Estimation of salt intake assessed by urinary excretion of sodium over 24 h in Spanish subjects aged 7-11 years.

PURPOSE: High intake of salt is associated with early development of cardiovascular risk factors (e.g., hypertension, obesity). In "developed" countries, individuals frequently exceed dietary recommendations for salt intake. Taking into account the limited data on sodium intake by 24-h excretion in urine in schoolchildren, we wished to determine baseline salt intake in Spanish subjects aged 7-11 years. METHODS: The present study was an observational study involving 205 schoolchildren (109 boys and 96 girls) selected from various Spanish provinces. Sodium intake was ascertained by measuring sodium excretion in urine over 24 h. Creatinine was used to validate completeness of urine collections. The correlation between fat-free mass determined by anthropometry and that determined via urinary excretion of creatinine was calculated (r = 0.651; p < 0.001). RESULTS: Mean 24-h urinary excretion of sodium was 132.7 ± 51.4 mmol/24 h (salt equivalent: 7.8 ± 3.1 g/day). Hence, 84.5 % of subjects aged ≤10 years had intakes of >4 g salt/day, and 66.7 % of those aged >10 years had intakes of >5 g salt/day. Urinary excretion of sodium was correlated with systolic blood pressure and diastolic blood pressure (r = 0.1574 and r = 0.1400, respectively). Logistic regression analyses, adjusted by sex, showed that a high body mass index (odds ratio = 1.159; 95 % CI 1.041-1.290; p < 0.05) was associated with an increased likelihood of high urinary excretion of sodium. CONCLUSIONS: Sodium intake, as estimated by 24-h urinary excretion, was (on average) higher than recommended. Reducing the sodium content children's diet is a sound policy to reduce cardiovascular risk.

Percepción sobre la calidad de la dieta en un colectivo de adultos. Comparación con la calidad real / Perception of the quality of the diet in a group of adults. Comparison with real quality

Introducción: A pesar de las recomendaciones dietéticas dirigidas a la prevención de enfermedades siguen existiendo discrepancias entre las pautas aconsejadas y los consumos reales, posiblemente por una percepción errónea de la calidad de la dieta. Objetivo: Conocer la percepción de la calidad de la dieta de un colectivo de adultos y compararla con la calidad real de la misma. Material y métodos: Se recogieron datos dietéticos y de la calidad de la dieta de 124 adultos (18-50 años). La población fue dividida en función de que la dieta fuera percibida como inadecuada (DIN), regular (DRE) o buena (DBU). Resultados: La percepción de la calidad de la dieta correlacionó positiva y significativamente con el número de raciones de frutas (r=0,182; p<0,05), ingesta de fibra dietética (FD) (en g/día: r=0,199; p<0,05 y en g/1000kcal: r=0,254; p<0,01) de vitamina C (r= 0,250; p<0,01), equivalentes de folatos (r=0,287; p<0,01), vitamina K (r=0,216; p<0,05), ácido pantoténico (r=0,191; p<0,05) y magnesio (r=0,186; p<0,05) así como con la cobertura de las ingestas recomendadas de folatos (r=0,230; p<0,05), vitaminas A (r=0,191; p<0,05), K (r=0,220; p<0,05), C (r=0,261; p<0,01) y con el IAS (r=0,268; p<0,01). Y negativamente con el consumo de carnes, pescados y huevos (r= -0,181; p<0,05), el porcentaje de calorías provenientes los AGS (r=-0,213; p=<0,05) y la densidad de colesterol (r=-0,203; p<0,05) en la dieta. Discusión: Al no consumirse las raciones recomendadas de los diferentes grupos de alimentos, el desequilibrio dieté- tico se refleja en los perfiles -calórico y lipídico-, aunado a la insuficiente ingesta de algunos micronutrientes. Conclusiones: Las personas que perciben su dieta como buena realizan una dieta menos inadecuada, aunque en todos los casos, no se cumplen con las pautas de la dieta equilibrada (AU)

Introduction: Although the dietetic recommendations addressed to the prevention of illnesses, there are still differences between the advised guides and the real intake, possibly due to a misleading perception of the diet quality. Objective: To know the perception of the diet quality of a group of adults and to compare it with the real quality of itself. Material and methods: Dietetic and diet quality data were taken from 124 adults (18-50 years old). The population was divided in order for the diet to be perceived as inadequate (DIN), as regular (DRE), or as adequate (DBU). Results: The diet quality perception correlated positively and meaningfully with the number of fruit portions (r=0,182; p<0,05), dietetic fiber intake (in g/day: r=0,199; p<0,05 and in g/1000kcal: r=0,254; p<0,01), vitamin C (r=0,250; p<0,01) folate equivalents (r=0,287; p<0,01), vitamin K (r=0,216; p<0,05), pantothenic acid (r=0,191; p<0,05) and magnesium (r=0,186; p<0,05), as well as the coverage on the recommended folate intakes (r=0,230; p<0,05), vitamin A (r=0,191; p<0,05), K (r=0,220; p<0,05), C (r=0,261; p<0,01) and with the HEI (r=0,268; p<0,01). And negatively correlated with meat, fish and egg intake (r=-0,181; p<0,05), the percentage of calories from the SFAs (r=-0,213; p=<0,05) and the cholesterol density (r=-0,203; p<0,05) in diet. Discussion: When the recommended food groups and portions are not consumed, dietary imbalance is reflected in the profiles -caloric and lipid-, and inadequate intake of some micronutrients. Conclusions: People that perceive their diet as good carry out a less inadequate diet, although not in every case, balanced diet guides are not met (AU)

