Effectiveness of an intervention in multicomponent exercise in primary care to improve frailty parameters in patients over 70 years of age (MEFAP-project), a randomised clinical trial: rationale and study design.

BACKGROUND: Physical activity may reverse frailty in the elderly, but we encounter barriers to the implementation of exercise programs in this population. Our main aim is to evaluate the effect of a multicomponent physical activity program, versus regular medical practice, on reverting pre-frailty status among the elderly, 12 months post-intervention. METHODS: Randomized parallel group multicenter clinical trial located in primary care setting, among non-dependent and pre-frail patients > 70 years old, including 190 patients (95 intervention, 95 control group). INTERVENTION: Multicomponent physical activity program (MEFAP, for its acronym in Spanish) with twelve 1.5 h-weekly sessions comprised of: 1. Informative session; 2. Exercises for improving aerobic resistance, muscle strength, propioception-balance and flexibility; and 3. Handing out of at-home exercise chart (twice/week). Main variable: pre-frailty according to the Fried phenotype. Secondary variables: sociodemographic, clinical and functional variables; exercise program adherence, patient satisfaction with the program and quality of life. We will perform an intention-to-treat analysis by comparing the retrogression from pre-frailty (1 or 2 Fried criteria) to robust status (0 Fried criteria) by the end of the intervention, 6 months and 12 months post-intervention. The accumulated incidence in each group will be calculated, as well as the relative risk (RR) and the number needed to treat (NNT) with their corresponding 95% confidence intervals. Protocol was approved by the Ethics Committee Hospital la Paz. DISCUSSION: Within the context of regular clinical practice, our results will provide evidence regarding the effects of exercise interventions on frailty among pre-frail older adults, a key population given their significant potential for functional, physical, and mental health improvement. TRIAL REGISTRATION: NCT03568084 . Registered 26 June 2018. Date of enrollment of the first participant to the trial: July 2nd 2018.

[Physical activity by pregnant women and its influence on maternal and foetal parameters; a systematic review]. / Actividad física en embarazadas y su influencia en parámetros materno-fetales; revisión sistemática.

INTRODUCTION: Regular physical activity is known to be very beneficial to health. While it is important at all stages of life, during pregnancy doubts may arise about the suitability of physical exercise, as well as the type of activity, its frequency, intensity and duration. AIMS: To analyse major studies on the influence of physical activity on maternal and foetal parameters. METHOD: Systematic review of physical activity programmes for pregnant women and the results achieved, during pregnancy, childbirth and postpartum. 45 items were identified through an automated database search in PubMed, Scopus and Google Scholar, carried out from October 2013 to March 2014. In selecting the items, the criteria applied included the usefulness and relevance of the subject matter and the credibility or experience of the research study authors. The internal and external validity of each of the articles reviewed was taken into account. CONCLUSIONS: The results of the review highlight the importance of physical activity during pregnancy, and show that the information currently available can serve as an initial benchmark for further investigation into the impact of regular physical exercise, in an aquatic environment, on maternal-foetal health.

Introducción: Las múltiples ventajas que aporta a la salud la práctica de una actividad física de forma continuada son conocidas. Aunque es importante en todas las etapas de la vida, cuando llega la gestación aparecen algunas dudas sobre la conveniencia de realizar ejercicio físico, así como del tipo de actividad, de su frecuencia, intensidad y duración. Objetivo: Analizar los principales estudios sobre la influencia de la actividad física sobre los parámetros materno- fetales. Método: Revisión sistemática de programas de actividad física destinados a las mujeres embarazadas y sus resultados durante el embarazo, el parto y el postparto. Se identificaron 45 artículos a través de la búsqueda automatizada en las bases de datos PUBMED, Scopus y Google Scholar; se llevó a cabo entre los meses de octubre de 2013 y marzo de 2014. Para seleccionar los artículos fue preciso considerar la utilidad y la relevancia del tema estudiado y la credibilidad o experiencia de los autores en la temática. Se tuvo en cuenta la validez interna y externa de cada uno de los artículos revisados. Conclusiones: Los resultados de la revisión ponen de manifiesto la importancia de la actividad física durante el periodo gestacional y se constata que la información disponible en la actualidad puede servir de referente inicial para continuar profundizando en los resultados que sobre la salud materno fetal tiene la práctica de actividad física en el medio acuático.

[Accelerometer description as a method to assess physical activity in different periods of life; systematic review]. / Descripción del acelerómetro como método para valorar la actividad física en los diferentes periodos de la vida; revisión sistemática.

