Clinically Relevant Topics and New Tendencies in Childhood Nutrition during the First 2 Years of Life: A Survey among Primary Care Spanish Paediatricians.

A multicenter cross-sectional study was conducted among 245 experienced Spanish paediatricians, who completed an online survey based on clinically relevant topics in nutrition during the first two years of life and their recommendations to parents in daily clinical practice. Most participants advise about the choking risk associated with baby-led weaning (BLW) and more than 60% consider that infants can receive an insufficient variety and quantity of nutrients with this practice. The general opinion is that there is a lack of evidence for delaying the introduction of gluten and other allergenic foods in the complementary feeding of healthy infants. Most participants agree/strongly agree that two servings of dairy products are the adequate daily amount in a diversified diet and 93.4% disagree/strongly disagree with the use of vegetal beverages under 1 year of life. There is a general agreement to avoid added salt and sugar before 12 months of life, the consideration that organic foods do not have a better nutritional profile than non-organic ones, and the limitations of vegetarian diets especially for adequate provision of micronutrients. Overall, there is an adequate knowledge of the new trends by paediatricians and younger ones seemed more in favor of them and interested in receiving more information on most topics.

Differences between parents' and paediatricians' perceptions of mild respiratory infections in childhood: contrast study.

Introduction: Mild respiratory infections are a common reason for consultation in paediatrics, both in the emergency department and in primary care clinics. These conditions, mostly viral and self-limiting, have a significant impact on the healthcare system, school and work absenteeism, and family routines. Despite being common and banal illnesses from a medical perspective, they involve a significant concern in families. The main objective of the contrast study was to compare the perceptions of parents and paediatricians regarding mild respiratory infections in childhood and their impact on family conciliation. Materials and methods: Two online, cross-sectional surveys were conducted among Spanish paediatricians and parents with children aged 6 months to 12 years, involving 504 paediatricians and 1,447 families, with questions on attitudes towards visits to the paediatric consultation, care burden of minor pathologies, work, and family conciliation, and treatment and prevention of these illnesses. Results: Results showed significant differences in paediatricians' and parents' perceptions in many aspects. According to 34.5% of paediatricians and 27% of parents, families regularly go to the paediatrician without a scheduled visit. Only 4% of parents report having self-medicated their child, while paediatricians raise this percentage significantly to 48%. Regarding the question: "it is normal for a child to have an average of 4 colds a year," only 25.5% of the surveyed families "strongly agree" unlike to 70.2% of paediatricians. 72.8% of paediatricians "strongly agree" with: "in my opinion, it is good for children to get sick to improve their immune system" reduced to 45.9% of parents. Consultations for minor pathologies represent a "high workload" for 60.9% of paediatricians, while this opinion is agreed by only 18.9% of the parents. Conclusion: Mild respiratory infections in childhood are perceived differently by paediatricians and parents. While paediatricians perceive them as a common and manageable phenomenon, parents tend to show higher concern and demand for medical attention. This study underlines the need to improve communication between paediatricians and parents to align perceptions, optimise the use of the health system resources, and improve the efficiency in the management of these common paediatric illnesses.

Late bedtime combined with more screen time before bed increases the risk of obesity and lowers diet quality in Spanish children.

This cross-sectional study aimed to investigate whether the combination of bedtime and screen time (ST) before bed were associated with obesity and diet quality in toddlers and school-aged children. Parents reported children's bedtimes and ST before bed (0 min, 1-30 min, >30 min). We then defined bed + screen time behavior using bedtime median cut-offs (early [EB] or late [LB]) and ST responses, resulting in four groups: EB-0'ST, EB ≤ 30'ST/LB-0'ST, EB > 30'ST/LB ≤ 30'ST, and LB > 30'ST. For all participants (n = 1133; 5.4 ± 2.7 years, 49.7% girls, 51.9% school-aged) we evaluated body mass index (BMI), diet quality, sleep-related variables, physical activity, and health-related quality of life (HRQoL). Outcome variables were compared across bed + screen time behavior groups, stratified by age group (toddlers and school-aged children) using general linear models for continuous variables, as well as chi-squared tests or logistic regressions for categorical variables. Additionally, we calculated linear p-trends. Analyses were adjusted for sociodemographic variables, BMI, and physical activity (unless the variable was tested). The results showed that toddlers and school-aged children in the LB ≥ 30'ST group were more likely to have overweight/obesity (OR: 3.42 [95%CI:1.41,8.26] and OR: 2.53 [95%CI:1.10,5.03], respectively) than those in the EB-0'ST group. Additionally, toddlers and school-aged children in the EB > 30'ST/LB ≤ 30'ST and LB > 30'ST groups showed significantly lower adherence to the Mediterranean diet compared to the other groups (p < 0.001). Regarding sleep-related outcomes, we observed that the combination of LB and more ST was associated with poorer sleep quality and shorter sleep duration in toddlers and school-aged children (p < 0.001). These findings emphasize the importance of promoting earlier bedtimes and limiting ST before bed as part of obesity prevention strategies for children. Furthermore, such intervention could benefit the quality of children's diet and overall lifestyle.

