Impact of pregnancy on women's health-related lifestyle habits: Diet, physical activity, alcohol consumption, and smoking.

OBJECTIVES: To explore health-related lifestyles in women before and during pregnancy, and to determine the potential differences between both and the relevant factors. MATERIALS AND METHODS: A cross-sectional observational study including 348 women with a child <5 years of age was conducted in six health areas. The following variables were recorded: sociodemographic (age, educational level, marital status, social class, type of cohabitation, nationality), health-related habits (physical activity, diet, tobacco use, alcohol consumption), health conditions, and medication intake. RESULTS: Four lifestyle habits were compared between the pre-conception and pregnancy periods: diet, physical activity, and alcohol and tobacco use. The proportion of women who consumed alcohol (42.8 % vs 3.4 %) or smoked (19.3 % vs 12.4 %) was significantly higher before conception (p < 0.01). Conversely, the proportion of inactive women was lower before pregnancy, with 23.3 % (CI95%: 18.7-27.9) formerly classified as active versus 35.3 % (CI95%: 30.2-40.5) (p < 0.01). Similarly, adherence to the Mediterranean diet increased during pregnancy (62.9 % vs 75.0 %; p < 0.01). Furthermore, 53.2 % (CI95%: 47.8-58.5) of women reported a change from non-healthy to healthy in at least one of the evaluated habits. Logistic regression analyses revealed the variables associated with a positive change, which were being national Spanish (OR: 6.9) and experiencing the first pregnancy (OR: 1.8). CONCLUSIONS: The lifestyles of women undergo changes between the pre-gestation and pregnancy periods. However, such variations do not affect all health-related habits similarly. A positive change was observed in diet, alcohol consumption, and smoking habit, whereas pregnancy negatively impacted on physical activity and sedentary behaviours.

Transiluminación negativa en patología testicular / Negative transillumination in testicular pathology

Los tumores testiculares representan el 1-2% de las neoplasias masculinas, siendo el más frecuente el seminoma. En pacientes con aparición de una masa o dolor testicular subagudo, es importante hacer una anamnesis exhaustiva y una exploración física. Hemos de apoyarnos en dos técnicas exploratorias para poder hacer un diagnóstico diferencial adecuado y detectar patología testicular urgente: transiluminación y ecografía testicular. El tratamiento incluye una orquiectomía y, según el estadio tumoral, quimioterapia.(AU)

Testicular tumors account for 1% to 2% of male neoplasms, the most common being seminoma. In patients who consult due to the presence of a mass or subacute testicular pain, it is important to undertake a thorough history and physical examination. We must rely on two exploratory techniques to be able to perform a suitable differential diagnosis and detect urgent testicular pathology: transillumination and testicular ultrasound. Treatment includes performing an orchiectomy and depends on tumor stage and chemotherapy.(AU)

Influencia de los estilos de vida de la madre en el inicio de la lactancia materna: estudio de casos y controles / Influence of the mother's lifestyles on the initiation of breastfeeding: A case-control study

Introducción: La lactancia materna es la alimentación óptima durante los primeros meses de vida. El objetivo principal de este estudio fue analizar los factores relacionados con no iniciar la lactancia materna, tanto referidos a los estilos de vida maternos como a las características epidemiológicas y la información sobre lactancia. Material y método: Estudio analítico observacional de casos y controles en 6 centros de salud. Se seleccionaron mujeres con algún hijo menor de 5 años, estimando un tamaño muestral de 166 casos (mujeres que no iniciaron lactancia materna) y 166 controles (que iniciaron lactancia). Se midieron variables sociodemográficas y estilos de vida maternos antes y durante la gestación, como la actividad física mediante el cuestionario BPAAT, la dieta con el cuestionario MEDAS-14 y el consumo de tabaco y alcohol. Se valoró la información y opiniones sobre lactancia, así como la experiencia previa. Resultados: Se incluyeron 348 mujeres (174 casos y 174 controles) con una edad media de 33,4 años (DE 5,4). Fueron variables asociadas de manera independiente con no iniciar lactancia: ausencia de experiencia previa con lactancia (OR: 12,75), tomar la decisión durante la gestación o el parto (OR: 10,55), no estar casada o con pareja (OR: 3,42) y permanecer sedentaria≥2h/día durante la gestación (OR: 1,77). Conclusiones: En nuestro estudio, los factores determinantes que se asocian a no iniciar lactancia materna son la ausencia de experiencia previa con lactancia, el momento de la decisión sobre la lactancia y el estado civil. Entre los estilos de vida, solo el sedentarismo se asocia a no iniciar lactancia materna, mientras que no tienen influencia los hábitos alimentarios u otros. (AU)

