaria de las costumbres culinarias manchegas, influenciada desde sus orígenes con los métodos e ingredientes de la cocina del al-Ándalus. El establecimiento de la Corte en el siglo XVI hizo que existiesen dos gastronomías: la cortesana, que incorporaba los alimentos del nuevo mundo, y la popular, humilde y sencilla, y así se mantuvo hasta el siglo XIX. En la actualidad, un gran número de establecimientos mantiene viva la peculiar identidad de la gastronomía madrileña, combinación de tradición con las influencias más heterodoxas. (AU)

The gastronomy and typical food of Madrid is madeup of dishes composed mainly of fresh regional products such as vegetables or meat for spoon dishes, stewsor fried foods, but it incorporates a wide variety of products. One of the characteristics of Madrid gastronomyis its ability to adapt dishes from other geographical areas. The gastronomy of Madrid sources from the culinary customs of La Mancha, influenced from its origins by the methods and ingredients of the Al-Andalus cuisine. The establishment of the Court in the 16th century gave rise to two cuisines: the courtly one, which incorporated food from the new world, and the popular, humble and simple one, and remained so until the 19th century. Currently, a large number of establishment skeep alive the peculiar identity of Madrid gastronomy, a combination of tradition with the most heterodox influences. (AU)

COVID-19 detection in X-ray images using convolutional neural networks.

COVID-19 global pandemic affects health care and lifestyle worldwide, and its early detection is critical to control cases' spreading and mortality. The actual leader diagnosis test is the Reverse transcription Polymerase chain reaction (RT-PCR), result times and cost of these tests are high, so other fast and accessible diagnostic tools are needed. Inspired by recent research that correlates the presence of COVID-19 to findings in Chest X-ray images, this papers' approach uses existing deep learning models (VGG19 and U-Net) to process these images and classify them as positive or negative for COVID-19. The proposed system involves a preprocessing stage with lung segmentation, removing the surroundings which does not offer relevant information for the task and may produce biased results; after this initial stage comes the classification model trained under the transfer learning scheme; and finally, results analysis and interpretation via heat maps visualization. The best models achieved a detection accuracy of COVID-19 around 97%.

Waist circumference as a prognostic index of childhood abdominal obesity: findings in the Spanish population / Circunferencia de la cintura como índice pronóstico de obesidad abdominal infantil: hallazgos en la población española

INTRODUCTION: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). OBJECTIVE: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. METHODS: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity RESULTS: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. CONCLUSION: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity

INTRODUCCIÓN: la detección temprana de la obesidad durante la infancia es de vital importancia para la prevención de patologías durante la edad adulta. En la actualidad, la evaluación de la obesidad infantil se realiza principalmente utilizando el índice de masa corporal por edad percentilado, aunque este no aporta información sobre la distribución del tejido adiposo. Un marcador emergente de distribución de la grasa abdominal es la circunferencia de la cintura (CC). OBJETIVO: el objetivo de este trabajo fue evaluar las diferencias entre diferentes criterios diagnósticos para definir el sobrepeso y la obesidad con el fin de establecer el punto de corte óptimo de la CC en los niños españoles. MÉTODO: se llevó a cabo un estudio observacional transversal de 8241 niños/as (3-12 años) en Villanueva de la Cañada (Madrid, España). Se determinaron el peso, la talla y el perímetro de la cintura atendiendo a los criterios de la Sociedad Internacional para el Avance de la Cineantropometría (ISAK). Los valores obtenidos para los criterios diagnósticos (Fundación Orbegozo (OF), el Grupo Internacional de Obesidad (IOTF) y la Organización Mundial de la Salud (OMS)) se compararon utilizando la prueba de McNemar para proporciones emparejadas. El coeficiente kappa (κ) se utilizó para evaluar el grado de acuerdo de las tres clasificaciones. Analizamos la validez del índice de masa corporal (IMC) y el perímetro de la cintura (CC) utilizando el análisis de la curva característica operativa del receptor (ROC). El índice de Youden se utilizó para determinar los valores de corte de la CC que identifican la obesidad infantil. RESULTADOS: se calcularon las prevalencias del sobrepeso y la obesidad de acuerdo con criterios internacionales (IOTF, OMS) y nacionales (FO). Se observó un acuerdo "substancial" para el sobrepeso y la obesidad entre el criterio diagnóstico español y el IOTF (κ = 0,636), mientras que el acuerdo fue "ligero" entre el criterio español y el de la OMS (κ = 0,198). Los puntos de corte de la CC estimados variaron de 54,5 a 88,0 cm, modificándose en función de la edad y el sexo. CONCLUSIONES: los puntos de corte de la CC propuestos, establecidos por primera vez para niños españoles, son una alternativa simple y válida como criterio diagnóstico de obesidad abdominal

