How trustworthy is online dental information for individuals with Down syndrome from Ibero-American countries?

BACKGROUND: Internet has become an indispensable source of health-related information. However, several studies have shown there to be a lack of quality control for webpages related to disability. Specifically, available content concerning Down syndrome (DS) and dentistry is limited and of dubious quality. OBJECTIVE: The aim of the present study was to assess the quality of online content in Spanish and Portuguese on dental care for individuals with DS. METHODS: A simultaneous search in Google and Bing using the terms "Down syndrome" and "odontology/dentist/dental treatment" in Spanish and Portuguese was conducted in seven Ibero-American countries (Argentina, Brazil, Chile, Colombia, Spain, Mexico, and Portugal). The first 100 consecutive pages of results from the three combinations of terms in each of the search engines were accessed and selected by applying conventional exclusion criteria. The selected pages were classified according to their authorship, specificity and dissemination potential. The quality of the online content was assessed using the DISCERN questionnaire and the Questionnaire to Evaluate Health Web Sites According to European Criteria (QEEC). The presence of the Health On Net (HON) and Accredited Medical Website (AMW) seals was also assessed. RESULTS: The mean DISCERN score was 2.51 ± 0.85 and 2.57 ± 0.86 for the Spanish and Portuguese webpages, respectively. The mean readability score was 3.43 ± 1.26 and 3.25 ± 1.08 for the Spanish and Portuguese webpages, respectively. None of the selected webpages presented the HONcode or AMW trust seals. CONCLUSIONS: The content available online in Spanish and Portuguese regarding Down syndrome and dentistry is scarce and of highly questionable quality.

Automatic text classification of prostate cancer malignancy scores in radiology reports using NLP models.

This paper presents the implementation of two automated text classification systems for prostate cancer findings based on the PI-RADS criteria. Specifically, a traditional machine learning model using XGBoost and a language model-based approach using RoBERTa were employed. The study focused on Spanish-language radiological MRI prostate reports, which has not been explored before. The results demonstrate that the RoBERTa model outperforms the XGBoost model, although both achieve promising results. Furthermore, the best-performing system was integrated into the radiological company's information systems as an API, operating in a real-world environment.

Epithelial inclusion cyst secondary to glaucoma surgery: A case series.

Epithelial inclusion cysts (EIC) are a rare ocular disease and its physiopathology is not well-known. They consist on growths of ocular surface epithelial cells inside the anterior segment of the eye in the form of a cyst. To date several cases have been published in the literature, none of them related to glaucoma surgery. We describe two cases of EIC after glaucoma devices implantation. An 86 year-old male patient with primary open angle glaucoma develop an EIC in right eye three years after removal of PRESERFLO™ MicroShunt (Santen, Osaka, Japan) and a 9 year-old female patient with glaucoma secondary to uveitis for juvenile idiopathic arthritis develops an EIC under the tube of an Ahmed valve implant during postoperative period. EIC develop after ocular penetrating wounds and an inflammatory stimulus. They are benign proliferations, follow-up is necessary to detect space complications early, so less mutilating surgery is needed for removal.

Macrophage proteomic analysis of covalent immobilization of hyaluronic acid and graphene oxide on CoCr alloy in a tribocorrosive environment.

In this work, a sequential covalent immobilization of graphene oxide (GO) and hyaluronic acid (HA) is performed to obtain a biocompatible wear-resistant nanocoating on the surface of the biomedical grade cobalt-chrome (CoCr) alloy. Nanocoated CoCr surfaces were characterized by Raman spectroscopy and electrochemical impedance spectroscopy (EIS) in 3 g/L HA electrolyte. Tribocorrosion tests of the nanocoated CoCr surfaces were carried out in a pin on flat tribometer. The biological response of covalently HA/GO biofunctionalized CoCr surfaces with and without wear-corrosion processes was studied through the analysis of the proteome of macrophages. Raman spectra revealed characteristic bands of GO and HA on the functionalized CoCr surfaces. The electrochemical response by EIS showed a stable and protective behavior over 23 days in the simulated biological environment. HA/GO covalently immobilized on CoCr alloy is able to protect the surface and reduce the wear volume released under tribocorrosion tests. Unsupervised classification analysis of the macrophage proteome via hierarchical clustering and principal component analysis (PCA) revealed that the covalent functionalization on CoCr enhances the macrophage biocompatibility in vitro. On the other hand, disruption of the HA/GO nanocoating by tribocorrosion processes induced a macrophage proteome which was differently clustered and was distantly located in the PCA space. In addition, tribocorrosion induced an increase in the percentage of upregulated and downregulated proteins in the macrophage proteome, revealing that disruption of the covalent nanocoating impacts the macrophage proteome. Although macrophage inflammation induced by tribocorrosion of HA/GO/CoCr surfaces is observed, it is ameliorated by the covalently grafting of HA, which provides immunomodulation by eliciting downregulations in characteristic pro-inflammatory signaling involved in inflammation and aseptic loosening of CoCr joint arthroplasties. Covalent HA/GO nanocoating on CoCr provides potential applications for in vivo joint prostheses led a reduced metal-induced inflammation and degradation by wear-corrosion.

