Screening premorbid metabolic syndrome in community pharmacies: a cross-sectional descriptive study

Background: Premorbid metabolic syndrome (pre-MetS) is a cluster of cardiometabolic risk factors characterised by central obesity, elevated fasting glucose, atherogenic dyslipidaemia and hypertension without established cardiovascular disease or diabetes. Community pharmacies are in an excellent position to develop screening programmes because of their direct contact with the population. The main aim of the study was to determine the prevalence of pre-MetS in people who visited community pharmacies for measurement of any of its five risk factors to detect the presence of other risk factors. The secondary aims were to study the presence of other cardiovascular risk factors and determine patients" cardiovascular risk. Methods: Cross-sectional, descriptive, multicentre study. Patients meeting selection criteria aged between 18 and 65 years who visited participating community pharmacies to check any of five pre-MetS diagnostic factors were included. The study involved 23 community pharmacies in Catalonia (Spain). Detection criteria for pre-MetS were based on the WHO proposal following IDF and AHA/NHBI consensus. Cardiovascular risk (CVR) was calculated by Regicor and Score methods. Other variables studied were smoking habit, physical activity, body mass index (BMI), and pharmacological treatment of dyslipidemia and hypertension. The data were collected and analysed with the SPSS programme. Comparisons of variables were carried out using the Student"s T-test, Chi-Squared test or ANOVA test. Level of significance was 5% (0.05). Results: The overall prevalence of pre-MetS was 21.9% [95% CI 18.7-25.2]. It was more prevalent in men, 25.5% [95% CI 22.1-28.9], than in women, 18.6% [95% CI 15.5-21.7], and distribution increased with age. The most common risk factors were high blood pressure and abdominal obesity. About 70% of people with pre-MetS were sedentary and over 85% had a BMI ≥25 Kg/m2 . Some 22.4% had two metabolic criteria and 27.2% of patients with pre-MetS had no previous diagnosis. Conclusions: The prevalence of pre-MetS in our study (21.9%) was similar to that found in other studies carried out in Primary Care in Spain. The results of this study confirm emergent cardiometabolic risk factors such as hypertension, obesity and physical inactivity. Our study highlights the strategic role of the community pharmacy in the detection of pre-MetS in the apparently healthy population.

Clinical features of oral lichen planus. A retrospective study of 65 cases

Objectives: To describe the clinical features of patients diagnosed with oral lichen planus (OLP) and to establish the prevalence of its malignant transformation in our setting. Study design: A retrospective study was made of 65 patients clinically and histologically diagnosed with OLP in the Service of Oral Surgery (Dental Clinic of the University of Barcelona, Spain) in the period 1990-2005. A descriptive and bivariate statistical analysis was made. Results: The mean patient age was 59 years (SD ± 14.9). Most of the patients (61%) were women, and the most frequent location of the lesions was the buccal mucosa (90.8%). White forms of OLP were noted in 66% of the cases, and 46.2% of the patients reported symptoms of some kind. The patients diagnosed with diabetes mellitus (20%) showed a larger proportion of red lesions (p=0.088). No statistically significant association was observed between chronic liver disease and the OLP lesion types or symptoms. Two cases of squamous cell carcinoma were identified in two patients previously or simultaneously diagnosed with OLP. A statistically significant correlation was observed between dysplastic changes / malignization of the lesions and smoking habit (p=0.019). An association to alcohol abuse was also noted, though in this case statistical significance was not reached (p=0.085). Conclusions: The clinical features of our study population were similar to those described in other studies. Diabetic patients with OLP were seen to be more susceptible to the development of atrophic-erosive lesions. Smokers and/or patients with alcohol abuse in turn showed a greater tendency to develop dysplastic changes / malignization in the histopathological study of the lesions

Evaluation of potential breath biomarkers for active smoking: assessment of smoking habits

Different compounds have been reported as biomarkers of a smoking habit, but, to date, there is no appropriate biomarker for tobacco-related exposure because the proposed chemicals seem to be nonspecific or they are only appropriate for short-term exposure. Moreover, conventional sampling methodologies require an invasive method because blood or urine samples are required. The use of a microtrap system coupled to gas chromatography–mass spectrometry analysis has been found to be very effective for the noninvasive analysis of volatile organic compounds in breath samples. The levels of benzene, 2,5-dimethylfuran, toluene, o-xylene, and m- p-xylene have been analyzed in breath samples obtained from 204 volunteers (100 smokers, 104 nonsmokers; 147 females, 57 males; ages 16 to 53 years). 2,5-Dimethylfuran was always below the limit of detection (0.005 ppbv) in the nonsmoker population and always detected in smokers independently of the smoking habits. Benzene was only an effective biomarker for medium and heavy smokers, and its level was affected by smoking habits. Regarding the levels of xylenes and toluene, they were only different in heavy smokers and after short-term exposure. The results obtained suggest that 2,5-dimethylfuran is a specific breath biomarker of smoking status independently of the smoking habits (e.g., short- and long-term exposure, light and heavy consumption), and so this compound might be useful as a biomarker of smoking exposure

Efficacy of virtual reality for triggering smoking craving: relation with level of presence and nicotine dependence

Virtual Reality environments that reproduce typical contexts associated with tobacco use may be useful for aiding smoking cessation. The main objective of this study was to assess the capacity of eight environments to produce the craving to smoke and determine the relation of craving to nicotine dependence and level of presence. The results show that all the environments were able to generate the desire to smoke; a direct relation was found between sense of presence and craving.

