Total polyphenol excretion and blood pressure in subjects at high cardiovascular risk.

BACKGROUND AND AIMS: Dietary factors are critical for the prevention and treatment of hypertension, but data on the effects of specific nutrients on blood pressure (BP) are scarce. The aim of this study was to assess the relationship between total polyphenol excretion (TPE) in urine, as an objective measurement of total polyphenol intake and BP in an elderly population at high cardiovascular risk. METHODS AND RESULTS: Cross-sectional substudy of 589 high-risk participants entering in the PREDIMED trial. BP was measured and TPE was determined in urine by Folin-Ciocalteu assay. A significant positive association was observed between TPE in urine and daily intake of fruit and vegetables (F&V), coffee or wine after adjusting for potential confounders. The intake of 100 g of F&V (Beta=0.150;P<0.001) had a greater contribution to TPE than 100 mL of coffee (Beta=0.141;P=0.001), and the latter two foods contributed more than the consumption of 100 mL of wine (Beta=0.120;P=0.019). An inverse association was observed between urinary TPE and the prevalence of hypertension. Participants in the highest quartile of urinary TPE had a reduced prevalence of hypertension compared to those in the lowest quartile (Odds Ratio=0.64; 95% confidence interval 0.45 to 0.92; P=0.015). Systolic and diastolic BP were inversely associated with urinary TPE after adjustment for potential confounders (P=0.024 and P=0.003, respectively). CONCLUSIONS: Polyphenol intake, assessed via TPE in urine, was negatively associated with BP levels and prevalence of hypertension in an elderly Mediterranean population at high cardiovascular risk. Participants with the highest intake of polyphenol-rich foods showed the lowest BP measurements.

Multivariate explanatory model for sporadic carcinoma of the colon in Dukes' stages I and IIa.

OBJECTIVE: We obtained before an explanatory model with six dependant variables: age of the patient, total cholesterol (TC), HDL cholesterol (HDL-C), VLDL cholesterol (VLDL-C), alkaline phosphatase (AP) and the CA 19.9 tumour marker. Our objective in this study was to validate the model by means of the acquisition of new records for an additional analysis. DESIGN: Non-paired case control study. SETTING: Urban and rural hospitals and primary health facilities in Western Andalusia and Extremadura (Spain). PATIENTS: At both the primary care facilities and hospital level, controls were gathered in a prospective manner (n= 275). Cases were prospective and retrospective manner collected on (n=126). MAIN OUTCOME MEASURES: Descriptive statistics, logistic regression and bootstrap analysis. RESULTS: The AGE (odds ratio 1.02; 95% CI 1.003-1.037) (p= 0.01), the TC (odds ratio 0.986; 95% C.I. 0.980-0.992) (p< 0.001) and the CA 19.9 (odds ratio 1.023; 95% C.I. 1.012- 1.034) (p<0.001) were the variables that showed significant values at logistic regression analysis and bootstrap. Berkson's bias was statistically assessed. CONCLUSIONS: The model, validated by means of logistic regression and bootstrap analysis, contains the variables AGE, TC, and CA 19.9 (three of the original six) and has a level 4 over 5 according to the criteria of Justice et al. (multiple independent validations) [Ann. Intern. Med.1999; 130: 515].

Investigando enfermedades raras del adulto en atención primaria: una hipótesis clasificatoria / Rare diseases at a primary care facility

Las enfermedades raras (ER) han de ser un objetivo de investigación en atención primaria por su potencial de productividad científico-biológica. Nos parece necesaria una sistematización de los resultados. Hemos realizado este trabajo retrospectivo longitudinal que recoge los hallazgos más importantes de nuestro interés en las ER de base genética. Los resultados se han clasificado en: a) observación y comunicación de reacciones adversas a medicamentos raras (RAMR); b) diagnóstico de entidades nosológicas raras (ENR); y c) estudio de prevalencia de ER (PER)

A pragmatic classification. Rare diseases (RD) might be a research target on primary care because their gift of scientific knowledge building. A rational scheme would be necessary for clinical and scientific findings. Retrospective long-term report of the most important RD achieved for a ten years period by a general practitioner at a non-urban primary care facility (Andalusia-Spain). Our results are classified as: a) rare adverse drug reactions (RADR); b) accurate RD diagnosis (RDD); and c) RD prevalence study (RDP)

[Rare disease at a primary care facility]. / Investigando enfermedades raras del adulto en atención primaria: una hipótesis clasificatoria.

