Decisions have to be made about what data on patient characteristics and processes and outcome need to be collected, and standard definitions of these data items need to be developed to identify data quality concerns as promptly as possible and to establish ways to improve data quality. The usefulness of any clinical database depends strongly on the quality of the collected data. If the data quality is poor, the results of studies using the database might be biased and unreliable. Furthermore, if the quality of the database has not been verified, the results might be given little credence, especially if they are unwelcome or unexpected. To assure the quality of clinical database is essential the clear definition of the uses to which the database is going to be put; the database should to be developed that is comprehensive in terms of its usefulness but limited in its size.
The project of the European Commission Towards a European Space of Research, presented in the year 2000, aims at increasing the impact on R+ D and defining the scientific policy for Europe. The materialization of this project implies commitment and support from member States, the coordination of research activities between each one of them, and the development of modern management systems and methods. In Spain, R+ D + i activities include (regional, national, and international) Programs, Plans, and Actions on R + D and the participation in relevant Contracts with enterprises, the Administration, or both. In this setting, several general aspects of the National Plan on R + D + i (2004-2007) and of the 7th European Framework Program of the EU are presented and some issues on biomedical research, the role of universities in scientific production, the relevance of knowledge as a significant resource, and the need of managing the latter as a source of competitive advantage are commented.
Etoricoxib, a second generation selective cyclooxygenase-2 (COX-2) inhibitor had been studied for the chemopreventive response at its therapeutic anti-inflammatory dose in 1,2-dimethylhydrazine (DMH) induced colon carcinogenesis in rat model. Eight to ten weeks old male rats of Sprague-Dawley strain were divided into four groups. While group 1 served as control and received the vehicle of the drugs, group 2 and 3 were administered freshly prepared DMH in 1mM EDTA-saline (pH 7.0) (30 mg/kg body wt/week, subcutaneously). Group 3 was also given a daily treatment of etoricoxib (0.6 mg/kg body wt orally) while the group 4 received the same amount of etoricoxib only, prepared in 0.5% carboxymethyl cellulose. Animals were sacrificed at the end of 6 weeks, body weight recorded and the colons were subjected to macroscopic and histopathological studies. The maximum number of raised mucosal lesions called the multiple plaque lesions (MPL) were found in the DMH group which significantly reverted back in the DMH + etoricoxib group, while very few MPLs were recorded in the control and etoricoxib only group. Similarly, the number of aberrant crypt foci (ACF), the point of future carcinogenic growth, was recorded more in the DMH group and significantly less in the DMH + etoricoxib group. The histopathological analysis showed the presence of severe hyperplasia, occasional dysplasia and aggregates of lymphoid cells in the localized regions. Etoricoxib group showed near normal histological features with the crypt architecture and the surrounding stromal tissue remaining intact. To ascertain the molecular mechanism of such anti-carcinogenic features the colonocytes were isolated and studied in primary culture for the evidence of apoptosis by fluorescent staining and genotoxic changes by single cell gel electrophoresis assay (comet assay) which shows that the DMH treated animals produced much less apoptotic nuclei but more comet producing cell, while these features were reverted back with the etoricoxib treatment. The cytoplasmic expression of COX-2 protein was studied in paraffin sections of the colon by immunohistochemistry with COX-2 specific antibody which showed a very high presence of this inducible enzyme with the DMH group while in all other groups of animals it was not visible or weekly expressed. The anti-inflammatory effect of the drug, etoricoxib was also validated by a carrageenan-induced inflammation in rat model which showed an extremely high anti-inflammatory response within the dose range used in the present study. Also the growth profile of all the animals remained the same throughout the six week period of the investigation as there was no change in the body weight. It appears that apoptosis remains the dominant anti-proliferative end effect of this drug, mediated by an inhibition of the proinflammatory COX-2 isoform although further molecular probings are needed to arrive at a conclusive agreement in favor of the chemoprotective use of such drugs in colon cancers.
In patients with diabetes type 2 the individual diet is a main point to reach a good metabolic control. The objective of our study was to evaluate the fulfilment of a 1.500 kcal/day diet in a group of overweight patients with diabetes mellitus type 2.
A total of 89 diabetic patients were studied in Hospital Universitario del Río Hortega (Valladolid), from March to September of 2000. In all patients the next datas were recorded; age, sex, years of diabetes evolution, with a 24 hours nutritional questionnaire and a frequency questionnaire. All patients had a body mass index higher than 25.
Distribution of sex were (36 males y females), mean age 62.92 +/- 9.71 years, weight 75.62 +/- 13.06 kg and body mass index 29.92 +/- 5.97, with an evolution of diabetes (8.3 +/- 2.4 years). Nutritional evaluation showed a calorie intake of 1316 kcal, the recommended calories in the diet were 1522 kcal. Carbohydrates intake were lower than recommended (53.9% vs 43%), this decrease in the carbohidrates intake were compensated a high intake of lipids (23.4% vs 33%), proteins intake were 22%. Frequency questionnaire showed that 96% of population took 3 or more portions of fruit each day and 83% of population 3 or more portions of vegetables.
Patients with diabetes mellitus type 2 performed a hypocaloric diet. Carbohydrates intake were the most important, with a high percentage of monounsaturated lipids and a good percentage of proteins.
The editors of Nutrición Hospitalaria (Nutr Hosp) analyze the journal from its foundation in 1979 to the present time, on occasion of the first publication of its impact factorby Journal Citation Reports (JCR). The actions taken along this thirty year period are described, including its incorporation to multiple web databases, the Open Access policy of the journal, its progressive internationality, and the bibliometric analysis made in 1999. A figure with the journal citation trends is included. Nutr Hosp, included in the "Nutrition & Dietetics" group of JCR, is in the position 42/59, i.e. in the third quartile. Among the Spanish journals included in JCR,Nutr Hosp is located in the 14/37 position. A few considerations are made related to the economical aspects of the journal, the number of articles received so far, the articles expected in the future, the rejection rate and the language (Spanish or English) in which Nutr Hosp should be published.