Waist circumference as a prognostic index of childhood abdominal obesity: findings in the Spanish population.

INTRODUCTION: Introduction: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). Objective: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. Methods: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity Results: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. Conclusion: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity.

INTRODUCCIÓN: Introducción: la detección temprana de la obesidad durante la infancia es de vital importancia para la prevención de patologías durante la edad adulta. En la actualidad, la evaluación de la obesidad infantil se realiza principalmente utilizando el índice de masa corporal por edad percentilado, aunque este no aporta información sobre la distribución del tejido adiposo. Un marcador emergente de distribución de la grasa abdominal es la circunferencia de la cintura (CC). Objetivo: el objetivo de este trabajo fue evaluar las diferencias entre diferentes criterios diagnósticos para definir el sobrepeso y la obesidad con el fin de establecer el punto de corte óptimo de la CC en los niños españoles. Método: se llevó a cabo un estudio observacional transversal de 8241 niños/as (3-12 años) en Villanueva de la Cañada (Madrid, España). Se determinaron el peso, la talla y el perímetro de la cintura atendiendo a los criterios de la Sociedad Internacional para el Avance de la Cineantropometría (ISAK). Los valores obtenidos para los criterios diagnósticos (Fundación Orbegozo (OF), el Grupo Internacional de Obesidad (IOTF) y la Organización Mundial de la Salud (OMS)) se compararon utilizando la prueba de McNemar para proporciones emparejadas. El coeficiente kappa (κ) se utilizó para evaluar el grado de acuerdo de las tres clasificaciones. Analizamos la validez del índice de masa corporal (IMC) y el perímetro de la cintura (CC) utilizando el análisis de la curva característica operativa del receptor (ROC). El índice de Youden se utilizó para determinar los valores de corte de la CC que identifican la obesidad infantil. Resultados: se calcularon las prevalencias del sobrepeso y la obesidad de acuerdo con criterios internacionales (IOTF, OMS) y nacionales (FO). Se observó un acuerdo "substancial" para el sobrepeso y la obesidad entre el criterio diagnóstico español y el IOTF (κ = 0,636), mientras que el acuerdo fue "ligero" entre el criterio español y el de la OMS (κ = 0,198). Los puntos de corte de la CC estimados variaron de 54,5 a 88,0 cm, modificándose en función de la edad y el sexo. Conclusiones: los puntos de corte de la CC propuestos, establecidos por primera vez para niños españoles, son una alternativa simple y válida como criterio diagnóstico de obesidad abdominal.

Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study.

OBJECTIVE: To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. METHODS: Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (<6/6-10/11-15/>15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH >6 days vs. LOH <6 days (reference), and stratified by hospitalisation in cardiology, internal medicine, geriatrics, or short-stay units. RESULTS: We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4-11): 2934 (34.3%) had a LOH <6 days, 3184 (37.2%) 6-10 days, 1287 (15.0%) 11-15 days, and 1158 (13.5%) >15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined endpoint 37.4%. Mortality was increased by 36.5% (95%CI = 13.0-64.9) when LOH was 11-15 days, and by 72.0% (95%CI = 42.6-107.5) when >15 days. Conversely, no differences were found in readmission risk, and the combined endpoint only increased 21.6% (95%CI = 8.4-36.4) for LOH >15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH >15 days and no significant increments in readmission risk. CONCLUSIONS: Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments.

