Efficacy of octreotide in bleeding recurrence from small bowel angioectasia: A comparative study.

INTRODUCTION: Fifty percent of small bowel bleeding is caused by angioectasia and the rebleeding rate due to small bowel angioectasia (SBA) is 80%. Its endoscopic treatment is difficult. Beneficial effects of octreotide on gastrointestinal angioectasia have been described, but no studies have reported its efficacy in SBA. AIM: Our aim was to investigate the effectiveness of octreotide in the prevention of rebleeding due to SBA. MATERIAL AND METHODS: Sixteen patients with bleeding caused by SBA were assigned to treatment with octreotide 100 µg/24 h SC, for at least 6 months, and compared with a non-treatment group of 36 patients. The primary outcome was the rebleeding rate, and the secondary outcomes were the number of hospital readmissions, bleeding-related death, and adverse effects. RESULTS: Octreotide was administered for 10.5 ± 8.4 months. Follow-up was 12.9 ± 17.3 months and 15.3 ± 17.7 months, in the treatment and non-treatment groups, respectively (p = 0.09). At the end of follow-up, 4 (25%) treatment group patients and 26 (72.2%) non-treatment group patients presented with rebleeding (p = 0.002). In the treatment group and non-treatment group, the cumulative probability of remaining rebleeding-free at one year was 79% vs 44.2%, and 79% vs 34.6% at 2 years, respectively (p = 0.05). Through the multiple logistic regression analysis, treatment was the protective variable. Six patients presented with adverse events. One of those patients (6.25%) had a major adverse event. CONCLUSIONS: Our results suggest that treatment with octreotide could be efficacious in the prevention of rebleeding due to SBA.

Reuse of the digestate obtained from the biomethanization of olive mill solid waste (OMSW) as soil amendment or fertilizer for the cultivation of forage grass (Lolium rigidum var. Wimmera).

The principal by-product from the two-phase olive oil production process is olive mill solid waste (OMSW). It is a highly-pollutant by-product, not only because of its characteristics, but also because of the considerable volume of OMSW which is generated, amounting to 2 to 4 million tons per year in Spain. The anaerobic digestion of this by-product is a well-studied process, and results in the generation of biogas, methane and carbon dioxide mainly of high calorific values (20-25 MJ m-3), and an effluent or digestate. The digestate of this by-product has never been characterized. This study presents an informative view on how the composition of OMSW digestate shows promising implications as a soil amendment or fertilizer due to the quality of the biomass from Lolium rigidum, a useful grass specie for the production of forage. Three OMSW digestate alternative applications or treatments were investigated: the digestate and the solid fraction of the digestate for a nutrient-poor soil amendment and the liquid fraction of the digestate as fertilizer. The results confirm that all the OMSW digestate treatments studied presented suitable characteristics for agricultural use, and showed an optimal Carbon/Nitrogen ratio with adequate values for heavy metals which are below the limits established by the Spanish and European legislation in the absence of pathogens. However, fertirrigation was the treatment that provided Lolium rigidum with the best characteristics, improving its shoot biomass, photosynthetic rate and nutritional content.

Educando con el ejemplo. Alimentación y actividad física en los futuros promotores de salud / Training with the example. Food and physical activity in the future health promoters

FUNDAMENTOS: Los universitarios de enfermería y de actividad física y del deporte por su formación y futura actividad profesional deberían destacar por sus hábitos saludables. Estudiamos la implicación de la actividad física en sus estilos de vida y salud mental. MÉTODOS: Estudio transversal en 283 universitarios valorando actividad física (cuestionarios Minnesota y AMPEF sobre motivación), alimentación (recordatorio 24 horas y adherencia dieta mediterránea), EAT26 y calidad de vida (SF12). RESULTADOS: 54,4% realizaron actividad física continuadamente. El consumo de alcohol y tabaco disminuyó al incrementarse la actividad física. Encontramos mayor consumo de frutas y variedad de alimentos en aquellos con más de 300 minutos/semana de ejercicio físico. La adherencia a dieta mediterránea fue más elevada cuando la actividad física fue moderada. La motivación principal para la práctica física-deportiva fue estética y por salud en la mujer frente a competitiva, adquisición fuerza y resistencia en hombres. La actividad física se asoció a puntuación elevada en salud mental (SF12) aunque en la mujer tiempos muy elevados se asociaron a mayor riesgo para trastornos del comportamiento alimentario. CONCLUSIONES: La promoción de la salud sigue siendo una tarea que se enseña y se conoce pero no se aplica suficientemente ni siquiera en los futuros promotores de la salud