Predictors of smoking craving during virtual reality exposure

Cue exposure treatment (CET) consists of controlled and repeated exposure to drugrelated stimuli in order to reduce cue-reactivity. Virtual reality (VR) has proved to be a promising tool for exposition. However, identifying the variables that can modulate the efficacy of this technique is essential for selecting the most appropriate exposure modality. The aim of this study was to determine the relation between several individual variables and self-reported craving in smokers exposed to VR environments. Fortysix smokers were exposed to seven complex virtual environments that reproduce typical situations in which people smoke. Self-reported craving was selected as the criterion variable and three types of variables were selected as the predictor variables: related to nicotine dependence, related to anxiety and impulsivity, and related to the sense of presence in the virtual environments. Sense of presence was the only predictor of self-reported craving in all the experimental virtual environments. Nicotine dependence variables added predictive power to the model only in the virtual breakfast at home. No relation was found between anxiety or impulsivity and self-reported craving. Virtual reality technology can be very helpful for improving CET for substance use disorders. However, the use of virtual environments would make sense only insofar as the sense of presence was high. Otherwise, the effectiveness of exposure might be affected. © 2012 by the Massachusetts Institute of Technology.

The relevance of theobromine for the beneficial effects of cocoa consumption.

Cocoa consumption began in America and in the mid sixteenth Century it quickly spread to Europe. Beyond being considered a pleasant habit due to its rich sweet lingering taste, chocolate was considered a good nutrient and even a medicine. Traditionally, health benefits of cocoa have been related with the high content of antioxidants of Theobroma cocoa beans. However, the direct psychoactive effect due to methylxanthines in cocoa is notable. Theobromine and caffeine, in the proportions found in cocoa, are responsible for the liking of the food/beverage. These compounds influence in a positive way our moods and our state of alertness. Theobromine, which is found in higher amounts than caffeine, seems to be behind several effects attributed to cocoa intake. The main mechanisms of action are inhibition of phosphodiesterases and blockade of adenosine receptors. Further mechanisms are being explored to better understand the health benefits associated to theobromine consumption. Unlike what happens in other mammals -pets- included, theobromine is safe for humans and has fewer unwanted effects than caffeine. Therefore, theobromine deserves attention as one of the most attractive molecules in cocoa.

Risk perception and stages of smoking acquisition = Percepción de riesgo y etapas de iniciación en el consumo de tabaco

The purpose of this descriptive survey was to investigate the risk perceptions of smoking in a sample of 1,510 Spanish adolescents(49.1% males; mean age = 14.03; SD = 1.28). In addition, the present research categorised adolescents into one of the fourstages of smoking acquisition, as described by the Transtheoretical Model of Change (TMC): Precontemplation (notthinking about trying smoking in the next 6 months), Contemplation (thinking about trying smoking in the next 6 months), Preparation (thinking about starting smoking in the next 30 days) and Action (smokers), by gender and age. The results showed that age and risk perceptions are important variables in the progression through the stages of change towards regular tobacco consumption (Action stage). These results clearly demonstrate the importance of starting antismoking campaigns at an early age to prevent smoking acquisition or the thought of starting in the near future. These findings also highlight the need to continuously remind adolescents about the negative consequences of smoking

Asma y actividad física. Revisión

El asma es una enfermedad inflamatoria crónica de elevada prevalencia a nivel mundial, siendo el colectivo más afectado el formado por niños y adolescentes. Su sintomatología se caracteriza por la aparición de tos, disnea, sibilancias, sensación de opresión en el pecho y broncoconstricción. Tradicionalmente se había pensado que el deporte y el ejercicio físico estaban contraindicados en pacientes asmáticos. Por otro lado, el paciente asmático suele presentar niveles de condición física y práctica deportiva menores que los sujetos sanos. Actualmente se ha propuesto la actividad física regular como un camino válido para mejorar la percepción y el autoconocimiento personal sobre esta enfermedad. Se aconseja la prescripción de actividad física como forma de mejorar su sintomatología y evolución. La práctica de una actividad física regular en pacientes asmáticos debería ser considerada dentro de los actuales y futuros programas de salud como un objetivo fundamental.

