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Mostaza JM, Pintó X, Armario P, Masana L, Real JT, Valdivielso P, Arrobas-Velilla T, Baeza-Trinidad R, Calmarza P, Cebollada J, Civera-Andrés M, Cuende Melero JI, Díaz-Díaz JL, Espíldora-Hernández J, Fernández Pardo J, Guijarro C, Jericó C, Laclaustra M, Lahoz C, López-Miranda J, Martínez-Hervás S, Muñiz-Grijalvo O, Páramo JA, Pascual V, Pedro-Botet J, Pérez-Martínez P, Puzo J. SEA 2024 Standards for Global Control of Vascular Risk. Clin Investig Arterioscler 2024; 36:133-194. [PMID: 38490888 DOI: 10.1016/j.arteri.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/03/2024] [Indexed: 03/17/2024]
Abstract
One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to the knowledge, prevention and treatment of vascular diseases, which are the leading cause of death in Spain and entail a high degree of disability and health expenditure. Atherosclerosis is a multifactorial disease and its prevention requires a global approach that takes into account the associated risk factors. This document summarises the current evidence and includes recommendations for patients with established vascular disease or at high vascular risk: it reviews the symptoms and signs to evaluate, the laboratory and imaging procedures to request routinely or in special situations, and includes the estimation of vascular risk, diagnostic criteria for entities that are vascular risk factors, and general and specific recommendations for their treatment. Finally, it presents aspects that are not usually referenced in the literature, such as the organisation of a vascular risk consultation.
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Affiliation(s)
- José María Mostaza
- Servicio de Medicina Interna, Unidad de Lípidos y Arteriosclerosis, Hospital La Paz-Carlos III, Madrid, España.
| | - Xavier Pintó
- Unidad de Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario Bellvitge, Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Fundación para la Investigación y Prevención de las Enfermedades Cardiovasculares (FIPEC), Universidad de Barcelona, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España
| | - Pedro Armario
- Servicio de Medicina Interna, Área de Atención Integrada de Riesgo Vascular, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral (CSI), Sant Joan Despí, Universidad de Barcelona, Barcelona, España
| | - Luis Masana
- Unidad de Medicina Vascular y Metabolismo (UVASMET), Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universitat Rovira i Virgili, Tarragona, España
| | - José T Real
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Pedro Valdivielso
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand), Universidad de Málaga, Málaga, España
| | - Teresa Arrobas-Velilla
- Laboratorio de Nutrición y RCV, UGC de Bioquímica clínica, Hospital Virgen Macarena, Sevilla, España
| | | | - Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España; Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Jesús Cebollada
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Miguel Civera-Andrés
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España
| | - José I Cuende Melero
- Consulta de Riesgo Cardiovascular, Servicio de Medicina Interna, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - José L Díaz-Díaz
- Sección de Medicina Interna, Unidad de Lípidos y Riesgo Cardiovascular, Hospital Abente y Lago Complejo Hospitalario Universitario A Coruña, La Coruña, España
| | - Javier Espíldora-Hernández
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand), Universidad de Málaga, Málaga, España; Unidad de Lípidos y Unidad Asistencial de Hipertensión Arterial- Riesgo Vascular (HTA-RV), UGC Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Jacinto Fernández Pardo
- Servicio de Medicina Interna, Hospital General Universitario Reina Sofía de Murcia, Universidad de Murcia, Murcia, España
| | - Carlos Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorón, España
| | - Carles Jericó
- Servicio de Medicina Interna, Área de Atención Integrada de Riesgo Vascular, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral (CSI), Sant Joan Despí, Universidad de Barcelona, Barcelona, España
| | - Martín Laclaustra
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Investigación Sanitaria (ISS) de Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Carlos Lahoz
- Servicio de Medicina Interna, Unidad de Lípidos y Arteriosclerosis, Hospital La Paz-Carlos III, Madrid, España
| | - José López-Miranda
- Unidad de Lípidos y Arteriosclerosis, UGC de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Sergio Martínez-Hervás
- Servicio de Endocrinología y Nutrición, Hospital Clínico, Universidad de València, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - Ovidio Muñiz-Grijalvo
- Servicio de Medicina Interna, UCERV, UCAMI, Hospital Virgen del Rocío de Sevilla, Sevilla, España
| | - José A Páramo
- Servicio de Hematología, Clínica Universidad de Navarra, Navarra, España; Laboratorio Aterotrombosis, CIMA, Universidad de Navarra, Pamplona, España
| | - Vicente Pascual
- Centro de Salud Palleter, Universidad CEU-Cardenal Herrera, Castellón, España
| | - Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España
| | - Pablo Pérez-Martínez
- Unidad de Lípidos y Arteriosclerosis, UGC de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - José Puzo
- Servicio de Bioquímica Clínica, Unidad de Lípidos, Hospital General Universitario San Jorge de Huesca, Huesca, España; Departamento de Medicina, Universidad de Zaragoza, Zaragoza, España
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Morales-Suárez-Varela M, Peraita-Costa I, Guerrero Cervera B, Llopis-Morales A, Botella Juan L, Marcos Puig B. Arterial hypertension and smoking in pregnant women in the Valencian Community: maternal and neonatal outcomes. Semergen 2024; 50:102171. [PMID: 38159344 DOI: 10.1016/j.semerg.2023.102171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Hypertension and smoking during pregnancy have been linked to various adverse maternal and fetal outcomes. The objective of this work is to study how the smoking influences the development of hypertension, its effects on the pregnant woman, and on the newborn. MATERIALS AND METHODS An observational study in two phases was carried out: the descriptive first phase allows characterization of the sample and the analytical second phase is a case-control nested in a retrospective cohort corresponding to pregnancy. RESULTS A total of 712 women were included in the study. Of the 672 (94.4%) non-hypertensive women, 533 (79.3%) were non-smoking and 139 (20.7%) smoking. For the 40 (5.6%) hypertensive women, 30 (75.0%) were non-smoking and 10 (25.0%) smoking. The prevalence of hypertension was of 5.6%. Women who quit smoking before pregnancy saw a reduced risk of hypertension. For women who smoke during pregnancy, those of younger ages, with a normal body mass index, who are primiparous, employed and with a low-medium level of education have higher risk of hypertension. The risk of hypertension according to the level of physical activity during leisure time follows a "U" shape, with those who perform light physical activity at the lowest risk of hypertension. Hypertensive women have a higher risk of small for gestational age newborns. Smoking does not pose an additional risk for adverse outcomes once hypertension is diagnosed. CONCLUSIONS Future studies should aim to determine the role of smoking habit in the appearance of hypertension in pregnancy in order to establish adequate intervention guidelines that may aid in reducing the prevalence of hypertension.
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Affiliation(s)
- M Morales-Suárez-Varela
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot (València), Spain; CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - I Peraita-Costa
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot (València), Spain; CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - B Guerrero Cervera
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot (València), Spain; Department of Cardiology, La Fe University Hospital, Avinguda de Fernando Abril Martorell, 106, 46026 València, Spain
| | - A Llopis-Morales
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot (València), Spain
| | - L Botella Juan
- Area of Preventive Medicine and Public Health, Department of Biomedical Sciences, Faculty of Health Sciences, Universidad de León, 24071 León, Spain; The Research Group in Gene-Environment and Health Interactions (GIIGAS), Institute of Biomedicine (IBIOMED), Universidad de León, 24071 León, Spain
| | - B Marcos Puig
- Department of Obstetrics, La Fe University Hospital, Avinguda de Fernando Abril Martorell, 106, 46026 València, Spain
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Abellán Alemán J, Sabaris RC, Pardo DE, García Donaire JA, Romanos FG, Iriso JI, Penagos LM, Iglesias LJN, de Salinas APM, Pérez-Monteoliva NRR, Lezcano PSR, Saborido MT, Roca FV. Documento de consenso sobre tabaquismo y riesgo vascular. Hipertens Riesgo Vasc 2024; 41 Suppl 1:S1-S85. [PMID: 38729667 DOI: 10.1016/s1889-1837(24)00075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Consensus statement on smoking and vascular risk About 22% of the Spanish population are daily smokers. Men are more likely to smoke than women. In Spain, women between 15-25 years of age smoke as much or more than men. Every smoker should be assessed for: physical dependence on nicotine (Fagerström test), social and psychological dependence (Glover Nilsson test), level of motivation to quit (Richmond test), probability of therapy success (Henri-Mondor and Michael-Fiore tests), and stage of behavioral change development (Prochaska and DiClementi). Advice on smoking cessation is highly cost-effective and should always be provided. Smoking is an enhancer of cardiovascular risk because it acts as a pathogen agent in the development of arteriosclerosis and is associated with ischemic heart disease, stroke, and peripheral artery disease. Smoking increases the risk of chronic lung diseases (COPD) and is related to cancers of the lung, female genitalia, larynx, oropharynx, bladder, mouth, esophagus, liver and biliary tract, and stomach, among others. Combined oral contraceptives should be avoided in women smokers older than 35 years of age due to the risk of thromboembolism. In smoking cessation, the involvement of physicians, nurses, psychologists, etc. is important, and their multidisciplinary collaboration is needed. Effective pharmacological treatments for smoking cessation are available. Combined treatments are recommended when smoker's dependence is high. For individuals who are unable to quit smoking, a strategy based on tobacco damage management with a total switch to smokeless products could be a less dangerous alternative for their health than continuing to smoke.
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Affiliation(s)
- José Abellán Alemán
- Sociedad Murciana de Hipertensión Arterial y Riesgo Cardiovascular, Cátedra de Riesgo Cardiovascular, Universidad Católica de Murcia, Murcia, España.
| | - Rafael Crespo Sabaris
- Sociedad Riojana de Hipertensión y Riesgo Vascular, Centro de Salud de Entrena, La Rioja, España
| | - Daniel Escribano Pardo
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Centro de Salud Oliver, Zaragoza, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Unidad de Hipertensión, Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Fernando García Romanos
- Sociedad de Hipertensión y Riesgo Vascular de las Illes Balears, Centro de Salud Santa Catalina, Palma de Mallorca, España
| | - Jesús Iturralde Iriso
- Sociedad Vasca de Hipertensión y Riesgo Vascular, Centro de Salud la Habana-Cuba, Vitoria-Gasteiz, España
| | - Luis Martín Penagos
- Sociedad Cántabra de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - L Javier Nieto Iglesias
- Sociedad Castilla-La Mancha de Hipertensión y Riesgo Vascular, Unidad de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Alfonso Pobes Martínez de Salinas
- Sociedad Asturiana de Hipertensión y Riesgo Vascular, Área de Gestión Clínica, Interáreas de Nefrología VII y VIII del SESPA, Asturias, España
| | | | - Pablo Sánchez-Rubio Lezcano
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital General Universitario San Jorge, Huesca, España
| | - Maribel Troya Saborido
- Sociedad Catalana de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Francisco Valls Roca
- Sociedad Valenciana de Hipertensión y Riesgo Vascular, Centro de Salud de Beniganim, Valencia, España
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Xu J, Liu W, Liu X, Zhou X, Li G. Alcohol drinking, smoking, and cutaneous melanoma risk: Mendelian randomization analysis. Gac Sanit 2023; 37:102351. [PMID: 38052122 DOI: 10.1016/j.gaceta.2023.102351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/26/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To investigate the causal relationship between poor lifestyle habits, such as smoking and drinking, and cutaneous malignant melanoma. METHOD In the present study, alcohol consumption and smoking were used as exposure factors, and single nucleotide polymorphisms closely associated with alcohol consumption and smoking were used as instrumental variables, while cutaneous melanoma was set as an outcome variable. Two-sample Mendelian randomization analyses were run between alcohol consumption and melanoma and smoking and melanoma to investigate their causal associations, respectively. RESULTS We found a positive and statistically significant causal effect of alcohol intake on the risk of cutaneous malignant melanoma (OR: 2.23; 95%CI: 1.11-4.47; p=0.02). The present study showed no significant causal relationship between cigarettes per day and cutaneous melanoma (OR: 0.85; 95%CI: 0.54-1.35; p=0.50) or smoking initiation and cutaneous melanoma (OR: 1.02; 95%CI: 0.74-1.39; p=0.88). CONCLUSIONS This study provides Mendelian randomization evidence supporting alcohol consumption as a risk factor for cutaneous malignant melanoma. And the causal relationship between smoking and cutaneous malignant melanoma still needs to be further investigated.
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Affiliation(s)
- Jiaxiang Xu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Wenhui Liu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xuanjun Liu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xinlong Zhou
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Guangshuai Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
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Abstract
BACKGROUND Thyroid hormones (THs) have important effects on cardiovascular (CV) physiology. Thyroid disorders are accompanied by serious effects on the CV system. OBJECTIVE To study the association between hyperthyroidism and the main CV risk factors (CVRFs), such as hypertension, dyslipidemia, diabetes and smoking in the Spanish population. MATERIAL AND METHODS An observational, retrospective, non-interventional study was performed using the statistical portal of the Spanish Ministry of Health associated with the Base de Datos Clínicos de Atención Primaria (BDCA) database. RESULTS In 2019, 384,182 people [300,243 women (78.1%)] were diagnosed with hyperthyroidism, which represents 1.0% of the population with health problems registered in the BDCAP database (38,365,258 people). The prevalence of hyperthyroidism was more frequent in women (2.48 times) than in men and increased with age. When the whole population was considered, the prevalence of hypertension (34.90% vs. 19.90%; odds ratio, OR 2.16, 95% CI 2.14-2.17), dyslipidemia (34.47% vs. 21.57%; OR 1.90, 95% CI 1.88-1.91), diabetes (12.88% vs. 8.12%; OR 1.66, 95% CI 1.65-1.68) and smoking (10.89% vs. 7.61%; OR 1.48, 95% CI 1.46-1.49) was significantly (p<0.0001) higher in the population diagnosed with hyperthyroidism compared to those without this diagnosis. These significant differences were maintained in both women and men. A separate analysis of the age group 65 years or older showed statistically significant (p<0.0001) differences in the prevalence of hypertension (66.26% vs. 59.43%; OR 1.34, 95% CI 1.33-1.36), dyslipidemia (52.61% vs. 49.05%; OR 1.15, 95% CI 1.14-1.17) and smoking (6.29% vs. 5.93%; OR 1.06, 95% CI 1.04-1.09) between patients with and without a diagnosis of hyperthyroidism, but not in the prevalence of diabetes, which was similar (24.63% vs. 24.63%; OR 1.00, 95% CI 0.99-1.01; p=0.89). CONCLUSION Our study shows that the diagnosis of hyperthyroidism is significantly associated with the main CVRFs in Spanish population attended by primary care regardless of the gender of the patients. This association disappears in those patients aged 65 years or older diagnosed with diabetes.
