Influence of drinking water biofilm microbiome on water quality: Insights from a real-scale distribution system.

Biofilms, constituting over 95 % of the biomass in drinking water distribution systems, form an ecosystem impacting both the aesthetic and microbiological quality of water. This study investigates the microbiome of biofilms within a real-scale drinking water distribution system in eastern Spain, utilizing amplicon-based metagenomics. Forty-one biofilm samples underwent processing and sequencing to analyze both bacterial and eukaryotic microbiomes, with an assessment of active biomass. Genus-level analysis revealed considerable heterogeneity, with Desulfovibrio, Ralstonia, Bradyrhizobium, Methylocystis, and Bacillus identified as predominant genera. Notably, bacteria associated with corrosion processes, including Desulfovibrio, Sulfuricella, Hyphomicrobium, and Methylobacterium, were prevalent. Potentially pathogenic bacteria such as Helicobacter, Pseudomonas, and Legionella were also detected. Among protozoa, Opisthokonta and Archaeplastida were the most abundant groups in biofilm samples, with potential pathogenic eukaryotes (Acanthamoeba, Naegleria, Blastocystis) identified. Interestingly, no direct correlation between microbiota composition and pipe materials was observed. The study suggests that the usual concentration of free chlorine in bulk water proved insufficient to prevent the presence of undesirable bacteria and protozoa in biofilms, which exhibited a high concentration of active biomass.

Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013-2019).

The emergence of multidrug-resistant (MDR) bacteria in children is a growing concern, particularly among septic patients, given the need for first-right dosing. Our aim was to determine the incidence rates and factors associated with MDR-sepsis in the pediatric intensive care unit (PICU), using data from the Spanish ENVIN-HELICS PICU registry between 2013 and 2019. The rate of MDR bacteria among septic children ranged between 5.8 and 16.2% throughout this study period, with a significant increase since 2015 (p = 0.013). MDR-gram-negative bacteria (92%), particularly EBL-Enterobacterales (63.7%), were the most frequent causative microorganisms of MDR-sepsis. During this study period, sixteen MDR-sepsis (32.6%) corresponded to intrahospital infections, and 33 (67.4%) had community-onset sepsis, accounting for 10.5% of the overall community-onset sepsis. Independent risk factors associated with MDR-sepsis were antibiotics 48 h prior to PICU admission (OR 2.38) and PICU onset of sepsis (OR 2.58) in >1 year-old children, and previous malnourishment (OR 4.99) in <1 year-old children. Conclusions: There was an alarming increase in MDR among septic children in Spain, mainly by gram-negative (ESBL-Enterobacterales), mostly coming from the community setting. Malnourished infants and children on antibiotics 48 h prior to PICU are at increased risk and therefore require closer surveillance.

Psychometric Properties of Different Versions of the Body Shape Questionnaire in Female Aesthetic Patients.

The purpose of this study was to examine and compare the psychometric properties (internal consistency and factorial validity) of different versions of the Body Shape Questionnaire (BSQ) in a sample of female aesthetic patients. The sample included 296 women attending aesthetic clinics, with ages ranging between 18 and 70 years (M = 32.23, SD = 11.35) and body mass index between 17.10 and 45.00 kg/m2 (M = 24.70, SD = 4.07). Nine different length versions of the BSQ (BSQ-34, BSQ-32, BSQ-16A, BSQ-16B, BSQ-14, BSQ-8A, BSQ-8B, BSQ-8C and BSQ-8D) were subjected to confirmatory factor analyses, using a robust maximum likelihood estimator. Robust fit indices indicated that the BSQ-8D version was the better-fitting and more parsimonious model (S-Bχ2/df = 1.81, CFI = 0.963, RMSEA = 0.052, SRMR = 0.043). This short version also showed appropriate reliability (McDonald's omega and composite reliability = 0.87) and a very high correlation with the original BSQ-34 version (r = 0.95). In sum, these findings suggest that the BSQ-8D is the most valid, reliable and suitable BSQ version for measuring body shape concerns in female aesthetic patients.

Level of discomfort in critically ill paediatric patients and its correlation with sociodemographic and clinical variables, analgosedation and withdrawal syndrome. COSAIP multicentre study (Phase 2).

