Enfermedad pulmonar obstructiva crónica: morbimortalidad e impacto sanitario / Chronic obstructive pulmonary disease: Morbimortality and healthcare burden

La enfermedad pulmonar obstructiva crónica (EPOC) constituye un problema de salud pública de enorme y creciente importancia por su alta prevalencia, elevada morbimortalidad y costes socioeconómicos. Diversos estudios epidemiológicos españoles cifran la prevalencia en un 10% de la población adulta, pareciendo haberse estabilizado su crecimiento. Con todo, el infradiagnóstico sigue superando el 75%. El diagnóstico en fases de obstrucción leve y moderada se asocia a mayor supervivencia y menores costes (14 años y 9.730 D ), frente a los 10 años de supervivencia y 43.785 D de los pacientes diagnosticados en fases de obstrucción grave. La EPOC constituyó la cuarta causa de mortalidad en España en 2011, si bien las tasas de mortalidad ajustadas han disminuido en la última década más de un 20%, sobre todo en varones. Los pacientes con EPOC avanzada fallecen de la misma, pero los pacientes con EPOC leve o moderada lo hacen por enfermedades cardiovasculares o cáncer (sobre todo de pulmón). Se estima que el coste anual de la enfermedad alcanza los 3.000 millones de euros al año. Estos aumentan con la gravedad espirométrica y se asocian fundamentalmente con las agudizaciones (casi un 60% de los costes directos). La comorbilidad, entendida como la presencia de dolencias que coexisten con la enfermedad de estudio, es mayor en los pacientes con EPOC que en la población general, y condiciona resultados en salud (AU)

Chronic obstructive pulmonary disease (COPD) is an enormous public health problem and of growing importance due to its high prevalence, elevated morbimortality, and socioeconomic costs. Many Spanish epidemiological studies report a prevalence of 10% of the adult population, with its growth appearing to have stabilised. Nevertheless, over 75% of cases are still underdiagnosed. The diagnosis of mild and moderate obstruction is associated with a higher survival and lower costs (14 years and D 9,730) compared to 10 years survival and D 43,785 of patients diagnosed in the severe obstruction phase. COPD was the fourth cause of death in Spain in 2011, although the adjusted mortality rates have decreased more than 20% in the last decade, particularly in males. Patients with advanced COPD die from it, but patients with mild or moderate COPD die due to cardiovascular diseases or cancer (mainly of the lung). It is estimated that the annual cost of the disease is around 3,000 million Euros. These increase with the spirometric severity, and is mainly associated with exacerbations (almost 60% of the direct costs). Comorbidity, that is the presence of diseases that coexist with the studied disease, is higher in patients with COPD than in the general population and affects health results. © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Published by Elsevier España, S.L. All rights reserved (AU)

[Chronic obstructive pulmonary disease: Morbimortality and healthcare burden]. / Enfermedad pulmonar obstructiva crónica: morbimortalidad e impacto sanitario.

Chronic obstructive pulmonary disease (COPD) is an enormous public health problem and of growing importance due to its high prevalence, elevated morbimortality, and socioeconomic costs. Many Spanish epidemiological studies report a prevalence of 10% of the adult population, with its growth appearing to have stabilised. Nevertheless, over 75% of cases are still underdiagnosed. The diagnosis of mild and moderate obstruction is associated with a higher survival and lower costs (14 years and €9,730) compared to 10 years survival and €43,785 of patients diagnosed in the severe obstruction phase. COPD was the fourth cause of death in Spain in 2011, although the adjusted mortality rates have decreased more than 20% in the last decade, particularly in males. Patients with advanced COPD die from it, but patients with mild or moderate COPD die due to cardiovascular diseases or cancer (mainly of the lung). It is estimated that the annual cost of the disease is around 3,000 million Euros. These increase with the spirometric severity, and is mainly associated with exacerbations (almost 60% of the direct costs). Comorbidity, that is the presence of diseases that coexist with the studied disease, is higher in patients with COPD than in the general population and affects health results.

Effects of 7-weeks competitive training period on physiological and mental condition of top level judoists.