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Affiliation(s)
- Pedro Iglesias
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda (Majadahonda), Madrid, Spain; Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), Spain; Department of Medicine, Universidad Autónoma de Madrid, Spain.
| | - Juan J Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda (Majadahonda), Madrid, Spain; Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), Spain; Department of Medicine, Universidad Autónoma de Madrid, Spain
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Castro-Cuesta JY, Montoro-García S, Sánchez-Macarro M, Carmona Martínez M, Espinoza Marenco IC, Pérez-Camacho A, Martínez-Pastor A, Abellán-Alemán J. Adherence to the Mediterranean diet in first-year university students and its association with lifestyle-related factors: A cross-sectional study. Hipertens Riesgo Vasc 2023; 40:65-74. [PMID: 36244967 DOI: 10.1016/j.hipert.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Students' dietary habits are moving from Mediterranean diet guidelines towards unhealthy eating patterns. The aim of this study was to determine adherence to the Mediterranean diet in a sample of Spanish university students and its association with lifestyle factors. MATERIAL AND METHODS A descriptive cross-sectional study was conducted with 685 university students who completed a self-report questionnaire. The data collected included demographic characteristics, dietary habits, smoking habits, alcohol consumption and physical activity. Mediterranean diet adherence was assessed by measuring the consumption of the foods that compose this type of diet through a score (range 0-10). Adherence to the Mediterranean diet was considered poor, average, or good. RESULTS The mean adherence score for the Mediterranean diet was 4.9 (1.2) points out of 10. A higher degree of adherence to the Mediterranean diet was observed in physically active students (OR=2.31, 95% CI: 1.05-5.10; p=0.038). Students who performed ≥150min/week of physical activity (OR=0.45, 95% CI: 0.33-0.62; p<0.001) and those over 25 years old (OR=0.44, 95% CI: 0.26-0.73; p=0.002) were less prone to low adherence to the Mediterranean diet than sedentary and younger students. CONCLUSION The university students have poor adherence to the Mediterranean diet. The results of the current study indicate that age and physical activity are associated with Mediterranean diet adherence. It is urgent to raise awareness among university students and implement intervention programmes promoting a healthy lifestyle.
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Affiliation(s)
- J Y Castro-Cuesta
- Health Sciences PhD Program, Universidad Católica de Murcia (UCAM), Murcia, España
| | - S Montoro-García
- Cátedra de Riesgo Cardiovascular y Departamento de Nutrición, Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, España
| | - M Sánchez-Macarro
- Cátedra de Riesgo Cardiovascular y Departamento de Nutrición, Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, España
| | - M Carmona Martínez
- Administración y Dirección de Empresas, Facultad de Ciencias Jurídicas y de la Empresa, Universidad Católica de Murcia (UCAM), Murcia, España
| | - I C Espinoza Marenco
- Máster en Geriatría, Universidad Católica San Antonio de Murcia (UCAM), Murcia, España
| | - A Pérez-Camacho
- Cirugía Endovascular, Hospital Clínic de Barcelona, Barcelona, España
| | - A Martínez-Pastor
- Cátedra de Riesgo Cardiovascular y Departamento de Nutrición, Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, España
| | - J Abellán-Alemán
- Cátedra de Riesgo Cardiovascular y Departamento de Nutrición, Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, España.
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Ripoll Perelló J, Barrés Fernández PC, Pick Martín J. [Study of correlation between different scales that measure smoking dependence]. Aten Primaria 2023; 55:102581. [PMID: 36796179 PMCID: PMC9958443 DOI: 10.1016/j.aprim.2023.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To analyze the correlation between the degrees of smoking dependence, measured with the Fagerström Test Nicotine Dependence (FTND), Glover-Nilsson Smoking Behavioral Dependence (GN-SBQ) and a measure of self-perceived-dependence (SPD). DESIGN Cross-sectional descriptive observational study. SITE: Urban primary health-care center. PARTICIPANTS Men and women between 18 and 65 years old, daily smokers, selected by non-random consecutive sampling. INTERVENTIONS Self-administration of various questionnaires though an electronic device. MAIN MEASUREMENTS Age, sex and nicotine dependence assessed by: FTND, GN-SBQ and SPD. Statistical analysis, with SPSS 15.0: descriptive statistics, Pearson correlation analysis and conformity analysis. RESULTS Two hundred fourteen smokers were included, 54.7% were women. Median age 52 years (range: 27-65). Depending on the test used, different results of the high/very high degree of dependence were found: FTND 17.3%, GN-SBQ 15.4% and SPD 69.6%. A moderate magnitude (r≈0.5) correlation between the 3 test was found. When assessing concordance, comparing the FTND with SPD, 70.6% of smokers didn't coincide in the severity of dependence, reporting a milder degree of dependence with the FTND than with SPD. Comparing GN-SBQ versus FTND, showed conformity in 44.4% of patients while in 40.7%, the FTND underestimated the severity of dependence. Likewise, when comparing SPD with the GN-SBQ, in the 64% GN-SBQ underestimates, while in 34.1% smokers conformity was demonstrated. CONCLUSIONS The number of patients who consider their SPD to be high/very high was four times higher compared to the GN-SBQ or the FNTD; the latter, being the most demanding, categorizing patients with very high dependence. Requiring a FTND score greater than 7 to prescribe drugs for smoking cessation may exclude subsidiary patients from receiving treatment.
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Affiliation(s)
- Jazmin Ripoll Perelló
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España; Universidad de Valencia, Valencia, España.
| | - Paula C Barrés Fernández
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España
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Ramos-Morcillo AJ, García-Moral AT, Fernández-Salazar S, Leal-Costa C, Ruzafa-Martínez M, Granero-Moya N. [Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©]. Aten Primaria 2022; 54:102495. [PMID: 36347122 DOI: 10.1016/j.aprim.2022.102495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DESIGN Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SETTING Primary Health Care. PARTICIPANTS One hundred fifty-five general practitioners and nurses working at Primary Health Care. INTERVENTIONS Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. MAIN MEASURES Competence in brief tobacco intervention measured by the BTI-Prof©. RESULTS Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test-retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734-0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676-0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76-0.928), p<0.0001. CONCLUSIONS The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.
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Gómez Cerezo JF, López Paz JE, Fernández Pardo J. Update on new forms of tobacco use. Clin Investig Arterioscler 2022; 34:330-338. [PMID: 35606216 DOI: 10.1016/j.arteri.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 06/15/2023]
Abstract
Smoking remains the leading cause of morbidity and mortality worldwide. Because of its clear influence on cardiovascular and respiratory diseases, it is an important factor in internal medicine consultations. Although the rate of smoking cessation has been increasing in recent years, there is a percentage of patients who continue to smoke because they are unable or unwilling to quit, despite having tried existing pharmacological and non-pharmacological therapies. For this group of patients there are strategies based on interventions aimed at reducing the negative effects of smoking without the need for complete cessation. In this review it is shown that due to the absence of combustion of organic matter in conventional cigarettes, snus, e-cigarettes and heated tobacco products generate significantly lower levels of toxic substances.
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Navas Alcántara MS, Montero Rivas L, Guisado Espartero ME, Rubio-Rivas M, Ayuso García B, Moreno Martinez F, Ausín García C, Taboada Martínez ML, Arnalich Fernández F, Martínez Murgui R, Molinos Castro S, Ramos Muñoz ME, Fernández-Garcés M, Carreño Hernandez MC, García García GM, Vázquez Piqueras N, Abadía-Otero J, Lajara Villar L, Salazar Monteiro C, Pascual Pérez MDLR, Perez-Martin S, Collado-Aliaga J, Antón-Santos JM, Lumbreras-Bermejo C. Influence of smoking history on the evolution of hospitalized in COVID-19 positive patients: results from the SEMI-COVID-19 registry. Med Clin (Barc) 2022; 159:214-223. [PMID: 34895891 PMCID: PMC8590935 DOI: 10.1016/j.medcli.2021.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/05/2021] [Accepted: 10/14/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19). METHODS Observational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analyzed. A multivariate logistic regression and Kapplan Meier curves analyzed the relationship between smoking and in-hospital mortality. RESULTS The median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 [59.6-78.0 years]), more frequently male (80.3%) and with higher Charlson index (4 [2-6]) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events. CONCLUSIONS Active or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.
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Affiliation(s)
| | - Lorena Montero Rivas
- Servicio de Medicina Interna, Hospital Infanta Margarita, Cabra, Córdoba, España
| | | | - Manuel Rubio-Rivas
- Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat (Barcelona), Barcelona, España
| | - Blanca Ayuso García
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
| | | | | | | | | | | | - Sonia Molinos Castro
- Servicio de Medicina Interna, Hospital Clínico de Santiago de Compostela, A Coruña, España
| | | | | | - Mari Cruz Carreño Hernandez
- Unidad de Riesgo Vascular, Servicio de Neumología, Hospital Madrid Norte Sanchinarro, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| | | | - Nuria Vázquez Piqueras
- Servicio de Medicina Interna, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - Jesica Abadía-Otero
- Consulta de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, España
| | - Lourdes Lajara Villar
- Servicio de Medicina Interna, Hospital Universitario San Juan de Alicante, Alicante, España
| | - Cristina Salazar Monteiro
- Servicio de Medicina Interna, Hospital Nuestra Señora del Prado,Talavera de la Reina, Toledo, España
| | | | | | - Javier Collado-Aliaga
- Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca, España
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11
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Mostaza JM, Pintó X, Armario P, Masana L, Real JT, Valdivielso P, Arrobas-Velilla T, Baeza-Trinidad R, Calmarza P, Cebollada J, Civera-Andrés M, Cuende Melero JI, Díaz-Díaz JL, Fernández Pardo J, Guijarro C, Jericó C, Laclaustra M, Lahoz C, López-Miranda J, Martínez-Hervás S, Muñiz-Grijalvo O, Páramo JA, Pascual V, Pedro-Botet J, Pérez-Martínez P, Plana N, Puzo J, Sánchez Chaparro MÁ, Vila L. SEA 2022 Standards for Global Control of Cardiovascular Risk. Clin Investig Arterioscler 2022; 34:130-79. [PMID: 35090775 DOI: 10.1016/j.arteri.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 10/27/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023]
Abstract
One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to better knowledge of vascular disease, its prevention and treatment. It is well known that cardiovascular diseases are the leading cause of death in our country and entail a high degree of disability and health care costs. Arteriosclerosis is a multifactorial disease and therefore its prevention requires a global approach that takes into account the different risk factors with which it is associated. Therefore, this document summarizes the current level of knowledge and includes recommendations and procedures to be followed in patients with established cardiovascular disease or at high vascular risk. Specifically, this document reviews the main symptoms and signs to be evaluated during the clinical visit, the laboratory and imaging procedures to be routinely requested or requested for those in special situations. It also includes vascular risk estimation, the diagnostic criteria of the different entities that are cardiovascular risk factors, and makes general and specific recommendations for the treatment of the different cardiovascular risk factors and their final objectives. Finally, the document includes aspects that are not usually referenced in the literature, such as the organization of a vascular risk consultation.
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Ingrid A, Olaya L, Cuevas V, Castillo JS, Becerra N, Delgado J, Cañas A, Alba LH. Effectiveness of brief counselling in a hospital setting for smoking cessation and risky alcohol drinking reduction: randomised clinical trial protocol. Rev Colomb Psiquiatr (Engl Ed) 2022; 51:146-152. [PMID: 35717385 DOI: 10.1016/j.rcpeng.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 06/17/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Chronic diseases are a public health problem, and 80% of them are related to modifiable risk factors such as unhealthy diet, physical inactivity, smoking, and risky alcohol consumption. Although the intervention in smoking and hazardous alcohol drinking has proven to be effective in Primary Care, it is unknown whether it works in the same way in the hospital setting. OBJECTIVE To evaluate the effectiveness of brief counselling in order to modify the stage of change in smokers and at-risk drinkers treated in a high complexity hospital. METHODS A Randomised controlled trial to be conducted, in which an evaluation is made of four brief counselling strategies for smoking cessation and risky alcohol consumption compared to usual care, selected according to the patient's stage of change. The primary result will be the proportion of patients in each of the groups (intervention and control) with identified progress in the stage of change. The reduction of consumption will be also be analysed. Protocol registered at ClinicalTrials.gov (NCT03521622). RESULTS The results will be published in scientific journals, and its application aims to generate behavioural intervention protocols for modifiable risk factors in high complexity hospitals. The trial was presented and approved by the Ethics and Research Committee of the Pontificia Universidad Javeriana and Hospital Universitario de San Ignacio, Bogota, Colombia (Approval 01/2018).
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Affiliation(s)
- Almonacid Ingrid
- Departamento de Medicina Preventiva y Social, Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Lina Olaya
- Departamento de Medicina Preventiva y Social, Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Virginia Cuevas
- Departamento de Medicina Preventiva y Social, Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Juan Sebastián Castillo
- Departamento de Medicina Preventiva y Social, Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Nelci Becerra
- Departamento de Medicina Preventiva y Social, Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Jimena Delgado
- Programa de Promoción y Prevención, Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Alejandra Cañas
- Departamento de Medicina Interna, Hospital Universitario de San Ignacio-Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luz Helena Alba
- Departamento de Medicina Preventiva y Social, Hospital Universitario de San Ignacio, Bogotá, Colombia.
