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Background: Down Syndrome (DS) presents with systemic, craniofacial and oral alterations accompanied by different levels of intellectual disability and because of this, they frequently require professional dental care. Objective: This work aims to know the dental care patients with DS receive from dentists in the Balearic Islands. Material and Methods: An 11-question survey was carried out via email from the College of Dentists of the Balearic Islands. The researchers conducted the survey based on previous researchs. The first three questions refered the professional´s profile (age, sex and years since graduation) and the restant 8 were focused on the academic training and dental care provided to patients with DS. Results: 129 surveys were collected. 40.45% were between 34-43 years old, 67.84% were women, and 32.16% were men. 33.30% had been in professional practice for between 15-24 years, followed by those with 4-14 years with 27.33% and those with 25-34 years with 24.04%. 81.64% received undergraduate academic training, and 60.72% completed training after graduating. 57.17% believe that patients with DS should be treated by a dentist specialised in special patients, 20.67% by a pediatric dentist, and 18.87% by a general dentist. 63.40% perform sealing, fillings or dental extractions, 60.6% perform oral examination, oral cleaning and give prophylaxis instructions, and 26.72% state that they perform endodontic treatments. Significant differences were found between some of the variables analysed and the age, sex, academic training or professional scenario of the professionals. Conclusions: Post-graduate training increases the likelihood that dentists will feel comfortable with sealing-filling-extraction treatments by 7.48 times and endodontic treatments by 3.26 times. Key words:Down Syndrome, Trisomy 21, Surveys and Questionnaires, Dental Care for Children, Oral Health.

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AIM: To describe the latest scientific evidence regarding community-based interventions performed on patients in need of palliative care worldwide. INTRODUCTION AND BACKGROUND: Given the rise of chronic diseases, their complexities and the fragility of patients, we are facing around 56.8 million people in need of palliative care. Community-based healthcare, particularly palliative care, can address social inequalities and improve the biopsychosocial health of disadvantaged populations. Therefore, primary care, as the main health referent in the community, has a central role in the care of these patients. METHODS: This is an integrative review from January 2017 to June 2022 that follows the PRISMA statement and has been registered in PROSPERO. PubMed, Cuiden, the Web of Science (WoS), Cochrane and LILACS were the five databases searched. The scientific quality assessment of the articles was carried out following the CASPe methodology. Study selection was carried out by two researchers, A.V.L. and J.M.C.T., using the inclusion and exclusion criteria mentioned below. In cases of doubt or discrepancy, a third author (J.R.S.) was consulted. RESULTS: The interventions mentioned in the 16 articles analysed were classified under the following categories: music therapy, laughter therapy, spiritual and cognitive interventions, aromatherapy, interdisciplinary and community-based teams, advance care planning and community, volunteering, telemedicine and care mapping. EXAMPLE: Educating people to talk about different ethical issues could improve their quality of life and help develop more compassionate cities. CONCLUSIONS: We have identified interventions that are easily accessible (laughter therapy, telemedicine or music therapy), simple enough to be carried out at the community level and do not incur high costs. This is why they are recommended for people with palliative care needs in order to improve their quality of life.

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BACKGROUND: Cardiovascular diseases are the leading cause of death worldwide. Obesity and atherosclerosis are considered risk factors for this pathology. There are multiple methods to evaluate obesity, in the same way as there are different formulas to determine atherogenic risk. Since both pathologies are closely related, the objective of our work was to evaluate whether the ECORE-BF scale is capable of predicting atherogenic risk. METHODS: Observational, descriptive, and cross-sectional study in which 386,924 workers from several autonomous communities in Spain participated. The association between the ECORE-BF scale and five atherogenic risk indices was evaluated. The relationship between variables was assessed using the chi-square test and Student's t test in independent samples. Multivariate analysis was performed with the multinomial logistic regression test, calculating the odds ratio and 95% confidence intervals, with the Hosmer-Lemeshow goodness-of-fit test. ROC curves established the cut-off points for moderate and high vascular age and determined the Youden index. RESULTS: The mean values of the ECORE-BF scale were higher in individuals with atherogenic dyslipidemia and the lipid triad, as well as in those with elevated values of the three atherogenic indices studied, with p <0.001 in all cases. As atherogenic risk increased across the five evaluated scales, the prevalence of obesity also significantly increased, with p <0.001 in all cases. In the ROC curve analysis, the AUCs for atherogenic dyslipidemia and the lipid triad were above 0.75, indicating a good association between these scales and the ECORE-BF. Although the Youden indices were not exceedingly high, they were around 0.5. CONCLUSIONS: There is a good association between atherogenic risk scales, atherogenic dyslipidemia, and lipid triad, and the ECORE-BF scale. The ECORE-BF scale can be a useful and quick tool to evaluate atherogenic risk in primary care and occupational medicine consultations without the need for blood tests.

