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1. Relationship between Retinal Microvasculature, Cardiovascular Risk and Silent Brain Infarction in Hypertensive Patients

Author

Forés Raurell, Rosa, Manresa, Josep M., López-Lifante, Victor M., Heras, Antonio, Delgado Martínez, María Pilar, Vázquez, Xose, Ruiz, Susana, Alzamora, M. Teresa, Torán Montserrat, Pere, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Forés R, Heras A] Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain. Riu Nord-Riu Sud Primary Healthcare Centre, Santa Coloma de Gramenet, Gerència d’Àmbit d’Atenció Primària Metropolitana Nord, Institut Català de la Salut, 08921 Barcelona, Spain. [Manresa JM] Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain. [López-Lifante VM] Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain. Palau Healthcare Centre, Palau-Solità Plegamans, Gerència d’Àmbit d’Atenció Primària Metropolitana Nord, Institut Català de la Salut, 08124 Barcelona, Spain. [Delgado P] Laboratori de Recerca Neurovascular, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Unitat de Demència, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Vázquez X] Hospital Municipal de Badalona, Badalona Serveis Assistencials, Secció d’Oftalmologia, Badalona, 08911 Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
cardiovascular risk, medicine.medical_specialty, Hipertensió - Complicacions, Medicine (General), hypertension, Clinical Biochemistry, Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia::Brain Infarction [DISEASES], Primary care, Cardiovascular Diseases::Vascular Diseases::Hypertension [DISEASES], enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral::infarto encefálico [ENFERMEDADES], retinal microvasculature, 030204 cardiovascular system & hematology, Retinography, Logistic regression, Cardiovascular System::Blood Vessels::Retinal Vessels [ANATOMY], Article, 03 medical and health sciences, chemistry.chemical_compound, Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores], 0302 clinical medicine, R5-920, Internal medicine, medicine, sistema cardiovascular::vasos sanguíneos::vasos retinianos [ANATOMÍA], Retina - Vasos sanguinis, Retinal microvasculature, Silent brain infarction, medicine.diagnostic_test, business.industry, Retinal, Magnetic resonance imaging, Odds ratio, Cardiovascular risk, Risk evaluation, silent brain infarction, chemistry, Brain infarction, Hypertension, Cardiology, business, enfermedades cardiovasculares::enfermedades vasculares::hipertensión [ENFERMEDADES], 030217 neurology & neurosurgery, Malalties cerebrovasculars, Other subheadings::Other subheadings::/complications [Other subheadings]
Abstract

Objective: The aims of this study are to analyze the role of artery-vein ratio AVR assessment using VesselMap 2 software (Imedos Systems) and cardiovascular risk evaluation by means of REGICOR in the prediction of silent brain infarction (SBI) in middle-age hypertensive patients from the ISSYS study. Material and Methods: A cross-sectional study with 695 patients with hypertension aged 50 to 70 years who participated in the project Investigating Silent Strokes in HYpertensives: a Magnetic Resonance Imaging Study (ISSYS), was conducted in two Primary Care Centres of Barcelona. Participants agreed to a retinography and an MRI to detect silent brain infarction (SBI). The IMEDOS software was used for the semiautomatic caliber measurement of retinal arteries and veins, and the AVR was considered abnormal when &lt, 0.66. The REGICOR score was calculated for all patients. Results: Multivariate logistic regression analysis was used to evaluate the impact of AVR and REGICOR scores on SBI. The OR (odds ratio) for a high REGICOR score and an abnormal AVR were 3.16 and 4.45, respectively. When analysing the interaction of both factors, the OR of an abnormal AVR and moderate REGICOR score was 3.27, whereas with a high REGICOR score it reached 13.07. Conclusions: The measurement of AVR in patients with hypertension and with a high REGICOR score can contribute to the detection of silent brain infarction.

Published
2021
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2. Increasing Cervical Cancer Screening Coverage: a Randomised, Community-Based Clinical Trial

Author

Josep Maria Manresa, Josep Bonet, Pablo Hidalgo, Diego Rodríguez, Ana Rodríguez, N. Sánchez, Marta Trapero-Bertran, Silvia de Sanjosé, Amelia Acera, [Acera A] Atenció a la Salut Sexual i Reproductiva (ASSIR), SAP Cerdanyola-Ripollet, Institut Català de la Salut, Ripollet, Spain. Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Spain. Departament de Medicina, Universitat de Barcelona. Barcelona, Spain. Grup de Recerca en Atenció Sexual i Reproductiva, IDIAP Jordi Gol, Sabadell, Spain. [Manresa JM] Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Spain. Departament d’Infermeria, Universitat Autònoma de Barcelona. Bellaterra, Cerdanyola, Spain. [Rodríguez D, Rodríguez A] Atenció a la Salut Sexual i Reproductiva (ASSIR), SAP Cerdanyola-Ripollet, Institut Català de la Salut, Ripollet, Spain. [Bonet JM, Hidalgo P, Sànchez N] Servei d'Atenció Primària SAP Vallés Occidental, Institut Català de la Salut, Sabadell, Spain. [Trapero-Bertran M] Centre de Recerca en Economia I Salut (CRES), Universitat Pompeu Fabra, Barcelona, Spain. Universidad de Castilla-La Mancha, Ciudad Real, Spain. [Sanjosé-Llongueras S] Programa de Recerca en Epidemiologia del Càncer, Institut Català d’Oncologia (ICO-IDIBELL), L'Hospitalet de Llobregat, Spain. Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública CIBERESP, Barcelona, Spain, and IDIAP Jordi Gol