INTRODUCTION: There are clinical and sociodemographic factors that have an impact on the comfort of the critically ill paediatric patient. The main aim of this study was to determine the level of discomfort of paediatric patients admitted to different national hospitals, and to analyse its correlation with sociodemographic and clinical variables, analgosedation, and withdrawal syndrome. METHODS: An observational, analytical, cross-sectional, and multicentre study was conducted in five Spanish hospitals. The level of analgosedation was assessed once per shift over a 24 h period, using a BIS sensor, and pain with scales adapted to paediatric age population. The intensity of withdrawal syndrome was determined using the Withdrawal Assessment Tool (WAT-1) scale once per shift for 3 days. Discomfort level was simultaneously assessed using COMFORT Behaviour Scale-Spanish version (CBS-S). RESULTS: A total of 261 critically ill paediatric patients with median age of 1.61 years (IQR = 0.35-6.55) were included. An overall discomfort score of 10.79 ±â€¯3.7 was observed during morning compared to 10.31 ±â€¯3.3 during the night. When comparing analgosedation and non-analgosedation groups, statistical differences were found in both shifts (χ2: 45.48; P = .001). At the same time, an association was observed (P < .001) between low discomfort scores and development of withdrawal syndrome development assessed with WAT-1. CONCLUSIONS: As there is a percentage of the studied population with discomfort, specific protocols need to be developed, guided by valuated and clinically tested tools, like the COMFORT Behaviour Scale-Spanish version.

Improving water quality does not guarantee fish health: Effects of ammonia pollution on the behaviour of wild-caught pre-exposed fish.

Ammonia is a pollutant frequently found in aquatic ecosystems. In fish, ammonia can cause physical damage, alter its behaviour, and even cause death. Exposure to ammonia also increases fish physiological stress, which can be measured through biomarkers. In this study, we analysed the effect of sublethal ammonia concentrations on the behaviour and the oxidative stress of Barbus meridionalis that had been pre-exposed to this compound in the wild. Wild-caught fish from a polluted site (pre-exposed fish) and from an unpolluted site (non-pre-exposed fish) were exposed, under experimental conditions, to total ammonia concentrations (TAN) of 0, 1, 5, and 8 mg/L. Swimming activity, feeding behaviour, and oxidative stress response based on biomarkers were analysed. Pre-exposed fish showed both an altered behaviour and an altered oxidative stress response in the control treatment (0 mg/L). Differences in swimming activity were also found as pre-exposed fish swam less. Lower feeding activity (voracity and satiety) and altered response to oxidative stress were also observed at ≥ 1 mg/L TAN. Biomarker results confirmed pre-exposed fish suffer from a reduction in their antioxidant defences and, hence, showed increased oxidative tissue damage. In summary, pre-exposed fish showed more sensitivity to ammonia exposure than fish from a pristine site.

Characterization of eukaryotic microbiome and associated bacteria communities in a drinking water treatment plant.

The effectiveness of drinking water treatment is critical to achieve an optimal and safe drinking water. Disinfection is one of the most important steps to eliminate the health concern caused by the microbial population in this type of water. However, no study has evaluated the changes in its microbiome, specially the eukaryotic microbiome, and the fates of opportunistic pathogens generated by UV disinfection with medium-pressure mercury lamps in drinking water treatment plants (DWTPs). In this work, the eukaryotic community composition of a DWTP with UV disinfection was evaluated before and after a UV disinfection treatment by means of Illumina 18S rRNA amplicon-based sequencing. Among the physicochemical parameters analysed, flow and nitrate appeared to be related with the changes in the eukaryotic microbiome shape. Public health concern eukaryotic organisms such as Blastocystis, Entamoeba, Acanthamoeba, Hartmannella, Naegleria, Microsporidium or Caenorhabditis were identified. Additionally, the relation between the occurrence of some human bacterial pathogens and the presence of some eukaryotic organisms has been studied. The presence of some human bacterial pathogens such as Arcobacter, Mycobacterium, Pseudomonas and Parachlamydia were statistically correlated with the presence of some eukaryotic carriers showing the public health risk due to the bacterial pathogens they could shelter.