Rolipram impacts on redox homeostasis and cellular signaling in an experimental model of abdominal aortic aneurysm. / Impacto del tratamiento con rolipram sobre la homeostasis rédox y la señalización celular en un modelo experimental de aneurisma de aorta abdominal.

INTRODUCTION: Cyclic nucleotide phosphodiesterases (PDEs) of the PDE4 subfamily are responsible for the hydrolysis and subcellular compartmentalization of cAMP, a second messenger that modulates vascular functionality. We had shown that PDE4B is induced in abdominal aortic aneurysms (AAA) and that PDE4 inhibition by rolipram limits experimental aneurysms. In this study we have delved into the mechanisms underlying the beneficial effect of rolipram on AAA. METHODS: AAA were induced in ApoE-/- mice by angiotensin II (Ang II) infusion. Aneurysm formation was evaluated by ultrasonography. The expression of enzymes involved in rédox homeostasis was analyzed by real-time RT-PCR and the activation of signaling pathways by Western blot. RESULTS: Induction of PDE4B in human AAA has been confirmed in a second cohort of patients. In Ang II-infused ApoE-/- mice, rolipram increased the percentage of animals free of aneurysms without affecting the percentage of aortic ruptures. Quantitative analyses determined that this drug significantly attenuated aortic collagen deposition. Additionally, rolipram reduced the increased Nox2 expression triggered by Ang II, exacerbated Sod1 induction, and normalized Sod3 expression. Likewise, PDE4 inhibition decreased the activation of both ERK1/2 and the canonical Wnt pathway, while AKT activity was not altered. CONCLUSIONS: The inhibition of PDE4 activity modulates the expression of enzymes involved in rédox homeostasis and affects cell signaling pathways involved in the development of AAA.

[Early life nutrition and immunity]. / Nutrición e inmunidad en las primeras etapas de la vida.

Introduction: The first 1,000 days of life, from conception to two years of age, are a critical time window for human growth and development, since the interaction of different factors can generate relevant changes in different structures and functions of the organism, both at short and long term. Most of the studies in this area have been carried out in the prenatal and neonatal period. Some of the most relevant factors that can affect immune development at this time are smoking, maternal obesity and inadequate intake of micronutrients during pregnancy. In the case of the postnatal period, breastfeeding is primarily the most important factor related to the nutritional and immunological status of the newborn, also being associated with a protective effect against obesity. Subsequently, the proper introduction of complementary feeding will be essential to offer an adequate percentage of nutrients. Likewise, the intestinal microbiota also plays a key role during this period since it is part of different metabolic, protective, and immunological functions of the host. Fluctuations in homeostasis will condition the appearance of dysbiosis, which is associated with the development of different diseases in childhood, adolescence, and adulthood.

