Diseño y desarrollo de una intervención dietética en niños con prediabetes / Design and development of a dietary intervention in children with prediabetes

Introducción La prediabetes es una condición patológica donde la concentración de glucemia se presenta en valores más elevados a las concentraciones normales, pero menores a las consideradas en el diagnóstico de una diabetes mellitus tipo 2 (DM2). La condición de prediabetes hasta hace unos años se presentaba en adultos con unos factores de riesgo asociados como eran sobrepeso u obesidad, sedentarismo, malos hábitos alimenticios, problemas cardiovasculares, etc. En los últimos años se ha empezado a detectar en niños, cobrando cada vez una mayor importancia los hábitos familiares que estos niños tienen instaurados. Material y métodos En nuestro estudio se han evaluado 29 niños prediabéticos de Pedro Abad, Córdoba. para ello hemos realizado un ensayo aleatorizado cruzado con grupo de intervención (GI) y grupo de control (GC), empleando una intervención dietética con refuerzo nutricional. El objetivo principal del presente estudio fue determinar si los hábitos alimentarios de niños prediabéticos mejoraban con una intervención dietética basada en una educación nutricional. Resultados A través de una evaluación nutricional mediante diferentes test y visitas realizadas a los niños, los resultados correspondientes a la primera fase del estudio, relacionan una mejora en los hábitos alimentarios y en la adherencia a la dieta mediterránea por parte de los niños intervenidos. Conclusiones Los hábitos alimentarios de los niños prediabéticos mejoran con una intervención dietética basada en una educación nutricional, ya que al proveerles del conocimiento de los distintos alimentos y del aporte de nutrientes que estos nos proporcionan, pueden hacer una mejor selección de los alimentos (AU)

Introduction Prediabetes is a pathological condition where the blood glucose concentration is higher than normal concentrations, but lower than those considered in the diagnosis of type 2 diabetes mellitus (DM2). Until a few years ago, the prediabetes condition occurred in adults with associated risk factors such as overweight or obesity, sedentary lifestyle, poor eating habits, cardiovascular problems, etc. In recent years it has begun to be detected in children, with the family habits that these children have established becoming increasingly important. Material and methods In our study, 29 pre-diabetic children from Pedro Abad, Córdoba, have been evaluated. For this, we have carried out a randomized crossover trial with an intervention group (IG) and a control group (CG), using a dietary intervention with nutritional reinforcement. The main objective of the present study was to determine if the eating habits of pre-diabetic children improved with a dietary intervention based on nutritional education. Results Through a nutritional evaluation through different tests and visits made to the children, the results corresponding to the first phase of the study, relate an improvement in eating habits and adherence to the Mediterranean Diet by the intervened children. Conclusions The eating habits of pre-diabetic children improve with a dietary intervention based on nutritional education, since by providing them with knowledge of the different foods and the contribution of nutrients that they provide us, they can make a better selection of foods (AU)

[Design and development of a dietary intervention in children with prediabetes]. / Diseño y desarrollo de una intervención dietética en niños con prediabetes.

INTRODUCTION: Prediabetes is a pathological condition where the blood glucose concentration is higher than normal concentrations, but lower than those considered in the diagnosis of type 2 diabetes mellitus (DM2). Until a few years ago, the prediabetes condition occurred in adults with associated risk factors such as overweight or obesity, sedentary lifestyle, poor eating habits, cardiovascular problems, etc. In recent years it has begun to be detected in children, with the family habits that these children have established becoming increasingly important. MATERIAL AND METHODS: In our study, 29 pre-diabetic children from Pedro Abad, Córdoba, have been evaluated. For this, we have carried out a randomized crossover trial with an intervention group (IG) and a control group (CG), using a dietary intervention with nutritional reinforcement. The main objective of the present study was to determine if the eating habits of pre-diabetic children improved with a dietary intervention based on nutritional education. RESULTS: Through a nutritional evaluation through different tests and visits made to the children, the results corresponding to the first phase of the study, relate an improvement in eating habits and adherence to the Mediterranean Diet by the intervened children. CONCLUSIONS: The eating habits of pre-diabetic children improve with a dietary intervention based on nutritional education, since by providing them with knowledge of the different foods and the contribution of nutrients that they provide us, they can make a better selection of foods.

