[2022 Practice guidelines for the management of arterial hypertension of the Spanish Society of Hypertension]. / Guía práctica sobre el diagnóstico y tratamiento de la hipertensión arterial en España, 2022. Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA).

Hypertension is the most important risk factor for global disease burden. Detection and management of hypertension are considered as key issues for individual and public health, as adequate control of blood pressure levels markedly reduces morbidity and mortality associated with hypertension. Aims of these practice guidelines for the management of arterial hypertension of the Spanish Society of Hypertension include offering simplified schemes for diagnosis and treatment for daily practice, and strategies for public health promotion. The Spanish Society of Hypertension assumes the 2018 European guidelines for management of arterial hypertension developed by the European Society of Cardiology and the European Society of Hypertension, although relevant aspects of the 2017 American College of Cardiology/American Heart Association guidelines and the 2020 International Society of Hypertension guidelines are also commented. Hypertension is defined as a persistent elevation in office systolic blood pressure ≥ 140 and/or diastolic blood pressure ≥ 90 mmHg, and assessment of out-of-office blood pressure and global cardiovascular risk are considered of key importance for evaluation and management of hypertensive patients. The target for treated blood pressure should be < 130/80 for most patients. The treatment of hypertension involves lifestyle interventions and drug therapy. Most people with hypertension need more than one antihypertensive drug for adequate control, so initial therapy with two drugs, and single pill combinations are recommended for a wide majority of hypertensive patients.

Kinesiotape on quadriceps and gluteus in counter movement jump and sprint in soccer players.

BACKGROUND: Kinesiotape (KT) is a technique commonly used in sports practice. It may be beneficial in enhancing muscle function by additional cutaneous afferent stimulation. The objective of this study was to analyse the effect of KT on countermovement jump (CMJ) and 20-m sprints (sp) immediately and 24 h after its application on the quadriceps and gluteus maximus. METHODS: 37 male soccer players (19.7 ± 0.9 years old) were randomly assigned to one of 3 groups: experimental group: KT activation (KTact), placebo group: sham tape (KTst), and control group (CG). Participants performed a 30-min preliminary warm-up, after which they conducted CMJ and 20-m sp tests. These tests were repeated later (with KT application or not) and after 24 h. RESULTS: Intergroup results found no significant differences either post-test (CMJ, p = 0.115; sp, p = 0.307) or after 24 h (p = 0.053). Intragroup results showed no significant results for CMJ, although 20-m sp seemed to display significant differences in the (KTst) (p = 0.002, post-hoc: 0.015 in pre_sp vs post_sp) and the (KTact) (0.021, in post-hoc: 0.007 in pre_sp vs post_sp), with a moderate effect in pre_sp vs post_sp (0.66) in the (KTact) after KT was applied. CONCLUSION: KT application on the gluteus maximus and quadriceps in young soccer players increases the sprint execution time immediately and 24 h after application, even that the sprint execution time had not been grater that one tenth of the second (0.08 s). It also has no effect on CMJ.

Life-stage variation in insecticide resistance of the western flower thrips (Thysanoptera: Thripidae).

The life-stage variations in insecticide resistance of western flower thrips, Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae), to selective insecticides (acrinathrin, formetanate, and methiocarb) were studied using resistant laboratory strains. In each strain, the second-instar larva was less susceptible to the insecticides tested than the adults. The lower the resistance level of the adults, the higher the difference between larva and adult susceptibility: 32-fold to methiocarb, 15.4-fold to formetanate, and 180-fold to acrinathrin in the reference strain. In laboratory-selected resistant strains, these differences were much lower: 5.8-fold to methiocarb, 4.8-fold to formetanate, and 2.0-fold to acrinathrin. In selected strains, higher resistance levels for each insecticide were found, both for larvae and adults, compared with the reference strain. These results show that after insecticide resistance selection in adults, the resistance is carried over to the larvae, but at lower levels.

Climate change impact on karstic aquifer hydrodynamics in southern Europe semi-arid region using the KAGIS model.