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Chiner-Vives E, Cordovilla-Pérez R, de la Rosa-Carrillo D, García-Clemente M, Izquierdo-Alonso JL, Otero-Candelera R, Pérez-de Llano L, Sellares-Torres J, de Granda-Orive JI. Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases. Arch Bronconeumol 2022; 58 Suppl 1:39-50. [PMID: 35501222 PMCID: PMC9012323 DOI: 10.1016/j.arbres.2022.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic. Till now, it affected 452.4 million (Spain, 11.18 million) persons all over the world with a total of 6.04 million of deaths (Spain, 100,992). It is observed that 75% of hospitalized COVID-19 patients have at least one COVID-19 associated comorbidity. It was shown that people with underlying chronic illnesses are more likely to get it and grow seriously ill. Individuals with COVID-19 who have a past medical history of cardiovascular disorder, cancer, obesity, chronic lung disease, diabetes, or neurological disease had the worst prognosis and are more likely to develop acute respiratory distress syndrome or pneumonia. COVID-19 can affect the respiratory system in a variety of ways and across a spectrum of levels of disease severity, depending on a person's immune system, age and comorbidities. Symptoms can range from mild, such as cough, shortness of breath and fever, to critical disease, including respiratory failure, shock and multi-organ system failure. So, COVID-19 infection can cause overall worsening of these previous respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease, etc. This review aims to provide information on the impact of the COVID-19 disease on pre-existing lung comorbidities.
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Affiliation(s)
- Eusebi Chiner-Vives
- Multidisciplinary Sleep Unit, Respiratory Department, Sant Joan University Hospital, Sant Joan d'Alacant, Alicante, Spain
| | - Rosa Cordovilla-Pérez
- Respiratory Department, Salamanca University Hospital, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | | | - Marta García-Clemente
- Lung Management Area, HUCA, Institute for Health Research of the Principality of Asturias (ISPA), Oviedo, Asturias, Spain
| | - José Luis Izquierdo-Alonso
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain; Respiratory Medicine, University Hospital of Guadalajara, Guadalajara, Spain
| | | | - Luis Pérez-de Llano
- Respiratory Department, Lucus Augusti University Hospital, EOXI Lugo, Monforte, CERVO, Lugo, Spain
| | - Jacobo Sellares-Torres
- Interstitial Lung Diseases Working Group, Respiratory Department, Clinic-University Hospital-IDIBAPS, Barcelona, Spain
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Carral F, Tomé M, Fernández JJ, Piñero A, Expósito C, Jiménez AI, García C, Ayala C. The presence of microvascular complications is associated with a poor evolution of metabolic control in patients with type 1 diabetes mellitus. ENDOCRINOL DIAB NUTR 2021; 68:389-397. [PMID: 34742472 DOI: 10.1016/j.endien.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/22/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To report the evolution of metabolic control and to assess the clinical and metabolic factors associated with the presence of microvascular complications in patients with type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS This was a retrospective, observational study analysing clinical, laboratory, and therapeutic data from a registry of patients with T1DM created in 2010. RESULTS Data recorded from 586 patients (males: 50.2%; mean age: 36.1±13.5 years; T1DM duration: 18.0±12.1 years) followed for a mean of 6.0±3.1 years were assessed, and 8133 HbA1c levels (13.2±7.6 measurements/patient) were analysed, with a mean evolutionary HbA1c of 7.9%±1.2%. The mean annual HbA1c level gradually improved from 8.6%±1.6% in 2010 to 7.5%±1.4% in 2019, with 34.3% and 69.0% of patients having HbA1c levels ≤7% and ≤8% respectively. Patients with T1DM duration of <10 years and ≥20 years, non-smokers, CSII users, and those using the insulin/carbohydrate ratio had better current and evolutionary HbA1c levels. The presence of microvascular complications was independently associated with T1DM lasting ≥20 years, the presence of HBP, and evolutionary HbA1c≥7.0%. CONCLUSION A progressive but still inadequate improvement in metabolic control over 10 years was seen in patients with T1DM. Poor metabolic control (mean HbA1c over 10 years ≥7%) was independently associated with the presence of microvascular complications.
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Affiliation(s)
- Florentino Carral
- Unidad de Endocrinología y Nutrición, Hospital Universitario Puerto Real, Cádiz, Spain.
| | - Mariana Tomé
- Unidad de Endocrinología y Nutrición, Hospital Universitario Puerto Real, Cádiz, Spain
| | - Juan Jesús Fernández
- Unidad de Obstetricia y Ginecología, Hospital Universitario Puerto Real, Cádiz, Spain
| | - Antonia Piñero
- Unidad de Endocrinología y Nutrición, Hospital Universitario Puerto Real, Cádiz, Spain
| | - Coral Expósito
- Unidad de Endocrinología y Nutrición, Hospital Universitario Puerto Real, Cádiz, Spain
| | - Ana Isabel Jiménez
- Unidad de Endocrinología y Nutrición, Hospital Universitario Puerto Real, Cádiz, Spain
| | - Concepción García
- Unidad de Endocrinología y Nutrición, Hospital Universitario Puerto Real, Cádiz, Spain
| | - Carmen Ayala
- Unidad de Endocrinología y Nutrición, Hospital Universitario Puerto Real, Cádiz, Spain
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15
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Abstract
Introduction Obesity, diabetes, hypertension and age have been pointed at as factors that influence on the progression of COVID-19; however, evidence for other conditions is inconclusive. Objective To identify which clinical characteristics are related to COVID-19 severity and to determine whether age acts a modifier of the relationship between cardio-metabolic comorbidities (CMC) and COVID-19 progression. Method Data on ≥ 20-year-old confirmed cases (n = 159,017) were analyzed. Hospitalization, development of pneumonia, intubation requirement, intensive care unit admission and death were the dependent variables in Poisson regression models estimation, whereas the interaction between age and different CMCs were the independent variables. Results Having CMCs, as well as other comorbidities, was directly related to COVID-19 progression, whereas chronic obstructive pulmonary disease was only related to an increase in the risk of dying. The risk for COVID-19 severity was lower as age was more advanced. Asthma and smoking were not risk factors for the progression of COVID-19. Conclusion In the Mexican population, the risk of COVID-19 progression associated with comorbidities was higher in young adults.
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Affiliation(s)
- Miguel A Pérez-Sastré
- Master's Degree and Doctorate Program in Medical, Dental and Health Sciences, Universidad Nacional Autónoma de México. Mexico City, Mexico
| | - Jesús Valdés
- Biochemistry Department, Center for Research and Advanced Studies, Instituto Politécnico Nacional. Mexico City, Mexico
| | - Luis Ortiz-Hernández
- Health Care Department, Universidad Autónoma Metropolitana, Xochimilco Unit. Mexico City, Mexico
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Alpaydin AÖ, Aktan R, Keleş E, Özalevli S. Factors affecting the severity of fatigue in male patients with chronic obstructive pulmonary disease. Rev Clin Esp 2021; 221:86-92. [PMID: 38108662 DOI: 10.1016/j.rce.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/20/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease. METHODS Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire-Short Form), and health-related quality of life (36-Item Short Form Health Survey). RESULTS A total of 64 male chronic obstructive pulmonary disease patients were evaluated (mean age 61.1±4.7 years, mean Fatigue Severity Scale score 39.8±14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared=0.84, F=29.48, df=60, p<.001). It showed that the Medical Research Council Dyspnea Scale score (β=.40), cigarette consumption (β=.35), and physical activity level (β=-.37) were significantly correlated with the severity of fatigue (p<.001 for all) and that they independently contributed to the prediction of severity of fatigue. CONCLUSION Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and health-related quality of life were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.
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Affiliation(s)
- A Ö Alpaydin
- Departamento de Enfermedades Torácicas, Facultad de Medicina, Universidad Dokuz Eylul, Esmirna, Turquía
| | - R Aktan
- Departamento de Fisioterapia, Escuela vocacional de Servicios de Salud, Universidad de Economía de Esmirna, Esmirna, Turquía; Instituto de Ciencias de la Salud, Universidad Dokuz Eylul, Esmirna, Turquía
| | - E Keleş
- Departamento de Fisioterapia y Rehabilitación, Facultad de Ciencias de la Salud, Universidad Izmir Kâtip Celebi, Esmirna, Turquía
| | - S Özalevli
- Departamento de Rehabilitación Pulmonar, Universidad Dokuz Eylul, Esmirna, Turquía.
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Alpaydin AÖ, Aktan R, Keleş E, Özalevli S. Factors affecting the severity of fatigue in male patients with chronic obstructive pulmonary disease. Rev Clin Esp 2021; 221:86-92. [PMID: 33998493 DOI: 10.1016/j.rceng.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease. METHODS Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire Short-Form), and health-related quality of life (36-Item Short Form Health Survey). RESULTS A total of 64 male COPD patients were evaluated (mean age 61.1 ± 4.7 years, mean FSS score 39.8 ± 14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared = 0.84, F = 29.48, df = 60, p < .001). It showed that the MRC score (β = .40), cigarette consumption (β = .35), and physical activity level (β = -.37) were significantly correlated with the severity of fatigue (p < .001 for all) and that they independently contributed to the prediction of severity of fatigue. CONCLUSION Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and HRQOL were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.
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Jiménez-Ruiz CA, Chatkin JM, Morais A, Zabert G, Rosa P, Gea J, Cavalcanti Lundgren FL, Boléo-Tomé JP, Araújo AJD, Borrajo C, Buljubasich D, Garcia Rueda M. Consensus Document on Medical Faculty Education on the Treatment of Smoking. Arch Bronconeumol 2020; 56:806-811. [PMID: 32513588 DOI: 10.1016/j.arbres.2020.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/06/2020] [Accepted: 04/26/2020] [Indexed: 11/23/2022]
Abstract
We report the results of a consensus reached by an expert group of representatives from different medical societies in Latin America on the objectives, competencies (knowledge, and skills), content, and duration of smoking cessation education in Latin American medical schools. The document discusses the following aspects: epidemiology, nicotine dependence, factors for initiation and maintenance of tobacco use, smoking-related disorders, diagnosis, minimal intervention, non-pharmacological and pharmacological interventions for smoking cessation, and prevention of smoking.
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Affiliation(s)
- Carlos A Jiménez-Ruiz
- Presidente de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR); Unidad Especializada en Tabaquismo, Hospital Clínico San Carlos, Madrid, España.
| | - Jose Miguel Chatkin
- Presidente Sociedade Brasileira Pneumologia e Tisiologia; Medicina Interna/Pneumologia, Escola de Medicina PUCRS, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Antonio Morais
- Presidente Sociedade Portuguesa Pneumologia; Centro Hospitalar Universitário São João, Oporto, Portugal; Faculdade de Medicina do Porto, Oporto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Oporto, Portugal
| | - Gustavo Zabert
- Presidente de Asociación Latinoamericana del Tórax; Facultad de Ciencias Médicas, Universidad Nacional de Comahue, Argentina
| | - Paula Rosa
- Serviço de Pneumologia, Hospital Vila França de Xira, Vila Franca de Xira, Portugal
| | - Joaquim Gea
- Facultad de Medicina, Universidad Pompeu Fabra, Barcelona, España
| | | | | | - Alberto José de Araújo
- Departamento de Tabaquismo de la Asociación Latinoamericana de Tórax (ALAT), Montevideo, Uruguay
| | - Cristina Borrajo
- Núcleo de Estudos e Tratamento do Tabagismo, Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Marcos Garcia Rueda
- Servicio de Neumología, Hospital Regional Universitario Carlos Haya, Málaga, España
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Almonacid I, Olaya L, Cuevas V, Castillo JS, Becerra N, Delgado J, Cañas A, Alba LH. Effectiveness of Brief Counseling in a Hospital Setting for Smoking Cessation and Risky Alcohol Drinking Reduction: Randomized Clinical Trial Protocol. Rev Colomb Psiquiatr (Engl Ed) 2020; 51:S0034-7450(20)30085-8. [PMID: 33735015 DOI: 10.1016/j.rcp.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/19/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Chronic diseases are a public health problem, and 80% of them are related to modifiable risk factors such as unhealthy diet, physical inactivity, smoking, and risky alcohol consumption. Although the intervention in smoking and hazardous alcohol drinking has proven to be effective in Primary Care, it is unknown whether it works in the same way in the hospital setting. OBJECTIVE To evaluate the effectiveness of brief counselling in order to modify the stage of change in smokers and at-risk drinkers treated in a high complexity hospital. METHODS A Randomised controlled trial to be conducted, in which an evaluation is made of four brief counselling strategies for smoking cessation and risky alcohol consumption compared to usual care, selected according to the patient's stage of change. The primary result will be the proportion of patients in each of the groups (intervention and control) with identified progress in the stage of change. The reduction of consumption will be also be analysed. Protocol registered at ClinicalTrials.gov (NCT03521622). RESULTS The results will be published in scientific journals, and its application aims to generate behavioural intervention protocols for modifiable risk factors in high complexity hospitals. The trial was presented and approved by the Ethics and Research Committee of the Pontificia Universidad Javeriana and Hospital Universitario de San Ignacio, Bogota, Colombia (Approval 01/2018).
