Alerta Cannabis: A Tailored-Computer Web-Based Program for the Prevention of Cannabis Use in Adolescents: A Cluster-Randomized Controlled Trial Protocol.

BACKGROUND: The growing use of cannabis in adolescence is a public health problem that must be addressed through prevention. In Spain, the average age of initiation of cannabis use in the adolescent population is 14.8 years. At 14 years, the lifetime prevalence of cannabis use is 11.7%, which increases to 51.,5% at the age of 18; the prevalence of cannabis use in the population aged 14 to 18 years is 28.6%, a figure that must be tried to reduce, that is why this school prevention program is proposed: Alerta Cannabis. METHODS: The Alerta Cannabis research project consists of design, implementation, and evaluation. In the first phase, a computer-tailored eHealth program (Alerta Cannabis) is developed based on the I-Change Model, an integrated model based on three main behavioral change processes: awareness, motivation, and action. This program consists of four 30-minute sessions that will provide culturally adapted and personalized advice to motivate students not to use cannabis through text feedback, animations, and gamification techniques. This phase will also include usability testing. In the implementation phase, secondary school students from Western Andalusia, Spain (Seville, Cádiz, Huelva, and Córdoba) and Eastern Andalusia (Jaén, Málaga, and Granada) will be randomized to an experimental condition (EC) or a control condition (CC) for a cluster randomized clinical trial (CRCT). Each condition will have 35 classes within 8 schools. GI will receive the online intervention Alerta Cannabis. EC and CC will have to fill out a questionnaire at baseline, six months, and twelve months of follow-up. In the last phase, the effect of Alerta Cannabis is evaluated. The primary outcomes are the lifetime prevalence of cannabis use and its use in the last 30 days and at 6 months. At 12 months of follow-up, the prevalence in the last 12 months will also be assessed. The secondary outcome is the intention to use cannabis. DISCUSSION: The study tests the effect of the innovative program specifically aimed to reduce the use of cannabis in the adolescent population through eHealth in Spain. The findings aim to develop and implement evidence-based cannabis prevention interventions, which could support school prevention, for instance, the assistance of school nurses. If the program proves to be effective, it could be useful to prevent cannabis use on a national and international scale. TRIAL REGISTRATION: NCT05849636. Date of registration: March 16, 2023.

Choledochoduodenostomy with LAMS (Hot-Axios type) for malignant obstructive jaundice - An increasingly used technique.

An 82-year-old woman who presented with obstructive jaundice and constitutional syndrome was diagnosed with pancreatic adenocarcinoma. Palliative management was decided with endoscopic ultrasound drainage as it was impossible to perform ERCP due to anatomical alterations, a consequence of the neoplastic lesion.

Lenvatinib in severe hypoglycemia associated with hepatocellular carcinoma.

We present the case of a 24-year-old male with multicentric hepatocellular carcinoma (HCC) over HBV-related compensated liver cirrhosis, on treatment with sorafenib and tenofovir. He had multiple admissions in recent months for severe hypoglycemia episodes with neurological symptoms.

Cardiorespiratory complications of digestive endoscopy not related to sedation.

Although digestive endoscopy is considered to be a safe procedure, both the growing complexity of the techniques and the underlying diseases of patients increase the risk of adverse events during the procedure. Cardiorespiratory events are the most frequent complications, and can occur in patients with or without sedation, although they appear more often when the patient is sedated. The body's physiological response to stress is what causes these adverse events, which are generally mild and transient, although they can be serious. They are more frequent in patients with cardiopulmonary diseases, which logically increase risk. The autonomic nervous system, through its sympathetic and parasympathetic branches, is primarily responsible for these alterations. Patients with asthma or chronic obstructive pulmonary disease have a higher risk of hypoxemia, bronchospasm, and arrhythmia during the endoscopic procedure. Patients with arrhythmia and ischemic heart disease have a higher risk of myocardial ischemia and heart rhythm disturbances. The risk of adverse events during the procedure can be reduced by reviewing the patient's medical history along with a basic clinical examination before endoscopy. A brief interrogation about symptom control can also help the safety of endoscopy.

Adequacy of usual macronutrient intake and macronutrient distribution in children and adolescents in Spain: A National Dietary Survey on the Child and Adolescent Population, ENALIA 2013-2014.