Nowadays, there are many urban settlements in arid and semiarid areas supplied by groundwater from adjacent small aquifers. Climate projections with expected decreases in averages precipitation values jointly with increases in the frequency of heavy rainfall events does not show a clear pattern to how water resources in karstic aquifers are going to evolve. This paper, focused in the province of Alicante (Southeast of Spain), assesses the behaviour of a small karstic aquifer, the Mela aquifer, whose resources supply urban water consumption for close municipalities. We assess the hydrogeological response of the aquifer, through the KAGIS black-box GIS-based model, for the present climate conditions and for the long period analysing the four scenarios provided by the International Panel of Climate Change. Main results prove that, if we do not diminish the greenhouse gas emissions, the climate change impact on the hydrological response of the study aquifer shows a decrease in the flow rate from its unique spring and will be non-existent during the summer months. So, it will be necessary to design supply strategies for these municipalities and to carry out them, meeting budget restrictions and avoiding potential water shortages.

Drone-based imaging to assess the microbial water quality in an irrigation pond: A pilot study.

Microbial water quality datasets are essential in irrigated agricultural practices to detect and inform measures to prevent the contamination of produce. Escherichia coli (E. coli) concentrations are commonly used to evaluate microbial water quality. Remote sensing imagery has been successfully used to retrieve several water quality parameters that can be determinants of E. coli habitats in waterbodies. This pilot study was conducted to test the possibility of using imagery from a small unmanned aerial vehicle (sUAV or drone) to improve the estimation of microbial water quality in small irrigation ponds. In situ measurements of pH, turbidity, specific conductance, and concentrations of dissolved oxygen, chlorophyll-a, phycocyanin, and fluorescent dissolved organic matter were taken at depths of 0-15 cm in 23 locations across a pond in Central Maryland, USA. The pond surface was concurrently imaged using a drone with three modified GoPro cameras, and a multispectral MicaSense RedEdge camera with five spectral bands. The GoPro imagery was decomposed into red, blue, and green components. Mean digital numbers for 1-m radius areas in the images were combined with the water quality data to provide input for a regression tree-based analysis. The accuracy of the regression-tree data description with "only imagery" inputs was the same or better than that of trees constructed with "only water-quality parameters" as inputs. From multiple cross-validation runs with "only imagery" inputs for the regression trees, the average (±SD) determination coefficient and root-mean-squared error of the decimal logarithm of E. coli concentrations were 0.793 ±â€¯0.035 and 0.131 ±â€¯0.011, respectively. The results of this study demonstrate the opportunities for using sUAV imagery for obtaining a more accurate delineation of the spatial variation of E. coli concentrations in irrigation ponds.

Geographic density of landfill sites and risk of congenital anomalies in England.

OBJECTIVE: To investigate the risk of congenital anomalies in relation to an index of geographic density of landfill sites across 5x5 km grid squares in England. METHODS: 2 km zones were constructed in a geographical information system around 8804 landfill sites, including 607 that handled special (hazardous) wastes, and intersected with postcode coordinates of over 10 million births (136,821 with congenital anomalies), 1983-98. A landfill exposure index was calculated to represent the geographic density of landfill sites within 2 km of births for each 5x5 km grid square, calculated separately for landfill sites handling special, and non-special or unknown, waste. For each group of landfills, the index was classified into four categories of intensity, and risks for the second, third and top categories were compared to the bottom category, comprising areas with no such landfill sites within 2 km (index of zero). We used hierarchical logistic regression modelling in a Bayesian framework, with adjustment for potential confounding. RESULTS: For special waste sites, adjusted odds ratios were significant for the third category of the landfill exposure index for all anomalies combined and cardiovascular defects (OR 1.08 (95% credible interval 1.02 to 1.13) and 1.16 (1.00 to 1.33), respectively) and for hypospadias and epispadias for the third and top categories (OR 1.11 (1.02 to 1.21) and 1.12 (1.02 to 1.22), respectively). After adjustment, there were no excess risks in relation to sites handling non-special or unknown waste types. CONCLUSIONS: There was a weak spatial association between risk of certain congenital anomalies and geographic density of special (hazardous) waste sites at the level of 5x5 km grid squares. Exposure pathways and mechanisms to help interpret these findings are not well-established.