Evaluación de la carga aterosclerótica en hipertensos con prediabetes / Evaluation of the atherosclerotic burden in hypertensive patients with prediabetes

Objetivo: Conocer la carga aterosclerótica (carga ATC) de pacientes hipertensos prediabéticos sin enfermedad cardiovascular. Pacientes y métodos: Seleccionamos pacientes hipertensos en situación de prediabetes (glucemia en ayunas 100-125 mg/dl y/o glicohemoglobina A1c 5,7-6,4%), excluyendo aquellos con enfermedad cardiovascular establecida o de muy alto riesgo. Registramos los principales factores de riesgo vascular. Se calculó el índice tobillo/brazo (ITB) y el grosor íntima-media (GIM) carotídeo. Se consideró enfermedad arteriosclerosa ligera cuando el GIM fue > percentil75 para edad y sexo y/o ITB de 0,70-0,90 y moderada-grave en presencia de placa ateromatosa y/o ITB < 0,7. Resultados: Incluimos 53 pacientes, de 63 ± 7años; mujeres: 50,9% (IC95%: 36,8-64,9). Se detectó carga ATC en el 66,0% (IC95%: 51,7-78,5) de los sujetos. El 24,5% (IC95%: 13,8-38,3) de los pacientes presentaron enfermedad arteriosclerosa ligera y un 41,5% (IC95%: 28,1-55,9) moderada-grave. Esto nos permitió reclasificar como de riesgo vascular muy alto a un 41,5% (IC95%: 28,1-55,9) de los pacientes. Un 45,4% (IC95%: 16-74,8) de los sujetos de riesgo inicial moderado pasaron a considerarse de alto o muy alto riesgo. En el análisis multivariante los fumadores o exfumadores presentaron 2,3 veces más riesgo (odds ratio = 2,3; IC95%: 0,6-7,6) de presentar carga ATC, aunque sin alcanzar significación estadística. Conclusiones: Dos tercios de los pacientes hipertensos con prediabetes tienen enfermedad arteriosclerótica silente cuando se evalúan mediante el ITB y la ecografía carotídea. Aproximadamente un 40% de los sujetos fueron reclasificados como de muy alto riesgo. Cerca de la mitad de los hipertensos prediabéticos clasificados inicialmente como de riesgo moderado pasaron a considerarse de riesgo alto o muy alto. El tabaquismo parece ser el factor de riesgo más relacionado con la presencia de carga ATC

Aim: To assess the atherosclerotic burden in hypertensive patients with prediabetes without cardiovascular disease. Patients and methods: We included patients with hypertension and prediabetes (fasting blood glucose: 100-125 mg/dL and/or glycohemoglobin A1c: 5.7-6.4%), excluding those with established cardiovascular disease or those at very high risk. We recorded major vascular risk factors. Subclinical arteriosclerosis was measured by the ankle/brachial index (ABI) and carotid intima-medial thickness (IMT). Subclinical arteriosclerosis was mild if IMT was > 75p adjusted by age and sex and/or ABI was 0.7-0.9 and was considered moderate-severe when there was plaque and/or ABI < 0.7. Results: We included 53 patients, 63±7 years-old; women: 50,9% (95%CI: 36.8-64.9). Atherosclerotic burden was detected in 66.0% (95%CI: 51.7-78.5) of subjects. 24,5% (95%CI: 13.8-38.3) of patients had mild arteriosclerosis disease and 41.5% (95%CI: 28.1-55.9) had moderate-severe. This allowed us to re-stratified as very high vascular risk the 41.5% (95%CI: 28.1-55.9) of patients. 45.4% (95%CI: 16-74.8) of subjects with moderate initial risk were considered high or very high risk. In multivariate analyses, only smoking was associated with atherosclerotic burden (P = .07). Conclusions: Two thirds of hypertensive patients with prediabetes had subclinical arteriosclerotic disease when they were evaluated by the ankle/brachial index and carotid ultrasonography. Approximately forty percent of patients were re-stratified as very high vascular risk. Nearly half of the prediabetic hypertensive patients initially classified as moderate risk were considered high or very high risk

Evaluation of the atherosclerotic burden in hypertensive patients with prediabetes. / Evaluación de la carga aterosclerótica en hipertensos con prediabetes.

