Diagnosis and treatment of benign adipocytic tumors in children.

PURPOSE: To describe demographic, clinical, diagnostic and therapeutic aspects of pediatric patients with benign adipocytic tumors admitted to a high complexity teaching hospital from 2007 to 2021. METHODS: Retrospective observational descriptive study. Patient information was retrieved from clinical records. A descriptive analysis was carried out for qualitative data and frequencies were calculated for quantitative data. RESULTS: 76 patients were included with a mean age of 7.5 years old where 60.5% were boys. The main symptom was a mass (73.7%) mostly found in the lower limbs (23.6%). Congenital birth defects were identified in 48.6% of the cases. Preoperative imaging was available in 78.9% of the patients allowing characterization of lesions or differential diagnosis. The therapeutic goal was resection with negative margins, which was feasible in all cases except for one case. The histopathological diagnosis was lipoma in 68.4% of the cases followed by lipoblastoma in 13.1%. The mean follow-up period was 17.9 months. 79.7% of the patients were asymptomatic at their last out-patient visit. CONCLUSION: Benign adipocytic tumors constitute a wide spectrum of lesions, which involve diverse anatomic segments from the neural axis to the inguinoscrotal region. The present work contributes to the general understanding of the clinical presentation and differential diagnosis for these infrequent neoplasms.

Traffic Density Exposure, Oxidative Stress Biomarkers and Plasma Metabolomics in a Population-Based Sample: The Hortega Study.

Exposure to traffic-related air pollution (TRAP) generates oxidative stress, with downstream effects at the metabolic level. Human studies of traffic density and metabolomic markers, however, are rare. The main objective of this study was to evaluate the cross-sectional association between traffic density in the street of residence with oxidative stress and metabolomic profiles measured in a population-based sample from Spain. We also explored in silico the potential biological implications of the findings. Secondarily, we assessed the contribution of oxidative stress to the association between exposure to traffic density and variation in plasma metabolite levels. Traffic density was defined as the average daily traffic volume over an entire year within a buffer of 50 m around the participants' residence. Plasma metabolomic profiles and urine oxidative stress biomarkers were measured in samples from 1181 Hortega Study participants by nuclear magnetic resonance spectroscopy and high-performance liquid chromatography, respectively. Traffic density was associated with 7 (out of 49) plasma metabolites, including amino acids, fatty acids, products of bacterial and energy metabolism and fluid balance metabolites. Regarding urine oxidative stress biomarkers, traffic associations were positive for GSSG/GSH% and negative for MDA. A total of 12 KEGG pathways were linked to traffic-related metabolites. In a protein network from genes included in over-represented pathways and 63 redox-related candidate genes, we observed relevant proteins from the glutathione cycle. GSSG/GSH% and MDA accounted for 14.6% and 12.2% of changes in isobutyrate and the CH2CH2CO fatty acid moiety, respectively, which is attributable to traffic exposure. At the population level, exposure to traffic density was associated with specific urine oxidative stress and plasma metabolites. Although our results support a role of oxidative stress as a biological intermediary of traffic-related metabolic alterations, with potential implications for the co-bacterial and lipid metabolism, additional mechanistic and prospective studies are needed to confirm our findings.

[Adherence to mediterranean diet and its associated factors in adolescents from Madrid.] / Adherencia a la dieta mediterránea y su asociación con factores sociodemográficos y antropométricos en adolescentes de Madrid.