Carbamates synergize the toxicity of acrinathrin in resistant western flower thrips (Thysanoptera: Thripidae).

The insecticidal efficacy of mixtures of acrinathrin (pyrethroid) with carbamate fungicides (propamocarb, carbendazim, iprovalicarb, and diethofencarb) and insecticides (carbaryl, thiodicarb, pirimicarb, and oxamyl) was studied in a field strain of Frankliniella occidentalis (Pergande). The fungicide propamocarb and the insecticides pirimicarb and oxamyl were selected for further studies of their synergism action with more detailed bioassays. The method consisted of combining increasing concentrations of acrinathrin with a constant sublethal rate of the carbamate as synergist. These three carbamates did not show synergism to acrinathrin in a laboratory insecticide-susceptible strain, but they did in two field strains, with higher acrinathrin resistance corresponding to higher synergism. Carbamates such as pirimicarb, oxamyl, and propamocarb could be practical candidates for field use as synergists, even against other pests with metabolic resistance.

Standalone direct pumping photovoltaic system or energy storage in batteries for supplying irrigation networks. Cost analysis.

Solar photovoltaic systems have become one of the most popular topics in the water management industry. Moreover, irrigation networks are water- and energy-hungry, and utility managers are likely to adapt water consumption (and consequently energy demand) to the hours in which there is energy availability. In countries such as Spain (with high irradiance values), solar energy is an available green alternative characterised by zero electricity costs and significantly lower environmental impact. In this work, several types of irrigation scheduled programmes (according to different irrigation sectors) that minimise the number of photovoltaic solar panels to be installed are studied; moreover, the effects of the variable costs linked to energy (energy and emissions costs) are presented. Finally, the effect of incorporating batteries for storing energy to protect the system against emergencies, such as unfavourable weather, is proposed. The irrigation hours available to satisfy water demands are limited by sunlight; they are also limited by the condition that the irrigation schedule type has to be rigid (predetermined rotation) and that the pressure at any node has to be above minimum pressure required by standards. A real case study is performed, and the results obtained demonstrate that there is no universal solution; this is because the portfolio of alternatives is based on investments for purchasing equipment at present and also on future energy savings (revenues). Apart from these two values, there is an economic value (equivalent discontinuous discount rate), which also influences the final results.

Reproducibility of sonographic measurements of carotid intima-media thickness.

BACKGROUND: Carotid intima-media thickness (IMT), measured with B-mode ultrasound, is a marker for atherosclerosis and widely used as an outcome in intervention trials. PURPOSE: To evaluate the reproducibility of carotid intima-media thickness measurements using tissue harmonic imaging (THI) sonography between two observers with different levels of experience. MATERIAL AND METHODS: IMT measurement was performed in 40 patients: 26 males and 14 females, with a mean age of 62.6 years. The measurements were taken on the posterior wall of the right common carotid artery using a standardized protocol. Observer measurement of the IMT was independent and blind. Statistical analysis was done with parametric tests and Pearson's correlation coefficient. RESULTS: The measurements of the IMT were taken satisfactorily in all cases. IMT measurement time was 5 min/study. No significant differences were noted between the means obtained by the two observers. The interobserver correlation of the measurements was very high (97.2%). CONCLUSION: The results of this study show that carotid IMT measurement using THI sonography and a standardized protocol is accurate and reproducible.

Lack of fitness costs of insecticide resistance in the western flower thrips (Thysanoptera: Thripidae).