OBJECTIVES: To describe the nutritional profile and assess the National Dietary Survey on the Child and Adolescent Population project in Spain (ENALIA) regarding usual total energy and macronutrient intake. METHODS: A cross-sectional nationally representative sample of 1862 children and adolescents (age 6 months to 17) was surveyed between 2013 and 2014 following European methodology recommendations. Dietary information was collected using two methods, dietary records (for children from age 6 months to 9 years) and 24-h dietary recall (participants age 10 and older). Usual intake was estimated by correcting for within-person intake variance using the Iowa State University (ISU) method. A probability analysis was used to assess compliance with dietary reference intakes in the target population. RESULTS: Protein consumption in the age 1-3 group as a percentage of total energy exceeded the upper limit of the Acceptable Macronutrient Distribution Range (AMDR) by 4.7% for boys and 12.1% for girls. 42.9% of girls age 4-8 were under the lower limit of the AMDR for carbohydrates. 43.4% of boys and 46.9% of girls between 4 and 17 exceeded the AMDR in total fat intake, saturated fatty acids (SFAs) accounting for 12.3% of total energy. CONCLUSIONS: The results suggest that Spanish children and adolescents could improve macronutrient distribution by reducing fat and increasing carbohydrate intake across all age groups, and decreasing protein intake, especially in young children.

Morphological and functional changes of chronic pancreatitis in patients with dyspepsia: A prospective, observational, cross-sectional study.

OBJECTIVE: Whether chronic pancreatitis (CP) may present with dyspepsia is controversial. We aimed at evaluating the frequency and risk factors of changes of CP in patients presenting with epigastric pain syndrome (EPS)-like symptoms. DESIGN: A prospective, observational, cross-sectional study was carried out in patients with EPS-like symptoms. Patients underwent endoscopic ultrasound (EUS) evaluation of the pancreas, and changes of CP were defined as the presence of five or more EUS criteria of the disease. In patients with 3 or 4 EUS criteria, magnetic resonance dynamic evaluation of the pancreas (MRI/sMRCP) and endoscopic pancreatic function test (ePFT) were carried out to confirm or exclude the presence of changes of CP. A multivariate logistic regression analysis was performed to evaluate factors associated with CP findings, and results are shown as odds ratio (OR) and 95% confidence interval (CI). RESULTS: 213 patients were included. Changes of CP were confirmed by EUS (≥5 criteria) in 18 patients (8.4%). Thirty-four patients had 3-4 EUS criteria, and changes of CP were confirmed in 27 of them by MRI/sMRCP and ePFT (12.7%). Morphological and functional findings of CP were then present in 45 patients (21.1%). Male gender (OR 2.97; 95%CI 1.39-6.37) and alcohol and tobacco consumption (OR 6.56; 95%CI 1.97-21.85) were associated with the presence of changes of CP. CONCLUSION: Morphological and functional changes of CP are frequent in patients with EPS-like symptoms. Whether these pancreatic changes explain EPS-like symptoms requires further investigation.

The relationship between hours of sleep, screen time and frequency of food and drink consumption in Spain in the 2011 and 2013 ALADINO: a cross-sectional study.

BACKGROUND: The frequency of intake of food and beverages depends on a number of ill-defined behaviour patterns. The objectives of this study were to evaluate the effects of screen time and sleep duration on food consumption frequency, and to describe frequencies and types of food consumption according to BMI category and parents' level of education. METHODS: We studied 6287 and 2806 children drawn from the 2011 and 2013 cross-sectional ALADINO studies respectively. Data were collected on number of hours of sleep, screen time, and weekly frequency of consumption of 17 food groups. Weight status was measured, and information was also collected on parents' educational level. Average food consumption frequencies were calculated by reference to hours of sleep and hours of screen time, and were defined as ≥4 times or <4 times per week (once per week for soft drinks and diet soft drinks). Differences in frequency were evaluated for screen times of more and less than 2 h per day, and for sleep durations longer or shorter than the daily average. We fitted logistic regression models to evaluate the independent association between screen exposure and hours of sleep on the one hand, and food consumption frequency on the other. RESULTS: Consumption of fruit and vegetables was lower among children who had parents with no formal or only primary school education. High levels of screen time were associated with a greater frequency of consumption of energy-dense, micronutrient-poor products and a lower frequency of consumption of fruit and vegetables. Sleeping a sufficient number of hours was associated with a higher consumption of fruit and vegetables. The results for 2011 were concordant with those for 2013. CONCLUSIONS: If efforts to ensure healthier eating habits among children are to be at all successful, they should focus on promoting a sufficient amount of sleep for children, limiting the time they spend watching television and/or playing with computers or video games, and educating parents accordingly.

