The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers.

BACKGROUND: Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters. METHODS: A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative. RESULTS: All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%. CONCLUSIONS: The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.

Relación predictiva de los índices de adiposidad visceral y adiposidad disfuncional con el riesgo cardiovascular en población laboral / Predictive relationship of visceral adiposity index (VAI) and dysfunctiuonal adiposity index (DAI) with cardiovascular risk in the spanish working population

Objetivo: estimar la capacidad predictiva de los índices de adiposidad visceral (VAI) y disfuncional (DAI) en riesgo cardiovascular (RCV) de población laboral española. Métodos: análisis descriptivo en 418.343 trabajadores españoles de diferentes sectores durante la vigilancia de la salud en sus empresas. Se calculó el VAI y el DAI ajustándose a sus ecuaciones y el RCV mediante Registre Gironí del Cor (REGICOR), Systematic Coronary Risk Evaluation (SCORE) y estudio DORICA. Se estimó fortaleza asociativa mediante curvas de características operativas del receptor (ROC). El programa estadístico fue SPSS 27.0, considerando significación estadística p < 0,05. Resultados: los valores de RCV con los tres métodos son más elevados en hombres (p < 0,0001). El RCV más alto en mujeres se obtiene con REGICOR (1,58%) y en hombres con Score (11,28%). Con los métodos de valoración de RCV utilizados en ambos sexos, los valores medios de VAI y DAI van aumentando según lo hace el RCV. VAI y DAI son estimadores útiles de RCV en mujeres con DORICA AUC (área bajo la curva)-VAI 0,865 (intervalo de confianza [IC] 95%: 0,836-0,894) y AUC-DAI 0,859 (IC 95%: 0,829-0,888). En hombres, solo muestran moderada capacidad predictiva (valores AUC-VAI 0,774 (IC 95%: 0,768-0,780), AUC-DAI 0,762 (IC 95%: 0,756-0,768). La fortaleza asociativa es baja en ambos sexos con Score y REGICOR (AUC < 0,7). Conclusión: VAI y DAI aumentan sus valores medios según aumenta el RCV estimado con REGICOR, SCORE y DORICA. VAI y DAI tienen elevada capacidad predictiva con el RCV estimado con DORICA en mujeres y moderada fortaleza en hombres. (AU)

Aim: to estimate the predictive relationship of visceral adiposity (VAI) and dysfunctional adiposity (DAI) indices with cardiovascular risk (CVR) in the Spanish working population. Methods: descriptive analysis in 418,343 Spanish workers from different sectors during health monitoring in their companies. VAI and DAI were calculated according to their equations and cardiovascular risk was calculated using Regicor, Score and Dorica. Associative strength was estimated using ROC curves. The statistical programme used was SPSS 27.0, considering statistical significance P<0.05. Results: CVR values with the three methods are higher in men (P<0.0001). The highest CVR in women and men is obtained with Regicor (1.58%) and Score (11.28%), respectively. With the CVR evaluation methods used and in both sexes, the mean values of VAI and DAI increase as CVR increases. VAI and DAI are useful estimators of CVR in women with Dorica AUC -VAI 0.865 (95%CI 0.836-0.894) and AUC-DAI 0.859 (95%CI 0.829-0.888). In men they show only a moderate predictive relationship (AUC values for VAI 0.774 [95%CI 0.768-0.780] AUC DAI 0.762 [95%CI 0.756-0.768]). Strength of association is low in both sexes with Score and Regicor (AUC<0.7). Conclusion: VAI and DAI increase their mean values as estimated CVR increases with Regicor, Score and Dorica. VAI and DAI have a high predictive relationship with estimated CVR-Dorica in women and moderate strength in men. (AU)

Relationship between Abdominal Volume Index and Body Adiposity Index and Scales of Insulin Resistance and Metabolic Syndrome.

Introduction, objectives: Obesity is a global health problem with a great negative impact on health. Among the pathologies caused by obesity are insulin resistance and metabolic syndrome, which constitute an increasingly common health problem in both developed and developing countries. The aim of this study was to examine the relationship between two scales that assess obesity-based on hip circumference-and metabolic syndrome (MetS) and insulin resistance risk scales as predictors of these alterations. MATERIALS, METHODS: A descriptive, cross-sectional study was carried out on 193,462 workers from different Spanish regions and work groups between January 2019 and September 2021. Abdominal volume index (AVI) and body adiposity index (BAI) were evaluated to assess obesity and its association with insulin resistance using three risk scales (TyG index, Triglycerides/HDL, and METS-IR), while their association with metabolic syndrome was determined using the NCEP ATP III, IDF, and JIS models. RESULTS: The results of the ROC curves to determine the predictive value of BAI and AVI in relation to the three criteria evaluated to calculate MetS in all instances presented a higher area under the curve (AUC) for AVI. The high values of AVI stand out for predicting MetS when applying the IDF criteria. The cut-off point in women was 13.70 with a Youden index of 0.802, whereas in men, the cut-off point was set at 17.59 with a Youden index of 0.672. Regarding the relationship of BAI and AVI with insulin resistance risk scales for both sexes, the AUC only revealed high values when using the METS-IR formula for both AVI and BAI. The AVI cut-off points to predict high values of insulin resistance risk scales in women were established at 13.12 with a Youden index of 0.722. In men, the cut-off point was 17.59, with a Youden index of 0.626. The BAI cut-off points in women were set at 33.88 with a Youden index of 0.748. In men, the cut-off point was 27.91, with a Youden index of 0.598. CONCLUSIONS: AVI demonstrated its value as a predictor of metabolic syndrome while exclusively applying the IDF criteria. AVI and BAI demonstrated their value as predictors of high values of insulin resistance risk scales only in the case of METS-IR. This predictive value is also higher in women.

[Predictive estimation of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) for metabolic syndrome in a working population]. / Estimación predictiva en población laboral del Índice de adiposidad visceral (VAI) y adiposidad disfuncional (DAI) en síndrome metabólico.