The fitness costs of spinosad and acrinathrin resistance was investigated in the western flower thrips, Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae). Fitness studies were conducted on susceptible and resistant strains of F. occidentalis. Resistant females were significantly more fecund (number of eggs per female) than susceptible females. The hatching rate (fertility) for both susceptible and acrinathrin-resistant strains was significantly lower than in the spinosad-resistant strain. Mean developmental time from egg to adult did not differ between thrips populations. Similarly, female longevity did not differ between populations. These data suggest that lack of fitness costs related to insecticide resistance may accelerate the development of insecticide resistance in populations of F. occidentalis from southeastern Spain.

Impact of production system on development of insecticide resistance in Frankliniella occidentalis (Thysanoptera: Thripidae).

The western flower thrips, Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae), has become one of the most difficult insects to control in the intensive agriculture of southeastern Spain. However, resistance problems are quite different in two neighboring areas, Murcia and Almeria, with distinct production systems. Thirty-six field populations of western flower thrips from sweet pepper crops were collected in two different dates in Murcia and Almeria in 2005 and 2006. Western flower thrips populations collected were exposed to a diagnostic concentration of spinosad, methiocarb, acrinathrin, and formetanate. The results allowed the recognition of higher levels of resistance in Almeria compared with Murcia throughout the growing season. The mortality at the diagnostic concentration for spinosad (120 ppm) in western flower thrips populations ranged from 34 to 81% in Almeria, and from 73 to 100% in Murcia. The mortalities at the diagnostic concentration to acrinathrin (800 ppm) and formetanate (8000 ppm) were 17-31% in Almeria and 77-100% in Murcia, and 14-41% in Almeria and 48-99% in Murcia, respectively, indicating large geographic variations. Toxicity of methiocarb was higher for western flower thrips populations from both areas. However, mortality at the diagnostic concentration of methiocarb (2000 ppm) varied from 56 to 90% in Almeria, and it was from 94 to 100% in Murcia. The impact of production systems and agricultural practices of each area on the development and stability of insecticide resistance is discussed.

Distributed support vector machines.

A truly distributed (as opposed to parallelized) support vector machine (SVM) algorithm is presented. Training data are assumed to come from the same distribution and are locally stored in a number of different locations with processing capabilities (nodes). In several examples, it has been found that a reasonably small amount of information is interchanged among nodes to obtain an SVM solution, which is better than that obtained when classifiers are trained only with the local data and comparable (although a little bit worse) to that of the centralized approach (obtained when all the training data are available at the same place). We propose and analyze two distributed schemes: a "naïve" distributed chunking approach, where raw data (support vectors) are communicated, and the more elaborated distributed semiparametric SVM, which aims at further reducing the total amount of information passed between nodes while providing a privacy-preserving mechanism for information sharing. We show the feasibility of our proposal by evaluating the performance of the algorithms in benchmarks with both synthetic and real-world datasets.

[Growth charts: Impact on the prevalence of nutritional disorders]. / Tablas de crecimiento: impacto sobre la prevalencia de los trastornos nutritivos.

INTRODUCTION: The references used to assess child growth in Spain are the graphs of the Orbegozo Foundation and the charts of the World Health Organization (WHO). The objective of this study is to analyze the differences between the two charts for weight, height and body mass index, and assess their relevance to identify growth or nutritional problems. MATERIAL AND METHODS: The values of the extreme percentiles of height, weight and body mass index for each sex from 0 to 10 years in both charts are compared. For each value Absolute differences and Z scores are calculated for each value. To evaluate the impact on the prevalence of the various nutritional or growth disorders the location of the value of the respective percentiles of in each of the charts were assessed. RESULTS: Significant differences were observed between the 3th percentile of height and weight, 97th of weight, and 85th and 97th of body mass index. Marked differences were observed for the extreme values of body mass index. During the first years, the Orbegozo charts overestimate the prevalence of malnutrition (between 2% and 19% depending on age and sex) compared to the WHO charts. In subsequent ages Orbegozo underestimates WHO between 0.7% and 2.89%. Orbegozo underestimates the prevalence of overweight (between 2.5% and 14.8%) compared to the WHO charts. The 97th percentile of Body mass index in the Orbegozo charts corresponds in most cases with WHO percentiles above 99.99%. CONCLUSION: The two charts analyzed have significant differences from a clinical and the public health point of view, in the estimation of overweight/obesity and malnutrition.

