Position of the international forum of internal medicine on habits, lifestyle changes and a healthy environment for the prevention of cardiovascular diseases.

Cardiovascular diseases (CVD), mainly ischemic heart disease and stroke, is the main cause of death worldwide and each year more people die from CVD than from any other cause. These data call for a paradigm shift, where health promotion and cardiovascular prevention will acquire a central role in health policies. From this perspective, dedicating time during the consultation to promoting the acquisition of heart-healthy habits would be indicated in all individuals, regardless of cardiovascular risk classification, the role of the internist being fundamental.

[Position of the international forum of internal medicine on habits, lifestyle changes and a healthy environment for the prevention of cardiovascular diseases].

Cardiovascular diseases (CVD), mainly ischemic heart disease and stroke, is the main cause of death worldwide and each year more people die from CVD than from any other cause. These data call for a paradigm shift, where health promotion and cardiovascular prevention will acquire a central role in health policies. From this perspective, dedicating time during the consultation to promoting the acquisition of heart-healthy habits would be indicated in all individuals, regardless of cardiovascular risk classification, the role of the internist being fundamental.

OPENCRONIC Study. Knowledge and Experiences of Spanish Patients and Carers about Chronic Disease.

: Chronic diseases are currently the main cause of morbidity and mortality and represent a major challenge to healthcare systems. The objective of this study is to know Spanish public opinion about chronic disease and how it affects their daily lives. : Through a telephone or online survey of 24 questions, data was gathered on the characteristics of the respondents and their knowledge and experiences of chronic diseases.

Increased Incidence of Stroke, but Not Coronary Heart Disease, in Elderly Patients With Sleep Apnea.

Background and Purpose- The influence of age on the relationship between obstructive sleep apnea (OSA) and the incidence of hard cardiovascular events remains controversial. We sought to analyze the relationship between OSA and the incidence of stroke and coronary heart disease in a large cohort of elderly patients, as well as to investigate the role of continuous positive airway pressure (CPAP) treatment in these associations. Methods- Post hoc analysis of a prospective observational study of consecutive patients ≥65 years studied for OSA suspicion at 2 Spanish University Hospitals.

Unanswered clinical questions in the management of cardiometabolic risk in the elderly: a statement of the Spanish Society of Internal Medicine.

Background: Despite the progressive increase in life expectancy and the relationship between aging with multi-morbidities and the increased use of healthcare resources, current clinical practice guidelines (CPG) on cardiometabolic risk cannot be adequately applied to elderly subjects with multiple chronic conditions. Its management frequently becomes complicated by both, an excessive use of medications that may lead to overtreatment, drug interactions and increased toxicity, and errors in dosage and non-compliance. Concerned by this gap, the Spanish Society of Internal Medicine created a group of independent experts on cardiometabolic risk who discussed what they considered to be unanswered questions in the management of elderly patients.

Internal consistency and validity of the Spanish version of the quality of life questionnaire specific for obstructive sleep apnea: sleep apnea quality of life index.

Introduction: The objective of the present study was to validate the Spanish version of the SAQLI, which is a health-related quality of life (HRQL) questionnaire specific for sleep apnea-hypopnea syndrome (SAHS), and to assess its sensitivity to change.

Material And Methods: A multicenter study performed in a group of patients with SAHS (apnea-hypopnea index [AHI] ≥5) who had been referred to the centers' Sleep Units. All patients completed the following questionnaires: SF-36, FOSQ, SAQLI and Epworth scale.

Clinical efficacy and safety of budesonide-formoterol in non-cystic fibrosis bronchiectasis.

Background: The aim of this study is to evaluate the efficacy and safety of medium-dose formoterol-budesonide combined inhaled treatment in a single inhaler compared with high-dose budesonide treatment in patients with non-cystic fibrosis (non-CF) bronchiectasis.

Methods: This is a 12-month randomized, double-blind, parallel-groups clinical trial, to run in 40 patients with non-CF bronchiectasis diagnosed by high-resolution CT scan of the chest, receiving formoterol-budesonide combined treatment (18/640 μg daily) or budesonide treatment (1,600 μg daily). Variables concerning clinical condition, health-related quality of life (HRQL), lung function, β(2)-adrenergic agonist use, potentially pathogenic microorganism (PPM) isolates, and medication side effects were analyzed by intention-to-treat analysis.

Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow-up study.

Rationale: Obstructive sleep apnea (OSA) is an independent risk factor for stroke, but little is known about the role of continuous positive airway pressure (CPAP) on mortality in patients with stroke.

Objectives: To analyze the independent impact of long-term CPAP treatment on mortality in patients with ischemic stroke.

Methods: Prospective observational study in 166 patients with ischemic stroke.