OBJECTIVE: To evaluate metabolic syndrome using three methods proposed by  recognizedinternational institutions, and the visceral adiposity (VAI) and dysfunctional adiposity (DAI) indices for prediction and prevalence estimation in working populations. METHODS: Cross-sectional study in workers from different Spanish autonomous communities who underwent a health examination between January 2019 and September 2021 at four occupational risk prevention services. Metabolic syndrome was evaluated according to criteria from the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III), the International Diabetes Federation (IDF) and  the Joint Interim Statement (JIS). VAI and DAI values were calculated using their specific formulas and their predictive capacity was measured using ROC curves. The SPSS 27.0 program was used, with statistical significance level set at p< 0.05. RESULTS: 418 343 workers were included, mostly men (58.8%), average age between 30 and 49 years (58.0%), social class III, mostly manual workers (75.9%) and nonsmokers (66.9%). The prevalence of metabolic syndrome differed  depending on the criteria used, being higher in men with IDF and JIS, and in women with ATPIII. For the three definitions of metabolic syndrome, the values of the area under the curve were > 0.8 (>80%). The highest VAI was obtained with the JIS, and the highest DAI with the ATPIII. The highest confidence index was for ATPIII and JIS. CONCLUSIONS: The VAI and ICD adiposity indices show high predictive capacity in metabolic syndrome with all three criteria used and can be useful for prevention activities in occupational health.

Introducción: Evaluar el síndrome metabólico utilizando tres métodos propuestos por instituciones internacionales de referencia, y los índices de adiposidad visceral (VAI) y adiposidad disfuncional (DAI), en la predicción y estimación de la prevalencia en población laboral. Métodos: Estudio transversal en trabajadores de distintas comunidades autónomas españolas a los que se les realizó un examen de salud entre enero 2019 y septiembre 2021. Se evaluó el síndrome metabólico con criterios del National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III), International Diabetes Federation (IDF) y Joint Interin Statement (JIS). Se calcularon los valores de VAI y DAI mediante sus fórmulas específicas y su capacidad predictiva mediante curvas ROC. Se utilizó el programa SPSS 27.0, considerando significación estadística p< 0,05. Resultados: Se incluyeron 418 343 trabajadores, la mayoría hombres (58,8%), de edad media entre 30 y 49 años (58,0%), clase social III, tipo de trabajo manual (75,9%) y no fumadores (66,9%). La prevalencia de síndrome metabólico muestra diferencias según el criterio utilizado, siendo superior en hombres con IDF y JIS, y en mujeres con ATPIII. Para las tres definiciones de síndrome metabólico, los valores del área bajo la curva fueron > 0,8 (>80%). El VAI más elevado se obtuvo con JIS, y el DAI más alto con ATPIII. El índice de mayor confianza fue para ATPIII y JIS. Conclusiones: Los índices de adiposidad VAI y DAI muestran una elevada capacidad predictiva del síndrome metabólico con los tres criterios utilizados y pueden ser de utilidad preventiva en salud laboral.

Occupational and Leisure Physical Activity on Cardiovascular Risk and Body Composition Among Courier Workers.

OBJECTIVE: There is some controversy about the beneficial effects of occupational physical activity (OPA) on cardiovascular risk (CVR). The main aim of this study was to explore the effect of the combination of different frequencies of leisure-time physical activity (LTPA) and two types of OPA on CVR and body composition, and whether the association between physical activity (PA) and CVR was mediated by visceral adipose tissue (VAT). METHODS: This cross-sectional study included data from 2516 couriers living in Spain, delivering either by motorbike or foot, and practicing LTPA never, occasionally, or regularly. Couriers were classified into six categories according to LTPA and OPA; body composition was assessed by Bioelectrical Impedance, and CVR by the Framingham equation. General linear models were performed to explore the association between different categories with each outcome (CVR and body composition) and the possible role of VAT as a mediator between PA and CVR. RESULTS: Compared with the most sedentary group (motorbike couriers that never practice PA), walking couriers who practice regular PA presented the lowest CVR [ß -1.58 (95% CI -2.31; -0.85)] and the lowest VAT [ß -2.86 (95% CI -3.74; -1.98) followed by the motorbike couriers who practiced regular PA [ß -0.51 (95% CI -1.00; -0.03) for CVR and ß -2.33 (95% CI -2.91; -1.75) for VAT]. The association between PA and CVR was partially mediated by VAT. CONCLUSION: The present results indicated that both OPA and LTPA are protective factors for CVR and play an important role on VAT accumulation.

Influencia de hábitos de vida y variables socio-demográficas en trabajadores españoles / Influence of lifestyle habits and socio-demographic variables in spanish workers

Justificación: Se conocen muchos factores que influyen en el riesgo cardiovascular, sin embargo, hay otros cuya influencia no está tan bien delimitada. Objetivo: Conocer la influencia de diferentes factores de riesgo en las enfermedades cardiovasculares. Material y Métodos: Estudio descriptivo transversal en 1.457 trabajadores de Mallorca. Para cada trabajador se elaboró una hoja de recogida de datos que incluía diferentes variables sociodemográficas, antropométricas, analíticas y clínicas. Los datos se analizaron mediante un análisis bivariante y multivariante. Resultados: En general, los individuos con una alta adherencia a la dieta mediterránea y con altos niveles de actividad física presentaron los mejores valores en todas las variables analizadas relacionadas con el riesgo cardiovascular. Además, estos mismos individuos también presentaron una menor prevalencia de valores alterados de los parámetros estudiados. Ser menor de 50 años y ser mujer fue un factor protector para no presentar valores elevados en los parámetros asociados al riesgo cardiovascular. Conclusiones: La dieta, la actividad física, la edad y el sexo tienen una influencia directa sobre las variables asociadas al riesgo cardiovascular. (AU)

