Estado de salud y nutrición del adulto mayor que concurre al Hospital Geriátrico del Seguro Social en la Asunción. Paraguay / Health status of older adults attending the Geriatric Hospital of the Social Security, in Asunción, Paraguay

Resumen El aumento de la población de adultos mayores y su mayor demanda de atención en salud en Paraguay, requiere de una evaluación multidimensional que identifique sus condiciones de riesgo o deterioro. El objetivo de esta investigación, fue evaluar el estado de salud y nutrición de una muestra de adultos mayores que acudieron a la consulta ambulatoria del Hospital Geriátrico de la Previsional, en la Asunción, Paraguay. La investigación tuvo un diseño observacional, descriptivo y de corte transverso, de 108 adultos mayores a quienes se les realizó la Valoración Geriátrica Integral (VGI) y se evaluaron parámetros nutricionales. La edad promedio fue de 71 años con predominio del sexo femenino. De acuerdo al IMC, el 64% presentó sobrepeso u obesidad. De acuerdo a la VGI, 18% presentó riesgo nutricional, 43% dependencia leve para las actividades de la vida diaria y 12% para las actividades instrumentales. El 18% mostró déficit cognitivo, el 6% depresión y el 30% riesgo social. La población se caracterizó por presentar altas frecuencias de exceso de peso e hipertensión, con una baja frecuencia de riesgo de desnutrición, las mayores limitaciones se dieron en las actividades básicas de la vida diaria y en el riesgo social. El ser mujer y el exceso de peso se asociaron significativamente con las limitaciones básicas funcionales. Este trabajo constituyó uno de los primeros en el país sobre adultos mayores ambulatorios, permitiendo configurar una línea de base de las áreas comprometidas o en riesgo de declinación y desarrollar estrategias y acciones preventivas para promover un envejecimiento saludable.

Abstract The increase in the population of older adults and their more significant demand for health care in Paraguay requires a multidimensional evaluation to identify risks or deteriorating conditions. The objective of this research was to evaluate the health and nutrition status of a sample of older adults who attended the Geriatric Hospital of the Social Security for outpatient consultation. The research had a cross-sectional descriptive observational design, which included 108 older adults who underwent the Comprehensive Geriatric Assessment (CGA) and whose nutritional parameters were evaluated. Their average age was 71 years, with a predominance of females. According to their BMI, 64% were overweight or obese. As for the CGA, 18% presented a nutritional risk, 43% had mild dependence on activities of daily living and 12% on instrumental activities, 18% had a cognitive deficit, 6% had depression, and 30% had social risk. The population was characterized by a high prevalence of overweight and hypertension and a low frequency of risk of malnutrition. The most significant limitations were in the basic activities of daily life and social risk. Being female and being overweight were significantly associated with basic functional limitations. This work was one of the first in the country on ambulatory older adults, allowing the establishment of a baseline for areas where health is compromised or at risk of decline and the development of preventive strategies and actions to promote healthy aging.

Impact of school-based nutrition and physical activity intervention on body mass index eight years after cessation of randomized controlled trial (AVall study).