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Affiliation(s)
- Ingrid Almonacid
- Departamento de Medicina Preventiva y Social. Pontificia Universidad Javeriana. Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Lina Olaya
- Departamento de Medicina Preventiva y Social. Pontificia Universidad Javeriana. Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Virginia Cuevas
- Departamento de Medicina Preventiva y Social. Pontificia Universidad Javeriana. Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Juan Sebastián Castillo
- Departamento de Medicina Preventiva y Social. Pontificia Universidad Javeriana. Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Nelci Becerra
- Departamento de Medicina Preventiva y Social. Pontificia Universidad Javeriana. Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Jimena Delgado
- Programa de promoción y prevención, Hospital Universitario de San Ignacio, Bogotá, Colombia
| | - Alejandra Cañas
- Departamento de Medicina Interna, Hospital Universitario de San Ignacio-Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luz Helena Alba
- Departamento de Medicina Preventiva y Social. Pontificia Universidad Javeriana. Hospital Universitario de San Ignacio, Bogotá, Colombia.
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Almadana Pacheco V, Benito Bernáldez C, Luque Crespo E, Perera Louvier R, Rodríguez Fernández JC, Valido Morales AS. [Do COPD patients lie about their smoking habit?]. Aten Primaria 2020; 52:523-528. [PMID: 32741661 PMCID: PMC7505893 DOI: 10.1016/j.aprim.2020.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To determine the deception rate or concordance between the interview on smoking and cooximetry in COPD patients from a monographic consultation. DESIGN Prospective observational study to evaluate the concordance between the values of cooximetry and the response to a clinical interview on smoking. SETTING COPD monographic consultation, Pneumology, Seville. PARTICIPANTS Patients with a confirmed diagnosis of COPD in any degree. INTERVENTIONS Clinical interview and measurement of carbon monoxide by cooximetry. MAIN MEASUREMENTS Cooximetry values, responses on smoking, sociodemographic variables. RESULTS n: 169. 107 patients presented values less than or equal to 6 ppm compared to 62 with values greater than 6 ppm, determining a prevalence of active smoking of 36.7%. The deception rate was 19.5% of the total sample (24.3% of all those who claimed not to smoke), with a Cohen kappa of 0.48 and p < 0.000. 40% of patients confessed not having told the truth. No relationship of this data was found with age, accumulated tobacco consumption or FEV1. A significant relationship with sex was found (deception rate: 31.8% in women vs. 15.2% in men, p 0.017). CONCLUSIONS In spite of our attempts to make patients stop smoking, a considerable deception rate was found in our consultation; higher among women, recent ex-smokers or in the process of abandonment, so it would be essential to incorporate objective measures such as the cooximeter in the approach of this type of patient.
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Affiliation(s)
| | | | - Estefanía Luque Crespo
- Unidad de Gestión Clínica de Neumología. Hospital Universitario Virgen Macarena, Sevilla, España
| | - Rafael Perera Louvier
- Unidad de Gestión Clínica de Neumología. Hospital Universitario Virgen Macarena, Sevilla, España
| | | | - Agustín S Valido Morales
- Unidad de Gestión Clínica de Neumología. Hospital Universitario Virgen Macarena, Sevilla, España
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Lorenzo-Gómez MF, Santos-Antunes MT, Nieto-Huertos A, Lorenzo-Gómez A, Marquez-Sanchez MT, Flores-Fraile MC, Valverde-Martinez LS, González-Casado I, García-Cenador MB, Mirón-Canelo JA, Padilla-Fernández B. The influence of smoking on bacterial resistance after vaccine or antibiotic prophylaxis against recurrent urinary tract infections. Actas Urol Esp 2020; 44:497-504. [PMID: 32595091 DOI: 10.1016/j.acuro.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/20/2020] [Accepted: 04/07/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The influence of tobacco on the microbiological spectrum, resistance-sensitivity pattern and evolution in patients with recurrent urinary tract infections (RUTI) is analyzed. Evaluation of the effect of polyvalent bacterial vaccine on the prevention of RUTI and smoking status. MATERIAL AND METHODS Retrospective multicenter study of 855 women with RUTI receiving suppressive antibiotic treatment or bacterial vaccine between 2009 and 2013. Group A (GA): Antibiotic (n=495); Subgroups: GA1 non-smoker (n=417), GA2 smoker (n=78). Group B (GB): Vaccine (n=360); Subgroups: GB1 non-smoker (n=263), GB2 smoker (n=97). VARIABLES Age, pre-treatment UTI, disease-free time (DFT), microbial species, sensitivity and resistance. Follow-up at 3, 6 and 12 months with culture and SF-36 questionnaire. RESULTS Mean age 56.51 years (18-75), similar between groups (P=.2257). No difference in the number of pretreatment UTIs (P=.1329) or in the distribution of the bacterial spectrum (P=.7471). DFT was higher in subgroups B compared with A. Urine cultures in GA1: E. coli 62.71% with 8.10% resistance (33% quinolones; 33% cotrimoxazole; 33% quinolones + cotrimoxazole); in GA2 E. coli 61.53% with 75% resistance (16.66% quinolones; 33.33% quinolones + cotrimoxazole; 16.66% amoxicillin-clavulanate; 16.66% erythromycin + phosphomycin + clindamycin) (P=.0133). There were no differences between patients of GA treated with cotrimoxazole and nitrofurantoin (P=.8724). Urine cultures in GB1: E. coli 47.36% with 22.22% resistance (5.55% ciprofloxacin; 5.55% cotrimoxazole; 5.55% ciprofloxacin + cotrimoxazole; 5.55% amoxicillin/clavulanic acid). In GB2 E. coli 70.02% with 61.90% resistances (30.76% quinolones; 30.76% cotrimoxazole; 30.76% quinolones + cotrimoxazole; 17.69% amoxicillin-clavulanic acid) (P=.0144). CONCLUSIONS The development of bacterial resistance is more frequent among women with smoking habits and recurrent urinary infections. This could influence a worse response to preventive treatments, either with antibiotics or vaccines.
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Jiménez-Ruiz CA, López-Padilla D, Alonso-Arroyo A, Aleixandre-Benavent R, Solano-Reina S, de Granda-Orive JI. COVID-19 and Smoking: A Systematic Review and Meta-Analysis of the Evidence. Arch Bronconeumol 2020; 57:21-34. [PMID: 34629638 PMCID: PMC7381922 DOI: 10.1016/j.arbres.2020.06.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of this study was to determine if tobacco use in patients with Covid-19 is associated with a negative disease course and adverse outcome, and if smoking, current and past, is associated with a greater possibility of developing COVID-19. MATERIAL AND METHODS A systematic review (SR) and meta-analysis (MA) of previously published works were performed. The search strategy included all known descriptors for Covid-19 and tobacco and was conducted in different databases. Appropriate statistical models were used to address the effect size in meta-analysis, namely random effects and fixed effects model. RESULTS Thirty-four articles were identified in the SR of which 19 were included in the MA. Being a smoker or former smoker was shown to be a risk factor for worse progression of Covid-19 infection (OR 1.96, 95% CI, 1.36 - 2.83) and a greater probability of presenting a more critical condition (OR 1.79 95% CI, 1.19 - 2.70). As limitations of the MA, we found that most of the studies analyzed were observational with limited publication bias. Two studies that disagreed with the rest were included, although after withdrawing them from the MA, smoking was maintained as a risk factor for worse progress. CONCLUSION Current and past smoking produces a more serious clinical form of Covid-19 and more frequently leads to intensive care admission, intubation, and death.
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Affiliation(s)
| | - Daniel López-Padilla
- Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Adolfo Alonso-Arroyo
- Departamento de Historia de la Ciencia y Documentación, Universidad de Valencia, Valencia, España
| | | | | | - José Ignacio de Granda-Orive
- Servicio de Neumología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España.
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Cuevas Fernández FJ, Iglesias Girón MJ, Rodríguez Pérez MDC, Ortiz Simarro S, Cabrera de León A, Aguirre-Jaime A. [Evolution of Smoking According to Social Class in the Adult Population of the Canary Islands During 2000-2015: Follow-up of the CDC-Canary Cohort]. Aten Primaria 2020; 52:381-388. [PMID: 31272849 PMCID: PMC7256798 DOI: 10.1016/j.aprim.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 12/02/2022] Open
Abstract
Objetivo Conocer la evolución del consumo de tabaco en Canarias durante 2000-2015 según clase social. Emplazamiento Comunidad Autónoma de Canarias. Participantes Cohorte CDC-Canarias con cortes en 2000 (n = 6.729), 2008 (n = 6.171) y 2015 (n = 4.705). Mediciones principales Tabaquismo, sexo, edad y clase social. Resultados El consumo disminuyó un 6% (5-7%, p < 0,001) en general, siendo más acentuado en el periodo 2000-2008 (5%). La disminución fue mayor en hombres, aunque siguieron fumando más que las mujeres, con una prevalencia del 25% (24-26%) frente al 18% (17-19%, p < 0,001). Solo hubo una disminución del consumo en los grupos jóvenes (6% [3-5%]; p = 0,011) y de edades intermedias (7% [6-8%]; p < 0,001). En todas las clases sociales se observó una disminución similar, con mayor prevalencia de tabaquismo en la clase alta: 24% (23-25%) en 2015 (p < 0,001). Al valorar conjuntamente sexo, edad y clase social, los hombres más jóvenes y de edad intermedia presentaron los mayores descensos de consumo: 8% (7-9%) clase baja y alta, 10% (9-11%) clase media. En la clase social baja, las mujeres más jóvenes continúan fumando más (27%) aunque abandonaron más el consumo (14%), fenómeno que en las de clase media se produjo en edades intermedias. Conclusiones La evolución del consumo de tabaco en Canarias sigue un patrón similar al conjunto de España. El abandono del consumo de tabaco se ha frenado en el periodo 2008-2015, especialmente en hombres y en clases sociales medias y altas.
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Affiliation(s)
- Francisco Javier Cuevas Fernández
- Área de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de La Laguna, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España; Gerencia de Atención Primaria de Tenerife, Santa Cruz de Tenerife, España
| | | | - María Del Cristo Rodríguez Pérez
- Unidad de Investigación, Gerencia de Atención Primaria de Tenerife, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España
| | - Silvia Ortiz Simarro
- Dependencia de Sanidad, Subdelegación del Gobierno, Santa Cruz de Tenerife, España
| | - Antonio Cabrera de León
- Área de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de La Laguna, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España; Unidad de Investigación, Gerencia de Atención Primaria de Tenerife, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España.
| | - Armando Aguirre-Jaime
- Instituto de Investigación en Cuidados, Iltre. Colegio de Enfermeros de Santa Cruz de Tenerife, Santa Cruz de Tenerife, España; Departamento de Salud Pública, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife, España
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Muñoz-Pindado C, Muñoz-Pindado C, Gómez-Fernández M, Lora-Pablos D, Muñoz-Méndez J. [High level of student smokers in Madrid compared with a similar previous study of 2014]. Semergen 2020; 46:313-323. [PMID: 32089401 DOI: 10.1016/j.semerg.2019.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/24/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022]
Abstract
Smoking is a public health problem that affects young people, and influenced by the environment and cultural level. OBJECTIVES To determine smoking prevalence among high-level baccalaureate students in the Autonomous Community of Madrid during the 2018-2019 academic year. To assess the influence of the socio-cultural environment on the onset of youth smoking. To compare the results with previous studies conducted on students of baccalaureate of excellence (BE) and the general population. POPULATION AND METHODS Cross-sectional study on BE students in the Autonomous Community of Madrid. Using an anonymous questionnaire, they were asked about tobacco, alcohol and drug consumption, as well as the influence of the environment, friends, and family in the beginning. To compare with previous studies. RESULTS A total of 740 valid questionnaires were collected, of which 430 (58.1%) were female, an overall mean age of 16.57±0.61 years, and 53 (7.18%) were smokers. The majority 39 (78%) of smokers acknowledged their friends' influence at its onset. Alcohol was consumed by 349 (47.48%) and other drugs by 109 (15.27%). Being a smoker was related to alcohol, other drugs, a smoking mother, smoking siblings and smoking friends. CONCLUSIONS Smoking prevalence among students of BE in Autonomous Community of Madrid continues to be lower than the prevalence of adolescents of their age and there are no variations from previous reports. Starting smoking is related to smoking by friends, siblings, and the mother and with the consumption of alcohol and other substances. Education is very important in the beginning and prevention of smoking, and it is necessary to implement prevention programs at early ages in order to promote their effectiveness, and aimed at young people, parents and teachers.