Justification: Many factors that influence cardiovascular risk are known and there are others whose influence is not so well defined. Objective: To know the influence of different risk factors in cardiovascular diseases. Materials and Methods: A cross-sectional descriptive study in a sample of 1.457 workers from Mallorca. For each worker, a data collection sheet was prepared that included different sociodemographic, anthropometric, analytical and clinical variables. Data were analyzed using a bivariate and multivariate analysis. Results: In general, individuals with a alto adherence to a Mediterranean diet and with alto levels of physical activity presented the best values in all the analyzed variables related to cardiovascular risk. Furthermore, these same individuals also presented a lower prevalence of altered values of the parameters studied. Being under 50 years of age and being a woman was a protective factor against presenting alto values in parameters associated to cardiovascular risk. Conclusions: Diet, physical activity, age and sex have a direct influence on the variables associated to cardiovascular risk. (AU)

Terapias complementarias en migraña y variables relacionadas. Encuesta Europea / Complementary therapies in migraine and related variables. European Survey

Objetivo: valorar el uso de terapias alternativas no farmacológicas en migraña y variables relacionadas. La migraña afecta a una de cada diez personas en el mundo, con aumento creciente y mayor prevalencia entre mujeres de zonas urbanas. Aunque los tratamientos habituales son farmacológicos, se ha incrementado el uso de terapias alternativas no farmacológicas en migraña y variables relacionadas. Materiales y métodos: estudio observacional transversal mediante encuesta anónima vía web a 3.342 pacientes de países europeos sobre el uso de terapias alternativas para tratamiento de migraña. Variables de estudio: edad, género, país, tipo de localidad, nivel de estudios, ámbito rural o urbano y respuesta al tratamiento. Resultados: la utilización de terapias alternativas en migraña es un fenómeno creciente, con mayor uso en pacientes entre 41-60 años y estudios superiores. Conclusiones: en migraña se observan diferencias por edad, género, nivel cultural y país de procedencia. El uso de la medicina complementaria como alternativa terapéutica en la migraña es poco habitual y se debería indagar con mayor profundidad estableciendo relaciones que permitan apoyar al paciente afectado y priorizar las de mayor evidencia científica..(Au)

Objective: to evaluate the use of alternative non-pharmacological therapies in migraine and related variables. Migraine affects one in ten people worldwide, with a growing increase and a higher prevalence among women in urban areas. Although the usual treatments are pharmacological, the use of alternative techniques is increasing. Materials and methods: cross-sectional observational study by anonymous web survey of 3,342 patients from European countries on the use of alternative therapies. Study variables: age, gender, country, type of locality, educational level, rural or urban setting and treatment response. Results: the use of alternative therapies in migraine treatment is a growing phenomenon, with greater use in patients between 41-60 years of age and higher education. Conclusions: in Migraine, differences are observed by age, gender, cultural level and country of origin. The use of complementary medicine as an therapeutic alternative in migraine is uncommon and should be investigated in greater depth, establishing relationships that allow supporting the affected patient and prioritizing, if possible, some over others with scientific evidence..(Au)

[Preventive Aspects for Migraine and the Workplace: A European Survey]. / Aspectos preventivos en migraña y trabajo. Encuesta europea.

INTRODUCTION: Workplace health promotion integrates initiatives in health and safety in the occupational field, with personal improvements, increased productivity and lower risks and social cost, especially with respect to migraine headaches, a neurological disorder affecting approximately 11% of the population. The objective of this study was to know the preventive resources available to workers with migraine headaches and the preventive management options in their companies. METHOD: Cross-sectional observational study of 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany and other European Union countries, conducted through an anonymous survey on the web of the European Migraine & Headache Alliance (EMHA-web), from September 2018 to January 2019. RESULTS: Occupational stress (77.65%) and use of computer monitors (63.87%) are the most common risks described by workers with migraine. About. 43.71% of workers are not familiar with the type of occupational health service present in their company, 49.06% do not have a medical service; 67.67% reported no work-related limitations due to migraine, neither dismissal nor non-renewal of their contract (88.29%), but 42.14% had experienced some conflict due to decreased productivity; 26.54% were unaware of the concept of vulnerable workers or had not requested this status because of their migraine (63.8%), nor had.

INTRODUCCIÓN: La promoción de la salud en el trabajo integra las iniciativas en salud y seguridad en ámbito ocupacional, con mejoras personales, incremento de productividad y menores riesgos y gastos sociales, especialmente en migraña, como enfermedad neurológica con prevalencia estimada en el 11% de la población. El objetivo de este trabajo fue conocer las condiciones preventivas de los trabajadores con migraña y las opciones de gestión preventiva en sus empresas. MÉTODO: Estudio observacional transversal realizado en 3.342 pacientes de España, Italia, Francia, Portugal, Irlanda, Reino Unido, Alemania y otros países de la UE mediante encuesta anónima en la web de la European Migraine & Headache Alliance(EMHA-web), entre septiembre de 2018 y enero de 2019.RESULTADOS: Estrés laboral (77.65%) y uso de PVD (63.87%) son los riesgos más referidos por los trabajadores con migraña. El 43.71% de trabajadores desconoce el tipo de Servicio de Prevención de su empresa, 49.06% no dispone de servicio médico; el 67.67% no ha tenido impedimentos de acceso laboral por migraña, ni despido o no renovación del contrato (88,29%), pero el 42,14% tuvo algún conflicto por pérdida de productividad; el 26,54% desconoce el concepto de especial sensibilidad o no lo ha solicitado por migraña (63,8%), ni ha demandado modificaciones laborales (67,64%) o cambio de puesto de trabajo (80,89%); un 55,42% no se ha sentido comprendido ni apoyado por su empresa en sus limitaciones por migraña, pero sí por los compañeros (63,07%). CONCLUSIÓN:Se observa una deficiente información preventiva y escaso uso de las opciones de gestión adaptativa en las empresas para personas con migraña.