Hormone replacement therapy for oxidative stress in postmenopausal women with hot flushes.

OBJECTIVE: To assess the association of hot flushes during postmenopause with oxidative stress and to determine whether hormone replacement therapy (HRT) affects the plasma redox status of postmenopausal women. METHODS: We conducted a prospective clinical study of 49 postmenopausal women who have (n = 29) or do not have (n = 20) hot flushes. Twelve of the postmenopausal women with hot flushes and six without were treated with HRT (estradiol patches and medroxyprogesterone acetate) for 4 months. Plasma level of estradiol, total antioxidant status, reduced sulfhydryl groups, lipoperoxides, total cholesterol, and triglycerides were measured at 4-month intervals in both groups, before and after treatment. RESULTS: Postmenopausal women who have hot flushes, had lower total basal antioxidant status in plasma (.9 +/-.01 compared with 1.14 +/-.01 mmol/L), lower concentration of reduced sulfhydryl groups (145 +/- 4 compared with 200 +/- 3 micromol/L), and higher concentration of lipoperoxides (2.88 +/-.04 compared with 2.61 +/-.04 micromol/L) than women without hot flushes. After HRT, total antioxidant status and reduced sulfhydryl groups increased, and lipoperoxides decreased similarly in both groups. Hormone replacement therapy decreased the frequency of hot flushes per day from 11.2 +/- 0.8 to 1.4 +/- 0.3. CONCLUSION: Hot flushes in postmenopausal women were associated with the oxidative process. Hormone replacement therapy decreases oxidative stress and the number of episodes of hot flushes. Because oxidative stress is associated with a high risk for cardiovascular diseases, HRT might protect women with hot flushes.

[Prevalence of renal involvement in a population of type Ii diabetics followed up in primary care]. / Prevalencia de la afectación renal en una población de diabéticos tipo 2 seguidos en atención primaria.

UNLABELLED: Patients with type 2 diabetes use to be managed in their primary care settings during the early stages of the disease. The main objective of the study was to determine renal impairment prevalence, and to assess its significance, within type 2 diabetics controlled by their family physicians. PATIENTS AND METHOD: Transverse observation of patients with type 2 diabetes who were the first 20 unselected cases seen by 183 family physicians from 16 of the 17 Autonomic Communities of our country. The following variables were determined: serum creatinine, glucose, and HbA1c concentrations, proteinuria (dipstick test in a first-voided morning urine sample), blood pressure levels, and associated cardiovascular disease. RESULTS: Data from 3,583 type 2 diabetic subjects were evaluated. Mean age was 64 +/- 10 years and 45% were male. A serum creatinine > or = 1.2 mg/dl was observed in 523 (15.5%) patients. Proteinuria was present in 794 (23.5%) cases, being > or = 2 + in 215 (6.5%) subjects. Patients with a serum creatinine > or = 1.2 mg/dl were older, shower higher blood pressure levels, and suffered from more cardiovascular disease (32.0 vs 19.5%) than those with a serum creatinine < 1.2 mg/dl. In a multivariate analysis, this difference continued to be significant (OR 1.47; 95% CI 1.14 to 1.90; p = 0.002. Patients with proteinuria showed a higher prevalence of cardiovascular disease (OR 1.83; 95% CI 1.47 to 2.27; p < 0.0001) than those without proteinuria. This association was continuous through no proteinuria to the > or = 2 + proteinuria (p < 0.001). Blood pressure level was > or = 140/90 mmHg in 69% of the cases, being < 130/85 mmHg in only 8% of the subjects. CONCLUSIONS: There is a high prevalence of renal impairment, approximately of 25% within type 2 diabetic patients seen at the primary care level. Optimal blood pressure level seems to be extremely infrequent bearing in mind the diagnosis of diabetes and the associated cardiovascular disease.

