Reproducibilidad, correlación y concordancia de un cuestionario abreviado del Dietary Score / Reproducibility, correlation and concordance of the Abbreviated Dietary Score questionnaire

OBJETIVO: El objetivo de este estudio es evaluar la reproducibilidad, la correlación y la concordancia del Dietary Score abreviado (DSa) utilizado en el estudio IBERICAN. MATERIAL Y MÉTODOS: Estudio transversal. Se evaluó la reproducibilidad del DSa mediante una prueba test-retest, evaluando su consistencia interna mediante alfa de Cronbach y la fiabilidad de las mediciones mediante el coeficiente de correlación intraclase (CCI). A partir del cuestionario de frecuencia alimentaria (CFA) del estudio PREDIMED-Plus se evaluó la adherencia a un patrón de dieta mediterránea mediante el DS, valorándose su correlación y concordancia con el DSa. En ambos casos se utilizaron técnicas de regresión lineal, de Bland-Altman e índice de kappa. RESULTADOS: Participaron 142 sujetos, mayoritariamente hombres (56,3%), con una media de edad de 64,6+/-4,9 años. En términos de reproducibilidad, se obtuvo un coeficiente de correlación de Pearson de 0,538; una media de las diferencias de 2,03 puntos y un índice kappa ponderado de 0,400 (IC del 95%=0,295-0,577). El instrumento tuvo buena consistencia interna (alfa de Cronbach=0,699), así como buena fiabilidad (CCI=0,931). El DSa presentó un coeficiente de correlación con el DS de 0,517; una media de las diferencias de 1,19 puntos y un índice kappa ponderado de 0,450 (IC del 95%=0,366-0,532). CONCLUSIONES: El DSa presenta una moderada reproductibilidad y una buena correlación y concordancia con el DS, por lo que puede ser una herramienta útil en Atención Primaria para valorar la adherencia a la dieta mediterránea

OBJECTIVE: The objective of this study was to evaluate the reproducibility, correlation and concordance of the abbreviated Dietary Score (aDS) used in the IBERICAN study. MATERIAL AND METHODS: A cross-sectional study was performed in order to assess the reproducibility of the aDS using a test-retest. Its internal consistency was evaluated using Cronbach's alpha, and reliability of the measurements using the intraclass correlation coefficient (ICC). From the food frequency questionnaire (FFQ) of the PREDIMED-Plus study, adherence to a Mediterranean diet pattern was evaluated using DS, and its correlation and agreement with aDS was assessed. In both cases the lineal regression, Bland-Altman, and kappa index techniques were used. RESULTS: A total of 142 subjects participated, mostly men (56.3%), with a mean age of 64.6+/-4.9 years. In terms of reproducibility, a Pearson correlation coefficient of 0.538 was obtained; a mean of the differences of 2.03 points, and a weighted kappa index of 0.400 (95% CI=0.295-0.577). The instrument had good internal consistency (Cronbach's alpha=0.699), as well as good reliability (CCI=0.931). The aDS had a correlation coefficient with the DS of 0.517, a mean difference of 1.19 points, and a weighted kappa index of 0.450 (95% CI=0.366-0.532). CONCLUSIONS: The aDS has moderate reproducibility and a good correlation and agreement with the DS, so it can be a useful tool in Primary Care to assess adherence to the Mediterranean diet

[Reproducibility, correlation and concordance of the Abbreviated Dietary Score questionnaire]. / Reproducibilidad, correlación y concordancia de un cuestionario abreviado del Dietary Score.