INTRODUCTION: The accelerometer is shown as one of the most accurate techniques in recording and saving the amount and level of physical activity, by each person in a given period of time. AIMS: This review aims to describe and analyze the main items that use this method to assess physical activity. METHODS: The review articles were identified through the following specialized Internet browser: SCOPUS, PUBMED, GOOGLE SCHOLAR, those were selected for inclusion with a total of 56 items. The validity of the articles was given by the degree of evidence demonstrated by describing the recommendations and the applicability to our context. This review has considered studies evaluating physical activity through accelerometers. RESULTS: The results show that this method can be used in ages 3 to 90 years. It can also be used in subjects with overweight/obesity, articulation injuries, Down syndrome (just children), autism and people with psychological problems. Studies in pregnant women show satisfactory results. CONCLUSION: The literature reviewed provides the accelerometer as a reliable and effective method to assess physical activity.

Introducción: La acelerometría, se muestra como una de las técnicas más fiables, en el registro y almacenamiento de la cantidad y el nivel de actividad física, realizada por cada persona y en un periodo de tiempo determinado. Objetivo: Esta revisión tiene como objetivo describir y analizar los principales artículos que utilizan este método para valorar la actividad física. Método: Los artículos seleccionados para ser incluidos en esta revisión se identificaron a través de los siguientes motores de búsqueda especializados: SCOPUS, PUBMED, GOOGLE SCHOLAR; con un total de 56 artículos. La validez de los artículos estuvo dada por el grado de evidencias demostrado, por las recomendaciones que describen y por la aplicabilidad a nuestro contexto. Esta revisión ha considerado los estudios que evalúan la actividad física a través de acelerómetros. Resultados: Los resultados demuestran que este método se puede utilizar en edades comprendidas entre 3 y 90 años. También se puede utilizar en personas con sobrepeso/ obesidad, con lesiones articulares, niños con síndrome de Down, autistas, así como personas con problemas psicológicos. Los estudios en mujeres embarazadas muestran datos fiables. Conclusión: La literatura analizada establece la acelerometría como un método eficaz para valorar la actividad física.

Satisfaction Level of New Mothers with Prenatal Care and the Healthcare Professionals Who Provide It.

INTRODUCTION: Prenatal care is a key strategy to reduce maternal mortality. The aims of this work were to ascertain the level of satisfaction of new mothers with their pregnancy monitoring and with the medical professionals who provided prenatal care. SUBJECTS AND METHODS: A descriptive study was conducted on 265 new mothers, 18-43 years of age, who had given birth at the Virgen de las Nieves University Hospital and the San Cecilio University Hospital in Granada (Spain) in April and May 2012. The data were collected with a questionnaire consisting of 28 items that elicited information from the subjects about their pregnancy, prenatal care activities, the healthcare professionals that provided the care, and those that they would like to monitor future pregnancies. There were also two open questions. The first was about the perceived needs of the participants and the second asked them to suggest ways that prenatal care could be improved. RESULTS: The majority of the subjects (59.6%) had given birth for the first time. The midwife was the healthcare professional who performed most of the monitoring activities and resolved their doubts and problems (32.74%), gave the subjects tranquility and security (37.86%) and listened to their worries (34.53%). The subjects' satisfaction with the healthcare professionals was generally high. This was particularly true of the midwife (90.75%). Half of the subjects surveyed said that they wanted the midwife, obstetrician and general practitioner to monitor their pregnancy. They also underlined the need for longer and more visits with the midwife as well as more consultations with the obstetrician and higher number of ultrasounds. CONCLUSIONS: The subjects were very satisfied with the work of the healthcare professionals that monitored their pregnancy, particularly with the midwife. However, they also highlighted expectations and needs that, if met, would increase their satisfaction.

