ABSTRACT
BACKGROUND: It remains uncertain whether individualization of pneumoperitoneum pressures during laparoscopic surgery improves postoperative recovery. This study compared an individualized pneumoperitoneum pressure (IPP) strategy with a standard pneumoperitoneum pressure (SPP) strategy with respect to postoperative recovery after laparoscopic colorectal surgery. METHODS: This was a multicentre RCT. The IPP strategy comprised modified patient positioning, deep neuromuscular blockade, and abdominal wall prestretching targeting the lowest intra-abdominal pressure (IAP) that maintained acceptable workspace. The SPP strategy comprised patient positioning according to the surgeon's preference, moderate neuromuscular blockade and a fixed IAP of 12 mmHg. The primary endpoint was physiological postoperative recovery, assessed by means of the Postoperative Quality of Recovery Scale. Secondary endpoints included recovery in other domains and overall recovery, the occurrence of intraoperative and postoperative complications, duration of hospital stay, and plasma markers of inflammation up to postoperative day 3. RESULTS: Of 166 patients, 85 received an IPP strategy and 81 an SPP strategy. The IPP strategy was associated with a higher probability of physiological recovery (odds ratio (OR) 2·77, 95 per cent c.i. 1·19 to 6·40, P = 0·017; risk ratio (RR) 1·82, 1·79 to 1·87, P = 0·049). The IPP strategy was also associated with a higher probability of emotional (P = 0·013) and overall (P = 0·011) recovery. Intraoperative adverse events were less frequent with the IPP strategy (P < 0·001) and the plasma neutrophil-lymphocyte ratio was lower (P = 0·029). Other endpoints were not affected. CONCLUSION: In this cohort of patients undergoing laparoscopic colorectal surgery, an IPP strategy was associated with faster recovery, fewer intraoperative complications and less inflammation than an SPP strategy. Registration number: NCT02773173 ( http://www.clinicaltrials.gov).
ANTECEDENTES: No se sabe con certeza si individualizar las presiones del neumoperitoneo durante la cirugía laparoscópica mejora la recuperación postoperatoria. Comparamos una estrategia con individualización de la presión del neumoperitoneo (individualised pneumoperitoneum pressure, IPP) frente a una estrategia con presión estándar del neumoperitoneo (standard pneumoperitoneum pressure, SPP) respecto a la recuperación postoperatoria tras cirugía colorrectal laparoscópica. MÉTODOS: Ensayo clínico aleatorizado multicéntrico. La estrategia IPP consistió en una modificación de la posición, bloqueo neuromuscular profundo, y una distensión de la pared abdominal conseguida con la presión intraabdominal (intra-abdominal pressure, IAP) más baja en la que el espacio quirúrgico operativo siguiera siendo aceptable. La estrategia SPP consistió en una posición de acuerdo con la preferencia del cirujano, bloqueo neuromuscular moderado, e IAP fija de 12 mm Hg. El resultado primario fue la recuperación fisiológica postoperatoria, evaluada mediante la escala de calidad en la recuperación postoperatoria (Postoperative Quality of Recovery Scale, PQRS). Los resultados secundarios incluyeron la recuperación en otros dominios y la recuperación global, la aparición de complicaciones intraoperatorias y postoperatorias, duración de la estancia hospitalaria, y los valores de los marcadores inflamatorios séricos durante tres días postoperatorios. RESULTADOS: De un total de 166 pacientes, 85 recibieron una estrategia IPP y 81 una estrategia SPP. La estrategia IPP se asoció con una elevada probabilidad de recuperación fisiológica (razón de oportunidades, odds ratio OR, 2,8 (i.c. del 95% 1,2-6,4); P = 0,017, razón de riesgo, 1,8 (i.c. del 95% 1,7-1,9), P = 0,05)). La estrategia IPP también se asoció con una elevada probabilidad de recuperación emotiva (P = 0,013) y global (P = 0,011). Los eventos adversos intraoperatorios fueron menos frecuentes con la estrategia IPP (P < 0,001) y la tasa neutrófilo-linfocito fue más baja (P = 0,029). No se observaron cambios en otras variables. CONCLUSIÓN: En esta cohorte de pacientes sometidos a cirugía colorrectal laparoscópica, una estrategia IPP se asoció con una recuperación más rápida, menos complicaciones intraoperatorias y menos inflamación en comparación con una estrategia SPP.
Subject(s)
Colon/surgery , Laparoscopy/methods , Pneumoperitoneum, Artificial/methods , Postoperative Care/methods , Precision Medicine/methods , Rectum/surgery , Aged , Female , Humans , Laparoscopy/adverse effects , Male , Middle Aged , Treatment OutcomeABSTRACT
After publication of our article [1] the authors have notified us that there are changes in the primary outcome and the statistical analysis plan of the study.