Enseñanza de las maniobras de soporte vital básico en alumnos de un ciclo formativo, ¿se mantiene la calidad de las maniobras en el tiempo? / Teaching basic life support maneuvers in students of a training cycle, is the quality of the maneuvers maintained over time?

Objetivo Evaluar la calidad de las maniobras de soporte vital básico tras un proceso formativo normalizado y estudiar su evolución a corto plazo. Materiales y métodos Estudio experimental con alumnos de los ciclos formativos de Técnico Superior en Acondicionamiento Físico y Técnico Superior en Enseñanza y Animación Sociodeportiva del Colegio de la Trinidad de Córdoba. Se realiza una evaluación inicial, una evaluación 15 días tras la formación y otra a los 30 días, que constan de una evaluación mediante un test teórico y una evaluación práctica de 2min de RCP. Para el desarrollo de las evaluaciones prácticas, se utiliza el simulador Resusci Anne® QCPR. Se considera como variable principal el porcentaje global de RCP obtenido mediante SimPad SkillReporter®. Resultados Se estudia una muestra de 45 alumnos, 71,1% varones. Se observan diferencias estadísticamente significativas entre la puntuación teórica total de la evaluación inicial y la de los 15 días (7,81 vs. 6,82 puntos; p<0,0001) y entre la evaluación de los 15 días y la de los 30 días (6,82 vs. 7,66 puntos; p<0,0001), y en el porcentaje global de RCP entre la evaluación inicial y la de los 15 días (27 vs. 49 puntos; p=0,008) y entre la evaluación inicial y la evaluación a los 30 días (27 vs. 6,15 puntos; p<0,0001). Conclusiones La calidad de la maniobra de RCP mejora a corto plazo tras la formación, siendo cercana a los estándares de calidad establecidos por la ERC (AU)

Objective To evaluate the quality of basic life support after a standardized training process and study their short-term evolution. Materials and methods Experimental study with students from the training cycles of Higher Technician in Physical Conditioning and Higher Technician in Teaching and Socio-Sports Animation of the Colegio de la Trinidad from Córdoba. An initial evaluation is carried out, an evaluation of 15 days after training and another 30 days later; consisting of an evaluation by a theoretical test, and a practical evaluation of 2min of CPR. For the development of practical evaluations, we used the Resusci Anne® QCPR simulator. The main outcome variable is the global percentage of CPR obtained using the SimPad SkillReporter®. Results We study 45 students, 71.1% of them male. Statistically significant differences are observed in the total theoretical score of the initial evaluation and the 15 days evaluation (7.81 vs. 6.82 points; P<.0001), and between the 15-day and 30-day evaluation (6.82 vs. 7.66 points; P<.0001); and in the overall percentage of CPR between the initial evaluation and the 15-day evaluation (27 vs. 49 points; P=.008) and between the initial evaluation and the 30 days evaluation (27 vs. 6.15 points; P<.0001). Conclusions The CPR quality improves after training, being close to the quality standards established by the ERC (AU)

Análisis cuantitativo del COVID-19 y sus impactos psicológicos y educativos en estudiantes universitarios y de secundaria en Córdoba, España / Quantitative analysis of COVID-19 and its psychological and educational impacts on university and secondary students in Córdoba, Spain

Introducción La pandemia COVID-19, que empezó en Wuhan, China, a finales del 2019, y, que hoy amenaza a todos los habitantes del planeta, configura el tema de investigación prioritaria en la actualidad. En este contexto, este artículo enfoca la manera en que este problema de salud afecta directamente al estado psicológico y educativo de 344 estudiantes universitarios y de secundaria, en Córdoba, España. Material y métodos Para el análisis se ha empleado el modelo de ecuaciones estructurales (SEM), a través de la cuantificación de un conjunto de relaciones entre una o más variables independientes, intentando condensar el escenario de pandemia y sus implicaciones sanitarias, psicológicas y educativas. Resultados La primera variable latente «Salud», es causal de la variable latente «Psicología», y de las variables endógenas «efectos relaciones sociales», «efectos tristeza» y «efectos sexualidad», lo cual confirma que la COVID-19 afectó seriamente al comportamiento psicológico de los estudiantes de universidad y de secundaria de Córdoba (AU)