Disseny i elaboració d'un gimnàs on-line

L’evolució que ha experimentat la societat, les grans ciutats, la industrialització i molts altres factors han modificat l’estil de vida de les persones accentuant-ne, irremediablement, el sedentarisme i l’abstinència de realitzar exercici físic. La pràctica esportiva i/o d’exercici físic realitzada sota les condicions recomanades pels professionals, és beneficiosa per millorar el nivell de salut o mantenir-lo en tot el possible, ja que provoca modificacions beneficioses sobre el metabolisme, el sistema cardiovascular i l’aparell locomotor. Lamentablement, l’hàbit de realitzar exercici físic no és comú en totes les persones, ja sigui per l’estil de vida que genera incompatibilitats d’horaris amb la feina, fills i familiars o bé per mandra o desgana d’haver d’aprofitar aquelles estones de temps lliure per dedicar-los al culte del cos i de la salut. Els efectes negatius que suposa una modalitat de vida sedentària per a la salut són notablement elevats, amb la qual cosa, cal buscar sistemes per augmentar l’ interès de la població per la pràctica de l’esport i l’activitat física. La creació d’aquest projecte neix de la idea d’unir el fet d’enginyar un mètode per incrementar l’interès de les persones per l’exercici físic amb els avenços tecnològics que s’han realitzat aquesta última dècada relacionats amb el desenvolupament web i multimèdia. A grans trets, la idea general d’aquest projecte es basa en el cas d’un gimnàs real i en actiu, amb necessitat de crear un portal web que serveixi alhora de pàgina web informativa i d’eina de gestió acadèmica del centre proporcionant certes funcionalitats als clients tot presentant-los una nova modalitat de realitzar exercici físic dirigit: realitzar-lo des de casa. Per desenvolupar tot el sistema informàtic que ho durà a terme, després de realitzar una recerca, anàlisi i elecció de les eines mitjançant les quals poder-ho realitzar, s’ha optat per crear l’entorn web mitjançant els llenguatges HTML i PHP en combinació amb els fulls d’estil CSS. Pel que fa a l’entorn de desenvolupament, s’ha utilitzat Notepad++ i com a entorn de proves, WAMP Server. Per últim, pel que fa a la transmissió del contingut multimèdia (vídeos de les sessions d’activitats) s’ha utilitzat Flash Media Interactive Server en combinació de Flash Media Live Encoder per codificar-ne el contingut. L’usuari final, des de qualsevol punt del planeta, podrà realitzar (sempre i quan disposi del temps i el material necessari i una connexió a Internet) en temps real i en directe les classes dirigides que es realitzen al centre. Tanmateix, també s’ha desenvolupat una botiga virtual on qualsevol persona podrà comprar-hi, entre d’altres coses relacionades amb la pràctica de l’exercici físic, tot el material necessari per realitzar qualsevol de les activitats que s’imparteixen al gimnàs i ho rebrà còmodament a casa. Aprofitar unes circumstàncies econòmiques adverses per generar una nova manera de captar clients proporcionant-los una alternativa econòmica, diferent, nova i original d’anar al gimnàs. Temps de crisis, temps d’oportunitats. Aquesta és la moralitat que pretén donar aquest projecte.

Características de la conducta de fumar en función de la fase de abandono en una muestra de personal de la Universidad de Girona

Objetivos: Determinar la prevalencia y las características de la conductade fumar y la distribución por estadios de abandono del tabaquismoentre el personal de la Universidad de Girona.Pacientes y método: Se diseñó un estudio descriptivo transversal.Para ello se realizó una entrevista sobre la conducta de fumar a una muestrarepresentativa de los 941 miembros del personal de la Universidadde Girona en el segundo semestre de 1999.Resultados: De los 281 participantes en el estudio, 77 (27,4%) eranfumadores, 67 (23,9%) exfumadores y 137 (48,7%) no fumadores. PorFacultades, la mayor prevalencia de fumadores se encontró en: Letras:38,9%; Ciencias de la Educación: 31% y Enfermería: 28,3%. La distribuciónde los sujetos por etapas de abandono fue la siguiente: precontemplación:36,8%; contemplación: 13,2%; preparación: 3,5%; acción:3,5% y mantenimiento: 43%. El consumo de tabaco light fue del49,1% en precontemplación, 47,1% en contemplación y 33,3% en preparación.Respondieron haber recibido consejo médico para dejar de fumar:precontemplación: 35,8%; contemplación: 52,6%, preparación:60%, acción: 20% y mantenimiento: 24,2%.Conclusiones: 1. Las Facultades relacionadas con el ámbito de lasalud, Ciencias de la Educación y Enfermería son, junto con las de Letraslas que presentan mayor consumo de tabaco. 2. Los fumadores en precontemplación,en comparación con los sujetos en contemplación y preparación,informan con mayor frecuencia de consumir tabaco bajo ennicotina y de no haber recibido consejo médico