Ultrasound assessment of ventilator-induced diaphragmatic dysfunction in mechanically ventilated pediatric patients.

INTRODUCTION: Ultrasonography has recently emerged as a promising technique that can rapidly estimate diaphragm function, especially during the weaning period. The aims of this study were to describe the evolution of diaphragmatic morphology and functional measurements by ultrasound in ventilated children. MATERIAL AND METHODS: This was a prospective, observational, single-center study. All the children admitted to our Pediatric Intensive Care Unit requiring mechanical ventilation for more than 48 h were included. Diaphragmatic thickness and the thickening fraction were assessed by ultrasound. RESULTS: From June to December 2018, 47 patients (median age 3 months; interquartile range, 1-17) underwent 164 ultrasonographic evaluations. The median duration of mechanical ventilation was 168 h (interquartile range, 96-196). At the initial measurement, the thickness at end-inspiration was 2.2 mm (interquartile range, 1.8-2.5) and the thickness at end-expiration was 1.8 mm (interquartile range, 1.5-2.0) with a median decrease in thickness of -14% (interquartile range, -33% to -3%) and a -2% daily atrophy rate (interquartile range, -4.2% to 0%). Diaphragmatic atrophy was observed in 30/47 cases. Children who had been exposed to neuromuscular blockade infusion (n = 31) had a significantly lower mean thickness [-22% (interquartile range, -34% to -13%) vs. -6% (interquartile range, -12% to 0%); p = 0.009] and increased daily atrophy rate [-2.2% (interquartile range, -4.6 to 0%) vs. -1.4% (interquartile range, -2.6 to 0%); p = 0.049] compared to unexposed children. The decrease in thickness was significantly less in children ventilated for at least 12 hours with pressure support before extubation compared with those with shorter periods of spontaneous respiratory effort [-9.5% (interquartile range, -21 to 0%) vs. -26% (interquartile range, -37 to -12%); p = 0.011]. CONCLUSIONS: Point-of-care diaphragmatic ultrasound can detect diaphragmatic atrophy in mechanically ventilated children. Diaphragmatic atrophy was strongly associated with the use of mechanical ventilation and neuromuscular blockade. Diaphragmatic thickness also tended to decrease less in the pre-extubation stage with pressure support. We found no correlation between progressive diaphragm thinning, extubation failure, or an increased need for non-invasive ventilation post extubation.

[Level of discomfort in critically ill paediatric patients and its correlation with sociodemographic and clinical variables, analgosedation and withdrawal syndrome. COSAIP multicentre study (Phase 2)]. / Grado de disconfort del paciente crítico pediátrico y correlación con variables sociodemográficas y clínicas, analgosedación y síndrome de abstinencia. Estudio multicéntrico COSAIP (Fase 2).

INTRODUCTION: There are clinical and sociodemographic factors that have an impact on the comfort of the critically ill paediatric patient. The main aim of this study was to determine the level of discomfort of paediatric patients admitted to different national hospitals, and to analyse its correlation with sociodemographic and clinical variables, analgosedation, and withdrawal syndrome. METHODS: An observational, analytical, cross-sectional, and multicentre study was conducted in five Spanish hospitals. The level of analgosedation was assessed once per shift over a 24h period, using a BIS sensor, and pain with scales adapted to paediatric age population. The intensity of withdrawal syndrome was determined using the Withdrawal Assessment Tool (WAT-1) scale once per shift for 3 days. Discomfort level was simultaneous assessed using COMFORT Behaviour Scale-Spanish version (CBS-S). RESULTS: A total of 261 critically ill paediatric patients with median age of 1.61 years (IQR=0.35-6.55) were included. An overall discomfort score of 10.79±3.7 was observed during morning compared to 10.31±3.3 observed during the night. When comparing analgosedation and non-analgosedation groups, statistically differences were found in both shifts (χ2: 45.48; P=.001). At the same time, an association was observed (P<.001) between low discomfort scores and development of withdrawal syndrome development assessed with WAT-1. CONCLUSIONS: As there is a percentage of the studied population with discomfort, specific protocols need to be developed, guided by valuated and clinically tested tools, like the COMFORT Behaviour Scale-Spanish version.

