SAS - D.S.A.P. Costa del Sol

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TARGET ORGAN DAMAGE IN DIABETIC PATIENTS OF THE IBERICAN STUDY
(Lippincott williams & wilkins, 2019-07-01) Romero Secin, A. A.; Piera Carbonell, A. M.; Gonzalez Gamarra, A.; Mico Perez, R. M.; Zambrana Calvi, G. D. R.; Lasso Oria, V.; Pineiro Diaz, C.; Gomez Montes, C.; Gil Gil, I.; Murillo Jelsbak, C.; Panisello Royo, J. M.; Gomez Gonzalez, M. J.; Pinto Pena, L.; Alonso Moreno, F. J.; Cinza Sanjurjo, S.; [Romero Secin, A. A.] Hlth Primary Care Sespa, Asturias, Spain; [Piera Carbonell, A. M.] Hlth Primary Care Sespa, Asturias, Spain; [Gonzalez Gamarra, A.] Hlth Primary Care Sermas, Madrid, Spain; [Lasso Oria, V.] Hlth Primary Care Sermas, Madrid, Spain; [Murillo Jelsbak, C.] Hlth Primary Care Sermas, Madrid, Spain; [Mico Perez, R. M.] CS Fontanars Dels Alforins, Valencia, Spain; [Zambrana Calvi, G. D. R.] CS Ciudad Real 3, Ciudad Real, Spain; [Pineiro Diaz, C.] Hlth Primary Care Sergas, La Coruna, Spain; [Cinza Sanjurjo, S.] Hlth Primary Care Sergas, La Coruna, Spain; [Gomez Montes, C.] CS Estepona, Malaga, Spain; [Gil Gil, I.] CS De Vielha, Lleida, Spain; [Panisello Royo, J. M.] Hlth Primary Care Catsalut, Barcelona, Spain; [Pinto Pena, L.] Hlth Primary Care Catsalut, Barcelona, Spain; [Gomez Gonzalez, M. J.] CS Garrucha, Almeria, Spain; [Alonso Moreno, F. J.] CS Silleria, Toledo, Spain
[ANALES DE PEDIATRÍA: We take over].
(2021-09-02) Antón Gamero, Montserrat; Ávila Álvarez, Alejandro; Balaguer-Martínez, Josep Vicent; Bueno Campaña, Mercedes; Navas López, Víctor Manuel
[Comprehensive approach to children with cerebral palsy].
(2021-08-27) Peláez Cantero, María José; Moreno Medinilla, Esther Eugenia; Cordón Martínez, Ana; Gallego Gutiérrez, Silvia
Infantile cerebral palsy is one of the most prevalent diseases and the most frequent cause of disability in paediatrics. Children with cerebral palsy have complex health care needs and often require the care of a multidisciplinary team. However, in many cases there is no paediatrician with overall responsibility for coordinating follow-up. We have produced a support document intended for paediatricians coordinating the care of children with cerebral palsy. Our aim is to provide an ordered compilation of the main issues these patients may develop, to know how to identify and address them if necessary, and to establish criteria for referring these patients to other specialists.
Does Consumption of Ultra-Processed Foods Matter for Liver Health? Prospective Analysis among Older Adults with Metabolic Syndrome.
(MDPI, 2022-09-27) Konieczna, Jadwiga; Fiol, Miguel; Colom, Antoni; Martínez-Gonzalez, Miguel Angel; Salas-Salvado, Jordi; Corella, Dolores; Soria-Florido, Maria Trinidad; Martinez, J Alfredo; Alonso-Gomez, Angel M; Wärnberg, Julia; Vioque, Jesus; Lopez-Miranda, Jose; Estruch, Ramon; Bernal-Lopez, M Rosa; Lapetra, Jose; Serra-Majem, Lluís; Bueno-Cavanillas, Aurora; Tur, Josep A; Martin-Sanchez, Vicente; Pinto, Xavier; Gaforio, Jose J; Matia-Martin, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Bes-Rastrollo, Maira; Pascual, Maria; Sorli, Jose V; Goday, Albert; Zulet, Maria Angeles; Moreno-Rodriguez, Anai; Carmona-Gonzalez, Francisco Jesus; Valls-Enguix, Rafael; Janer, Juana M; Garcia-Rios, Antonio; Casas, Rosa; Gomez-Perez, Ana M; Santos-Lozano, Jose Manuel; Basterra-Gortari, F Javier; Martinez, Maria Angeles; Ortega-Azorin, Carolina; Bayo, Joan; Abete, Itziar; Salaverria-Lete, Itziar; Ruiz-Canela, Miguel; Babio, Nancy; Carres, Lourdes; Romaguera, Dora; European Research Council; Spanish National Health Institute of Health Carlos III (ISCIII); “Fondo de Investigación para la Salud” (FIS); Consejería de Salud de la Junta de Andalucía; Spanish Ministry of Economy, Industry and Competitiveness
Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been sufficiently assessed. We aimed to investigate the prospective association between UPF consumption and liver health biomarkers. Methods: We followed for 1 year 5867 older participants with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus trial. A validated 143-item semi-quantitative food frequency questionnaire was used to evaluate consumption of UPF at baseline, 6, and 12 months. The degree of processing for foods and beverages (g/day) was established according to the NOVA classification system. The non-invasive fatty liver index (FLI) and hepatic steatosis index (HSI) were used to evaluate liver health at three points in time. The associations between changes in UPF consumption (percentage of total daily dietary intake (g)) and liver biomarkers were assessed using mixed-effects linear models with repeated measurements. Results: In this cohort, UPF consumption at baseline was 8.19% (SD 6.95%) of total daily dietary intake in grams. In multivariable models, each 10% daily increment in UPF consumption in 1 year was associated with significantly greater FLI (β 1.60 points, 95% CI 1.24;1.96 points) and HSI (0.43, 0.29; 0.57) scores (all p-valuess < 0.001). These associations persisted statistically significant after adjusting for potential dietary confounders and NAFLD risk factors. Conclusions: A higher UPF consumption was associated with higher levels of NAFLD-related biomarkers in older adults with overweight/obesity and MetS
Clinical and Functional Outcome of Meniscal Injuries Treated with Platelet-Rich Plasma: A Single-Center Case Series.
