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Terrassa, Spain

Vernet Vernet M.,CAP Terrassa Nord | Sender Palacios M.J.,CAP Terrassa Nord | Jovell Fernandez E.,Servicio de Epidemiologia | Tor Figueras E.,CAP Terrassa Nord | And 2 more authors.
Atencion Primaria | Year: 2010

Objectives: To evaluate the cardiovascular risk factors (CVRF), their relationship with insulin resistance (IR) and pancreatic beta-cell (PBC) function in a known non-diabetic population, and to follow its progress over a period of 5 years. Design: Nested case-control study developed in two phases: the identification and characterisation of the cohort to study and the follow up. Setting: Urban Primary Care Centre. Participants: A non-diabetic population sample from 40 to 70 years. Main measurements: History of CVRF, physical examination (body mass index, abdominal girth, blood pressure), laboratory tests (fasting glucose, lipid profile and fasting insulin) and calculation of IR and PBC using the Homeostasis Model Assessment mathematical program. Results: Identification phase: 326 subjects. CVRF 32.5% dyslipaemia, 28.8% smoking, 28.2% obesity and 24.8% increased blood pressure. Number of CVRF: 37.7% had one, 21.5% two, 10.1% three and 2.1% four. Relationship between number of CVRF and IR. More IR in hypertensive, obese and dyslipaemic subjects. Follow up phase (5 years): 121 subjects. Significant proportion of dyslipaemia and impaired fasting glucose (IFG). Conclusions: The most common CVRF were dyslipaemia, smoking, obesity and raised blood pressure, with more IR in patients with high blood pressure, dyslipaemia and obesity and a higher number of CVRF in comparison with the rest of the population. At five years of follow up, an increase was only observed in the number of dyslipaemia and IFG and no reduction was achieved in the percentage of active smokers. © 2009 Elsevier España, S.L. All rights reserved.

Sender Palacios M.J.,CAP Terrassa Nord | Vernet Vernet M.,CAP Terrassa Nord | Maseras Bove M.,Servicio de Oftamologa | Salvador Playa A.,Servicio de Oftalmologa | And 3 more authors.
Atencion Primaria | Year: 2011

Objective: To study the feasibility of a basic ophthalmological examination for the eye disease in diabetic patients by Primary Health Care (PHC). Patients and methods: A multi-centre prospective study. A sample of 712 type 2 diabetics. Interventions: Visual acuity examination, intraocular pressure measurement and the eye fundus photograph with a non-mydriatic camera taken by an optometrist. The interpretation and subsequent referral to an ophthalmology department by ophthalmologists and general practitioners (GP). Results: Visual acuity deficiency: GP, 43.7%; ophthalmologist, 36.1%; concordance, 70%; glaucoma suspicion: GP, 8.8%; ophthalmologist, 7.6%; concordance, 94%; diabetic retinopathy: GP, 28.2%; ophthalmologist, 13.4%; concordance, 78%. Ophthalmology Department referral: GP, 56.8%; ophthalmologist, 41.3% (P=0.001). Conclusions: Agreement between GP and ophthalmologist leads to a reliable ophthalmological examination of the diabetic patient in PHC. Despite an over-diagnosis and 16% of non-justified referrals by the GP, Ophthalmology Department referral is avoided in almost half of the diabetic patients. © 2009 Elsevier España, S.L. All rights reserved.