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Aterosclerosis , Obesidad , Humanos , España/epidemiología , Aterosclerosis/epidemiología , Estudios Transversales , Femenino , Masculino , Persona de Mediana Edad , Adulto , Obesidad/epidemiología , Factores de Riesgo , Medición de Riesgo , Dislipidemias/epidemiología , Dislipidemias/sangre , Prevalencia , Curva ROC

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(1) Background: To analyze the prevalence of physical activity (PA) according to the presence of overweight or obesity and other sociodemographic factors in the Spanish adult population. (2) Methods: Cross-sectional study using the European Health Interview Surveys for Spain from 2014 and 2020. (3) Results: In overweight and obese people, the percentage of those who reported not performing any type of PA remained constant between 2014 and 2020, while a statistically significant increase was observed in the percentage of people who walked for 10 min a day and exercised at least 2 days a week. The probability of being obese with respect to normal weight was higher in individuals who reported not engaging in PA during leisure time (OR 1.42; 95% CI 1.31-1.53), those who did not walk 10 min a day at least 2 days a week (OR 1.25; 95% CI 1.15-1.35), and those who did not exercise at least 2 days a week (OR 1.42; 95% CI 1.32-1.53). The probability of being overweight was higher in individuals who reported not performing PA during leisure time (OR 1.07; 95% CI 1.02-1.15) and in those who did not exercise at least 2 days per week (OR 1.15; 95% CI 1.09-1.22). (4) Conclusions: Small increases in PA have been observed in both overweight and obese individuals from 2014 to 2020.

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BACKGROUND: Obesity constitutes a public health problem worldwide and causes non-alcoholic fatty liver disease (MALFD), the leading cause of liver disease in developed countries, which progresses to liver cirrhosis and liver cancer. MAFLD is associated with obesity and can be evaluated by validated formulas to assess MAFLD risk using different parameters such as the body mass index (BMI) and waist circumference (WC). However, these parameters do not accurately measure body fat. As MAFLD is strongly associated with obesity, we hypothesize that measuring body and visceral fat by electrical bioimpedance is an efficient method to predict the risk of MAFLD. The objective of our work was to demonstrate that electrical bioimpedance is a more efficient method than the BMI or WC to predict an elevated risk of MAFLD. METHODS: A cross-sectional, descriptive study involving 8590 Spanish workers in the Balearic Islands was carried out. The study's sample of employees was drawn from those who underwent occupational medicine examinations between January 2019 and December 2020. Five MAFLD risk scales were determined for evaluating very high levels of body fat and visceral fat. The determination of body and visceral fat was performed using bioimpedanciometry. Student's t-test was employed to ascertain the mean and standard deviation of quantitative data. The chi-square test was used to find prevalences for qualitative variables, while ROC curves were used to define the cut-off points for body and visceral fat. The calculations included the area under the curve (AUC), the cut-off points along with their Youden index, sensitivity, and specificity. Correlation and concordance between the various scales were determined using Pearson's correlation index and Cohen's kappa, respectively. RESULTS: As both total body fat and visceral fat increase, the risk of MAFLD increases with a statistically significant result (p < 0.001), presenting a higher risk in men. The areas under the curve (AUC) of the five scales that assess overweight and obesity to determine the occurrence of high values of the different MAFLD risk scales were very high, most of them exceeding 0.9. These AUC values were higher for visceral and body fat than for the BMI or waist circumference. FLD-high presented the best results in men and women with the AUC at around 0.97, both for visceral fat and total body fat, with a high Youden index in all cases (women body fat = 0.830, visceral fat = 0.892; men body fat = 0.780, visceral fat = 0.881). CONCLUSIONS: In our study, all the overweight and obesity scales show a very good association with the scales assessing the risk of MAFLD. These values are higher for visceral and body fat than for waist circumference and the BMI. Both visceral fat and body fat are better associated than the BMI and waist circumference with MAFLD risk scales.