Introducción: Los primeros 1.000 días de vida, que van desde la concepción hasta los dos años, son una ventana de tiempo crítica para el crecimiento y desarrollo humano, ya que la interacción de diversos factores puede generar cambios relevantes en diferentes estructuras y funciones del organismo tanto a corto como a largo plazo. La mayoría de los estudios en este ámbito se han realizado en el periodo prenatal y neonatal. Algunos de los factores más relevantes que pueden afectar el desarrollo inmunitario en esta etapa son el tabaquismo, la obesidad materna y la ingesta inadecuada de micronutrientes durante el embarazo. En el caso de la etapa posnatal, la lactancia materna es en primera instancia el factor más importante relacionado con el estado nutricional e inmunológico del recién nacido, asociándose también con un efecto protector frente a la obesidad. Posteriormente, la introducción apropiada de la alimentación complementaria será fundamental para ofrecer un porcentaje adecuado de nutrientes. Por su parte, la microbiota intestinal también juega un papel clave durante este periodo, ya que interviene en diferentes funciones metabólicas, protectoras e inmunológicas del hospedador. Fluctuaciones en su homeostasis van a condicionar la aparición de disbiosis, la cual se asocia con el desarrollo de diferentes enfermedades, tanto en la niñez como en la adolescencia y también en la edad adulta.

Spanish Pediatricians' Positions Regarding Prevention, Diagnosis, Nutritional Management, and Challenges in Cow's Milk Protein Allergy.

Management of cow's milk protein allergy (CMPA) can vary depending on the experience and area of expertise of the clinician responsible for the patient's follow-up, which may or may not align with the recently published literature. To analyze the perspectives of Spanish pediatricians on this topic, a survey was conducted. The survey aimed to determine the current opinions and attitudes of 222 primary care and hospital pediatricians toward CMPA prevention and nutritional management. Participating pediatricians completed the questionnaire, providing insights into their daily clinical practices, including access to testing, attitudes with respect to various aspects of CMPA diagnosis, prevention, oral food challenges, and treatment. The findings revealed that pediatricians generally agree on the use of extensively hydrolyzed formulas (eHFs) to prevent CMPA in high-risk atopic children, despite limited evidence supporting the widespread use of this practice. However, consensus was lacking regarding the utility of formulas with prebiotics and probiotics for expediting tolerance development. In most cases, pediatricians preferred eHFs for the nutritional management of CMPA, followed by hydrolyzed rice formulas (HRFs), with amino-acid-based formulas (AAFs) being the third option. Certain issues remained controversial among pediatricians, such as prevention methods, symptom assessment, and the role of probiotics. These variations in management approaches reflect the influence of clinician experience and area of expertise, underscoring the need for standardized guidelines in this field.

Post-Pandemic Feeding Patterns and Mediterranean Diet Adherence in Spanish Toddlers.

During the last decade, feeding patterns, more specifically those of children, have worsened-affecting dietary habits and Mediterranean diet adherence. Here, we examine the post-pandemic feeding habits of Spanish toddlers. A total of 2465 parents of children aged between 12 and 36 months completed an online 25-item multiple-choice survey asking about dietary habits and Mediterranean diet adherence. Only 34 children (1.38%) had an adequate intake of all of the food groups included in the questionnaire. Adherence worsened as toddlers grew (p < 0.0001). Further, lower compliance was found in children with a higher intake of fast food (p < 0.001), those with siblings (p = 0.0045), and children who were the second or third child (p = 0.0005). The food group with the most commonly reported adequate intake was fish (88% of children), followed by pulses (80%), water (79%), and meat (78%). Cow's milk was the most commonly consumed dairy product among all age groups analyzed. Half of the children exhibited a low consumption of milk and dairy products. These results showed that a lack of adherence to a balanced diet is common among Spanish toddlers in the post-pandemic period and that greater parent education could improve the nutrition of toddlers.

Impact of the COVID-19 pandemic on the digitization of routine pediatric practice in Spain: A nationwide survey study.

Introduction: The COVID-19 pandemic forced a change in the working dynamics of all healthcare professionals, leading to the sudden introduction of telemedicine. Although until that moment telemedicine applications had been described in the paediatric age, their use was anecdotal. Objective: To analyse the experience of Spanish paediatricians after the forced digitization of consultations due to the pandemic. Methods: A cross-sectional survey-type study was designed to obtain information from Spanish paediatricians about the changes that took place in the usual clinical practice. Results: 306 health professionals participated in the study Most of them agreed on the use of the internet and social networks during the pandemic, referring to mail or WhatsApp® as usual channels of communication with their patients' families. There was a great agreement among paediatricians that the evaluation of newborns after hospital discharge and establishing methodologies that allow childhood vaccination and the identification of subsidiary patients for face-to-face evaluation were necessary although the limitations of the lockdown. The idea that telephone and digital consultations have optimized the consultation time and that they will probably continue after the end of the pandemic was generally accepted. No changes in adherence to breastfeeding or the start of complementary feeding were referred to, but an increase in the duration of breastfeeding and the appearance of frequent hoaxes in social networks concerning infant feeding were found. Conclusions: It is necessary to analyse the impact of telemedicine in paediatric consultations during the pandemic to evaluate its effectiveness and quality to maintain it in routine paediatric practice.