ABSTRACT
The Muscle Dysmorphia (MD) is a subcategory of body dysmorphic disorder in which subjects develop a pathological concern for their musculature. The population at risk that suffers from, or can develop MD, prevails in terms of age of appearance in subjects between 16 to 35 years; and it is more frequent in men. This study aimed to determine which variables of the personality, gender identity and passion (harmonious or obsessive) allow to predict MD in adolescents through the Adonis Complex (AC) Scale. A cross-sectional study was conducted on 506 subjects between 16 and 21 years (M=18.20; SD=1.72). The higher correlation was between AC and Emotional Control in men, and impulse control in women. Then a binary logistic regression analysis was performed and model yielded R2=.176 (X2=47.95 (16) <.001) and classified correctly in 88.5% of cases. Results of the analysis showed that harmonious passion (β=-.028, p=.046) and emotional control (β=-.616, p=.002) are protective variables while obsessive passion (β=.065, p=.013) and scrupulosity (β=.344, p=.046) were risk factors. The results show the importance of performing interventions aimed at the prevention of DM, starting from the relevance of working emotional control and harmonious passion in this stage of life and training
La Dismorfia Muscular (DM) es una subcategoría del trastorno dismórfico corporal en el que los sujetos desarrollan una preocupación patológica por su musculatura. La población en riesgo que sufre o puede desarrollar DM prevalece en términos de edad de aparición en sujetos de entre 16 y 35 años; Y es más frecuente en los hombres. Este estudio tuvo como objetivo determinar qué variables de la personalidad, la identidad de género y la pasión (armoniosa u obsesiva) permiten predecir la DM en adolescentes a través de la Escala del Complejo de Adonis (CA). Se realizó un estudio transversal en 506 sujetos entre 16 y 21 años (M = 18.20; SD = 1.72). La mayor correlación fue entre CA y Control emocional en hombres y control de impulsos en mujeres. Luego se realizó un análisis de regresión logística binaria y el modelo produjo R2 = .176 (X2 = 47.95 (16) <.001) y se clasificó correctamente en el 88.5% de los casos. Los resultados del análisis mostraron que la pasión armoniosa (β= -. 028, p = .046) y el control emocional (β= -.616, p = .002) son variables protectoras mientras que la pasión obsesiva (β= .065, p =. 013) y escrupulosidad (β= .344, p = .046) fueron factores de riesgo. Los resultados muestran la importancia de realizar intervenciones dirigidas a la prevención de la DM, a partir de la relevancia del control emocional de trabajo y la pasión armoniosa en esta etapa de la vida y la formación
A dismorfia muscular (DM) é uma subcategoria do transtorno dismórfico corporal em que os indivíduos desenvolvem uma preocupação patológica pela sua musculatura. A população em risco que sofre ou pode desenvolver DM prevalece em termos de idade de aparecimentoem indivíduos entre 16 a 35 anos; e é mais frequente nos homens. Este estudo teve comoobjetivo determinar quais variáveis da personalidade, identidade de gênero e paixão (harmoniosa ou obsessiva) permitem prever a DM em adolescentes por meio da Escala do Complexo de Adônis (CA). Um estudo transversal foi realizado em 506 sujeitos entre 16 e 21 anos (M = 18,20; SD = 1,72). A maior correlação foi entre CA e Controle Emocional em homens e controle de impulso em mulheres. Em seguida, foi realizada uma análise de regressão logística binária e o modelo rendeu R2 = .176 (X2 = 47,95 (16) <0,001) e classificado corretamente em 88,5% dos casos. Os resultados da análise mostraram que a paixão harmoniosa (β= -.028, p =, 046) e controle emocional (β= -. 616, p = 0,002) são variáveis de proteção, enquanto paixão obsessiva (β= .065, p = .013) e escrupulosidade (β=, 344, p =, 046) foram fatores de risco. Os resultados mostram a importância da realização de intervenções voltadas à prevenção do DM, a partir da relevância do controle emocional do trabalho e da paixão harmoniosa nesta etapa da vida e do treinamento
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Body Dysmorphic Disorders/psychology , Body Image/psychology , Cross-Sectional Studies , Body Dysmorphic Disorders/diagnosis , Sex Factors , Personality Tests , Risk Factors , Muscles/physiology , Emotions/physiologyABSTRACT
BACKGROUND: A recent study shows that a multifaceted strategy using an individualised intra-abdominal pressure titration strategy during colorectal laparoscopic surgery results in an acceptable workspace at low intra-abdominal pressure in most patients. The multifaceted strategy, focused on lower to individualised intra-abdominal pressures, includes prestretching the abdominal wall during initial insufflation, deep neuromuscular blockade, low tidal volume ventilation settings and a modified lithotomy position. The study presented here tests the hypothesis that this strategy improves outcomes of patients scheduled for colorectal laparoscopic surgery. METHODS: The Individualized Pneumoperitoneum Pressure in Colorectal Laparoscopic Surgery versus Standard Therapy (IPPCollapse-II) study is a multicentre, two-arm, parallel-group, single-blinded randomised 1:1 clinical study that runs in four academic hospitals in Spain. Patients scheduled for colorectal laparoscopic surgery with American Society of Anesthesiologists classification I to III who are aged > 18 years and are without cognitive deficits are randomised to an individualised pneumoperitoneum pressure strategy (the intervention group) or to a conventional pneumoperitoneum pressure strategy (the control group). The primary outcome is recovery assessed with the Post-operative Quality of Recovery Scale (PQRS) at postoperative day 1. Secondary outcomes include PQRS score in the post anaesthesia care unit and at postoperative day 3, postoperative complications until postoperative day 28, hospital length of stay and process-related outcomes. DISCUSSION: The IPPCollapse-II study will be the first randomised clinical study that assesses the impact of an individualised pneumoperitoneum pressure strategy focused on working with the lowest intra-abdominal pressure during colorectal laparoscopic surgery on relevant patient-centred outcomes. The results of this large study, to be disseminated through conference presentations and publications in international peer-reviewed journals, are of ultimate importance for optimising the care and safety of laparoscopic abdominal surgery. Selection of patient-reported outcomes as the primary outcome of this study facilitates the translation into clinical practice. Access to source data will be made available through anonymised datasets upon request and after agreement of the Steering Committee of the IPPCollapse-II study. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02773173 . Registered on 16 May 2016. EudraCT, 2016-001693-15. Registered on 8 August 2016.