[Weight status in the 6- to 9-year-old school population in Spain: results of the ALADINO 2019 Study]. / Situación ponderal de la población escolar de 6 a 9 años en España: resultados del estudio ALADINO 2019.

INTRODUCTION: Introduction: childhood obesity is a public health problem whose prevalence has grown steadily in recent decades. Objective: to describe the weight status of schoolchildren aged 6 to 9 years in Spain in 2019, and their associated factors. Methods: ALADINO is a cross-sectional study in schoolchildren aged 6 to 9 years, representative of the Spanish population, and aligned with the Child Obesity Surveillance Initative of the WHO Regional Office for Europe. Participants' weight, height, and abdominal circumference were measured, defining weight status according to different standards (WHO, IOTF, and Orbegozo). A questionnaire on lifestyle and socio-demographic characteristics was administered to parents. Results: a total of 16,665 schoolchildren from 276 schools were measured. Excess weight was observed in 40.6 %: 23.3 % overweight and 17.3 % obesity, with obesity being more prevalent in boys and overweight in girls, both increasing with age. The prevalence of abdominal obesity was 22.6 %. Excess weight decreased by 3.9 percentage points since 2011, mainly due to overweight in boys. Obesity remained stable. Excess weight was more prevalent in schoolchildren with less healthy eating and physical activity habits, and in families with a lower socioeconomic status. Conclusions: the prevalence of excess weight is high, although it has declined since 2011 and remains stable since 2015 among schoolchildren aged 6-9 years in Spain, this reduction being mainly due to a decrease in overweight in children. It is necessary to continue promoting healthy habits from the earliest stages of life, thus reducing health inequalities.

INTRODUCCIÓN: Introducción: la obesidad infantil es un problema de salud pública cuya prevalencia no ha dejado de crecer en las últimas décadas. Objetivo: describir la situación ponderal de los escolares de 6 a 9 años en España en 2019, y sus factores asociados. Métodos: ALADINO es un estudio transversal en escolares de 6 a 9 años, representativo de la población española, aplicando la metodología de la Child Obesity Surveillance Initative de la Oficina Regional para Europa de la OMS. Se midieron el peso, la talla y el perímetro abdominal de los participantes, definiendo la situación ponderal según diferentes estándares (OMS, IOTF y Orbegozo). Se pasó a los progenitores un cuestionario sobre estilo de vida y características sociodemográficas. Resultados: se midieron 16.665 escolares de 276 colegios. El 40,6 % presentaban exceso de peso ­23,3 % sobrepeso y 17,3 % obesidad­, siendo la obesidad más prevalente en los niños y el sobrepeso en las niñas, y aumentando ambos con la edad. La prevalencia de la obesidad abdominal era del 22,6 %. El exceso de peso disminuyó 3,9 puntos porcentuales desde 2011, principalmente el sobrepeso de los niños. La obesidad permaneció estable. El exceso de peso fue más prevalente en los escolares con hábitos menos saludables de alimentación y actividad física, y en las familias con menor nivel socioeconómico. Conclusiones: la prevalencia del exceso de peso es elevada, aunque ha descendido desde 2011 y permanece estable desde 2015 entre los escolares de 6 a 9 años en España, debiéndose esta reducción fundamentalmente al descenso del sobrepeso en los niños. Es necesario seguir fomentando hábitos saludables desde las etapas más tempranas, reduciendo las desigualdades en salud.

Weight status in the 6 to 9 year-old school population in Spain: Results of the ALADINO 2015 study.