OBJECTIVE: Unhealthy diet is the main contributor to childhood obesity. The aim of this study was to assess adherence to the mediterranean diet in a sample of adolescents and analyse adherence-related factors. METHODS: Cross-sectional descriptive study (June-October 2020), in a non-probabilistic sample of 473 patients with Substance Use Disorder, from the 8 Addiction Care Centers (CAD) of the Madrid City Council. Their demographic, habits and health characteristics, IgM and IgG for SARS-CoV-2, previous PCR, presence of symptoms, contact with COVID-19 cases were described, and multivariate analysis was performed using binary logistic regression. RESULTS: A total of 64.3% of participants displayed a medium level and 21.3% a high level of adherence to the mediterranean diet. High adherence was less frequent among teenage girls (17% [PR=0.63; p=0.02]), those whose mothers had not gone beyond primary school (16.3% [PR=0.58; p=0.07]), those who slept less than 8.5 h/day (16.8% [PR=0.54; p<0.01]), and those who used a mobile telephone for more than 2.6 hours per day (12.2% [PR=0.56; p=0.02]). CONCLUSIONS: Adherence to the mediterranean diet is less than optimum in four out of five adolescents, and is lower in teenage girls whose mothers had not gone beyond primary school or who devote more time to mobile telephones and less time to sleeping. Our results highlight the importance of paying attention to sleeping habits and reducing the use of screens when seeking to improve mediterranean diet adherence among adolescents.

OBJETIVO: La dieta poco saludable es el principal factor que contribuye a la obesidad infantil. El objetivo de este estudio fue evaluar la adherencia a la dieta mediterránea en una muestra de adolescentes y analizar los factores asociados a la misma. METODOS: Se realizó una encuesta transversal a 573 adolescentes de entre 11 y 14 años en Madrid en 2018. Se recogieron variables mediante un cuestionario. La adherencia a la dieta mediterránea se midió con el índice KIDMED. Las características asociadas a una alta adherencia se analizaron mediante razones de prevalencia (RP) obtenidas con regresión de Poisson de varianza robusta. RESULTADOS: El 64,3% de los participantes presentaron un nivel de adherencia medio a la dieta mediterránea. La alta adherencia fue menos frecuente en adolescentes mujeres (17% [RP=0,63; p=0,02]), cuyas madres no habían superado los estudios primarios (16,3% [RP=0,58; p=0,07]), que dormían menos de 8,5 horas al día (16,8% [RP=0,54; p<0,01]) o que usaban el móvil más de 2,6 horas al día (12,2% [RP=0,56; p=0,02]). CONCLUSIONES: La adherencia a la dieta mediterránea es inferior a la óptima en cuatro de cada cinco adolescentes, y resulta menor en adolescentes mujeres, cuyas madres no superaron los estudios primarios o que dedicaban más tiempo al móvil y menos a dormir. Nuestros resultados apuntan a la importancia de atender a los hábitos de sueño y a reducir el uso de pantallas para mejorar la adherencia a la dieta mediterránea en adolescentes.

COVID-19-Related Neuropsychiatric Symptoms in Patients With Alcohol Abuse Conditions During the SARS-CoV-2 Pandemic: A Retrospective Cohort Study Using Real World Data From Electronic Health Records of a Tertiary Hospital.

Patients with an alcohol abuse disorder exhibit several medical characteristics and social determinants, which suggest a greater vulnerability to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a worse course of the coronavirus disease 2019 (COVID-19) once infected. During the first wave of the COVID-19, most of the countries have register an increase in alcohol consumption. However, studies on the impact of alcohol addiction on the risk of COVID-19 infection are very scarce and inconclusive. This research offers a descriptive observational retrospective cohort study using real world data obtained from the Electronic Health Records. We found that patients with a personal history of alcohol abuse were 8% more likely to extend their hospitalization length of stay for 1 day (95% CI = 1.04-1.12) and 15% more likely to extend their Intensive Care Unit (ICU) length of stay (95% CI = 1.01-1.30). They were also 5.47 times more at risk of needing an ICU admission (95% CI = 1.61-18.57) and 3.54 times (95% CI = 1.51-8.30) more at risk of needing a respirator. Regarding COVID-19 symptoms, patients with a personal history of alcohol abuse were 91% more likely of exhibiting dyspnea (95% CI = 1.03-3.55) and 3.15 times more at risk of showing at least one neuropsychiatric symptom (95% CI = 1.61-6.17). In addition, they showed statistically significant differences in the number of neuropsychiatric symptoms developed during the COVID-19 infection. Therefore, we strongly recommend to warn of the negative consequences of alcohol abuse over COVID-19 complications. For this purpose. Clinicians should systematically assess history of alcohol issues and drinking habits in all patients, especially for those who seek medical advice regarding COVID-19 infection, in order to predict its severity of symptoms and potential complications. Moreover, this information should be included, in a structured field, into the Electronic Health Record to facilitate the automatic extraction of data, in real time, useful to evaluate the decision-making process in a dynamic context.