OBJECTIVE: The objective of this study was to evaluate the reproducibility, correlation and concordance of the abbreviated Dietary Score (aDS) used in the IBERICAN study. MATERIAL AND METHODS: A cross-sectional study was performed in order to assess the reproducibility of the aDS using a test-retest. Its internal consistency was evaluated using Cronbach's alpha, and reliability of the measurements using the intraclass correlation coefficient (ICC). From the food frequency questionnaire (FFQ) of the PREDIMED-Plus study, adherence to a Mediterranean diet pattern was evaluated using DS, and its correlation and agreement with aDS was assessed. In both cases the lineal regression, Bland-Altman, and kappa index techniques were used. RESULTS: A total of 142 subjects participated, mostly men (56.3%), with a mean age of 64.6±4.9 years. In terms of reproducibility, a Pearson correlation coefficient of 0.538 was obtained; a mean of the differences of 2.03 points, and a weighted kappa index of 0.400 (95% CI=0.295-0.577). The instrument had good internal consistency (Cronbach's alpha=0.699), as well as good reliability (CCI=0.931). The aDS had a correlation coefficient with the DS of 0.517, a mean difference of 1.19 points, and a weighted kappa index of 0.450 (95% CI=0.366-0.532). CONCLUSIONS: The aDS has moderate reproducibility and a good correlation and agreement with the DS, so it can be a useful tool in Primary Care to assess adherence to the Mediterranean diet.

Improving outcome in congenital diaphragmatic hernia - experience of a tertiary center without ECMO.

BACKGROUND: Congenital diaphragmatic hernia (CDH) has a high mortality rate, representing a therapeutic challenge. Prenatal diagnosis (PND) is essential in defining optimal perinatal strategy, particularly delivery planning. Hospital Pediátrico de Coimbra is the referral centre for all neonatal surgery, particularly CDH, for the central region of Portugal. The aim was to evaluate clinical management and outcome of newborns with CDH. METHODS: An exploratory retrospective study made up of newborns admitted to PICU with CDH was undertaken between January 1995 and December 2014. Two groups were formed based on their year of admission: group A (1995- 2004) and group B (2005- 2014) and were compared. RESULTS: The mean birth weight of the 69 newborns admitted was 2.762 ± 696 g; the median of the gestational age was 38 weeks. Associated malformations were observed in 28 (40.5%) and 15 (21.7%) had a right-sided diaphragm defect. The global mortality was 13.0%; in group A was significantly higher than in group B (22.2 vs 3.0%; p = 0.029). A reduction in mortality throughout the years was confirmed after adjusting for POS score (OR = 0.77; 95% CI: 0.62- 0.96, p = 0.021). PND was made in 30.6% of cases in the group A and 66.7% in the group B (p = 0.03). Tertiary perinatal hospital birth was achieved in 60% of newborns in the group A versus 84.8% in group B (p = 0.022). Maximum fraction of inspired oxygen showed a statistically significant difference between the two study groups (60% vs 40%; p = 0.009). CONCLUSIONS: A significant decrease in mortality was observed throughout the study. The authors highlight the increase in prenatal diagnosis and an improvement in perinatal care with planning delivery as important contributors to these results.

Old sleeping Sicilian beauty: seed germination in the palaeoendemic Petagnaea gussonei (Spreng.) Rauschert (Saniculoideae, Apiaceae).

Petagnaea gussonei (Apiaceae) is a perennial herbaceous species endemic to northeast Sicily (Nebrodi Mountains). It is considered a remnant of the Sicilian Tertiary flora, and is endangered according to the Red List. There is no information in the literature about the germinability of its seeds, even though seed production is know to occur. The aim of this study was to obtain data to better understand seed germination of this species and its biological implications. Thus, several approaches were employed: vitality analyses, gibberellic acid supply, germination and soil microbial flora analyses via end-point and qPCR. The results suggest that seed germination occurs after ca. 1.5 years at a rate of ca. 11%. The seeds can be classified as physiologically dormant, and probably require prolonged cold stratification for germination. Because seed germination is low, it is likely that agamic reproduction represents an important mean for its conservation and survival. These results have important implications for P. gussonei survival and should be considered in possible re-introduction attempts aimed at restoring threatened populations.

Contributions of mature granule cells to structural plasticity in temporal lobe epilepsy.