Subject(s)
Colon/surgery , Digestive System Surgical Procedures/methods , Laparoscopy , Pneumoperitoneum, Artificial/methods , Rectum/surgery , Colon/physiopathology , Digestive System Surgical Procedures/adverse effects , Humans , Laparoscopy/adverse effects , Length of Stay , Multicenter Studies as Topic , Pneumoperitoneum, Artificial/adverse effects , Postoperative Complications/etiology , Pressure , Randomized Controlled Trials as Topic , Recovery of Function , Rectum/physiopathology , Single-Blind Method , Spain , Time Factors , Treatment OutcomeABSTRACT
Estudio: Estudio descriptivo del consumo de tabaco en la adolescencia, que forma parte de un estudio más amplio sobre un estilo de vida saludable en la adolescencia temprana e intermedia. Personas y métodos. Profesores de educación física estudiaron a 1.112 adolescentes de 10 a 17 años de edad de los centros educativos mediante una encuesta de hábitos saludables y pruebas objetivas antropométricas y de condición física. Resultados. El 9% (IC-95%: 7,4% a 10,8%) de los adolescentes han fumado alguna vez, solo el 4,7% cuando no fuma ninguno de sus padres, el 12,6% cuando solo fuma uno de ellos y el 15,4% (IC-95%: 10,7% a 21,8%) cuando fuman ambos padres. El contacto con el tabaco empieza al inicio de la adolescencia, va aumentando hasta el 40,9% en los varones de 17 años y el 50,0% en las mujeres de igual edad. Las mujeres empiezan algo más tarde (13,8 años, IC-95%: 13,3 a 14,3) que los varones (12,7 años, IC-95%: 11,8 a 13,6), pero fuman más (5,1 cig/día, DE = 2,6) que los varones (4,4 cig/día, DE = 2,9). Actualmente fuma el 7,7% (IC-95%: 6,3% a 9,5%), unos ocasionalmente y otros habitualmente, con un consumo medio de 4,7 (DE = 2,74) cigarrillos diarios, dedicando las mujeres una media de 7,3 euros/sem (DE = 4,56) mientras que los varones solo 6,1 euros/sem (DE = 5,15). El 65,1% de los adolescentes piensan que el tabaco limita su actividad física, aunque no se evidencia en las pruebas de condición física, excepto en la prueba de course-navette en la que los varones fumadores rinden menos. Los fumadores duermen significativamente menos que los no fumadores (casi una hora menos los días laborables). Los fumadores valoran peor su satisfacción corporal, tanto los chicos (p = 0,013) como las chicas (p < 0,001). Otro hallazgo en este estudio es el distinto patrón en el test EnKid de alimentación sana, en el que los fumadores toman más bollería industrial, más alcohol, más comidas en fast-food y más chucherías, mientras que los no fumadores desayunan, desayunan un lácteo y un cereal, toman frutas a diario y toman verduras. No se observó asociación entre el estado nutricional y el hábito tabáquico y sí con el hábitat urbano. Conclusiones. El hábito tabáquico empieza en la primera etapa de la adolescencia, se consolida en la etapa intermedia y se caracteriza por su mayor predominio en las mujeres. Dicho hábito se asocia con dormir menos y cambios hacia una alimentación menos saludable y con una menor resistencia en las pruebas anaerobias en los varones
Aims: To analyze tobacco consumption, by age and sex, in primary and secondary school adolescents in Cantabria. Methodology. A cross-sectional study was carried out, analyzing a sample of 1,112 adolescents: 574 (51.6%) were men and 538 (48.4%) were women, aged between 10 and 17, attending 16 different primary and secondary education public centres in Cantabria, by means of a health habit questionnaire, objective anthropometric and physical condition trials. Results. 9% of adolescents from 10 to 17 years old have smoked sometime; only 4.7% of them do it when their parents are non-smokers, but this percentage rises to 12.6% when one of the two parents is a smoker and to 15.4% when both parents are smokers. The first contact with tobacco is at the beginning of adolescence and it is increases to 40.9% in 17 years old males and to 50.0% in females of the same age. The 7.7% of adolescents are current smokers, some of them are occasional users, but others are frequent users with an average consumption of 4.7 cigarettes per day. This consumption means an average expense of 7.3 euros per week in females and 6.1 euros in males. 65% of adolescents think tobacco limit their physical activity. Smokers sleep less than non-smokers; moreover, those have a worse valuation of their self-image. Finally, smokers eat more factory-produced cakes, rolls and buns, fast food and sweet candy, and consume more alcohol than non-smokers. Conclusions. The tobacco habit begins in the first stage of adolescence. It is consolidated at the intermediate stage and it is characterized by its greater predominance in females. This habit is associated with fewer hours of sleep and with changes towards a less healthy nutrition and less anaerobic trials resistance in males
Subject(s)
Humans , Male , Female , Child , Adolescent , Tobacco Use Disorder/epidemiology , Tobacco Use Disorder/prevention & control , Smoking/epidemiology , Smoking/prevention & control , Life Style , Anthropometry/methods , Body Image , Obesity/complications , Cross-Sectional Studies/methods , Surveys and Questionnaires , 28599ABSTRACT