Interleukin-6 deletion in mice driven by aP2-Cre-ERT2 prevents against high-fat diet-induced gain weight and adiposity in female mice.

AIM: Interleukin-6 (IL-6) is a major cytokine controlling body weight and metabolism, but because many types of cells can synthesize and respond to IL-6 considerable uncertainty still exists about the mechanisms underlying IL-6 effects. Therefore, the aim of this study was to analyse the effects of tissue-specific deletion of IL-6 using a fatty acid binding protein (aP2) promoter-Cre inducible system (aP2-Cre-ERT2). METHODS: Tissue-specific IL-6 KO mice (aP2-IL-6 KO mice) were produced upon tamoxifen administration and were fed a high-fat diet (HFD, 58.4% kcal from fat) or a control diet (18%) for 14 weeks. RESULTS: aP2-IL-6 KO female mice on a HFD gained less weight and adiposity than littermate wild-type mice, but these effects were not observed in males. Hypothalamic factors such as NPY and AgRP showed a pattern of expression consistent with this sex-specific phenotype. PGC-1α expression was increased in several tissues in aP2-IL-6 KO female mice, which is compatible with increased energy expenditure. Serum leptin, insulin, glucose, cholesterol and triglycerides levels were increased by HFD, and in females IL-6 deficiency reversed this effect in the case of insulin and cholesterol. HFD induced impaired responses to insulin and glucose tolerance tests, but no significant differences between genotypes were observed. CONCLUSION: The present results demonstrate that deletion of IL-6 driven by aP2-Cre regulates body weight, body fat and metabolism in a sex-specific fashion.

Neural dysregulation during a working memory task in human immunodeficiency virus-seropositive and hepatitis C coinfected individuals.

Cognitive and functional neural correlates of human immunodeficiency virus (HIV) are only partially understood at present. Variability in neural response, which has been noted in the literature, may relate to clinical factors associated with HIV, including time since HIV diagnosis, CD4 count and nadir, HIV viral load, and comorbid infectious processes, especially hepatitis C. The present investigation evaluated working memory-related functional neural activation in 26 HIV+ participants, 28 demographically matched HIV-seronegative individuals, and 8 HIV+ individuals with hepatitis C coinfection. Analyses examined impact of HIV infection duration, CD4 count and nadir, HIV viral load, and hepatitis C serostatus. Results showed that HIV-seronegative participants had fastest reaction times, and during the working memory task, HIV+ participants with hepatitis C coinfection showed strongest bias toward commission errors; however, signal detection (i.e., overall task performance) was equivalent across groups. Functional magnetic resonance imaging (fMRI) results showed HIV-related greater activation to an easier vigilance task and HIV-related lower activation to a more difficult working memory task, consistent with reduced cognitive reserve. Hepatitis C coinfection related to diffuse neural dysregulation. Correlational analyses suggested relationships of increasingly severe disease with poorer functioning in brain regions linked to error monitoring and attention regulation.

Predictors of CNS injury as measured by proton magnetic resonance spectroscopy in the setting of chronic HIV infection and CART.

The reasons for persistent brain dysfunction in chronically HIV-infected persons on stable combined antiretroviral therapies (CART) remain unclear. Host and viral factors along with their interactions were examined in 260 HIV-infected subjects who underwent magnetic resonance spectroscopy (MRS). Metabolite concentrations (NAA/Cr, Cho/Cr, MI/Cr, and Glx/Cr) were measured in the basal ganglia, the frontal white matter, and gray matter, and the best predictive models were selected using a bootstrap-enhanced Akaike information criterion (AIC). Depending on the metabolite and brain region, age, race, HIV RNA concentration, ADC stage, duration of HIV infection, nadir CD4, and/or their interactions were predictive of metabolite concentrations, particularly the basal ganglia NAA/Cr and the mid-frontal NAA/Cr and Glx/Cr, whereas current CD4 and the CPE index rarely or did not predict these changes. These results show for the first time that host and viral factors related to both current and past HIV status contribute to persisting cerebral metabolite abnormalities and provide a framework for further understanding neurological injury in the setting of chronic and stable disease.