Ulcers and chronic wounds are an ideal medium for bacterial growth. This growth occurs in both number and variety of species, resulting in lesions with polymicrobial flora. The use of antimicrobial treatments to control and/or prevention of infection is discussed. Silver dressings as an alternative safe and effective for treating infected wounds and/or in situations of critical colonization. There are already evidence of what kind of silver-containing dressings are more cost-effective. The aim of this study is to evaluate the efficacy and effectiveness of Atrauman Ag dressing in the treatment of skin lesions in acute and chronic, as to the resolution of signs of infection and progression of healing during a period of four weeks. MATERIAL AND METHODS: we performed an observational, prospective, multicenter open study where the patient inclusion period was from April to August 2007. The sample consisted of patients seen giving their informed consent in primary care centers, health centers and hospitals throughout the country and met the inclusion criteria and had none of the exclusion criteria. The study variables were collected sociodemographic, injury-related variables to study with the dressing and the ratings of professionals and patients. The values of each variable were collected weekly in a CRD. The recorded data are processed in a database originally composed of 116 variables, which were analyzed with SPSS software. RESULTS: we evaluated 219 patients finally included 147 who met the inclusion criteria and no exclusion. At the end of the study had chronic injuries granulation tissue in 84.8% and 100% acute wounds with statistically significant differences with respect to the initial assessment. Exudate levels in wounds evaluated at 4 weeks of treatment show a significant reduction, from exudate abundant or very abundant in 81.8% to a level of low or moderate exudate in 80.5% of the cases end of the study The evolution of clinical signs of infection by 87% (n=91) of the lesions disappeared after 4 weeks. 11.7% of lesions were healed in the study period. In the case of chronic wounds, we go from a median of 17.5 cm2 to 9.9 cm2, this means a relative reduction of 39.05% and a speed of 1. 12 cm2/week healing. In the case of acute wounds, a move from a median of 8.25 cm2 to 3.0 cm2 and a relative reduction of 65.03% with a healing rate of 2.28 cm2/week, with statistically significant differences both cases. The permeability of the dressing exudate was evaluated as good or very good in 88% of cases and the perilesional skin care by 79.9% as good or very good. The pain in the wounds was evaluated as nothing or very little, in 72% of cases.

Marques-Iturria I.,University of Barcelona | Garolera M.,University of Barcelona | Garolera M.,Neuropsychology Unit | Pueyo R.,University of Barcelona | And 11 more authors.
American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics | Year: 2014

The prevalence of obesity is increasing worldwide. Previous research has shown a relationship between obesity and both executive functioning alterations and frontal cortex volume reductions. The Brain Derived Neurotrophic Factor val66met polymorphism, involved in eating behavior, has also been associated with executive functions and prefrontal cortex volume, but to date it has not been studied in relation to obesity. Our aim is to elucidate whether the interaction between the Brain Derived Neurotrophic Factor val66met polymorphism and obesity status influences executive performance and frontal-subcortical brain structure. Sixty-one volunteers, 34 obese and 27 controls, age range 12-40, participated in the study. Participants were assigned to one of two genotype groups (met allele carriers, n=16, or non-carriers, n=45). Neuropsychological assessment comprised the Trail Making Test, the Stroop Test and the Wisconsin Card Sorting Test, all tasks that require response inhibition and cognitive flexibility. Subjects underwent magnetic resonance imaging in a Siemens TIM TRIO 3T scanner and images were analyzed using the FreeSurfer software. Analyses of covariance controlling for age and intelligence showed an effect of the obesity-by-genotype interaction on perseverative responses on the Wisconsin Card Sorting Test as well as on precentral and caudal middle frontal cortical thickness: obese met allele carriers showed more perseverations on the Wisconsin Card Sorting Test and lower frontal thickness than obese non-carriers and controls. In conclusion, the Brain Derived Neurotrophic Factor may play an important role in executive functioning and frontal brain structure in obesity. © 2014 Wiley Periodicals, Inc.

Garcia-Garcia I.,University of Barcelona | Garcia-Garcia I.,Institute for Brain | Jurado M.A.,University of Barcelona | Jurado M.A.,Institute for Brain | And 16 more authors.
Human Brain Mapping | Year: 2013

Obesity is a major health problem in modern societies. It has been related to abnormal functional organization of brain networks believed to process homeostatic (internal) and/or salience (external) information. This study used resting-state functional magnetic resonance imaging analysis to delineate possible functional changes in brain networks related to obesity. A group of 18 healthy adult participants with obesity were compared with a group of 16 lean participants while performing a resting-state task, with the data being evaluated by independent component analysis. Participants also completed a neuropsychological assessment. Results showed that the functional connectivity strength of the putamen nucleus in the salience network was increased in the obese group. We speculate that this abnormal activation may contribute to overeating through an imbalance between autonomic processing and reward processing of food stimuli. A correlation was also observed in obesity between activation of the putamen nucleus in the salience network and mental slowness, which is consistent with the notion that basal ganglia circuits modulate rapid processing of information. © 2012 Wiley Periodicals, Inc.

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