We determine the incidence of the malnutrition syndrome and its relation with probable risk factors, in 106 patients, with a mean age of 53.3 +/- 15.4 years, with a diagnosis of cancer confirmed histologically, and who received artificial nutrition either enterally or endovenously, during an average of 16.8 +/- 2 days, which included a supply of 60 to 100 mmol/day of phosphorus. We considered there to be a renutrition syndrome when there as hypophosphatemia; < 2.5 mmol/l, which took place during the nutritional treatment phase, and previous to which, the patients had normal serum levels of phosphorus. The serum electrolyte concentrations were measured prior to the start of the treatment, and daily during the first week, and later every 3 days until the end. The study variables were: age, sex, type of cancer, degree of malnutrition, degree of hypophosphatemia, day on which in occurred, and clinical manifestations associated to this. The relative risk was calculated for the variables of age, sex, malnutrition and cancer. The incidence of the renutrition syndrome was 24.5%; it was more frequent in the enteral group than in the endovenous group (37.5% vs. 18.9%, p < 0.005); and it took place 72 hours after starting the nutritional support, in 61.5% of the cases, with a mean phosphorus concentrations of 1.9 mmol/l; the most frequent clinical manifestations were the neuromuscular ones (30%), and the most frequent type of cancer was lymphoma (15.4%). The risk factors were age greater than 60 years (RR = 1.7), and moderate or severe malnutrition 8RR = 2.0). We conclude that the prevalence of the renutrition syndrome is high in the cancer patients, despite an intense preventive treatment with phosphorus.
Presented and described in detail is a clinical technique called subjective global assessment (SGA), which assesses nutritional status bases on features of the history and physical examination. Illustrative cases are presented. To clarify, further the nature of the SGA, the method was applied before gastrointestinal surgery to 202 hospitalized patients. The primary aim of the study was to determine the extent to which our clinicians' SGA ratings were influenced by the individual clinical variables on which the clinicians were taught to base their assessments. Virtually all of these variables were significantly related to SGA class. Multivariate analysis showed that ratings were most affected by loss of subcutaneous tissue, muscle wasting, and weight loss. A high degree of interobserver agreement was found (kappa = 0.78%, 95% confidence interval 0.624 to 0.944, p < 0.001). We conclude that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible. (Journal of Parenteral and Enteral Nutrition 1987; 11:8-13).
To know the family environment, living habits and social characteristics in 11-13 years-old school children.
A descriptive transversal study performed in 65 schools of Barcelona during the second three-month, involving 2354 school children aged 11-13 interviewed by 73 pharmacists. The questionnaire has thirty-nine questions referring to family structure, eating and drinking habits, preferences, life style parameters such as physical activity and television viewing.
The survey revealed a family unit of two children and their parents was the most common. Only a 12% of the children surveyed lived with their grandparents. Furthermore, the findings revealed a low family presence during the three main meals on the working days, which increased on weekends, 26% on breakfast, 44% on lunch and 11% on dinner. A 24% had breakfast alone and the 46% ate what they wanted. About the afternoon snack, the 25% alone and the 55% what they wanted. A 60% never or practically never participated in decision making, when buying food. A 70% reported they did other activities while eating. Concretely, a 40, 39 and 59% of the children reported they had breakfast, lunch and dinner while watching television. The consumption frequency of trinkets, soft drinks and television viewing were lower for the children from private compared to public schools.
This study show that food choice at shopping was mainly done by the parents, however, children had an important role in making decisions of what food they eat and the activities they do while eating. Therefore, pharmacists could have a potential role to intervene in the nutritional education to parents and children.
To assess the validity of a food frequency questionnaire (FFQ) by applying it to children and adolescents living in Salvador, Bahia.
The validity of this FFQ with 98 food items was investigated among 108 children and adolescents who were selected from a sample of 1445 that had been planned for a study on the risk factors for asthma and other allergic diseases. The adults responsible for these children and adolescents gave responses for a 24-hour recall (R24h) and an FFQ. The average energy and nutrient values from the FFQ were compared with those from the R24h by means of the paired t test and Pearson correlation coefficients. The concordance was evaluated using the Bland-Altman method and kappa statistics.
The energy and nutrient intake estimated using the FFQ was significantly higher than what was obtained using the R24h. The correlation coefficients adjusted for energy were statistically significant for protein, fat, vitamin C and zinc. The weighted kappa values ranged from 0.06 for vitamin A (p = 0.24) to 0.34 for energy (p < 0.00). The results from the Bland-Altman plots for lipid, protein and zinc showed the most significant validity parameters, and zinc was found to show the best concordance.
The results suggest that the FFQ showed satisfactory validity for use in studies involving children and adolescents.
Introduction: Overweight and obesity in children in the Mexico-USA border have evolved differently to the rest of their respective countries. New reference values of cholesterol, triglycerides and glucose are required to treatment. Objective: To determine the reference values of cholesterol, triglycerides and glucose in Hispanic children between 6 and 11 years in the Mexico-USA border. Methods: A prospective, cross-sectional, descriptive and observational study. A population of Hispanic children between 6 and 11 years of both boys and girls, belonging to three public institutions in the cities of Ensenada and Chihuahua, randomly selected, were studied. The study variables were the levels of total cholesterol (TC), triglycerides (TG) and glucose (G). Results: From 300 subjects studied just 54 children completed the study. Higher average values of TC (168.7 ± 27.2 mg / dl), TG (80.6 ± 48.4 mg / dl) and G (88.3 ± 8.9 mg / dl) were observed. An additional behavior was founded, never reported previously to the limit of the knowledge of the authors; glucose levels of the children studied decreased with increased of cholesterol and triglycerides. To discard a random relationship between the variables, the Pearson correlation coefficient was determined between waist circumference and BMI, verifying an inverse association with G and direct with the TG. Conclusion: The reference values for Hispanic children between 6 and 11 years living on the northern border of Mexico-USA differ with respect to the national average values of the countries studied. Further studies are needed in larger populations to confirm the trend ob served in glucose levels of normal children, overweight and obese.
Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Severe or morbid obesity (M.O.) is a pathological state which is very difficult to treat by non-surgical means. It is defined internationally on the basis of anthropometric measurements when a body mass index (BMI) of 40 kg/m2 is exceeded. In such cases, the pathological increase in body fat influences patient mortality and morbidity. The present state of bariatric surgery is reviewed in the series presented. The guidelines are submitted which are currently used as an approach to surgery, and the reasons are set out used by the authors, on the base of 5 years' experience and more than 110 patients operated on (ringed vertical gastroplasty-RVG, inflatable silicone gastric band, Salmon's technique) in a prospective approach to new surgical projects. The series presented is divided into two groups. It is shown that not all the severely obese (SMO) (BMI > 50 kg/m2) respond adequately to a simple restrictive technique (RVG) notwithstanding very considerable weight loss. Other techniques are currently under consideration for this group. It is concluded that bariatric surgery demonstrates effective and permanent results if the right technique is used on the patient selected.
The present study had the objective of comparing the lipid profile, nutritional status and body composition of adolescents and their parents.
A cross-sectional study was conducted with 120 adolescents from 10 to 13 years old, public schools students from the city of Viçosa, Minas Gerais, Brazil and their respective biological parents (104 mothers and 82 fathers). Data was collected regarding weight, height, waist and hip circumference, body fat, triglycerides, total and fraction cholesterol. Besides, taking the skinfold measurements (bicipital, tricipital, subscapular and suprailiac) of the adolescents; and evaluation of sexual maturity, excluding those that were in stage 1 according to Tanner. The statistical treatment includes descriptive analysis, the use of the Student's t-test, Mann Whitney, and Pearson and Spearman correlation. An Odds Ratio was conducted with a confidence interval of 95%, considering p < 0.05 significant.
A positive and significant correlation was seen for weight, BMI and total cholesterol between father and son; for all the variables, except body fat and wait/hip ratio between father and daughter; for weight and height between mother and son and BMI between mother and daughter. Adolescents that had both parents with hypertriglyceridemia, with inadequacies of LDL or HDL presented, respectively 19, 20 and 4 times more chances of presenting the same alterations.
This study confirmed differences in the anthropometric measurements, body composition and lipid profile between children of overweight, eutrophic and underweight parents, as well as greater chance for the adolescent to present an altered lipid profile when the parents also have presented that alteration.
Introduction: An association between consumption of sugar sweetened beverages (SSB) and metabolic diseases has been observed. Objective: The aim of this study was to analyze randomized clinical trials (RCT) of 18 or more weeks of intervention among ≥ 13 year old individuals, which examined the consumption of SSB on adiposity indicators. Methods: An electronic literature search was conducted in the PubMed database of RCT studies published up to April 10th, 2013. Term used for this search was "Sugar Sweetened Beverages". Results: Four studies were found. In one of the studies, after the reduction of SSB consumption, a small reduction of BMI was observed (p = 0.045). Another study showed that the reduction of 355 ml/day was associated with a weight loss of 0.7 kg (95% CI: 0.2-1.1, p = 0.01). In a different study, in the group consuming regular Coke, an increase in the visceral: abdominal subcutaneous fat ratio, was observed (p = 0.01). In another study, there were no differences on adiposity between the intervention and control groups. Conclusion: The results of this review indicate a trend toward an effect of the consumption of SSB on adiposity.
To describe the nutritional aversions and preferences of 14-18 years old adolescents schooled at Santander and analyze the changes taking place within the last decade.
A cross-sectional study was carried out analyzing a sample of 1134 adolescents: 549 males (48.4%, 95% CI: 45.5%-5.3%) and 585 females (5.6%, 95% CI: 48.7%-54.5%), ages comprised between 14 and 18 years, and schooled at centers of secondary educational level from Santander, by means of a questionnaire.
vegetables (54.7%) and legumes (18.7%) represent the main nutritional aversions of adolescents. On the other hand, grains (53.3%) and meats (14.6%) are the preferred foods. Lentils, lettuce, strawberry, water, and pasta generally were the best-valued foods within the groups of foods and drinks to which they belong.
nutritional aversions and preferences of adolescents from Santander generally are very similar to those observed in other studies and we have not observed important changes within the last decade. The data obtained may be useful to observe future trends on nutritional preferences that, together with other parameters, may help characterized the nutritional behavior of our adolescents.
The quality of home parenteral nutrition (NPD in its Spanish acronym) depends on the frequency and type of complication associated with NPD treatment and the likelihood of survival. The present study assesses the quality of the NPD programme in place in our hospital in terms of survival, infections and mechanical complications. A retrospective study was carried out into the clinical follow-up data of all the patients (n = 24) included in our NPD programme since its start in 1985 until 1998 (14 years). An estimate is made for: a) the annual index of infectious complications (IAC in its Spanish acronym), b) the annual index of mechanical complications (MAC in its Spanish acronym) and c) the likelihood of survival by means of the Kaplan-Meier method. The quality specifications adopted are those of the literature reflecting the current provision of NPD programmes and the survival values of patients undergoing dialysis for chronic kidney failure. The most frequent pathology in our context is benign (70.8%), distributed as follows: small bowel syndrome of ischaemic origin (45.8%), small bowel syndrome of non-ischaemic origin (12.5%) and idiopathic intestinal pseudo-obstruction (12.5%). The patients with benign pathologies present a higher survival rate than patients with neoplastic disease (95% in the fifth year of treatment versus 45% at twenty months), with a statistically significant difference. The annual index of infectious complications is 0.6 (median value of the 14 years studied). Similarly, the annual indices of obstructions and thromboses are 0.11 and 0.0095, respectively. In our opinion, the quality of the NPD programme in place at our hospital is highly satisfactory because both the survival rate and the annual indices of mechanical and infectious complications are acceptable with regard to the programmes in place in the international sphere. In addition, in terms of survival, NPD seems slightly more effective than dialysis for chronic kidney disease.
Introduction and objectives:
Plasma lipid levels in children and adolescents are evaluated with international references. The objective was to describe them in Chilean students, to compare them with the most used reference (Lipids Research Clinics Program) and the cut-off points recommended in 2011.