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Tejido Adiposo , Impedancia Eléctrica , Grasa Intraabdominal , Enfermedad del Hígado Graso no Alcohólico , Medición de Riesgo , Grasa Intraabdominal/metabolismo , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/patología , Tejido Adiposo/metabolismo , Tejido Adiposo/patología , España , Estudios Transversales , Medición de Riesgo/métodos , Valor Predictivo de las Pruebas , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adolescente , Adulto Joven , Anciano

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BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD, 2020 diagnostic criteria) and glomerular hyperfiltration share common risk factors, including obesity, insulin resistance, impaired glucose tolerance, diabetes, dyslipidemia, and hypertension. AIMS: To assess the prevalence of MAFLD and its association with glomerular hyperfiltration and age-related worsening of kidney function in subjects with normoglycemia, prediabetes and type 2 diabetes mellitus (T2DM). METHODS: We analysed data recorded during occupational health visits of 125,070 Spanish civil servants aged 18-65 years with a de-indexed glomerular filtration rate (GFR) estimated with the chronic-kidney-disease-epidemiological (CKD-EPI) equation (estimated glomerular filtration rate [eGFR]) ≥60 mL/min. Subjects were categorised according to fasting plasma glucose levels <100 mg/dL (normoglycemia), ≥100 and ≤ 125 mg/dL (prediabetes), or ≥126 mg/dL and/or antidiabetic treatment (T2DM). The association between MAFLD and glomerular hyperfiltration, defined as a de-indexed eGFR above the age- and gender-specific 95th percentile, was assessed by multivariable logistic regression. RESULTS: In the whole study group, MAFLD prevalence averaged 19.3%. The prevalence progressively increased from 14.7% to 33.2% and to 48.9% in subjects with normoglycemia, prediabetes and T2DM, respectively (p < 0.001 for trend). Adjusted odds ratio (95% CI) for the association between MAFLD and hyperfiltration was 9.06 (8.53-9.62) in the study group considered as a whole, and 8.60 (8.03-9.21), 9.52 (8.11-11.18) and 8.31 (6.70-10.30) in subjects with normoglycemia, prediabetes and T2DM considered separately. In stratified analyses, MAFLD amplified age-dependent eGFR decline in all groups (p < 0.001). CONCLUSIONS: MAFLD prevalence increases across the glycaemic spectrum. MAFLD is significantly associated with hyperfiltration and amplifies the age-related eGFR decline.

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Diabetes Mellitus Tipo 2 , Tasa de Filtración Glomerular , Estado Prediabético , Humanos , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/fisiopatología , Diabetes Mellitus Tipo 2/complicaciones , Estado Prediabético/epidemiología , Estado Prediabético/fisiopatología , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Adulto , Anciano , Adulto Joven , Adolescente , Glucemia/análisis , Factores de Riesgo , Prevalencia , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/fisiopatología , Pronóstico , Estudios de Seguimiento , Biomarcadores/sangre , Biomarcadores/análisis , Nefropatías Diabéticas/epidemiología , Nefropatías Diabéticas/fisiopatología , Nefropatías Diabéticas/etiología

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

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Enfermedades Cardiovasculares , Teléfono Celular , Dieta Mediterránea , Femenino , Masculino , Humanos , Estudios Prospectivos , Cabeza , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control