Nutrición e inmunidad en las primeras etapas de la vida / Early life nutrition and immunity

Los primeros 1.000 días de vida, que van desde la concepción hasta los dos años, son una ventana de tiempo crítica para el crecimiento ydesarrollo humano, ya que la interacción de diversos factores puede generar cambios relevantes en diferentes estructuras y funciones delorganismo tanto a corto como a largo plazo.La mayoría de los estudios en este ámbito se han realizado en el periodo prenatal y neonatal. Algunos de los factores más relevantes que puedenafectar el desarrollo inmunitario en esta etapa son el tabaquismo, la obesidad materna y la ingesta inadecuada de micronutrientes durante elembarazo. En el caso de la etapa posnatal, la lactancia materna es en primera instancia el factor más importante relacionado con el estadonutricional e inmunológico del recién nacido, asociándose también con un efecto protector frente a la obesidad. Posteriormente, la introducciónapropiada de la alimentación complementaria será fundamental para ofrecer un porcentaje adecuado de nutrientes.Por su parte, la microbiota intestinal también juega un papel clave durante este periodo, ya que interviene en diferentes funciones metabólicas,protectoras e inmunológicas del hospedador. Fluctuaciones en su homeostasis van a condicionar la aparición de disbiosis, la cual se asocia conel desarrollo de diferentes enfermedades, tanto en la niñez como en la adolescencia y también en la edad adulta. (AU)

The first 1,000 days of life, from conception to two years of age, are a critical time window for human growth and development, since theinteraction of different factors can generate relevant changes in different structures and functions of the organism, both at short and long term.Most of the studies in this area have been carried out in the prenatal and neonatal period. Some of the most relevant factors that can affectimmune development at this time are smoking, maternal obesity and inadequate intake of micronutrients during pregnancy. In the case of thepostnatal period, breastfeeding is primarily the most important factor related to the nutritional and immunological status of the newborn, alsobeing associated with a protective effect against obesity. Subsequently, the proper introduction of complementary feeding will be essential tooffer an adequate percentage of nutrients.Likewise, the intestinal microbiota also plays a key role during this period since it is part of different metabolic, protective, and immunologicalfunctions of the host. Fluctuations in homeostasis will condition the appearance of dysbiosis, which is associated with the development of differentdiseases in childhood, adolescence, and adulthood. (AU)

Sleep dimensions are associated with obesity, poor diet quality and eating behaviors in school-aged children.

Objectives: The aim of this cross-sectional study was to investigate the association between sleep dimensions (duration, patterns, and disturbances) with body mass index (BMI), diet quality, and eating behaviors in school-aged children. Additionally, we aimed to investigate whether obesogenic eating behaviors (higher food responsiveness, lower satiety responsiveness, and less slowness in eating) and poor diet quality could mediate the potential association between sleep and obesity in school-aged children. Materials and methods: For all participants (n = 588 children, age 5-12 years; 51% girls) we evaluated: sleep dimensions, BMI, diet quality, eating behaviors (food responsiveness, satiety responsiveness and slowness in eating). Linear regression models were used to test associations between exposure and outcome variables. Additionally, path analysis was conducted to test whether eating behaviors mediated the relationship between sleep and obesity. Results: Shorter sleep duration (ß = -0.722, p = 0.009) and greater sleep disturbances (ß = 0.031, p = 0.012) were significantly associated with BMI. Additionally, we observed that diet quality was significantly associated with sleep duration (ß = 0.430, p = 0.004), the midpoint of sleep (ß = -0.927, p < 0.001), and sleep disturbances (ß = -0.029, p < 0.001). Among other findings, greater sleep disturbances were associated with food responsiveness (ß = 0.017, p < 0.001), satiety responsiveness (ß = 0.015, p < 0.001), and slowness in eating (ß = 0.012, p < 0.001). Importantly, food responsiveness was found as significant mediator of the relationship between sleep and BMI (R = 0.427, R 2 = 0.182, p < 0.001). Conclusions: Late sleep patterns, short sleep duration, and greater sleep disturbances are significantly related with what and how school-aged children eat. Importantly, poor diet quality was significantly related to all three sleep dimensions, while eating behaviors had a significant relationship with greater sleep disturbances. These findings may be relevant to the development of behavioral targets to prevent childhood obesity, including sleep hygiene guidelines as a strategy to improve children's eating habits, as well as their BMI.