BACKGROUND & AIMS: The prevalence of obesity and overweight among children is increasing, representing a new and pressing societal problem. Excess weight in childhood is an independent risk factor for adult obesity. Although school-based interventions are generally considered effective in the short term, few studies analyze their longterm impact. The aim of study was to assess if the effect of the intervention on body mass Index (BMI) immediately after the intervention remained eight years later (AVall Study). METHODS: In 2006-2008, an intervention for primary school children promoted healthy eating habits and physical activity in the school setting using the Investigation, Vision, Action and Change (IVAC) educational methodology, which involves children as active participants in healthy change. At baseline, parents reported their weight, height and educational level by questionnaire. Children's weight and height were measured in situ in 2006, 2008, 2010, 2012 and 2016, and levels of physical activity were assessed by questionnaire. Multilevel mixed effects linear regression was used to assess changes in BMI over time. RESULTS: Increases in BMI from 2006 to 2016 were 0.68 kg/m2 (95% CI, 0.02, 1.34; P = 0.045) higher in the control group than in the intervention group. The prevalence of obesity and overweight combined in 2006 and 2016 was 22.2% and 27.9%, respectively, in the control group and 25.6% and 21.2% respectively, in the intervention group. Changes in BMI in the intervention group were maintained from 2006 on: at the end of the intervention in 2008, -0.4 kg/m2 (P = 0.001); in 2010, -0.23 g/m2 (P = 0.012); in 2012, -0.63 kg/m2 (P < 0.001) and in 2016, -0.27 kg/m2 (P = 0.025). The child's BMI increased by 0.52 kg/m2 (P = 0.046) if the father was obese, by 1.26 kg/m2 (p = 0.011) if the mother was obese, and by 2.37 kg/m2 (P < 0.001) if both parents were obese. Parental education levels were not associated with childhood obesity. CONCLUSIONS: A school-based healthy eating habits and physical activity intervention using IVAC methodology contributed to lower increases in BMI among children in primary school. Although parental BMI also influenced children's BMI, the intervention was effective. TRIAL REGISTRATION: ClinicalTrials.gov NCT01156805.

Synthesis, pharmacological study and docking calculations of new benzo[f]coumarin derivatives as dual inhibitors of enzymatic systems involved in neurodegenerative diseases.

BACKGROUND: Due to the complex etiology of neurodegenerative diseases, there is growing interest in multitarget drugs. In this study we synthesized and evaluated a new series of compounds, with benzo[f]coumarin structure, as potential inhibitors of MAO-A, MAO-B, AChE and BuChE. RESULTS: In vitro studies show that most of the studied compounds inhibited the activity of MAO-B in the nano- to micro-molar range. 3-(3´-methoxyphenyl)benzo[f]coumarin is the most active compound with an IC50 value against MAO-B of 2.44 nM. Most of the derivatives exhibited an important selectivity profile against the MAO-B isoform. Some of them also acted as in vitro inhibitors of BuChE, with 3-(2´-hydroxyphenyl)benzo[f]coumarin being the most active with an IC50 value of 1.13 µM. In addition, a theoretical study of the physicochemical properties of the new compounds, as well as a docking study in both MAO isoforms, were carried out. Important structure-activity relationships were obtained. CONCLUSION: Important preliminary structure-activity relationships were concluded from the experimental results. These results encourage us to further explore the potential of this chemical family as potential drug candidates for the treatment of Alzheimer's disease.

Novel (coumarin-3-yl)carbamates as selective MAO-B inhibitors: synthesis, in vitro and in vivo assays, theoretical evaluation of ADME properties and docking study.

A series of (coumarin-3-yl)carbamates was synthesized and evaluated in vitro as monoamine oxidase (MAO-A and MAO-B) inhibitors. Most of the new compounds selectively inhibited MAO-B isoenzyme with IC50 values in the micro or nanoMolar ranges. Since these compounds must achieve the brain cells, theoretical evaluation of ADME properties were also carried out. Compound 8 (benzyl(coumarin-3-yl)carbamate), which presented the most interesting in vitro MAO-B inhibitory profile (IC50 against MAO-B = 45 nM), was subjected to further studies. This in vitro MAO-B inhibitory activity is comparable with that of the selegiline, the reference compound (IC50 against MAO-B = 20 nM). Taking into account the in vitro results of compound 8, in vivo assays and docking calculations were also carried out for this derivative.

Frontal Plane Motion of the Pelvis and Hip during Gait Stance Discriminates Children with Diplegia Levels I and II of the GMFCS.

Objective. To determine if gait waveform could discriminate children with diplegic cerebral palsy of the GMFCS levels I and II. Patients. Twenty-two children with diplegia, 11 classified as level I and 11 as level II of the GMFCS, aged 7 to 12 years. Methods. Gait kinematics included angular displacement of the pelvis and lower limb joints during the stance phase. Principal components (PCs) analyses followed by discriminant analysis were conducted. Results. PC1s of the pelvis and hip in the frontal plane differ significantly between groups and captured 80.5% and 86.1% of the variance, respectively. PC1s captured the magnitude of the pelvic obliquity and hip adduction angle during the stance phase. Children GMFCS level II walked with reduced pelvic obliquity and hip adduction angles, and these variables could discriminate the groups with a cross-validation of 95.5%. Conclusion. Reduced pelvic obliquity and hip adduction were observed between children GMFCS level II compared to level I. These results could help the classification process of mild-to-moderate children with diplegia. In addition, it highlights the importance of rehabilitation programs designed to improve pelvic and hip mobility in the frontal plane of diplegic cerebral palsy children level II of the GMFCS.