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INTRODUCTION: The acquisition of skills and manual dexterity in aesthetic dentistry in undergraduate teaching requires preclinical practices with simulation that should approximate real clinical situations. OBJECTIVE: We will present a digital procedure for the creation of three-dimensional (3D) resin models adapted to the practices of the Aesthetic Dentistry course. MATERIAL AND METHOD: Stereolithography or Standard Tesellation Language (STL) files of a real patient were previously obtained with a 3-shape intraoral scanner. Using the Exocad computer programme for dental prosthesis design, various modifications were made, such as incisor rotation, surface alterations imitating dysplasias or erosions, the creation of diastemas, or even changes in tooth size. The virtual model was printed in resin for use by students. Once the practices were finished, the students and the teachers evaluated the use of the 3D printed models. RESULTS: The result is the typodont model, in which seven laboratory sessions took place: 1-Restoration of conoid tooth morphology, 2-Cervical abrasion/ erosion restoration, 3-Direct Composite Veneer, 4-Aesthetic correction in a tooth with rotation, 5-Diastem closure, 6-Occlusal abrasions/ erosion, and 7-Maryland bridge. 90.48% of the students evaluated the designed 3D model as the best method for laboratory practice compared to other methods, obtaining a general assessment of 8.3 out of 10. CONCLUSION: The method used has provided a reproducible standard analog model for direct aesthetic dental restoration practice, with a good assessment by students and teachers.

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Técnica de Impresión Dental , Educación en Odontología , Estética Dental , Modelos Dentales , Impresión Tridimensional , Humanos , Educación en Odontología/métodos , Diseño de Prótesis Dental , Diseño Asistido por Computadora

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Introducción:El envejecimiento de la población conlleva una mayor prevalencia de trabajadores con patología psicofísica y cognitiva con riesgo de fragilidad.Objetivo:Estimar la relación entre envejecimiento asociado a la edad en hombres y mujeres, y la salud psicofísica, emocional y deterioro cognitivo en población laboral y su repercusión según tipo de trabajo y turnicidad.Material y Método:Estudio transversal en 389 trabajadores. Se valora <50 y ≥50 años con prensión manual, circunferencia del gemelo, Fragilidad-Frail, depresión-Beck, Ansiedad-Estado-Rasgo y deterioro cognitivo-Pfeiffer y la influencia del tipo de trabajo y turnicidad.Resultados:Existe mayor fragilidad-Frail en hombres ≥ 50 años (p<0,05). El resto de variables relacionadas con estado físico, emocional y cognitivo no muestra diferencias por edad, ni con el tipo de trabajo y turnicidad (p>0,05).Conclusiones:La fragilidad estimada con el cuestionario de Frail muestra los resultados más precoces de fragilidad en hombres ≥ 50 años. (AU)

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Introduction:The aging of the population leads to a higher prevalence of workers with psychophysical and cognitive pathologies at risk of frailty.Objective:To estimate the relationship between age-associated aging in men and women and psychophysical, emotional health, and cognitive impairment in the working population and its impact according to the type of work and shift work.Material and Method:Cross-sectional study with 389 workers. We assessed individuals aged <50 and ≥50 years using handgrip strength, calf circumference, Frailty-Frail assessment, Beck Depression Inventory for depression, State-Trait Anxiety Inventory for anxiety, and Pfeiffer test for cognitive impairment, while also considering the influence of the type of work and shift work.Results:There is a higher prevalence of frailty in men aged ≥50 years (p<0.05). The rest of the variables related to physical, emotional, and cognitive status do not show significant differences based on age, type of work, or shift work (p>0.05).Conclusions:Frailty, as assessed by the Frail questionnaire, reveals the earliest signs of frailty in men aged ≥50 years. (AU)

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Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Envejecimiento , Población en Edad de Trabajar , Trastornos Mentales , Estudios Transversales

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

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

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Humanos , Masculino , Femenino , Adiposidad , Indicadores (Estadística) , Salud Laboral , Epidemiología Descriptiva