During the development of epilepsy in adult animals, newly generated granule cells integrate abnormally into the hippocampus. These new cells migrate to ectopic locations in the hilus, develop aberrant basal dendrites, contribute to mossy fiber sprouting, and exhibit changes in apical dendrite structure and dendritic spine number. Mature granule cells do not appear to exhibit migration defects, basal dendrites, and mossy fiber sprouting, but whether they exhibit apical dendrite abnormalities or spine changes is not known. To address these questions, we examined the apical dendritic structure of bromodeoxyuridine (Brdu)-birthdated, green fluorescent protein (GFP)-expressing granule cells born 2 months before pilocarpine-induced status epilepticus. In contrast to immature granule cells, exposing mature granule cells to status epilepticus did not significantly disrupt the branching structure of their apical dendrites. Mature granule cells did, however, exhibit significant reductions in spine density and spine number relative to age-matched cells from control animals. These data demonstrate that while mature granule cells are resistant to developing the gross structural abnormalities exhibited by younger granule cells, they show similar plastic rearrangement of their dendritic spines.

Use of a hydrocapillary dressing in the management of highly exuding ulcers: a comparative study.

OBJECTIVE: To evaluate the safety and performance of Alione Hydrocapillary dressing (Coloplast A/S) in the management of highly exuding chronic venous leg ulcers and compare it with two hydropolymer dressings,Tielle and Tielle Plus (Johnson & Johnson). METHOD: A comparative clinical trial was conducted on 97 patients with an ankle brachial pressure index > or = 0.8 and a highly exuding leg ulcer. Ulcer duration was at least four weeks. Treatment continued until healing or for a maximum of 12 months. RESULTS: There was no statistically significant difference in healing time or wound area reduction between the two treatment protocols. The test dressing (Alione Hydrocapillary) had better absorption capacity and was more comfortable for the patients than the comparator dressings (Tielle/Tielle Plus) and adhered less to the wound bed.Also, more patients preferred the test dressing to their previous treatment. Although severe leakage and maceration were observed more frequently in the comparator group compared with the test group, this was not statistically significant. CONCLUSION: Both treatment protocols were safe and effective in treating highly exuding chronic venous leg ulcers. The test dressing performed as well as or better than the comparator dressings for all study parameters and more patients preferred the test dressing to their previous dressing compared with the comparator dressings.

Novel approach for spastic hemiplegia classification through the use of support vector machines.

The use of computer based classification methods for spastic hemiplegia (SH) is a relatively new approach. Before and still, the classification is primarily done by specialized physicians through manual template matching on kinematics plots of the sagittal plane data from the affected limb generated by gait laboratories. In the past, several methods for computer based automation of this classification have been attempted. This paper introduces the use of support vector machine (SVM) as a model that contributes to this process. The results obtained from the use of SVM are quite efficient considering the data set utilized involves patients from an array of ages and both sex. It should be mentioned that even though the number of patients is not trivial; the percentages of accurate classification represented are promising. Since the SVM method improves its accuracy with an increased number of training cases, this approach has the advantage of becoming more accurate with time. Many more significant discoveries are expect from the introduction of SVM in the analysis of SH and further studies of gait related pathologies are expected to contribute as well.

[Treatment of chronic skin lesions]. / Tratamiento de las lesiones cutáneas crónicas.

Leg Ulcers as well as Pressure Sore Ulcers are a pathology, although considered different due to their ethiology, that have a common denominator of the possibility to be healed using a moist wound healing environment. Taking advantage of this interesting therapeutic alternative, a multicentric, open, prospective study was carried out in order to evaluate the behaviour and efficiency of the new alveolar tridimensional structure hydropolymetric dressing, in the treatment of both leg ulcers and pressure sore ulcers, all with moderate to high exudate. The results obtained confirm the efficiency of the dressing in the pathology studied, along with the high acceptance of the hydropolimetric dressing chosen by the professionals and the excellent adaptation to the patients needs.

[Pure calcium-sodium alginate dressing. Multicenter evaluation of chronic cutaneous lesions]. / Apósito de alginato cálcico-sódico puro. Evaluación multicéntrica en lesiones cutáneas crónicas.