Introduction: Breast milk is the optimal food during the first months of life. The main objective was to analyse the factors associated with not initiating breastfeeding in terms of maternal lifestyles, epidemiological characteristics and information on breastfeeding. Material and method: Observational analytical study of cases and controls in 6 primary care centres. The sample included women with a child under 5 years, with an estimated necessary sample size of 166 cases (women who did not initiate breastfeeding) and 166 controls (women who began breastfeeding). Sociodemographic and maternal lifestyle variables were measured before and during pregnancy, such as physical activity using the BPAAT questionnaire, diet with the MEDAS-14 questionnaire, and tobacco and alcohol consumption. We assessed the information and opinions about breastfeeding as well as previous experience with it. Results: The study included 348 women (174 cases and 174 controls) with a mean age of 33.4 years (SD 5.4). The variables independently associated with not initiating breastfeeding were: absence of previous experience with breastfeeding (OR 12.75), making the decision during pregnancy or delivery (OR 10.55), not being married or in a partnership (OR 3.42) and being sedentary for periods of 2h or greater/day during pregnancy (OR 1.77). Conclusions: In our study, the determining factors associated with not initiating breastfeeding were the lack of previous experience with breastfeeding, the timing of the decision about breastfeeding, and marital status. When it came to lifestyle, only a sedentary lifestyle was associated with not initiating breastfeeding, while dietary or other habits had no influence. (AU)

Actitudes y opiniones de la población adolescente sobre las recomendaciones de protección de la salud frente a la COVID-19 / Attitudes and opinions of adolescents on recommendations for health protection against COVID-19

Objetivo: determinar las opiniones y actitudes de los estudiantes de enseñanza secundaria sobre las medidas de prevención frente al virus SARS-CoV-2, así como analizar los factores asociados a una mejor actitud hacia ellas.Diseño: estudio descriptivo transversal.Emplazamiento: centros de enseñanza secundaria.Participantes: 1.886 adolescentes que cursaban enseñanza secundaria de quince institutos de cinco comunidades autónomas.Mediciones principales: mediante encuesta anónima autocumplimentada, se valoraron aspectos sociodemográficos, hábitos de salud (actividad física, consumo de alcohol y tabaco) y opiniones, percepciones y actitudes sobre las recomendaciones preventivas durante la pandemia de la COVID-19.Resultados: edad media: 13,8 años (desviación estándar [DE]:1,3). El 88,6% (intervalo de confianza [IC] 95%: 87,1-90,1) conocía las recomendaciones. El 43,4% (IC 95%: 41,2-45,7) cumplió todas las medidas durante el confinamiento y el 31,3% (IC 95%: 29,2-33,5) cumplió todas las medidas durante el resto de pandemia. La medida peor considerada fue el adelanto del cierre de establecimientos (36,1%), seguida del cierre entre ciudades (35%) y de evitar reuniones (26,6%). Mediante regresión logística, fueron variables asociadas de forma independiente a una mejor actitud hacia las medidas durante la pandemia: menor edad (odds ratio [OR]: 1,14), no consumir alcohol (OR: 2,11), conocer las recomendaciones (OR: 2,11) y creer que existirán consecuencias negativas para el país (OR: 1,48).Conclusiones: los jóvenes y las jóvenes mostraron una actitud positiva hacia las medidas frente a la COVID-19 y una mayoría las conocía. Cumplieron en gran medida las recomendaciones preventivas, aunque no en su totalidad, siendo superior su cumplimiento durante el confinamiento. La opinión sobre las medidas se relaciona con la edad, la actitud con el alcohol, el conocimiento de las medidas y las posibles consecuencias de la pandemia.(AU)