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BACKGROUND: Insulin resistance (IR) is an alteration of the action of insulin in cells, which do not respond adequately to this action, leading to an increase in blood glucose levels. IR produces a very diverse clinical picture and increases the cardiometabolic risk of the population that suffers from it. Among the factors that influence IR are genetics, unhealthy lifestyle habits, overweight, and obesity. The objective of this work was to determine how different sociodemographic variables and healthy habits influence the values of different scales that assess the risk of presenting IR in a group of Spanish workers. METHODS: An observational, cross-sectional, descriptive study was carried out in 386,924 workers from different Spanish regions. Different sociodemographic variables and lifestyle habits were studied (age, social class, educational level, smoking, Mediterranean diet, physical exercise) along with their association with four scales to evaluate the risk of insulin resistance (TyG index, TyG-BMI, METS-IR, TG/HDL-c). To analyse the quantitative variables, Student's t test was used, while the Chi-squared test was used for the qualitative variables. A multinomial logistic regression analysis was performed, calculating the odds ratio with its 95% confidence intervals. The accepted level of statistical significance was set at p < 0.05. RESULTS: In the multivariate analysis, all variables, except educational level, increased the risk of presenting high values on the IR risk scales, especially a sedentary lifestyle and low adherence to the Mediterranean diet. CONCLUSIONS: Our results demonstrate an association between the practice of regular physical exercise and a reduction in the risk of IR; a strong role of the Mediterranean diet as a protective factor for IR; an association between aging and increased IR, which has also been suggested in other studies; and, finally, a relationship between a low socioeconomic level and an increase in IR.

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Resistencia a la Insulina , Humanos , Estudios Transversales , Índice de Masa Corporal , Obesidad , Sobrepeso , Triglicéridos , Glucemia/análisis

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

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Introduction, objectives: Although cardiovascular events have been traditionally associated mainly with men, some data reflect an increase in women, which may even exceed their male counterparts, constituting the leading cause of death in working women in Spain. The objective of this present study was to analyze the level of cardiovascular risk in Spanish working women by assessing the influence of age, type of work, and tobacco consumption. MATERIAL, METHODS: A descriptive cross-sectional study was carried out in 172,282 working women from different Spanish geographical areas and from different companies between January 2018 and June 2020. A range of variables and risk factors were assessed and various cardiovascular risk scales were used to analyze the data. RESULTS: An increase in cardiovascular risk was observed in the least qualified work groups, mainly corresponding to blue-collar workers, when using the SCORE or REGICOR risk equation. The prevalence of altered values for all the parameters analyzed (overweight and obesity, hypertension, dyslipidemia, diabetes, fatty liver, hepatic fibrosis, atherogenic indexes, and cardiovascular risk scales) was higher among blue-collar women. Age was the only factor that influenced all the cardiovascular risk scales studied, increasing risk when comparing the group of women aged 50 years and older with the others. CONCLUSIONS: Aging and belonging to the blue-collar job category meant worse results in the cardiovascular risk scales and in all the parameters analyzed. This is in line with numerous studies that argue that age and zip code are more influential than genetic code.

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

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

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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Síndrome Metabólico/prevención & control , Adiposidad , Salud Laboral , Estudios Transversales , Valor Predictivo de las Pruebas

RESUMEN

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

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

Asunto(s)

Diabetes Mellitus , Síndrome Metabólico , Adulto , Masculino , Humanos , Femenino , Persona de Mediana Edad , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Adiposidad , Estudios Transversales , Obesidad , Factores de Riesgo