Effects of industrial pollution on the reproductive biology of Squalius laietanus (Actinopterygii, Cyprinidae) in a Mediterranean stream (NE Iberian Peninsula).

Mediterranean rivers are severely affected by pollutants from industry, agriculture and urban activities. In this study, we examined how industrial pollutants, many of them known to act as endocrine disruptors (EDCs), could disturb the reproduction of the Catalan chub (Squalius laietanus). The survey was conducted throughout the reproductive period of S. laietanus (from March to July 2014) downstream an industrial WWTP located in the River Ripoll (NE Iberian Peninsula). Eighty fish (28 females and 52 males) were caught by electrofishing upstream and 77 fish (33 females and 44 males) downstream a WWTP. For both sexes, the gonadosomatic index (GSI) and gonadal histology were examined and related to water chemical analysis and fish biomarkers. Female fecundity was assessed using the gravimetric method. Fish from the polluted site showed enhanced biomarker responses involved in detoxification. Also, in the polluted site, lower GSI values were attained in both sexes and females displayed lower numbers of vitellogenic oocytes. Gonadal histology showed that all maturation stages of testicles and ovaries were present at the two study sites but fish males from the polluted site had smaller diameter seminiferous tubules. Water chemical analysis confirmed greater presence of EDCs in the river downstream the industrial WWTP. The chemicals benzotriazole and benzothiazole could be partially responsible for the observed alterations in the reproductive biology of S. laietanus.

Towards Non-Invasive Methods in Measuring Fish Welfare: The Measurement of Cortisol Concentrations in Fish Skin Mucus as a Biomarker of Habitat Quality.

Cortisol levels in fish skin mucus have shown to be good stress indicators in farm fish exposed to different stressors. Its applicability in free-ranging animals subject to long-term environmental stressors though remains to be explored. The present study was therefore designed to examine whether skin mucus cortisol levels from a wild freshwater fish (Catalan chub, Squalius laietanus) are affected by the habitat quality. Several well-established hematological parameters and cortisol concentrations were measured in blood and compared to variations in skin mucus cortisol values across three habitats with different pollution gradient. Fluctuations of cortisol in skin mucus varied across the streams of differing habitat quality, following a similar pattern of response to that detected by the assessment of cortisol levels in blood and the hematological parameters. Furthermore, there was a close relationship between cortisol concentrations in skin mucus and several of the erythrocytic alterations and the relative proportion of neutrophils to lymphocytes. Taken together, results of this study provide the first evidence that skin mucus cortisol levels could be influenced by habitat quality. Although results should be interpreted with caution, because a small sample size was collected in one studied habitat, the measurement of cortisol in skin mucus could be potentially used as a biomarker in freshwater fish.

Ultrasound-guided or landmark techniques for central venous catheter placement in critically ill children.

PURPOSE: To assess whether ultrasound guidance improves central venous catheter placement outcomes compared to the landmark technique in critically ill children. METHODS: A prospective multicentre observational study was carried out in 26 paediatric intensive care units over 6 months. Children 0-18 years old who received a temporary central venous catheter, inserted using either ultrasound or landmark techniques, were eligible. The primary outcome was the first-attempt success rate. Secondary outcomes included overall placement success, number of puncture attempts, number of procedures requiring multiple punctures (> 3 punctures), number of procedures requiring punctures at more than one vein site and immediate mechanical complications. To account for potential confounding factors, we used propensity scores. Our primary analysis was based on 1:1 propensity score matching. The association between cannulation technique and outcomes in the matched cohort was estimated using generalized estimating equations and mixed-effects models to account for patient-level and hospital-level confounders. RESULTS: Five hundred central venous catheter-placement procedures involving 354 patients were included. Ultrasound was used for 323 procedures, and the landmark technique was used for 177. Two hundred and sixty-six procedures were matched (133 in the ultrasound group and 133 in the landmark group). Ultrasound was associated with an increase in the first-attempt success rate [46.6 vs. 30%, odds ratio 2.09 (1.26-3.46); p < 0.001], a reduced number of puncture attempts [2 (1-3) vs. 2 (1-4), B coefficient - 0.51 (95% confidence interval - 1.01 to - 0.03), p = 0.035], and fewer overall mechanical complications [12 vs. 22.5%, odds ratio 0.47 (95% confidence interval 0.24-0.91), p = 0.025] in the matched cohort. The number of puncture attempts was the main factor associated with overall complications. CONCLUSIONS: Compared with the landmark technique, ultrasound guidance was associated with an increased first-attempt success rate, a reduced number of puncture attempts, and fewer complications during central venous catheter placement in critically ill children.