Objective: to determine the opinions and attitudes of secondary school students about prevention measures against the SARS-CoV-2 virus, as well as to analyze the factors associated with a better attitude towards them.Design: cross-sectional descriptive study.Site: cecondary schools.Participants: a total of 1886 adolescents in secondary education at fifteen secondary schools in five Autonomous Communities.Main measures: sociodemographic aspects, health habits (physical activity, alcohol and tobacco consumption) and opinions, perceptions and attitudes about the preventive recommendations to follow during the COVID-19 pandemic were evaluated by means of an anonymous self-completed survey.Results: mean age of 13.8 years (SD: 1.3). A total of 88.6% (95% CI: 87.1-90.1) were aware of the recommendations; 43.4% (95% CI: 41.2-45.7) complied with all the measures during confinement and 31.3% (95% CI: 29.2-33.5) during the rest of the pandemic. The worst considered measure was early closure of establishments (36.1%), followed by closure between cities (35%) and avoiding meetings (26.6%). Using logistic regression, variables independently associated with a better attitude towards the measures during the pandemic were: younger age (OR: 1.14), not consuming alcohol (OR: 2.11), familiarity with the recommendations (OR: 2.11) and the belief that there will be negative consequences for the country (OR: 1.48).Conclusions: young people showed a positive attitude towards the measures against COVID-19 and most were aware of them. By and large they complied with the preventive recommendations, although not in their entirety; compliance was higher during confinement. Opinion about the measures was related to age, attitude towards alcohol, knowledge of the measures and possible consequences of the pandemic.(AU)

Influence of the mother's lifestyles on the initiation of breastfeeding: A case-control study.

INTRODUCTION: Breast milk is the optimal food during the first months of life. The main objective was to analyse the factors associated with not initiating breastfeeding in terms of maternal lifestyles, epidemiological characteristics and information on breastfeeding. MATERIAL AND METHOD: Observational analytical study of cases and controls in 6 primary care centres. The sample included women with a child under 5 years, with an estimated necessary sample size of 166 cases (women who did not initiate breastfeeding) and 166 controls (women who began breastfeeding). Sociodemographic and maternal lifestyle variables were measured before and during pregnancy, such as physical activity using the BPAAT questionnaire, diet with the MEDAS-14 questionnaire, and tobacco and alcohol consumption. We assessed the information and opinions about breastfeeding as well as previous experience with it. RESULTS: The study included 348 women (174 cases and 174 controls) with a mean age of 33.4 years (SD, 5.4). The variables independently associated with not initiating breastfeeding were: absence of previous experience with breastfeeding (odds ratio [OR], 12.75), making the decision during pregnancy or delivery (OR, 10.55), not being married or in a partnership (OR, 3.42) and being sedentary for periods of 2 hours or greater/day during pregnancy (OR, 1.77). CONCLUSIONS: In our study, the determining factors associated with not initiating breastfeeding were the lack of previous experience with breastfeeding, the timing of the decision about breastfeeding, and marital status. When it came to lifestyle, only a sedentary lifestyle was associated with not initiating breastfeeding, while dietary or other habits had no influence.

Manifestaciones cutáneas por COVID-19 en paciente polisintomática / Cutaneous manifestations of COVID-19 in a polysymptomatic patient

La infección por SARS-CoV-2 se caracteriza por manifestaciones múltiples, entre las que las más habituales son la fiebre, la tos y la dificultad respiratoria. Sin embargo, se ha observado la presencia, cada vez más frecuente, de diferentes lesiones cutáneas que pueden persistir durante el curso de toda la enfermedad, constituyendo la principal o única sintomatología en determinados casos. No se ha demostrado que la presencia ni el grado de afectación de estas manifestaciones cutáneas estén relacionados con el pronóstico. Presentamos el caso de una mujer de 25 años, con fiebre de cinco días de evolución, acompañada de clínica respiratoria. Tras la desaparición de dicha sintomatología, comenzó con un exantema maculopapular, de doce días de duración. La aparición de nuevas enfermedades, especialmente con la gravedad e importancia epidemiológica de la infección ocasionada por SARS-CoV-2, obliga al especialista en Medicina de Familia a considerar en su sospecha diagnóstica cualquier tipo de sintomatología, aunque no se incluya entre la que habitualmente caracteriza a la nueva patología

SARS-CoV-2 virus infection is characterized by multiple manifestations, among which fever, cough, and shortness of breath are the most frequent. However, an increasing presence of different skin lesions has been observed, which may persist over the whole course of the disease, and which in certain cases are the main or only symptom. The connection of the presence or the degree of affectation of these cutaneous manifestations with prognosis has not been confirmed. We present the case of a 25-year-old woman, who had had fever for five days, together with respiratory symptoms. After those symptoms had resolved, a maculopapular rash appeared, lasting for twelve days. The emergence of new diseases, especially those with the severity and epidemiological significance of the SARS-CoV-2 infection, compels the Family Medicine specialist to consider any type of symptomatology in their suspected diagnosis, even if it is not included among the usual symptoms of the new disease