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Affiliation(s)
| | - C Muñoz-Pindado
- Medicina Familiar y Comunitaria, Centro de Atención Primaria de Manlleu, Hospital Universitario de Vic, Barcelona, España.
| | - M Gómez-Fernández
- Servicio de Neumología, Hospital HM Puerta del Sur, Móstoles, Madrid, España; Facultad de Medicina USP-CEU, Madrid, España
| | - D Lora-Pablos
- Servicio de Estadística, Hospital Universitario 12 de Octubre, Madrid, España
| | - J Muñoz-Méndez
- Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España
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Martínez JW, Cardona-Miranda L, Barbosa-Gantiva Ó, Martínez MA, Álvarez JF, López JA, Chica CD, Restrepo-Rojas S, Naranjo Y, Marín-Medina DS. Tobacco consumption in the population of Risaralda, Colombia. Rev Med Inst Mex Seguro Soc 2020; 58:408-416. [PMID: 34543546 DOI: 10.24875/rmimss.m20000065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCCIÓN El tabaquismo tiene una alta prevalencia en todo el mundo, y genera alta mortalidad, morbilidad e inequidad social. OBJETIVO Determinar la prevalencia e identificar las características del tabaquismo en la población del departamento de Risaralda, Colombia. MATERIAL Y MÉTODOS Estudio de corte transversal que incluyó 2084 personas mayores de 18 años residentes en los municipios del departamento de Risaralda, en la región cafetalera de Colombia. Se les preguntó por el consumo de tabaco, el grado de dependencia del tabaco (prueba de Fagerström) y el nivel de ansiedad por el consumo (cuestionario QSU-brief). MATERIAL Y MÉTODOS El 12% fueron fumadores activos, el 17% exfumadores y un 20-24% convivió, trabajó o estudió con alguien que fumaba. El 94% de los fumadores intentó dejar de fumar y el 67% lo logró por más de 1 año. La mediana de la escala de Fagerström fue de 4 (rango intercuartílico [RIC]: 2-5) y la del QSU-brief fue de 28 (RIC: 16-44). El consumo del cigarrillo sin llegar al filtro (p < 0.001), comprar la caja de cigarrillos entera (p < 0.001), haber intentado dejar de fumar (p < 0.001), consumir café (p < 0.001), desear dejar de fumar (p < 0.001) y fumar aunque se esté enfermo (p = 0.002) aumentaron el riesgo de ser fumador actual, mientras que pedirle el cigarrillo a un amigo o familiar (p = 0.004) y haber dejado de fumar en algún momento (p < 0.001) lo disminuyeron. CONCLUSIONES La frecuencia de consumo fue alta, pero los niveles de dependencia y ansiedad permiten establecer que un programa de cesación de consumo de tabaco sería exitoso en esta población. Se sugiere aplicar la encuesta definida en esta investigación para identificar a los fumadores actuales e implementar estrategias de cesación de consumo de tabaco en este grupo. BACKGROUND Smoking has a high prevalence worldwide, generates high mortality, morbidity and social inequity. OBJECTIVE Determine the prevalence and identify the characteristics of tobacco smoking in the population of Risaralda, Colombia. MATERIAL AND METHODS Cross-sectional study that included 2084 people over 18 years living in the municipalities of the Department of Risaralda, in the coffee region of Colombia. They were asked about tobacco consumption, level of tobacco dependence (Fagerström test) and level of consumption anxiety (QSU-brief questionnaire). MATERIAL AND METHODS 12% were active smokers, 17% were ex-smokers and 20-24% lived, worked or studied with someone who smoked. 94% of smokers have tried to stop smoking, and 67% achieved it for more than one year. The median of the Fagerström scale was 4 (interquartile range [IQR]: 2-5) and the QSU-brief was 28 (IQR: 16-44). Consumption of the cigarette without reaching the filter (p < 0.001), buying the whole cigarette package (p < 0.001), having tried to stop smoking (p < 0.001), consuming coffee (p < 0.001), wishing to stop smoking (p < 0.001) and smoking even if sick (p = 0.002) increased the risk of being a current smoker, while asking a friend or family member for a cigarette (p = 0.004) and achieved smoking cessation at some point (p < 0.001), decreased it. CONCLUSIONS The frequency of consumption was high, due and the levels of dependence and anxiety found, it is possible to propose that a smoking cessation program would be successful in this population. It is suggested to apply the survey defined in this research to identify the current smoker and implement tobacco cessation strategies in this group.
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Affiliation(s)
- José William Martínez
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias Comunitarias
| | - Leison Cardona-Miranda
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias del Deporte y la Recreación
| | - Óscar Barbosa-Gantiva
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias Comunitarias
| | - Marco Alexander Martínez
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias del Deporte y la Recreación
| | - Juan Fernando Álvarez
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias del Deporte y la Recreación
| | - John Alejandro López
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias del Deporte y la Recreación
| | - Christian David Chica
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias del Deporte y la Recreación
| | - Santiago Restrepo-Rojas
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Departamento de Ciencias del Deporte y la Recreación
| | - Yonatan Naranjo
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Programa de Medicina. Pereira, Risaralda, Colombia
| | - Daniel Stiven Marín-Medina
- Universidad Tecnológica de Pereira, Facultad de Ciencias de la Salud, Programa de Medicina. Pereira, Risaralda, Colombia
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Jiménez-Ruiz CA, Zabert G, Buljubasich D, de Granda-Orive JI, Buendía I, Luhning S, Rodriguez-Portal JA, Caro F, Albert ML, Riesco-Miranda JA, Borrajo C, Sánchez-Angarita E, Acuña-Izcaray A. Questions and Answers on Smoking in Patients With Diffuse ILD. Use of PICO Methodology. Arch Bronconeumol 2020; 56:435-40. [PMID: 31753676 DOI: 10.1016/j.arbres.2019.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 08/12/2019] [Accepted: 09/02/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The Smoking and the Diffuse Interstitial Lung Diseases (ILD) groups of ALAT and SEPAR collaborated in the preparation of this document. MATERIALS AND METHODS This document uses PICO methodology to answer various questions on the relationship between tobacco use and diffuse ILD. RESULTS AND CONCLUSIONS The main recommendations are: a) moderate level of evidence and strong recommendation to consider smoking as a risk factor for the development and/or modification of the progression of diffuse ILD; b) moderate level of evidence to identify an increase in mortality in diffuse ILD, irrespective of histologic pattern. Low evidence for ascribing it to smoking and strong recommendation for the early identification of patients with diffuse ILD. Further studies are needed to evaluate the effect of smoking cessation in patients with diffuse ILD; c) low level of evidence and weak recommendation for defining the impact of passive smoking in diffuse ILD; d) low level of evidence to demonstrate that smoking cessation improves the outcomes of patients diagnosed with diffuse ILD and strong recommendation to advise smoking cessation in smokers with diffuse ILD, and e) low level of evidence to support the clinical or epidemiological usefulness of active case finding for diffuse ILD in smoking cessation programs, and strong recommendation justifying the performance of spirometry in active case finding, based not on current smoking status, but on previous accumulated consumption, even in asymptomatic cases.
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García de Veas Silva JL, González Rodríguez C, Hernández Cruz B. Association of the Shared Epitope, Smoking and the Interaction Between the Two With the Presence of Autoantibodies (Anti-CCP and RF) in Patients With Rheumatoid Arthritis in a Hospital in Seville, Spain. Reumatol Clin (Engl Ed) 2019; 15:289-295. [PMID: 29102586 DOI: 10.1016/j.reuma.2017.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/28/2017] [Accepted: 08/11/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To evaluate the association of shared epitope, smoking and their interaction on the presence of autoantibodies (anti-cyclic citrullinated peptide [CCP] antibodies and rheumatoid factor) in patients with rheumatoid arthritis in our geographical area. METHODS A descriptive and cross-sectional study was carried out in a cohort of 106 patients diagnosed with RA. Odds ratios (OR) for antibody development were calculated for shared epitope, tobacco exposure and smoking dose. Statistical analysis was performed with univariate and multivariate statistics using ordinal logistic regression. Odds ratios were calculated with 95% confidence interval (95% CI) and a value of P<.05 was considered significant. RESULTS In univariate analysis, shared epitope (OR=2.68; 95% CI: 1.11-6.46), tobacco exposure (OR=2.79; 95% CI: 1.12-6.97) and heavy smoker (>20 packs/year) (OR=8.93; 95% CI: 1.95-40.82) were associated with the presence of anti-CCP antibodies. For rheumatoid factor, the association was only significant for tobacco exposure (OR=3.89; 95% CI: 1.06-14.28) and smoking dose (OR=8.33; 95% CI: 1.05-66.22). By ordinal logistic regression analysis, an association with high titers of anti-CCP (>200U/mL) was identified with South American mestizos, patients with homozygous shared epitope, positive FR and heavy smokers. CONCLUSIONS Being a South American mestizo, having a shared epitope, rheumatoid factor positivity and a smoking dose>20 packs/year are independent risk factors for the development of rheumatoid arthritis with a high titer of anti-CCP (>200U/mL). In shared epitope-positive rheumatoid arthritis patients, the intensity of smoking is more strongly associated than tobacco exposure with an increased risk of positive anti-CCP.
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Affiliation(s)
| | | | - Blanca Hernández Cruz
- Consulta de Artritis Precoz, Unidad de Reumatología Clínica, Hospital Universitario Virgen Macarena, Sevilla, España
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Mostaza JM, Pintó X, Armario P, Masana L, Ascaso JF, Valdivielso P; en nombre de la Sociedad Española de Arteriosclerosis., Miembros de la Sociedad Española de Arteriosclerosis. Standards for global cardiovascular risk management arteriosclerosis. Clin Investig Arterioscler 2019; 31 Suppl 1:1-43. [PMID: 30981542 DOI: 10.1016/j.arteri.2019.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
One of the main goals of the Spanish Society of Arteriosclerosis is to contribute to a wider and greater knowledge of vascular disease, its prevention and treatment. Cardiovascular diseases are the leading cause of death in our country and also lead to a high degree of disability and health expenditure. Arteriosclerosis is a multifactorial disease, this is why its prevention requires a global approach that takes into account the different risk factors with which it is associated. Thus, this document summarizes the current level of knowledge and integrates recommendations and procedures to be followed for patients with established cardiovascular disease or high vascular risk. Specifically, this document reviews the main symptoms and signs to be evaluated during the clinical visit, the laboratory and imaging procedures to be routinely requested or those in special situations. It also includes the estimation of vascular risk, the diagnostic criteria of the different entities that are cardiovascular risk factors, and presents general and specific recommendations for the treatment of the different cardiovascular risk factors and their final objectives. Finally, the document includes aspects that are not often mentioned in the literature, such as the organisation of a vascular risk consultation.
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Barrueco-Otero E, Bartol Sánchez M, Pérez Rodríguez J, González Ruiz JM, Barrueco Ferrero M. Adherence to Long-Term Oxygen Therapy. Influence of Tobacco Use. Arch Bronconeumol 2019; 55:368-372. [PMID: 30713013 DOI: 10.1016/j.arbres.2018.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Domiciliary oxygen therapy (DOT) is a treatment that requires a high level of cooperation from patients due to the time it takes every day. A high level of non-compliance has been determined among patients receiving DOT. The aim of our study was to assess the level of non-compliance and the influence of active tobacco consumption on compliance. MATERIAL AND METHODS Patients were monitored in the home using direct and indirect methods, to assess both compliance and tobacco consumption. RESULTS The level of non-compliance detected by indirect methods was 22.6%, and 66.3% by direct methods. Tobacco consumption determined by indirect methods was 5.8%-8%, depending on the method used, and 16.2% when CO in exhaled air ≥10ppm was established as an indicator of tobacco use. The group of smokers complied with oxygen therapy for a significantly fewer number of hours per day (P<.001) than non-smokers. CONCLUSIONS There is a high level of therapeutic non-compliance and a significant percentage of patients receiving DOT continue to smoke. Compliance must be monitored, and the correct use of DOT must be emphasized. Additional efforts should also be made to help smokers with DOT to stop smoking, since continued smoking impacts negatively on therapeutic non-compliance.
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Affiliation(s)
- Enrique Barrueco-Otero
- Unidad Docente de Medicina Familiar y Comunitaria, Hospital de Barbastro, Huesca, España
| | | | | | - José María González Ruiz
- Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España; Departamento de Medicina, Universidad de Salamanca, Salamanca, España
| | - Miguel Barrueco Ferrero
- Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España; Departamento de Medicina, Universidad de Salamanca, Salamanca, España.
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Olano Espinosa E, Lozano Polo A, Grifell Guàrdia M, Pinet Ogué MC, Isorna Folgar M, Moreno Arnedillo JJ. [Why and how keep in mind cannabis in our smoking outpatients?]. Aten Primaria 2019; 52:47-53. [PMID: 30598304 PMCID: PMC6939018 DOI: 10.1016/j.aprim.2018.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/04/2018] [Accepted: 05/25/2018] [Indexed: 11/19/2022] Open
Abstract
El Proyecto ÉVICT (Evictproject.org), a raíz del aumento de consumo de cannabis en población juvenil española, ha estudiado su asociación con el tabaco, concluyendo que el consumo conjunto de tabaco y cannabis: tiene una influencia en el proceso de aprender a fumar, pues el inicio puede ser conjunto y con influencia bidireccional; tiene una influencia en el desarrollo de dependencia pues su interacción es relevante para el desarrollo de este trastorno, y tiene una influencia en la toxicidad, pues probablemente, el fumar tabaco y cannabis genera mayores problemas que fumar solo una de las 2. Y, por tanto, el equipo EVICT emite unas consideraciones en prevención: diferenciar uso medicinal y recreativo; comunicar que fumar cannabis no es terapéutico ni inocuo, y puede ayudar a generar dependencia de nicotina o, menos frecuentemente, al propio cannabis. Consideraciones en abordaje y tratamiento: en personas que consumen tabaco/cannabis debemos plantear como primera opción el cese de las 2 sustancias. Consideraciones en reducción de daños: a quienes solo consumen productos de tabaco/cannabis, los programas serían más aplicables a aquella cuyo consumo se considere más problemático.