Aspectos preventivos en migraña y trabajo. Encuesta europea / Preventive Aspects for Migraine and the workplace: A European Survey

INTRODUCCIÓN: La promoción de la salud en el trabajo integra las iniciativas en salud y seguridad en ámbito ocupacional, con mejoras personales, incremento de productividad y menores riesgos y gastos sociales, especialmente en migraña, como enfermedad neurológica con prevalencia estimada en el 11% de la población. El objetivo de este trabajo fue conocer las condiciones preventivas de los trabajadores con migraña y las opciones de gestión preventiva en sus empresas. MÉTODO: Estudio observacional transversal realizado en 3.342 pacientes de España, Italia, Francia, Portugal, Irlanda, Reino Unido, Alemania y otros países de la UE mediante encuesta anónima en la web de la European Migraine & Headache Alliance (EMHA-web), entre septiembre de 2018 y enero de 2019. RESULTADOS: Estrés laboral y uso de PVD son los riesgos más referidos por los trabajadores con migraña. El 43.71% de trabajadores desconoce el tipo de Servicio de Prevención de su empresa, 49.06% no dispone de servicio médico; el 67.67% no ha tenido impedimentos de acceso laboral por migraña, ni despido o no renovación del contrato, pero el 42,14% tuvo algún conflicto por pérdida de productividad; el 26,54% desconoce el concepto de especial sensibilidad o no lo ha solicitado por migraña; un 55,42% no se ha sentido comprendido ni apoyado por su empresa en sus limitaciones por migraña, pero sí por los compañeros. CONCLUSIÓN: Se observa una deficiente información preventiva y escaso uso de las opciones de gestión adaptativa en las empresas para personas con migraña

INTRODUCTION: Workplace health promotion integrates initiatives in health and safety in the occupational field, with personal improvements, increased productivity and lower risks and social cost, especially with respect to migraine headaches, a neurological disorder affecting approximately 11% of the population. The objective of this study was to know the preventive resources available to workers with migraine headaches and the preventive management options in their companies. METHOD: Cross-sectional observational study of 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany and other European Union countries, conducted through an anonymous survey on the web of the European Migraine & Headache Alliance (EMHA-web), from September 2018 to January 2019. RESULTS: Occupational stress (77.65%) and use of computer monitors (63.87%) are the most common risks described by workers with migraine. About. 43.71% of workers are not familiar with the type of occupational health service present in their company, 49.06% do not have a medical service; 67.67% reported no work-related limitations due to migraine, neither dismissal nor non-renewal of their contract (88.29%), but 42.14% had experienced some conflict due to decreased productivity; 26.54% were unaware of the concept of vulnerable workers or had not requested this status because of their migraine (63.8%), nor had they demanded job accommodations (67.64%) or job change (80.89%); 55.42% did not feel understood or supported by their company in their limitations due to migraine, although they did feel they were supported by their colleagues (63.07%). CONCLUSION: We found that preventive resources and information were deficient, and that there was little use of adaptive management options for workers with migraine in their companies

Revisión bibliográfica sobre la eficacia del ejercicio excéntrico como tratamiento para la tendinopatía del tendón de Aquiles / Efficacy of eccentric exercise as a treatment for Achilles Tendinopathy: literature review

INTRODUCCIÓN: las tendinopatías son consecuencia de cargas excesivas en el tendón, por lo que son frecuentes en el ámbito laboral debido a movimientos repetitivos y posturas forzadas. La tendinopatía de Aquiles se caracteriza por una respuesta de curación desorganizada, asociada a cierto grado de neovascularización, siendo el tratamiento conservador la estrategia inicial. OBJETIVOS: realizar una revisión bibliográfica para analizr la efectividad de los tratamientos utilizados en la tendinopatía aquilea a partir de los estudios incluidos. MATERIAL Y MÉTODOS: revisión bibliográfica de artículos científicos consultando las bases de datos PubMed y The Cochrane Library utilizando las palabras clave "((tendinopathy) AND (Achilles Tendon) AND (exercise OR exercise therapy OR Muscle Stretching Exercises OR physical therapy modalities OR rehabilitation))". RESULTADOS: Se obtuvieron 635 refrencias en Pubmed y 134 en Cochrane Library, de los cuales 14 cumplieron los criterios de inclusión. Los estudios seleccionados mostraron que, en general, los ejercicios excéntricos son una terapia efectiva aplicada entre 6 y 12 semanas en la tendinopatía de Aquiles, sin combinar o combinada con la plataforma de vibración, complementos nutricionales, tratamiento de tejidos blandos, terapia de láser o terapia de ondas de choque. CONCLUSIÓN: la revisión muestra que el ejercicio excéntrico presenta los mejores resultados en el tratamiento de la tendinopatía aquilea

INTRODUCTION:Tendinopathies are a consequence of excessive tendon loads, so they are frequent both in athletes and in the workplace due to repetitive movements and forced postures. Achilles tendinopathy is characterized by a disorganized healing response, associated with a certain degree of neovascularization, with conservative treatment being the initial strategy. OBJECTIVES: To carry out a bibliographic review in order to identify the different eccentric exercise protocols and their effectiveness in Achilles tendinopathy. METHODS: A literature review of scientific articles has been implemented in the databases of PubMed and The Cochrane Library databases using the key words "((tendinopathy) AND (Achilles Tendon) AND (exercise OR exercise therapy OR Muscle Stretching Exercises OR physical therapy modalities OR rehabilitation))". RESULTS: 635 studies were obtained from Pubmed and 134 from Cochrane Library of which 14 met all the inclusion criteria. Selected studies showed that, in general, eccentric exercises are an effective therapy applied between 6 and 12 weeks in Achilles tendinopathy, either on their own or combined with the vibration platform, nutritional supplements, soft tissue treatment, laser therapy or shock wave therapy. CONCLUSION: this review showed eccentric exercise has a great scientific evidence in Achilles tendinopathy treatment

Tratamiento sintomático en migraña. Fármacos utilizados y variables relacionadas. Resultados de la encuesta europea sobre trabajo y migraña / Symptomatic treatment for migraña. Drugs used and related variables. Results of the european survey on work and migraine

