Alicia Oliva Ramos

Clustering of unhealthy lifestyle behaviors is associated with a low adherence to recommended preventive practices among COPD patients in Spain.

Abstract Aims: To analyze clustering of unhealthy lifestyle behavior and its relationship with non-adherence to recommended clinical preventive care services among Spanish COPD patients. Methods: Cross-sectional study including 2,575 COPD subjects from the 2006 Spanish National Health Survey (NHS) and 2009 European Health Survey for Spain (EHISS). Subjects were asked about the following recommended preventive practices: uptake of blood pressure (BP) measurement, lipid profile, influenza vaccination and dental examination. Lifestyle behaviors included: smoking status, physical activity, alcohol consumption and obesity. Logistic regression models were built to assess the association between clustering of unhealthy lifestyle and the uptake of preventive activities. Results: Blood pressure measurement in the previous 6 months and a blood lipid test in the last year had not been taken by 11.74% and 23.26% of the subjects, respectively, in 2006 NHS and by 11.16% and 16.33% of the subjects, respectively, in EHISS 2009. Then, 36.36% percent had not been vaccinated and 70.61% had not received dental examination in 2006 NHS and these percentages decreased to 27.33% and 66.22%, respectively, in 2009 EHISS. A higher number of unhealthy lifestyle behaviors increased the probability of not being vaccinated and not having a dental examination. Clustering of unhealthy lifestyle behaviors is linearly associated with a greater number of preventive measures unfulfilled. Conclusions: Compliance with healthy lifestyles and adherence to recommended clinical preventive services is under desirable levels among Spanish COPD patients. Patients with lifestyles considered as “worse” are those who also have lower uptake of recommended preventive activities.

Síndrome de apnea-hipopnea del sueño

Sleep apnea-hypopnea syndrome is an underdiagnosed medical condition which is gainingin importance. It is associated with cardiovascular disease, stroke, hypertension, insulin resistance and traffic accidents, resulting in deterioration of quality of life and increased mortality in these patients. The most characteristic symptoms of the disease are snoring, documented apnoeas and excessive daytime sleepiness. Polysomnography is the gold standard for diagnosis, but in patients with high pre-test probability, we should opt for respiratory polygraphy, a more accessible and less expensive test. Besides making lifestyle changes, the treatment of choice is continuous positive airway pressure. Some surgical techniques may be useful in the treatment of sleep apnoea-hypopnoea syndrome. In patients who cannot tolerate continuous positive airway pressure, are not candidates for surgery or have a high surgical risk intraoral devices might be used.