Severe exacerbations and BODE index: two independent risk factors for death in male COPD patients.

Objectives: 1) To determine whether severe exacerbation of COPD is a BODE index independent risk factor for death; 2) whether the combined application of exacerbations and BODE (e-BODE index), offers greater predictive capacity than BODE alone or can simplify the model, by replacing the exercise capacity (BODEx index).

Methods: A prospective study was made of a cohort of COPD patients. In addition to calculation of the BODE index we register frequency of exacerbations.

[Efficacy of a training program on sleep apnea-hypopnea syndrome aimed at primary care physicians].

Objective: The level of clinical suspicion of sleep apnea-hypopnea syndrome (SAHS) among primary care physicians is low. The aim of this study was to analyze the impact of a primary care training program on the quality and quantity of referrals made due to suspected SAHS.

Material And Methods: A group of 16 primary care physicians were offered the option of participating in a training program consisting of 2 talks-workshops, the provision of up-to-date information on SAHS and a form for making referrals according to an established protocol, and the opportunity to contact the sleep department at our hospital directly.

[The association between bronchiectasis, systemic inflammation, and tumor necrosis factor alpha].

Objective: The relationship between systemic inflammation and different measures of bronchiectasis severity has not been described. The objective of this study was to analyze the relationship between plasma concentrations of tumor necrosis factor alpha (TNF-alpha), as a marker of systemic inflammation, and some commonly used criteria for quantifying bronchiectasis severity in clinically stable patients whose disease was not caused by cystic fibrosis.

Patients And Methods: Sixty-eight clinically stable patients with bronchiectasis and 19 age- and sex-matched healthy control subjects were included in the study.

Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis.

Background: Bronchiectasis remains a major public health problem, but factors influencing its natural history are not well characterized. The objective of our study was to explore modifiable and nonmodifiable factors associated with lung function decline in a clinical cohort of patients with stable non-cystic fibrosis (CF) bronchiectasis.

Methods: Seventy-six stable adult patients (mean age, 69.

[Bronchiectasis in the elderly. Study of serum levels of immunoglobulin G subclasses].

Background And Objective: To analyze the serum levels of immunoglobulin G (IgG) subclasses in a broad range of elderly patients with bronchiectasis.

Patients And Method: Data were collected from all patients who had a high-resolution chest computerized axial tomography diagnosis of bronchiectasis in our center. We gathered data related to case history, respiratory symptoms, forced spirometry, general laboratory tests, immunoglobulin concentration (including IgG subclasses), Mantoux test, sputum culture and staining, paranasal sinus X-rays/computerized axial tomography, and a specific etiologic evaluation based on the available clinical evidence.

Improvement in nocturnal disordered breathing after first-ever ischemic stroke: role of dysphagia.

Study Objective: The aim of this study was to analyze the role of dysphagia as a model of pharyngeal muscle dysfunction in the time course of nocturnal disordered breathing (NDB) in patients who experienced a first-ever ischemic stroke.

Design: Prospective study.

Patients And Interventions: Fifty-nine consecutive patients (mean age, 73.

Inhaled steroids improve quality of life in patients with steady-state bronchiectasis.

Background: The effects of inhaled steroids upon the quality of life of patients with bronchiectasis remain unknown.

Study Objective: To analyze the effect of inhaled fluticasone propionate (FP) for 6 months upon the clinical, functional, microbiological and outcome parameters of patients with steady-state bronchiectasis not due to cystic fibrosis, and its repercussions for patient health-related quality of life (HRQoL).

Design: Prospective, randomized, double-blind (for effective doses) study.

Continuous positive airway pressure treatment in sleep apnea prevents new vascular events after ischemic stroke.

Study Objectives: A study was made of the role of continuous positive airway pressure (CPAP) treatment in the prevention of new vascular events following ischemic stroke or transient ischemic attack.

Design: Prospective study.

Patients And Interventions: Demographic data, vascular risk factors, clinical manifestations associated to sleep apnea-hypopnea syndrome, and neurologic parameters were recorded in a group of patients presenting with acute ischemic stroke at least 2 months previously.

Mid-arm muscle area is a better predictor of mortality than body mass index in COPD.

Background: A low body mass index (BMI) has been shown to be an independent indicator of poor prognosis in patients with COPD. However, some studies suggest that muscle mass depletion (MD) is the main factor responsible for the negative effects attributable to malnutrition.

Study Objective: To evaluate the prognostic influence of MD estimated from anthropometric parameters.

Quality-of-life determinants in patients with clinically stable bronchiectasis.

Study Objective: To determine the most important variables influencing health-related quality of life (HRQL) in patients with clinically stable bronchiectasis (SB).

Design: Cross-sectional study.

Patients And Interventions: A total of 86 patients (mean age, 69.