New records of Trichinella patagoniensis from Argentina.

Trichinella spiralis was long considered the sole Trichinella species in Argentina. However, since 2004, various Trichinella species, including the encapsulated Trichinella patagoniensis and Trichinella britovi, as well as the unencapsulated Trichinella pseudospiralis, have been detected in the country. The present study aimed to identify Trichinella ML at the species level from cougars naturally infected from Argentina. To this end, muscle tissue samples from one cougar each from Córdoba, Neuquén, and Santa Cruz Provinces were individually analysed using the artificial digestion technique. DNA extraction and molecular identification of Trichinella species were conducted on individual muscle larvae by PCR amplification of the ESV region and subsequent PCR amplification and sequencing of the COI gene. Morphological analysis revealed muscle larvae with characteristics consistent with Trichinella genus. PCR revealed a single band of approximately 127 bp for each individual muscle larva. PCR amplification of the COI gene from each isolate generated a 309 bp band. Sequencing of the mitochondrial COI gene confirmed the identity of the parasite as T. patagoniensis. The present study documents new occurrences of T. patagoniensis in Puma concolor from Argentina, including the first detection of T. patagoniensis in Puma concolor from Córdoba and Neuquén Province. These findings expand the limited knowledge of T. patagoniensis distribution in Argentina.

Preventive strategies in paediatric cardiovascular surgery: impact on surgical site infections and beyond.

BACKGROUND: Surgical management of congenital heart disease (CHD) has increased worldwide, but healthcare-associated infections (HAIs) can threaten these efforts. AIM: To analyse the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery programme. METHODS: Cohort study including children aged <12 years with CHD who underwent cardiovascular surgery between 2010 and 2021 in Medellín, Colombia (a middle-income setting). Data were collected from medical and laboratory records and infection control programme databases. Impact of various preventive interventions was assessed using a Poisson model. P < 0.05 was considered statistically significant. FINDINGS: A total of 2512 surgeries were analysed. Incidence of surgical site infection (SSI) was 5.9%, followed by central line-associated bloodstream infection (CLABSI; 4.7%), catheter-associated urinary tract infection (CAUTI; 2.2%), and ventilator-associated pneumonia (VAP; 1.4%). Most of the strategies focused on preventing SSI, resulting in a reduction from 9.5% in 2010 to 3.0% in 2021 (P = 0.030). Antibiotic prophylaxis based on patient weight and continuous infusion had an impact on reducing SSI (RR: 0.56; 95% CI: 0.32-0.99). Vacuum-assisted closure (VAC) in clean wounds reduced 100% of infections. No significant risk reduction was observed for other HAI with the implemented interventions. CONCLUSION: Preventive strategies effectively reduced SSI but no other infections, emphasizing the need for targeted approaches to address a broader spectrum of HAI successfully.

Improving early cholecystectomy rate in acute cholecystitis with an evidence-based local multidisciplinary protocol and a surgical audit: single-center experience through an Acute Care Surgery Division.

PURPOSE: To analyze if, after implementation of an evidence-based local multidisciplinary protocol for acute cholecystitis (AC), an intermediate surgical audit could improve early cholecystectomy (EC) rate and other therapeutic indicators. METHODS: Longitudinal cohort study at a tertiary center. The local protocol, promoted, created, and periodically revised by the Acute Care Surgery Unit (ACSu) was updated and approved on March 2019. A specific registry was prospectively fulfilled with demographics, comorbidity, type of presentation, diagnostic items, therapeutic decision, and clinical course, considering both non-operative management (NOM) or cholecystectomy, early and delayed (EC and DC). Phase 1: April 2019-April 2021. A critical analysis and a surgical audit with the participation of all the involved Departments were then performed, especially focusing on improving global EC rate, considered primary outcome. Phase 2: May 2021-May 2023. Software SPSS 23.0 was used to compare data between phases. RESULTS: Initial EC rate was significantly higher on Phase 2 (39.3%vs52.5%, p < 0.004), as a significantly inferior rate of patients were initially bailed out from EC to NOM because of comorbidity (14.4%vs8%, p < 0.02) and grade II with severe inflammatory signs (7%vs3%, p < 0.04). A higher percentage of patients was recovered for EC after an initial decision of NOM on Phase 2, but without reaching statistical significance (21.8%vs29.2%, n.s.). Global EC rate significantly increased between phases (52.5%vs66.3%, p < 0.002) without increasing morbidity and mortality. A significant minor percentage of elective cholecystectomies after AC episodes had to be performed on Phase 2 (14%vs6.7%, p < 0.009). Complex EC and those indicated after readmission or NOM failure were usually performed by the ACSu staff. CONCLUSION: To adequately follow up the implementation of a local protocol for AC healthcare, registering and periodically analyzing data allow to perform intermediate surgical audits, useful to improve therapeutic indicators, especially EC rate. AC constitutes an ideal model to work with an ACSu.