¿Qué le depara al paciente tras el diagnóstico de trombosis venosa profunda? Estudio de factores pronósticos de la mortalidad, síndrome prostrombótico y calidad de vida / GAT awaits the patient following a diagnosis of deep vein trombosis? A study of the factors predicting mortality, post-thrombotic syndrome and quality of life

Introducción. El pronóstico de una trombosis venosa profunda (TVP) implica considerar complicaciones como el síndrome postrombótico (SPT), la afectación de calidad de vida (CV) y muerte. Objetivos. Describir la historia natural del paciente tras una TVP, y detectar factores pronósticos de muerte, SPT y CV, además del valor pronóstico del dímero D en el diagnóstico de TVP. Pacientes y métodos. Cohorte histórica (n = 118) de pacientes con TVP; período: 1/1/2001-1/12/2002. Control a 3 años. Valoración con escalas visuales, CEAP, eco-Doppler (ED); CV mediante SF-36 y CIVIQ; dímero D mediante ELISA. Resultados. 118 pacientes (55,1% varones; 59,8 años de media). Fallecidos 31,4%, perdidos 16,1%, casos excluidos 5% y válidos para control clínico 49,2%. Riesgo de muerte: 31,4% (IC 95% = 23,2-40,5); el cáncer fue factor pronóstico de muerte, con RR = 2,9 (IC 95% = 1,7-4,8) y supervivencia media 22 meses menor. A los 3 años (n = 58): 29% clínica positiva y 30% CEAP > 2; 49% presentaron SPT (por clínica o CEAP positivo); 74% ED positivo. Acudir a Urgencias con clínica < 9 días ha sido pronóstico para desarrollo de SPT (RR = 2,7; p = 0,045). La CV ha sido significativamente peor en el grupo con SPT en los dos cuestionarios utilizados. Un dímero D ≥ 3,870 µg/L presenta un valor pronóstico positivo del 94%. Conclusiones. Uno de cada tres pacientes con TVP morirá a los tres años. De los supervivientes, uno de cada dos tendrá un SPT, y mermará su CV. Acudir a Urgencias en < 9 días puede ser un indicador indirecto de gravedad clínica. Un dímero D ≥ 3,870 µg/L en el diagnóstico de TVP predice un SPT en un 94% de los casos

INTRODUCTION. To determine the prognosis of deep vein thrombosis (DVT), complications such as postthrombotic syndrome (PTS), impact on the quality of life (QL) and death must be taken into account. AIMS. To describe the natural history of patients following TVP and to detect factors that predict death, PTS and QL, in addition to evaluating the prognostic value of the D-dimer test in diagnosing DVT. PATIENTS AND METHODS. Historical cohort (n = 118) of patients with DVT; period: 1/1/2001-1/12/2002. A clinical control was conducted at 3 years. Assessment with visual scales, CEAP, Doppler ultrasound (DU); QL was evaluated with SF-36 and CIVIQ, and D-dimer by ELISA. RESULTS. 118 patients (55.1% males; mean age 59.8 years). Deaths 31.4%, losses 16.1%, excluded cases 5% and number of valid subjects for clinical control 49.2%. Risk of death: 31.4% (CI 95% = 23.2-40.5); cancer was a factor predictive of death, with RR = 2.9 (CI 95% = 1.7-4.8) and mean survival was 22 months less. At 3 years (n = 58): 29% positive clinical features and 30% CEAP > 2; 49% had PTS (from clinical symptoms or positive CEAP); 74% were DU positive. Going to the Emergency Department with clinical symptoms < 9 days is predictive of the development of PTS (RR = 2.7; p = 0.045). The QL was found to be significantly poorer in the PTS group in both the surveys that were used. A D-dimer test ≥ 3.870 µg/L offered a positive prognostic value of 94%. CONCLUSIONS. One out of every three patients with DVT will die within three years. Of the survivors, one out of every two will have PTS, which will deteriorate his or her QL. Going to the Emergency Department in < 9 days can be an indirect indicator of the severity of the condition. D-dimer ≥ 3.870 µg/L in the diagnosis of DVT is predictive of PTS in 94% of cases

¿Son válidos los documentos de consentimiento informado que utilizamos en cirugía vascular? / are the informed consent documents we use in vascular surgery valid?