OBJETIVOS: Conocer el uso de tratamientos sintomáticos para las crisis de migraña en distintos países de Europa y las diferencias que se observan en función de variables sociales y demográficas. MATERIAL Y MÉTODOS: Estudio observacional transversal mediante encuesta anónima vía web a 3342 pacientes de España, Italia, Francia, Portugal, Irlanda, Reino Unido, Alemania y otros países de la Unión Europea. Variables de estudio: edad género, país, tipo de localidad, nivel de estudios y ámbito rural o urbano. Los tratamientos sintomáticos que se recogen son: analgésicos simples, antinflamatorios no esteroideos, triptanes, otros tratamientos, varios tratamientos, sin tratamiento, desconocimiento de tratamiento sintomático. RESULTADOS: En analgésicos simples los mayores consumidores están entre 41-60 años (p < 0,0001). España y Alemania son los países con mayor uso (p < 0,0001). El cuanto a los antinflamatorios el mayor uso se da entre 21-60 años (p < 0,0001). España, Italia y Alemania son los países que mayor uso hacen de ellos (p < 0,0001) y mayor consumo en pacientes con estudios superiores (p < 0,003). El uso de triptanes muestra relación con la edad y el género, mayor uso entre 21-60 años (p < 0,0001) y en mujeres (p < 0,0001). Por países, el mayor consumo es en Alemania, resto de países de Unión Europea, España y Reino Unido (p < 0,0001). Mayor consumo en pacientes que viven en ciudades de más de 500 habitantes (p < 0,010) y con estudios medios o superiores (p < 0,0001). En el grupo de estudios medios y superiores se encuentra por contraste el mayor porcentaje de pacientes que desconocen qué es un tratamiento sintomático (p < 0,0001). CONCLUSIONES: Existe una gran variabilidad de los resultados en cada país y se modifican en función de distintas condiciones sociales y demográficas, siendo la edad, el género, el ámbito rural o urbano y el nivel cultural los factores que más condicionan el uso de cada medicación sintomática para las crisis de migraña

GOALS: To know the use of migraine crisis symptomatic treatments in different countries of Europe and the differences observed depending on social and demographic variables. MATERIAL AND METHODS: Cross-sectional observational study by anonymous web survey to 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany and other countries of the European Union. Study variables: age, gender, country, type of location, level of studies and rural or urban area. The symptomatic treatments that are collected are: simple analgesics, non-steroidal anti-inflammatory drugs, triptans, other treatments, several treatments, without treatment, ignorance of symptomatic treatment. RESULTS: For simple analgesics, the largest consumers are between 41-60 years (p < 0.0001). Spain and Germany are the countries with the highest use (p < 0.0001). For the anti-inflammatories, the greatest use is between 21-60 years (p < 0.0001). Spain, Italy and Germany are the countries that make the most use of them (p < 0.0001) and higher consumption in patients with higher education (p < 0.003). Triptans use shows a relationship with age and gender, greater use between 21-60 years (p < 0.0001) and in women (p < 0.0001). By countries, the highest sintomáconsumption is in Germany, the rest of the European Union countries, Spain and the United Kingdom (p < 0.0001). Greater consumption in patients living in cities with more than 500 inhabitants (p < 0.010) and with medium or higher studies (p < 0.0001). In the group of middle and upper studies, we find, by contrast, the highest percentage of patients who do not know what a symptomatic treatment is (p < 0.0001). CONCLUSIONS: The result varies according each country greatly and they are modified depending on different social and demographic conditions, being the age, gender, rural or urban environment and cultural level the factors that most affect the use of each symptomatic medication for the migraine crisis

Cuestionarios de valoración funcional en traumatología / Trauma functional assessment questionnaires

RESUMEN Introducción: Las enfermedades musculoesqueléticas son dolencias de alta prevalencia, impacto y repercusión. La historia clínica y las pruebas complementarias son las primeras pautas para diagnosticarlas. Se recomienda el uso de cuestionarios para la valoración de las limitaciones e impacto en la calidad de vida de los pacientes. Objetivo: Valorar el uso y eficacia de los cuestionarios en traumatología. Métodos: Se revisaron las bases de datos Medline, Pubmed. Se obtuvieron 32 publicaciones, fundamentalmente, en inglés, aunque también en español y otros idiomas, realizadas entre 2001-2018, que recogen la experiencia de los investigadores con el uso de los cuestionarios. Los términos de búsqueda empleados fueron: Musculoskeletal Disorders, Musculoskeletal pain; and Foot and Ankle, hip and knee, Upper Extremity, low back pain; and disability, quality of life questionnaires and assessment tool. Resultados: Se han revisado 46 cuestionarios: 4 de calidad de vida, 16 de miembro superior (1 general y 15 por localización de la lesión), 19 de miembro inferior (4 generales y 15 por localización de la lesión) y 7 para raquis. Conclusiones: No hay acuerdo en los autores sobre cuál es el mejor cuestionario para la valoración de impacto y repercusión, y se combinan varios de ellos. La elección del cuestionario y el que sea genérico (de calidad de vida) o específico (de miembro superior, inferior o raquis), está en consonancia con el objetivo buscado en la investigación, la experiencia del investigador, su uso clínico y tiempo necesario para cumplimentarlo(AU)

ABSTRACT Introduction: Musculoskeletal diseases are ailments of high prevalence, impact and impact. The medical record and the complementary tests are the first guidelines to diagnose them. The use of questionnaires is recommended to assess the limitations and impact on the quality of life of patients. Objective: To assess the use and effectiveness of traumatology questionnaires. Methods: Medline, Pubmed databases were reviewed. We recovered 32 publications mainly in English, but also in Spanish and other languages, made from 2001 to 2018. These publications collect the experience of researchers with the use of questionnaires. The search terms used were Musculoskeletal Disorders, Musculoskeletal pain; and Foot and Ankle, hip and knee, Upper Extremity, low back pain; and disability, quality of life questionnaires and assessment tool. Results: Forty six questionnaires were reviewed. Four on quality of life, 16 on the upper limbs (one general and 15 by location of the lesion), 19 on the lower limbs (four general and 15 by location of the lesion) and 7 on spine. Conclusions: There is no consensus among the authors on which is the best questionnaire for assessing of the impact and repercussion. Several of them are combined. The choice of the questionnaire and the one that is generic (on quality of life) or specific (on upper, lower limbs or spinal) is in line with the objective sought in this research, the researcher´s experience, clinical use and the time needed to fill it out(AU)