Selenium status in a group of schoolchildren from the region of Madrid, Spain.

BACKGROUND: To assess the selenium status of a group of schoolchildren from the Region of Madrid, Spain. METHODS: Study subjects comprised 483 children (216 boys and 267 girls) aged between 8 and 13 years. Selenium intake was determined using a 3-day food record. The foods consumed were transformed into energy and nutrients, and the selenium intake was compared with that recommended. Serum selenium levels were also recorded. RESULTS: Mean (SD) selenium intake [91.0 (25.2) µg day(-1) ] was above the recommended level in 99.4% of subjects; the main dietary sources were cereals, meats, fish and milk products. The serum selenium concentration [mean (SD) 71.1 (14.4) µg L(-1) ], however, was <60 µg L(-1) in 13.9% of subjects, and <45 µg L(-1) in 5.6%. The serum selenium concentration correlated with the selenium intake (r = 0.169; P < 0.05). Children with a serum selenium concentration of <75 µg L(-1) had significantly smaller selenium intakes than those with a serum concentration of ≥75 µg L(-1) . CONCLUSIONS: Although selenium intake was generally above that recommended, the serum selenium concentration of the children could be improved. This could be achieved by increasing the relative consumption of cereals and other selenium rich foods such as fish.

[Risk factors for metabolic syndrome in a case control study in Temuco, Chile]. / Factores asociados a síndrome metabólico en la comuna de Temuco, Chile.

BACKGROUND: Metabolic syndrome is becoming an important public health problem in affluent societies. AIM: To identify factors associated to metabolic syndrome in a Southern Chilean city. MATERIAL AND METHODS: Using a case control design, 200 participants, aged 35 to 70 years with at least three criteria for metabolic syndrome according to the National Cholesterol Education Program (NCEP_ATPIII) and 200 subjects with less than three criteria, were studied. Both groups were compared in terms of ethnic background, educational level, family history of diabetes and coronary artery disease, menopausal status, smoking, stress and depression, physical activity, changes in body mass index in the last five years and diet. RESULTS: Among subjects aged more than 54 years, among males and among overweight individuals, having a Mapuche origin was a risk factor with odds ratios (OR) of 7.2; 88 and 3.9 respectively. Among subjects aged more than 54 years, among women and among overweight individuals, a family history of diabetes was a risk factor with OR of 17.7; 3.2 and 3.9 respectively. Among subjects aged more than 54 years and among women a change in body mass index of more than three points was a risk factor with OR of 12.5 and 7.4, respectively. Depression also was a risk factor among subjects aged more than 54 years (OR 3.3). Regular consumption of wine was a protective factor among participants of more than 54 years, with an OR of 0.17. CONCLUSIONS: The risk factors for metabolic syndrome detected in this group of participants, were having a Mapuche origin, a family history of diabetes mellitus and depression. Wine consumption was associated with a lower risk.

Factores asociados a síndrome metabólico en la comuna de Temuco, Chile / Risk factors for metabolic syndrome in a case control study in Temuco, Chile

Background: Metabolic syndrome is becoming an important public health problem in affluent societies. Aim: To identify factors associated to metabolic syndrome in a Southern Chilean city. Material and methods: Using a case control design, 200 participants, aged 35 to 70 years with at least three criteria for metabolic syndrome according to the National Cholesterol Education Program (NCEP_ATPIII) and 200 subjects with less than three criteria, were studied. Both groups were compared in terms of ethnic background, educational level, family history of diabetes and coronary artery disease, menopausal status, smoking, stress and depression, physical activity, changes in body mass index in the last five years and diet. Results: Among subjects aged more than 54 years, among males and among overweight individuals, having a Mapuche origin was a risk factor with odds ratios (OR) of 7.2; 88 and 3.9 respectively. Among subjects aged more than 54 years, among women and among overweight individuals, a family history of diabetes was a risk factor with OR of 17.7; 3.2 and 3.9 respectively. Among subjects aged more than 54 years and among women a change in body mass index of more than three points was a risk factor with OR of 12.5 and 7.4, respectively. Depression also was a risk factor among subjects aged more than 54 years (OR 3.3). Regular consumption of wine was a protective factor among participants of more than 54 years, with an OR of 0.17. Conclusions: The risk factors for metabolic syndrome detected in this group of participants, were having a Mapuche origin, a family history of diabetes mellitus and depression. Wine consumption was associated with a lower risk.

Interleukin-6 regulates the expression of hypothalamic neuropeptides involved in body weight in a gender-dependent way.