Impact of Omega-3 Fatty Acids Among Other Nonpharmacological Interventions on Behavior and Quality of Life in Children with Compromised Conduct in Spain.

The aim of this study was to assess the impact of omega-3 fatty acid supplementation among other nonpharmacological treatments on mental health and quality of life (QOL) of children with behavioral disorders. An observational multicenter study of 6- to 12-year-old children with behavior-related problems was performed in Spain with a three-month follow-up assessment. The Kidscreen-10 and Strengths and Difficulties Questionnaires (SDQ) were used to assess effectiveness of each intervention. Characteristics of study population were compared with those of the general population. Subanalyses of two homogenous subgroups, who received versus did not receive dietary supplementation with omega-3 fatty acids, were performed. The study included 942 children (69.1% male) with a mean (SD) age of 8.5 (1.8) years. Overall, patients' health status and QOL significantly improved at three months (p < .001). Scores on the SDQ also improved, with significant reductions on all subscales (p < .05). Comparison of SDQ results with the same-age general population showed higher overall scores in the study population (8.5 [5.5] vs. 18.6 [8.1], respectively) and on all the subscales (p < .001 in all cases). The omega-3 fatty acid supplementation subgroup presented greater improvements in each category of SDQ (p < .05), except for the emotion subscale. Omega-3 fatty acid supplementation alone or in combination with other nonpharmacological treatments is effective in improving children's mental health. Overall, nonpharmacological recommendations currently made by pediatricians seem to be effective in improving the perceived health status and patients' QOL and in the reduction of health problems, especially hyperactivity/inattention and conduct problems.

Use of Dietary Supplements among Spanish Pediatricians in Daily Practice: A Cross-Sectional Survey Study.

A cross-sectional survey study was designed to gather information on the use of dietary supplements by Spanish pediatricians. The study questionnaire was completed by 433 pediatricians (62% men, mean age 52.5 years) throughout the country. They also provided data on 10 of their patients (n = 4304) in which synbiotics, immune stimulants, and omega-3 polyunsaturated fatty acids (PUFAs) had been prescribed. Synbiotics were used by 92% of pediatricians, immune stimulants by 80.4%, and omega-3 PUFAs by 75.1%. Synbiotics were mainly used combined with antibiotics (92.6%) and for gastrointestinal disorders (91.2%), immune stimulants to enhance defenses and cold prevention (87.1%), and omega-3 PUFAs to improve symptoms of attention-deficit hyperactivity disorder (ADHD) (84.8%) and concentration (80.1%). Confidence and previous experience with the product (51.6%), composition and indications of the product (43.1%), and tolerability (39.9%) were main factors involved in decision-making. Children treated with omega-3 supplements were significantly older (mean age 7.6 (3.0) years) than those treated with synbiotics (3.9 (3.9) years) or immune stimulants (3.4 (2.8) years) (P < 0.001). Short duration of treatment (<1 month) was significantly more common in the synbiotics group (90.5%), whereas longer duration of treatment (>3 months) was more frequent in the omega-3 group (79.1%). In the immune stimulants group, 60.4% of patients were treated for a period between 1 and 3 months. Clinical improvement was rated by participants as "a lot" in 39% of cases and as "quite" improvement in 50.6%. The overall level of satisfaction was rated as "very satisfied" by 52.1% of participants and as "quite satisfied" by 40.9%. The results show that the use of dietary supplements to improve different conditions, particularly minor disorders, is a widespread clinical practice among Spanish pediatricians. Administration regimens for the three types of supplements, synbiotics, immune stimulants, and omega-3 PUFAs, were consistent with guideline recommendations.