(MDPI, 2022-06-10) Medina-Porqueres, Ivan; Martin-Garcia, Pablo; Sanz-De-Diego, Sofia; Gomez-Caceres, Abel; Moya-Torrecilla, Francisco; Reyes-Eldblom, Marcelo; Rosado-Velazquez, Daniel
Meniscal injuries are among the most frequently encountered conditions in the knee joint. Therapeutic approaches are diverse and are largely dependent on the extent and location of the injury. The purpose of this study was to describe the clinical and functional outcomes of an intraarticular and percutaneous platelet-rich plasma (PRP) injection regime in patients with stable meniscal injuries. Demographics, the type of tear, affected knee, surgical procedure, type of intervention, follow-up period, and outcomes were recorded in all cases. Patient-reported outcome measures included the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity level scale. Overall patient satisfaction, quality of life, and pain intensity were also assessed. A total of 38 cases (8 females) had sustained a stable meniscal lesion (32 medial, 6 lateral) and met the inclusion criteria. All of them received three intraarticular and percutaneous PRP injections. Patients receiving the PRP injection regime reported clinically (p = 0.000) and functionally (p = 0.000 and p = 0.001) significant improvement in all outcome measures during this interval. All patients reported they were very satisfied or satisfied with the outcome. The results of this study suggest that the treatment of stable meniscal injuries with percutaneous-intraarticular PRP injections can achieve a significant clinical and functional improvement.
Use of health care services according to functional performance in community-dwelling older adults in Spain. An approach using GAMLSS models.
(2022-11-17) Mateo-Abad, Maider; Vrotsou, Kalliopi; Padilla Ruiz, María; Montiel-Luque, Alonso; Saucedo Figueredo, María Del Carmen; Machón, Mónica; Rivas Ruiz, Francisco; Vergara, Itziar
Functional performance in older adults is a predictor of survival and other health outcomes and its measurement is highly recommended in primary care settings. Functional performance and frailty are closely related concepts, and frailty status is associated with the use of health care services. However, there is insufficient evidence on the utilization of services profile according to the functional performance of older adults. The aim of this study was to assess the relationship between functional performance and the use of a wide range of health services in community-dwelling older adults. Generalized additive models for location, scale and shape were used to study these complex data of services utilization, from primary to hospital care. A total of 749 participants from two Spanish regions were followed up for 2 years. Of those, 276 (37%) presented low functional performance and 473 (63%) normal performance according to the Timed Up and Go test. The results showed that even after adjusting for burden of comorbidity and polypharmacy, participants with low functional performance used primary and secondary care health services more intensively, visited emergency rooms more often, and were hospitalized more frequently and for longer periods of time. A negative binomial distribution and a variant thereof were found to be the best models to describe health service utilization data. In conclusion, functionality should be considered as an important health indicator for tailoring the provision of health services for older adults.
Components of case management in caring for patients with dementia: a mixed-methods study.
(2022-06-23) Jerez-Barranco, Desirée; Gutiérrez-Rodríguez, Laura; Morilla-Herrera, Juan Carlos; Cuevas Fernandez-Gallego, Magdalena; Rojano-Perez, Remedios; Camuñez-Gomez, María Dolores; Sanchez-Del Campo, José Luis; García-Mayor, Silvia
Case management has shown improvements in some health outcomes for dementia patients and their families. However, despite its benefits the components of case management in order to provide effective patient and family care remain unknown at present. Thus, the aim of this study is to identify the specific components of case management in caring for patients with dementia and to determine the necessary intensity of its deployment to enhance outcomes for these patients and their caregivers. Mixed-methods study with a qualitative phase to characterise forms of service provision, according to the case management components involved, followed by a quantitative phase to analyse the correlations between different patterns of service provision, adverse events in patients and caregiver overload. This study will be based on the variables described in the RANGE.COM register. This research is expected to achieve a reproducible, evaluable set of interventions that can be modelled to optimise case management effectiveness for patients with dementia. Interactions between patients with dementia, their family caregivers and case management healthcare services, the components of these interactions and their association with the conditions of the individuals concerned are issues of great interest in the field of case management, which is constantly evolving.