Introducción: Con la Ley 14/2007 de 3 de julio de Investigación Biomédica se establece la obligación del consentimiento informado así como el informe favorable del Comité Ético de Investigación Clínica (CEIC). No existen publicaciones dentro del ámbito de la Farmacia Comunitaria que aborden este tema, por eso hemos realizado esta revisión. Objetivos: Evaluar y describir la prevalencia de artículos publicados en España sobre Farmacia Comunitaria con Consentimiento Informado y la aprobación del CEIC en el año 2015. Método: Se analizó una muestra de ren Pubmed utilizando el término MESH «community pharmacy services», en el año 2015. Se realizó una búsqueda en revistas más leidas en este campo (Pharmaceutical Care España, Farmacéuticos Comunitarios, Ars Pharmaceutica, Pharmacy Practice) y webs especializadas (web del Grupo de Investigación del Grupo de Atención Farmacéutica de la Universidad de Granada, web de la Cátedra de Atención Farmacéutica de la Universidad de Granada). En las fuentes anteriormente citadas se seleccionó una muestra de todos los artículos correspondientes al año 2015. Se excluyeron los estudios realizados fuera de España, casos clínicos, los informes de opiniones, las editoriales, las revisiones y los estudios realizados fuera del ámbito de farmacia comunitaria. De los 268 artículos se seleccionó una muestra de 23. Se realizó una estadística descriptiva. Las variables cualitativas se describen mediante porcentajes con intervalos de confianza según el método recomendado de Wilson. Resultados: Un 65,2% de los estudios incluidos en la muestra seleccionada no presentaron consentimiento informado previo a los pacientes. De todas las publicaciones revisadas un 87,0% no presenta la aprobación del CEIC (Comité Ético de Investigación Clínica). Conclusiones: La prevalencia de consentimiento informado previo así como la aprobación del CEIC es baja en la muestra utilizada. Son necesarios más estudios que apoyen el resultado de este trabajo
Introduction: The Act 14/2007 of 3 July about Biomedical Research establishes the requirement for Informed Consent as well as the favorable report of the Clinical Research Ethics Committee (CREC). In the Community Pharmacy scope, there is a lack of publications that deal with this issue. Therefore, we have carried out this review. Objectives: To evaluate and describe the prevalence of articles published in Spain about Community Pharmacy with Informed Consent and the endorsement of the CREC in 2015. Methods: In 2015, a sample of PubMed was analyzed using as search term «community pharmacy services». It was done a search among the most widely read magazines of this field (Pharmaceutical Care España, Farmacéticos Comunitarios, Ars Pharmaceutica and Pharmacy Practice) and specialized websites (the web of the Research Group of the Phamaceutical Care of the University of Granada (Spain), the web of the Pharmaceutical Care Chair of the University of Granada (Spain). In the sources above mentioned, a sample of all the articles of 2015 was chosen. All the studies done outside Spain, the clinical cases, the opinion reports, the editorials, the reviews and the studies done outside the scope of the Community Pharmacy were excluded. Among the 268 articles, a sample of 23 was chosen. It was carried out a descriptive figure. The qualitative variables are described through percentages with confidence intervals according to the recommended method of Wilson. Results: 65.2% of the studies included in the chosen sample didnt offer previous Informed Consent to patients. Among all the publications reviewed, 87.0% didnt have the endorsement of the CREC (Clinical Research Ethics Committee). Conclusions: In the sample used, the prevalence of the previous Informed Consent just as the endorsement of the CREC is low. More studies that support the result of this review are needed
Subject(s)
Humans , Community Pharmacy Services , Ethics, Research , Informed Consent/ethics , Ethics Committees, Research/organization & administration , Bioethics/trends , Periodicals as Topic/ethicsABSTRACT
Objetivo: Analizar determinadas prácticas alimentarias en adolescentes escolarizados en centros de educación pública de Cantabria, participantes en el Proyecto 'Promoción de Hábitos Saludables en Adolescentes desde el Ámbito Educativo'. Sujetos: Se realizó un estudio transversal, analizando una muestra de 1.101 adolescentes: 568 (51,6%) varones y 533 (48,4%) mujeres, de edades comprendidas entre los 10 y los 17 años, escolarizados en dieciséis centros de enseñanza primaria y secundaria, mediante un cuestionario autocumplimentado. Resultados: Los adolescentes suelen realizar entre cuatro (41,5%) y cinco (31,6%) ingestas diarias. Durante los días de colegio, el 34% emplea entre diez y quince minutos en desayunar, y entre 30 y 35 minutos en comer (33,5%) y cenar (23%). Un elevado porcentaje (49,4%) de adolescentes desayunaba en soledad durante los días lectivos. Las principales ingestas alimenticias se realizan en el hogar. Las bebidas no alcohólicas (53,6%) y los dulces (42%) son los principales destinos de su dinero de bolsillo. En la casi totalidad