Introduccion The COVID-19 pandemic that began in Wuhan, China, at the end of 2019, and which today threatens all the inhabitants of the planet, is currently the priority research topic. In this context, this article focuses on how this health problem directly affects the psychological and educational status of 344 university and high school students in Córdoba, Spain. Material and methods For the analysis, the structural equation model (SEM) has been used, through the quantification of a set of relationships between one or more independent variables, trying to condense the pandemic scenario and its health, psychological and educational implications. Results The first latent variable “Health” is causal of the latent variable “Psychology”, and, of the endogenous variables, “social relations effects”, “sadness effects” and “sexuality effects”, which confirms that the COVID-19 seriously affected the psychological behavior of university and high school students in Córdoba (AU)

[Quantitative analysis of COVID-19 and its psychological and educational impacts on university and secondary students in Córdoba, Spain]. / Análisis cuantitativo del COVID-19 y sus impactos psicológicos y educativos en estudiantes universitarios y de secundaria en Córdoba, España.

INTRODUCCION: The COVID-19 pandemic that began in Wuhan, China, at the end of 2019, and which today threatens all the inhabitants of the planet, is currently the priority research topic. In this context, this article focuses on how this health problem directly affects the psychological and educational status of 344 university and high school students in Córdoba, Spain. MATERIAL AND METHODS: For the analysis, the structural equation model (SEM) has been used, through the quantification of a set of relationships between one or more independent variables, trying to condense the pandemic scenario and its health, psychological and educational implications. RESULTS: The first latent variable "Health" is causal of the latent variable "Psychology", and, of the endogenous variables, "social relations effects", "sadness effects" and "sexuality effects", which confirms that the COVID-19 seriously affected the psychological behavior of university and high school students in Córdoba.

[Teaching basic life support maneuvers in students of a training cycle, is the quality of the maneuvers maintained over time?] / Enseñanza de las maniobras de soporte vital básico en alumnos de un ciclo formativo, ¿se mantiene la calidad de las maniobras en el tiempo?

OBJECTIVE: To evaluate the quality of basic life support after a standardized training process and study their short-term evolution. MATERIALS AND METHODS: Experimental study with students from the training cycles of Higher Technician in Physical Conditioning and Higher Technician in Teaching and Socio-Sports Animation of the Colegio de la Trinidad from Córdoba. An initial evaluation is carried out, an evaluation of 15 days after training and another 30 days later; consisting of an evaluation by a theoretical test, and a practical evaluation of 2min of CPR. For the development of practical evaluations, we used the Resusci Anne® QCPR simulator. The main outcome variable is the global percentage of CPR obtained using the SimPad SkillReporter®. RESULTS: We study 45 students, 71.1% of them male. Statistically significant differences are observed in the total theoretical score of the initial evaluation and the 15 days evaluation (7.81 vs. 6.82 points; P<.0001), and between the 15-day and 30-day evaluation (6.82 vs. 7.66 points; P<.0001); and in the overall percentage of CPR between the initial evaluation and the 15-day evaluation (27 vs. 49 points; P=.008) and between the initial evaluation and the 30 days evaluation (27 vs. 6.15 points; P<.0001). CONCLUSIONS: The CPR quality improves after training, being close to the quality standards established by the ERC.

Cocaine using patient who presents with dyspnoea.

We present the case of a 17-year-old male patient with a history of cocaine use who consulted for chest pain and dyspnoea. A pneumomediastinum is defined as the irruption of air in the mediastinal space, and is associated with different causes, including addiction to inhaled drugs. It occurs in people with predisposing factors and the presence of precipitating factors such as consumption of inhaled drugs. X-ray and computed tomography of the thorax are very useful tools in guiding the diagnosis. The low incidence of this pathology represents a difficult diagnosis for the doctor, although in some characteristic work environments a high level of suspicion is necessary.