AIM: We examined hormonal and haematological parameters and the profile of mood states (POMS) in top level judoists undertaking a 7-week competitive training period in a real contest. METHODS: Participants were 10 top level judoists belonging to the Spanish National Team. Training load was calculated by multiplying the training session intensity by the duration of the training session. The judoists competed in two official events on weeks 3 and 6 of the study. RESULTS: Urinary catecholamines increased at the end of the competitive period. Serum cortisol increased during the weeks in which judoists competed, confirming the existence of and anticipatory cortisol response to exercise; although we failed to find serum testosterone increases. Because of leukocyte values did not change, except monocytes, we speculate that the intensity of training was not sufficiently high to evoke injury to muscle tissue. Anger, tension, and fatigue increased according with training load, suggesting that the training exercise led participants into a negative psychological state. CONCLUSION: Findings indicate that during competitive periods, judoists suffer hormonal and mood changes according to training load and competitive events. Results support the usefulness of monitoring biological and psychological markers during season in order to adjust training loads and periods of recovery.

Effects of different vibration exercises on bench press.

This study was undertaken to analyze the effects of different vibration recovery strategies via feet or hands on the number of repetitions performed and on mean velocity, peak velocity and blood lactate concentration during consecutive bench-press sets. 9 elite judo athletes performed 3 sets of bench press at 60% of one-repetition maximum (1RM), leading to failure and allowing a 180 s rest period between sets. During the rest period, 1 of the 3 following procedures was performed: 150 s rest plus 30 s push-up vibration exercise (Push-up), 150 s rest plus 30 s squat vibration exercise (Squat) or 180 s only rest (Passive). Statistical analysis revealed that the Squat condition resulted in a significant increase in the number of repetitions achieved, in comparison with all other rest strategies. However, kinematic parameters and blood lactate concentration were not affected by vibration. These data suggest that a vibration stimulus applied to the feet, between sets, can result in positive improvements in upper body resistance exercise performance. Although the mechanisms are not fully understood, this positive effect of vibration could be due to an increased motor cortex excitability and voluntary drive.

Tratamiento del carcinoma diseminado de estómago: ¿pauta estándar? / No disponible

No disponible

Comparative study of different methods of inducing acute and chronic hypercalcemia in rats.

Experimental studies are frequently carried out using calcium salt treatment in rats. Modifications in plasma calcium levels could suggest important changes in cellular functions, transmitters and drug responses. Changes during continuous maintenance of hypercalcemia could, on the other hand, be different from those produced by an acute increase in calcemia. Nevertheless, to date no specific studies exist which evaluate and compare the modifications in calcemia and other alterations when different methods of administering acute and chronic calcium are used in rats. This paper presents a method for inducing acute hypercalcemia in Sprague-Dawley rats after intraperitoneal administration of different quantities of CaCl2. Different oral calcium treatments to induce chronic hypercalcemia were also evaluated. Hypercalcemia was more consistent when calcium was administered in both the solid and liquid diets. On day 14 of treatment the highest total and ionic plasma calcium levels appeared in rats fed with CaCO3 in the solid diet (4% Ca) and with CaCl2 in the liquid diet (1.5% Ca). With this treatment hypercalcemia was maintained for 2 months.

[Prevalence of antibodies against the hepatitis C virus among the staff of a general hospital]. / Prevalencia de anticuerpos contra el virus de la hepatitis C en personal de un hospital general.

The prevalence of antibodies against hepatitis C virus (HCV) in 413 hospital staff (57% total staff) was 1.7%. There were no significant differences in the sanitary workers (physicians, nurses and assistants of clinic and laboratory) versus cleaners, office and other non-sanitary workers of hospital staff. The seropositivity to HCV was not related to sex, age, years in occupation and the prevalence of hepatitis B virus serological markers. This relatively low prevalence let suppose than the hospital staff is not a high risk group for HCV infection.

[Serology against Toxoplasma gondii in pregnant women. Development of prevalence rates in the course of 4 years]. / Serología frente a Toxoplasma gondii en mujeres gestantes. Evolución de las tasas de prevalencia a lo largo de cuatro años.

Sera from 1,221 pregnant women were screened for antibodies against Toxoplasma gondii. The prevalence rate of antibodies was 38.9%. We have observed specific IgM antibodies 15 pregnant women (1.2%). The prevalence rate was not increased significantly with the age and number of pregnancies. The seropositivity was reduced significantly in the 4th year studied. The high rate of seronegativity observed in the pregnant women represent a high risk of Toxoplasma infestation.