The implications of the foot health status in Parkinson patients: A case-control study.
(2022-05-17) Jiménez-Cebrián, Ana María; López-López, Luis; Losa-Iglesias, Marta Elena; Becerro-de-Bengoa-Vallejo, Ricardo; Romero-Morales, Carlos; López-López, Daniel; Montiel-Luque, Alonso; Navarro-Flores, Emmanuel; de Labra, Carmen
Parkinson's disease (PD) is a neurodegenerative disorder that affects both health of the feet, as to gait patterns. This study aimed to find out about foot problems and their impact on self-perceived quality of life and related to foot health in Parkinson's patients compared to a group of healthy subjects and to measure it with Spanish Podiatry Health Questionnaire (PHQ-S). It is about a case-control study in a sample of Parkinson's patients n = 62, healthy controls n = 62. The PHQ-S was reported, it describes perception the subject has in each of podiatric 6 dimensions consulted, assessing appreciation of health status of interviewee's feet and a self-rated the foot health score on the visual analog scale (VAS). There were statistically significant differences (P
One-year changes in fruit and vegetable variety intake and cardiometabolic risk factors changes in a middle-aged Mediterranean population at high cardiovascular risk.
(Nature Publishing Group, 2022-03-14) Lopez-Gonzalez, Leyre; Becerra-Tomas, Nerea; Babio, Nancy; Martinez-Gonzalez, Miguel Angel; Nishi, Stephanie K; Corella, Dolores; Goday, Albert; Romaguera, Dora; Vioque, Jesus; Alonso-Gomez, Angel M; Wärnberg, Julia; Martinez, J Alfredo; Serra-Majem, Luis; Estruch, Ramon; Bernal-Lopez, M Rosa; Lapetra, Jose; Pinto, Xavier; Tur, Josep A; Lopez-Miranda, Jose; Bueno-Cavanillas, Aurora; Delgado-Rodriguez, Miguel; Matia-Martin, Pilar; Daimiel, Lidia; Martin-Sanchez, Vicente; Vidal, Josep; Vazquez, Clotilde; Ros, Emilio; Vazquez-Ruiz, Zenaida; Martin-Lujan, Francisco M; Sorli, Jose V; Castañer, Olga; Zulet, M Angeles; Tojal-Sierra, Lucas; Carabaño-Moral, Rosa; Roman-Macia, Josefa; Rayo, Elena; Garcia-Rios, Antonio; Casas, Rosa; Gomez-Perez, Ana M; Santos-Lozano, Jose M; Buil-Cosiales, Pilar; Asensio, Eva M; Lassale, Camille; Abete, Itziar; Salaverria-Lete, Itziar; Sayon-Orea, Carmen; Schröder, Helmut; Salas-Salvado, Jordi; ISCIII, through the Fondo de Investigación para la Salud (FIS); Consejería de Salud de la Junta de Andalucía; PREDIMED-Plus Investigators
Previous studies have shown beneficial associations between fruit and vegetable (FV) consumption and cardiometabolic risk factors. However, variety in FV, which may play an important role on cardiovascular health due to the different nutrient and phytochemical content among the different groups and subgroups of FV has been poorly investigated. We longitudinally investigated associations between 1-year changes in variety and quantity of FV and concurrent changes in cardiometabolic risk factors in elderly subjects with overweight/obesity and metabolic syndrome. a one-year data longitudinal analysis of 6647 PREDIMED-plus study participants (48% women) was conducted. Data were collected at baseline, six months and 1-year of follow-up. Variety and quantity of FV were estimated using a food frequency questionnaire and continuous scores for variety were created based on items/month of FV. Linear mixed-models adjusted for potential confounders were performed to estimate associations (β-coefficients and 95% confidence interval) between 1-year changes in FV variety and/or quantity and concurrent changes in cardiometabolic risk factors. Two points increment in the FV variety score over one year was associated with a concurrent decrease in glucose (-0.33 mg/dL (0.58, -0.07)), body weight (-0.07 kg (-0.13, -0.02)) and waist circumference (WC) (-0.08 cm (-0.16, -10.01)). An increment of 100 g/d of FV over one year was associated with a concurrent decrease in triglycerides (-0.50 mg/dL (-0.93, -0.08)), glucose (-0.21 mg/dL (-0.32, -0.11)), body weight (-0.11 kg (-0.15, -0.07)) and WC (-0.10 cm (-0.14, -0.06)) over 1-year. Changes in FV consumption which led to higher quantity and variety over one year were associated with downward changes in glucose (-1.26 mg/dL (-2.09, -0.43)), body weight (-0.40 kg (-0.58, -0.23)) and WC (-0.50 cm (-0.73, -0.28)). Greater variety, in combination with higher quantity of FV was significantly associated with a decrease in several cardiometabolic risk factors among elderly subjects at high cardiovascular risk.