Recomendación de uso de infusiones pediátricas por parte de los profesionales de la salud / Recomendação de uso de infusões pediátricas por profissionais de saúde / Use recommendation of pediatric infusions by health professionals

Pese a su amplia utilización, la información disponible sobre el grado de recomendación en pediatría de infusiones instantáneas por parte de los profesionales de la salud en nuestro país es escasa. El presente estudio tuvo como finalidad analizar esta situación. Los resultados pusieron de manifiesto que este tipo preparados se recomiendan desde edades tempranas (2,9 ± 3,0 semanas), en un 60% de los casos para los trastornos digestivos leves. Se observaron diferencias en la edad de inicio de consumo de las infusiones infantiles, siendo las indicadas para las molestias digestivas las que se introducen en primer lugar. Tanto la mejoría de la evolución de los síntomas como el grado de satisfacción con este tipo productos se consideraron satisfactorios. La conclusión general del presente estudio es que las infusiones instantáneas pediátricas son una opción útil en la mejora de las molestias leves de los lactantes (AU)

Apesar da sua ampla utilização, a informação disponível sobre o grau de recomendação de infusões instantâneas em pediatria, por parte dos profissionais de saúde no nosso país é escassa. O presente estudo teve como objectivo analisar esta situação. Os resultados demonstraram que este tipo de preparações é recomendado desde idades precoces (2,9 ± 3,0 semanas), em 60% dos casos para distúrbios digestivos ligeiros. Foramobservadas diferenças na idade de início de consumo das infusões infantis, sendo as indicadas para os problemas digestivos as que se introduzem em primeiro lugar. Tanto a melhoria da evolução dos sintomas como o grau de satisfação com este tipo de produtos são considerados satisfatórios. A conclusão geral do presente estudo é que as infusões infantis instantâneas são uma opção útil na melhoria dos problemas de saúde ligeiros dos lactentes (AU)

Despite its wide use by health professionals in our country, the information available on the recommendation of herbal instant teas for infants is limited. The aim of the present study was to analyze this situation. Results showed that these preparations are recommended from early ages (2.9 ± 3.0 weeks), in 60% of cases for mild digestive discomforts. Differences were observed in the starting age of consumption of infant teas, those indicated for digestive discomfort being introduced the first. Both, evolution of symptoms improvement and satisfaction degree with this type of products, were considered satisfactory. General conclusion of the present study is that instant pediatric teas are a useful option for infants mild discomforts improvement (AU)

Estudio PROBIT sobre la utilización de probióticos orales en las infecciones vaginales / PROBIT Study about the use of oral probiotics in vaginal infections

Introducción: las infecciones vulvovaginales afectan al 75 % de las mujeres a lo largo de su vida, siendo un motivo recurrente en las consultas de ginecología y observándose generalmente un desequilibrio de la microbiota normal. Por ello, la administración de probióticos y prebióticos orales que contribuyan a la regeneración de la microbiota, parece aumentar la efectividad del tratamiento farmacológico y disminuir la tasa de recidivas. Objetivos: conocer la situación clínica actual de las infecciones vaginales y la utilización de un complemento alimenticio a base de lactobacilos (Lactobacillus crispatus LBV88, Lactobacillus rhamnosus LBV96, Lactobacillus jensenii LBV116 y Lactobacillus gasseri LBV150) y fructooligosacáridos, para el tratamiento coadyuvante de estas infecciones. Métodos: se trata de un estudio observacional de carácter retrospectivo, desarrollado en un periodo de dos años en el que participaron 186 ginecólogos, obteniendo un tamaño de muestra de n=649 casos clínicos (mujeres). Los datos se obtuvieron mediante cuestionarios validados por profesionales y los resultados fueron analizados mediante el programa informático IBM SPSS Statistic 22.0. Resultados: la mayoría de los ginecólogos (57,4 %) reciben más de 20 consultas al mes por infecciones vaginales, con una alta incidencia de recidivas (25-50 % de los casos según el 59,1 % de los expertos). La vía de elección para la administración de probióticos y prebióticos es la oral, con una media (D.T) de 6,4 (2,5) mujeres de cada 10. En los casos en los que se indicó el complemento alimenticio por vía oral, en el 41% fue como coadyuvante en el tratamiento de candidiasis, en el 19,6% como coadyuvante para el tratamiento de vaginosis, el 33,3% de los casos para la prevención de infecciones vaginales de repetición y en un 38,4% para la recuperación y mantenimiento del equilibrio de la microbiota tras procesos infecciosos, combinando la posología indicada por el fabricante y la recomendación personalizada en función de la experiencia de los ginecólogos. En cuanto a la satisfacción de las pacientes, > 90 % de las mujeres afirma que la mejoría al utilizar el complemento alimenticio es alta. Entre las características más valoradas por los ginecólogos, destaca la eficiencia con una media de 9,2 puntos, la tolerabilidad (8,8 puntos), la experiencia previa (8,5 puntos), y el perfil de probióticos utilizados (8,1 puntos). Discusión: los resultados del estudio coinciden con los datos de las sociedades científicas en cuanto a incidencia de infecciones vaginales, perfil del paciente y aparición de recidivas. Además, se refuerza la evidencia de la eficacia de los complementos alimenticios con probióticos y prebióticos como coadyuvantes para el tratamiento de estas infecciones. Aparece la vía oral como preferente para la administración de probióticos y prebióticos y se respeta la posología indicada por el fabricante del complemento en la mayoría de los casos, predominando la preferencia personal y profesional de cada ginecólogo en aquellas ocasiones en los que se indica una pauta diferente. Conclusiones: la administración por vía oral de complementos alimenticios a base de probióticos y prebióticos como coadyuvante del tratamiento de las infecciones vaginales, se muestra como una estrategia eficaz para mejorar la resolución del proceso infeccioso y prevenir la aparición de recidivas mediante la recuperación del equilibrio de la microbiota normal

