Motiva.DM2 project. A pilot behavioral intervention on diet and exercise for individuals with type 2 diabetes mellitus.

AIM: The purpose of this study was to assess the efficacy of an educational intervention based on the Behavior Change Wheel (BCW) framework for individuals with type 2 diabetes mellitus (DM2) on dietary and exercise behavior in a Spanish region. METHODS: A two-arm pilot research was developed. The intervention consisted of a 6-month period with guidelines and 4 in-person interventions. The outcome was changes in behaviors, motivation, competence, autonomy, social support to implement the recommendations, HbA1c, and body composition. RESULTS: n = 111 patients were recruited. Individuals in the intervention experienced a significative improvement on adherence to dietary recommendations (+1.23; p = 0.026), exercise (+0.86; p = 0.001), and a decrease in HbA1c levels (-0.6%; p = 0.002) and BMI (-0.73; p < 0.001). CONCLUSION: The intervention for DM2 individuals, based on the BCW framework, developed, and implemented by primary care nurses has been effective in improving the adherence to healthy eating, exercise, HbA1c levels, and body composition.

Características de los alimentos y bebidas incluidos en la publicidad buzoneada por supermercados en el Principado de Asturias (España): estudio transversal / Analysis of the characteristics of door-to-door advertising sent by supermarkets in the Principality of Asturias (Spain): a cross-sectional study

FUNDAMENTO: Analizar qué alimentos y bebidas, de los que se incluyen con más frecuencia en la publicidad buzoneada por los supermercados en el Principado de Asturias, pueden ser considerados prescindibles para el consumo de la población, y comparar su precio con el de los alimentos esenciales. MÉTODOS: Estudio descriptivo, transversal, de la publicidad buzoneada en siete domicilios de Asturias (España) por cuatro cadenas de supermercados entre julio y diciembre de 2018. Se registró el tipo de producto, su clasificación como esencial o prescindible y su precio, comparándolos entre cadenas de supermercados. RESULTADOS: Se identificaron 14.314 productos. "Dulces, bollería, chocolates, azúcares y edulcorantes" (15,3 %), "leche y derivados" (9,7 %), "carnes procesadas" y "bebidas alcohólicas" (8,9 % cada categoría) y "precocinados" (8,4 %). Se observó un predominio de productos considerados prescindibles (61,9 %). Se observaron diferencias significativas en cuanto al tipo de producto según la cadena comercial. El precio medio de los productos esenciales fue menor que el de los prescindibles, tanto globalmente como en cada cadena comercial, siendo la diferencia significativa en una de ellas. CONCLUSIONES: En la publicidad buzoneada por los supermercados en los domicilios de Asturias predominan los productos considerados como prescindibles desde el punto de vista de la salud como ricos en azúcar, carnes procesadas y alcohol. En sentido positivo destaca que el precio de los productos esenciales, como frutas y verduras frescas, fue, de media, significativamente menor que el de los prescindibles

BACKGROUND: To analyze which foods and beverages, frequently included in advertising mail delivered by supermarkets in the Principality of Asturias, can be considered essential for consumption by the population, as well as to compare their price with that of essential products. METHODS: Cross-sectional, descriptive study of supermarket sales circulars delivered to seven homes in Asturias (Spain) by four supermarket chains from July to December 2018. Type of product, its classification as essential or non-essential and mean price of the advertised product were registered. RESULTS: The study identified 14,314 products, mostly belonging to the categories: "cakes, pastries, chocolate, sugar, and sweeteners" (15.3 %), "milk and milk derivatives" (9.7 %), "processed meats".and "alcoholic beverages" (8.9 % each) and "ready-made" (8.4 %). Products considered to be non-essential were found to predominate (61.9 %). Significant differences in product type were observed between supermarket chains. Essential products had a lower mean price than the non-essential products, both overall and for each supermarket chain, and was significantly lower for one of them. CONCLUSIONS: Products which are non-essential from the point of view of health, such as sugar-rich products, processed meats, and alcoholic beverages, dominated the advertising mail delivered door-to-door by supermarkets in the Principality of Asturias. On a positive note, the prices of essential products, such as fresh fruit and vegetables, were, on average, significantly lower than the prices of non-essential products

[Analysis of the characteristics of door-to-door advertising sent by supermarkets in the Principality of Asturias (Spain): a cross-sectional study].

