Características nutricionales y composición de las galletas disponibles en el mercado español y de las galletas dirigidas a la población infantil / Nutritional characteristics and composition of the biscuits available in the Spanish market and biscuits marketed to children

INTRODUCCIÓN: en España existe un elevado consumo de galletas en la población infantil. Son productos ultraprocesados de alto contenido energético y densidad calórica, en general con azúcar añadido y grasas poco saludables. MATERIAL Y MÉTODOS: estudio descriptivo transversal sobre características y composición nutricional de galletas disponibles en supermercados españoles y comparativo entre las dirigidas al público infantil y el resto. RESULTADOS: se analizaron 350 galletas: valor energético medio 471,86 ± 35,83 kcal/100 g. El 53,1% contenían grasas saturadas, aceite de palma el 47,1% y azúcar añadido el 90%. Mediana de azúcares 25 g/100 g (rango intercuartílico [RI]: 20-33). Mediana de fibra alimentaria 3,2 g/100 g (RI: 2,4-5,2); 86 galletas mostraban publicidad sobre fibra y 95,34% indicaban la cantidad, mediana de 5,45 g/100 g (RI: 4-7,9). Se analizaron 53 galletas (15,1%) dirigidas al público infantil. Valor energético medio 466,47 ± 19,31 kcal/100 g. El aceite de oliva/girasol alto oleico (GAO) fue la grasa principal en el 67,9%. Aceite de palma presente en el 37,7% y azúcar añadido en 98,1% (media 25,88 ± 6,82 g/100 g). Mediana de fibra alimentaria 2,9 g/100 g (RI: 2,27-3,42). El 75,5% mostraron publicidad de reclamo. Las galletas dirigidas al público infantil contenían azúcar añadido en mayor porcentaje (98,1 frente a 88,6%; p = 0,033), menos fibra (mediana 2,9 g/100 g frente a 3,5 g/100 g; p = 0,005), aceite de oliva/GAO en mayor porcentaje (67,9 frente a 36,7%; p <0,001) y más publicidad de reclamo (75,5 frente a 45,5%; p <0,001). CONCLUSIONES: las galletas dirigidas al público infantil contienen azúcar añadido, elevado contenido calórico, grasas saturadas en más del 37% y publicidad de reclamo en elevado porcentaje. Por otro lado, se observa el uso de grasas monoinsaturadas en más del 50%. La información de este estudio podría facilitar intervenciones de salud pública e incentivar a los fabricantes para reformular sus productos

INTRODUCTION: the consumption of biscuits is high in the Spanish paediatric population. Biscuits are ultra-processed products with a high energy content and energy density and generally contain added sugars and unhealthy fats. METHODS: we conducted a cross-sectional descriptive study on the characteristics and nutritional composition of biscuits available in Spanish supermarkets, and compared biscuits marketed to children to all other biscuits. RESULTS: we analysed a sample of 350 biscuits. The mean energy content was 471.86 ± 35.83 kcal/100 g. Saturated fats were used in 53.1%, palm oil in 47.1% and added sugars in 90% (median content, 25 g/100 g; IQR: 20-33). The median dietary fibre content was 3.2 g/100 g (IQR: 2.4-5.2). The packaging of 86 advertised that the product contained fibre, specifying the total fibre content in 95.34% of cases, with a median value of 5.45 g/100 g (IQR: 4-7.9). Of the total products, 53 (15.1%) were marketed to children, and their mean energy content was 466.47 ± 19.31 kcal/100 g. The main fat was olive oil or high oleic sunflower oil (HOSO) in 67.9%, and palm oil was present in 20 (37.7%). There were added sugars in 98.1% (mean sugar content, 25.88 ± 6.82 g/100 g). The median dietary fibre content was 2.9 g/100 g (IQR 2.27-3.42). The packaging of 75.5% featured some form of advertising. The comparative analysis showed that a greater percentage of biscuits specifically marketed to children had added sugars (98.1% vs 88.6%, p = 0.033) and that these biscuits had a lower fibre content (median, 2.9 g/100 g vs. 3.5 g/100 g, p = 0.005), that a greater percentage contained olive oil or HOSO (67.9% vs 36.7%, p <0.001), and a greater percentage featured promotional advertising in their packaging (75.5% vs 45.5%, p <0.001). CONCLUSIONS: biscuits marketed to the paediatric population had added sugars and a high energy content; more than 37% had saturated fats and a high proportion featured advertising in the packaging. On the other hand, we found that monounsaturated fats were used in more than 50% of these products. The findings of this study could serve as reference to guide the development of public health interventions or product reformulation by manufacturers

Encuesta en Twitter en relación al tabaco / Survey in Twitter in regards to smoking

No disponible

Síndrome de apneas-hipopneas durante el sueño / Obstructive sleep apnoea síndrome

Introducción: El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio. Pacientes y métodos: Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución. Resultados: Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad. Conclusiones: La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso

Introduction: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Patients and methods: Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. Results: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Conclusions: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight

[Obstructive sleep apnoea syndrome]. / Síndrome de apneas-hipopneas durante el sueño.