Evaluación a medio plazo de una intervención educativa en hábitos alimentarios y de actividad física en escolares: estudio Avall 2 / Medium-term evaluation of an educational intervention on dietary and physical exercise habits in schoolchildren: The Avall 2 study

Objetivo Determinar si los beneficios observados en alimentación, actividad física e índice de masa corporal se mantenían a los 2 años de haber finalizado la intervención educativa. Material y método Estudio longitudinal experimental de 4 años de duración, aleatorizado por conglomerados, para evaluar un programa de intervención dirigido a escolares de primer curso de educación primaria de las escuelas de Granollers. La intervención consistió en promover hábitos alimentarios saludables y potenciar la actividad física mediante la pedagogía educativa Investigación, Visión, Acción y Cambio (IVAC) aplicada a lo largo de 2 cursos escolares (2006-2008). Se determinó in situ el peso y la talla de cada niño, y las familias autocompletaron una encuesta de actividad física y alimentación en el 2006, 2008 y 2010.ResultadosEn el 2010 se observó un mayor incremento del índice de masa corporal de los escolares del grupo control (2,84±0,22 vs 1,96±0,163 kg/m2, p<0,001). La prevalencia de escolares con sobrepeso y obesidad aumentó respectivamente en un 8 y un 0,5% en el grupo control, mientras que en el grupo intervención se incrementó la prevalencia de sobrepeso (5,3%) y se redujo la de obesidad (3,6%). La prevalencia de escolares con exceso de peso aumentó en un 8,5% en el grupo control y en un 1,8% en el de intervención. A los 2 años de finalizar la intervención educativa se mantuvo la reducción del incremento del índice de masa corporal, independientemente del sexo, la procedencia, la obesidad materna y el nivel de estudios de los progenitores. Conclusiones La intervención educativa mediante el empleo del método pedagógico IVAC ayuda a contener el actual incremento de obesidad infantil (AU)

Objective To assess whether the benefits seen in nutrition, physical activity and body mass index were maintained at 2 years of completion of the educational intervention. Material and methods An experimental, longitudinal, 4-year, two-arm, parallel study with cluster randomization to assess an intervention program aimed at children in their first year of primary schooling attending schools in the city of Granollers. Intervention consisted of promoting healthy dietary habits and increasing physical activity through the educational pedagogy Investigation, Vision, Action and Change (IVAC), applied over 2 school years (2006-2008). Weight and height of each child were measured in situ, and families self-completed a physical activity survey and the Krece Plus quick test in 2006, 2008, and 2010.ResultsA greater increase in body mass index was seen in 2010 in children from the control group (2.84±0.22 vs 1.96±0.163kg/m2, <0.001). Prevalence of overweight and obesity increased by 8% and 0.5%, respectively in schoolchildren in the control group, while the intervention group showed a 5.3% increase in prevalence of overweight and a 3.6% decrease in prevalence of obesity. Prevalence of excess weight therefore increased by 8.5% in the control group and by 1.8% in the intervention group. Reduction in body mass index increase was maintained 2 years after completion of educational intervention regardless of sex, origin, maternal obesity, and educational level of parents. Conclusions These results confirm that school-based interventions may help contain the current increase in childhood obesity (AU)

Medium-term evaluation of an educational intervention on dietary and physical exercise habits in schoolchildren: the Avall 2 study.