How to live with COPD: patient's perception.
(Univ murcia, 2016-01-01) Munoz-Cobos, Francisca; Acero-Guasch, Nieves; Cuenca-del-Moral, Rebeca; Barnestein-Fonseca, Pilar; Leiva-Fernandez, Francisca; Garcia-Ruiz, Antonio; [Munoz-Cobos, Francisca] Dist Sanitario Malaga, Ctr Salud El Palo, Malaga, Spain; [Acero-Guasch, Nieves] Area Salud Ibiza & Formentera, Illes Balears, Spain; [Cuenca-del-Moral, Rebeca] Dist Sanitario Costa del Sol, Ctr Salud Albarizas, Malaga, Spain; [Barnestein-Fonseca, Pilar] Dist Sanitario Malaga, Unidad Docente Multiprofes Atenc Familiar & Comun, Malaga, Spain; [Leiva-Fernandez, Francisca] Dist Sanitario Malaga, Unidad Docente Multiprofes Atenc Familiar & Comun, Malaga, Spain; [Garcia-Ruiz, Antonio] Univ Malaga, Fac Med, Dept Farmacol & Terapeut, E-29071 Malaga, Spain
The aim of this study is to determine the mental model that patients with COPD (chronic obstructive pulmonary disease) have about their illness analyzed by the Leventhal's Common Sense of Self-Regulation Model. An exploratory-descriptive study using qualitative methodology was performed. We included COPD-diagnosed patients attending three urban and a rural primary care centres. We used video-taped group interviews and transcribed them using Atlas.Ti 5.2 program. 22 group interviews (2009 - 2011) and 58 patients were included. There were 3 additional sessions to final inform validation. The results show that patients did not have a defined mental model about COPD: this disease was insufficiently recognized; diagnosis was made in exacerbations and it was confused with other diseases; the cause of illness was related to tobacco consumption and to "something else": fumes, colds and hard work. Patients tended to minimize their symptoms and limitations. Participants had wrong beliefs about colds, smoking only a few cigarettes effects and damage of inhaled treatment. Emotions as despair, resignation and fear were reported. We conclude that COPD patients showed confusion about many aspects of the disease (causes, symptoms, treatments). It was difficult to identify a mental model of the disease among COPD patients.
Relationship between perceived emotional intelligence and professional quality of life with the achievement of occupational objectives in the costa del sol primary health care district
(Ediciones doyma s a, 2016-05-01) Macias Fernandez, Antonio Jose; Gutierrez-Castaneda, Carlos; Carmona Gonzalez, Francisco Jesus; Crespillo Vilchez, Daniel; [Macias Fernandez, Antonio Jose] Serv Andaluz Salud, Unidad Gest Clin Torrequebrada, Malaga, Spain; [Carmona Gonzalez, Francisco Jesus] Serv Andaluz Salud, Unidad Gest Clin Torrequebrada, Malaga, Spain; [Gutierrez-Castaneda, Carlos] Univ Malaga, Inst Invest Biomed Malaga IBIMA, Serv Andaluz Salud, Unidad Gest Clin La Lobilla, Estepona, Spain; [Crespillo Vilchez, Daniel] Serv Andaluz Salud, Unidad Salud Mental Torrequebrada, Malaga, Spain
To examine the relationship between "Quality of Professional Life" and "Perceived Emotional Intelligence" and the relationship of both of these with the level of achievement of occupational objectives in the Costa del Sol Primary Health Care District. Multicentre descriptive cross-sectional observational study. The Costa del Sol Primary Health Care District in the province of Málaga. Sample of Employees of all categories in fixed and contracted employment in the Management Units of the Costa del Sol District. (N=303). Respondents 247 (81.5%) The data collected was that of the percentage of achievement of objectives in 2010 and the socio-demographic data of the participants, using ad hoc designed self-report questionnaires. The TMMS -24 questionnaire was used to measure the "Perceived Emotional Intelligence", with the following dimensions: Perception, comprehension, and emotional control, and the CVP-35 measuring: management support, work demands, and intrinsic motivation. Significant correlationas were observed between Quality of Professional Life and Emotional Intelligence in the Regulation (p The perceived quality of professional life is related to perception and regulation dimensions of Emotional Intelligence. Knowledge of emotion management methods should be promoted by management organisations for all employees.
Fruit and Vegetable Consumption is Inversely Associated with Plasma Saturated Fatty Acids at Baseline in Predimed Plus Trial.