INTRODUCTION: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. PATIENTS AND METHODS: Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. RESULTS: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. CONCLUSIONS: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight.

Inhaled nitric oxide in adult patients with acute respiratory distress syndrome / Óxido nítrico inhalado en pacientes adultos con síndrome de distrés respiratorio agudo

In some patients, acute respiratory distress syndrome (ARDS) leads to life-threatening refractory hypoxemia developing. Physicians may consider hypoxemic rescue therapies in an attempt to improve oxygenation in these patients while on conventional mechanical ventilation support. Use of inhaled nitric oxide (iNO) in ARDS is one of the most widely-studied pharmacological interventions over the past two decades. Its efficacy was examined in several randomized clinical trials and has undergone meta-analyses. Although iNO treatment was associated with improved oxygenation, researchers unfortunately never demonstrated a concomitant decrease in mortality or any improved outcome. Hence the current evidence suggests that iNO should not be routinely used in patients with ARDS however may be considered as adjunct therapy to tentatively improve oxygenation while other therapies are being considered in patients with severely hypoxemic ARDS. This review focuses on the therapeutic use of iNO in adult ARDS patients. We set out some recommendations for its use as rescue therapy against refractory hypoxemia (AU)

En algunos pacientes, el síndrome de distrés respiratorio agudo (SDRA) provoca el desarrollo de una hipoxemia refractaria que compromete la vida. En este contexto pueden considerarse terapias de rescate en un intento de mejorar la oxigenación mientras los pacientes permanecen en ventilación mecánica. El uso de óxido nítrico inhalado (NOi) en el SDRA ha sido una de las terapias farmacológicas más estudiadas en las últimas dos décadas. Diversos ensayos clínicos y metaanálisis han evaluado su eficacia, y aunque se ha demostrado un aumento en la oxigenación, no se ha podido demostrar un descenso en la mortalidad o una mejora en el pronóstico. La evidencia actual sugiere que aunque el NOi no debe usarse de forma rutinaria en pacientes con SDRA, puede considerarse su uso para mejorar la oxigenación en pacientes severamente hipoxémicos. Esta revisión examina la aplicación terapéutica del NOi en pacientes adultos con SDRA. Se propone un esquema con diversas recomendaciones para su uso como terapia de rescate frente a la hipoxemia refractaria (AU)

Inhaled nitric oxide in adult patients with acute respiratory distress syndrome.

In some patients, acute respiratory distress syndrome (ARDS) leads to life-threatening refractory hypoxemia developing. Physicians may consider hypoxemic rescue therapies in an attempt to improve oxygenation in these patients while on conventional mechanical ventilation support. Use of inhaled nitric oxide (iNO) in ARDS is one of the most widely-studied pharmacological interventions over the past two decades. Its efficacy was examined in several randomized clinical trials and has undergone meta-analyses. Although iNO treatment was associated with improved oxygenation, researchers unfortunately never demonstrated a concomitant decrease in mortality or any improved outcome. Hence the current evidence suggests that iNO should not be routinely used in patients with ARDS however may be considered as adjunct therapy to tentatively improve oxygenation while other therapies are being considered in patients with severely hypoxemic ARDS.This review focuses on the therapeutic use of iNO in adult ARDS patients. We set out some recommendations for its use as rescue therapy against refractory hypoxemia.

En algunos pacientes, el síndrome de distrés respiratorio agudo (SDRA) provoca el desarrollo de una hipoxemia refractaria que compromete la vida. En este contexto pueden considerarse terapias de rescate en un intento de mejorar la oxigenación mientras los pacientes permanecen en ventilación mecánica. El uso de óxido nítrico inhalado (NOi) en el SDRA ha sido una de las terapias farmacológicas más estudiadas en las últimas dos décadas. Diversos ensayos clínicos y metaanálisis han evaluado su eficacia, y aunque se ha demostrado un aumento en la oxigenación, no se ha podido demostrar un descenso en la mortalidad o una mejora en el pronóstico. La evidencia actual sugiere que aunque el NOi no debe usarse de forma rutinaria en pacientes con SDRA, puede considerarse su uso para mejorar la oxigenación en pacientes severamente hipoxémicos.Esta revisión examina la aplicación terapéutica del NOi en pacientes adultos con SDRA. Se propone un esquema con diversas recomendaciones para su uso como terapia de rescate frente a la hipoxemia refractaria.

Generic-type hierarchical multi digital signal processor system for hard-field tomography.

This article introduces the design and implementation of a hierarchical multi digital signal processor system aimed to perform parallel multichannel measurements and data processing of the type widely used in hard-field tomography. Details are presented of a complete tomography system with modular and expandable architecture, capable of accommodating a variety of data processing modalities, configured by software. The configuration of the acquisition and processing circuits and the management of the data flow allow a data frame rate of up to 250 kHz. Results of a case study, guided path tomography for temperature mapping, are shown as a direct demonstration of the system's capabilities. Digital lock-in detection is employed for data processing to extract the information from ac measurements of the temperature-induced resistance changes in an array of 32 noninteracting transducers, which is further exported for visualization.