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Affiliation(s)
- Eduardo Olano Espinosa
- Centro de Salud Los Castillos, DAO, Servicio Madrileño de Salud, Alcorcón, Madrid, España.
| | - Adelaida Lozano Polo
- Servicio Promoción y Educación para la Salud, D.G. Salud Pública y Adicciones, Consejería de Salud, Murcia, España
| | - Marc Grifell Guàrdia
- Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar, Barcelona, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, España
| | | | - Manuel Isorna Folgar
- Universidade de Vigo, Facultad Ciencias Educación, Campus Universitario As Lagoas, Orense, España
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Muñoz-Pindado C, Muñoz-Pindado C, Roura-Poch P, Riesco-Miranda JA, Muñoz-Méndez J. [Smoking Prevalence in High School Students in the Barcelona Region (De Osona District)]. Semergen 2018; 45:215-224. [PMID: 30554989 DOI: 10.1016/j.semerg.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/28/2018] [Accepted: 11/12/2018] [Indexed: 11/27/2022]
Abstract
The socio-cultural setting influences youth smoking and its prevalence presumibly has decreased. OBJECTIVES To assess smoking prevalence in high school students, as well as the environmental influence on its onset in the Osona Disrtict of Barcelona (ODB), and to determine whether it has decreased. MATERIAL AND METHODS A cross-sectional study was conducted on high school students in the ODB. In the anonymous questionnaire it was sked asked about smoking and the influence of the social and cultural setting on its onset. RESULTS A total of 842 students participated, with 714 questionnaires completed, of which 705 were included as valid. A total of 203 (93.5%) students lived in an urban setting. There were 159 smoker students and 62% were women. The smokers were 70 (44%) christians, 3 (1.9%) muslims, 14 (8.%) students with other religions, and 72 (45.3%) non-denominational students. It was detected that 529 (76.3%) of the students consumed alcohol consumers, and 308 (46.5%) consumed other substances. There were 40 (61%) students that suffered a disease, and also 334 students who had ill relatives. There were 207 (29.4%) fathers and 152 (22%) mothers who smoked and 214 (59%) students declared family smoking. Finally 582 (82.6%) had smoker friends. Among fathers, 212 (30.1%), had high level studies, 331 (48.7%) had mid- level studies, and 137 (20.1%) fathers had primary studies. Among mothers, it was 279 (39.6%), 294 (41.7%), and 116 (16.5%). respectively. Being a smoker was associated with alcohol (P=.000) and other substances consumption (P=.000), being non-denominational (P=.000), did not to suffer any disease (P=.043), with having mother (P=.001), father (P=.005), brother or sister (P=.006), and family members (P=.016) who smoked, and smoker friends (P=.000). CONCLUSIONS smoking prevalence in high school students in the ODB is high, but has decreased. Smoking was associated with alcohol and consumption of other substances, being non-denominational, and with friends, parents, and relatives who smoked. It is necessary to establish prevention programs addressed to teenagers, parents and teachers.
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Affiliation(s)
- C Muñoz-Pindado
- Centro Atención Primaria de Manlleu, Institut Catalá de la Salut, Manlleu, Barcelona, España.
| | | | - P Roura-Poch
- Servicio de Epidemiología, Hospital Universitari de Vic, Consorci Hospitalari de Vic, Vic, Barcelona, España
| | - J A Riesco-Miranda
- Servicio de Neumología, Hospital San Pedro Alcántara, Servicio Extremeño de Salud, Cáceres, España
| | - J Muñoz-Méndez
- Servicio de Neumología, Hospital 12 de Octubre, Servicio Madrileño de Salud, Madrid, España
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de Granda-Orive JI, Pascual-Lledó JF, Asensio-Sánchez S, Solano-Reina S, García-Rueda M, Martínez-Muñiz MÁ, Lázaro-Asegurado L, Bujulbasich D, Pendino R, Luhning S, Cienfuegos-Agustín I, Jiménez-Ruiz CA. Is There an Association Between the Degree of Nicotine Dependence and the Motivation to Stop Smoking? Arch Bronconeumol 2019; 55:139-45. [PMID: 30316531 DOI: 10.1016/j.arbres.2018.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/27/2018] [Accepted: 08/20/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To evaluate the association between degrees of nicotine dependence measured by the Fagerström test (FTCD) and different tests of motivation to stop smoking. MATERIAL AND METHODS Observational study, multicenter conducted in smoking clinics in daily clinical practice. Demographics, smoking status, FTCD scores, and motivation test results were collected: Richmond test (TR), Henri Mondor Paris motivation test (HMP), Khimji-Watts test (KW), and the visual analog scale of motivation to stop smoking. The statistical analysis was descriptive, and correlation and analysis tests and regression models were used. RESULTS A total of 314 subjects were included [162 women (51.59%)]. Males smoked an average of 3.3 cigarettes/day more than women (95% CI: 0.9-5.6 cigarettes/day, p=0.006) and their cumulative consumption was 7.8 pack-years higher than in women (95% CI: 2.1 to 13.5 pack-years). We found no association between FTCD and the motivation tests to stop smoking used in this study. CONCLUSIONS We found no association between the degree of dependence and the motivation to quit smoking measured by the aforementioned instruments.
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Muñoz-Cifuentes P, Córdoba R, Altisent R, Delgado-Marroquín MT. [Autonomy and heteronomy, a necessary alliance to address smoking cessation. Views of professionals and patients]. Gac Sanit 2018; 33:401-407. [PMID: 30033093 DOI: 10.1016/j.gaceta.2018.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 04/19/2018] [Accepted: 04/24/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore the perception of professionals and patients with regard to ethical issues involved in addressing the habit of smoking in primary care consultations. METHOD A qualitative study was designed, consisting of 12 semi-structured interviews with professionals, 7 interviews with patients and 2 focus groups with 6 professionals and 7 primary care patients (a total of 32 participants). An intentional sampling was conducted, including profiles of professionals and patients of both sexes, different ages and experience in relation to smoking. A content analysis was performed with an inductive analytical approach from data to the creation of theoretical categories. RESULTS Four main categories were identified: 1) ethical issues related to the responsibility of the professional when treating patients who smoke; 2) issues related to attitude to patients who smoke; 3) issues related to fair and equitable distribution of resources and to the role of the different levels of government in relation to the control of smoking; and 4) issues related to smokers' autonomy regarding their habit and smoking cessation. CONCLUSIONS An alliance is needed between the ethics that support the autonomy of patients who smoke and the regulation of tobacco consumption. This approach should be included in clinical training programmes dealing with tobacco use, dependence and cessation.
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Affiliation(s)
- Pablo Muñoz-Cifuentes
- Grupo de investigación en Bioética, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, España.
| | - Rodrigo Córdoba
- Centro de Salud Delicias Sur, IIS Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Rogelio Altisent
- Centro de Salud Actur Sur, IIS Aragón, Cátedra de Profesionalismo y Ética Clínica, Universidad de Zaragoza, Zaragoza, España
| | - María Teresa Delgado-Marroquín
- Centro de Salud Delicias Norte, IIS Aragón, Cátedra de Profesionalismo y Ética Clínica, Universidad de Zaragoza, Zaragoza, España
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Gancedo-García A, Fuente-González P, Chudáčik M, Fernández-Fernández A, Suárez-Gil P, Suárez Martínez V. [Factors associated with the anxiety level and knowledge about childcare and lactation in first-time pregnant women]. Aten Primaria 2018; 51:285-293. [PMID: 29803399 PMCID: PMC6839201 DOI: 10.1016/j.aprim.2017.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/16/2017] [Accepted: 12/13/2017] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To know the level of anxiety and knowledge of childcare and lactation of the current pregnant women, and the clinical-demographic variables with which they are related. DESIGN Cross-sectional study. SETTING Seven health centers of Area V (Asturias). PARTICIPANTS First-time pregnant women who completed preparatory courses from 01.06.2015 to 31.10.2015, excluding multiple gestation, risk pregnancy, contraindicated breastfeeding and language problems. INTERVENTIONS Sociodemographic variables questionnaire, STAI state anxiety questionnaire and 23 questions about childcare and lactation. MAIN MEASUREMENTS We performed descriptive and multivariate analysis (program R) of the variables of the questionnaire. RESULTS We captured 104 pregnant women; average age 34.2(SD: 4.5), 94.2% Spanish, 61.5% university, 17.3% smokers in pregnancy, 23.1% with psychopathological antecedents; 88.4% planned to give breastfeeding. The mean STAI-S was 18.1(SD: 7.4) and scored 4.5(SD: 2.3) mean errors. The most faulty ones were on causes of fever (56.7%), fever measurement (54.8%) and physiological stools (55.7%). The multivariate analysis between knowledge and profile showed statistically significant associations with: being foreign, university, pregnancy planning and matron. In relation to the STAI-S was significant for being a smoker, receiving breastfeeding, psychopathological antecedents and matron. CONCLUSIONS The current pregnant women who complete preparatory courses are mainly mature, university and Spanish. They have good concepts about breastfeeding but many are unaware of basic concepts of fever and stool of the infant. Foreign mothers with unwanted pregnancy and primary education seem to have more confusing concepts. Smoking mothers with psychopathological antecedents and who have not received breastfeeding present more anxiety. The matron significantly influences anxiety and acquired concepts.
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Affiliation(s)
- Ana Gancedo-García
- Medicina de Familia y Comunitaria, Área V, Gijón, Asturias, España; Mutua Fraternidad-Muprespa, Avilés, Asturias, España.
| | | | - Michal Chudáčik
- Medicina de Familia y Comunitaria, Área III, Avilés, Asturias, España
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Echazarreta AL, Arias SJ, Del Olmo R, Giugno ER, Colodenco FD, Arce SC, Bossio JC, Armando G, Soriano JB. Prevalence of COPD in 6 Urban Clusters in Argentina: The EPOC.AR Study. Arch Bronconeumol 2017; 54:260-269. [PMID: 29221827 DOI: 10.1016/j.arbres.2017.09.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/22/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The prevalence of chronic obstructive pulmonary disease (COPD) has not been studied in Argentina. OBJECTIVES To determine the prevalence and relevant clinical characteristics of COPD in a representative sample. MATERIAL AND METHODS We performed a cross-sectional study in a population of adults aged ≥ 40 years randomly selected by cluster sampling in 6 urban locations. Subjects answered a structured survey and performed pre- and post-bronchodilator spirometry (PBD). COPD was defined as FEV1/FVC ratio < 0.7 predicted value. The total prevalence was estimated for each cluster with its 95% confidence interval (CI). RESULTS Of 4,599 surveys and 3,999 spirometries, 3,469 were considered of adequate quality (86.8%) for our study. The prevalence of COPD was 14.5% (CI: 13.4-15.7). The distribution of COPD cases according to FEV1 (GOLD 2017) was stage 1: 38% (CI: 34-43); stage 2: 52% (CI: 47-56); stage 3: 10% (CI: 7-13); and stage 4: 1% (CI: 0-2), and according to the refined ABCD (GOLD 2017) assessment: A: 52% (CI: 47-56); B: 43% (CI: 39-48); C: 1% (CI: 0-2); D: 4% (CI: 2-6). The rate of underdiagnosis was 77.4% (CI 73.7-81.1%) and diagnostic error 60.7% (CI 55.1-66.3%). A significant association was found between COPD and age (OR 3.77 in individuals 50-59 years of age and 19.23 in those > 80 years), male gender (OR 1.62; CI 1.31-2), smoking (OR 1.95; CI 1.49-2.54), low socioeconomic status (OR 1.33; CI 1.02-1.73), and previous tuberculosis (OR 3.3; CI 1.43-7.62). CONCLUSIONS We estimate that more than 2.3 million Argentineans have COPD, with high rates of underdiagnosis and diagnostic error.
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Affiliation(s)
- Andrés L Echazarreta
- Hospital Interzonal Especializado de Agudos y Crónicos San Juan de Dios, La Plata, Argentina.
| | - Sergio J Arias
- Instituto Nacional de Enfermedades Respiratorias Emilio Coni, Ministerio de Salud de la Nación, Santa Fe, Argentina
| | - Ricardo Del Olmo
- Hospital María Ferrer , Ciudad Autónoma de Buenos Aires, Argentina
| | - Eduardo R Giugno
- Hospital Dr. Antonio A. Cetrángolo, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Santiago C Arce
- Instituto de Investigaciones Médicas A. Lanari, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan C Bossio
- Instituto Nacional de Enfermedades Respiratorias Emilio Coni, Ministerio de Salud de la Nación, Santa Fe, Argentina
| | - Gustavo Armando
- Instituto Nacional de Enfermedades Respiratorias Emilio Coni, Ministerio de Salud de la Nación, Santa Fe, Argentina
| | - Joan B Soriano
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, España
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Szulman GA, Freilij H, Behrends I, Gentile Á, Mallol J. [Recurrent wheezing: prevalence and associated factors in infants from Buenos Aires City, Argentina]. Bol Med Hosp Infant Mex 2017; 74:419-426. [PMID: 29382526 DOI: 10.1016/j.bmhimx.2017.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/26/2017] [Accepted: 08/10/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The episodes of bronchial obstruction at early age constitute a frequent problem in Pediatrics. The aim of this study was to evaluate the prevalence of recurrent wheezing in infants in Buenos Aires City, as well as to identify any associated factors. METHODS Cross-sectional study performed from 2011 to 2012 in the Children Hospital Ricardo Gutiérrez, Buenos Aires City, as part of the International Study of Wheezing in Infants. A validated questionnaire was applied to parents of infants aged between 12 and 15 months. The prevalence of wheezing, mostly the recurrent episodes (three or more), and their probable associated factors were evaluated. Data were statistically analyzed with χ2, Fisher's test, binary and logistics multiple regression analysis. The significance level was 0.05. RESULTS Over 1063 infants, 58.9% (confidence interval (CI) 95% 55.9-61.9) presented at least one episode of wheezing and 26.3% (CI95% 23.8-29.9) three or more episodes (recurrent wheezing). Risk factors associated to wheezing were male gender (p=0.001), six or more episodes of cold during the first year of life (p <0.0001), age at first cold <4 months (p <0.0001); pneumonia (p <0.0001) and smoking during pregnancy (tobacco) (p=0.01). For recurrent wheezing, risk factors we considered as six or more episodes of cold during the first year of life (p <0.0001), early (< 4 month of age) onset wheezing (p <0.0001) and nocturnal wheezing (p <0.0001). CONCLUSIONS The prevalence of recurrent wheezing among infants in Buenos Aires Ciy was high (26.3%). Some identified associated factors can be preventable.