INTRODUCTION: Overweight and obesity in childhood and adolescence has grown alarmingly in the last twenty years or so in many countries of Europe, including Spain. This study presents the prevalences of overweight and obesity in 6-9 year-old schoolchildren in 2015, and their associated characteristics. METHODOLOGY: ALADINO (Its initials in Spanish for Diet, physical activity, child development and obesity) is a cross-sectional study of a representative sample of 6-9 year-old schoolchildren in Spain, in line with the Childhood Obesity Surveillance Initiative (COSI) of the World Health Organisation (WHO). The height and weight of the participants, defining the weight status according to WHO standards, and a questionnaire was given to the parents on lifestyle and sociodemographic characteristics. RESULTS: Anthropometric measurements were taken on 10,899 schoolchildren for 168 primary education centres. Excess weight was observed in 41.3% (95% CI: 40.0-42.6), overweight in 23.2% (95% CI: 22.1-24.3) and obesity in 18.1% (95% CI: 17.2-19.1), with obesity being more prevalent in boys, overweight in girls. The prevalence of abdominal obesity was 23.2% (95% CI: 21.8-24.6). The prevalence of overweight and obesity increased with age. Excess weight decreased by 3.2% compared to 2011, mainly due to the decrease in overweight in boys, while that of obesity remained stable. Excess weight was more prevalent in schoolchildren from families with a lower socioeconomic level. CONCLUSIONS: The prevalence of excess weight in 6-9 year-old schoolchildren in Spain has decreased by 3.2% since 2011, due to the decrease in overweight, whilst obesity remained stable. Action must be taken in the obesogenic environment, by promoting healthy eating habits and physical activity, bearing in mind the inequalities in health.

Percutaneous endoscopic gastrostomy. Indications, care and complications. / Gastrostomía endoscópica percutánea. Indicaciones, cuidados y complicaciones.

Percutaneous endoscopic gastrostomy (PEG) is an effective and safe method for nutritional support in patients with malnutrition and impossibility of oral intake with an estimated survival higher than the months that require enteral nutrition beyond four weeks. The main indications include neoplasms of the upper air-digestive tract and neurological diseases, with dementia currently considered a controversial indication. Anatomical alterations and infectious diseases are the most frequent contraindications. There are different endoscopic techniques; the most widely used being the "pull" method, with a low mortality. Complications are more frequent in patients with multiple pathologies and the elderly. Wound infection, extraction of the tube, tube blockage and bronchoaspiratory pneumonia are the most prevalent complications. Adequate prior preparation of the patient and exhaustive maintenance of the tube can reduce the appearance of these.

Iron deposition in periaqueductal gray matter as a potential biomarker for chronic migraine.

OBJECTIVE: To study iron deposition in red nucleus (RN), globus pallidus (GP), and periaqueductal gray matter (PAG) as a potential biomarker of chronic migraine (CM) and its association with levels of biomarkers related to migraine pathophysiology. METHODS: This case-control study included 112 patients with migraine (55 CM, 57 episodic migraine [EM]) and 25 headache-free controls. We analyzed iron deposition using 3T MRI and the NIH software platform ImageJ; we analyzed serum levels of markers of inflammation, endothelial dysfunction, and blood-brain barrier (BBB) disruption by ELISA in peripheral blood during interictal periods. RESULTS: Patients with CM showed larger iron grounds volume in RN compared to patients with EM (70.2 ± 6.8 vs 25.5 ± 7.3 µL, p < 0.001) and controls (70.2 ± 6.8 vs 15.1 ± 10.8 µL, p < 0.001), as well as larger iron deposits in PAG compared to patients with EM (360.3 ± 6.5 vs 249.7 ± 6.9 µL, p < 0.001) and controls (360.3 ± 6.5 vs 168.6 ± 10.3 µL, p < 0.001). In PAG, differences were also significant between patients with EM and controls. No significant differences were obtained for GP. Receiver operating characteristic curves showed that the optimal threshold for iron volume was 15 µL in RN (80% sensitivity, 71% specificity) and 240 µL in PAG (93% sensitivity, 97% specificity). Iron grounds volume in PAG was correlated with higher plasma levels of soluble tumor necrosis factor-like WEAK (r = 0.395, p = 0.005) and cellular fibronectin (r = 0.294, p = 0.040). CONCLUSIONS: Patients with CM showed increased iron deposition in RN and PAG compared to patients with EM and controls. Iron grounds volume in PAG identified correctly patients with CM and was associated with elevated biomarkers of endothelial dysfunction and BBB disruption.