Cross-sectional study in 3325 children, 10 to 14 years of age. Anthropometry and auto-report of pubertal development were performed. A 12 hours fast blood sample was taken to measure total (TC), highdensity lipoprotein cholesterol (HDLC) and triglycerides (TG). Low-density lipoprotein cholesterol (LDLC) was calculated with Friedewald formula. Variables were described, Hochberg test for multiple comparisons and stepwise lineal regression were applied. The degree of agreement between local percentiles and the two international references was studied.
We studied 3,063 children, 11.4 ± 0.9 years old, 53% girls, 20.9% pre-pubertal, 22.6% had overweight, and 15.8% obesity. Averages: TC: 159.2 ± 28.3, HDLC: 51.9 ± 12.1, LDLC: 89.0 ± 31.5 and TG: 93.2 ± 60 mg/dL. Boys had higher HDLC: 53.3 ± 12.2 vs. 50.6 ± 11.8 mg/dL and lower TG: 86.2 ± 58.2 vs. 99.5 ± 61.7 mg/dL than girls (p < 0,001). Influences of nutritional status, sex and age were significant. We founded high agreement with the reference for TC and LDLC, but HDLC levels were lower and TG were higher, for their cut-off points: percentiles 10th and 95th, respectively.
Blood lipids were influenced by nutritional status, sex and age. Percentile values were comparable to the international reference except for HDLC and TG, showing a more atherogenic pattern.
Overweight and obesity are epidemic worldwide. The purpose of this research is to estimate whether the prevalence of obesity among primary school children is high, and to identify its potential determinants to optimize the methods of prevention to combat further increases in childhood overweight.
A cross-sectional study was designed to collect the routine health screening data for primary school children in Wannan area, China. Overweight and obesity status were determined using the International Obesity Task Force standard (IOTF) BMI cut-off points.
A total of 67956 subjects (36664 male and 31292 female) aged 5-14 years were recruited in this study. Depending on the references used (IOTF), the overall prevalence of overweight, including obesity of the subjects was 17.85% , the prevalence of overweight, including obesity was 22.9% in male subjects and 11.9% in female subjects, respectively. The overall prevalence of obesity was3.7%, the prevalence of obesity was 5.2 % in male subjects and 1.8% in female subjects, respectively. An interesting observation made was that the prevalence of overweight was high in male subjects.
Overweight is prevalence among primary school children, especially in male children. The relate department of school and government should take some measure to reduce the prevalence of overweight and obesity.
The Liber de arte medendi (Lyon, 1564) is the most relevant book of Prima Professor of The Faculty of Medicine of Universidad de Alcalá, doctor Cristóbal de Vega (1510-1573). It is a treatise--674 pages in folio--of theoretical and practical medicine. This doctrinal expose, scholar and bookisk, changes its tone in the second of the three parts, the liber II, that deals with "no natural things" of galenism, which necessarily affect the organism and that, depending on how they are used, they may strengthen or weaken its health: air, physical activity, foods and drinks, sleep, evacuations and passions of the soul.
Within the section dedicated to foods and drinks, we have studied the interesting chapter about wines, where the author makes a hygienic assessment about wine.
The chapter on spanish wines consigned at the Liber de arte medendi and some other references about the therapeutic capabilities of some of the wines described by the author.
He we undertaken a critical analysis of that chapter, glossing the most significant texts about spanish wines mentioned by the author.
In this chapter vega praises the class and hygienic applications of white Alcarrian wines from Yepes, Lillo and Santorcaz, of the Galician from Rivadavia, from Cantalapiedra in the Salamanca region, and the Andalusians from Jerez, Cazalla and Alanís. He also extols the smooth reds from Santorcaz; though the best in this category would be, for the adaptation of its temperament to the human nature, the Illana wine.
at Liber de arte medendi, wines from Cantalapiedra (Ded Castille), Rivadavia (Galicia), Jerez, Ca- zalla and Alanís (Andalusia), Santorcaz, Corpa, Yepes, San Martín de Valdeiglesias, Villalbilla, Illana and Lillo (New Castille) are mentioned.
The comparison study of two school children groups with different income level shows that those from a poor peripheral district of Madrid suffer from a delay in their physical development, with weight and height measurements below their age standard. Weight delay is proportionally higher than that of the height. A 2.94 years delay is observed when applying WETZEL to these groups of children within an average age of 10.14. The global delay in the somatic development represents 29% of the average chronological age. This delay in the development may be mostly due to causes related to diet, not only to specific deficiencies, but rather to deficient amounts in the overall food intake. From the quality point of view, milk deficiency is probably one of the main factors linked to the origin of this development disorder.
Vitamin D can play an important role in maintaining bone health and in the prevention of some diseases. Few foods are a natural source of vitamin D and these are not normally consumed, being the most common oily fish and yolk.
To analyze the intake and sources of vitamin D in schoolchildren aged 7-16 years.
A representative sample of the Spanish population aged 7-16 years (n = 1,976) selected from ten Spanish provinces was studied. Dietary data were obtained by using a 3-day food record. The body weight and height were measured.
Results and discussion:
Mean vitamin D intake (1.63 (0.96-3.35) μg/day) was lower than the recommended intake (RI) in 85.4% of study participants and it was influenced by age (OR = 0.935; IC: 0.889-0.983; p < 0.01). The main sources of vitamin D were eggs (27.7%), followed by cereals (25.8%), fish (20.9%) and dairy products (12.7%). Additionally, it has been found that vitamin D RI can be adequately covered the greater the consumption of fish is (r = 0.734; p < 0.001). Thereby, an increase of one fish serving decreased a 72.5% the odds of not covering vitamin D RI.
Vitamin D intake is lower than the recommended intake in a high percentage of the participants. Having into account that the contribution of vitamin D is mainly determined by fish, an increase in the consumption of this food group would be desirable. Young children merit special attention.