(Wiley, 2021-07-28) Dominguez-Lopez, Ines; Marhuenda-Muñoz, Maria; Tresserra-Rimbau, Anna; Hernaez, Alvaro; Moreno, Juan Jose; Martinez-Gonzalez, Miguel Angel; Salas-Salvado, Jordi; Corella, Dolores; Fito, Montserrat; Martinez, Jose Alfredo; Alonso-Gomez, Angel M; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; Lopez-Miranda, Jose; Bernal-Lopez, M Rosa; Lapetra, Jose; Serra-Majem, J Luis; Bueno-Cavanillas, Aurora; Tur, Josep A; Martin-Sanchez, Vicente; Pinto, Xavier; Delgado-Rodriguez, Miguel; Matia-Martin, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Serra-Mir, Merce; Vazquez-Ruiz, Zenaida; Nishi, Stephanie K; Sorli, Jose V; Castañer, Olga; Abete, Itziar; Luna, Jessica Vaquero; Carabaño-Moral, Rosa; Asencio, Alberto; Prohens, Lara; Garcia-Rios, Antonio; Casas, Rosa; Gomez-Perez, Ana Maria; Santos-Lozano, Jose Manuel; Razquin, Cristina; Martinez, Maria Angeles; Saiz, Carmen; Robledo-Pastor, Vanesa; Zulet, Maria Angeles; Salaverria, Itziar; Eguaras, Sonia; Babio, Nancy; Malcampo, Mireia; Ros, Emilio; Estruch, Ramon; Lopez-Sabater, M Carmen; Lamuela-Raventos, Rosa M; Consejería de Salud de la Junta de Andalucía; Ministerio de Ciencia, Innovación y Universidades; Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS); European Research Council
Plasma fatty acids (FAs) are associated with the development of cardiovascular diseases and metabolic syndrome. The aim of our study is to assess the relationship between fruit and vegetable (F&V) consumption and plasma FAs and their subtypes. Plasma FAs are assessed in a cross-sectional analysis of a subsample of 240 subjects from the PREDIMED-Plus study. Participants are categorized into four groups of fruit, vegetable, and fat intake according to the food frequency questionnaire. Plasma FA analysis is performed using gas chromatography. Associations between FAs and F&V consumption are adjusted for age, sex, physical activity, body mass index (BMI), total energy intake, and alcohol consumption. Plasma saturated FAs are lower in groups with high F&V consumption (-1.20 mg cL-1 [95% CI: [-2.22, -0.18], p-value = 0.021), especially when fat intake is high (-1.74 mg cL-1 [95% CI: [-3.41, -0.06], p-value = 0.042). Total FAs and n-6 polyunsaturated FAs tend to be lower in high consumers of F&V only in the high-fat intake groups. F&V consumption is associated with lower plasma saturated FAs when fat intake is high. These findings suggest that F&V consumption may have different associations with plasma FAs depending on their subtype and on the extent of fat intake.
High Fruit and Vegetable Consumption and Moderate Fat Intake Are Associated with Higher Carotenoid Concentration in Human Plasma.
(MDPI, 2021-03-12) Marhuenda-Muñoz, Maria; Rinaldi-de-Alvarenga, Jose Fernando; Hernaez, Alvaro; Tresserra-Rimbau, Anna; Martinez-Gonzalez, Miguel Angel; Salas-Salvado, Jordi; Corella, Dolores; Malcampo, Mireia; Martinez, Jose Alfredo; Alonso-Gomez, Angel M; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; Lopez-Miranda, Jose; Estruch, Ramon; Tinahones, Francisco J; Lapetra, Jose; Serra-Majem, J Lluis; Bueno-Cavanillas, Aurora; Tur, Josep A; Sanchez, Vicente Martin; Pinto, Xavier; Delgado-Rodriguez, Miguel; Matia-Martin, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Serra-Mir, Merce; Vazquez-Ruiz, Zenaida; Nishi, Stephanie K; Sorli, Jose V; Zomeño, Maria Dolores; Zulet, Maria Angeles; Vaquero-Luna, Jessica; Carabaño-Moral, Rosa; Notario-Barandiaran, Leyre; Morey, Marga; Garcia-Rios, Antonio; Gomez-Perez, Ana M; Santos-Lozano, Josr Manuel; Buil-Cosiales, Pilar; Basora, Josep; Portoles, Olga; Schröder, Helmut; Abete, Itziar; Salaverria-Lete, Itziar; Toledo, Estefania; Babio, Nancy; Fito, Montse; Martinez-Huelamo, Miriam; Lamuela-Raventos, Rosa M; European Research Council; Consejería de Salud de la Junta de Andalucía; CIBEROBN; Ministerio de Ciencia, Innovación y Universidades; ISCIII
Carotenoids are pigments contained mainly in fruit and vegetables (F&V) that have beneficial effects on cardiometabolic health. Due to their lipophilic nature, co-ingestion of fat appears to increase their bioavailability via facilitating transfer to the aqueous micellar phase during digestion. However, the extent to which high fat intake may contribute to increased carotenoid plasma concentrations is still unclear. The objective was to examine the degree to which the consumption of different amounts of both carotenoid-rich foods and fats is associated with plasma carotenoid concentrations within a Mediterranean lifestyle context (subsample from the PREDIMED-Plus study baseline) where consumption of F&V and fat is high. The study population was categorized into four groups according to their self-reported consumption of F&V and fat. Carotenoids were extracted from plasma samples and analyzed by HPLC-UV-VIS-QqQ-MS/MS. Carotenoid systemic concentrations were greater in high consumers of F&V than in low consumers of these foods (+3.04 μmol/L (95% CI: 0.90, 5.17), p-value = 0.005), but circulating concentrations seemed to decrease when total fat intake was very high (-2.69 μmol/L (-5.54; 0.16), p-value = 0.064). High consumption of F&V is associated with greater systemic levels of total carotenoids, in particular when fat intake is low-to-moderate rather than very high.