BACKGROUND: University students of nursing and of physical activity and sport due to their training and attitudes, present healthy habits to a greater extent than other young people. We set out to know the implication of physical activity in the lifestyles and mental health. METHODS: Cross-sectional study in 283 university students. We assessment physical activity (Minnesota and AMPEF questionnaires about practice reasons), 24 hour consumption reminder survey, Mediterranean diet adherence, riskeating disorder (EAT26) and quality of life (SF12). RESULTS: 54.4% performed physical activity continuously. The consumption of alcohol and tobacco decreased with increasing physical activity. We found greater fruit consumption and variety of foods in those who practice more than 300 minutes/week of physical activity. Adherence to the Mediterranean diet was higher when sports activity reached moderate levels. The main motivation for physical-sport practice was aesthetics and health in women versus competitive and strength in men. We found better mental health in young people with more sport activity, only in the female when increasing this time of sports activity, the risk of eating disorders increased. CONCLUSIONS:The promotion of health continues to be a task that is taught and known but not applied enough even in future health promoters

Assessment of Alimentación Normal con Ajuste de Insulina (ANAIS), a Spanish version of the DAFNE programme, in people with Type 1 diabetes: a randomized controlled parallel trial.

AIM: To evaluate the effects of Alimentación Normal con Ajuste de Insulina (ANAIS), a group-based, therapeutic education programme for Type 1 diabetes based on a flexible insulin regimen adjusted to the individual's food intake. METHODS: Participants with Type 1 diabetes and HbA1c levels of 53-86 mmol/mol (7-10%) were recruited from outpatient clinics at a tertiary care centre. They were randomized (using opaque, sealed envelopes, with a 2:1 treatment allocation ratio) to attend the training course immediately (immediate ANAIS; intervention group) or a year later (delayed ANAIS; control group). The main outcome was HbA1c level at 1 year. Secondary outcomes included lipid levels, weight, hypoglycaemic events, insulin dose, treatment satisfaction, self-perceived dietary freedom, quality of life and participant-defined goals. RESULTS: A total of 48 participants were assigned to the intervention group and 32 to the control group. Twelve months after completing the training, adjusted HbA1c was not significantly different in the intervention group [64 ± 1.3 vs 68 ± 1.6 mmol/mol (8.0 ±0.1% vs 8.4 ±0.1%); P=0.081]. Treatment satisfaction was significantly higher in the intervention group, but no differences were found in hypoglycaemic events, weight, insulin dose or changes in dietary freedom. At 1 year after the intervention, 72% of the participants (vs 33% in the control group; P=0.046) reported exceeding their expectations regarding achievement of their main personal goal. CONCLUSION: Promoting dietary freedom and empowering people with Type 1 diabetes through structured education programmes, such as ANAIS, improves treatment satisfaction and self-defined goals. No significant improvement in HbA1c level was achieved.

The shape of dementia: new measures of morphological complexity in event-related potentials (ERP) and its application to the detection of Alzheimer's disease.

In this paper, we address the problem of quantifying the commonly observed disorganization of the stereotyped wave form of the ERP associated with the P300 component in patients with Alzheimer's disease. To that extent, we propose two new measures of complexity which relate the spectral content of the signal with its temporal waveform: the spectral matching coefficient and the spectral matching entropy. We show by means of experiments that those measures effectively measure complexity and are related to the shape in an intuitive way. Those indexes are compared with commonly used measures of complexity when comparing AD patients against age-matched healthy controls. The results indicate that AD ERP signals are, indeed, more complex in the shape than that of controls, and this result is evidenced mainly by means of our new measures which have a better performance compared to similar ones. Finally, we try to explain this increase in complexity in light of the communication through coherence hypothesis framework, relating commonly found changes in the EEG with our own results.

Nuevas tecnologías; posibilidades de apoyo a la investigación en red / New technologies: support opportunities for network research