Interleukin (IL)-6 has been involved in the control of body weight and body fat. Nevertheless, the mechanisms underlying these effects are not completely understood because central and peripheral actions of IL-6 are plausible. To gain further insight into the central effects of IL-6, we used transgenic mice expressing the IL-6 gene under the control of the glial fibrillary acidic protein (GFAP) promoter (GFAP-IL-6 mice), therefore with central nervous system-restricted over-expression of IL-6, and we studied the expression of the main neuropeptides responsible for energy homeostasis in specific hypothalamic nuclei. Neuropeptide Y (NPY), agouti-related peptide (AgRP), melanin-concentrating hormone (MCH), prepro-orexin (preproOX) (orexigenic and anabolic neuropeptides), pro-opiomelanocortin (POMC) and corticotrophin-releasing hormone (CRH) (anorexigenic and catabolic peptides) mRNA levels were determined using in situ hybridisation in young (2-4 month-old) and old (10-12 month-old) female and male mice under different feeding conditions: normal diet (control) and high-fat diet (HFD), and 24 h-food deprivation. In GFAP-IL-6 females fed a control diet (GFAP-IL-6-control), we showed a significant decrease in NPY and AgRP mRNA levels at all ages, and a late increase in POMC expression (only significant in older animals). These differences were blunted in HFD mice. By contrast, GFAP-IL-6-control males showed a decrease in CRH mRNA content at early ages (2-4 months), and an increase in older mice (10-12 months). Interestingly, these differences were again blunted in HFD mice. Finally, central IL-6 was not able to counteract the effects of 24 h of fasting on body weight, plasma glucose levels and the mRNA content of the peptides evaluated in the present study. Our results demonstrate that IL-6 may regulate the expression of hypothalamic neuropeptides involved in the control of body weight and body fat acting at the central level in a gender- and age-dependent way.

Selegiline and oxidative stress in HIV-associated cognitive impairment.

OBJECTIVE: To assess the effectiveness of the selegiline transdermal system (STS) in reversing HIV-induced metabolic brain injury (as measured by proton magnetic resonance spectroscopy [MRS]) and in decreasing oxidative stress, measured by CSF protein carbonyl concentration. METHODS: Sixty-two subjects with HIV-associated cognitive impairment were coenrolled in a 24-week placebo-controlled study (AIDS Clinical Trial Group protocol A5090) and were randomly assigned to receive STS 3 mg/24 h, STS 6 mg/24 h, or matching placebo. Cognitive performance was evaluated using the neuropsychological z score (NPZ)-8 and NPZ-6, as well as cognitive domain scores. Subjects underwent proton MRS at study entry and weeks 12 and 24. CSF protein carbonyl was measured at baseline and week 24. RESULTS: A slight increase in N-acetyl aspartate/creatine from baseline to week 24 was found in the basal ganglia (p = 0.023) and centrum semiovale (p = 0.072) of the placebo group compared with the STS groups; however, there were no significant changes when the absolute metabolite concentrations were analyzed. The levels of choline/creatine in the midfrontal cortex were also significantly higher during the week 12 visit in the combined STS groups. This persisted to the week 24 visit (p = 0.002). Evaluation of the change in NPZ-8, NPZ-6, and cognitive domain scores from baseline to weeks 12 and 24 revealed no significant differences between treatment arms. Protein carbonyl analysis revealed no significant changes among the groups. CONCLUSION: In this 24-week study, the selegiline transdermal system (STS) had no effect on either magnetic resonance spectroscopy (MRS) metabolites or oxidative stress, as measured by CSF protein carbonyl concentration. The lack of effect on these biomarkers is also reflected in the lack of cognitive improvement in the STS groups compared to placebo. LEVEL OF EVIDENCE: This study provides Class II evidence that STS had no effect on either MRS metabolites or oxidative stress, as measured by CSF protein carbonyl concentration over a period of 24 weeks.

[Mother's age as a conditioning factor of food consumption and energy and nutrients intake of their offspring at pre-school age]. / La edad de la madre como condicionante del consumo de alimentos y la ingesta de energía y nutrientes de sus hijos en edad preescolar.

OBJECTIVES: The aim of this study was to analyse whether the mother's age at the offspring's birth may condition food consumption and energy and nutrients intake as well as the appropriateness of the diet of their offspring at pre-school age. MATERIALS AND METHODS: socio-economic, anthropometrical, and dietary data were collected from a group of 103 pre-school children from Madrid, and the population was divided according to the mother's age (= 26 years (percentile 25) or < 26 years) at birth. RESULTS: Twenty-two point five of the mothers of the preschool children studied had their offspring before 26 years of age and 6.8% before 18. Children from younger mothers consumed less sugars (p < 0.01) and alcohol-free beverages (p < 0.05), but also less fruits (p < 0.01) and others (p < 0.05). The energy from fats was lower (p < 0.05) and that from carbohydrates higher (p < 0.05) among children with older mothers. Besides, the lipid profile was also better in this children, with less caloric intake from polyunsaturated fats (p < 0.05). Besides, fibre (p < 0.05) and vitamin C (p < 0.001) intake was higher in children from older mothers. CONCLUSIONS: It seems that mother's age may have an influence on dietary habits of their children and be a protection factor against dietary inappropriateness of the offspring, so that younger mothers might need special counselling in this respect.