Introducción. La cumplimentación de un documento escrito de consentimiento informado (DCI) antes de realizar intervenciones quirúrgicas o exploraciones invasivas es un requisito ético (código deontológico) y legal (Ley 41/2002 de Autonomía del Paciente). Los DCI deben ser específicos para cada procedimiento y suministrar una información suficiente y comprensible. La información que tiene que contener un DCI está ampliamente consensuada en las fuentes bibliográficas. Las técnicas de análisis de legibilidad validadas para nuestra lengua son un instrumento útil para evaluar qué grado de comprensión del DCI tendrá el ciudadano medio. Objetivo. Valorar si en nuestra especialidad disponemos de DCI adecuados: específicos, comprensibles y con un contenido apropiado. Materiales y métodos. Se recogieron los DCI recomendados por la Sociedad Española de Angiología y Cirugía Vascular y sociedades regionales. Se practicó un análisis de legibilidad mediante tres parámetros validados para ello en castellano: índice de Flesh (IF), de complejidad oracional (ICO) y de legibilidad integrada (LEGIN). Se valoró el contenido según el grado de cumplimiento sobre un total de 15 apartados que deben contener los DCI. Resultados. Se encontraron 16 DCI sobre 10 procedimientos. Ningún DCI cumplía criterios de legibilidad mínima según el IF y seis lo cumplían según el ICO y el LEGIN. Ningún DCI cumplía con todos los requisitos de contenido. Conclusiones. Disponemos de DCI sobre pocos procedimientos. La legibilidad formal de los consentimientos informados analizados es deficiente. Los DCI analizados no cumplen con los requisitos de contenido exigibles a este tipo de documentos. Los DCI analizados no parecen apropiados para dar una correcta información al paciente

Introduction. Patients are required to fill in a written informed consent document (ICD) before undergoing surgical interventions or invasive examinations on both ethical (professional code of conduct) and legal grounds (Autonomía del Paciente Law 41/2002). ICDs must be specific for each procedure and provide an adequate amount of information in an understandable form. There is widespread agreement in the literature about the information that must be included in an ICD. Readability analysis techniques that have been validated for Spanish are a useful instrument for assessing how comprehensible the ICD will be to the average citizen. Aim. To examine whether the ICDs used in our speciality are appropriate, specific and understandable, and contain suitable information. Materials and methods. We collected samples of the ICDs recommended by the SEAVC (Spanish Society of Angiology and Vascular Surgery) and regional societies. A readability analysis was performed using three parameters that have been validated for such studies in Spanish: the Flesh index (FI), sentence complexity index (SCI) and integrated readability level index (LEGIN). The content was evaluated according to the extent to which it complied with a total of 15 points that ICDs have to include. Results. In all, 16 ICDs concerned with 10 procedures were found. None of the ICDs met the minimum readability criteria according to the FI and six of them fulfilled SCI and LEGIN criteria. None of the ICDs met all the content criteria. Conclusions. We only have ICDs for a scant number of procedures. The formal readability of the informed consent documents analysed is poor. The ICDs analysed do not comply with the requirements regarding content that this type of documents ought to satisfy. The ICDs examined in this study do not seem to offer patients the information they should be given in this kind of document

[Congenital absence of a cervical spine pedicle. Incidental finding in patient with cervical pain. Diagnostic approach by helical CT]. / Agenesia congénita del pediculo en una vértebra cervical. Hallazgo casual en pacientes con cervicalgia. Diagnóstico de certeza mediante TC espiral.

Congenital absence of a cervical pedicle is usually an incidental finding in radiological studies made after trauma in patients with cervical pain. We report the case of a patient with congenital absence of the right pedicle in a cervical vertebra. Recognition of this anomaly is important to avoid confusion with more clinically significant anomalies, such as unilateral facet dislocation, that may result in inappropriate surgical intervention.

[Dilation of the ventriculus terminalis, an infrequent cause of lower back pain. Magnetic resonance findings]. / Dilatación del ventrículo terminal, causa infrecuente de lumbalgia. Hallazgos en resonancia magnética.

INTRODUCTION: Ventriculus terminalis is the name given to a congenital disorder that consists in the appearance of a small oval ependymal cystic cavity in the conus medullaris. It is formed during embryogenesis as a result of the differentiation between the canalisation and regression of the spinal cord. The aim of this study is to describe the findings obtained by magnetic resonance (MR) imaging concerning the dilation of the ventriculus terminalis in a symptomatic patient. CASE REPORT: A 41-year-old female with a three-year history of lower back pain and irradiated pain in the left leg, together with paresthesias. The physical exploration revealed hypoesthesia with a low level of sensitivity in D12, L1 and L2. MR images revealed the presence of a cystic lesion located in the conus medullaris, with a well defined outline, and which was not enhanced following contrast IV. CONCLUSION: The ventriculus terminalis is the ependymal cavity that lies in the conus medullaris. It may present an abnormal dilation and we need to know of its existence, where it is typically located and its signal characteristics in MR in order to be able to diagnose and differentiate it from cystic tumours situated in the same place, which can display a similar appearance in MR images. The therapeutic management of these patients will depend on their clinical progress. MR scanning is fundamental for diagnosing and monitoring symptomatic patients.