AIM: To assess the atherosclerotic burden in hypertensive patients with prediabetes without cardiovascular disease. PATIENTS AND METHODS: We included patients with hypertension and prediabetes (fasting blood glucose: 100-125mg/dL and/or glycohemoglobin A1c: 5.7-6.4%), excluding those with established cardiovascular disease or those at very high risk. We recorded major vascular risk factors. Subclinical arteriosclerosis was measured by the ankle/brachial index (ABI) and carotid intima-medial thickness (IMT). Subclinical arteriosclerosis was mild if IMT was >75p adjusted by age and sex and/or ABI was 0.7-0.9 and was considered moderate-severe when there was plaque and/or ABI<0.7. RESULTS: We included 53 patients, 63±7 years-old; women: 50,9% (95%CI: 36.8-64.9). Atherosclerotic burden was detected in 66.0% (95%CI: 51.7-78.5) of subjects. 24,5% (95%CI: 13.8-38.3) of patients had mild arteriosclerosis disease and 41.5% (95%CI: 28.1-55.9) had moderate-severe. This allowed us to re-stratified as very high vascular risk the 41.5% (95%CI: 28.1-55.9) of patients. 45.4% (95%CI: 16-74.8) of subjects with moderate initial risk were considered high or very high risk. In multivariate analyses, only smoking was associated with atherosclerotic burden (P=.07). CONCLUSIONS: Two thirds of hypertensive patients with prediabetes had subclinical arteriosclerotic disease when they were evaluated by the ankle/brachial index and carotid ultrasonography. Approximately forty percent of patients were re-stratified as very high vascular risk. Nearly half of the prediabetic hypertensive patients initially classified as moderate risk were considered high or very high risk.

Documento de Consenso SEMERGEN - CEFyL de la SEACV: Trombosis venosa superficial de miembros inferiores / Consensus document of SEMERGEN - CEFyL of the SEACV: super cial venous thrombosis of lower members in Primary Care

La trombosis venosa superficial (TVS) de miembros inferiores venía considerándose como una patología de naturaleza benigna con un curso clínico autolimitado. Actualmente se conoce que sus potenciales complicaciones pueden ser graves o incluso mortales, como la trombosis venosa profunda o el tromboembolismo pulmonar. Existen diferentes formas de presentación clínica, factores de riesgo y diferentes tratamientos para su abordaje, principalmente en Atención Primaria. Nuestro grupo de trabajo de vasculopatías de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) ha elaborado esta actualización con la evidencia científica actual de forma conjunta con el Capílulo Español de Flebología y Linfología de la Sociedad Española de Angiología y Cirugía Vascular

The superficial venous thrombosis of the lower limbs was considered a pathology of a benign nature with a self-limiting clinical course. It is now known that its potential complications can be serious or even deadly, such as deep vein thrombosis or pulmonary thromboembolism. There are different forms of clinical presentation, risk factors and different treatments for its approach mainly in Primary Care. Our working group of vasculopathies of the Spanish Society of Primary Care Physicians (SEMERGEN) has developed this update with the current scientific evidence jointly with the Spanish Chapter of Phlebology and Lymphology of the Spanish Society of Angiology and Vascular Surgery

Educación para una gastronomía saludable: retos y oportunidades en la alimentación institucional / Healthy gastronomy education: challenges and opportunities in the institutional food service