La edad de la madre como condicionante del consumo de alimentos y la ingesta de energía y nutrientes de sus hijos en edad preescolar / Mother's age a conditioning factor of food consumption ands energy and nutrients intake of their offspring at pre-school age

Objetivos: El objeto de este trabajo ha sido analizar si la edad de la madre al nacimiento del niño, puede condicionar el consumo de alimentos y la ingesta de energía y nutrientes, así como la adecuación de la dieta, de sus hijos en edad preescolar. Material y métodos: Se han recogido datos socioeconómicos, antropométricos y dietéticos, de un colectivo de 103 preescolares de Madrid, y se ha dividido a la población en función de que la madre fuera = 26 años (Percentil 25) o menor de 26 años en el momento de nacer su hijo. Resultados: Un 25,2% de las madres de los preescolares estudiados, tuvieron a su hijo antes de los 26 años de edad y un 6,8% antes de los 18. Los niños de madres más jóvenes consumen menos azúcares (p < 0,01) y bebidas sin alcohol (p < 0,05), pero también menos frutas (p < 0,01), y más varios (p < 0,05). La energía aportada por las grasas fue inferior (p < 0,05) y la de hidratos de carbono superior (p < 0,05), en los niños de madres más mayores. Además, el perfil lipídico también fue más adecuado en estos niños, con un menor aporte calórico por parte de las grasas poliinsaturadas (p < 0,05). Igualmente, la ingesta de fibra (p < 0,05) y de vitamina C (p < 0,001) fue superior en los hijos de madres de mayor edad. Conclusiones: Parece que la edad de la madre supone una influencia sobre los hábitos alimentarios y la dieta de sus hijos, pudiendo resultar un factor de protección frente a la inadecuación dietética en el niño, por lo que las madres más jóvenes quizás puedan requerir un asesoramiento especial en este sentido (AU)

Objectives: The aim of this study was to analyse whether the mother's age at the offspring's birth may condition food consumption and energy and nutrients intake as well as the appropriateness of the diet of their offspring at pre-school age. Materials and methods: socio-economic, anthropometrical, and dietary data were collected from a group of 103 pre-school children from Madrid, and the population was divided according to the mother's age (= 26 years (percentile 25) or < 26 years) at birth. Results: Twenty-two point five of the mothers of the preschool children studied had their offspring before 26 years of age and 6.8% before 18. Children from younger mothers consumed less sugars (p < 0.01) and alcohol-free beverages (p < 0.05), but also less fruits (p < 0.01) and others (p < 0.05). The energy from fats was lower (p < 0.05) and that from carbohydrates higher (p < 0.05) among children with older mothers. Besides, the lipid profile was also better in this children, with less caloric intake from polyunsaturated fats (p < 0.05). Besides, fibre (p < 0.05) and vitamin C (p < 0.001) intake was higher in children from older mothers. Conclusions: It seems that mother's age may have an influence on dietary habits of their children and be a protection factor against dietary inappropriateness of the offspring, so that younger mothers might need special counselling in this respect (AU)

Costo efectividad de los abordajes terapéuticos para tabaco dependencia en La Paz-Bolivia / Cost effectiveness of therapeutic approaches snuff dependence on La Paz-Bolivia

Pregunta de la investigación¿Cuál será el costo efectividad de las diferentes políticas de intervención para el cese de tabaquismo, en La Paz-Bolivia en el periodo2005? Objetivos General Desarrollar un protocolo para evaluar el costo efectividad de las diferentes políticas de intervención para el cese de tabaquismo, en el municipio urbano de la ciudad de La Paz, periodo 2005.Diseño o tipo de estudio Estudio tipo económico: Este consiste en realizar un análisis comparativo de las acciones alternativas tanto en términos de costes comode beneficios, cuyo objetivo principal es evaluar el costo de oportunidad, es decir el costo real de los programas para usar lo mejor con los menores recursos. Tamaño de muestraLa muestra está constituida por aquellos decisores importantes dentro del sistema de salud del país, que representen al Sector Público(incluye seguros públicos, redes públicas de salud, dependencias de organismos del Estado, etc.), al Sector de Seguridad Social (incluyecajas de seguro, Obras Sociales, Empresas prestadoras de servicios y otras organizaciones que reciban financiamiento compulsivo poraportes y contribuciones de los trabajadores y empleadores y/o subsidios del Estado), al Sector privado (incluye empresas con y sinfines lucro que reciben aportes voluntarios de parte de sus adherentes individuales o corporativos) y al Sector Mixto (incluye aquellas organizaciones que combinan 2 o más de los sectores descritos anteriormente).Universo de trabajo Estará constituido por todos los organismos gestores de salud del país.Población objetivoTodos los protagonistas en gestión de políticas de salud anti-tabáquicas...