Adherencia a la dieta mediterránea y su asociación con factores sociodemográficos y antropométricos en adolescentes de Madrid / Adherence to mediterranean diet and its associated factors in adolescents from Madrid

FUNDAMENTOS: La dieta poco saludable es el principal factor que contribuye a la obesidad infantil. El objetivo de este estudio fue evaluar la adherencia a la dieta mediterránea en una muestra de adolescentes y analizar los factores asociados a la misma. MÉTODOS: Se realizó una encuesta transversal a 573 adolescentes de entre 11 y 14 años en Madrid en 2018. Se recogieron variables mediante un cuestionario. La adherencia a la dieta mediterránea se midió con el índiceKIDMED. Las características asociadas a una alta adherencia se analizaron mediante razones de prevalencia (RP) obtenidas con regresión de Poisson de varianza robusta. RESULTADOS: El 64,3% de los participantes presentaron un nivel de adherencia medio a la dieta mediterránea. La alta adherencia fue menos frecuente en adolescentes mujeres (17% [RP=0,63; p=0,02]), cuyas madres no habían superado los estudios primarios (16,3% [RP=0,58; p=0,07]), que dormían menos de 8,5 horas al día (16,8% [RP=0,54; p<0,01]) o que usaban el móvil más de 2,6 horas al día (12,2% [RP=0,56; p=0,02]). CONCLUSIONES: La adherencia a la dieta mediterránea es inferior a la óptima en cuatro de cada cinco adolescentes, y resulta menor en adolescentes mujeres, cuyas madres no superaron los estudios primarios o que dedicaban más tiempo al móvil y menos a dormir. Nuestros resultados apuntan a la importancia de atender a los hábitos de sueño y a reducir el uso de pantallas para mejorar la adherencia a la dieta mediterránea en adolescentes.(AU)

BACKGROUND: Unhealthy diet is the main contributor to childhood obesity. The aim of this study was to assess adherence to the mediterranean diet in a sample of adolescents and analyse adherence-related factors. METHODS: Cross-sectional descriptive study (June-October 2020), in a non-probabilistic sample of 473 patients with Substance Use Disorder, from the 8 Addiction Care Centers (CAD) of the Madrid City Council. Their demographic, habits and health characteristics, IgM and IgG for SARS-CoV-2, previous PCR, presence of symptoms, contact with COVID-19 cases were described, and multivariate analysis was performed using binary logistic regression. RESULTS: A total of 64.3% of participants displayed a medium level and 21.3% a high level of adherence to the mediterranean diet. High adherence was less frequent among teenage girls (17% [PR=0.63; p=0.02]), those whose mothers had not gone beyond primary school (16.3% [PR=0.58; p=0.07]), those who slept less than 8.5 h/day (16.8% [PR=0.54; p<0.01]), and those who used a mobile telephone for more than 2.6 hours per day (12.2% [PR=0.56; p=0.02]).CONCLUSIONS: Adherence to the mediterranean diet is less than optimum in four out of five adolescents, and is lower in teenage girls whose mothers had not gone beyond primary school or who devote more time to mobile telephones and less time to sleeping. Our results highlight the importance of paying attention to sleeping habits and reducing the use of screens when seeking to improve mediterranean diet adherence among adolescents.(AU)

Compliance with objectives based on different guidelines (KDIGO/S.E.N.) and analysis of the individual variability of mineral metabolism in haemodialysis patients in the medium term.