de los hogares, es la madre la que se encarga de la compra de los alimentos, de la preparación de las comidas y de decidir tanto el almuerzo como la merienda. La pizza (72,6%) y las patatas fritas (70,8%) son los alimentos considerados más ricos entre los analizados, mientras que el perrito caliente (49,4%) y la hamburguesa (48,5%) son considerados como los menos sanos. El 58,6% de los encuestados cena viendo la televisión. Conclusión: En el estudio del comportamiento alimentario es necesario analizar la influencia de otros factores que, en muchas ocasiones, están detrás de las recomendaciones dietéticas y que casi siempre son ignorados. Prácticas alimentarias como las analizadas en el presente estudio, permiten, cuando estas se desarrollan de forma adecuada, una mejora sustancial en la salud alimentaria y nutricional de las personas
Objetive: To analyse some food practices, by age and sex, in primary and secondary schools adolescents in Cantabria, who are participating in the "Adolescents Health Habits Promotion since Education field" project. Methodology: A cross-sectional study was carried out, analysing a sample of 1101 adolescents: 568 (51.6%) were men and 533 (48.4%) were women, aged between 12 and 17, attending 16 different primary and secondary education centers in Cantabria, by means of questionnaire. Results: Adolescents usually eats between 4 and 5 times a day. They use between 10 to 15 minutes in having breakfast, between 30 to 35 minutes in having lunch and dinner on school days. A high percentage have breakfast alone on school days. The main eats were carried on at home. Soft drinks and sweet are the main purchase with their pocket money. Almost always, the mother is charged of buying the foods, preparing the meals and decide the morning and the afternoon snacks. Pizza and fried potatoes are considerated as most taste, whereas hot dog and hamburger are considerated as less healthy. The 58.6% of adolescents having dinner watching television. Conclusions: In the food behavior study, it is necessary to analyse the influence of other factors which, in many occasions, are behind of dietetic recommendations and the almost always are ignored. Food practices as we have analysed permit, when these are carry out in a right way, an important improve in the people nutritional health
Subject(s)
Humans , Adolescent , Feeding Behavior , Feeding Behavior , Food and Nutrition Education , Adolescent Behavior , Adolescent NutritionABSTRACT
En este trabajo se tratan los aspectos éticos más importantes relacionados con la investigación en humanos. En primer lugar, se diferencia entre práctica clínica e investigación clínica. Se refieren los tres principios éticos aplicables a la investigación en humanos: autonomía, beneficencia y justicia; se presenta el papel del Comité ético de Investigación Clínica como salvaguarda en la investigación en humanos. En segundo lugar, se presentan las principales características de la Hoja de Información al Paciente y de la Hoja de Firma del Consentimiento Informado. Finalmente, se comenta brevemente la Declaración de Helsinki
In this article the most important ethical issues surrounding human research are discussed. First, the difference between clinical research and clinical practice. The three ethical principles governing research on human studies: autonomy, beneficence and justice; the role of the ethics committee for clinical research as a safeguard in human research is presented. Second, the main characteristics of the participant informed consent, and patient information sheet. Finally, we briefly discuss Helsinki declaration
Subject(s)
Biomedical Research/ethics , Biomedical Research/legislation & jurisprudence , Ethics Committees, Clinical/legislation & jurisprudence , Ethics Committees, Research , Ethics, Pharmacy , Informed Consent/legislation & jurisprudence , Bioethics/history , Confidentiality , Consent Forms , Helsinki Declaration , Human Experimentation/ethics , Human Experimentation/historyABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Obesity/prevention & control , Obesity/epidemiology , Pharmaceutical Services , Anti-Obesity Agents/therapeutic use , Epidemiological Monitoring/trends , Feeding and Eating Disorders , Obesity/therapy , Feeding Behavior , Exercise , Spain/epidemiologyABSTRACT
Seventeen Middle Pleistocene crania from the Sima de los Huesos site (Atapuerca, Spain) are analyzed, including seven new specimens. This sample makes it possible to thoroughly characterize a Middle Pleistocene hominin paleodeme and to address hypotheses about the origin and evolution of the Neandertals. Using a variety of techniques, the hominin-bearing layer could be reassigned to a period around 430,000 years ago. The sample shows a consistent morphological pattern with derived Neandertal features present in the face and anterior vault, many of which are related to the masticatory apparatus. This suggests that facial modification was the first step in the evolution of the Neandertal lineage, pointing to a mosaic pattern of evolution, with different anatomical and functional modules evolving at different rates.