[The Spanish strategy for nutrition, physical activity and the prevention of obesity (NAOS Strategy)]. / La estrategla para la nutrición, actividad física y prevención de la obesidad (Estrategia NAOS).

Obesity, the prevalence of which is still on the rise, is related to the main chronic diseases affecting the health of the population. Therefore, in 2004, the World Health Assembly approved the Global Strategy on Diet, Physical Activity and Health with the aim of reducing the risk factors of nontransmittable diseases related to unhealthy diets and physical inactivity. Along this same line, the Spanish Ministry of Health and Consumer Affairs began implementing the NAOS Strategy in 2005 as a platform from which to include and promote all those initiatives contributing to achieving the necessary social change in the promotion of healthy eating and the prevention of a sedentary lifestyle by meeting certain specific challenges within different scopes of action. The NAOS Strategy extends far beyond the healthcare and educational areas, by combining actions in all those sectors of society playing a role in preventing obesity. Informative campaigns, agreements with public and private institutions, voluntary working agreements, educational programs and supporting health promotion initiatives are some of the activities being carried out as part of the NAOS Strategy. Carrying out these activities and incorporating yet others, in conjunction with the work of evaluating and monitoring all of these activities, will be what is going to make it possible to maintain a high degree of effectiveness in preventing obesity.

Trans-fatty acid content of food products in Spain in 2015.

OBJECTIVE: To ascertain the content of trans-fatty acids (TFA) in food products in Spain in 2015 and assess trends in TFA content since 2010. METHODS: We analysed the fat content of 277 food products purchased in Spanish supermarkets in 2015 and calculated both the total fat and TFA content and the proportion of TFA to total fats. The results obtained in 2015 were compared to those yielded by a similar study in 2010. RESULTS: In 2015, the majority of food products studied had a TFA content of less than 0.2g/100g product, and a TFA/total fat ratio of less than 2%. No significant increases were found compared to 2010. Food groups with a higher TFA content were dairy products of possible natural origin. CONCLUSIONS: TFA content in Spain is low and has significantly fallen since 2010.

[CONTENT OF TRANS FATTY ACIDS IN FOOD PRODUCTS IN SPAIN]. / CONTENIDO DE ÁCIDOS GRASOS TRANS EN LOS ALIMENTOS EN ESPAÑA.

BACKGROUND: trans fatty acids are associated to several health disorders, as ischemic heart disease or diabetes mellitus. OBJECTIVES: to assess the content of trans fatty acids in products in Spain, and the percentage of trans fatty acids respecting total fatty acids. METHODS: 443 food products were acquired in Spain, and they were classified into groups. The content in fatty acids was analyzed using gas chromatography. Estimates of central tendency and variability of the content of trans fatty acids in each food group were computed (in g of trans fatty acids/100 g of product). The percentage of trans fatty acids respecting total fatty acids was calculated in each group. RESULTS: 443 products were grouped into 42 groups. Median of trans fatty acids was less than 0.55 g / 100 g of product in all groups except one. 83 % of groups had less than 2 % of trans fatty acids, and 71 % of groups had less than 1 %. DISCUSSION: the content of trans fatty acids in Spain is low, and it currently doesn't play a public health problem.

Introducción: los ácidos grasos trans están asociados con problemas de salud, como enfermedad coronaria o diabetes. Objetivos: conocer la cantidad de ácidos grasos trans en los alimentos en España, y el porcentaje que representan con respecto al total de los ácidos grasos. Métodos: se estudió el contenido en ácidos grasos de 443 alimentos adquiridos en España en el año 2010, y clasificados en grupos. Determinación analítica de grasas en los productos mediante cromatografía de gases. Se calcularon estimadores de tendencia central y dispersión de la cantidad de ácidos grasos trans en cada grupo (g de ácidos grasos trans/100 g de producto). Se calculó el porcentaje de ácidos grasos trans con respecto a la grasa total en cada grupo. Resultados: los productos se agruparon en 42 grupos. En todos, salvo uno, la mediana de ácidos grasos trans fue inferior a 0,55 g/100 g de producto. El 83 % de los grupos tienen menos del 2 % de ácidos grasos trans con respecto a las grasas totales, y el 71 %, menos del 1 %. Discusión: el contenido de AGT en los alimentos en España es bajo y no representa actualmente un problema de salud pública.

