Research priorities in perioperative fluid therapy and hemodynamic monitoring: A Delphi Consensus Survey from the Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section (SHTF) of the Spanish Society of Anesthesiology and Critical Care (SEDAR).

BACKGROUND: Research in fluid therapy and perioperative hemodynamic monitoring is difficult and expensive. The objectives of this study were to summarize these topics and to prioritize these topics in order of research importance. METHODS: Electronic structured Delphi questionnaire over three rounds among 30 experts in fluid therapy and hemodynamic monitoring identified through the Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section of the Spanish Society of Anesthesiology and Critical Care. RESULTS: 77 topics were identified and ranked in order of prioritization. Topics were categorized into themes of crystalloids, colloids, hemodynamic monitoring and others. 31 topics were ranked as essential research priority. To determine whether intraoperative hemodynamic optimization algorithms based on the invasive or noninvasive Hypotension Prediction Index versus other management strategies could decrease the incidence of postoperative complications. As well as whether the use of renal stress biomarkers together with a goal-directed fluid therapy protocol could reduce hospital stay and the incidence of acute kidney injury in adult patients undergoing non-cardiac surgery, reached the highest consensus. CONCLUSIONS: The Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section of the Spanish Society of Anesthesiology and Critical Care will use these results to carry out the research.

[A school breaks card game improves eating habits in adolescents]. / Un juego de cartas durante los recreos escolares mejora los hábitos alimentarios en adolescentes.

INTRODUCTION: Feeding habits among the Spanish population are currently an increasing and concerning problem, especially during adolescence. OBJECTIVES: To improve feeding habits (breakfast, consumption of fruit and water, soft drinks, pastries, sweets and fried food) in adolescents. METHODS: The intervention was conducted for 3 months in students from 12 to 16 years old, through an educational proposal based on a card game (built ad hoc) called "Fighting for my health", which was developed during the school breaks. This game was supplemented with the methodology of a healthy commitment, based mainly on the cooperative work between schools and families and the promotion of the responsibility among students about their health. Two groups were included (intervention and control), each one with a total number of 48 adolescents. RESULTS: After the intervention, significant improvements were achieved in 5 of the 6 habits addressed (the exception was consumption of fried food) in the intervention group. Among them, it is necessary to highlight the significant difference (p < 0.001) obtained in breakfast and consumption of fruit between pretest and posttest and between pretest and retest. However, in the control group there were no significant differences in any of them. CONCLUSION: A school-based intervention conducted from the Department of Physical Education, through healthy commitments using a card game, improved the feeding habits in adolescents.

[Increase in cigarette smoking and decrease in the level of physical activity among Spanish adolescentes. AVENA study]. / Incremento del consumo de tabaco y disminución del nivel de práctica de actividad física en adolescentes españoles. Estudio AVENA.

OBJECTIVE: Cigarette smoking among adolescents as well as the level of physical activity constitutes a public health care issue. The aim is knowing the relationship between cigarette smoking and practice of physical activity. SETTING: Schooled Spanish adolescents SUBJECTS: 2859 Spanish adolescents (1357 boys, 1502 girls; age range: 13-18.5 years). INTERVENTIONS: A questionnaire is applied to know the level of cigarette smoking and four other questionnaires to know the level of physical activity during different periods. RESULTS: 40.8% of the adolescents stated not doing any physical activity at all, boys being more active than girls (p < 0.001). 29.9% of the adolescents stated usually smoking cigarettes, without differences by gender. Both active boys and girls stated smoking less (P < or = 0.01). The greater the age, the higher cigarette smoking and the lower the level of physical activity, both in boys and girls (p < 0.001). CONCLUSIONS: The level of physical activity is low, being even lower for girls. Cigarette smoking shows a negative relationship with the level of physical activity, the individuals more physically active being those smoking the less.