Subject(s)
Fossils , Neanderthals/anatomy & histology , Neanderthals/genetics , Skull/anatomy & histology , Animals , Brain/anatomy & histology , Extinction, Biological , Genetic Drift , Humans , Organ Size , Reproductive Isolation , SpainABSTRACT
OBJECTIVE: To analyse nutritional risk, by age and sex, among primary and secondary education adolescents from Cantabria. METHODOLOGY: a cross-sectional study was carried out, analysing a sample of 1101 adolescents: 568 (51.6%) were men and 533 (48.4%) were women, aged 12 to 17, attending 16 different primary and secondary education centres in Cantabria, by means of a Krece Plus questionnaire. RESULTS: A high percentage of adolescents with a high nutritional risk (35%) can be observed. Men show a high nutritional risk slightly higher than women (37.8% male vs 32.1% female). Moreover, the high nutritional risk experiences a notable increase as young people get older. Significant statistical differences can be seen both in male and female groups, and as a global group. In all three cases, the nutritional risk distribution in the youngest group is very similar (35.2-35.8% in male, 27.9-29.7% in female, 31.7-32.7% in the global group); whereas in elder adolescents, those values are practically doubled (57.1% in male, 69.0% in female, y 62.2% in the global group). CONCLUSIONS: Results are alarming mainly given the high percentage of adolescents with a high nutritional risk. Men and older adolescents are the groups in which high nutritional risk is more evident.
Objetivo: Evaluar el riesgo nutricional, por edad y sexo, que presentan los adolescentes escolarizados en la Comunidad Autónoma de Cantabria. Sujetos: Se realizó un estudio transversal, analizando una muestra de 1101 adolescentes, de los que 51,6% eran varones y 48,4% fueron mujeres de edades comprendidas entre los 10 y los 17 años, escolarizados en centros de enseñanza pública, mediante el cuestionario Krece Plus. Resultados: Se observa un elevado porcentaje de adolescentes que presentan un riesgo nutricional elevado (35%). Los varones presentan un riesgo nutricional alto en un porcentaje ligeramente superior a las mujeres (37,8 % vs 32,1%). Además, el riesgo nutricional alto sufre un notable incremento a medida que la edad de los jóvenes aumenta. Se aprecian diferencias estadísticamente significativas tanto en los grupos de edad de los varones (p = 0,024), de las mujeres (p < 0,001) como en el grupo global (p = 0,001). En los tres casos, la distribución del riego nutricional en los grupos de menor edad es muy similar (entre 35,2 y 35,8% en los h, entre 27,9 y 29,7% en las m, y entre 31,7 y 32,7% en el grupo total). Mientras que en el grupo de mayor edad estos valores prácticamente se duplican (57,1% en los h, 69,0% en las m, y 62,2 % en el grupo total). Conclusión: Los resultados obtenidos muestran una realidad preocupante debido, principalmente, al elevado porcentaje de adolescentes que presentan un riesgo nutricional elevado. Siendo los varones y los adolescentes de mayor edad los sectores en los que este riesgo nutricional elevado es superior.
