Reporting of Perinatal Outcomes in Probiotic Randomized Controlled Trials. A Systematic Review and Meta-Analysis.

The use of probiotic microorganisms in clinical practice has increased in recent years and a significant number of pregnant women are regular consumers of these products. However, probiotics might modulate the immune system, and whether or not this modulation is beneficial for perinatal outcomes is unclear. We performed a systematic review and meta-analysis to evaluate the reporting of perinatal outcomes in randomized controlled trials including women supplemented with probiotic microorganisms during pregnancy. We also analyzed the effects that the administration of probiotic microorganisms exerts on perinatal outcomes. In the review, 46 papers were included and 25 were meta-analyzed. Reporting of perinatal outcomes was highly inconsistent across the studies. Only birth weight, cesarean section, and weeks of gestation were reported in more than 50% of the studies. Random effects meta-analysis results showed that the administration of probiotic microorganisms during pregnancy did not have any a positive or negative impact on the perinatal outcomes evaluated. Subgroup analysis results at the strain level were not significantly different from main analysis results. The administration of probiotic microorganisms does not appear to influence perinatal outcomes. Nonetheless, future probiotic studies conducted in pregnant women should report probiotic strains and perinatal outcomes in order to shed light upon probiotics' effects on pregnancy outcomes.

Uso de cinacalcet para el control del hiperparatiroidismo en pacientes con diferentes grados de insuficiencia renal / Use of cinacalcet for the management of hyperparathyroidism in patients with different degrees of renal failure

Antecedentes: Los efectos de cinacalcet en el hiperparatiroidismo secundario (HPTS), persistente o asociado a hipercalcemia han sido descritos en pacientes en diálisis. Objetivos: Analizar la eficacia y seguridad de cinacalcet en HPTS no sometido a diálisis y sus efectos sobre marcadores de recambio óseo. Métodos: Estudio analítico observacional, no aleatorizado, longitudinal, de pacientes con enfermedad renal crónica (ERC) e HPTS (PTH > 80 pg/mL); con normohipercalcemia (≥8,5mg/dL), tratados con cinacalcet. Resultados: La dosis media de cinacalcet fue de 30mg/día en un 66,7%. Estudiamos 15 pacientes (10 mujeres), con edad de 66,0±17,93 años. Etiología desconocida en 20% de los casos. Registramos variables sociodemográficas y parámetros de función renal. Comparamos valores basales, tras 6 y 12 meses. Descendieron los niveles de iPTH (392,4±317,65 vs. 141,8±59,26) y calcio (10,3±0,55 vs. 9,4±1,04). Aumentaron los valores de fósforo (3,7±1,06 vs. 3,9±0,85) y ß-CTX (884,2±797,22 vs. 1.053,6±999,00), sin variaciones significativas del FG, calciuria y demás marcadores óseos. Registrados 2 abandonos (intolerancia digestiva y paratiroidectomía, respectivamente). Conclusiones: Cinacalcet a dosis bajas es eficaz en el manejo del HPTS del paciente con ERC no tratado mediante diálisis, al disminuir la iPTH y la calcemia, sin ocasionar efectos adversos graves ni variación significativa de la función renal (AU)

Background: The effects of cinacalcet in persistent and/or hypercalcaemia-associated secondary hyperparathyroidism (SHPT) have been described in patients on dialysis. Objectives: To evaluate the efficacy and safety of cinacalcet in SHPT not on dialysis and its effects on bone turnover markers. Methods: Non-randomised, longitudinal, observational, analytical study of patients with chronic kidney disease (CKD) and SHPT (PTH> 80 pg/mL) as well as normo- or hypercalcaemia (≥8.5mg/dL), treated with cinacalcet. Results: Mean cinacalcet dose was 30mg/day in 66.7%. We studied 15 patients (10 women), aged 66.0±17.93years. The aetiology was unknown in 20% of cases. Sociodemographic variables and renal function parameters were recorded. We compared values at baseline as well as after 6 and 12 months. Calcium (10.3±0.55 vs. 9.4±1.04) and iPTH (392.4±317.65 vs. 141.8±59.26) levels decreased. Increased levels of phosphorus (3.7±1.06 vs. 3.9±0.85) and ß-CTX (884.2±797.22 vs. 1053.6±999.00) were detected, although there were no significant changes in GFR, urinary calcium or other bone markers. Two patients withdrew from the study (gastrointestinal intolerance and parathyroidectomy, respectively). Conclusions: Cinacalcet at low doses is effective in the management of SHPT in CKD patients who are not on dialysis. Its use reduces iPTH and calcaemia, without causing serious side effects or significant changes in renal function (AU)

Use of cinacalcet for the management of hyperparathyroidism in patients with different degrees of renal failure.