Introducción: la población demanda una gastronomía saludable (un binomio entre gastronomía y nutrición), por lo que debe incluir los conocimientos de alimentación y la salud. Salud, educación y gastronomía se complementan entre sí. La alimentación institucional debe ser saludable y, a su vez, placentera. Objetivos: recopilar actividades, recursos e intervenciones que se han llevado a cabo en diversos centros de alimentación institucional (comedores escolares, residencias y hospitales), donde se incluyen los conocimientos sobre gastronomía y alimentación saludable como método de enseñanza a diferentes niveles. Métodos: se ha realizado una revisión de las acciones y/o materiales elaborados para educar en gastronomía saludable desde distintos ámbitos de la alimentación institucional. Además, se ha realizado una búsqueda de artículos científicos en las bases de datos PubMed, Dialnet y Google académico. Resultados: los talleres del gusto son un material educativo complementario y muy útil para el profesorado de Educación Infantil y Primaria. Los menús de las instituciones geriátricas deben tener un buen aporte nutricional y una buena calidad organoléptica que estimule el bienestar y la socialización de los usuarios, ya que en la vejez se producen pérdidas sensoriales que afectan al placer de comer. El modelo alimentario en el hospital está adaptado principalmente a las necesidades de salud de los usuarios, y debe alcanzar una idoneidad gastronómica que produzca bienestar durante la estancia. Conclusiones: la alimentación institucional plantea retos en la elaboración, la conservación, la calidad y el valor nutritivo de los alimentos, así como en la seguridad alimentaria y en sus implicaciones en la salud de las poblaciones, y, desde el punto de vista gastronómico, como rutina diaria en grupos de población vulnerables (escolares, personas hospitalizadas o adultos mayores)

Introduction: the population demands a healthy gastronomy (binomial Gastronomy and Nutrition), so it must include knowledge of food and health. Health, Education and Gastronomy complement each other. The institutional food service must be healthy and at the same time pleasant. Objectives: collect activities, resources and interventions that have been carried out in various institutional food services (school lunches, nursing homes and hospitals) where knowledge about gastronomy and healthy eating has been included as a teaching method at different levels. Methods: a review of the actions and/or materials developed to educate on healthy gastronomy from different areas of collective catering has been carried out, as well as the search for scientific articles in the PubMed, Dialnet and Google academic databases. Results: the Taste Workshops are complementary and useful educational material for the teachers of Infant and Primary School Education. The menus of nursing home must have a good nutritional contribution and organoleptic quality that stimulates the well-being and socialization of the users, considering that in old age sensory losses affects the pleasure of eating. The alimentary model in the hospital is adapted mainly to the health needs of the users and must reach a gastronomic suitability that will produce well-being during the stay. Conclusions: institutional food service poses challenges in food preparation and conservation, quality and food safety, nutritional value of food and its implications for the health of populations, and from the point of view of gastronomy, since it involves a daily routine in groups of vulnerable population such as schoolchildren, hospitalized people or the elderly

[Healthy gastronomy education: challenges and opportunities in the institutional food service]. / Educación para una gastronomía saludable: retos y oportunidades en la alimentación institucional.

INTRODUCTION: the population demands a healthy gastronomy (binomial Gastronomy and Nutrition), so it must include knowledge of food and health. Health, Education and Gastronomy complement each other. The institutional food service must be healthy and at the same time pleasant. OBJECTIVES: collect activities, resources and interventions that have been carried out in various institutional food services (school lunches, nursing homes and hospitals) where knowledge about gastronomy and healthy eating has been included as a teaching method at different levels. METHODS: a review of the actions and/or materials developed to educate on healthy gastronomy from different areas of collective catering has been carried out, as well as the search for scientific articles in the PubMed, Dialnet and Google academic databases. RESULTS: the Taste Workshops are complementary and useful educational material for the teachers of Infant and Primary School Education. The menus of nursing home must have a good nutritional contribution and organoleptic quality that stimulates the well-being and socialization of the users, considering that in old age sensory losses affects the pleasure of eating. The alimentary model in the hospital is adapted mainly to the health needs of the users and must reach a gastronomic suitability that will produce well-being during the stay. CONCLUSIONS: institutional food service poses challenges in food preparation and conservation, quality and food safety, nutritional value of food and its implications for the health of populations, and from the point of view of gastronomy, since it involves a daily routine in groups of vulnerable population such as schoolchildren, hospitalized people or the elderly.