[Vitamin D deficiency and morbimortality in critically ill paediatric patients]. / Déficit de vitamina D y morbimortalidad en pacientes críticos pediátricos.

OBJECTIVES: To determine the prevalence and risks factors of vitamin D deficiency, as well as its relationship with morbidity and mortality in a PICU. MATERIAL AND METHODS: An observational prospective study in a tertiary children's University Hospital PICU conducted in two phases: i: cohorts study, and ii: prevalence study. The study included 340 critically ill children with ages comprising 6 months to 16 years old. EXCLUSION CRITERIA: Chronic kidney disease, known parathyroid disorders, and vitamin D supplementation. Total 25-hydroxyvitamin D [25(OH)D] was measured in the first 48hours of admission to a PICU. Parathormone, calcium, phosphate, blood gases, blood count, C-reactive protein, and procalcitonin were also analysed. A record was also made of demographic features, characteristics of the episode, and complications during the PICU stay. RESULTS: The overall prevalence rate of vitamin D deficiency was 43.8%, with a mean of 22.28 (95% CI 21.15-23.41) ng/ml. Patients with vitamin D deficiency were older (61 vs 47 months, P=.039), had parents with a higher level of academic studies (36.5% vs 20%, P=.016), were admitted more often in winter and spring, had a higher PRISM-III (6.8 vs 5.1, P=.037), a longer PICU stay (3 vs 2 days, P=.001), and higher morbidity (61.1% vs 30.4%, P<001) than the patients with sufficient levels of 25(OH)D. Patients who died had lower levels of 25(OH)D (14±8.81ng/ml versus 22.53±10.53ng/ml, P=.012). Adjusted OR for morbidity was 5.44 (95%CI; 2.5-11.6). CONCLUSIONS: Vitamin D deficiency is frequent in critically ill children, and it is related to both morbidity and mortality, although it remains unclear whether it is a causal relationship or it is simply a marker of severity in different clinical situations.

Trends in nosocomial infections and multidrug-resistant microorganisms in Spanish pediatric intensive care units.

INTRODUCTION: Nosocomial infections (NI) are a major healthcare problem. National surveillance systems enable data to be compared and to implement new measures to improve our practice. METHODS: A multicentre, prospective, descriptive and observational study was conducted using the data from surveillance system for nosocomial infections created in 2007 for Spanish pediatric intensive care units. Data were collected for one month, between 01 and 31 March, for every study year (2008-2012). The objective was to report 5-years of NI surveillance data, as well as trends in infections by multidrug resistant organisms in Spanish pediatric intensive care units. RESULTS: A total of 3667 patients were admitted to the units during the study period. There were 90 (2.45%) patients with nosocomial infections. The mean rates during the 5 years study were: central line-associated bloodstream infection, 3.8/1000 central venous catheter-days, Ventilator-associated pneumonia 7.5/1000 endotracheal tube-days, and catheter-associated urinary tract infections 4.1/1000 urinary catheter-days. The comparison between the 2008 and 2009 rates for nosocomial infections did not show statistically significant differences. All rates homogeneously decreased from 2009 to 2012: central line-associated bloodstream infection 5.83 (95% CI 2.67-11.07) to 0.49 (95% CI 0.0125-2.76), P=0.0029; ventilator-associated pneumonia 10.44 (95% CI 5.21-18.67) to 4.04 (95% CI 1.48-8.80), P=0.0525; and Catheter-associated urinary tract infections 7.10 (95% CI 3.067-13.999) to 2.56 (95% CI 0.697-6.553), P=0.0817; respectively. The microorganism analysis: 63 of the 99 isolated bacteria (63.6%) were Gram-negative bacteria (36.5% were resistant), 19 (19.2%) Gram-positive bacteria, and 17 (17.2%) were Candida spp. infections. CONCLUSIONS: The local surveillance systems provide information for dealing with nosocomial infections rates.