BACKGROUND: The effects of cinacalcet in persistent and/or hypercalcaemia-associated secondary hyperparathyroidism (SHPT) have been described in patients on dialysis. OBJECTIVES: To evaluate the efficacy and safety of cinacalcet in SHPT not on dialysis and its effects on bone turnover markers. METHODS: Non-randomised, longitudinal, observational, analytical study of patients with chronic kidney disease (CKD) and SHPT (PTH> 80 pg/mL) as well as normo- or hypercalcaemia (≥8.5mg/dL), treated with cinacalcet. RESULTS: Mean cinacalcet dose was 30mg/day in 66.7%. We studied 15 patients (10 women), aged 66.0±17.93years. The aetiology was unknown in 20% of cases. Sociodemographic variables and renal function parameters were recorded. We compared values at baseline as well as after 6 and 12 months. Calcium (10.3±0.55 vs. 9.4±1.04) and iPTH (392.4±317.65 vs. 141.8±59.26) levels decreased. Increased levels of phosphorus (3.7±1.06 vs. 3.9±0.85) and ß-CTX (884.2±797.22 vs. 1053.6±999.00) were detected, although there were no significant changes in GFR, urinary calcium or other bone markers. Two patients withdrew from the study (gastrointestinal intolerance and parathyroidectomy, respectively). CONCLUSIONS: Cinacalcet at low doses is effective in the management of SHPT in CKD patients who are not on dialysis. Its use reduces iPTH and calcaemia, without causing serious side effects or significant changes in renal function.

[USE, EFFECTS, AND KNOWLEDGE OF THE NUTRITIONAL SUPPLEMENTS FOR THE SPORT IN UNIVERSITY STUDENTS]. / USO, EFECTOS Y CONOCIMIENTOS DE LOS SUPLEMENTOS NUTRICIONALES PARA EL DEPORTE EN ESTUDIANTES UNIVERSITARIOS.

BACKGROUND: consumption and marketing of supplements that help improve athletic performance has increased in semi-professional sport. Moreover, in the market are increasingly a wide variety of such products pressure and high performance requirements push many young athletes to have recourse to the use of supplements to improve your fitness. However, this type of treatment should be advised and guided by an expert since improper use of such supplements favors the appearance of adverse effects and can be harmful to the health of the individual. OBJECTIVE: to know the use of supplements to improve athletic performance by college athletes methods: was a systematic review in the Pubmed database, care, BIREME CUIDEN, BIREME (IBECS y Scielo) and CINHAL limited to articles published in the last ten years. RESULTS: 25 articles were analyzed. The main themes were found in the literature reviewed have been three: the "levels of supplements to increase athletic performance in college students", "effect of sports supplements" and "knowledge, behaviors and motivations for sports supplements". CONCLUSIONS: taking into account that the around 55% of University athletes using supplements but show a lack significant knowledge is necessary to provide a health education on such supplements.

Introducción: el consumo y comercialización de suplementos que ayudan a mejorar el rendimiento físico ha aumentado en el ámbito deportivo semiprofesional. Además, la comercialización de este tipo de productos en el mercado cada vez es más variada. La presión y las altas exigencias de rendimiento personal empujan a muchos jóvenes estudiantes y deportistas a recurrir al uso de suplementos con objeto de mejorar su forma física. Sin embargo, este proceso debiera ser aconsejado y guiado por un experto, puesto que un uso incorrecto de dichos suplementos favorece la aparición de efectos adversos, con el consecuente perjuicio para la salud del individuo. Objetivo: conocer el grado de conocimientos, usos y efectos de los suplementos para la mejora del rendimiento deportivo por parte de estudiantes universitarios. Métodos: se efectuó una revisión sistemática en las bases de datos de Pubmed, CUIDEN, BIREME (IBECS y Scielo), CINHAL y Scopus limitada a artículos publicados en los últimos diez años. Resultados: se analizaron 32 artículos. Las temáticas principales encontradas en la literatura revisada han sido tres: los "niveles de consumo de suplementos para aumentar el rendimiento deportivo en estudiantes universitarios", el "efecto del consumo de suplementos deportivos" y los "conocimientos, conductas y motivaciones para el consumo de suplementos deportivos". Conclusiones: existe una gran heterogeneidad sobre el consumo de suplementos para la mejora del rendimiento deportivo y son muchas las sustancias que se ponen a prueba para comprobar su verdadero efecto, no consiguiendo en múltiples ocasiones el objetivo de mejorar dicho rendimiento.