RÉSUMÉ Introduction: Les troubles musculo-squelettiques sont des affections dont la prévalence, l'impact et le retentissement sont élevés. Le dossier médical et les examens complémentaires sont les premières orientations pour les diagnostiquer. L'emploi des questionnaires pour évaluer les limitations et l'impact sur la qualité de vie des patients est recommandé. Objectif: Évaluer l'emploi et l'efficacité des questionnaires en traumatologie. Méthodes: On a consulté les bases de données Medline et PubMed. On a obtenu 32 publications notamment en anglais, mais aussi en espagnol et d'autres langues, parues entre 2001-2018, recueillant toute l'expérience des chercheurs dans l'usage des questionnaires. Les termes de recherche utilisés ont été: Musculoskeletal Disorders, Musculoskeletal pain ; and Foot and Ankle, hip and knee, Upper Extremity, low back pain ; and disability, quality of life questionnaires and assessment tool. Résultats: Sur 46 questionnaires, on a révisé 4 concernant la qualité de vie, 16 concernant les membres supérieurs (1 de sujet général et 15 de localisation de la lésion), 19 concernant les membres inférieurs (4 de sujet général et 15 de localisation de la lésion), et 7 concernant le rachis. Conclusions: Les auteurs ne sont pas arrivés à un consensus sur le meilleur questionnaire pour évaluer l'impact et le retentissement; on a fait une combinaison de plusieurs d'entre eux. La sélection d'un questionnaire et le fait qu'il soit générique (qualité de vie) ou spécifique (membre supérieur, inférieur ou rachis) ont été en concordance avec l'objectif de la recherche, l'expérience du chercheur, l'usage clinique et le temps nécessaire pour le compléter(AU)

Alcohol consumption in Spanish mental health patients vs. working population / Consumo de alcohol en España en pacientes de unidades de salud mental versus trabajadores en general

Abstract Introduction: Alcohol consumption has a high prevalence in society and its chronic consumption is one of the main factors related to health condition in an individual, along with other aspects concerning lifestyle. Regarding the health-disease correlation, it is one of the main determinants of health, from an epidemiological point of view, and has been a traditional object of study from different perspectives and in diverse population groups. Objective: To compare consumption patterns and related variables in two different groups: patients in mental health units and workers in general. Materials and methods: Cross-sectional study in a population of 1 180 service workers and 304 patients in a mental health unit. Sociodemographic and work aspects, as well as pattern of alcohol consumption were analyzed for both populations. Results: Differences in both groups were observed regarding the number of consumers, quantity of consumption and type of beverages consumed, differences that disappear, in part, when comparing groups of workers of both population samples. Conclusions: Differences in the consumption pattern of both populations lead to different preventive-assistance strategies and to the need for implementing coordinated actions by specific programs among those affected.

Resumen Introducción. El consumo de alcohol tiene una elevada prevalencia en la sociedad y su consumo crónico es uno de los principales factores relacionados con el estado de salud de los individuos, junto a otros aspectos concernientes al estilo de vida. Debido a su importancia, este tema ha sido objeto tradicional de estudio desde diferentes perspectivas epidemiológicas y en diversos colectivos poblacionales. Objetivo. Realizar una comparativa de patrones de consumo y variables relacionadas en dos colectivos diferenciados: pacientes de unidades de salud mental y trabajadores en general. Materiales y métodos. Estudio transversal realizado en una población de 1 180 trabajadores del sector servicios de la administración pública y 304 pacientes de una unidad de salud mental. Se analizaron variables sociodemográficas y laborales y el patrón de consumo de alcohol. Resultados. Existen diferencias en ambos colectivos en cuanto al número de consumidores, cantidad de consumo y tipo de bebidas consumidas, diferencias que desaparecen en parte cuando se comparan colectivos de trabajadores de ambas muestras poblacionales. Conclusiones. Las diferencias en el patrón de consumo de ambas poblaciones orientan hacia actuaciones preventivo-asistenciales distintas en ambos grupos y hacia una necesidad de implementar actuaciones coordinadas entre todos los afectados mediante programas específicos.

Apnea obstructiva del sueño valorada con los cuestionarios Epworth y Stop-Bang y su relación con síndrome metabólico / Obstructive sleep apnea assessed with Epworth and Stop-Bang questionnaires and its relationship with metabolic syndrome

Resumen: ANTECEDENTES El síndrome metabólico se define como un grupo de afecciones que implican incremento de riesgo de enfermedad cardiovascular y diabetes tipo 2. Su prevalencia va en aumento y es una prioridad preventiva en la comunidad científica. OBJETIVO cuantificar las horas de sueño y conocer el riesgo de síndrome de apnea-hipopnea obstructiva del sueño y su relación con síndrome metabólico en trabajadores. MATERIAL Y MÉTODO Estudio epidemiológico transversal, efectuado en trabajadores de la Administración Pública española durante los reconocimientos de vigilancia periódica de la salud de enero a diciembre de 2015. Se valoró el riesgo de síndrome de apnea-hipopnea obstructiva del sueño mediante los cuestionarios Epworth y Stop-Bang y su influencia en el síndrome metabólico con criterios de la Federación Internacional de Diabetes (IDF) y Adult Treatment Panel III (ATP III). RESULTADOS Se incluyeron 1110 pacientes; se encontró que el número de horas de sueño no guarda relación con la existencia mayor de síndrome metabólico en población trabajadora. La detección de síndrome de apnea-hipopnea obstructiva del sueño con la prueba Epworth y con Stop-Bang mostró relación significativa con la existencia de síndrome metabólico con ambos criterios (IDF y ATP III). CONCLUSIONES El mayor riesgo de síndrome de apnea-hipopnea obstructiva del sueño muestra relación estadística con mayor prevalencia de síndrome metabólico.