The prevalence of obesity among Mexicans is alarming in both the child and adult populations. The objective of this study was to determine the levels of overweight, obesity and abdominal obesity in pre-school (PS), elementary (ES), and middle high (MHS) public school children from Tijuana. From February to April of 2011, a bietapic random sample was selected by cluster method of 30 PS, 30 ES, and 30 MHS children. And a sample of 30 groups for each level was chosen. Twenty elementary teachers and eight graduate students were trained at one central location on how to take anthropometric measurements using a portable scale, a stadiometer, and a measuring tape to determine weight, height, and waist circumference. Body Mass Index values were computed and compared to age/gender BMI percentiles according to WHO criteria. Waist circumference for-age at the 90th percentile from NHANES III (Mexican-American) was used to define abdominal obesity. The sample was composed of 646 PS children, 961 ES children, and 1,095 MHS children. Their ages ranged from 4- 16 years. Results showed an overall prevalence of overweight and obesity in younger than 5y preschool children (> 2 SD) of 23.1%, in = 5 y PS (> 1 SD) of 33.8%, in ES children of 46.3%, and in MHS children of 41.9%. Abdominal obesity in PS children was 18%, in ES children was 16.7%, and in MHS children was 15.2%. These results warrant immediate and comprehensive actions to prevent a critical public health problem in Mexico.
The urinary ratio 2-hydroxyoestrone/16-hydroxyoestrone (URME), has been proposed in various populations on the world as a risk indicator for breast cancer (BC), however in the Mexican population has never been determined. Objective: To determine URME Mexican women and establish its relationship with risk factors for BC. Material and Methods: Cross-sectional study of 142 premenopausal and 42 posmenopausal women. The URME was determined with the kit ESTRAMETTM and was related to risk factors for BC. Correlations and linear regressions were performed. Results: The median URME was 0.90 (RIQ 0.64-1.18). The body mass index (BMI) and early menarche contribute 5.4% of their variability (F=5.17; p.
Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
To investigate relationships between nutritional status and growth among a sample of schoolchildren and adolescents living in a rural district of Kenya.
Cross-sectional nutritional and anthropometric survey.
The data are from schools in a rural district of south-western Kenya.
Schoolchildren and adolescents aged between 5 and 17 years of age. Anthropometric measurements and interviews on dietary intake were carried out in 2001 and 2002 on 1,442 subjects.
In this African rural sample, the degree of malnutrition differs with age (increasing with age) and sex (more accentuated in males). Several correlations (P < 0.05) were observed between nutrient adequacy ratios and anthropometric values, particularly in males. There were no correlations between anthropometric characteristics and sodium or vitamin C (in males and females) and vitamin A or potassium (in females).
Malnutrition was more evident in subjects at puberty. The diet was deficient in sodium, calcium and potassium. Although weight-for-age (WAZ) and BMI-for-age (BMIZ) did not show significant relationships with nutrients in girls, the anthropometric variables were significantly correlated with micronutrients and thiamine in boys. To develop effective intervention strategies, it is vital to understand both how changes in malnutrition do occur and how different factors influence nutrient intake. The different growth pattern of boys and girls could be caused by sexual differences in environmental sensitivity, access to food and energy expenditure.
The aim of this study was to provide percentiles values for four different aerobic performance tests in 2752 (1,261 girls) Spanish children aged 6 to 17.9 years. Aerobic performance was assessed by the shuttle run test (20 mSRT), 1-mile, 1/2-mile and 1/4-mile run/walk tests. Height and weight were measured, and body mass index was calculated. Boys had significantly better score than girls in the studied tests in all age groups, except in 1/4-mile test in 6-7 year old children. Underweight children had similar performance than their normalweight counterparts, and underweight boys had better performance than their obese counterparts. Overweight and obese children had lower performance than their normalweight counterparts. Having percentile values of the most used field tests to measure aerobic performance in youth may help to identify children and adolescents at risk for the major chronic diseases, as well as to evaluate the effects of alternative interventions.
When assessing a patient nutritional support the state of the gastrointestinal tract is the most important point to consider, whenever possible we should choose the enteral nutrition (EN) over parenteral nutrition (PN) and recognized by its various advantages. The percutaneous gastrostomy (GRP) were introduced in clinical practice as an alternative to surgical gastrostomy (GQ). The speed, simplicity, low cost, low morbidity and low mortality of these techniques has allowed its rapid development.The feeding tubes types used were the balloon-retained devices catheter, the pig tail and the ballon-retained with gastropexia (gastropexia). It is a retrospective study of all patients who were placed GPR in the Virgen del Rocío University Hospital, Sevilla, between September 1996 and September 2013, which aims to study is to describe the characteristics of patients and the complications presented for different types of enteral feeding tubes used. GPR 186 were performed in 176 patients (135 males (76.70%), with an average duration of 303.6 days, the most frequent diseases were cancers of the head and neck 49.46%. The types of feeding tubes used were pigtail 118 (63.44%), balloon-retained devices 22 (11.83%), and gastropexia 46 (24.73%). The most common early complications in the pigtail group were early purulent exudate and early bleeding (2.5 and 3.4% respectively), while in the balloon catheter group the initial output of the probe was most frequent early complication (13.7%), none of these complications were observed in the group of gastropexy. The most common late complication was obstruction probe. The GPR is a safe technique with lower mortality of 1%; Low frequently of early and late complications. A better understanding of this technique can reduce the frequency of complications.
Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Overweight and obesity are serious public health problem, which is specially among children populations.
To determine the effectiveness of educational interventions conducted in Latino America for the prevention of overweight and obesity in scholar children from 6 to 17 years old. Metodology: MEDLINE, LILACS and EMBASE were searched between february and may 2014 to retrieve randomized controlled trials and longitudinal studies that evaluated the effects of educational interventions intended to retrieve randomized controlled trials and longitudinal studies aiming to prevent overweight and obesity among Latinoamerican children. Risk of bias was evaluated using the PEDro scale and the CASPe tool.
Twenty one studies were included (n=12,092). Different types of educational interventions were identified, such as nutritional campaigns, physical activity practice and environmental changes. Mixed approaches combining nutritional campaigns, physical activity promotion and enviromental changes were the most effective interventions, since their results produced the largest improvements in the overweight and obesity of children. None evidence of reporting bias was observed.