Uso, efectos y conocimientos de los suplementos nutricionales para el deporte en estudiantes universitarios / Use, effects, and knowledge of the nutritional supplements for the sport in university students

Introducción: el consumo y comercialización de suplementos que ayudan a mejorar el rendimiento físico ha aumentado en el ámbito deportivo semiprofesional. Además, la comercialización de este tipo de productos en el mercado cada vez es más variada. La presión y las altas exigencias de rendimiento personal empujan a muchos jóvenes estudiantes y deportistas a recurrir al uso de suplementos con objeto de mejorar su forma física. Sin embargo, este proceso debiera ser aconsejado y guiado por un experto, puesto que un uso incorrecto de dichos suplementos favorece la aparición de efectos adversos, con el consecuente perjuicio para la salud del individuo. Objetivo: conocer el grado de conocimientos, usos y efectos de los suplementos para la mejora del rendimiento deportivo por parte de estudiantes universitarios. Métodos: se efectuó una revisión sistemática en las bases de datos de Pubmed, CUIDEN, BIREME (IBECS y Scielo), CINHAL y Scopus limitada a artículos publicados en los últimos diez años. Resultados: se analizaron 32 artículos. Las temáticas principales encontradas en la literatura revisada han sido tres: los «niveles de consumo de suplementos para aumentar el rendimiento deportivo en estudiantes universitarios», el «efecto del consumo de suplementos deportivos» y los «conocimientos, conductas y motivaciones para el consumo de suplementos deportivos». Conclusiones: existe una gran heterogeneidad sobre el consumo de suplementos para la mejora del rendimiento deportivo y son muchas las sustancias que se ponen a prueba para comprobar su verdadero efecto, no consiguiendo en múltiples ocasiones el objetivo de mejorar dicho rendimiento (AU)

Background: consumption and marketing of supplements that help improve athletic performance has increased in semi-professional sport. Moreover, in the market are increasingly a wide variety of such products pressure and high performance requirements push many young athletes to have recourse to the use of supplements to improve your fitness. However, this type of treatment should be advised and guided by an expert since improper use of such supplements favors the appearance of adverse effects and can be harmful to the health of the individual. Objective: to know the use of supplements to improve athletic performance by college athletes methods: was a systematic review in the Pubmed database, care, BIREME CUIDEN, BIREME (IBECS y Scielo) and CINHAL limited to articles published in the last ten years. Results: 25 articles were analyzed. The main themes were found in the literature reviewed have been three: the «levels of supplements to increase athletic performance in college students», «effect of sports supplements» and «knowledge, behaviors and motivations for sports supplements». Conclusions: taking into account that the around 55% of University athletes using supplements but show a lack significant knowledge is necessary to provide a health education on such supplements (AU)

Fitoestrógenos y sus efectos sobre la osteoporosis en la mujer posmenopáusica / Phytoestrogens and their effects on osteoporosis in postmenopausal women

Los fitoestrógenos son sustancias de origen vegetal con efecto estrogénico débil, de inhibición enzimática y antioxidante. Desde un punto de vista clínico, se han barajado como una alternativa de tratamiento en la mujer menopáusica y sus síntomas asociados. Teniendo en cuenta que los estrógenos son los principales responsables del mantenimiento de la masa ósea en la mujer, inhibiendo la resorción ósea a través de su interacción con los osteoblastos, la reducción de sus niveles durante la menopausia constituirá un factor de riesgo para el desarrollo de osteoporosis en la mujer posmenopáusica. En este sentido, cabe plantearse si la terapia con fitoestrógenos constituye o no una herramienta terapéutica por su potencial efecto estrogénico en la prevención de la osteoporosis posmenopáusica. El objetivo de este trabajo ha sido proporcionar una revisión amplia y precisa acerca de la evidencia científica existente por el momento en torno al papel de los fitoestrógenos en la prevención de la osteoporosis en la mujer posmenopáusica y sus implicaciones en la clínica (AU)

Phytoestrogens are plant substances with a weak estrogenic effect, an enzyme inhibitory effect and antioxidant activity. The possibility of using them for menopause associated symptoms has been entertained. Given that estrogens are primarily responsible for maintaining bone mass in women by inhibiting bone resorption through their interaction with osteoblasts, reducing estrogen levels during menopause constitutes a risk factor for developing osteoporosis in postmenopausal women. In view of this, the question arises as to whether phytoestrogens, due to their potential estrogenic effect, constitute or not a therapeutic tool in the prevention of postmenopausal osteoporosis. The aim of this study was to provide a comprehensive, accurate review on the available scientific evidence regarding the role of phytoestrogens in preventing osteoporosis in postmenopausal women and its implications in clinical practice (AU)