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Affiliation(s)
- Gabriela Aída Szulman
- Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina; Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Héctor Freilij
- Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ilse Behrends
- Servicio de Alergia, Hospital Churruca, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ángela Gentile
- Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina
| | - Javier Mallol
- Departamento de Medicina Respiratoria Infantil, Hospital CRS El Pino, Escuela de Medicina, Universidad de Santiago de Chile, Santiago de Chile, Chile
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Jimenez-Ruiz CA, Pascual Lledó JF, Cícero Guerrero A, Cristóbal Fernández M, Mayayo Ulibarri M, Villar Laguna C. [Analysis of quality of life in patients with Chronic Obstructive Pulmonary Disorder (COPD) who give up smoking]. Semergen 2017; 44:310-315. [PMID: 28918179 DOI: 10.1016/j.semerg.2017.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/10/2017] [Accepted: 08/03/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To analyse the impact in COPD patients' quality of life who stop smoking. PATIENTS AND METHODS We studied a group of COPD patients who received smoking cessation treatment. All patients were treated with bronchodilators according to the severity of their disorder. This treatment was not changed during the process of smoking cessation. Patients received a smoking cessation programme that consisted of a combination of pharmacological treatment plus cognitive-behavioural treatment. All subjects fill in CAT questionnaire before starting smoking cessation programme and after 6 months of abstinence. All subjects included had stop smoking. RESULTS The study included 59 patients, with 27 (45.8%) males, and a mean age of 61.8 (7.5) years. Mean CAT score before quitting was 18.9 (7.3) points, and after 6 months of abstinence was 8.1 (6.1) points, P=.038. Multiple regression analysis showed: a) the higher the baseline CAT score the greater is the difference after quitting, at 6 months, at same age, gender, and grade of severity of COPD, and b) the older the age, the lower is the difference between baseline CAT score and the 6 months CAT score. CONCLUSIONS Smoking cessation is associated with improvement in the quality of life in COPD patients. Those with worse quality of life get the biggest benefit from quitting, although this difference can be diminished in ageing patients.
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Affiliation(s)
- C A Jimenez-Ruiz
- Unidad Especializada en Tabaquismo, Comunidad de Madrid, Madrid, España.
| | - J F Pascual Lledó
- Servicio de Neumología, Hospital Universitario de Alicante, Alicante, España
| | - A Cícero Guerrero
- Unidad Especializada en Tabaquismo, Comunidad de Madrid, Madrid, España
| | | | - M Mayayo Ulibarri
- Unidad Especializada en Tabaquismo, Comunidad de Madrid, Madrid, España
| | - C Villar Laguna
- Unidad Especializada en Tabaquismo, Comunidad de Madrid, Madrid, España
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Godoy R, Callejas FJ, Cruz J, Tornero AI, Tárraga PJ, Rodríguez-Montes JA. [Comparative analysis: Effectiveness of nicotine addiction treatment in people with psychiatric comorbidity]. Semergen 2017. [PMID: 28645694 DOI: 10.1016/j.semerg.2017.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine whether or not nicotine addiction treatment was less effective in psychiatric than in the healthy population. MATERIAL AND METHODS A retrospective, descriptive and comparative cohort study was conducted in Albacete University Hospital during years 2008-2012 on all patients that attended the Tobacco Cessation Unit. The statistical tests used were Chi-squared, likelihood ratio, and the Student t test. Statistical significance P≤.05. RESULTS The study included a total of 1,484 patients, of which 48.6% were female. The mean age was 46.8 years, and the mean age of starting smoking was 17.6 years. The mean number of previous attempts to quit was 1.48, and mean number of cigarettes smoked was 25.39. They had a mean Fagerström score of 6.04, a Richmond score of 8.13, and a mean carbon monoxide level of 16.65ppm. Most patients were referred from Primary Care (38.7%) and Chest Diseases department (33%), and the type of tobacco smoked was "light" in 75.8%. There was 15% with chronic obstructive pulmonary disease, 8% with asthma, and 9.4% with obstructive sleep apnoea syndrome. Furthermore, there was respiratory disease in 28.7%, cardiovascular disease in 4.6%, and both in 3.5%. Hiatus hernia was present in 7.2%, thyroid disease in 3.8%, hypertension in 19%, diabetes in 10.7%, and dyslipidaemia in 29.4%, Drugs were used by 7.1%, and 12.6% consumed alcohol. There was 39.3% psychiatric comorbidity (PC), and were comparable except in gender, age of onset, Fagerström, Richmond, source of referral, asthma, hiatus hernia, thyroid disease, hypertension, as well as drugs and treatment. Drug treatment was completed by 22.3% in the PC group, with no significant difference. There were differences in success (P=.008), but not in failure and relapse rates. CONCLUSION Anti-smoking treatment in psychiatric patients is effective. An increase in the probability of treatment success is observed in patients without psychiatric comorbidity.
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Affiliation(s)
- R Godoy
- Servicio de Neumología, Gerencia de Atención Integrada (GAI) de Albacete, Albacete, España.
| | - F J Callejas
- Servicio de Neumología, Gerencia de Atención Integrada (GAI) de Albacete, Albacete, España
| | - J Cruz
- Servicio de Neumología, Gerencia de Atención Integrada (GAI) de Albacete, Albacete, España
| | - A I Tornero
- Servicio de Neumología, Gerencia de Atención Integrada (GAI) de Albacete, Albacete, España
| | - P J Tárraga
- Medicina Familiar y Comunitaria, Gerencia de Atención Integrada (GAI) de Albacete, Albacete, España
| | - J A Rodríguez-Montes
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Paz, Madrid, España
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López Zubizarreta M, Hernández Mezquita MÁ, Miralles García JM, Barrueco Ferrero M. Tobacco and diabetes: clinical relevance and approach to smoking cessation in diabetic smokers. ACTA ACUST UNITED AC 2017; 64:221-231. [PMID: 28417877 DOI: 10.1016/j.endinu.2017.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/15/2017] [Accepted: 02/18/2017] [Indexed: 01/19/2023]
Abstract
Smoking is, together with diabetes mellitus, one of the main risk factors for cardiovascular disease. Diabetic patients have unique features and characteristics, some of which are not well known, that cause smoking to aggravate the effects of diabetes and impose difficulties in the smoking cessation process, for which a specificand more intensive approach with stricter controls is required. This review details all aspects with a known influence on the interaction between smoking and diabetes, both as regards the increased risk of macrovascular and microvascular complications of diabetes and the factors with an impact on the results of smoking cessation programs. The treatment guidelines for these smokers, including the algorithms and drug treatment patterns which have proved most useful based on scientific evidence, are also discussed.
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Affiliation(s)
| | | | | | - Miguel Barrueco Ferrero
- Servicio de Neumología, Complejo Asistencial Universitario de Salamanca, Salamanca, España; Departamento de Medicina USAL, IBSAL, Salamanca, España
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Abstract
We do have very effective and efficient interventions to help our patients to stop smoking. The strategy that has more evidence and consensus in primary care is the 5 A's, that is, ask, advise, assess willingness to try to quit smoking, helping those who want to try and make follow-up visits. However, we intervene lot less than we should. The available protocols oversized interventions, and propose elements without scientific evidence or therapeutic effect. It is therefore necessary to develop more simple, useful and evidence-based interventions to assist us in carrying out our work interventions, and stop doing those that dońt contribute. In this article we will use as an example a critical review of Smoker Care Service Portfolio of Madrid Health Service, and we will propose a number of alternatives to allow a simple, effective and evidence-based intervention.
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Affiliation(s)
- Eduardo Olano-Espinosa
- Centro de Salud Los Castillos, Alcorcón, Madrid, miembro del Grupo de Abordaje al Tabaquismo (GAT) de la Sociedad Madrileña de Medicina Familiar y Comunitaria (SoMaMFyC).
| | - César Minué-Lorenzo
- Centro de Salud Perales del Río, Getafe, Madrid, coordinador del Grupo de Abordaje al Tabaquismo (GAT) de la Sociedad Madrileña de Medicina Familiar y Comunitaria (SoMaMFyC)
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González Romero PM, Cuevas Fernández FJ, Marcelino Rodríguez I, Rodríguez Pérez MDC, Cabrera de León A, Aguirre-Jaime A. [ETAP: A smoking scale for Primary Health Care]. Aten Primaria 2016; 48:288-94. [PMID: 26454625 PMCID: PMC6877883 DOI: 10.1016/j.aprim.2015.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/23/2015] [Accepted: 04/28/2015] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To obtain a scale of tobacco exposure to address smoking cessation. DESIGN Follow-up of a cohort. Scale validation. SETTING Primary Care Research Unit. Tenerife. PARTICIPANTS A total of 6729 participants from the "CDC de Canarias" cohort. METHODS A scale was constructed under the assumption that the time of exposure to tobacco is the key factor to express accumulated risk. Discriminant validity was tested on prevalent cases of acute myocardial infarction (AMI; n=171), and its best cut-off for preventive screening was obtained. Its predictive validity was tested with incident cases of AMI (n=46), comparing the predictive power with markers (age, sex) and classic risk factors of AMI (hypertension, diabetes, dyslipidaemia), including the pack-years index (PYI). RESULTS The scale obtained was the sum of three times the years that they had smoked plus years exposed to smoking at home and at work. The frequency of AMI increased with the values of the scale, with the value 20 years of exposure being the most appropriate cut-off for preventive action, as it provided adequate predictive values for incident AMI. The scale surpassed PYI in predicting AMI, and competed with the known markers and risk factors. CONCLUSION The proposed scale allows a valid measurement of exposure to smoking and provides a useful and simple approach that can help promote a willingness to change, as well as prevention. It still needs to demonstrate its validity, taking as reference other problems associated with smoking.
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Affiliation(s)
| | | | - Itahisa Marcelino Rodríguez
- Unidad de Investigación Atención Primaria, Hospital Universitario NS de Candelaria, Sta. Cruz de Tenerife, España
| | | | - Antonio Cabrera de León
- Dirección del Servicio Canario de la Salud, Área de Medicina Preventiva de la Universidad de La Laguna, Sta. Cruz de Tenerife, España.
| | - Armando Aguirre-Jaime
- Unidad de Investigación Atención Primaria, Hospital Universitario NS de Candelaria, Sta. Cruz de Tenerife, España
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Solano Reina S, Jiménez Ruiz CA, de Higes Martinez E, Garcia Rueda M, Callejas González FJ, de Granda Orive JI, Vaquero Lozano P, de Lucas Ramos P, Alfageme Michavila I. Prevalence, Knowledge and Attitudes Towards Smoking Among SEPAR Members. Arch Bronconeumol 2016; 52:605-610. [PMID: 26905777 DOI: 10.1016/j.arbres.2016.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/09/2016] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
Abstract
The aims of this study were to estimate the prevalence of smoking among SEPAR members, and their approach to smoking cessation in their patients. An online survey was completed by 640 members (496 pulmonologists, 45 nurses, 34 thoracic surgeons, 37 physiotherapists, and 28 other specialists). Of the members interviewed, 5% confessed that they were smokers: 3.5% pulmonologists; 8.9% nurses; 8.8% thoracic surgeons, and 13.5% physiotherapists. A total of 96% of members assign a lot or quite a lot of importance to setting an example; 98% of members always or often ask their patients about their smoking habit. The most effective anti-smoking intervention, according to 77% of members, is a combination of drugs and psychological support. These results are an indicator of the awareness and commitment of SEPAR members to smoking and its cessation.
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Affiliation(s)
| | | | | | | | | | | | - Paz Vaquero Lozano
- Área de Enfermeria (SEPAR), Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Pilar de Lucas Ramos
- Servicio de Neumologia, Hospital General Universitario Gregorio Marañón, Madrid, España
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de Lossada A, Rejas J. [Health-related quality-of-life in the smoking general population of Spain: An approach from the National Health Survey]. Semergen 2016; 42:431-9. [PMID: 26776660 DOI: 10.1016/j.semerg.2015.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/25/2015] [Accepted: 09/04/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Smoking has been associated with an important health risk. The aim was to analyze the health-related quality of life (HRQoL) status of the adult Spanish general population included in the National Health Survey according to its smoking status. METHODS Data were included from National Health Survey for the year 2011-2012 with information of HRQoL status in general population over 15 years of age. Adult male and female, 18 years of age or above, were categorized into 3 exclusive groups according to their current smoking status: smokers (daily smokers of any form of tobacco, at least the previous 12 months), ex-smokers of one or more years since quitting smoking and people who have never smoked (non smokers). HRQoL was assessed with the Spanish version of the EQ-5D-5L questionnaire included into the National Health Survey. RESULTS A total of 19,604 records were analyzed: 4,723 (24.09%) smokers, 3,797 (19.37%) ex-smokers, and 11,084 (56.54%) non smokers, male and female with 18 years of age or above. Smokers showed significantly adjusted mean scores (95% CI) in utility of 0.903 (0.899-0.908) and 75.36 (74.06-76.69) in the visual analogue scale of current state of health, ex-smokers 0.924 (0.919-0.929) and 76.85 (76.67-78.07), and non smokers 0.902 (0.899-0.905) and 76.25 (75.02-77.51), P<.01 between groups in both variables. CONCLUSIONS In the Spanish general population, subjects who are ex-smokers showed better utility values and state health scores, supporting the hypothesis that quitting smoking could be associated with a discreet improvement of HRQoL.
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Suárez-Bonel MP, Villaverde-Royo MV, Nerín I, Sanz-Andrés C, Mezquida-Arno J, Córdoba-García R. Health care costs and work absenteeism in smokers: study in an urban community. Arch Bronconeumol 2015. [PMID: 26198012 DOI: 10.1016/j.arbres.2015.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Higher morbidity caused by smoking-related diseases could increase health costs. We analyzed differences in the use of healthcare resources, healthcare costs and days of work absenteeism among smokers and non-smokers. METHODS Cross-sectional study in smokers and non-smokers, aged between 45 and 74 years, from one urban health area. The variables studied were: age, sex, alcohol intake, physical activity, obesity, diseases, attendance at primary care clinics and hospital emergency rooms, days of hospitalization, prescription drug consumption and work absenteeism (in days). Annual cost according to the unit cost of each service (direct costs), and indirect costs according to the number of days missed from work was calculated. Crude and adjusted risks were calculated using logistic regression. RESULTS Five hundred patients were included: 50% were smokers, 74% (372) men and 26% (128) women. Smokers used more healthcare resources, consumed more prescription drugs and had more days off work than non-smokers. Respective direct and indirect costs in smokers were 848.64 euros (IQ 25-75: 332.65-1517.10) and 2253.90 euros (IQ 25-75: 1024.50-13113.60), and in non-smokers were 474.71 euros (IQ 25-75: 172.88-979.59) and 1434.30 euros (IQ 25-75: 614.70-4712.70). The likelihood of generating high healthcare costs was more than double for smokers (OR=2.14; 95% CI: 1.44-3.19). CONCLUSION More investment in programs for the prevention and treatment of smoking, as a health policy priority, could help to reduce the health and social costs of smoking.