Subject(s)
Malnutrition/epidemiology , Nutritional Status , Adolescent , Age Factors , Child , Cross-Sectional Studies , Female , Humans , Male , Malnutrition/diagnosis , Risk Assessment , Sex Factors , Spain/epidemiologyABSTRACT
Objetivo: Evaluar el riesgo nutricional, por edad y sexo, que presentan los adolescentes escolarizados en la Comunidad Autónoma de Cantabria. Sujetos: Se realizó un estudio transversal, analizando una muestra de 1101 adolescentes, de los que 51,6% eran varones y 48,4% fueron mujeres de edades comprendidas entre los 10 y los 17 años, escolarizados en centros de enseñanza pública, mediante el cuestionario Krece Plus. Resultados: Se observa un elevado porcentaje de adolescentes que presentan un riesgo nutricional elevado(35%). Los varones presentan un riesgo nutricional alto en un porcentaje ligeramente superior a las mujeres (37,8% vs 32,1%). Además, el riesgo nutricional alto sufre un notable incremento a medida que la edad de los jóvenes aumenta. Se aprecian diferencias estadísticamente significativas tanto en los grupos de edad de los varones (p =0,024), de las mujeres (p < 0,001) como en el grupo global(p = 0,001). En los tres casos, la distribución del riego nutricional en los grupos de menor edad es muy similar(entre 35,2 y 35,8% en los h, entre 27,9 y 29,7% en las m, y entre 31,7 y 32,7% en el grupo total). Mientras que en el grupo de mayor edad estos valores prácticamente se duplican (57,1% en los h, 69,0% en las m, y 62,2 % en el grupo total).Conclusión: Los resultados obtenidos muestran una realidad preocupante debido, principalmente, al elevado porcentaje de adolescentes que presentan un riesgo nutricional elevado. Siendo los varones y los adolescentes de mayor edad los sectores en los que este riesgo nutricional elevado es superior (AU)
Objective: To analyse nutritional risk, by age and sex, among primary and secondary education adolescents from Cantabria. Methodology: a cross-sectional study was carried out, analysing a sample of 1101 adolescents: 568 (51.6%) were men and 533 (48.4%) were women, aged 12 to 17,attending 16 different primary and secondary education centres in Cantabria, by means of a Krece Plus questionnaire. Results: A high percentage of adolescents with a high nutritional risk (35%) can be observed. Men show a high nutritional risk slightly higher than women (37.8% h vs32.1% m). Moreover, the high nutritional risk experiences a notable increase as young people get older. Significant statistical differences can be seen both in male and female groups, and as a global group. In all three cases, the nutritional risk distribution in the youngest group is very similar (35.2-35.8% in h, 27.9-29.7% in m, 31.7-32.7% in the global group); whereas in elder adolescents, those values are practically doubled (57.1% in h, 69.0% in m, y62.2% in the global group).Conclusions: Results are alarming mainly given the high percentage of adolescents with a high nutritional risk. Men and older adolescents are the groups in which high nutritional risk is more evident (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Nutrition Assessment , Nutritional Status , Nutrition Disorders/epidemiology , School Feeding , Nutritional Requirements , Risk Factors , Risk Adjustment/methods , Age and Sex Distribution , Nutrition SurveysABSTRACT
Se trata de la descripción de la imagen corporal en un amplio grupo de alumnos escolarizados en Cantabria (n=1179 adolescentes), de 10 a 17 años de edad (adolescencia temprana e intermedia) dentro de un estudio más amplio encaminado a evidenciar un estilo de vida saludable en estos adolescentes, llevado a cabo por profesores de universidad y profesores de educación física de los centros educativos. Los principales hallazgos consisten en que los adolescentes tienen, en general, una buena imagen de sí mismos y, aunque no reconocen la elevada prevalencia de sobrepeso y obesidad, desean adelgazar y el grado de satisfacción que tienen con su imagen corporal va empeorando conforme avanza la adolescencia, significativamente más en las del sexo femenino. Esta insatisfacción debe ser tenida en cuenta en el abordaje de los adolescentes con obesidad
This paper describes the body image in an large group of students from Cantabria, Spain (n=1179 adolescents), 10 to 17 years old (early and intermediate adolescence) within a ampler study directed to demonstrate a healthful lifestyle in these adolescents carried out by professors of university and professors of physical education of the educative centers. The main findings are that the adolescents have, generally, a good self-image, and although they do not recognize the high prevalence of overweight and obesity, they wish to become thin and the satisfaction degree that they have with his body image is getting worse as advances the adolescence, significantly more in girls. This dissatisfaction must be considered in the boarding of the adolescents with obesity
Subject(s)
Humans , Male , Female , Child , Adolescent , Body Image/psychology , Self Concept , Obesity/psychology , Overweight/psychology , Personal SatisfactionABSTRACT
Introducción: El estudio de interacciones farmacológicas en la farmacia comunitaria no está integrado en el día a día del profesional farmacéutico. Una de las principales barreras para lograrlo ha sido la falta de un historial farmacoterapéutico único. Se sabe que este tipo de problema relacionado con los medicamentos tiene un elevado impacto sobre la salud de los pacientes, asociado a la efectividad o seguridad de éstos, así como un gran coste económico para el sistema sanitario. Objetivos: Calcular la prevalencia de interacciones farmacológicas en usuarios de receta electrónica; clasificar las interacciones según su gravedad, según su evidencia y por su recomendación en la intervención; buscar factores asociados a la aparición de interacciones farmacológicas. Material y métodos: Se incluyó a todos los pacientes con dos o más medicamentos distintos prescritos con receta electrónica. Se evaluaron las interacciones de la receta electrónica utilizando la base de datos Bot PLUS y Medinteract. Resultados: Entre los 285 pacientes incluidos, 38 presentan una o más interacciones de carácter grave, cuya prevalencia fue del 13,3% (intervalo de confianza del 95%: 13,3-19,8). El 87,8% de las interacciones graves estaban documentadas. La interacción grave más frecuente fue la asociación de antiinflamatorios no esteroideos y ácido acetilsalicílico. Conclusiones: La prevalencia de interacciones farmacológicas graves es elevada. El uso de la receta electrónica agiliza y facilita su identificación (AU)