Preclinical evaluation of collagen type I scaffolds, including gelatin-collagen microparticles and loaded with a hydroglycolic Calendula officinalis extract in a lagomorph model of full-thickness skin wound.

Previously, we have developed collagen type I scaffolds including microparticles of gelatin-collagen type I (SGC) that are able to control the release of a hydroglycolic extract of the Calendula officinalis flower. The main goal of the present work was to carry out the preclinical evaluation of SGC alone or loaded with the C. officinalis extract (SGC-E) in a lagomorph model of full-thickness skin wound. A total of 39 rabbits were distributed in three groups, of 13 animals each. The first group was used to compare wound healing by secondary intention (control) with wound healing observed when wounds were grafted with SGC alone. Comparison of control wounds with wounds grafted with SGC-E was performed in the second group, and comparison of wounds grafted with SGC with wounds grafted with SGC-E was performed in the third group. Clinical follow-ups were carried in all animals after surgery, and histological and histomorphometric analyses were performed on tissues taken from the healed area and healthy surrounding tissue. Histological and histomorphometric results indicate that grafting of SGC alone favors wound healing and brings a better clinical outcome than grafting SGC-E. In vitro collagenase digestion data suggested that the association of the C. officinalis extract to SGC increased the SGC-E cross-linking, making it difficult to degrade and affecting its biocompatibility.

Fiebre botonosa mediterránea: a propósito de dos casos en área de asistencia primaria urbana / Mediterranean boutonneuse fever: based on two cases in urban primary care area

La fiebre botonosa mediterránea es una enfermedad infecciosa causada por la Rickettsia conorii que, habitualmente, tiene un curso benigno, aunque sólo un 10% suele presentar complicaciones graves. Su incidencia es en países de la cuenca mediterránea y sobre todo en épocas estivales, donde coincide con el ciclo biológico de su vector, la garrapata Ixodes

Mediterranean boutonneuse fever is an infectious disease caused by Rickettsia conorii which generally has a benign course, although only 10% generally have serious complications. Its incidence is in countries of the Mediterranean Basin and, above all, in summer period, where it coincides with the biological cycle of its vector, the Ixodes tick

The experience with transcatheter ablation of supraventricular tachycardia in Puertorican adults

Data of the transcatheter radio frequency ablations for patients with supraventricular tachycardia conducted in Puerto Rico is presented. One group includes the first 100 patients performed from September 1994 to March 1997 at the Cardiovascular Center of Puerto Rico and the Caribbean and the Second group includes 157 ablations done in the year 2003. Ablations performed in the different types of supraventricular tachycardias is analyzed including success rates and complications. Results are compared to those reported in the 1998 NASPE registry. The results obtained demonstrated a high successful rate of procedures with minimal complications in both series of patients. One procedure related death occurred in the 2003 year group and none in the earlier group.

Iodine-131 treatment of thyroid papillary carcinoma in patients undergoing dialysis for chronic renal failure: a dosimetric method.

Until recently, the therapeutic protocol widely accepted for ablation of the thyroid remnant and for metastases of thyroid papillary carcinoma was the administration of 131I after surgery. However, at present, some data question the usefulness of such treatment in patients considered low risk. The treatment with radioiodine in patients suffering from end-stage renal disease (ESRD) undergoing hemodialysis requires controlled dosages and individualized administration guidelines. The need to include these patients on the waiting list for a renal transplantation, once they have overcome the disease, and the higher prevalence of thyroid carcinoma in ESRD patients makes this an increasingly significant problem. The cases reported in the literature are few and the therapeutic models followed are very difficult. In this paper we propose a therapeutic model that provides the highest thyroid ablative dosage, minimizing radiation exposure to the rest of the organs. The main difference between our protocol and that already described is the performance of daily hemodialysis during the first 5 days of treatment, as well as the administration of a dose of 131I equivalent to that administered to patients who show normal renal function.

A shared pathway in atrioventricular nodal reentrant tachycardia and atrial flutter: implications for pathophysiology and therapy.