Sodium intake may promote weight gain; results of the FANPE study in a representative sample of the adult Spanish population.

INTRODUCTION: Recent studies have indicated that diets rich in sodium may predispose to the development of obesity, either directly, or be associated with the consumption of foods that promote weight gain. OBJECTIVE: The aims of this study were to analyze the association between urinary sodium and the presence of excess of weight. Additionally, the study investigated the relationships between salt intake and dietary habits, as a high salt intake may be associated with inadequate eating habits and a high incidence of obesity. METHODS: This study involved 418 adults (196 men and 222 women) aged 18 to 60 years old. Weight, height and waist circumference were measured, and we calculated, BMI and waist/height ratio. Dietary intake was estimated using a "24 h recalls", for two consecutive days, and sodium content was determined from 24 h urine sample. RESULTS: The 34.4% of the population had overweight and 13.6% had obesity. A positive association was seen between BMI and urinary sodium concentration. Urine sodium values were also positively associated with others adiposity indicators such as waist circumference and waist/height ratio. Body weight, BMI, waist circumference, and waist/height ratio were higher in the group of individuals with a urinary sodium excretion ≥154 mmol/l (Percentile 50) (P50). Additionally, individuals placed in this group presented a higher caloric intake and total food intake, in particular, more meat, processed food and snacks. Adjusting by energy intake, a higher sodium intake was a risk factor of being overweight or obese (OR = 1.0041, IC 95% 1.0015-1.0067, p < 0.01). CONCLUSIONS: Salt intake was associated with obesity; since people with higher sodium intake consumed more energy and presented worse eating habits. Additionally, sodium intake itself appears to be related to obesity.

Introducción: Estudios recientes, han señalado que las dietas ricas en sodio podrían predisponer a la aparición de obesidad, ya sea de forma directa, o por estar asociadas con el consumo de alimentos que favorecen el aumento de peso. Objetivo: El objeto de este estudio fue analizar la asociación entre sodio urinario y presencia de sobrepeso y obesidad, en una muestra representativa de adultos españoles, así como conocer si el mayor consumo de sal, se asocia con unos peores hábitos alimentarios y con una mayor ingesta de alimentos, que puedan predisponer a la aparición de la misma. Métodos: Se ha estudiado un grupo de 418 adultos (196 hombres y 222 mujeres) de 18 a 60 años de edad. Se recogieron datos de peso, talla, circunferencia de cintura y se calculó, a partir de ellos, el IMC y el índice cintura/talla. Con el fin de conocer el consumo de alimentos, se aplicó un "Recuerdo de 24 horas" durante dos días consecutivos y se determinó el sodio en orina de 24 horas. Resultados: Un 34,4% de la población presentó sobrepeso y un 13,6% obesidad. Se observó una asociación positiva entre el IMC y la excreción urinaria de sodio. Los valores de sodio en orina también se relacionaron de forma directa con otros parámetros indicadores de adiposidad, como la circunferencia de la cintura o la relación cintura/talla. Tanto el peso, como el IMC, la circunferencia de la cintura y la relación cintura/talla, fueron mayores en el grupo con una excreción urinaria de sodio ≥154 mmol/l (Percentil 50) (P50). Además, las personas con una mayor eliminación urinaria de sodio presentaron una mayor ingesta calórica y un mayor consumo de alimentos totales y, en concreto, de carnes, precocinados y aperitivos. Tras ajustar por la ingesta de energía, la mayor ingesta de sodio resultó ser un factor de riesgo de tener un IMC más alto (OR = 1.0041, IC 95% 1.0015-1.0067, p < 0,01). Conclusiones: La ingesta de sal estuvo asociada con la presencia de obesidad, ya que las personas con una mayor ingesta de sodio ingirieron más energía y presentaron peores hábitos alimentarios. Sin embargo, la ingesta de sodio por sí misma, también parece estar relacionada con el padecimiento de obesidad.

jClustering, an open framework for the development of 4D clustering algorithms.