OBJECTIVE: To assess whether the benefits seen in nutrition, physical activity. and body mass index were maintained at 2 years of completion of the educational intervention. MATERIAL AND METHODS: An experimental, longitudinal, 4-year, two-arm, parallel study with cluster randomization to assess an intervention program aimed at children in their first year of primary schooling attending schools in the city of Granollers. Intervention consisted of promoting healthy dietary habits and increasing physical activity through the educational pedagogy Investigation, Vision, Action and Change (IVAC), applied over 2 school years (2006-2008). Weight and height of each child wee measured in situ, and families self-completed a physical activity survey and the Krece Plus quick test in 2006, 2008, and 2010. RESULTS: A greater increase in body mass index was seen in 2010 in children from the control group (2.84 ± 0.22 vs 1.96 ± 0.163 kg/m(2), <.001). Prevalence of overweight and obesity increased by 8% and 0.5% respectively in schoolchildren in the control group, while the intervention group showed a 5.3% increase in prevalence of overweight and a 3.6%decrease in prevalence of obesity. Prevalence of excess weight therefore increased by 8.5% in the control group and by 1.8% in the intervention group. Reduction in body mass indexincrease was maintained 2 years after completion of educational intervention regardless of sex, origin, maternal obesity, and educational level of parents. CONCLUSIONS: These results confirm that school-based interventions may help contain the current increase in childhood obesity.

Assessment of a school-based intervention in eating habits and physical activity in school children: the AVall study.

BACKGROUND: Obesity has become a global public health problem, which also affects children. It has been proposed that the educational interventions during childhood could be a key strategy in the prevention of obesity. OBJECTIVE: To evaluate the efficacy of an intervention on food habits and physical activity in school children. METHODS: A 2-year cluster-randomised prospective study with two parallel arms was used to evaluate an intervention programme in children in their first year of primary schooling (5-6 years of age) in schools in the city of Granollers. The intervention consisted of the promotion of healthy eating habits and physical activity by means of the educational methodology Investigation, Vision, Action and Change (IVAC). At the beginning and at the end of the study (2006 and 2008) the weight and height of each child was measured in situ, while the families were given a self-report physical activity questionnaire and the Krece Plus quick test. RESULTS: Two years after the beginning of the study, the body mass index of the children in the control group was 0.8 kg/m(2) higher than that of the intervention schools. The intervention reduced by 62% the prevalence of overweight children. Similarly, the proportion of children that ate a second piece of fruit and took part in an after-school physical activity increased in the intervention group. In the control group, the weekly consumption of fish was reduced. CONCLUSIONS: The educational intervention in healthy eating habits and physical activity in the school could contribute to lessen the current increase in child obesity.

[Weight, dietary patterns and exercise habits in first-year primary school children: the AVall study]. / Estado ponderal, hábitos alimentarios y de actividad física en escolares de primer curso de educación primaria: estudio AVall.

OBJECTIVE: To evaluate weight, dietary patterns and exercise habits in children attending the first year of primary school in the city of Granollers (Spain). METHODS: We performed a cross-sectional study of children enrolled in the schools of the city of Granollers. All the children were born in 2000. Data were collected from September to October 2006. Weight and height were measured in each schoolchild. The parents completed a questionnaire on the frequency of food intake and physical activity and the Krece Plus test. The International Obesity Task Force cut-offs for body mass index were used to define overweight and obesity. RESULTS: A total of 566 schoolchildren were included. The prevalence of overweight was 19.6% and that of obesity was 8.5%. Only 3.8% of the children had an adequate breakfast and 17.1% ate five portions of fruit and vegetables a day. Some families consumed a low amount of fruit (22%), vegetables (37%), bread/pasta/ rice/cereals (14%), fish (32%), legumes (13%) and nuts (9%). Children who had lunch at school ate more fruits (38% vs 29%), vegetables (35% vs 25%) and fish (82% vs 73%) than those who did not have lunch at school. A total of 82% of the schoolchildren exercised regularly. CONCLUSIONS: A quarter of the children who participated in the study were overweight. The schoolchildren who had lunch at school had better dietary patterns. Inappropriate family habits can determine children's dietary habits.