Introducción: la población demanda una gastronomía saludable (un binomio entre gastronomía y nutrición), por lo que debe incluir los conocimientos de alimentación y la salud. Salud, educación y gastronomía se complementan entre sí. La alimentación institucional debe ser saludable y, a su vez, placentera.Objetivos: recopilar actividades, recursos e intervenciones que se han llevado a cabo en diversos centros de alimentación institucional (comedores escolares, residencias y hospitales), donde se incluyen los conocimientos sobre gastronomía y alimentación saludable como método de enseñanza a diferentes niveles.Métodos: se ha realizado una revisión de las acciones y/o materiales elaborados para educar en gastronomía saludable desde distintos ámbitos de la alimentación institucional. Además, se ha realizado una búsqueda de artículos científicos en las bases de datos PubMed, Dialnet y Google académico.Resultados: los talleres del gusto son un material educativo complementario y muy útil para el profesorado de Educación Infantil y Primaria. Los menús de las instituciones geriátricas deben tener un buen aporte nutricional y una buena calidad organoléptica que estimule el bienestar y la socialización de los usuarios, ya que en la vejez se producen pérdidas sensoriales que afectan al placer de comer. El modelo alimentario en el hospital está adaptado principalmente a las necesidades de salud de los usuarios, y debe alcanzar una idoneidad gastronómica que produzca bienestar durante la estancia.Conclusiones: la alimentación institucional plantea retos en la elaboración, la conservación, la calidad y el valor nutritivo de los alimentos, así como en la seguridad alimentaria y en sus implicaciones en la salud de las poblaciones, y, desde el punto de vista gastronómico, como rutina diaria en grupos de población vulnerables (escolares, personas hospitalizadas o adultos mayores).

La psiquiatría militar alemana en la Segunda Guerra Mundial. Artículo histórico / German military psychiatry in the Second World War. Historical article

Resumen Introducción La reacción de estrés de combate (REC), que hoy en día podría ser denominada «reacción a estrés agudo¼ (ICD-10), se refiere a una reacción de ansiedad transitoria en el soldado, la cual históricamente llevó a una incapacidad para afrontar la lucha de la guerra. La mayoría de los análisis militares, históricos y médicos de la actividad realizada por la Wehrmacht § en la Segunda Guerra Mundial reportan que no se presentaron serios problemas debido al «quiebre¼ por estrés. Las razones se fundamentan en la calidad excepcional y el liderazgo de las pequeñas unidades militares del ejército alemán. Sin embargo, con el paso de los años, ya no fue posible evitar el reporte de un elevado número de bajas secundarias a la REC, lo que ha puesto en duda el mito de la inmunidad del soldado alemán al estrés de la guerra. Conclusiones Al final de la WWII, la reacción de estrés de combate fue un tópico común en las guías oficiales. Los psiquiatras fueron quienes subestimaron de forma continua el papel de este trastorno en la Wehrmacht. La percepción generalizada de que la Wehrmacht no sufría los serios problemas del quiebre emocional en los soldados puede ser modificada hasta cierto punto.

Abstract Introduction Combat stress reaction (CSR), now called «acute stress reaction¼ (ICD-10), refers to a transient anxiety reaction in the soldier, which has historically led to an inability to face the struggle of war. Most military, historical and medical analyzes of the activity carried out by the Wehrmacht in World War II reported no serious problems due to stress. The reasons are based on the exceptional quality of the small military units and the leadership of the German Army. However, over the years, it was no longer possible to avoid reporting the high number of casualties secondary to combat stress reactions, which has cast doubt on the myth of the German soldiers' immunity to the stress of war. Conclusions At the end of WWII, the CSR was a common topic in official reports, meetings and guides. The psychiatrists who had the opportunity to report it were those who continuously underestimated the role of this stress disorder in the Wehrmacht. Thus, the widespread perception that the Wehrmacht did not suffer serious problems of emotional breakdown in soldiers, typical of combat stress, can be modified to some extent.