Determinación de HDL-colesterol en el laboratorio clínico: estudio comparativo entre el método directo automatizado y dos métodos indirectos / Assay of HDL cholesterol in the clinical laboratory: comparision of a new direct assay with two indurect methodos requiring precipitation

Se ha demostrado que el colesterol circulante transportado por las lipoproteínas de alta densidad (HDL-C) es un factor negativo-de riesgo para sufrir cardiopatía- squémica. La medida de HDL-colesterol es demandada con frecuencia, siendo importante disponer de técnicas simples y fiables para su análisis. En el presente estudio se compara un nuevo método directo y automatizable para determinación de HDL-C con dos métodos indirectos ampliamente utilizados en la rutina clínica. El método directo se basa en el uso de las enzimas colesterol oxidasa y colesterol esterasa modificadas con PEG y a-ciclodextrina y dextrano. Los métodos indirectos se basan, respectivamente, en la precipitación de fracciones lipoprotéicas no-HDL mediante PEG y ácido fosfotungsténico MgCI2. El método directo y ambos métodos indirectos muestran un adecuado nivel de correlación. Al comparar el método directo con el método indirectoPEG, se obtiene una recta de regresión cuya ecuación es y(x)=0.96x-I.38, un coeficiente de regresión r=0.95 y un Error Total de 5.16. Al comparar el método directo con el método de precipitación que utiliza ácido fosfotungsténico MgCI2, la ecuación es y(x)=l.06x-8.32, r=0:97 y el Error Total=7.75. El método de precipitación con PEG ofrece un coeficiente de variación intra-ensayo de 2:I5 por ciento; el método de precipitación con ácido fosfotungsténico/Clmg2+ presenta un coeficiente de variación de 2.49 por ciento; la medida de HDL-C mediante el método directo presenta un coeficiente de variación de I.58 por ciento, una excelente recuperación y una sensibilidad de 3.45 mg/dl de HDL-C, esto último determinado mediante técnica de dilución sucesiva. El volumen de muestra requerido para el método directo es de solo 4ul, frente a los 400 o 500 ul que requieren los métodos indirectos (AU)

[Serum lipids. lipoproteins, and apolipoproteins in adult epileptics treated with carbamazepine, valproic acid, or phenytoin]. / Lípidos, lipoproteínas y apolipoproteínas séricas en epilépticos adultos tratados con carbamacepina, ácido valproico o fenitoína.

INTRODUCTION: It is known that anticonvulsants are able to modify lipid profile; nevertheless the initial studies were performed in patients or polytherapy whereas later investigations were carried out mostly in children. OBJECTIVES: To evaluate serum lipids, lipoproteins and apolipoproteins in adult epileptic patients on monotherapy. MATERIAL AND METHODS: Total cholesterol, triglycerides, low- and high-density lipoprotein cholesterol (including the HDL2 and the HDL3 subfractions) and apolipoproteins A1 and B were measured in 120 epileptics patients treated with carbamazepine (n = 42), sodium valproate (n = 38) and phenytoin (n = 40) and compared with the values of 48 healthy subjects. RESULTS: Most of the measured parameters were significantly higher in patients receiving carbamazepine or phenytoin; carbamazepine-treated subjects showed specifically an increase in HDL2 lipoprotein cholesterol, whereas phenytoin-treated subjects showed specifically an increase of triglycerides; all of the observed alterations, save the increase in HDL lipoprotein cholesterol and apolipoprotein A1, were significant in women but not in men. Carbamazepine nor phenytoin related changes showed any correlation with the dose or the plasma levels of the drugs. No relevant modifications of serum lipids were seen in patients who received sodium valproate. CONCLUSIONS: The observed alterations in serum lipids were associated to the use of anticonvulsants with enzyme inducing activity and showed significant differences between both sexes.

[Growth hormone and its effects on cholesterol and lipoprotein metabolism following surgical intervention (hGH and cholesterol metabolism during surgery)]. / La hormona de crecimiento y sus efectos sobre el metabolismo del colesterol y lipoproteínas postagresión quirúrgica (hGH y metabolismo del colesterol tras la cirugía).

The objective of this work was to determine whether the increase in serum GH, IGF1, glucose and insulin levels caused by the administration of hGH modifies the normal response of cholesterol and lipoproteins to surgical aggression. A prospective, randomized, and double blind study is carried out in 28 patients operated for gallstones and diverticulitis. The control group (n = 15) was not given anything except conventional fluidtherapy in the postoperative period: the patients in the hGH (n = 13) group were also given 8 IU of hGH during the first five days after the intervention. The comparative study of the triglycerides, cholesterol, LDLc, HDL-c, and A-1 B apolipoproteins shows that in the group treated with hGH the normal response of cholesterol and lipoproteins to surgical aggression is attenuated.