Atrioventricular (AV) nodal reentrant tachycardia and atrial flutter are considered 2 distinct supraventricular tachycardias. Recent clinical and experimental data suggest that both these tachycardias include an area in the lower right atrial septum in their reentrant pathways. This study was designed to test the hypothesis that there is an association between the mechanisms of AV nodal reentrant tachycardia and atrial flutter because of a shared pathway of reentry. Consecutive patients referred for evaluation and management of supraventricular tachycardia, thought to be due to AV nodal reentry, underwent electrophysiologic testing protocols designed to induce both AV nodal reentrant tachycardia and atrial flutter, if present. Fifteen of 29 patients (52%) had both AV nodal reentrant tachycardia and atrial flutter induced during electrophysiologic testing. Seven of these 15 patients (47%) underwent transcatheter radiofrequency current application (mean power 34 +/- 4 W) against the tricuspid annulus above the coronary sinus. In each patient, neither AV nodal reentrant tachycardia nor atrial flutter could be induced after the procedure. Repeat study after successful ablation (mean 6 days) showed no inducible supraventricular arrhythmia of either type at baseline study or during isoproterenol infusion. Atrial flutter occurs frequently (15 of 29 patients; 52%) in patients with AV nodal reentrant tachycardia, because of a shared pathway in their reentry circuits. Because of this shared pathway, both arrhythmias can be ablated at the same site. These observations promote new insights into the mechanism and therapeutics of supraventricular tachycardias.

Sudden cardiac death. Magnitude of the problem, substrate/trigger interaction, and populations at high risk.

Sudden cardiac death continues to be a major clinical and public health problem. Prospective identification of patients at high risk for cardiac arrest is difficult, being limited by the large size of the population subgroups that contain the majority of victims of sudden cardiac death and by the time dependence of risk of sudden death. Pathophysiologically, sudden cardiac death can be viewed as an interaction between structural abnormalities of the heart, transient functional disturbances, and the specific electrophysiologic events responsible for fatal arrhythmias. Further understanding of the dynamics of high-risk populations and mechanisms of sudden death may lead to effective measures for control of risk.

Funcion fagocitica de los leucocitos polimorfonucleares neutrofilos (PMN) en pacientes con fiebre hemorragica por dengue (FHD). / Phagocytic function of polymorphonuclear neurophilic leukocytes (PMN) in patients with dengue hemorrhagic fever (DHF)

Se realizaron estudios en 49 pacientes (31 ninos y 18 adultos) con fiebre hemorragica por dengue (FHD) de la capacidad fagocitica frente a la Candida albicans, de la reduccion intracelular del azul de nitrotetrazolio (NBT) y de la adherencia en los leucocitos polimorfonucleares neutrofilos (PMN) perifericos, asi como de la capacidad opsonica del suero. Los pacientes se clasificaron en leves, moderados severos y graves en dependencia de su cuadro clinico La capacidad fagocitica estaba incrementada en los adultos al compararla con los resultados en los ninos y en los controles (p < igual 0,05). Tambien se encontro una disminucion estadisticamente significativa (p < igual 0,05) en la reduccion intracelular del NBT y en la adherencia de los leucocitos PMN de los pacientes con dengue al compararlos con el grupo control, con valores promedio de 2,3 +/- 1,7% de celulas adherentes por 89,0 +/- 5,0% en los controles. Estos datos sugieren que en la fiebre hemorragica por dengue aparecen disfunciones parciales de los leucocitos PMN que podrian intervenir en algunas de las complicaciones que se ven en estos pacientes

Hepatic uptake of small-latticed immune complexes does not alter mononuclear phagocyte system function.

The hepatic and splenic uptake of circulating, small-latticed immune complexes and the effect of these complexes on the hepatic mononuclear phagocyte system (MPS) were examined in mice. The small-latticed immune complexes were prepared at fifty-fold antigen excess. The clearance from circulation and uptake by the liver and spleen of two probes of MPS function, aggregated human IgG and aggregated mouse albumin, were quantified. The hepatic uptake of a dose of small-latticed complexes, containing 5 mg of antibodies, at 1 hr was comparable with the uptake of a similar dose of complexes that contained large-latticed complexes. At later time points, the hepatic uptake of the small complexes was significantly less than that of the larger complexes. The splenic uptake of the small-latticed complexes was less at all time points. Doses of the small-latticed complexes, ranging from 1 to 5 mg antibody in the complexes, produced no significant inhibition of the clearance or organ uptake of the MPS probes when administered 1 hr after the preload injections. In contrast, large-latticed complexes produced a dose-dependent delay in clearance due to a decreased hepatic uptake of the probes. These observations showed that small-latticed immune complexes were ineffectively removed by the hepatic MPS and that the presence of large quantities of small-latticed complexes in circulation did not alter MPS function.