Subjects
Psychological intervention, Grups d'edat, Cribado, Logistic regression, law.invention, 0302 clinical medicine, Salud pública, Public and Occupational Health, Càncer, lcsh:Science, Early Detection of Cancer, education.field_of_study, Correspondence as Topic, Telephones, Oncology, 030220 oncology & carcinogenesis, Engineering and Technology, neoplasias::neoplasias por localización::neoplasias urogenitales::neoplasias de los genitales femeninos::neoplasias uterinas::neoplasias del cuello uterino [ENFERMEDADES], medicine.medical_specialty, Càncer de coll uterí, Death Rates, Persuasive Communication, Citologia, Health Promotion, 03 medical and health sciences, Salut laboral, Citología, Intervention (counseling), Cancer Detection and Diagnosis, Humans, education, Aged, Demography, Úter -- Càncer, Public health, lcsh:R, Biology and Life Sciences, Salut pública, Clinical trial, Diagnosis::Early Diagnosis::Early Detection of Cancer [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT], Community-based clinical trial, Cervical cancer, Population Groupings, lcsh:Q, Age groups, Health Screening, Uterine Cervical Neoplasms, lcsh:Medicine, Study Characteristics::Clinical Study::Clinical Trial::Controlled Clinical Trial::Randomized Controlled Trial [PUBLICATION CHARACTERISTICS], Randomized controlled trial, Cervix cancer, law, Telèfon--Aparells i accessoris, Medicine and Health Sciences, Cribatge (Medicina), 030212 general & internal medicine, Úter -- Malalties, Multidisciplinary, Age Factors, Middle Aged, Cáncer, Europe, Female, Coll uterí - Càncer, Europa, Cancer Screening, Research Article, Adult, Population, Equipment, diagnóstico::diagnóstico precoz::detección precoz del cáncer [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], características del estudio::estudio clínico::ensayo clínico::ensayo clínico controlado::ensayo clínico controlado aleatorizado [CARACTERÍSTICAS DE PUBLICACIONES], Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms, Female::Uterine Neoplasms::Uterine Cervical Neoplasms [DISEASES], Patient Education as Topic, Diagnostic Medicine, Internal medicine, Mortalitat, medicine, Teléfono, Occupational Health, Communication Equipment, business.industry, Death rate, Cancers and Neoplasms, Salud laboral, Cell Biology, Patient Acceptance of Health Care, Telephone, Spain, People and Places, Mortalidad, Pamphlets, business, Cytology, Gynecological Tumors, Assaigs clínics
Abstract

Altres ajuts: The project received a research grant from the Carlos III Institute of Health, Ministry of Economy and Competitiveness (Spain), awarded on the 2010 call under the Health Strategy Action 2013-16, within the National Research Program oriented to Societal Challenges within the Technical, Scientific and Innovation Research National Plan 2013-16 with reference PI10/01275 co-funded with European Union ERDF funds. Additional support was provided by the European Regional Development Fund (ERDF), public grants from the Carlos III Institute of Health (RTIC RD06/0020/0095 RD12/0036/0056 and CIBERESP) and the Agència de Gestió d'Ajuts Universitaris i de Recerca (grants AGAUR 2014SGR1077 and 2014SGR2016) and the Primary Health Care Unit IDIAP Jordi Gol and the Catalan Institute of Health resolved 07/04/2014. Background. Opportunistic cervical cancer screening can lead to suboptimal screening coverage. Coverage could be increased after a personalised invitation to the target population. We present a community randomized intervention study with three strategies aiming to increase screening coverage.Methods. The CRICERVA study is a community-based clinical trial to improve coverage of population based screening in the Cerdanyola SAP area in Barcelona.A total of 32,858 women residing in the study area, aged 30 to 70 years were evaluated. A total of 15,965 women were identified as having no registration of a cervical cytology in the last 3.5 years within the Public Health data base system. Eligible women were assigned to one of four community randomized intervention groups (IGs): (1) (IG1 N = 4197) personalised invitation letter, (2) (IG2 N =3601) personalised invitation letter + informative leaflet, (3) (IG3 N = 6088) personalised invitation letter + informative leaflet + personalised phone call and (4) (Control N = 2079) based on spontaneous demand of cervical cancer screening as officially recommended. To evaluate screening coverage, we used heterogeneity tests to compare impact of the interventions and mixed logistic regression models to assess the age effect. We refer a ªrescueº visit as the screening visit resulting from the study invitation. Results. Among the 13,886 women in the IGs, 2,862 were evaluated as having an adequate screening history after the initial contact; 4,263 were lost to follow-up and 5,341 were identified as having insufficient screening and thus being eligible for a rescue visit. All intervention strategies significantly increased participation to screening compared to the control group. Coverage after the intervention reached 84.1% while the control group reached 64.8%. The final impact of our study was an increase of 20% in the three IGs and of 9% in the control group (p