Elimination of meat, fish, and derived products from the Spanish-Mediterranean diet: effect on the plasma lipid profile.

UNLABELLED: The effect of eliminating all animal (meat and fish) products except eggs and milk products from the current Spanish-Mediterranean diet was studied in 14 healthy subjects. This dietary manipulation decreased saturated and monounsaturated fat, protein, and cholesterol intakes. During the 2-month intervention period, a decrease in total plasma cholesterol concentrations (4.53 +/- 0.13 vs. 4.29 +/- 0.13 mmol/l, p < 0.05) was observed, mostly as a result of decreased high-density lipoprotein cholesterol levels (1.66 +/- 0.08 vs. 1.47 +/- 0.08 mmol/l, p < 0.05). The decrease in low-density lipoprotein cholesterol levels (2.51 +/- 0.15 vs. 2.43 +/- 0.13 mmol/l) did not reach statistical significance. Nevertheless, there was a significant association between the decrease in cholesterol intake and the decrease in low-density lipoprotein cholesterol levels (r = 0.719, p < 0.01). The decrease in protein intake was also correlated with the decrease in total cholesterol levels (r = 0.629, p < 0.05). Body weight and lean body mass were not modified during the study. Maximal aerobic power and maximal oxygen consumption were not significantly affected by the diet manipulation. IN CONCLUSION: a 2-month change from the current Spanish-Mediterranean diet to an ovolactovegetarian diet in young healthy persons decreases total plasma cholesterol levels, but mainly due to a decrease in high-density lipoprotein cholesterol levels.

Deterioration of the plasma lipid profile during hospitalization of aged non-insulin-dependent diabetic patients. Comparison with non-diabetic control patients.

This study aimed at investigating the changes occurring in the plasma lipid profile of patients with non-insulin-dependent diabetes mellitus (NIDDM) hospitalized for treatment of intercurrent diseases. Twenty-nine non-insulin requiring NIDDM patients (13 men, 16 women; mean age: 67 +/- 2 yrs) and 26 adequately matched patients (12 men, 14 women; mean age: 71 +/- 2 yrs) have been prospectively studied. They were all hospitalized for treatment of various diseases. Diabetic and non-diabetic patients received similar treatment except for intensive insulin therapy in the former group. On admission, diabetic subjects had significantly higher plasma levels of triglycerides and lower levels of HDL cholesterol; during hospitalization, LDL, HDL cholesterol and apo A1 levels increased significantly. In the non-diabetic group, hospitalization and treatment induced significant increases in triglycerides, LDL cholesterol and apo B levels. In conclusion, although insulin treatment during hospitalization of non-insulin requiring NIDDM patients does not fully reverse the abnormal lipid profile, it may help to prevent its further deterioration, particularly by increasing HDL cholesterol levels and hence by decreasing the LDL/HDL cholesterol ratio.

Measurement of apolipoproteins B and A by radial immunodiffusion: methodological assessment and clinical applications.

The clinical evaluation of apolipoproteins is of interest in order to characterize the risk profile for ischemic heart disease both in normolipidemic and hyperlipidemic subjects. In the non-specialized and/or small practice clinical laboratory, the measurement of some apolipoproteins can be undertaken by simple methods of immunological analysis, among which radial immunodiffusion can be of interest due to its simplicity of use and because it does not require specific equipment. In this work several methodological questions concerning the measurement of plasma apolipoproteins B and A by radial immunodiffusion have been addressed; the results show that this method is particularly reliable for the apo B assay. Regression analysis between values obtained with radial immunodiffusion and radioimmunoassay was r = 0.972 for apo B and r = 0.782 for apo A. The recovery rate was above 90% for both apolipoproteins (93.8% for apo B and 99.5% for apo A). The inter and intraassay coefficients of variation were below 5%, and the detection limits were estimated as 9.6 mg/dl for apo A and 6.9 mg/dl for apo B. Neither the ingestion of a standard breakfast (500 Cal, 17 g fat, 120 mg cholesterol) 2 h prior to testing nor freezing the sample significantly affected the measurement of apolipoproteins B and A. Mean plasma concentrations of both apolipoproteins measured by radial immunodiffusion in normo and hyperlipidemic subjects are also presented.