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Affiliation(s)
| | - María Victoria Villaverde-Royo
- Centro de Salud Cariñena, Cariñena, Zaragoza, España; Facultad de Ciencias de la Salud, Universidad San Jorge, Zaragoza, España
| | - Isabel Nerín
- Unidad de Tabaquismo FMZ, Departamento de Medicina y Psiquiatría, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España.
| | - Concepción Sanz-Andrés
- Centro de Salud Bombarda, Zaragoza, España; Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
| | | | - Rodrigo Córdoba-García
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España; Centro de Salud Delicias Sur, Zaragoza, España
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Jiménez Ruiz CA, Buljubasich D, Sansores R, Riesco Miranda JA, Guerreros Benavides A, Luhning S, Chatkin JM, Zabert G, de Granda Orive JI, Solano Reina S, Casas Herrera A, de Lucas Ramos P. SEPAR-ALAT Consensus Document on Antipneumoccal Vaccination in Smokers. Arch Bronconeumol 2015; 51:350-4. [PMID: 25641351 DOI: 10.1016/j.arbres.2014.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/10/2014] [Accepted: 12/12/2014] [Indexed: 01/06/2023]
Abstract
Streptococcus pneumoniae is responsible for several clinical syndromes, such as community-acquired pneumonia, sinusitis, otitis media, and others. The most severe clinical entity caused by this bacteria is undoubtedly invasive pneumococcal disease. Certain factors are known to increase the risk of presenting invasive pneumococcal disease, the most important being smoking habit and underlying concomitant diseases. This article comprises a consensus document on antipneumococcal vaccination in smokers, drawn up by a Smoking Expert Group from the Spanish Society of Pulmonology and Thoracic Surgery and the Latin American Chest Association.
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Affiliation(s)
| | | | - Raúl Sansores
- Asociación Latinoamérica del Tórax (ALAT), Montevideo, Uruguay
| | | | | | - Susana Luhning
- Asociación Latinoamérica del Tórax (ALAT), Montevideo, Uruguay
| | | | - Gustavo Zabert
- Asociación Latinoamérica del Tórax (ALAT), Montevideo, Uruguay
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Juárez-Jiménez MDLV, Pérez-Milena A, Valverde-Bolívar FJ, Rosa-Garrido C. [Prevalence and factors associated with clinical counselling on drug use among internal specialists residents of Andalusia (Spain)]. Aten Primaria 2015; 47:659-68. [PMID: 25704792 PMCID: PMC6983614 DOI: 10.1016/j.aprim.2014.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/02/2014] [Accepted: 11/04/2014] [Indexed: 11/26/2022] Open
Abstract
Objetivos Conocer la frecuencia de la oferta de consejo clínico contra el consumo de alcohol, tabaco y drogas ilegales por los especialistas internos residentes (EIR) y los factores relacionados con dicho consejo. Diseño Estudio multicéntrico transversal mediante encuesta autoadministrada. Emplazamiento y participantes EIR de Andalucía (España), mediante correo electrónico. Mediciones principales Consejo declarado contra alcohol, tabaco y drogas ilegales, mediante escala Likert categorizada como «frecuente»/«no frecuente». Variables independientes: edad/sexo, especialidad, país de origen y características del consumo de drogas. Análisis mediante regresión logística. Resultados Cuatro mil doscientos cuarenta y cinco participantes con el 66% de respuestas, 29% no respondedores y 5% mala cumplimentación; edad media 29,1 ± DE 5,1 años, 69% mujeres, 89% nacionalidad española, 84% con formación en medicina (hospitalaria 73%, medicina familiar 27%). El consejo frecuente contra tabaco (85%) y alcohol (82%) es superior al de drogas ilegales (56%; p < 0,001 test de Chi cuadrado). El consejo frecuente contra el alcohol se relaciona con la especialidad (medicina familiar: OR = 2,8, IC 95% [1,4-4,6]; enfermería: OR = 2,5 [1,7-4,4]) y la edad del primer consumo alcohólico (OR = 1,07; [1,03-1,1]). Para el tabaco hay relación con la especialidad (medicina familiar: OR = 12,9 [7,6-21,9]; enfermería: OR = 8,4, [4,3-16,5]), el tabaquismo (OR = 1,5 [1,2-2,0]) y edad del primer consumo alcohólico (OR = 1,06 [1,01-1,1]), más importante para el vino (OR = 1,1 [1,04-1,3]). Aconsejar contra drogas ilegales se relaciona con la edad del primer consumo alcohólico (OR = 1,09 [1,05-1,1]) y el tabaquismo (OR = 0,58 [0,4-0,7]). Conclusión Hay una alta oferta de consejo contra el consumo por los EIR, aunque llamativamente menor para drogas ilegales. Los factores que influyen son tanto elementos formativos de su propia especialidad como el consumo personal de alcohol y tabaco, que deben ser tenidos en cuenta para una mejora de esta actividad preventiva.
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Affiliation(s)
| | - Alejandro Pérez-Milena
- Centro de Salud El Valle, Distrito Sanitario de Jaén (Servicio Andaluz de Salud), Jaén, España.
| | | | - Carmen Rosa-Garrido
- Fundación Pública Andaluza para la Investigación Biosanitaria de Andalucía Oriental Alejandro Otero (Consejería de Salud, Junta de Andalucía), Jaén, España
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Juárez-Jiménez MV, Valverde-Bolívar FJ, Pérez-Milena A, Moreno-Corredor A. [Characteristics of smoking, nicotine dependence and motivation for change in specialists training in health sciences (residents) in Andalusia (Spain)]. Semergen 2015; 41:296-304. [PMID: 25242238 DOI: 10.1016/j.semerg.2014.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/17/2014] [Accepted: 07/09/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE As there are few studies on the smoking habits of specialists training in health sciences (residents), it is of interest to determine the prevalence of smoking, nicotine dependence and motivation for change, and their relationship with other variables (personal, work and consumption of other drugs). MATERIAL AND METHODS A multicentre, cross-sectional study using a questionnaire was conducted in 2012. All the residents who were studying in Teaching Health Centres in Andalusia (Spain) completed a questionnaire, which was sent by e-mail, collecting: age, sex, specialty, country of origin, qualitative-quantitative consumption of tobacco, age of onset/cessation, Fagerström test and stage of change (Proschaka). RESULTS A total of 2667 residents (63% of total) completed the questionnaire. The mean age was 29.1 years (± 5.2), 69% female, 89% Spanish, and 86% physicians. Of the 17% who smoked (daily pattern-47%, intermittently-41%, related to leisure-3%), starting at 17.4 years (±3.5) and mean of 7.5 cigarettes per day (±7.1), higher medical specialties (P=.067 ANOVA), and in men (P=.074, Student-t). More than three-quarters (82%) had a low nicotine dependence, being higher in hospital medical specialties (P=.078 χ(2)). Of the total, 7% were former smokers, and 48% wanted to quit smoking (contemplation 38%, preparation 10%). In the multivariate analysis there was a link between smoking and alcohol consumption (OR 2.84) and illegal drugs (OR 3.57). There were no differences by age or country. CONCLUSIONS The consumption of tobacco in residents is less than the general population, with a low dependence and better willingness to change. The period of specialised training is a good time to offer tobacco interventions.
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Casas Maldonado F, Alfageme Michavila I, Barchilón Cohen VS, Peis Redondo JI, Vargas Ortega DA. [Pneumococcal vaccine recommendations in chronic respiratory diseases]. Semergen 2014; 40:313-25. [PMID: 25107494 DOI: 10.1016/j.semerg.2014.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 06/22/2014] [Indexed: 11/30/2022]
Abstract
Community-acquired pneumonia is an acute respiratory infectious disease which has an incidence of 3-8 cases/1,000 inhabitants, and increases with age and comorbidities. The pneumococcus is the organism most frequently involved in community-acquired pneumonia in the adult (30-35%). Around 40% of patients with community-acquired pneumonia require hospital admission, and around 10% need to be admitted to an intensive care unit. The most serious forms of pneumococcal infection include invasive pneumococcal disease (IPD), which covers cases of bacteremia (associated or not to pneumonia), meningitis, pleuritis, arthritis, primary peritonitis and pericarditis. Currently, the biggest problem with the pneumococcus is the emergence of resistance to antimicrobial agents, and its high morbimortality, despite the use of appropriate antibiotics and proper medical treatment. Certain underlying medical conditions increase the risk of IPD and its complications, especially, from the respiratory diseases point of view, smoking and chronic respiratory diseases. Pneumococcal disease, according to the WHO, is the first preventable cause of death worldwide in children and adults. Among the strategies to prevent IPD is vaccination. WHO considers that its universal introduction and implementation against pneumococcus is essential and a priority in all countries. There are currently 2 pneumococcal vaccines for adults: the 23 serotypes polysaccharide and conjugate 13 serotypes. The scientific societies represented here have worked to develop some recommendations, based on the current scientific evidence, regarding the pneumococcal vaccination in the immunocompetent adult with chronic respiratory disease and smokers at risk of suffering from IPD.
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Affiliation(s)
- F Casas Maldonado
- Asociación de Neumología y Cirugía Torácica del Sur (NEUMOSUR), España.
| | | | | | - J I Peis Redondo
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN-Andalucía), España
| | - D A Vargas Ortega
- Sociedad Española de Médicos Generales y de Familia (SEMG-Andalucía), España
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Leiro-Fernández V, Mouronte-Roibás C, Ramos-Hernández C, Botana-Rial M, González-Piñeiro A, García-Rodríguez E, Represas-Represas C, Fernández-Villar A. Changes in clinical presentation and staging of lung cancer over two decades. Arch Bronconeumol 2014; 50:417-21. [PMID: 24814028 DOI: 10.1016/j.arbres.2014.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Important clinical and epidemiological changes have been observed in lung cancer (LC) in our healthcare area compared to the previous decade. In the last 10 years, specific LC care circuits have been implemented and the active search for cases has been stepped up. The aim of this study was to analyze the progress of these changes over the last 20 years. METHODS This is a retrospective study comparing clinical and epidemiological changes between 2 historical cohorts of LC patients (1992-1994 [group 1, 164 patients] and 2004-2006 [group 2, 250 patients]) and a current group from the period 2011-2012 (group 3, 209 patients) RESULTS Two hundred and nine (209) LC patients were included in group 3 (2011-2012 period). After comparing groups 3 and 2, a non-significant rise in smoking was observed in women (59% vs 41%, p=.25), while the prevalence of adenocarcinoma was unchanged (45% vs 44%, p=.9). The main changes observed were the increase in cases with previous malignancies (23% vs 16%, p=.04), the rise in patients with no associated LC symptoms (33% vs 16%, p<.001), and an increased number of localized NSCLC (non-small cell LC) diagnoses (42% vs 24% in series 2, p<.001 and 14.2% in series 1, p<.001). CONCLUSIONS The number of LC patients diagnosed in localized stages has increased significantly. Furthermore, the number of patients with no symptoms associated with LC and with a history of previous malignancy were significantly increased.
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Cabrera López C, Juliá Serdá G, Cabrera Lacalzada C, Martín Medina A, Gullón Blanco JA, García Bello MÁ, Cabrera Navarro P. Prevalence of chronic obstructive pulmonary disease in the Canary Islands. Arch Bronconeumol 2014; 50:272-7. [PMID: 24507558 DOI: 10.1016/j.arbres.2013.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/09/2013] [Accepted: 12/10/2013] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The prevalence of chronic obstructive pulmonary disease (COPD) varies significantly among the different geographical areas reported. In Spain, two epidemiological studies have shown a prevalence of 9-10% in the population aged over 40. However, neither of these studies included the Canary Islands, which are of interest due to their climatic conditions and high incidence of smoking. MATERIALS AND METHODS A random group of 1,353 subjects aged between 40 and 70years was selected from a sample population of 596,478 individuals. Participants completed a questionnaire and then performed spirometry with bronchodilator testing if obstruction was observed. COPD was diagnosed when the post-bronchodilator FEV1/FVC ratio was less than 0.70. RESULTS The prevalence of COPD was 7.3% (95%CI: 5.5-9.5) and was higher in males than in females (8.7% vs. 6.3%, P=.134). The incidence of smoking was 29.4% (95%CI: 25.4-33.1) and was also higher in males than in females (35.1% vs 25.4%, P<.001). The prevalence of COPD stratified by severity of obstruction, according to the GOLD criteria, was 16% in groupi, 69.9% in groupii, 10.4% in groupiii and 3.3% in groupiv. 71.6% of the subjects were underdiagnosed and 63.5% undertreated. CONCLUSIONS Despite having one of the highest rates of smoking in Spain, the prevalence of COPD in the Canary Islands is lower than in most of the Spanish regions studied.
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Affiliation(s)
- Carlos Cabrera López
- Servicio de Neumología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
| | - Gabriel Juliá Serdá
- Servicio de Neumología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | | | - Ana Martín Medina
- Servicio de Neumología, Hospital Universitario de Canarias, La Laguna, Tenerife, España
| | | | - Miguel Ángel García Bello
- Unidad de Investigación, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | - Pedro Cabrera Navarro
- Servicio de Neumología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
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