Síndrome metabólico y otros modificadores de riesgo cardiovascular en adultos hipertensos de 65 o menos años de edad / Metabolic syndrome and other cardiovascular risk modifiers in hypertensive adults aged 65 or younger

OBJETIVOS: Describir la prevalencia de síndrome metabólico, de cada uno de sus componentes y de otros modificadores del riesgo cardiovascular (RCV) en hipertensos ≤ 65 años, así como analizar su relación con el grado de control de la presión arterial (PA). MATERIAL Y MÉTODOS: Estudio descriptivo observacional transversal realizado en 267 adultos de ≤ 65 años, diagnosticados de hipertensión arterial (criterios Guías Europeas hipertensión y riesgo cardiovascular), atendidos en consultas de medicina de familia de cuatro Zonas Básicas de Salud. La variable principal fue la presencia de síndrome metabólico (ATPIII/AHA-2004). Se recogieron variables sociodemográficas, problemas de salud, consumo de fármacos, cumplimiento terapéutico, actividad física (IPAQ-breve y BPAAT), consumo de tabaco, determinaciones analíticas, riesgo cardiovascular, cifras de presión arterial y su grado de control. RESULTADOS: Edad media 56,7 años (DE: 6,6). La prevalencia de síndrome metabólico fue del 40,4% (IC95%: 34,4%-46,5%). Un 76,8% mostró obesidad abdominal, 36,7% hipertrigliceridemia, 25,8% c-HDL disminuido y 26,2% hiperglucemia. El 55,8% presentaba dislipemia, 54,3% obesidad, 24,7% diabetes y 21,3% fumaba. Un 40,2% (IC95%: 33,9%-45,8%) no mostró adecuado control de PA. Mediante regresión logística, fueron variables asociadas a inadecuado control de presión arterial: menor puntuación cuestionario-BPAAT (OR:1,19; p = 0,027), menor número de problemas de salud (OR:1,20; p = 0,009), incumplimiento terapéutico (OR:1,93; p = 0,043) y síndrome metabólico (OR:2,85; p < 0,001). CONCLUSIONES: Más de un tercio de hipertensos adultos presentan síndrome metabólico y tres cuartos obesidad abdominal. El síndrome metabólico no sólo es un factor modificador de RCV, sino que también se debe considerar en el control de la PA en adultos hipertensos junto con el cumplimiento terapéutico, la comorbilidad y la actividad física

OBJECTIVES: To describe the prevalence of metabolic syndrome, of each of its components, and of other cardiovascular risk (CVR) modifiers in hypertensive patients ≤ 65 years of age, as well as to analyze its relationship with the degree of control of blood pressure (BP). MATERIAL AND METHODS: Descriptive cross-sectional observational study carried out in 267 adults aged ≤ 65 years, diagnosed with arterial hypertension (European Guidelines criteria for hypertension and cardiovascular risk), seen in family medicine consultations in four Basic Health Zones. The main variable was the presence of metabolic syndrome (ATPIII / AHA-2004). Sociodemographic variables, health problems, drug consumption, therapeutic compliance, physical activity (IPAQ-brief and BPAAT), tobacco consumption, analytical determinations, cardiovascular risk, blood pressure readings and their degree of control were collected. RESULTS: Average age 56.7 years (SD: 6.6). The prevalence of metabolic syndrome was 40.4% (95% CI: 34.4%-46.5%). 76.8% showed abdominal obesity, 36.7% hypertriglyceridemia, 25.8% decreased HDL-c, and 26.2% hyperglycemia. 55.8% had dyslipidemia, 54.3% obesity, 24.7% diabetes, and 21.3% smoked. 40.2% (95% CI: 33.9%-45.8%) did not show adequate BP control. Using logistic regression, variables associated with inadequate blood pressure control were: lower BPAAT-questionnaire score (OR: 1.19; p = 0.027), fewer health problems (OR: 1.20; p = 0.009), therapy non-compliance (OR: 1.93; p = 0.043) and metabolic syndrome (OR: 2.85; p < 0.001). CONCLUSIONS: More than one third of hypertensive adults have metabolic syndrome and three quarters have abdominal obesity. Metabolic syndrome is not only a modifying factor of CVR, but it should also be considered in the control of BP in hypertensive adults along with therapeutic compliance, comorbidity and physical activity