Research questionWhat is the cost effectiveness of different intervention policies for smoking cessation, in La Paz, Bolivia, in the year 2005? Objective To develop a protocol for assessing the cost effectiveness of different intervention policies to stop smoking in the municipality of the city of La Paz, year 2005. DesignEconomic Survey: this is a comparative analysis of alternative actions in terms of cost and benefits, whose main objective is to evaluate the opportunity cost, the actual cost of the best programs to use with fewer resources.Sample SizeThe sample consists of those key decision makers within the country’s health system, representing the public sector (including public security, public health networks, units of state agencies, etc.), the social security sector (includes health security, social work, service companies and...

Modification of iron status in young overweight/mildly obese women by two dietary interventions designed to achieve weight loss.

AIMS: To determine the modification of iron status in a group of overweight/mildly obese women following two different weight control programs. METHODS: The study subjects were 57 women who were assigned to one of two slightly hypocaloric diets: V (increased consumption of vegetables), or C (increased consumption of cereals, especially breakfast cereals). All data were determined at the start of the study and at 2 and 6 weeks into the dietary intervention period. RESULTS: Both diets led to a reduction in body weight and heme iron intake, and an increase in the intake of total and non-heme iron, at 2 and 6 weeks. At 6 weeks, a reduction in transferrin levels was seen in C subjects. Subjects with the worst initial iron status (hemoglobin

El Rombo de la Alimentación. Guía útil en la planificación de dietas ajustadas a las pautas recomendadas / No disponible

Estudios realizados en diversos colectivos dela población española ponen de relieve la existencia de desequilibrios del perfil calórico y lipídico(con excesivo consumo de grasa, sobre todo de grasa saturada, y bajo aporte de carbohidratos),junto con deficiencias frecuentes, en relación con diversas vitaminas y minerales. También se ha comprobado la existencia de un desconocimiento, en la población en general, sobre lo que es una alimentación variada y sobre el número de raciones de cada grupo de alimentos que conviene tomar cada día. En base a esta realidad, para ayudar en la educación nutricional de los individuos y facilitar la planificación de dietas se han elaborado unas pautas adaptadas a las peculiaridades de la población española. Las pautas, conocidas como “El Rombo de la Alimentación” esquematizan en una superficie en forma de rombo el número de raciones de cada grupo de alimentos que conviene consumir cada día, existiendo una relación entre el número de raciones que se aconseja consumir para cada grupo de alimentos y el área que los representa en el interior del rombo. Se especifican los alimentos incluidos en cada grupo y los tamaños de ración orientativos, así como consejos de carácter general encaminados a mejorar el estado nutritivo de la población. El presente trabajo muestra cómo utilizar “El Rombo de la Alimentación” como guía base en la planificación de dietas, elaborando el menú a consumir durante una semana, transformando los alimentos incluidos en energía y nutrientes y comparando los aportes obtenidos con las ingestas recomendadas. La dieta que cumple con las pautas marcadas en “El Rombo de la Alimentación” permite conseguir aportes de energía y nutrientes similares o ligeramente superiores a los recomendados y hace posible conseguir dietas con el perfil calórico y lipídico aconsejados, lo que resulta útil tanto desde el punto de vista nutritivo como desde el punto de vista sanitario (AU)

Studies performed with several different groups belonging to the Spanish population have shown the existence of imbalances in their energy and fat profiles. There is excessive consumption of fat, especially saturated fat, and to low an intake of carbohydrates. Several vitamin and mineral deficiencies have also been found to be common. Further, the population shows a general lack of knowledge with respect to what a varied diet really is, and how much of each food group should be consumed each day. In an attempt to increase the public’s nutritional knowledge and to facilitate the planning of diets, this paper describes a series of guidelines adapted to the needs of the Spanish population. The guidelines are presented as a rhomboid scheme known as the Food Diamond. The Diamond includes the number of rations of each food group that should be taken daily, with a relationship between this number and the area they occupy within the diamond. The types of food within each food group is explained and ration sizes are suggested. Some general comments aimed at improving nutrition are also included. The present paper explains the use of the Food Diamond as a basic guide in the planning of diets, leading to the production of weekly menus. It also transforms the foods included into energy and nutrients and compares the provision of the same with that recommended. A diet which follows the guidelines of the Food Diamond provides the recommended (or slightly higher than recommended) amounts of energy and nutrients. It also helps one to meet the recommendations regarding energy and Iipid profiles. This is undoubtedly important, both from a nutritional and health point of view (AU)

The AIDS dementia complex: clinical and basic neuroscience with implications for novel molecular therapies.