RESUMEN

BACKGROUND: Atherogenic dyslipidaemia (AD) and lipid triad (LT) are characterised by high triglyceride levels together with low HDL and normal or high LDL cholesterol and are favoured by a persistent state of insulin resistance (IR), which increases the release of free fatty acids from abdominal adipose tissue. This alteration in the lipid profile favours the accelerated development of atherosclerosis, which is the most important cause of morbidity and mortality in all countries in the developed and developing world. One of the elements that plays a major role in the genesis of AD is IR. The aim of this study was to determine the relationship between variables that assess atherogenic risk (AD and LT) and scales that assess the risk of presenting insulin resistance. METHODS: A descriptive cross-sectional study of 418,343 workers was conducted to evaluate atherogenic dyslipidaemia and lipid triad; a relationship with three insulin resistance risk scales (Triglycerides/HDL, TyG index, METS-IR) was established. The usefulness of IR risk scales for predicting AD and LT was calculated by applying ROC curves, obtaining the area under the curve (AUC) and cut-off points with their sensitivity, specificity, and Youden index. Multivariate analysis was performed by binary logistic regression. RESULTS: The prevalence of high-risk values for insulin resistance with all of the scales is much higher in people with AD and LT compared to those without. The ROC curves present us with an AUC with the three insulin resistance risk scales for the two dyslipidaemias studied with figures ranging between 0.856 and 0.991, which implies that the results are good/very good. CONCLUSIONS: A relationship between atherogenic dyslipidaemia and the three insulin resistance risk scales assessed is revealed, with higher IR mean values and prevalence in people with atherogenic dyslipidaemia and lipid triad. The three scales make it possible to adequately classify the presence of AD and LT. The highest AUC is presented by the triglycerides/HDL scale, with a result close to 1. METS-IR is the most recommended formula to estimate insulin resistance.

Asunto(s)

Aterosclerosis , Dislipidemias , Hipercolesterolemia , Resistencia a la Insulina , Humanos , Estudios Transversales , Dislipidemias/epidemiología , Aterosclerosis/epidemiología , Aterosclerosis/etiología , Ácidos Grasos no Esterificados , Triglicéridos

RESUMEN

AIMS: To investigate the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) in prediabetes, visceral obesity, and preserved kidney function, and explore whether MAFLD is associated with hyperfiltration. METHODS: We analyzed data from 6697 Spanish civil servants, aged 18-65 years, with fasting plasma glucose ≥ 100 and ≤ 125 mg/dL (prediabetes, ADA), waist circumference ≥ 94 cm in men and ≥ 80 cm in women (visceral obesity, IDF) and de-indexed estimated glomerular filtration rate (eGFR) ≥ 60 ml/min, collected during occupational health visits. The association between MAFLD and hyperfiltration (eGFR > age- and sex-specific 95th percentile) was tested by multivariable logistic regression analyses. RESULTS: Overall, 4213 patients (62.9%) had MAFLD, and 330 (4.9%) were hyperfiltering. MAFLD was more frequent in hyperfiltering than in non-hyperfiltering subjects (86.4% vs 61.7%, P < 0.001). BMI, waist circumference, systolic, diastolic, mean arterial pressure, and prevalence of hypertension were higher in hyperfiltering than in non-hyperfiltering subjects (P < 0.05). MAFLD was independently associated with hyperfiltration, even after adjusting for common confounders [OR (95% CI): 3.36 (2.33-4.84), P < 0.001]. In stratified analyses MAFLD potentiated age-related eGFR decline vs. non-MAFLD (P < 0.001). CONCLUSIONS: More than half of subjects with prediabetes, visceral obesity and eGFR ≥ 60 ml/min presented MAFLD that was associated with hyperfiltration and potentiated the age-related eGFR decline.

Asunto(s)

Enfermedades Renales , Estado Prediabético , Masculino , Humanos , Femenino , Estudios Transversales , Obesidad Abdominal/epidemiología , Glomérulos Renales , Tasa de Filtración Glomerular

RESUMEN

Introduction: Cardiovascular diseases are responsible for a significant morbimortality rate around the world. Due to the characteristics of their work, health care professionals, including veterinarians, are more prone to present this type of pathology. Objectives: To determine the level of cardiovascular risk using different scales in a group of veterinarians. Methods: A descriptive and cross-sectional study of 610 Spanish veterinarians was conducted to assess cardiovascular risk scores, including 14 overweight and obesity scales, six fatty liver scales, six cardiovascular risk scales, four atherogenic indices, and three metabolic syndrome scales. Results: The prevalence of obesity among women was 7.95%, and 17.53% among men. Hypertension was present in 15.23% of women and 24.68% of men. Dyslipidemia affected 45% of women and 58.64% of men. The prevalence of metabolic syndrome according to the International Diabetes Federation criteria was slightly over 10% while 10.90% of women and 14.93% of men showed moderate to high values on the Registre Gironí del Cor scale. Conclusions: There is a moderate to high level of cardiovascular risk among veterinarians in this group.

