Ultra-processed foods consumption as a promoting factor of greenhouse gas emissions, water, energy, and land use: A longitudinal assessment.

BACKGROUND: Dietary patterns can produce an environmental impact. Changes in people's diet, such as the increased consumption of ultra-processed food (UPF) can not only influence human health but also environment sustainability. OBJECTIVES: Assessment of the impact of 2-year changes in UPF consumption on greenhouse gas emissions and water, energy and land use. DESIGN: A 2-year longitudinal study after a dietary intervention including 5879 participants from a Southern European population between the ages of 55-75 years with metabolic syndrome. METHODS: Food intake was assessed using a validated 143-item food frequency questionnaire, which allowed classifying foods according to the NOVA system. In addition, sociodemographic data, Mediterranean diet adherence, and physical activity were obtained from validated questionnaires. Greenhouse gas emissions, water, energy and land use were calculated by means of the Agribalyse® 3.0.1 database of environmental impact indicators for food items. Changes in UPF consumption during a 2-year period were analyzed. Statistical analyses were conducted using computed General Linear Models. RESULTS: Participants with major reductions in their UPF consumption reduced their impact by -0.6 kg of CO2eq and -5.3 MJ of energy. Water use was the only factor that increased as the percentage of UPF was reduced. CONCLUSIONS: Low consumption of ultra-processed foods may contribute to environmental sustainability. The processing level of the consumed food should be considered not only for nutritional advice on health but also for environmental protection. TRIAL REGISTRATION: ISRCTN, ISRCTN89898870. Registered 05 September 2013, http://www.isrctn.com/ISRCTN89898870.

Endoscopic repair of late-presenting Morgagni and Bochdalek hernia in children: case report and review of the literature.

BACKGROUND: Delayed presentation of a congenital diaphragmatic hernia (CDH) is not usual. Primary laparoscopic repair is becoming the standard in many centers. Different approaches and techniques have been proposed. There is not enough evidence in the literature to recommend one technique over another. PATIENTS AND METHODS: In this paper, we report one case of Morgagni hernia (MH) and one case of Bochdalek hernia (BH), 2 and 6 years old, respectively, operated on in our hospital. In the first case, the diaphragmatic defect was directly sutured with extracorporeal interrupted nonabsorbable sutures, passed through the abdominal wall with a Reverdin needle. In the second one, intracorporeal nonabsorbable stitches were placed. A search of the literature was made using PubMed and the following words: congenital diaphragmatic hernia, laparoscopy or thoracoscopy, and children. The neonatal Bochdalek hernias were discarded. Data about surgical approach, suturing technique, management of the hernia sac, complications, and recurrence were summarized for both pathologies. RESULTS: Both patients were discharged 48 hours after surgery. There were no complications. No recurrence was evident after 6 months. Eleven articles on the treatment of MHs were found, with a total of 30 patients. For BHs, 10 articles met the inclusion criteria, with a total of 54 patients. In both groups, all the papers were case reports or retrospective reviews of case series. The MH is best approached through laparoscopy, and the BH can be treated through thoracoscopy or laparoscopy. Most researchers prefer direct suture with nonabsorbable material. Both complication and recurrence rates are very low. CONCLUSIONS: The endoscopic approach of late-presenting Morgagni and Bochdalek CDH is a safe technique. It offers all the advantages of minimally invasive surgery (MIS), and laparoscopy also permits the diagnosis and treatment of other associated conditions. There are a short number of cases reported and no prospective study comparing open with the MIS approach for the treatment of diaphragmatic malformations.

Aspiració de cossos estranys: la nostra experiència / Foreign body aspiration: the experience of a single institution

Fonament. L'aspiració de cossos estranys és una patologiad'elevada incidència a l'edat pediàtrica, i té greuscomplicacions si passa desprevinguda.Objectiu. Analitzar els registres dels pacients ambsospita d'aspiració de cossos estranys, i intentar obtenirconclusions per millorar el diagnòstic i el maneig d'aquestspacients.Mètode. S'ha fet un estudi retrospectiu dels 68 infantsals quals es va fer una broncoscòpia sota l'orientaciódiagnòstica d'aspiració de cos estrany, entre gener de 1998i juny de 2002, analitzant les variables demogràfiques elementalsi les característiques més significatives de la històriaclínica i l'evolució.Resultats. L'edat mitjana dels pacients va ser de 2,85anys. La simptomatologia més freqüent va ser la tos. El91.2% dels casos presentava un antecedent d'ennuegada.La majoria eren fruits secs (82.3%). El temps mitjà d'evolucióva ser de 8.96 dies.Conclusions. Els avenços tècnics han permès millorarel tractament, però el diagnòstic continua basant-se ambl'anamnesi, l'exploració i la sospita clínica. La prevenció ésla mesura fonamental per millorar el maneig d'aquestaentitat

Background. Foreign body aspiration is commonin children, and may have important consequences ifundiagnosed.Objective. To review our experience with the evaluationof patients with a suspected foreign body aspiration,and to develop guidelines to improve diagnosis and treatment.Method. Retrospective study including children whounderwent a bronchoscopy for the presumptive diagnosisof aspiration of a foreign body, between January 1998 andJune 2002.Results. Sixty-eigh patients (median age 2.85 years)were identified. The most common symptom was cough.In 91.2% of the cases there was history of chocking. Inmost cases (82.3%), the foreign body was a nut. The mediantime of symptoms was 8.96 days.Conclusions. New technologies have contributed toimproved treatments, but the most important diagnostictools remain the clinical history, physical examination, andthe high level of suspicion; preventive measures are critical