By means of a descriptive, non-comparative study of a series of clinical cases, the authors analyze the behavior of a dressing of pure calcic-sodium alginate with a stabilizing network in the treatment of pressure sores and profusely bleeding and/or infected vascular uclers. Based on the results of their studies, the authors confirm the effectiveness of this dressing under these conditions: no adverse reactions; the shrinking of the lesion in area or degree of severity; if there is tissue debridement accompanied by sloughing and necrotic tissue, the elimination of infection; ease of application and the reduction of the lesions; use as part of a non-daily cure treatment plan.

C-MOPP/ABV yields good results in a public hospital population with Hodgkin disease in Brazil.

BACKGROUND: Over the last 15 years, a number of combination chemotherapy regimens have been reported to induce more than 80% complete remissions (CR) in patients with advanced Hodgkin disease (HD). Almost all such studies have been conducted in large institutions from North America and Europe. It remains to be proven, however, that those regimens are equally effective for the larger population of patients with HD who live in very different social conditions in third-world countries. METHODS: Fifty-nine patients with advanced-stage or early bulky HD were treated in two public hospitals with the C-MOPP/ABV hybrid program, in which cyclophosphamide was substituted for mechlorethamine. RESULTS: The median number of cycles administered was six, and the median follow-up was 32 months. Fifty patients (85%) reached a CR. The actuarial failure-free survival (FFS) rate was 69%, and the actuarial overall survival rate was 78% at 68 months. The only significant prognostic factor that predicted for improved FFS rate was the absence of B symptoms (P = 0.02). Overall survival was better for patients who reached a CR (P = 0.0003) and those with no systemic symptoms (P = 0.007). Toxic effects were moderate, with one treatment-related death and six episodes of serious infection. CONCLUSIONS: The target population consisted of lower-class Brazilians, many living in poor social conditions. Nevertheless, these results compare equitably with other results reported in the literature. C-MOPP/ABV is an adequate treatment for HD in third-world populations.

[Amelanotic melanoma. Study of 18 cases]. / Melanoma amelanótico. Estudo de 18 casos.

The authors analyze a retrospective study of 18 cases of amelanotic melanoma, coming from 7 Departments of Dermatopathology, and 3 from private clinics in Brazil, during the period from 1980 through 1987. Nine of the 18 patients were men, and seven were women; 14 of the 18 were caucasian and 2 were blacks. Their average combined age was 56 years, varying from 24 years to 86 years. The average size of the lesions was 2.7 cm. and the location was: extremities = 7, thoracic wall = 5, upper limb = 2, and lower limb = 2. Only 2 cases included in this analyses, didn't have any other additional information about color, age, sex and location. The authors found that amelanotic melanoma is rare, in accordance with the literature. They point out, that the rarity or the lack of the melanic pigment within the tumors cells, makes the clinical diagnosis much more complex.

Blepharoplasty to form the orbitopalpebral sulcus and nasal bone graft in oriental subjects (Occidentalization).

The procedures of blepharoplasty and rhinoplasty have been applied successfully, alone or in combination, to the occidentalization of Oriental patients for aesthetic reasons. The blepharoplasty, using the Sayoc-Millard technique, and the rhinoplasty, using an autogenous osteoperiosteal graft from the crest of tibia, are described in detail.

Significant details regarding treatment of prognathism using angled osteotomy of the mandibular rami.

A simplified technique for surgical correction of prognathism, consisting of an angled or L-shaped osteotomy in the mandibular ramus starting from the sigmoid notch and ending on the posterior border of the ascending ramus, has been performed on 365 patients. Modifications of the procedure allow for concomitant correction of mild and severe open-bite conditions. Morbidity was not significant; 12 patients experienced transient dysfunction of the facial nerve, which disappeared within an average of 60 days; in 10 patients, there was an accumulation of saliva in the preauricular area, which was relieved by 3 or 4 punctures. In some of the early open-bite cases, regression occurred, leading to modifications in the technique. There are many advantages to the procedure, including simplicity, low risk of infection, inconspicous scarring, no impairment of muscle strength, and low complication rate.