Tackling frailty at primary care: evaluation of the effectiveness of a multicomponent intervention through a randomised controlled trial: study protocol.
(2020-02-20) Rivas-Ruiz, Francisco; Machón, Mónica; Mateo-Abad, Maider; Contreras-Fernández, Eugenio; Güell, Carolina; Baro-Rodríguez, Luis; Vrotsou, Kalliopi; Quirós-López, Raúl; Vergara, Itziar; InFrAP investigators
This project focuses on how frailty is addressed in primary healthcare (PHC) and will evaluate the effectiveness of a multifactorial intervention (considering the appropriateness of the pharmaceutical prescription, the nutritional care provided and the exercise intervention) for persons with frailty, in terms of improving their functional capacity and reducing the incidence of adverse events related to frailty. The final evaluation will be made at 12 months' follow-up. Pragmatic multicentre cluster randomised controlled clinical trial, single blind with two arms: multifactorial intervention in PHC versus usual follow-up. The randomisation unit is the patient list and the analysis unit is the patient. In addition, a cost-effectiveness study and a qualitative study will be carried out, the latter based on semistructured interviews and focus groups. Two hundred persons (100 per study branch) all aged ≥70 years, presenting frailty, but functionally independent and resident in the community, will be recruited. A baseline evaluation will be carried out prior to the intervention, with follow-up at 6 and 12 months. The main study variables considered will be functional capacity and incidence of adverse events; the secondary variables considered will be the patients' sociodemographic characteristics, nutritional status, level of physical activity and drug consumption, together with data on comorbidity, cognitive and affective status and health-related quality of life. Data will be analysed according to the intention-to-treat principle using a 5% significance level. The study will at all times be conducted in strict accordance with the provisions of the Declaration of Helsinki and with the national legislation regulating patients' autonomy. All patients recruited will be asked to provide written informed consent before taking part in the clinical trial. On completion of the study, the principal investigator expects to publish the results of this research in a peer-reviewed open access scientific journal. ISRCTN17143761.
Prevalence of frailty among community-dwelling elderly persons in Spain and factors associated with it.
(2019-10-22) Rivas-Ruiz, Francisco; Machón, Mónica; Contreras-Fernández, Eugenio; Vrotsou, Kalliopi; Padilla-Ruiz, María; Díez Ruiz, Ana Isabel; de Mesa Berenguer, Yolanda; Vergara, Itziar; Group GIFEA
Background: For effective prevention and intervention, and reduction of dependency, it is essential to determine the presence of frailty in the community.Objectives: To describe the prevalence of frailty among elderly persons living independently, in two primary healthcare areas in Spain; to identify factors correlated with its presence.Methods: This descriptive cross-sectional study was conducted between May 2015 and July 2016 among non-institutionalized individuals aged ≥70 years living in the primary healthcare areas of Gipuzkoa and Costa del Sol (Spain). The main outcome variable was the prevalence of frailty (determined by modified Fried criteria). The independent study variables were sociodemographic characteristics, anthropometric data and health-related life habits.Results: The study population consisted of 855 individuals (53% women). The overall prevalence of frailty was 26.2% (Gipuzkoa 14.2%, Costa del Sol 38.0%). Using multiple logistic regression, the following factors were associated with frailty: female sex (OR: 1.98; 95%CI: 1.37-2.86); cumulative illness rating scale (OR: 1.05; 95%CI: 1.00-1.10); self-perceived health status (OR: 0.96; 95%CI: 0.95-0.97); self-perceived unhealthy lifestyle (OR: 3.37; 95%CI: 2.05-8.87); dissatisfaction with the domestic environment (OR: 2.11; 95%CI: 1.18-3.76); and cognitive impairment (OR: 4.10; 95%CI: 2.05-8.19). In the multivariable model, 'geographical area' differences persisted, with an OR of 3.51 (95%CI: 2.29-5.36) for the Costa del Sol area, using Gipuzkoa as reference.Conclusion: In this population of community-dwelling persons aged 70 years and over, the prevalence of frailty was 26%. Factors correlated with frailty were female sex, comorbidity, poorer self-perceived lifestyle and health status, and dissatisfaction with the domestic environment.
Psychological factors are associated with local and generalized pressure pain hypersensitivity, pain intensity, and function in people with chronic shoulder pain: A cross-sectional study.