Educational interventions performed in the educational environment that combined an adequate nutrition and the promotion of physical activity practice, are more effective for preventing overweight and obesity in Latino American children, although familiar interventions are also encouraged approach, associated with better responses on the behavioral change in scholar children.
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The objective of this study, focused on parents and children to reduce sedentary behavior, consumption of soft drinks and high-fat and salt containing snacks, and increase the consumption of fruits and vegetables, was to assess the effect of a six month intervention and an 18 month follow-up intervention on the body mass index, food consumption and physical activity of 2nd and 3rd grade elementary school children.
This was a randomized cluster controlled trial. School children were selected from 2nd and 3rd (n = 532) grade.
BMI z-score for age and sex was calculated and classified according to the WHO (2006). Abdominal obesity was defined as WC > 90th of NHANES III.
At six months of the study differences were observed in BMI, -0.82 (p = 0.0001). At 24 months, results such as an increase of z-score BMI and waist circumference, a decrease in abdominal obesity, eighth per cent remission and an incidence of 18% of overweight and obesity were observed. Additionally, an increase (p = 0.007) in vegetable intake and physical activity (p = 0.0001) was also reported, along with a decrease in sedentary activities and the consumption of snacks high in fat and salt.
The results of this study indicate that with a comprehensive intervention there is a positive response to lifestyle changes and a reduction of abdominal obesity.
Growth is a complex phenomenon that has in pediatric age special relevancy because it constitutes a fundamental indicator of nutritional status.
To evaluate differences about weight analysis of infants aged 0-18 months depending on the population reference used.
This is a longitudinal weight and length study in a representative sample of 383 infants from Aragon since birth until 18 months of age. A descriptive analysis was realized and "z-scores" were calculated from five growth curves. Finally there was calculated the percentage of children who were staying above or under 2DS for weight depending on the standard used.
50.1% were males and 49.9% women. Weight and length of the children were higher in girls than in boys in all the ages (p<0.01). Major differences between weight z-score averages from standards were at 6 months and later. The percentage of children on a weight<2 DS ranged between 0.5 and one 3.3% at 18 months of age depending on the standard.
Global differences exist when weight is evaluated in the same sample of infants up to 18 months of age depending on different population standards, as well as in the number of children who stay out of the limits of the normality with each of them.
Anthropometry is important as clinical tool for individual follow-up as well as for planning and health policy-making at population level. Recent references of Bolivian Adolescents are not available. The aim of this cross sectional study was to provide age and sex specific centile values and charts of Body Mass Index, height, weight, arm, wrist and abdominal circumference from Bolivian Adolescents. Data from the MEtabolic Syndrome in Adolescents (MESA) study was used. Thirty-two Bolivian clusters from urban and rural areas were selected randomly considering population proportions, 3445 school going adolescents, 12 to 18 y, 45% males; 55% females underwent anthropometric evaluation by trained personnel using standardized protocols for all interviews and examinations. Weight, height, wrist, arm and abdominal circumference data were collected. Body Mass Index was calculated. Smoothed age- and gender specific 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th Bolivian adolescent percentiles(BAP) and Charts(BAC) where derived using LMS regression. Percentile-based reference data for the antropometrics of for Bolivian Adolescents are presented for the first time.
Introduction: Gestational diabetes has been associated with obesity later in life. However, reported results have not been consistent and the methods used have shown weakness. Objective: To analize prospective and retrospective cohort studies that assess the gestational diabetes effects on adiposity indicators in the offspring during their first 18 years. Methodology: A search was made for prospective or retrospective cohort studies registered in Medline/ Pubmed database, from January 2011 to September 2013 that evaluated the gestational diabetes effects on adiposity indicators at birth or after birth. Results: Eleven studies met the inclusion criteria. A total of 472,959 pairs of mother and child were studied. Children age at the moment of evaluation ranged from birth to 18 years. In nine out of eleven articles an association between gestational diabetes and adiposity indicators was observed. In seven studies adjustments for potential confounders (pre gestational BMI, maternal age) were made. In five of those an association between gestational diabetes and adiposity was found. Conclusion: The results of this review indicate that the evidence showing that gestational diabetes increase adiposity indicators later in life is moderate.
Prolonged Total Parental Nutrition (TPN) is associated with life-threatening complications in the pediatric population, being cholestasis one of the most important ones. The source of fatty acids, the amount of phytosterols and the dose of lipids in the nutritional support, have been linked to the development of this complication.
To describe the behavior of liver function tests in pediatric patients with TPN where lipid based omega 3 fatty acids (OmegavenR) were used.
A retrospective research was made in a population of children under 18 years old where omega 3 fatty acids were used for a minimum of 8 days. Patients were initially classified into two groups: cholestasis and abnormal liver tests. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), direct bilirubin (DB) gamma glutamyl transferase (GGT) and alkaline phosphatase (AP) before and after treatment with OmegavenR was evaluated.
33 patients met the inclusion criteria. At the end of treatment with OmegavenR, 82.4% of patients who initially presented cholestasis showed resolution or improvement. The group of patients with abnormal liver tests 18.8% progressed to cholestasis.
Our study suggests that the use of OmegavenR in pediatric patients with TPN and DB ≥ 2 mg/dL, seem to reverse or improve cholestasis while in patients with abnormal liver tests we still don't have clear effect.
In the preparation of a centralized parenteral nutrition unit project in our hospital, following the creation of a multi-disciplinary commission entrusted with the study of this project, we proceeded to evaluate parenteral nutrition protocols of national and foreign hospitals, as a first approach to the subject. This study evaluates and extracts the data we consider most relevant in a sample of 19 American hospitals. With regard to the types of parenteral diet, we observed that most of them (63%) had "standard diets", mainly formulated with 25% glucose and 4.25% crystalline amino acids. None of the protocols studied contained alternatives to glucose as a calorie-contributor, nor were there special formulae for amino acids, although many of them included it in their therapies for use if considered necessary. In all protocols, the contribution of fats was reduced to concrete situations and administered in a different way to the rest of the food in 73% of cases. With regard to additives, despite the existence of standard formulations of electrolytes and vitamins and oligoelements, in 100% of the hospitals studied, there was the possibility of formulating each element separately. Administration was done in several doses per day in 42% of cases and in 100%, using perfusion pumps. The data obtained from this review was of great value in preparing our own parenteral nutrition protocols.