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Introdução: As doenças cardiovasculares são responsáveis por uma taxa de morbimortalidade significativa no mundo. Devido às características do seu trabalho, os profissionais de saúde, incluindo veterinários, são mais propensos a apresentar este tipo de patologia. Objetivos: Determinar o nível de risco cardiovascular utilizando diferentes escalas num grupo veterinários. Métodos: Estudo descritivo e transversal em 610 veterinários em que foram avaliadas diferentes escalas relacionadas com o risco cardiovascular, incluindo 14 escalas de excesso de peso e obesidade, seis de fígado gordo, seis de risco cardiovascular, quatro índices aterogênicos e três de síndrome metabólica. Resultados: A prevalência da obesidade foi de 7,95% nas mulheres e 17,53% nos homens. A hipertensão estava presente em 15,23% das mulheres e 24,68% dos homens. A dislipidemia afetou 45% das mulheres e 58,64% dos homens. A prevalência da síndrome metabólica com critérios da International Diabetes Federation foi ligeiramente superior a 10% enquanto valores moderados ou elevados da escala Registre Gironí del Cor foram encontrados em 10,90% das mulheres e 14,93% dos homens. Conclusões: Neste grupo de veterinários, o nível de risco cardiovascular pode ser considerado de moderado a elevado.

RESUMEN

Excessive alcohol consumption is a major public health issue that can negatively affect behavior among university students. The objective of this study was to estimate the frequency of alcohol consumption in nursing students as well as to describe the pattern of alcohol consumption after COVID-19 lockdown. A descriptive, cross-sectional observational study was carried out, in which 1162 degree-level nursing students were evaluated. Sociodemographic characteristics, lifestyles and levels of physical activity were determined using the International Physical Activity Questionnaire: Short Form (IPAQ-SF), and alcohol consumption was determined using the ISCA (Systematized Alcohol Consumption Questionnaire) and AUDIT (Alcohol Use Disorders Inventory Test) questionnaires. According to the AUDIT questionnaire, 36.7% of the students met the criteria for excessive alcohol consumption (26.8% men vs. 39.9% women; p < 0.001). The prevalence of hazardous drinkers was found to be 10.2% (95% CI 5.6-11.7), with the difference between men and women being statistically significant. The IPAQ-SF questionnaire indicated that 26.1% of students were sedentary. No relationship was observed between alcohol consumption and the level of physical activity. The frequency of hazardous drinkers was significantly higher in women (OR: 2.2) and in smokers (OR: 4.2). In conclusion, approximately 10% of nursing students can be considered hazardous drinkers, with significant differences between the sexes. The percentage is higher in women and in smokers. Strategies should be created that encourage healthy lifestyles, emphasizing preventive activities against excessive alcohol consumption. Furthermore, given the differences in excessive alcohol consumption between men and women, it would be advisable to include the gender perspective in these activities.

RESUMEN

Nanotechnology is a developing field that has boomed in recent years due to the multiple qualities of nanoparticles (NPs), one of which is their antimicrobial capacity. We propose that NPs anchored with 2-(dimethylamino)ethyl methacrylate (DMAEMA) have antibacterial properties and could constitute an alternative tool in this field. To this end, the antimicrobial effects of three quaternised NPs anchored with DMAEMA were studied. These NPs were later copolymerized using different methylmethacrylate (MMA) concentrations to evaluate their role in the antibacterial activity shown by NPs. Clinical strains of Staphylococcus aureus, S. epidermidis, S. lugdunensis and Enterococcus faecalis were used to assess antibacterial activity. The minimal inhibitory concentration (MIC) was determined at the different concentrations of NPs to appraise antibacterial activity. The cytotoxic effects of the NPs anchored with DMAEMA were determined in NIH3T3 mouse fibroblast cultures by MTT assays. All the employed NPs were effective against the studied bacterial strains, although increasing concentrations of the MMA added during the synthesis process diminished these effects without altering toxicity in cell cultures. To conclude, more studies with other copolymers are necessary to improve the antibacterial effects of NPs anchored with DMAEMA.