Abstract: BACKGROUND Metabolic syndrome includes a group of conditions involving an increased risk of developing cardiovascular disease and type 2 diabetes. Its growing prevalence makes it a preventive priority in the scientific community. OBJECTIVE To quantify sleep hours and to know the risk of sleep apnoea detected and the relationship with the metabolic syndrome in workers. MATERIAL AND METHOD An epidemiological cross-sectional study was done in 1110 workers in the Spanish Public Administration during periodic health surveillance from January to December 2015. The risk of presenting nocturnal apnoea was assessed using Epworth and Stop-Bang questionnaires, and their influence on metabolic syndrome with International Diabetes Federation (IDF) and Adult Treatment Panel III (ATP III) criteria. RESULTS The number of hours of sleep is not related to the greater presence of metabolic syndrome in the working population. The detection of obstructive sleep apnoea-hypopnea syndrome with Epworth and Stop-Bang questionnaires showed significant relationship with metabolic syndrome with IDF and ATP III criteria. CONCLUSIONS The highest risk of obstructive sleep apnoea-hypopnea syndrome assessed shows statistic relation to a higher prevalence of metabolic syndrome.

[Disability leave and sick leave in Spain. 2016 legislative update]. / Discapacidad e incapacidad laboral en España. Actualización legislativa 2016.

In Spanish, the concepts of discapacidad (disability leave) and incapacidad (sick leave) jointly refer to the impairment of a person due to injuries, diseases or deficiencies that limit their activity in a social, personal or occupational field. However, this common link does not imply that both concepts are the same. Statistical data from INE (Instituto Nacional de Estadística: Statistic National Institute) show that Spain had in 2015 3.85 million persons with a disability (59.8% were women). Statistical data from 2015 from INSS (Instituto Nacional de Seguridad Social: Social Security National Institute) show high levels in the number of processes and in workers affected by temporary sick leave, with social costs to the social security system. Both concepts have been updated: about disability leave, Law 39/2006 adjusted terminology by avoiding the use of concepts with discriminating or pejorative connotation. Regarding sick leave, the Ley General de Seguridad Social (General Social Security Law)has been amended and came into effect in January, 2016. It is necessary to know and distinguish these aspects for a better administrative management, and a more oriented information to the affected patient.

Los conceptos de discapacidad e incapacidad hacen referencia conjuntamente al menoscabo de una persona por lesiones, enfermedades o deficiencias que limitan su actividad en el ámbito social, personal o laboral. Pero este nexo común no implica equiparación entre ambos. Datos estadísticos del 2015 del Instituto Nacional de Estadística (INE) muestran en España 3.85 millones de personas con alguna discapacidad, el 59.8% mujeres. Datos estadísticos del 2015 del Instituto Nacional de la Seguridad Social (INSS), tanto en número de procesos, como de trabajadores afectados por incapacidad muestran cifras elevadas, con costos sociales en prestaciones a cargo de la seguridad social. Ambos conceptos han sido objeto de actualización legislativa: en discapacidad, la Ley 39/2006 ajusta la terminología y evita el uso de conceptos con connotación peyorativa o discriminativa. En incapacidad, la Ley General de la Seguridad Social ha sido modificada y ha entrado en vigor en enero de 2016. Es necesario conocer y diferenciar estos aspectos para una mejor gestión administrativa, e información más orientada al paciente afectado.

Riesgo cardiovascular y obesidad en el síndrome de apnea del sueño valorado con el cuestionario Stop-Bang / Cardiovascular risk and obesity in sleep apnea syndrome assessed with the Stop-Bang questionnaire

Introducción: Los trastornos durante el sueño engloban un conjunto de procesos diversos, de los que el más prevalente es el síndrome de apnea-hipopnea del sueño (SAHS). La prevalencia del SAHS ha aumentado en todo el mundo, y tiene importante repercusión sociosanitaria por riesgo cardiometabólico aumentado atribuido a la obesidad y al síndrome metabólico asociado. Material y método: Estudio epidemiológico transversal en 1.110 trabajadores de empresas del sector servicios de la Administración Pública del área mediterránea española (Islas Baleares y Comunidad Valenciana), realizado entre enero a diciembre de 2015. Se calcula el riesgo cardiovascular con los índices de Castelli, Kannel y TG/HDL y la prevalencia de obesidad mediante el índice de masa corporal, perímetro de cintura, índice cintura-altura y grasa visceral. Se valora el riesgo de SAHS mediante el cuestionario Stop-Bang. Resultados: El 77% de los pacientes tienen un riesgo bajo de SAHS frente al 23% con riesgo intermedio-alto. Todos los parámetros de obesidad muestran asociación estadísticamente significativa (p valor < 0,001), con riesgo intermedio/alto de SAHS. Hay mayor prevalencia de obesidad cuanto peor es la calidad del sueño. Se observa relación estadísticamente significativa entre el riesgo de SAHS y el cardiovascular con los índices aterogénicos estudiados. Conclusiones: Un 23% de los trabajadores presentaban riesgo intermedio/alto de SAHS. Los resultados de este estudio apoyan la relación del SAHS con el incremento del RCV y con los parámetros de obesidad. Estudios posteriores prospectivos en diversos sectores productivos pueden resultar de utilidad para confirmar los resultados obtenidos en este trabajo (AU)