La consolidación de una zona de apoyo a la investigación en red, que fomente la investigación colaborativa, la formación y la difusión de conocimientos mediante las Tecnologías de la Información y la Comunicación (TIC) suponen ante todo la organización de una metodología de trabajo para compartir e intercambiar recursos en una red concreta que ya está en funcionamiento. Serán necesarios el establecimiento de mecanismos de comunicación entre los investigadores de distintos grupos; introducción de las TIC en la formación y entornos avanzados de formación en investigación; diversos inventarios de recursos de investigación susceptibles de intercambio y de utilización conjunta entre grupos y laboratorios; un sistema de documentación científica compartida y un adecuado mantenimiento de todas estas herramientas. No se trata de crear grandes estructuras administrativas y planes detallados para cumplir todas estas funciones, sino de disponer de herramientas efectivas para combinar esfuerzos y buscar recursos en todas estas áreas, con la agilidad y flexibilidad que nos permiten hoy el uso de las nuevas tecnologías de comunicación e información. Los resultados de esta zona de apoyo a la investigación, deben traducirse en un aumento de la eficacia y calidad de la red, al aumentar el flujo de información y la colaboración intergrupos en la docencia, investigación y desarrollo profesional así como la transferencia y difusión de los resultados de investigación (AU)

The consolidation of a support area for network research, which promotes collaborative research, training and the dissemination of knowledge through the use of ICTs, requires the organization of a work methodology to share and exchange resources in a specific network that is already running. The establishment of communication mechanisms between researchers from different groups will be necessary along with the introduction of the ICTs in the teaching and advanced environments of research training, different inventories of the research resources that are available for exchanges and shared use between groups and laboratories, and finally, a shared scientific documentation system with the appropriate maintenance of the previously listed tools. Large administrative structures and detailed plans are not needed to comply with all of the above functions. The availability of effective tools, however, to combine efforts and search for resources in all of these areas is needed, with the agility and flexibility that allow us to currently use new communication and information technologies. The results of this research support area should lead to an increase in the efficacy and quality of the network by increasing the flow of information and the inter-group collaboration in teaching, research and professional development, along with the transfer and dissemination of research results (AU)

[New technologies: support opportunities for network research]. / Nuevas tecnologías: posibilidades de apoyo a la investigación en red.

The consolidation of a support area for network research, which promotes collaborative research, training and the dissemination of knowledge through the use of ICTs, requires the organization of a work methodology to share and exchange resources in a specific network that is already running. The establishment of communication mechanisms between researchers from different groups will be necessary along with the introduction of the ICTs in the teaching and advanced environments of research training, different inventories of the research resources that are available for exchanges and shared use between groups and laboratories, and finally, a shared scientific documentation system with the appropriate maintenance of the previously listed tools. Large administrative structures and detailed plans are not needed to comply with all of the above functions. The availability of effective tools, however, to combine efforts and search for resources in all of these areas is needed, with the agility and flexibility that allow us to currently use new communication and information technologies. The results of this research support area should lead to an increase in the efficacy and quality of the network by increasing the flow of information and the inter-group collaboration in teaching, research and professional development, along with the transfer and dissemination of research results.

Implicaciones de la desnutrición en atención primaria / Implications of malnutrition in primary care

La OPS/OMS reconoce que la Atención Primaria de Salud (APS) constituye la estrategia principal para alcanzar los Objetivos de Desarrollo del Milenio: reducir la pobreza, eliminar la desnutrición aguda y crónica y reducir la mortalidad infantil y materna. Ha constituido un elemento central en las políticas de salud en los países de las Américas. La OPS/OMS Recomiendan introducir actividades en APS orientadas a mejorar la alimentación y el estado nutricional de la población, dado que la desnutrición crónica afecta no sólo al estado físico y mental de las personas sino a su calidad de vida. Un elevado número de patologías atendidas en atención primaria, requieren un consejo o tratamiento nutricional, previa valoración y consideración de suplementación nutricional. Se estima una prevalencia de un 10% de enfermos desnutridos aumentando hasta el 60-85% en caso de personas institucionalizadas. Grupos de edad con riesgos especiales son los niños y la población envejeciente. Según la Organización Mundial de la Salud, hay unos 20 millones de niños con desnutrición aguda severa en el mundo. En América Latina el 7% de los menores de cinco años sufren desnutrición global y el 16% desnutrición crónica. Tratar la patología social que da origen a la desnutrición es la base primordial de los centros de prevención. Esta actuación se lleva a cabo desde la APS a través de la Nutrición Comunitaria mediante un equipo interdisciplinar (AU)

PAHO/WHO recognizes that the Primary Health Care (PHC) is the strategy for attaining the Millennium Development Goals: reducing poverty, eliminating acute and chronic malnutrition and reducing infant and maternal mortality. It has been a central element in the health policies in the countries of the Americas. PAHO/WHO recommends introducing PHC activities aimed at improving food and nutritional status of the population, due to chronic malnutrition affects not only the physical and mental condition of the people but to their quality of life. A large number of diseases treated in primary care, require nutritional advice or treatment after evaluation and consideration of nutritional supplementation. It is estimated a prevalence of 10% of malnourished, rising to 60-85% for institutionalized persons. Age groups at particular risk are children and the aging population. According to the World Health Organization, there are 20 million children with severe acute malnutrition in the world. In Latin America, 7% of children under five suffer malnutrition and 16% chronically malnourished. Treating the social pathology that gives rise to malnutrition is the primary basis of prevention centers. This action is carried out from the PHC through the Community Nutrition by an interdisciplinary team (AU)

Kinetics of anaerobic degradation of screened dairy manure by upflow fixed bed digesters: effect of natural zeolite addition.