We present jClustering, an open framework for the design of clustering algorithms in dynamic medical imaging. We developed this tool because of the difficulty involved in manually segmenting dynamic PET images and the lack of availability of source code for published segmentation algorithms. Providing an easily extensible open tool encourages publication of source code to facilitate the process of comparing algorithms and provide interested third parties with the opportunity to review code. The internal structure of the framework allows an external developer to implement new algorithms easily and quickly, focusing only on the particulars of the method being implemented and not on image data handling and preprocessing. This tool has been coded in Java and is presented as an ImageJ plugin in order to take advantage of all the functionalities offered by this imaging analysis platform. Both binary packages and source code have been published, the latter under a free software license (GNU General Public License) to allow modification if necessary.

Perceptions of diabetes obtained through drawing in childhood and adolescence.

OBJECTIVE: To examine whether drawing is useful in the detection of problems of psychosocial adaptation in children and adolescents with type 1 diabetes (T1D) and in improving communication with health professionals. METHODS: We performed an exploratory descriptive study in 199 children and adolescents with T1D aged 4-13 years. The participants were asked to render a drawing on a suggested topic. The variables analyzed were related to the drawing and to clinical and sociodemographic data. RESULTS: Most participants showed evidence of having a well-balanced personality, but there were also signs of affective or psychosocial difficulties. CONCLUSION: Drawing is a useful technique by which to identify children's and adolescents' feelings and possible problems in adapting to T1D, as well as to gain information directly from the children themselves. Future studies should delimit the possibilities of this technique in clinical practice in greater detail.

Automatic TAC extraction from dynamic cardiac PET imaging using iterative correlation from a population template.

This work describes a new iterative method for extracting time-activity curves (TAC) from dynamic imaging studies using a priori information from generic models obtained from TAC templates. Analytical expressions of the TAC templates were derived from TACs obtained by manual segmentation of three (13)NH3 pig studies (gold standard). An iterative method for extracting both ventricular and myocardial TACs using models of the curves obtained as an initial template was then implemented and tested. These TACs were extracted from masked and unmasked images; masking was applied to remove the lungs and surrounding non-relevant structures. The resulting TACs were then compared with TACs obtained manually; the results of kinetic analysis were also compared. Extraction of TACs for each region was sensitive to the presence of other organs (e.g., lungs) in the image. Masking the volume of interest noticeably reduces error. The proposed method yields good results in terms of TAC definition and kinetic parameter estimation, even when the initial TAC templates do not accurately match specific tracer kinetics.

[Social determinants of overweight and obesity in Spain in 2006]. / Determinantes sociales de sobrepeso y obesidad en España 2006.

BACKGROUND AND OBJECTIVE: Obesity in the Spanish adult population has almost doubled from 1987 to 2003. The aim is to update the prevalence of overweight and obesity, and reassess its main social determinants using the National Health Household Survey (ENS) from 2006. PATIENTS AND METHODS: Cross sectional study based on the ENS-2006. Sample of 29,478 adults who answered questions on self-reported weight and height. We calculated the body mass index (WHO classification) for the dependent variable. Sociodemographic independent variables used were age, sex, marriage status, educational level, social class (manual, non-manual), and monthly income. A descriptive study was conducted as well as different logistic regression models. RESULTS: In 2006, the prevalence of overweight is higher in men (43.9%) than women (28.9%). Sex differences were not observed in the prevalence of obesity (15.0%). The multinomial logistic regression analysis shows significant associations between obesity and marriage status: married OR=1.69 (1.51-1.89), widower OR=1.77 (1.45-2.16); population without education: OR=2.77 (2.34-3.28) and income below 600 €: OR=1.50 (1.18-1.91). There was a statistically significant interaction (p<0.001) between sex and social class. Women from manual social class have 49% more chances to be overweight and 96% greater risk of obesity compared to non-manual social class women. In addition, men of manual social class have less risk of overweight (18%) and obesity (12%) than non-manual social class men. CONCLUSIONS: Gender and socioeconomic status are key social determinants for obesity in Spain and, consequently, this needs to be addressed when developing preventive activities.