BACKGROUND: To analyze which foods and beverages, frequently included in advertising mail delivered by supermarkets in the Principality of Asturias, can be considered essential for consumption by the population, as well as to compare their price with that of essential products. METHODS: Cross-sectional, descriptive study of supermarket sales circulars delivered to seven homes in Asturias (Spain) by four supermarket chains from July to December 2018. Type of product, its classification as essential or non-essential and mean price of the advertised product were registered. RESULTS: The study identified 14,314 products, mostly belonging to the categories: "cakes, pastries, chocolate, sugar, and sweeteners" (15.3?%), "milk and milk derivatives" (9.7?%), "processed meats".and "alcoholic beverages" (8.9?% each) and "ready-made" (8.4?%). Products considered to be non-essential were found to predominate (61.9?%). Significant differences in product type were observed between supermarket chains. Essential products had a lower mean price than the non-essential products, both overall and for each supermarket chain, and was significantly lower for one of them. . CONCLUSIONS: Products which are non-essential from the point of view of health, such as sugar-rich products, processed meats, and alcoholic beverages, dominated the advertising mail delivered door-to-door by supermarkets in the Principality of Asturias. On a positive note, the prices of essential products, such as fresh fruit and vegetables, were, on average, significantly lower than the prices of non-essential products.

Síntomas de trastornos de ansiedad en niños y adolescentes: Diferencias en función de la edad y el sexo en una muestra comunitaria / Anxiety disorder symptoms in children and adolescents: Differences by age and gender in a community sample

Introducción:Los síntomas de ansiedad en la infancia y adolescencia constituyen un importante factor de riesgo para el desarrollo de los trastornos de ansiedad en etapas evolutivas posteriores. Este estudio examina la frecuencia y características de los síntomas de los principales trastornos de ansiedad en niños y adolescentes empleando una medida de autoinforme basada en las categorías diagnósticas del manual de la APA. Material y métodos:Se trata de un estudio transversal no intervencionista. Participaron 2.522 niños y adolescentes de 8 a 17 años (49% varones), reclutados de diversos colegios de la provincia de Alicante, que completaron la Escala de Ansiedad Infantil de Spence. Resultados:La puntuación media obtenida en la escala (rango: 0-114) fue 25,15 (DT=13,54). El 26,41% de los niños y adolescentes mostraron puntuaciones elevadas en cualquier trastorno de ansiedad. Los síntomas de ansiedad por separación son los más frecuentes en la muestra (5,5%), seguidos por los miedos físicos (5,1%). Las niñas puntúan significativamente más alto en todos los trastornos (p<,001), excepto en el trastorno obsesivo-compulsivo. Se hallaron diferencias en función de la edad en todos los trastornos, excepto en los miedos físicos, pero los tamaños del efecto fueron medios únicamente en la ansiedad por separación, que desciende con la edad, y en la ansiedad generalizada, mayor en los adolescentes que en los niños. Conclusiones:Se destaca la importancia de que, desde el ámbito de salud mental, se lleve a cabo una detección temprana de los síntomas de ansiedad en los niños a partir de 8 años para facilitar la intervención y evitar el desarrollo posterior de los trastornos de ansiedad(AU)

Introduction:Anxiety symptoms in childhood and adolescence are an important risk factor for developing anxiety disorders in subsequent development stages. This study examines the frequency and characteristics of the symptoms of the principal anxiety disorders in children and adoloscents using a self-report questionnaire based on the diagnostic categories of the American Psychiatric Association (APA) manual. Material and methods:A cross-sectional, non-interventional study was conducted on 2522 children and adolescents form 8 to 17 years (49% males), enrolled from different schools in the Province of Alicante who completed the Spence Children's Anxiety Scale. Results:The mean score obtained on the scale (range: 0-114) was 25.15 (standard deviation (SD)=13.54). More than one in four (26.41%) of the children and adolescents showed high scores in any anxiety disorder. The anxiety symptoms due to separation were the most frequent in the sample (5.5%), followed by physical fears (5.1%). Girls scored significantly higher in all disorders (P<.001), except in obsessive-compulsive disorder. Differences were found as regards age in all disorders, except physical fears, but the effect sizes were only in anxiety due to separation, which decreased with age, and generalised anxiety, which was higher in adolescents than in children. Conclusions:From the mental health perspective, it is important to be able to detect anxiety symptoms in children from 8 years onwards, in order to intervene early and prevent the development of anxiety disorders in later life(AU)

Occurrence and densities of bacteriophages proposed as indicators and bacterial indicators in river waters from Europe and South America.

AIMS: To evaluate the feasibility of bacteriophages as a complementary tool for water quality assessment in surface waters from different parts of the globe. METHODS AND RESULTS: Faecal coliform bacteria, enterococci, spores of sulphite-reducing clostridia, somatic coliphages, F-specific RNA bacteriophages and bacteriophages infecting Bacteroides fragilis were determined by standardized methods in raw sewage and in 392 samples of river water from 22 sampling sites in 10 rivers in Argentina, Colombia, France and Spain, which represent very different climatic and socio-economic conditions. The results showed that the indicators studied maintained the same relative densities in the raw sewage from the different areas. Classifying the river water samples according to the content of faecal coliform bacteria, it can be observed that the relative densities of the different bacterial indicators and bacteriophages changed according to the concentration of faecal coliform bacteria. There was a relative increase in the densities of all groups of bacteriophages and sulphite-reducing clostridia with respect to faecal coliforms and enterococci in the samples with low counts of faecal coliform bacteria. CONCLUSIONS: The numbers of bacterial indicators and bacteriophages were similar in the different geographical areas studied. Once released in rivers, the persistence of the different micro-organisms differed significantly. Bacteriophages and spores of sulphite-reducing clostridia persisted longer than faecal coliforms and enterococci. SIGNIFICANCE AND IMPACT OF THE STUDY: Bacteriophages in river water samples provide additional information to that provided by bacteria about the fate of faecal micro-organisms in river water. The easy, fast and cheap methods for phage determination are feasible both in industrialized and developing countries.