A pragmatic classification. Rare diseases (RD) might be a research target on primary care because their gift of scientific knowledge building. A rational scheme would be necessary for clinical and scientific findings. Retrospective long-term report of the most important RD achieved for a ten years period by a general practitioner at a non-urban primary care facility (Andalusia-Spain). Our results are classified as: a) rare adverse drug reactions (RADR); b) accurate RD diagnosis (RDD); and c) RD prevalence study (RDP).

[An evaluation of the Spacelabs 90207 model of the ambulatory arterial pressure monitoring system]. / Validación del sistema de monitorización ambulatoria de presión arterial modelo SpaceLabs 90207.

BACKGROUND: The aim of the present study was to validate the SpaceLabs 90207 apparatus used in non-invasive outpatient monitoring of blood pressure. METHODS: The measurements of blood pressure (BP) and cardiac frequency (CF) obtained with the SpaceLabs monitor were compared with those obtained with a mercury sphygmomanometer used as the reference method in 86 patients with a wide range of ages and BP. The differences between both methods of measurement were quantified by a previously protocolized grade system from the British Hypertension Society (BHS). RESULTS: The mean of the differences between both systems of reading was 1.59 +/- 5.9 mmHg for systolic BP (SBP) 1.05 +/- 4.4 mmHg for diastolic BP (DBP) and -0.64 +/- 2.55 beats per minute for the CF. The accumulated percentage of differences of BP less than or equal to 5, 10 and 15 mmHg was of 74, 89 and 96%, respectively corresponding to grade B according to the validation protocol of the BHS. Grade B was obtained in all the interval differences of BP except within the range of DBP greater than or equal to 100 mmHg which showed grade A. Grades A or B were obtained in all the age groups except for grade C in the SBP of subjects over the age of 65. CONCLUSIONS: The SpaceLabs 90207 monitor satisfies the criteria of internationally accepted validation criteria, therefore, its use can be recommended for the outpatient blood pressure measurement.

[Mycoplasma pneumoniae pneumonia: serologic study of a family outbreak in primary care]. / Neumonía por Mycoplasma pneumoniae: estudio serológico de un brote familiar en atención primaria.

OBJECTIVE: To describe the clinical-radiological, epidemiological, therapeutic and evolutive characteristics of an outbreak of atypical Pneumonia in a family, which was serologically diagnosed by means of the technique of complement fixation of Pneumonia caused by Mycoplasma. DESIGN: A descriptive study. SETTING: An urban Health Centre. PATIENTS AND OTHER PARTICIPANTS: A family of 7 members, consisting of father, mother and five children. MEASUREMENTS AND MAIN RESULTS: Three presented Pneumonia caused by Mycoplasma pneumoniae, with the other family members remaining asymptomatic and serologically negative. The three cases evolved until cure. Treatment was with Macrolides in two of the cases and Penicillin in the other. Clinical-radiological dissociation existed in two of the patients. 33% had a secondary attack. CONCLUSION: The accessibility of Primary Care to microserological methods, together with the greater ease with which this level of Care can reach the family environment, allows for more precise knowledge of infectious epidemic outbreaks which occur in the community.

[The degree of participation in a family planning survey performed by personal interview]. / Grado de participación en una encuesta sobre planificación familiar mediante entrevista personal.

OBJECTIVE: To analyse participation levels in a family planning survey. DESIGN: Descriptive and sectorial survey by means of personal interviews. SITE. Primary Care. Rural Context. Basic Health Area of Sanlúcar la Mayor (Sevilla). PARTICIPANTS: 271 women of child-bearing age (15 to 49) chosen at random from the Municipal Census, who were invited by letter to the place of work of those doing the survey. INTERVENTIONS: Those who did not attend were invited on two further occasions. MAIN MEASUREMENTS AND RESULTS: The level of reply was 24.8% of those invited by the first letter, 25.12% by the second and 28.9% by the third. 40% of the total number did not attend on any of the three occasions: in 29.9% of cases because of work or study; in 22.9% because they hadn't received the letter; in 18.1% because of another commitment; in 26.5% due to lack of interest; 6% due to absence; and 3.6% owing to other reasons. 72.3% had no School Graduation Certificate. Only 10.3% were working. Differences of age, level of studies achieved and work activity between those attending and those not attending were considered significant but of no overall relevance. CONCLUSIONS: A survey based on personal interviews is a useful and valid way of collecting information in a rural community. Poor participation is thought to be due to both the low social and cultural levels and to the survey's subjects-matter. We consider that sending follow-up letters of invitation is a sound method of reducing as much as possible the number of home interviews which would otherwise have to be administered to those who did not attend.