Use of adenosine in the treatment of supraventricular tachycardia in a pediatric emergency department.

OBJECTIVE: Supraventricular tachycardia (SVT) is the most frequent arrhythmia requiring treatment in childhood, with an estimated incidence of 1/100 to 1/250 children. The treatment of choice of the acute event is intravenous adenosine. This study aimed to determine if doses of adenosine higher than previously described are needed to successfully revert SVT in children. METHODS: This is a retrospective study of SVT cases in a tertiary hospital from January 2007 to December 2011. RESULTS: A total of 44 episodes of SVT were recorded in 26 patients. Mean age was 3.1 years. In 39 patients (89%), adenosine was administered, reverting to stable sinus rhythm in 29 episodes, which represents an effectiveness of 75%. In relation to the number of doses administered, 12 patients (30%) received a single dose, with a mean (SD) response dose of 112 (35) µg/kg; 16 (41%) received 2 doses, with a mean (SD) response dose of 188 (55) µg/kg; and 9 (24%) received 3 doses, with a mean (SD) response dose of 249 (108) µg/kg. Finally, in 2 patients (4%), 4 doses of adenosine were administered, with only 1 of them responding to a dose of 300 µg/kg. The mean (SD) dose that reverted the SVT to normal sinus rhythm was 173 (84) µg/kg, and the mean (SD) number of doses administered was 1.7 (0.8) (range, 1-4). Sixty-six percent were discharged home, without the need to be transferred to pediatric intensive care unit or pediatric ward. CONCLUSIONS: Most of the patients with SVT episodes require treatment with more than 1 dose of adenosine. Doses higher than the usually described in the guidelines are necessary to revert SVT. Most patients can be discharged home from the emergency department, without the need of hospital admission.

Prognostic factors in pediatric sepsis study, from the Spanish Society of Pediatric Intensive Care.

BACKGROUND: Sepsis and septic shock represent up to 30% of admitted patients in pediatric intensive care units, with a mortality that can exceed 10%. The objective of this study is to determine the prognostic factors for mortality in sepsis. METHODS: Multicenter prospective descriptive study with patients (aged 7 days to 18 years) admitted to the pediatric intensive care units for sepsis, between January 2011 and April 2012. RESULTS: Data from 136 patients were collected. Eighty-seven were male (63.9%). The median age was a year and a half (P25-75 0.3-5.5 years). In 41 cases (30.1%), there were underlying diseases. The most common etiology was Neisseria meningitidis (31 cases, 22.8%) followed by Streptococcus pneumoniae (16 patients, 11.8%). Seventeen cases were fatal (12.5%). In the statistical analysis, the factors associated with mortality were nosocomial infection (P = 0.004), hypotension (P <0.001) and heart and kidney failure (P < 0.001 and P = 0.004, respectively). The numbers of leukocytes, neutrophils and platelets on admission were statistically lower in the group that died (P was 0.006, 0.013 and <0.001, respectively). Multivariate analysis showed that multiple organ failure, neutropenia, purpura or coagulopathy and nosocomial infection were independent risk factors for increased mortality (odds ratio: 17, 4.9, 9 and 9.2, respectively). CONCLUSIONS: Patients with sepsis and multiorgan failure, especially those with nosocomial infection or the presence of neutropenia or purpura, have a worse prognosis and should be monitored and treated early.

Vigorexia e níveis de dependência de exercício em frequentadores de academias e fisiculturistas / Vigorexy and levels of exercise dependence in gym goers and bodybuilders