Valores normales para la tecnica de reduccion intracelular del azul de nitrotetrazolio (NBT) en leucocitos polimorfonucleares neutrofilos humanos. / Normal values for nitroblue-tetrazolium (NBT) intracellular reduction technic in human polymorphonuclear neutrophilic leukocytes

Es bien conocido el papel del leucocito polimorfonuclear neutrofilo en el fenomeno de la fagocitosis y la posterior digestion intracelular del material fagocitado al luchar contra las particulas infestantes que podrian causar enfermedades. El azul de nitrotetrazolio (NBT) es una sustancia red-ox que se utiliza como marcador intracelular para detectar actividad metabolica en estas celulas. Los valores de reduccion del NBT obtenidos en neutrofilos de 71 individuos sanos, dan como media aritmetica el 8,4% de celulas formazan positivas con una desviacion standard de +/- 4,0%. Estos resultados confirman los hallazgos de otros investigadores. Esta tecnica permite conocer la integridad funcional de esta importante celula fagocitica en circunstancias basales

Effect of supply source on oral contraceptive use in Mexico.

PIP: A study undertaken to determine the differential effects, if any, of supply source on continuation rates of oral contraceptive usage in Mexican women. A sample of 2063 women aged 15 to 49 years was surveyed over a 6 year period ending in 1979. Of this group, 44% initially obtained the pill from the national family planning population program, 39% from pharmacies, and 17% from private physicians. Average age of users of the 3 sources differed by no more than 1/2 year; government program users tend to be less educated and private physician users to be somewhat more educated than the other women. Results show no striking differences in continuation rates among the 3 groups, and do not support the hypothesis that women who use the pill under supervision of a physician will have a higher continuation rate and lower pregnancy rates than those obtaining their oral contraceptives from other sources. In fact, a group of little educated, older, high parity rural women from among the pharmacy users show slightly higher continuation rates and probabilities of contraceptive use than any other user. In addition, there was no group of women whose contraceptive experience with the pharmacy was less favorable than the experience of women seen by a physician or the family planning program. An interaction effect between the service provider and the contraceptive user which facilitates more effective communication may be in operation across all 3 conditions. Many important questions about access to oral contraceptives, such as incidence of contraindications in users, and incidence and nature of side effects among pill users of various sources, remain unanswered. Further research is needed to clarify these issues.^ieng

Evaluation of aggregated IgG in mice as an Fc receptor specific probe of the hepatic mononuclear phagocyte system.

In experimental models of immune complex diseases the hepatic mononuclear phagocyte system removes circulating immune complexes (CIC) by interaction with Fc receptors, and the spleen has a relatively insignificant role in this function. We have used heat-aggregated human IgG (AHGG) to detect altered hepatic mononuclear phagocyte system activity in an acute immune complex model in mice in order to evaluate its suitability for possible use in humans. Immune complexes inhibited the clearance of AHGG, as a function of the dose and of the time after injection of complexes. The delayed clearance resulted from decreased hepatic uptake of the AHGG. Alterations in the comparatively small splenic uptake of AHGG did not correlate with changes in the clearance or the hepatic uptake that were produced by the complexes. Studies with Rose Bengal showed that the complexes caused a small but definite decrease in hepatic blood flow. Immune complexes also inhibited the clearance and hepatic uptake of aggregated mouse albumin and aggregated ovalbumin. The aggregated albumins, however, were cleared very rapidly, indicating high extraction ratios, so their clearance was more affected by the decreased blood flow than the clearance of AHGG. We conclude that a small dose of AHGG is a sensitive probe for hepatic Fc receptor function and has potential for human use.