Introduction: vulvovaginal infections affect 75 % of women throughout their life, being a recurrent issue in the gynecological practices and generally observing an imbalance of the normal microbiota. Thus, the administration of oral probiotics and prebiotics that contribute to regenerate the microbiota, seems to increase the effectiveness of the pharmacological treatment and decrease the recurrence rate. Objectives: knowing the current clinic situation of vaginal infections and the use of a food supplement based on lactobacilli (Lactobacillus crispatus LBV88, Lactobacillus rhamnosus LBV96, Lactobacillus jensenii LBV116 y Lactobacillus gasseri LBV150) and Fructooligosaccharides, for the adjuvant treatment of these infections. Methods: this is a retrospective observational study, developed in a two years period in which 186 gynecologists participated, obtaining a sample size of n=649 clinical cases (women). Data were collected by questionnaires validated by professionals and results were analysed by the IBM SPSS Statistic 22.0 software. Results: most gynecologists (57,4 %) received more than 20 consultations per month due to vaginal infections, with a high recurrence rate (25-50 % of the cases according to 59,1 % of specialists). The route of choice for the administration of probiotics and prebiotics is oral, with a mean (SD) of 6,4 (2,5) women out of every 10. In the cases in which oral administration was indicated for the food supplement, 41 % was as adjuvant in the treatment of candidiasis, 19,6 % as adjuvant for vaginosis treatment, 33,3 % of cases for the prevention of recurrent vaginal infections and 38,4 % for the recovery and maintenance of the microbiota balance after infectious processes, combining the dosage indicated by the manufacturer and personalized recommendations based on the experience of gynecologists. As for patient’s satisfaction, > 90 % of women confirm that the improvement when using the food complement is high. Among the characteristics most valued by gynecologists, it is highlighted efficiency with a mean of 9,2 points, tolerability (8,8 points), previous experience (8,5 points), and the probiotic profile used (8,1). Discussion: The results of the study coincide with scientific societies data regarding vaginal infections incidence, patient profile and recurrences. Besides, evidence of the efficacy of food supplements with probiotics and prebiotics as adjuvants for the treatment of these infections, is reinforced. Oral route of administration appears as a referent for the administration of probiotics and prebiotics and the dosage indicated by the manufacturer is respected in most of the cases, taking into account personal and professional preference of each gynecologist in those cases in which a different dosage is indicated. Conclusions: oral route of administration for food supplements based on probiotics and prebiotics as adjuvants for the treatment of vaginal infections, is shown as an effective strategy to improve the infectious process resolution and to prevent recurrences by recovering the balance of normal vaginal microbiota