Introduction: Diabetes Mellitus (DM) type 2 is a common pathology with multifactorial etiology, which exact genetic bases remain unknown. Some studies suggest that single nucleotides polymorphisms (SNPs) in the CAPN10 gene (Locus 2q37.3) could be associated with the development of this disease, including the insertion/deletion polymorphism SNP-19 (2R→3R). Objective: The present study determined the association between the SNP-19 and the risk of developing DM type 2 in Ciudad Juarez population. Methodology: For this study 107 participants were selected: 43 diabetics type 2 (cases) and 64 non diabetics with no family history of DM type 2 in first grade (control). Anthropometric studies were realized as well as lipids, lipoproteins and serum glucose biochemical profiles. The genotypification of SNP-19 was performed using peripheral blood lymphocytes DNA, polymerase chain reactions (PCR), and electrophoretic analysis in agarose gels. Once obtained the genotypic and allelic frequencies, the Hardy-Weinberg equilibrium test (GenAlEx 6.4) was also performed. Results: Using the X² analysis it was identified the genotypic differences between cases and control with higher frequency of the homozygous genotype 3R of SNP- 19 in the cases group (0.418) compared to control group (0.265). Also, it was observed an association between genotype 2R/3R with elevated weight, body mass index, and waist and hip circumferences, but only in the diabetic group (P=< 0.05). Conclusion: The findings in this study suggest that SNP-19 in CAPN10 may participate in the development of DM type 2 in the studied population.
Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
In this lecture, given at the International Conferences on Neuroscience, in Quito, May 31st-June 1st of 2013, the topic of famine situations during the Spanish Civil War, 1936-1939, was approached. Madrid, the capital of Spain, was under food, water and milk rationing during that period. This situation led to conditions that showed the relationships between the nervous system and nutrition. The Madrilenian population was submitted to a real experiment of hyponutrition, similar to the one that may be reproduced at the laboratory. At the end of the war, the National Direction on Health and the Institute of Medical Investigations, with the collaboration of the Rockefeller Foundation, carried out a series of clinical and food consumption surveys among the Madrilenian population. There were three medical situations that were of particular relevance during the Civil War and after it: the pellagra epidemics, the onset of lathyrism, and the socalled Vallecas syndrome. The occurrence of pellagra cases was paramount because it allowed reconsidering all the unspecific symptoms observed from an already known vitamin deficiency. Pellagra became the most prevalent deficitrelated disease, and most clearly related to nutrition. Lathyrism is a chronic intoxication produced by the accumulation of neurotoxins. It is due to common intake of chickling peas (Lathyrus sativus). Chickling peas are toxic only if they represent more than 30% of the daily calories consumed for a prolonged period greater than two to three months. Lathyrism would reoccur in the Spanish population after the war, in 1941 and 1942, the so called "famine years", when due to the scarcity of foods chickling pea flour was again consumed in high amounts. Deficiency-related neuropathies observed in Madrid during the Civil War led to new and original clinical descriptions. In children from schools of the Vallecas neighborhood, a deficiency syndrome, likely related to vitamin B complex deficiency, was described, which manifested by muscle cramps and weakness, and was termed the Vallecas syndrome. Poor fat content in the diet and a light decrease in calcium levels, which were already very low, were observed in the group with cramps. Both the administration of tablets containing an adequate amount of calcium and phosphorus and the daily intake of 4-6 milligrams of thiamine, achieved a considerable reduction in the frequency and severity of the cramps, or their complete resolution.
The general mortality rate among patients suffering from peptic ulcer has been materially reduced by surgical care. The reduction has been due chiefly to early operation in those having one type of ulcer lesion; that is, ruptured ulcer.¹ The rate following operations for chronic peptic ulcer, uncomplicated by rupture or gross hemorrhage, has always been much lower, but proportionate progress in reducing this figure further has not been made. This rate has remained for some time at a relatively stationary level of about 10 per cent,² except in selected series. To present further observations on the sequence of events leading to this sustained rate is my object in this communication.
The ordinary patient chronically ill with peptic ulcer is to be dealt with here. Those patients with ruptured peptic ulcer, with acute hemorrhage or with gastrojejunal ulcer are naturally not under consideration, since they all present preoperative and
A clinical study on the nutritional status of a group of school-aged children from a poor Madrilenian neighbourhood reveals the -relatively infrequent- existence of specific signs of deficiencies. There is a surprising contrast between this status and the considerable delay observed in the somatic development. Evidences seem to show that these children's nutritional problem is mainly a quantitative one. Their development delay is associated with an overall diet deficiency and more specifically with calcium deficiency, which is probably the most deficient item in these children diets. Anemia, present in 98% of the children, is not probably only due to a deficiency in iron, as the diet seems to bring a sufficient amount. It is more likely to be related to the poor content of animal protein in their daily intake.
To analyse the institutionalisation of nutrition sciences in Spain in the second half of the twentieth century, and evaluate the activities of the journal Anales de Bromatología.
Descriptive bibliometric study of the original articles. Full names of the authors and the complete article title were recorded. Using key words, each article was assigned by consensus of the researchers to a single main subject in accordance with the thirteen subject areas addressed by the Spanish Society of Bromatology in its meetings. An analysis was conducted of the distribution and trends of general productivity indicators and their characteristics.
A total of 917 original articles were published, with a mean of 20.8 papers/year. The subjects for which the highest percentage of articles was recorded were foreign substances in foods, foods of plant origin and nutrition. A total of 874 authors contributed, with a collaboration rate of 2.43 and a transience rate of 70.1%. Distribution of the number of authors per article was close to that indicated by Lotka's law of scientific productivity. The top twelve producers, predominantly women, participated in 49.9% of the articles published.