Introduction: The identification of pharmacological drug-interactions is not integrated in the daily practice of the community pharmacy. The main barrier has always been the lack of a complete patient medication record. It is known that this drug-related problem has a great economic and social impact. Objectives: To know the potential drug interactions in a community pharmacy on patients using electronic prescription. To assess their severity, recommendations and the clinical evidence. Methods: Prevalence study. The study took place in a community pharmacy with patients who acquires two or more electronic prescriptions. Potential drug interactions were checked by two database, Bot PLUS and Medinteract. Main results: 285 patients were included. Among these patiens 38 had one or more fatal interactions. The prevalence of these fatal interactions was 13.3% (95%CI: 13.3-19.8). 87.8% of the fatal interactions were documented. Interaction between antiinflamatory drugs and salycilic acid was of high prevalence. Conclusions: There is a high prevalence of fatal drug interactions between patients using electronical prescription. The use of this system makes easy the identification and prevention of interactions by the pharmacists (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Drug Interactions/physiology , Pharmacies/organization & administration , Electronic Prescribing/standards , Drug Therapy, Computer-Assisted/instrumentation , Drug Therapy, Computer-Assisted/methods , Drug Therapy, Computer-Assisted , Drug Therapy, Computer-Assisted/trends , Confidence Intervals , Primary Health Care/methods , Primary Health Care/organization & administrationSubject(s)
Humans , Female , Child , Renal Insufficiency/complications , Renal Insufficiency/diagnosis , Renal Insufficiency/drug therapy , Malaria/complications , Malaria/diagnosis , Malaria , Dexamethasone/therapeutic use , Renal Insufficiency/physiopathology , Anemia/complications , Anemia/diagnosis , Amoxicillin/therapeutic use , Diagnosis, DifferentialSubject(s)
Acute Kidney Injury/parasitology , Malaria/complications , Child, Preschool , Female , HumansSubject(s)
Embolization, Therapeutic/methods , Hemorrhage/etiology , Hemorrhage/therapy , Intraoperative Complications/etiology , Intraoperative Complications/therapy , Renal Artery/diagnostic imaging , Renal Artery/injuries , Adolescent , Biopsy/adverse effects , Female , Humans , Kidney/pathology , RadiographyABSTRACT
OBJECTIVE: To evaluate the functional outcomes and complications among a series of second in comparison to first kidney transplantations in pediatric patients. MATERIALS AND METHODS: We reviewed 163 consecutive kidney transplants in pediatric recipients performed from 1978 to present: 120 cases (69.3%) were first transplants (group A) and 43 (24.8%), second transplant (group B). We analyzed the incidences of delayed graft function (DGF), medical and surgical complications, as well as medium- and long-term graft survivals. RESULTS: We observed DGF among 51 group A patients (43%) versus 32.5% of group B. Ten patients suffered vascular complications in group A (8.3%) versus one in group B (2.3%) (P < .05). The 15-year graft survivals were 54.2% for group A and 45% for group B. The 15-year patient survivals were 84.9% in group A versus 93.6% in group B. CONCLUSIONS: Second kidney transplantations for children are a satisfactory option that achieves good functional results as well as acceptable graft and patient survivals.
Subject(s)
Kidney Transplantation , Reoperation , Child , Graft Rejection , Graft Survival , Humans , Medical Audit , Treatment OutcomeABSTRACT
INTRODUCTION: Chronic kidney disease (CKD) affects the daily life of the child especially during the stage where their personal development takes place. Adult renal patients have a demonstrated worse health related quality of life (HRQL) mainly under hemodialysis (HD), however there are few published data about HRQL in children with CKD, most of them obtained after patient s childhood or with generic tests that do not discriminate changes in a specific disease. OBJECTIVE: To assess how our patients perceive their health by measuring the HRQL and its most affected domains. To determine how the different therapies affect the child with CKD and the agreement on the opinion between children and their parents. MATERIAL AND METHODS: We included 71 CKD children and their parents in a cross-sectional study (33 transplanted, 11 peritoneal dialysis [PD], 5 HD, 22 conservative treatment). We used a specific quality of life test for CKD children that we had previously developed (TECAVNER). If the child was younger than 9 years, only their parents completed the survey. RESULTS: children on HD refer a worse HRQL followed by those who underwent PD and those transplanted. The best HRQL was obtained in children with conservative treatment. Both parents and children agree that the domains more frequently affected are physical activity and school attendance especially those on HD. The way the adolescents 15 years and older perceived their health was similar to that of their parents. This was not the case in the younger group, 9 through 15 ears.