INTRODUÇÃO: Atualmente, a aparência é sinônimo de sucesso, saúde e determinação. De modo que a sociedade moderna oprima os indivíduos a seguir padrões estereotipados de beleza. E como herança dessa sociedade capitalista e egoísta surgem os transtornos psíquicos da aparência e as dependências psíquicas a eles associadas. OBJETIVOS: i) comparar os níveis de vigorexia e de dependência ao exercício entre frequentadores de academias e fisiculturistas; ii) relacionar as variáveis de prática de exercício físico (tempo de prática, frequência semanal e duração por sessão) com as dimensões de frequência de vigorexia e de dependência ao exercício; e, iii) comparar os níveis de vigorexia segundo grupos de dependência ao exercício (dependentes ou em risco, não dependente sintomático e não dependente assintomático). MÉTODOS: A amostra foi constituída por 151 frequentadores de academia (27,66 ± 6,54 anos e 27,56 ± 5,03 de IMC) e 25 fisiculturistas (30,80 ± 5,54 anos e 26,72 ± 4,24 de IMC), todos do sexo masculino. Os participantes responderam à Escala de Dependência ao Exercício e ao Inventário de Dismorfia Muscular. A análise estatística envolveu procedimentos de análise descritiva, normalidade univariada, comparativa e correlacional. RESULTADOS: Os principais resultados evidenciaram: i) não existir diferenças entre frequentadores de academias e fisiculturistas quanto aos níveis de vigorexia e de dependência ao exercício; ii) que a duração da sessão de treino se correlaciona positivamente com a maioria das dimensões da dependência ao exercício; e, iii) que o grupo classificado como dependente ou em risco revela níveis médios superiores de vigorexia. CONCLUSÃO: Por fim, constatou-se que tanto nos fisiculturistas como nos frequentadores de academias, quanto maior o nível de vigorexia, maior o nível de dependência ao exercício, sendo essa correlação maior em fisiculturistas.

INTRODUCTION: Currently, good appearance is a synonym to success, health and determination. So as to, the modern society overwhelms the individuals to follow beauty stereotypes. The heritage of this capitalist and selfish society is the psychological appearance disorders and the psychological dependence associated with them. Among these, we can mention vigorexy and exercise dependence. OBJECTIVES: I) to compare vigorexy levels and exercise dependence among gym goers and bodybuilders, II) to corelate the variables on physical practice (time of practice, weekly frequency and sessions time) to the frequency dimensions of vigorexy and exercise dependence; and, III) to compare vigorexy levels according to the exercise dependence groups (dependent or in risk, not symptomatic dependent and not asymptomatic dependent). METHODS: The sample was composed of 151 male gym goers (27.66 ± 6.54- year-old and 27.56 ± 5.03 BMI) and 25 bodybuilders (30.80 ± 5.54-year-old and 26.72 ± 4.24 BMI). The participants answered the Exercise Dependence Scale and the Muscle Dysmorphic Disorder Inventory. The statistical analysis involved descriptive, univariated normality, comparative and correlational analyses. RESULTS: The main results were: I) absence of differences between gym goers and bodybuilders concerning vigorexy levels and exercise dependence, II) training session time is positively correlated with most of the dimensions of the exercise dependence, and, III) the group classified as dependent or in risk reveals medium superior levels of vigorexy. CONCLUSION: Lastly, it was found that both in bodybuilders and gym goers, the higher the vigorexy level, the higher the exercise dependence wit this correlation is higher in bodybuilders.

First trimester screening for aneuploidies in successive pregnancies: correlations between markers.

OBJECTIVES: Screening for chromosomal abnormalities in the first trimester of pregnancy is based on maternal age, nuchal translucency (NT), and biochemical markers (pregnancy-associated plasma protein-A and free beta human chorionic gonadotrophin). We have assessed the influence of screenings and outcomes in previous pregnancies on screenings in subsequent pregnancies. METHODS: Retrospective study of the correlation between the variables of first trimester combined screening for chromosome abnormalities in patients with subsequent pregnancies. Excluded were gestations with fetal aneuploidies. RESULTS: Between July 1999 and December 2009, there were 2291 women with more than 1 euploid pregnancy screened in the first trimester in our hospital. There was a moderate correlation for pregnancy-associated plasma protein-A (ρ = 0.530, p <0.001) and free beta human chorionic gonadotrophin (ρ = 0.439, p <0.001) between the first and second pregnancy. The trend continued in successive pregnancies. NT showed no correlations of clinical importance. With an overall false positive (FP) rate of 2.1% for the combined screening, the probability of having a recurrent FP in the second pregnancy was 4.3% (not significant). CONCLUSION: There are significant correlations between biochemical markers but not NT in successive pregnancies, leading to increased risk of recurrence of FP results. However, such increase is not statistically significant if the overall FP rate is very low.