The journal showed low productivity and was of an endogamous nature, with a predominance of authors related to the School of Bromatology in the Faculty of Pharmacy, at the Complutense University. The subjects addressed reflected the demands of the nutrition transition in Spain.
The Spanish nutritional and food transition was consolidated over the course of the twentieth century. In the pre-transition stage, a renewed interest emerged in the deficiencies presented by children''s diets, and food and nutritional education was considered the best course of action to correct them. The aim of this study was to analyse the changes over time and regional differences in the nutritional status of Spanish schoolchildren in rural areas in the 1950s and 1970s, using their height as an anthropometric parameter. The results revealed the existence of two categories at the beginning of the 1960s: a first group in which the height of children from the Cantabrian coast, the Levante, Catalonia and the Balea - ric Islands was similar to that of well-nourished children, and a second group from the regions of Andalusia, Extremadura and Galicia, who were not as tall. Between 1954 and 1977, the height of well-nourished children rose, particularly between 1954 and the first half of the 1960s. There was also a significant increase in the height of children attending national schools in rural areas, and the regional differences that had existed at the beginning of the 1960s disappeared. These advances were undoubtedly influenced both by the milk supplement and the food and nutritional education activities carried out within the framework of the Spanish Diet and Nutrition Education programme (EDALNU).
This study provides a gender-based analysis of the Food and Nutrition Education Program, developed in Spain over the last decades of the 20th century, to explore nutrition education messages and strategies aimed at improving the skills of housewives as guardians of family welfare and experts in all areas of household management. The Program's specific approach to housewives, and the assumptions on which it was based, further entrenched a social model of gender in which men were solely responsible for household income and women were family carers.
Introduction: A good tool to determine the biotype of growing and developing subjects that has been observed is the somatotype (ST). Objetive: This research study aims to describe the ST tendency in Chilean adolescents along the years. Methods: The bibliographic review was carried out using data from Medline, ISI Web of Knowledge, and SciELO. The key words used for the search were: somatotype, somatotyping, adolescent (in English and Spanish). The selected articles must describe ST in Chilean adolescents between 15 and 18 years of age. The graphic representation was made through a somatochart and the series ST. To analyze the trajectory of the ST, the moving average method was used (SM), and the tendency line (lineal; TL), which expresses the data direction and projection. Results: Eight articles complied with the inclusion criteria. Samples of students between 1979 and 2011 from the Regions of Valparaíso, Araucanía, and the Metropolitan region of Chile were reported. All studies correspond to transversal samples. The authors cite and/or describe the Heath-Carter anthropometric methods to assess the ST. The results showed positive TL for the endomorph component in all ages and genders. The mesomorph component maintained in male, unlike the female's component, which was negative except for the one at 18 years old. SM trajectory describes a regularity of the mesomorphic endomorph profile in female, yet with an increase in the endomorphy. In male, a change was observed from an ectomorphic mesomorph to endomorphic mesomorph. Conclusions: This progressive rise of the adipose component in both genders increases the risk of suffering non-communicable diseases.
Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Presentation of the results of an anthropometric study conducted among the population of the province of Tenerife from 1985-1987. Tables of the parameters by age groups and sex were attached: these parameters included weight, height, triceps fold, circumference of arm, muscular and fatty areas of arm. A table of weights according to sex for each centimetre of height was also attached. Likewise, percentile graphs and their evolution throughout different decades of age were attached. Lastly, comments were made on the differences between this and other anthropometric studies.
To determine the trend of high school students from Valparaíso Chile by means of an anthropometrical somatotype.
two samples of students during the years 1984-1985 (86 men and 71 women) and 2009-2010 (77 men and 86 women) between 15 and 18 years of age have been studied. Somatotype was estimated by the Heath-Carter anthropometric method.
significant differences were found in all the variables of the somatotype during the periods studied (p < 0.01), except for height (p = 0.176) and humeral breadth in women (p = 0.067). Important distinctions were also found in the endomorphic, mesomorphic and ectomorphic components (p < 0.01). Men measurements registered remarkable differences in all the variables (p < 0.01), with the exception of weight (p = 0.156), calf breadth (p = 0.906) and arm breadth in contraction (p = 0.284). Measurement results of endomorphic (p < 0.01), ectomorphic (p < 0.01) and mesomorfic components (p < 0.05) revealed considerable differences. During the period 1984-1985, men classified as balanced mesomorph 2.7-4.8-3.1 which switched to mesomorph-endomorph 3.8-4.3-2.5 in the period 2009-2010. And the population of women in the 1984-1985 period is classified as mesomorph-endomorph 4.2-4.7-2.1 and changes to a mesomorphic-endomorph biotype 6.6-4.1-1.3 in the 2009-2010.
the somatotype of the adolescent population, especially women in Valparaiso, Chile has changed to a predominant endomorphic biotype, and its mesomorphic component has decreased. A high relative adiposity contributes to increase the probability for these people to suffer non-transmissible chronic diseases and cardiovascular issues.
Presented and described in detail is a clinical technique called subjective global assessment (SGA), which assesses nutritional status bases on features of the history and physical examination. Illustrative cases are presented. To clarify, further the nature of the SGA, the method was applied before gastrointestinal surgery to 202 hospitalized patients. The primary aim of the study was to determine the extent to which our clinicians' SGA ratings were influenced by the individual clinical variables on which the clinicians were taught to base their assessments. Virtually all of these variables were significantly related to SGA class. Multivariate analysis showed that ratings were most affected by loss of subcutaneous tissue, muscle wasting, and weight loss. A high degree of interobserver agreement was found (kappa = 0.78%, 95% confidence interval 0.624 to 0.944, p < 0.001). We conclude that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible.
Enteral nutrition is an artificial form of nutrition which is expanding an there are thus a great many commercial preparations on the market which are rapidly being developed. This study is a presentation of the quantitative and qualitative changes in these preparations from 1988-1991, classified depending upon their main nutrient: proteins. In global terms, there has been an increase of 18 formulae, distributed among different types, but with the most spectacular increase in special diets. Discussion of the trends observed, which respond to further knowledge on the absorption or tolerance of nutrients and nutritional needs in different pathologies.