Estado ponderal, hábitos alimentarios y de actividad física en escolares de primer curso de educación primaria: estudio A Vall / Weight, dietary patterns and exercise habits in first-year primary school children: the A Vall study

Objetivo: Determinar el estado ponderal y los hábitos alimentarios y de actividad física de escolares de primer curso de primaria de la ciudad de Granollers. Diseño y población de estudio: Estudio transversal de los niños censados en todas las escuelas de la ciudad de Granollers, nacidos en el año 2000. En septiembre-octubre de 2006 se determinó el peso y la talla de cada niño, las familias respondieron una encuesta de frecuencia de consumo de alimentos y de actividad física y el test rápido Krece Plus. Para definir el sobrepeso y la obesidad se utilizaron los puntos de corte de índice de masa corporal propuestos por la International Obesity Task Force. Resultados: Se estudió a 566 escolares. La prevalencia de sobrepeso fue del 19,6% y la de obesidad, del 8,5%. Sólo el 3,9% de los escolares tomaban un desayuno adecuado y el 17,1% comían 5 raciones de fruta y verduras al día. A escala familiar, destaca el bajo consumo de frutas (22%), verduras (37%), pan/pasta alimenticia/arroz/cereales (14%), pescado (32%), legumbres (13%) y frutos secos (9%). Los alumnos que almorzaban en la escuela tomaban más fruta (el 38 frente al 29%), verdura (el 35 frente al 25%) y pescado (el 82 frente al 73%). El 82% de los niños realizaban actividad física de manera regular. Conclusiones: Uno de cada 4 escolares de primero de primaria presenta ya problemas de peso. Los niños que almuerzan en la escuela tienen mejores hábitos alimentarios. Los hábitos inadecuados de la familia pueden condicionar los hábitos del escolar (AU)

Objective: To evaluate weight, dietary patterns and exercise habits in children attending the first year of primary school in the city of Granollers (Spain). Methods: We performed a cross-sectional study of children enrolled in the schools of the city of Granollers. All the children were born in 2000. Data were collected from September to October 2006. Weight and height were measured in each schoolchild. The parents completed a questionnaire on the frequency of food intake and physical activity and the Krece Plus test. The International Obesity Task Force cut-offs for body mass index were used to define overweight and obesity.Results: A total of 566 schoolchildren were included. The prevalence of overweight was 19.6% and that of obesity was 8.5%. Only 3.8% of the children had an adequate breakfast and 17.1% ate five portions of fruit and vegetables a day. Some families consumed a low amount of fruit (22%), vegetables (37%), bread/pasta/rice/cereals (14%), fish (32%), legumes (13%) and nuts (9%). Children who had lunch at school ate more fruits (38% vs 29%), vegetables (35% vs 25%) and fish (82% vs 73%) than those who did not have lunch at school. A total of 82% of the schoolchildren exercised regularly. Conclusions: A quarter of the children who participated in the study were overweight. The schoolchildren who had lunch at school had better dietary patterns. Inappropriate family habits can determine children’s dietary habits (AU)

Sesquiterpene lactones in Arnica montana: helenalin and dihydrohelenalin chemotypes in Spain.

An analytical RPLC method for sesquiterpene lactones in Arnica montana has been extended to include quantitative analyses of dihydrohelenalin esters. LC-ESI-MS-MS distinguished the isomeric helenalin and dihydrohelenalin esters. The dihydrohelenalin esters have lower response factors for UV detection than do helenalin esters, which must be taken into account for quantitative analyses. Analyses of flowers from 16 different wild populations of A. montana in Spain showed differing proportions of helenalin and dihydrohelenalin esters. For the first time a chemotype with high levels of helenalin esters (total helenalins 5.2-10.3 mg/g dry weight) is reported in Spanish A. montana. These samples were from heath lands at high altitude (1330-1460 m), whereas samples from meadows and peat bogs at lower altitudes were the expected chemotype with high levels of dihydrohelenalin esters (total dihydrohelenalins 10.9-18.2 mg/g). The phenolic compounds, both flavonoid glycosides and caffeoylquinic acids, in Spanish A. montana are reported for the first time. The levels of several of these compounds differed significantly between samples from heath lands and samples from peat bogs or meadows, with the heath land samples being most similar to central European A. montana in their phenolic composition.