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La hipertensión arterial es el principal factor de riesgo de enfermedad y muerte en España. El diagnóstico y el tratamiento de la hipertensión arterial constituyen objetivos básicos de salud porque el control adecuado reduce la morbimortalidad relacionada. El objetivo de esta guía práctica sobre el manejo de la hipertensión arterial de la Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA) es ofrecer unas recomendaciones básicas para la prevención, detección, diagnóstico y tratamiento de la hipertensión arterial. Para ello, la SEH-LELHA asume las directrices de 2018 de la Sociedad Europea de Hipertensión y la Sociedad Europea de Cardiología, si bien se comentan también los aspectos más relevantes de las últimas guías norteamericanas e internacionales. Con respecto al diagnóstico, se mantiene el umbral de 140/90 mmHg como definitorio de hipertensión arterial, se destaca la necesidad de conocer los valores de presión arterial fuera de la consulta, bien mediante monitorización ambulatoria o automedida o ambas, y se establece como prioritaria la estratificación del riesgo cardiovascular del paciente con hipertensión arterial. Con respecto al tratamiento, se destacan las modificaciones del estilo de vida como medida de prevención cardiovascular general y la necesidad de tratamiento antihipertensivo combinado para un control adecuado en la mayoría de los pacientes, reforzando la indicación de dos fármacos como tratamiento inicial, de combinaciones de fármacos en un solo comprimido y de una estrategia activa de consecución del control en un plazo breve de tiempo. El objetivo de control se establece en niveles de presión arterial por debajo de 130/80 mmHg en una amplia mayoría de pacientes.

Différents textes fondateurs de l’éthique en recherche biomédicale ont vu le jour. Le premier fut le Code de Nuremberg en 1947, suivi par la Déclaration d’Helsinki en 1964. En 1997, le Conseil d’État européen adopta la Convention d’Oviedo, réaffirmant les principes fondamentaux pour la protection des êtres humains impliqués dans ces recherches. Une évolution récente en France a fait suite à la loi dite « Jardé » du 5 mars 2012. Les travaux de recherches des thèses d’exercices en Médecine sont soumis à cette loi.

Las vacunas son la principal herramienta para prevenir la enfermedad neumocócica invasiva (ENI). El reemplazo por serotipos no vacunales es una amenaza para la efectividad de las vacunas antineumocócicas conjugadas (VCN). El objetivo principal de este estudio es valorar el impacto del SARS-CoV-2 en la epidemiología de neumococo, analizando concretamente los nuevos serotipos vacunales 22F y 33F.

Se evaluó la distribución de serotipos de la enfermedad neumocócica invasiva (ENI) por grupos de edad en España, así como el impacto de las vacunas antineumocócicas y el SARS-CoV-2.

The reported prevalence of masked uncontrolled hypertension (MUCH) varies because many studies are not comparable as they use different measurement methodologies. To evaluate the influence of the number of office blood pressure readings on the prevalence of MUCH we conducted a cross-sectional, multicenter study in treated hypertensive patients.

El objetivo principal de este trabajo fue estudiar la contribución de las actuales vacunas conjugadas antineumocócicas (VCN) en la resistencia a antibióticos en neumococo, vigilando el aumento de serotipos no vacunales resistentes. Además, se analizó el impacto de la actual pandemia por SARS-CoV-2 a la resistencia antibiótica en este patógeno.

The structuring of the inner surface of photocathode windows is of great interest with regard to the efficiency of photomultipliers. A way of increasing the number of photons absorbed by a given surface is to define periodic structures with a period lower or greater than the wavelength of light. Tailoring the structure of the surface to drastically reduce the reflectance, and thus increasing the effective absorption, is possible. Experiments have been conducted with fibre-optic faceplates of imaging tubes. In this work, these structures have been developed by chemical etchants, which selectively react with the transmission fibres or matrix glasses.

In this work, the complete fabrication process which combines Proton Exchange (PE) and Reverse Proton Exchange (RPE) in Neodymium doped LiNbO3 channel waveguides is reported. To produce the PE-RPE channel waveguides the fabrication of dielectric SiO2 masks had to be implemented. For this propose, we adopted a technique based on the Ion Plating Plasma Assisted Deposition of SiO2 followed by the standard ultraviolet photolithographic patterning. On the other hand, we determined the main optical and spectroscopic properties of Nd3+ ions in the channel waveguides including the study of the lifetime as function as the polarisation.

In this work, second harmonic generation (SHG) in nonlinear channel waveguides by quasi phase matching is reported. The photorefractive damage resistant waveguides were fabricated by Zn-diffusion technique using periodic poled lithium niobate wafers (PPLN). The SH wave, at 397.8 nm, was generated by using a CW diode laser with emission wavelength at 795.6 nm and 1 W peak power was used as fundamental wave. The nonlinear waveguides exhibit a stable conversion even at room temperature with no sign of deterioration induced by the optical damage.

This work reports the fabrication of photorefractive damageresistant channel waveguides by a two-step Zn-diffusion technique in LiNbO 3 :Nd 3+ crystals and the demonstration of laser operation at room temperature at u =1.085 w m.

The aim of this study was to evaluate the effect of a structured teaching/treatment programme on the clinical and metabolic control of non-insulin-dependent (type 2) diabetic patients. The programme was aimed at improving the overall treatment quality in these patients through measures involving self-care, diet, exercise and weight reduction. Four theoretical-practical teaching units were given once a week to group of 5–8 ambulatory patients by previously trained general practitioners. Clinical and biochemical parameters were recorded at the beginning of the course and 1 year after its completion in 40 patients attending the programme and in 39 patients of similar clinical characteristics under conventional diabetes treatment, but receiving no structured teaching before or during the survey period (control group). The drop-out percentage in the intervention group (25%) was significantly lower than in the control group (45%),P<0.05, suggesting an incentive toward greater compliance in the former. At the end of the 1-year follow-up, the mean differences observed in the control and in the intervention groups were: body weight loss -2.4±0.5 kg vs -0.4±0.5 (P<0.001); haemoglobin HbA1 -0.2%±0.4% vs +0.8±0.4% (NS); number of daily oral hypoglycaemic agent intake -1.4±0.2 vs +0.9±0.2 tablets (P<0.001). Our results strongly suggest that this programme, applied through family doctors, may constitute an efficient tool to improve the compliance and clinico-metabolic control of type 2 patients at the primary health care level.

Summary Seven members of the same family were studied on several occasions due to a history of hemorrhages. The propositus, a 12-year-old boy, his sister, one brother, and their father all had a low plasma factor VIII (FVIII) level. Von Willebrand factor (vWF) activity, vWF multimeric analysis, and vWF factor domain for binding to FVIII were normal in all seven subjects. The sister had a normal 46XX karyotype. The study of two intragenic restriction fragment length polymorphisms (RFLPs) and two closely linked, highly polymorphic extragenic markers showed a phenotypic expression of mild hemophilia A, which suggests that the sister of the propositus is homozygous or compound heterozygous at the hemophilia A locus. She would have inherited two hemophilic genes: one from her carrier mother and the other from her father, a mild hemophiliac.

To analyze the prevalence of Masked hypertension (MHT) and their associated predictive factors in non-hypertensive subjects with high normal BP values.

To analyze the prevalence of nocturnal hypertension (NHT) and their associated predictive factors in non-hypertensive subjects with high normal BP values.

Integrated hemodynamic management using a non-invasive hemodynamic study based on thoracic electrical bioimpedance, HOTMAN devices, allows clinicians to evaluate the status of tissue perfusion.