Hypertensive ulcer, also known as Martorell ulcer, comprises cutaneous lesions induced by microvascular arteriolitis, which leads to ischaemia and subsequent ulceration in patients with long‐standing hypertension. These lesions predominantly affect women and have traditionally been considered rare; however, recent studies suggest that their prevalence may be significantly higher than previously assumed. Early and accurate diagnosis is crucial, as these ulcers are often mistaken for lesions of alternative aetiologies, such as venous ulcers or pyoderma gangrenosum, thereby contributing to their frequent underdiagnosis. Moreover, this pathology is associated with pronounced painful symptomatology and exhibits a suboptimal response to both analgesic regimens and conventional wound care protocols, potentially necessitating alternative management strategies. This diagnostic delay or misdiagnosis consequently escalates the utilisation of healthcare resources. The primary objective of this study was to develop a predictive model for the differential diagnosis of Martorell ulcers. The investigation entailed a systematic case review, during which the most prevalent signs and symptoms, medical histories and demographic characteristics associated with these lesions were scrutinised. A comprehensive descriptive and inferential analysis of the various variables was performed, followed by a binomial logistic regression to construct the predictive model. In this logistic regression analysis, systolic blood pressure (SBP) emerged as the principal predictor among the cases examined. Additionally, pain intensity was incorporated into the predictive model as a clinically relevant variable, thereby confirming its utility in conjunction with SBP for the identification of this pathology. These findings underscore the importance of integrating key variables, such as elevated SBP and severe pain, into diagnostic tools to enhance early detection and clinical management of Martorell ulcers.

Background Detecting total cholesterol in dried blood spots could aid in identifying individuals with a high likelihood of familial hypercholesterolemia and could be used as a screening measure. This study aims to assess the diagnostic accuracy of dried blood spots on Whatman 903 paper cards using a manual enzymatic technique. Methods: A total of 394 samples were collected as serum and dried blood spots were compared. Cholesterol was determined in serum using the automated reference method, while cholesterol on paper was measured using a manual enzymatic method. Within- and between-day diagnostic variability were analyzed. The correlation between both methods was assessed using Passing–Bablok regression and Bland–Altman plot. Internal validation of our correlation formula was performed on 149 samples, along with external validation of the formula proposed by Corso et al. Results: The within- and between-day coefficient of variation was found to be lower than 10.14% and 14.09%, respectively. Passing–Bablok regression indicated a precision of 0.803 and an accuracy of 0.96. Internal validation precision was measured at 0.716. The resulting positive and negative predicted values were 0.77 and 0.92, respectively, vs. 0.46 and 0.96 from the external formula. Conclusions: Total cholesterol analysis in dried blood spots demonstrates high precision and reproducibility. This method reliably enables the incorporation of this biological marker into neonatal screening for familial hypercholesterolemia detection.

Background and aims: Current population-based data on cardiovascular risk and lipid target achievement in Mediterranean populations are limited. We assessed cardiovascular risk, lipid-lowering treatment, and low-density lipoprotein cholesterol control in the province of Huelva, southern Spain.Methods: MAPA-Huelva was a cross-sectional, population-based study of 318 participants selected using stratified random sampling. Cardiovascular risk was classified according to 2021 European Society of Cardiology criteria using SCORE2, SCORE2-OP, and, when applicable, SCORE2-Diabetes. Attainment of risk-specific absolute low-density lipoprotein cholesterol goals was assessed.Results: Hypertension, diabetes, and dyslipidaemia were present in 43.1%, 13.8%, and 46.2% of participants, respectively. Among classifiable participants, 32.3% were at high or very high risk. Lipid-lowering therapy use increased across risk categories (9.2%, 23.9%, 51.8%, and 71.8%; p <0.001), whereas low-density lipoprotein cholesterol goal attainment decreased (61.4%, 24.4%, 14.8%, and 15.8%; p <0.001). Only 15.2% of high- or very-high-risk participants with available low-density lipoprotein cholesterol attained their goal; among those above goal, 46.2% were untreated. In exploratory adjusted analysis, older age and current smoking were associated with goal non-attainment, whereas lipid-lowering therapy was associated with lower odds of being above goal (odds ratio 0.15, 95% confidence interval 0.06–0.37; p<0.001).Conclusions: Almost one-third of classifiable participants in this contemporary Mediterranean population were at high or very high cardiovascular risk. Gaps in treatment initiation, intensity, and low-density lipoprotein cholesterol goal attainment support more systematic implementation of guideline-directed lipid management.

BACKGROUND Detecting total cholesterol in dried blood spots could aid in identifying individuals with a high likelihood of familial hypercholesterolemia and could be used as a screening measure. This study aims to assess the diagnostic accuracy of dried blood spots on Whatman 903 paper cards using a manual enzymatic technique. METHODS A total of 394 samples collected as serum and dried blood spots were compared. Cholesterol was determined in serum using the automated reference method, while cholesterol on paper was measured using a manual enzymatic method. Within- and between-day diagnostic variability were analyzed. The correlation between both methods was assessed using Passing-Bablok regression and Bland-Altman plot. Internal validation of our correlation formula was performed on 149 samples, along with external validation of the formula proposed by Corso et al. RESULTS The within- and between-day coefficient of variation was found to be lower than 10.14% and 14.09%, respectively. Method comparison yielded an area under the curve of 0.976, with a standard error of 0.009. Passing-Bablok regression indicated a precision of 0.803 and an accuracy of 0.96. Internal validation precision was measured at 0.716. Regarding internal validation, calculated cholesterol with our regression line did not differ from serum cholesterol analysis, while significant differences were observed in calculated cholesterol levels using the external formula. CONCLUSIONS Total cholesterol analysis in dot blood spots demonstrates high precision and reproducibility. This method reliably enables the incorporation of this biological marker into neonatal screening for familial hypercholesterolemia detection.