A study on the efficacy and safety of losartan in elderly patients with mild to moderate essential hypertension.

Despite progress in the detection and treatment of hypertension the percentage of patients with controlled hypertension has failed to increase. The problem of poor blood pressure control is even more serious in elderly hypertensives than in the rest of the population. The antihypertensive drugs of the AIIRA (non-peptide angiotension II receptor antagonist) class are drugs whose use and experience are increasing and whose properties make them particularly useful in the elderly. We tried to assess the efficacy of treatment with losartan, the first AIIRA drug in a cohort of elderly patients with essential hypertension and to assess the percentage of patients achieving optimum BP control and to evaluate its safety, tolerability and metabolic effects. The intervention proved to be highly effective, achieving the anticipated blood pressure levels in the elderly in 77% of subjects after a 16-week follow-up, with very good tolerability. Renal function remained unchanged, as did the subjects' lipid profile.

[Incorporation of geostatistical methodology for influenza surveillance in a sentinel network]. / Incorporación de la metodología geoestadística a la vigilancia de la gripe en una red centinela.

OBJECTIVES: To evaluate geostatistical description of influenza data from the Valencian Sentinel Network (VSN) in Spain using the kringing method and to assess the possibility of incorporating this method into routine surveillance. METHODS: We use influenza surveillance data on three influenza seasons (1997-1998, 1998-1999 and 1999-2000) from the VSN to construct a geocodified data matrix of the incidence of this disease. The geographic distribution was studied using the kringing method, which enables estimation of the incidence in a few strategically distributed points. Influenza isoincidence maps for each week were plotted. Cross validation was used to evaluate the method. RESULTS: In most of the weeks, the values of reduced standard deviation and reduced mean were close to the optimal values (0 and 1, respectively). Out of range reduced standard deviation values were found in 12 of 20 weeks in the last season only. The estimation of rates in all three seasons showed coherence in spatial distribution and temporal evolution. CONCLUSIONS: In most situations the results were acceptable. The method does not require extra computer resources or an excessive amount of time and requires only annual adaptation. Because it is easy to use, the technique is appropriate for routine use but the accuracy of estimations could be improved by increasing the complexity of the model.

[Point processes as a tool for analyzing possible sources of contamination]. / Procesos puntuales como herramienta para el análisis de posibles fuentes de contaminación.

Point pattern analysis pattern comprises a series of techniques that enables the distribution of a series of events occurring in the vicinity of a particular region of a map to be studied. In epidemiology, this problem arises when a potential source of environmental contamination, possibly leading to cases of a specific disease, is investigated.The present study provides a brief description of point pattern analysis. The approach is illustrated through determination of the environmental source and study of the areas of greatest risk of incidence of an outbreak of legionella pneumonia that occurred between the middle of September and beginning of October in the city of Alcoi in Alicante (Spain).Point pattern analysis was able to confirm the environmental source of the outbreak and identify the areas of the city at greatest risk. This provided the justification for an exhaustive inspection of the installations generating aerosols after which, to date, the epidemics ceased.

[Therapeutic intervention in infantile autism and generalized developmental disorders: self-injury and self-stimulation]. / Intervención terapéutica en autismo infantil y trastornos generalizados del desarrollo: autolesión y autoestimulación.

INTRODUCTION: In this article we present a review of the aetiology and treatment of self-injury and self-stimulation in infantile autism and in generalized development disorders. We summarize 20 years of study and investigation in the treatment of these serious behaviour disorders, in a pioneer institution in Spain: the centre for rehabilitation 'El Cau' in Castellon. DEVELOPMENT: We describe the most frequent behaviour disorders, with particular reference to self-injury and self-stimulatory behaviour. Models explaining the aetiology and treatment are described in a brief general review of the subject, and we consider explicative models which integrate different treatments (in family and institutional contexts) by means of family therapy, psychoeducational models and social support networks.