(2019-09-21) Martinez-Calderon, Javier; Meeus, Mira; Struyf, Filip; Diaz-Cerrillo, Juan Luis; Clavero-Cano, Susana; Morales-Asencio, Jose Miguel; Luque-Suarez, Alejandro
To explore the association between psychological factors and shoulder pain intensity, function, as well as local and generalized pressure pain hypersensitivity. a cross-sectional study. 90 participants with chronic shoulder pain were included. Pressure pain thresholds determined the presence of pain hypersensitivity. Pain intensity, function, pain self-efficacy, emotional distress, and pain catastrophizing were also assessed. Analyses were adjusted for gender and age. The diagnosis of depression (yes/no answer) was associated with both greater local (standardized β = -0.19[95%CI -0.37 to -0.00]) and generalized (standardized β = -0.20[95%CI -0.39 to -0.01]) pressure pain hypersensitivity. Greater pain self-efficacy was associated with lower local pressure pain hypersensitivity (standardized β = 0.19[95%CI 0.04 to 0.38]). The standardized beta coefficient for the diagnosis of depression indicated that this variable showed the strongest association with pressure pain hypersensitivity. Additionally, greater pain self-efficacy was associated with lower pain intensity (standardized β = -0.34[95%CI -0.51 to -0.17]) and better function (standardized β = -0.47[95%CI -0.63 to -0.30]). Greater pain catastrophizing was associated with more pain intensity (standardized β = 0.35[95%CI 0.18 to 0.52]) and worse function (standardized β = 0.26[95%CI 0.10 to 0.43]). The standardized beta coefficients for pain catastrophizing and pain self-efficacy indicated that both variables showed the strongest association with shoulder pain intensity and function, respectively CONCLUSION: Psychological factors were associated with local and generalized pressure pain hypersensitivity, pain intensity, and function in people with chronic shoulder pain.
Development and Psychometric Validation of an Instrument to Identify Barriers to Self-Care Among Spanish Patients With Type 2 Diabetes on the Basis of Theory of Planned Behavior.
(2019-05-31) Caro-Bautista, Jorge; Espinar-Toledo, Milagrosa; Villa-Estrada, Francisca; Lupiáñez-Pérez, Inmaculada; Kaknani-Uttumchandani, Shakira; García-Mayor, Silvia; Salas-Samper, Felipe; Morales-Asencio, José-Miguel
Several instruments are available to evaluate barriers to self-care in people with type 2 diabetes, but with significant psychometric weaknesses and poor theoretical background. To develop and psychometrically validate a questionnaire to identify barriers to self-care in this population on the basis of the theory of planned behavior. The study was carried out in 15 primary healthcare centers belonging to the Public Health Care System in Andalusia (Spain). After content validity was confirmed, an initial pilot study was undertaken (n = 54) and the model was evaluated in 2 samples of 205 subjects each to test its configural and metric invariance by confirmatory factor analysis. Internal consistency, test-retest reliability, criterion validity, and interpretability were carried out following COSMIN standards. A 4-factor instrument (intention, subjective norms, perceived control, and attitudes) with 15 items was obtained with a good fit: goodness-of-fit index = 0.92, comparative fit index = 0.93, and root mean square error of approximation = 0.043 (90% confidence interval 0.034-0.052). Cronbach α was 0.78, and test-retest reliability was adequate (intraclass correlation coefficient 0.73; P A theory-driven instrument is suitable for its use with Spanish people with type 2 diabetes to assess their self-care needs and make tailored recommendations for lifestyle modifications on the basis of their behavioral determinants.
Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk.
(MDPI, 2019-06-27) Julibert, Alicia; Bibiloni, Maria Del Mar; Bouzas, Cristina; Martinez-Gonzalez, Miguel Angel; Salas-Salvado, Jordi; Corella, Dolores; Zomeño, Maria Dolors; Romaguera, Dora; Vioque, Jesus; Alonso-Gomez, Angel M; Wärnberg, Julia; Martinez, J Alfredo; Serra-Majem, Luis; Estruch, Ramon; Tinahones, Francisco J; Lapetra, Jose; Pinto, Xavier; Lopez-Miranda, Jose; Garcia-Molina, Laura; Gaforio, Jose Juan; Matia-Martin, Pilar; Daimiel, Lidia; Martin-Sanchez, Vicente; Vidal, Josep; Vazquez, Clotilde; Ros, Emili; Toledo, Estefanía; Becerra-Tomas, Nerea; Portoles, Olga; Perez-Vega, Karla A; Fiol, Miquel; Torres-Collado, Laura; Tojal-Sierra, Lucas; Carabaño-Moral, Rosa; Abete, Itziar; Sanchez-Villegas, Almudena; Casas, Rosa; Bernal-Lopez, Maria Rosa; Santos-Lozano, Jose Manuel; Galera, Ana; Ugarriza, Lucia; Ruiz-Canela, Miguel; Babio, Nancy; Coltell, Oscar; Schröder, Helmut; Konieczna, Jadwiga; Orozco-Beltran, Domingo; Sorto-Sanchez, Carolina; Eguaras, Sonia; Barrubes, Laura; Fito, Montserrat; Tur, Josep A; ISCIII through the Fondo de Investigación para la Salud (FIS); European Regional Development Fund; Consejería de Salud de la Junta de Andalucía; Predimed-Plus Investigators
Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55-75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3-1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia.
Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis.