Introduction: Sleep disorders include a number of different processes, of which the most prevalent is the sleep apnea-hypopnea syndrome (SAHS). Prevalence of SAHS has increased worldwide, and has a significant social and health impact because of the increased cardiometabolic risk attributed to obesity and the associated metabolic syndrome. Material and methods: A cross-sectional epidemiological study of 1110 workers from public service companies in the Spanish Mediterranean area (Balearic Islands and Valencian Community) was conducted between January and December 2015. Cardiovascular risk was calculated using the Castelli, Kannel and TG/HDL indices, and prevalence of obesity using body mass index, waist circumference, waist-height ratio, and visceral fat. SAHS risk was assessed using the Stop-Bang questionnaire. Results: Risk of SAHS was low in 77% of patients and intermediate-high in 23% of patients. All obesity parameters showed a statistically significant association (p value <.001) with intermediate/high risk of SAHS. Obesity prevalence is higher the worse the quality of sleep. There was a statistically significant relationship between risk of SAHS and cardiovascular risk with the atherogenic indexes found. Conclusions: Twenty-three percent of workers had intermediate/high SAHS risk. The results of this study support the relationship of SAHS with an increased CVR and with obesity parameters. Further prospective studies in different productive sectors may be useful to confirm the results of this research (AU)

Cardiovascular risk and obesity in sleep apnea syndrome assessed with the Stop-Bang questionnaire. / Riesgo cardiovascular y obesidad en el síndrome de apnea del sueño valorado con el cuestionario Stop-Bang.

INTRODUCTION: Sleep disorders include a number of different processes, of which the most prevalent is the sleep apnea-hypopnea syndrome (SAHS). Prevalence of SAHS has increased worldwide, and has a significant social and health impact because of the increased cardiometabolic risk attributed to obesity and the associated metabolic syndrome. MATERIAL AND METHODS: A cross-sectional epidemiological study of 1110 workers from public service companies in the Spanish Mediterranean area (Balearic Islands and Valencian Community) was conducted between January and December 2015. Cardiovascular risk was calculated using the Castelli, Kannel and TG/HDL indices, and prevalence of obesity using body mass index, waist circumference, waist-height ratio, and visceral fat. SAHS risk was assessed using the Stop-Bang questionnaire. RESULTS: Risk of SAHS was low in 77% of patients and intermediate-high in 23% of patients. All obesity parameters showed a statistically significant association (p value <.001) with intermediate/high risk of SAHS. Obesity prevalence is higher the worse the quality of sleep. There was a statistically significant relationship between risk of SAHS and cardiovascular risk with the atherogenic indexes found. CONCLUSIONS: Twenty-three percent of workers had intermediate/high SAHS risk. The results of this study support the relationship of SAHS with an increased CVR and with obesity parameters. Further prospective studies in different productive sectors may be useful to confirm the results of this research.

Relationship between blood glucose levels and cardiovascular risk in the Spanish Mediterranean population.

BACKGROUND/AIM: Diabetes is associated with an increased prevalence of cardiovascular disease. Impaired fasting glucose (IFG) is an intermediate clinical situation between normal glucose levels and type 2 diabetes. The aim of this study is to determine how fasting glucose concentrations affect different cardiovascular risk scales. MATERIALS AND METHODS: A descriptive study was conducted with 59,041 Mediterranean Spanish workers. IFG was determined using the American Diabetes Association (ADA) and the World Health Organization (WHO) criteria. Different indicators of cardiovascular risk were analyzed: body mass index, waist circumference, waist-to-height ratio, blood pressure, lipid parameters, atherogenic indices, metabolic syndrome, and various scales of cardiovascular risk such as REGICOR, DORICA, SCORE, Heart Age, and Vascular Age. RESULTS: All cardiovascular scales showed statistically significant differences between the IFG group and the normal glucose group. In all cases, values were worse in the IFG group; furthermore, men exhibited more unfavorable levels of cardiovascular risk factors than women. Higher odds ratio values were present in employees with metabolic syndrome according to ATP III criteria (9.42, 95% CI: 8.56-10.37 using WHO criteria and 9.25, 95% CI: 8.67-9.87 using ADA criteria).Conclusions: IFG increases cardiovascular risk whether using classical scales (REGICOR, SCORE, and metabolic syndrome) or other less studied scales (atherogenic indices, Heart Age, and Vascular Age).

[FINDRISC Test: Relationship between cardiovascular risk parameters and scales in Spanish Mediterranean population]. / Test FINDRISC: relación con parámetros y escalas de riesgo cardiovascular en población mediterránea española.

BACKGROUND: The Finnish Diabetes Risk Score (FINDRISC) questionnaire has been used to assess the risk of type 2 diabetes and metabolic syndrome. The objetive was to assess the relationship between different scales related to cardiovascular risk and FINDRISC questionnaire. METHODS: Values of different anthropometric and clinical parameters (body mass index, waist circumference, waist to height ratio, blood pressure), analytical parameters (lipid profile, blood glucose) and scales related to cardiovascular risk (atherogenic index, metabolic syndrome, REGICOR, SCORE, heart age and vascular age) were determined on the basis of the value of the FINDRISC questionnaire. RESULTS: All analyzed parameters related to cardiovascular risk were getting worse at the same time that the value of the FINDRISC questionnaire increased. CONCLUSIONS: There is a close relationship between FINDRISC questionnaire values and those obtained in the different parameters by which cardiovascular risk was measured directly or indirectly.

Introducción: el Finnish Diabetes Risk Score (test de FINDRISC) se ha empleado para valorar el riesgo de padecer diabetes tipo 2 y síndrome metabólico. El objetivo consistió en valorar la relación entre diferentes escalas relacionadas con el riesgo cardiovascular y el test de FINDRISC. Métodos: se determinaron los valores de difentes parámetros antropométricos, clínicos (índice de masa corporal, perímetro de cintura, índice cintura altura, tensión arterial), analíticos (perfil lipídico y glucemia) y escalas relacionadas con riesgo cardiovascular (indices aterogénicos, síndrome metabólico, REGICOR, SCORE, edad del corazón y edad vascular) según el valor del test de FINDRISC. Resultados: todos los parámetros relacionados con riesgo cardiovascular analizados fueron empeorando a medida que aumentaba el valor del test de FINDRISC. Conclusión: existe una estrecha relación entre los valores del test de FINDRISC y los obtenidos en los diferentes parámetros y escalas que valoran de forma directa o indirecta el riesgo cardiovascular.