The AIDS dementia complex (ADC, also referred to as HIV-associated cognitive impairment) is a common disorder among HIV-infected patients associated with both inflammatory and neurodegenerative processes. This review describes recent advances in the clinical and basic neurosciences of HIV infection and discusses the multivariable nature of what has become a chronic disorder in the context of highly active antiretroviral therapies (HAART). Since its initial description twenty years ago, advances in cell and molecular biology along with those in neuroimaging have furthered our understanding of the underlying pathogenic mechanisms. The clinical and neuropsychological profile of ADC is generally consistent with a "frontal-subcortical" pattern of injury. Neuropathogenesis is largely driven by indirect mechanisms mediated by infected, or more commonly, immune activated macrophages, which secrete viral and host-derived factors. Magnetic resonance spectroscopy (MRS) provides a robust in vivo method to measure the inflammatory and neurotoxic events triggered by these factors and their associated signals. Although the use of combined or highly active antiretroviral therapies (HAART) has significantly improved survival rates, cerebral injury and cognitive impairment remain common events. Factors such as aging and chronic infection will likely impact the course of this disease, its pathogenesis, and treatment. The combined observations presented in this review suggest a number of critical areas for future inquiry.

HIV leucoencephalopathy and TNFalpha expression in neurones.

BACKGROUND: Human immunodeficiency virus (HIV) leucoencephalopathy (HIVL) is an uncommon and rapidly progressive form of AIDS dementia complex (ADC) that has remained poorly understood. Tumour necrosis factor alpha (TNFalpha), which has been implicated in the pathogenesis of ADC, is predominantly localised in macrophages in the HIV infected brain, although in vitro studies indicate that neurones can express this cytokine. OBJECTIVE: To examine the clinical/neuroradiological features of HIVL and the expression of TNFalpha in HIVL. METHODS: Six patients who presented with rapidly progressive dementia within four to 12 weeks of the primary manifestation of their HIV infection were evaluated. Clinical history, treatment regimens, and imaging studies were reviewed, and brain samples from three of the patients were studied by means of immunohistochemistry. RESULTS: Imaging studies showed diffuse bilateral deep white matter changes in all six patients. Clinical and imaging abnormalities improved in five of the six patients within weeks after initiation of antiretroviral treatment. Brain biopsies of two showed pronounced microglia/macrophage activation, but only scant viral protein (gp41) expression. Staining for TNFalpha was found in microglia/macrophages, and surprisingly, in neurones also. Postmortem analysis of a third patient also showed TNFalpha expression in neurones of the frontal cortex and basal ganglia. CONCLUSION: This study provides the first demonstration of staining for TNFalpha in the neurones of the HIV infected brain, and suggests that the process underlying this rapidly progressive form of ADC may reflect indirect mechanisms mediated by host factors, particularly TNFalpha.

Validación del indice I/T como prueba diagnostica en infecciones neonatales / Values of the I/T radio of inmature to total neutrophils in neonatal-sepsis

PREGUNTA DE INVESTIGACIÓN ¿Cuál es la sensibilidad, especificidad y valores predictivos de la prueba diagnóstica del índice I/T en el diagnóstico de infecciones neonatales en recién nacidos pretérmino, término y post-término? OBJETIVO GENERAL: determinar los valores de sensibilidad, especificidad y valores predictivos en la prueba diagnóstica del índice I/T para infecciones neonatales en niños atendidos en el Servicio de Neonatología del Hospital de la Mujer de la ciudad de La Paz - Bolivia DISEÑO DE LA INVESTIGACIÓN: estudio de Test diagnóstico LUGAR IINSAD, Servicio de Neonatologia del Hospital de la Mujer, Instituto de Genética POBLACIÓN 268 recién nacidos, que provenían del Servicio de Neonatología del Hospital de la Mujer, los años 2002 a 2004 MÉTODOS Se tomó la muestra de sangre venosa de la región antecubital previa antisepsia de la piel, en un volumen de 3 mL: 2mL para hemocultivo de acuerdo a normas estandarizadas en el Laboratorio de Bacteriología de INLASA. 1 mL con anticoagulante (EDTA) para el hemograma y el recuento total de leucocitos y plaquetas, análisis de los cambios morfológicos del citoplasma de los neutrofilos identificando la vacuolización y granulaciones tóxicas. Se obtuvo información clínica de los pacientes con relación al peso de nacimiento, sexo, edad gestacional, complicaciones maternas y durante el embarazo y se anotó el puntaje de Apgar. RESULTADOS: la sensibilidad obtenida en el nuevo test, con gold estándar, hemocultivo y clínica nos muestra 55 y 63% respectivamente, para la especificidad 64 y 70%, en valor predictivo positivo 36 y 63%, en valor predictivo negativo 79 y 71%, lo cual demuestra que el índice I/T es más especifico y sensible cuando se relaciona con el diagnóstico clínico. CONCLUSIONES: conociendo la sensibilidad, especificidad y valor predictivo del índice I/T, es una prueba que ayuda al diagnóstico clínico de sepsis neonatal por ser prueba rápida y de bajo costo.