Removal and inactivation of indicator bacteriophages in fresh waters.

AIMS: The removal and inactivation of faecal coliform (FC) bacteria, enterococci (ENT), sulphite-reducing clostridia (SRC), somatic coliphages, F-specific RNA bacteriophages and bacteriophages infecting Bacteroides fragilis in fresh waters. METHODS AND RESULTS: Removal was studied in two areas of a river. The results showed different removal of each group of microbes. Faecal coliform bacteria were removed faster than any other, whereas SRC and bacteriophages infecting Bact. fragilis were the most persistent. Inactivation was measured by 'in situ' experiments, which showed significant differences in survival of the different groups of bacterial and bacteriophage indicators. The SRC and bacteriophages were more resistant than faecal coliforms and enterococci, with the exception of F-specific RNA bacteriophages in the summer. Inactivation experiments with pure cultures of bacteriophages confirmed that phage B40-8 of Bact. fragilis was the most resistant. CONCLUSIONS: Bacteria and bacteriophages show different resistance to natural inactivation. The use of phages allows information to be obtained in addition to that provided by bacterial indicators. Somatic coliphages and phages infecting Bact. fragilis might supply that indicator function. SIGNIFICANCE AND IMPACT OF THE STUDY: Confirmation was obtained that bacteriophages provided additional information to that provided by bacterial indicators to monitor the natural inactivation of viruses and/or pathogens.

[Topical nitroglycerin: an alternative in the conservative treatment of biliary fistula]. / Nitroglicerina tópica: una alternativa en el tratamiento conservador de la fístula biliar.

A patient with post-laparoscopic cholecystectomy cystic duct leak successfully treated with conservative treatment is presented. The cystic duct leak was diagnosed through a CPRE where a Oddy sphyncter spasm was noted. The use of a topic Nytroglicerine resulted in a sphincter release and resolution of the fistula. A literature review of the importance of CPRE in the diagnosis and treatment of biliary injuries was carried out. In patients with nondilated bile ducts where the sphincterotomy or endoprothesis undergo with high morbidity, the use of topic nitroglycerine could be an effective alternative procedure.

[Malignant thymoma with myasthenia gravis and hepatic metastasis. Report of a case and review of the literature]. / Timoma maligno con miastenia gravis y metástasis hepáticas. Presentación de un caso y revisión de la literatura.

This paper reports a case of an histological non aggressive thymoma with myasthenic symptoms as the first clinical manifestation. Three years after its complete surgical resection liver metastases appeared without evidence of intrathoracic neoplastic disease. The extrathoracic metastases are uncommon and the thymomatous myasthenia gravis is present in 25 to 50% of cases. We reviewed the literature and analyzed its clinical pathological characteristics and therapeutics approach.

[Early diagnosis of renal ischemia in arterial hypertension by means of urine N-acetyl-beta-D-glucosaminidase (author's transl)]. / Detección precoz de la isquemia renal en la hipertensión arterial mediante la N-acetil-beta-D-glucosaminidasa (NAG) en orina.

Essential arterial hypertension, malignant hypertension and renovascular hypertension were studied in 64 patients, divided into 5 groups according to creatinine clearance (Ccreat) and ophthalmic fundus. Urine N-Acetyl-b-d-glucosaminidase (NAG) was expressed in units/mg creatinine in urine. Results were; Group A: Ccreat greater than 60, ophthalmic fundus less than II (n=33), NAG 13.5 + 4.5; Group B: CCreat. greater than 60, ophthalmic fundus III-IV (n=4) NAG 42.4 +/- 12.5; Group C: Ccreat. less than 60, ophthalmic fundus less than II (n = 14) NAG 31.2 +/- 10,5; Group D: (clinically malignant arterial hypertension) Ccreat. less than 60, ophthalmic fundus III--IV (n = 8), NAG 91.1 +/- 55.7 and Group E: (renovascular hypertension) Ccreat. greater than 60, ophthalmic fundus less than II (n = 5), NAG 35.5 +/- 12.9. Only the patients in Group A had NAG within normal limits. Differences were found between groups: A-B (p less than 0.001), A-D (p less than 0.001), A-E (p less than 0.001) and C-D (p less than 0.001). Urine NAG is considered to be an early sign of renal involvement in arterial hypertension, an indication of the severity and a sign of ischemia even when the involvement is unilateral only, and helpful in the management of renovascular hypertension.