(MDPI AG, 2019-04-24) Cano-Ibañez, Naomi; Gea, Alfredo; Martinez-Gonzalez, Miguel A.; Salas-Salvado, Jordi; Corella, Dolores; Zomeño, M. Dolors; Romaguera, Dora; Vioque, Jesus; Aros, Fernando; Warnberg, Julia; Martinez, J. Alfredo; Serra-Majem, Lluis; Estruch, Ramon; Tinahones, Francisco J.; Lapetra, Jose; Pinto, Xavier; Tur, Josep A.; Garcia-Rios, Antonio; Riquelme-Gallego, Blanca; Delgado-Rodriguez, Miguel; Matia, Pilar; Daimiel, Lidia; Martin, Vicente; Vidal, Josep; Vazquez, Clotilde; Ros, Emilio; Buil-Cosiales, Pilar; Diaz-Lopez, Andres; Fernandez-Carrion, Rebeca; Fito, Montserrat; Konieczna, Jadwiga; Notario-Barandiaran, Leyre; Alonso-Gomez, Angel M.; Contreras-Fernandez, Eugenio; Abete, Itziar; Sanchez-Villegas, Almudena; Casas, Rosa; Muñoz-Garach, Araceli; Santos-Lozano, Jose Manuel; Gallardo-Alfaro, Laura; Basora, Josep; Portoles, Olga; Muñoz, Miguel Angel; Moñino, Manuel; Miralles Gisbert, Salvador; Moreno Rodriguez, Anai; Ruiz-Canela, Miguel; Palau Galindo, Antoni; Perez-Vega, Karla Alejandra; Bueno-Cavanillas, Aurora; Fondo de Investigación para la Salud (ISCIII); European Research Council; Consejería de Salud de la Junta de Andalucía; FEDER; Ministry of Education of Spain
Dietary guidelines emphasize the importance of a varied diet to provide an adequate nutrient intake. However, an older age is often associated with consumption of monotonous diets that can be nutritionally inadequate, increasing the risk for the development or progression of diet-related chronic diseases, such as metabolic syndrome (MetS). To assess the association between dietary diversity (DD) and nutrient intake adequacy and to identify demographic variables associated with DD, we cross-sectionally analyzed baseline data from the PREDIMED-Plus trial: 6587 Spanish adults aged 55-75 years, with overweight/obesity who also had MetS. An energy-adjusted dietary diversity score (DDS) was calculated using a 143-item validated semi-quantitative food frequency questionnaire (FFQ). Nutrient inadequacy was defined as an intake below 2/3 of the dietary reference intake (DRI) forat least four of 17 nutrients proposed by the Institute of Medicine (IOM). Logistic regression models were used to evaluate the association between DDS and the risk of nutritionally inadequate intakes. In the higher DDS quartile there were more women and less current smokers. Compared with subjects in the highest DDS quartile, those in the lowest DDS quartile had a higher risk of inadequate nutrient intake: odds ratio (OR) = 28.56 (95% confidence interval (CI) 20.80-39.21). When we estimated food varietyfor each of the food groups, participants in the lowest quartile had a higher risk of inadequate nutrient intake for the groups of vegetables, OR = 14.03 (95% CI 10.55-18.65), fruits OR = 11.62 (95% CI 6.81-19.81), dairy products OR = 6.54 (95% CI 4.64-9.22) and protein foods OR = 6.60 (95% CI 1.96-22.24). As DDS decreased, the risk of inadequate nutrients intake rose. Given the impact of nutrient intake adequacy on the prevention of non-communicable diseases, health policies should focus on the promotion of a healthy varied diet, specifically promoting the intake of vegetables and fruit among population groups with lower DDS such as men, smokers or widow(er)s.
Evaluation of Inappropriate Prescribing in Patients Older than 65 Years in Primary Health Care.
(Mdpi, 2019-03-04) Nuñez-Montenegro, Antonio; Montiel-Luque, Alonso; Martin-Aurioles, Esther; Garcia-Dillana, Felicisima; Krag-Jiménez, Monica; González-Correa, Jose A; The Andalusian Health Service; Care Research Group INVESCUIDA
To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care. Design: cross-sectional study. Setting: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain. Participants: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area. The data were collected by interview on a structured data collection form. Study variables. Dependent variable: Potentially inappropriate prescribing (PIP) (STOPP/START criteria). Predictor variables: Sociodemographic characteristics, clinical characteristics and medication use. A descriptive analysis of the variables was performed. Statistical inference was based on bivariate analysis (Student’s t or Mann-Whitney U test and chi-squared test) and multivariate analysis was used to control for confounding factors. 73.6% of participants met one or more STOPP/START criteria. According to information about prescribed treatments, 48.5% of participants met at least one STOPP criterion and 43.30% of them met at least one START criterion. The largest percentage of inappropriate prescriptions was associated with cardiovascular treatments. More than three-quarters of the participants had one or moreinappropriate prescriptions for medicines in primary care, according to STOPP/START criteria. In addition, PIP was directly related to the number of prescribed medications, gender and specific pathologies (diabetes).

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