RESEARCH QUESTION: which are the sensitivity, specificity and predictive values of the I/T ratio of immature to total neutrophils in neonatal Sepsis of preterm, term or post term newbornsg? METHODS: we collected blood samples for cultures and for I/T relationship, we follow the protocol of the National Committee for Clinical Laboratory Standards on Cellular Morphology. Clinical informationwere collected from each neonate including birth weight, sex, gestational age, maternal complications, intrapartum complications and apgar scores. RESULTS: the sensitivity obtainedf with the new test, the gold Standard, blood cultures and clinical signs was 55 and 63% respectively. OBJECTIVE: to determine the sensitivity, specificity and predictive values of the I/T ratio of immature to total neutrophils in neonatal sepsis. DESIGN: diagnostic test PARTICIPANTS: 268 preterm, term and post term neonates attended in the Neonatal Service of the Hospital de la Mujer with the clinical diagnosis of neonatal sepsis during the year 2002-04. PLACE: INLASA, Genetic Institute and IINSAD ­ UMSA The especificity was 64 and 70%. The positive predictive value was 36 and 63% and the negative was 79 and 71%. So, the I/T index is more specific when it is related to the clinical signs. CONCLUSIONS: The sensitivity, specificity and predictive values of the I/T test helps in the diagnosis of neonatal sepsis; it is a low cost rapid test.

A multicenter in vivo proton-MRS study of HIV-associated dementia and its relationship to age.

OBJECTIVE: Differences in diagnostic criteria and methods have led to mixed results regarding the metabolite pattern of HIV-associated brain injury in relation to neurocognitive impairment. Therefore, a multicenter MRS consortium was formed to evaluate the neurometabolites in HIV patients with or without cognitive impairment. METHODS: Proton magnetic resonance spectroscopy (MRS) at short-echo time (30 ms) was assessed in the frontal white matter, basal ganglia, and parietal cortex of 100 HIV patients [61 with AIDS dementia complex (ADC) and 39 neuroasymptomatic (NAS)] and 37 seronegative (SN) controls. RESULTS: Compared to SN, NAS had higher glial marker myoinositol-to-creatine ratio (MI/Cr) in the white matter (multivariate analyses, adjusted P=0.001), while ADC showed further increased MI/Cr in the white matter and basal ganglia (both P<0.001), and increased choline compounds (Cho)/Cr in white matter (P=0.04) and basal ganglia (P<0.001). Compared to NAS, ADC showed a reduction in the neuronal marker N-acetyl compound (NA)/Cr in the frontal white matter (P=0.007). CSF, but not plasma, viral load correlated with MI/Cr and Cho/Cr in white matter and NAA/Cr in parietal cortex. HIV infection and aging had additive effects on Cho/Cr and MI/Cr in the basal ganglia and white matter. CONCLUSIONS: The results suggest that glial activation occurs during the NAS stages of HIV infection, whereas further inflammatory activity in the basal ganglia and neuronal injury in the white matter is associated with the development of cognitive impairment. Aging may further exacerbate brain metabolites associated with inflammation in HIV patient and thereby increase the risk for cognitive impairment.

Niveles de IgE Sérica total y factores asociados al desarrollo de atopía en estudiantes de medicina / evels of IgE total Sérica and factors associated to the atopía development in medicine students

Las enfermedades alérgicas son las menos estudiadas en nuestro medio, no se tienen estudios sobre los niveles de la IgE sérica total, ni su relación con los factores que pueden predisponer al desarrollo de Atopia. Este trabajo pretende establecer el diagnóstico de la Atopía en individuos predispuestos dentro de una población estudiantil de 4° año de la carrera de Medicina de la UMSA, comprendidos entre 20 y 30 años de edad de ambos sexos, durante la gestión 2001. El cálculo de tamaño muestral se realizó por EPINFO 6.0 para un estudio de corte transversal con casos y controles. De una población de 3.000 alumnos, 114 fueron seleccionados mediante un cuestionario dirigido evaluando antecedentes elérgios personales, alimenticios, ambientales y familiares, de los cuales 57 sujetos presentaron alguno de los factores asociados (casos) y 57 sujetos no presentaron ningún factor (controles), excluyendo a embarazadas y sujetos con antecedentes de zonas endémicas parasitariasd. Se aplicó una prueba de ELISA para determinar los niveles de IgE sérica total, obsercándose que el grupo control presentó todos los niveles de IgE sérica total menores a 100 UI/ml; el grupo atópico, 38 sujetos presentaron valores menores de 100 UI/ml y 19 mayores a 100 UI/ml. Se observó también que los factores asociados alimenticios, ambientales y familiares inciden en el desarrollo de la Atopia, determinándose que cuanto más asociados existen mayor es la manifestación.