The effect of the hydraulic retention time (HRT) on the performance of two up-flow anaerobic fixed bed digesters (UFAFBDs) packed with waste tire rubber (D1) and waste tire rubber and zeolite (D2) as micro-organism immobilization supports was studied. It was found that a first-order kinetic model described well the experimental results obtained. The kinetic constants for COD, BOD5, total solids (TS) and volatile solids (VS) removal were determined to be higher in digester D2 than in digester D1 or control. Specifically, they were 0.28 +/- 0.01, 0.32 +/- 0.02, 0.16 +/- 0.01 and 0.24 +/- 0.01 d(- 1) respectively for D1 and 0.33 +/- 0.02, 0.40 +/- 0.02, 0.21 +/- 0.01 and 0.28 +/- 0.01 d(- 1) respectively for D2. This was significant at the 95% confidence level. In addition, the first-order model was also adequate for assessing the effect of the HRT on the removal efficiency and methane production. Maximum methane yield and the first-order constant for methane production were determined and the results obtained were comparable with those obtained by other authors but operating at higher HRTs. Maximum methane yields and the kinetic constant for methane production were 11.1% and 29.4% higher in digester D2 than in D1.

Heavy metals removal from acid mine drainage water using biogenic hydrogen sulphide and effluent from anaerobic treatment: effect of pH.

Four alternatives (runs A, B, C and D) for heavy metals removal (Fe, Cu, Zn and Al) from acid mine drainage water (AMDW) produced in the mining areas of the Huelva Province, Spain, were evaluated. In run A, the anaerobic effluent from the treatment of acid mine drainage water (cheese whey added as a source of carbon) was mixed with the raw AMDW. The pH increased to 3.5 with the addition of KOH. In run B, biogas with around 30% of hydrogen sulphide obtained in the anaerobic reactor was sparged to the mixture obtained in run A, but in this case at a pH of 5.5. In run C, the pH of the raw AMDW was increased to 3.5 by the addition of KOH solution. Finally, in run D, the pH of the raw AMDW was increased to 5.5 by the addition of KOH solution and further biogas was sparged under the same conditions as in run A. It was found that heavy metal removal was a function of pH. At a pH of 3.5 most of the iron was removed while Zn and Cu were partially removed. At a pH of 5.5 the removal of all metals increased considerably. The best results were obtained in run B where the percentages of removal of Fe, Cu, Zn and Al achieved values of 91.3, 96.1, 79.0 and 99.0%, respectively. According to the experimental results obtained tentative schemas of the flow diagram of the processes were proposed.

Fiebre recurrente como primera manifestación del cáncer de colon / Recurrent fever as presenting from of colon carcinoma

El cáncer de colon es una causa rara y mal conocida de fiebre de origen desconocido (FOD).Se estima que menos del 1 por ciento de todos los casos de FOD son secundarios a una neoplasia de oculta de colon. Los autores presentan 4 casos de FOD como primera manifestación de un cáncer oculto del colon, haciendo énfasis en sus peculiaridades diagnósticas y patogénicas. La fiebre recurrente, sin patrón definido, de breve duración, autolimitada, imprevisible en cuanto a su aparición, debería hacer sospechar la existencia de un cáncer de colon oculto. En ocasiones la bacteriemia por Escherichia coli es también primera manifestación de esta neoplasia (AU)

[Recurrent fever as presenting from of colon carcinoma]. / Fiebre recurrente como primera manifestación del cáncer de colon.

Fever of unknown origin (FUO) has been rarely associated with colonic cancer. In less than 1% of cases of FUO a colonic cancer is found as the main cause of fever. The authors reviewed 4 cases of colonic cancer whose first manifestation was FUO. Recurrent episodes of brief, self-limited fever, without a characteristic pattern, may be the first symptom of colonic cancer. On occassions, E. coli bacteremia may be the herald of an occult colonic malignancy.

Empleo de nuevas quinolonas en las infecciones respiratorias / Use of new quinolones in respiratory tract infections

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