Published
2017

3. Iodine nutritional status of women in their first trimester of pregnancy in Catalonia

Author

Gemma Falguera, Maria Teresa Torres, Roser Casamitjana, Lidia Francés, Lluís Vila, Pere Torán, Gemma Prieto, Josep Maria Manresa, [Torres MT] Atenció a la Salut Sexual i Reproductiva (ASSIR), CAP Antoni Creus i Querol, Institut Català de la Salut, Terrassa, Barcelona, Spain. Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Spain. GRASSIR research group, IDIAP Jordi Gol, Barcelona, Spain. Departament d’Infermeria, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. [Francés L] Departament d’Infermeria, Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain. [Vila L] Servei d’Endocrinología i Nutrició, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain. [Manresa JM] Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Spain. GRASSIR research group, IDIAP Jordi Gol, Barcelona, Spain. Departament d’Infermeria, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. [Falguera-Puig G] GRASSIR research group, IDIAP Jordi Gol, Barcelona, Spain. Atenció a la Salut Sexual i Reproductiva (ASSIR), Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Sabadell, Spain. [Prieto G] Gerencia de Atención Primaria, Ávila, Spain. [Casamitjana R] Centro de Diagnóstico Biomédico – Bioquímica y Genética Molecular, Hospital Clínic, Barcelona, Spain. [Toran P] Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Spain, Departament de Salut, and Universitat de Barcelona

Subjects
Cross-sectional study, Prevalence, Urine, Fenómenos Fisiológicos Reproductivos y Urinarios::Fenómenos Fisiológicos Reproductivos::Trimestres del Embarazo::Primer Trimestre del Embarazo [FENÓMENOS Y PROCESOS], 0302 clinical medicine, Pregnancy, Embaràs - Aspectes nutricionals, 030212 general & internal medicine, Nutrition in pregnancy, Prenatal Nutritional Physiological Phenomena, Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Pregnancy Trimesters::Pregnancy Trimester, First [PHENOMENA AND PROCESSES], Nutrició en l'embaràs, Obstetrics, Obstetrics and Gynecology, Prenatal Care, nutrición en salud pública::nutrición de los grupos de riesgo::nutrición materna [SALUD PÚBLICA], Iodised salt, Nutrition, Public Health::Nutrition for Vulnerable Groups::Maternal Nutrition [PUBLIC HEALTH], Food, Fortified, Nutrition, Public Health::Nutrition Disorders::Deficiency Diseases::Mineral Deficiency::Iodine Deficiency [PUBLIC HEALTH], Female, Iodine, Research Article, Adult, medicine.medical_specialty, Catalonia, Iode en l'organisme, Reproductive medicine, Nutritional Status, chemistry.chemical_element, 030209 endocrinology & metabolism, Prenatal care, lcsh:Gynecology and obstetrics, Young Adult, Embarassades, 03 medical and health sciences, medicine, Humans, Sodium Chloride, Dietary, Iodine in the body, lcsh:RG1-991, Gynecology, business.industry, Pregnant women, Catalunya, medicine.disease, fenómenos fisiológicos reproductivos y urinarios::fenómenos fisiológicos de la reproducción::trimestres del embarazo::primer trimestre del embarazo [FENÓMENOS Y PROCESOS], Pregnancy Trimester, First, Cross-Sectional Studies, nutrición en salud pública::trastornos nutricionales::enfermedades carenciales::deficiencia de minerales::deficiencia de yodo [SALUD PÚBLICA], chemistry, Spain, Dietary Supplements, business
Abstract

Background Sufficient iodine intake is needed during pregnancy to ensure proper fetal development. The iodine levels of women in their first trimester of pregnancy in Catalonia are currently unknown. This data would help to determine whether our public health services should establish recommendations or interventions in this line. The aim of this study was to investigate the iodine nutritional status, prevalence of urinary iodine 2 glasses, OR = 0.593 95% CI (0.37–0.95); iodized salt consumption, OR = 0.678 95% CI (0.51–0. 90); and use of iodine supplementation, OR = 0.410 95% CI (0.31–0.54), protected against the risk of UIC

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