OBJECTIVE: To assess the level of compliance and variability of mineral metabolism parameters over time in a sample of haemodialysis patients for the different ranges proposed (KDIGO guidelines/S.E.N recommendations) in both groups and individuals continuously. MATERIAL AND METHOD: Every four months, we collected data on calcium, phosphorus, PTH and treatment in a sample of 44 patients followed up continuously for 32 months. We established the percentages of patients who complied with the objectives set for each parameter in both ranges: optimal (KDIGO) and acceptable (S.E.N.) in each control and the percentage that individually complied with the objectives in at least 75% of the determinations. RESULTS: Compliance with the objective using the optimal range improved, although PTH did not exceed 50%. Using the acceptable range, the objective was achieved in the three parameters in over 70% and over 50% of patients achieved the three simultaneously while using the optimal range, 30% was never achieved. Individually, compliance with the optimal range was continuously achieved in 52.3% (calcium), 45.5% (phosphorus) and in only one patient in PTH, while when using the acceptable range, compliance was achieved in 84.1% (calcium) and 70.5% (phosphorus and PTH). CONCLUSIONS: The use of less stringent criteria than the KDIGO guidelines in calcium, phosphorus and PTH objectives allows patients to remain continuously within appropriate ranges with less intervention and less individual variability.

Cumplimiento de objetivos en función de diferentes guías (KDIGO/S. E. N. ) y análisis de la variabilidad individual del metabolismo mineral en pacientes en hemodiálisis a medio plazo / Compliance with objectives based on different guidelines (KDIGO/S. E. N. ) and analysis of the individual variability of mineral metabolism in haemodialysis patients in the medium term

Objetivos: Valorar el grado de cumplimiento y la variabilidad de los parámetros del metabolismo mineral a lo largo del tiempo en una muestra de pacientes en hemodiálisis según los distintos rangos propuestos (Guía KDIGO/Recomendaciones S.E.N.) tanto a nivel de grupo como individual de forma continuada. Material y métodos: Recogimos cuatrimestralmente los datos de calcio, fósforo, hormona paratiroidea (PTH) y de tratamiento en una muestra de 44 pacientes seguidos de forma continuada durante 32 meses. Establecimos los porcentajes de pacientes que cumplían los objetivos propuestos para cada parámetro en ambos rangos: óptimo (KDIGO) y aceptable (S.E.N.) en cada control y el porcentaje que cumplían individualmente los objetivos en al menos un 75 % de las determinaciones. Resultados: El cumplimiento del objetivo utilizando el rango óptimo mejoró, aunque en la PTH no superó el 50 %. Utilizando el rango aceptable, el objetivo se alcanzaba en los tres parámetros por encima del 70 % y más del 50 % de los pacientes cumplían los tres simultáneamente, mientras que utilizando el rango óptimo nunca se alcanzó el 30 %. A nivel individual el cumplimiento del rango óptimo se alcanzó de forma continuada en el 52,3 % (calcio), 45,5% (fósforo) y solo un paciente en la PTH, mientras que utilizando el rango aceptable el cumplimiento se alcanzó en el 84,1 % (calcio) y el 70,5 % (fósforo y PTH). Conclusiones: El uso de criterios menos exigentes que los KDIGO en los objetivos de calcio, fósforo y PTH permite mantener de forma continuada a los pacientes en rangos adecuados con menor intervencionismo y menor variabilidad individual

Objective: To assess the level of compliance and variability of mineral metabolism parameters over time in a sample of haemodialysis patients for the different ranges proposed (KDIGO guidelines/S.E.N recommendations) in both groups and individuals continuously. Material and method: Every four months, we collected data on calcium, phosphorus, PTH and treatment in a sample of 44 patients followed up continuously for 32 months. We established the percentages of patients who complied with the objectives set for each parameter in both ranges: optimal (KDIGO) and acceptable (S.E.N.) in each control and the percentage that individually complied with the objectives in at least 75% of the determinations. Results: Compliance with the objective using the optimal range improved, although PTH did not exceed 50%. Using the acceptable range, the objective was achieved in the three parameters in over 70% and over 50% of patients achieved the three simultaneously while using the optimal range, 30% was never achieved. Individually, compliance with the optimal range was continuously achieved in 52.3% (calcium), 45.5% (phosphorus) and in only one patient in PTH, while when using the acceptable range, compliance was achieved in 84.1% (calcium) and 70.5% (phosphorus and PTH). Conclusions: The use of less stringent criteria than the KDIGO guidelines in calcium, phosphorus and PTH objectives allows patients to remain continuously within appropriate ranges with less intervention and less individual variability (AU)