Primary sclerosing epitheloid fibrosarcoma of the kidney: First case reported in Mexico.

Here we reported a case of primary sclerosing epitheloid fibrosarcoma (SEF) of the kidney, an extremely rare and aggressive tumor. The patient presented a mass in the upper part of the right kidney with pulmonary metastasis at the time of diagnosis, a right radical nephrectomy was performed, it was a solid tumor of 15 cm × 9 cm affecting almost the entire kidney. Histological study revealed a neoplasm of uniform epithelioid cells with scant cytoplasm with dense and sclerotic stroma. immunohistochemistry positive for MUC-4, detection by fusion of EWSR1-CREB3L1 by FISH positive.

In vitro evaluation of methanol extracts of edible fungi Pleurotus ostreatus and Lentinula edodes against Rhyssomatus nigerrimus Fahraeus.

The study aimed to evaluate the insecticidal activity of extracts of edible mushrooms Pleurotus ostreatus and Lentinula edodes against Rhyssomatus nigerrimus. Methanol:water extracts (70:30) of P. ostreatus and L. edodes were made and evaluated in two in vitro tests (exposure and immersion toxic effect) against R. nigerrimus. Subsequently, the toxicity test of the extracts against Artemia salina was evaluated. These extracts were subjected to colorimetric tests and gas chromatography-mass spectrometry. The results showed a mortality effect against R. nigerrimus of 50% for the P. ostreatus 2 extracts at a concentration of 20% in the immersion test. Likewise, in the toxic effect test, 90% mortality was observed after five days of exposure to a concentration of 10%. On the other hand, for the toxicity test, the extract that showed the values with the highest mortality against A. salina was P. ostreatus, starting with 80% mortality at 100µg/mL. The functional groups present in the extracts were saponins, coumarins, and alkaloids. Furthermore, the presence of more than 7 compounds in the mushroom extracts evaluated is reported. This study demonstrates the insecticidal activity of P. ostreatus and L. edodes fungal extracts and indicates the importance of using different in vitro tests to elucidate the mechanism of action for future studies.

Manifestaciones oftálmicas en pacientes recuperados de COVID-19 en México / Ophthalmic manifestations in patients recovered from COVID-19 in Mexico

Introducción y objetivos Aunque las manifestaciones oftálmicas parecen estar asociadas a la enfermedad por coronavirus 2019 (COVID-19), no hay suficiente evidencia. Por ello, el objetivo de este estudio fue determinar los distintos tipos y la frecuencia de las manifestaciones oftálmicas en pacientes recuperados de la infección con SARS-CoV-2 en México. Material y métodos Este estudio retrospectivo, observacional y descriptivo incluyó a los pacientes infectados con SARS-CoV-2 de junio de 2020 a junio de 2022. El examen oftalmológico fue realizado bajo luz de linterna por un oftalmólogo del Departamento de Oftalmología. Los datos fueron analizados estadísticamente mediante la prueba exacta de Fisher y la correlación de Spearman. Resultados Se registraron un total de 3.081 pacientes positivos de SARS-CoV-2, de los cuales 318 (10,32%) cumplían los criterios de inclusión. De ellos, 21 (6,60%) tenían manifestaciones oftálmicas y la proporción entre mujeres y hombres era de 1,6:1. La edad media (±DE) fue 47,95±15,27 años y la mediana (rango intercuartil) del tiempo transcurrido desde el diagnóstico de COVID-19, definido por la prueba RT-PCR del SARS-CoV-2 positiva, hasta la detección de la manifestación oftálmica fue de 31 (142) días. La manifestación ocular más común fue la mucormicosis orbital (23,80%). Interesantemente, la presencia de manifestaciones oftálmicas no fue asociada con COVID-19 grave (p=0,665). Conclusiones Las manifestaciones oftálmicas son infrecuentes en los pacientes recuperados de COVID-19 grave. No obstante, se necesitan más estudios con una muestra de mayor tamaño para confirmar estos hallazgos (AU)

Introduction and objectives Although the ophthalmic manifestations appear to be associated with the coronavirus disease 2019 (COVID-19), there is not enough evidence. Hence, the aim of this study was to determine the various types and frequency of ophthalmic manifestations in patients recovered from SARS-CoV-2 infection in Mexico. Material and methods This retrospective, observational and descriptive study included all patients recovered from SARS-CoV-2 infection attending the tertiary level hospital of Mexican Social Security Institute (IMSS) from June 2020 to June 2022. During the hospital admission of patients, the demographic data such age, name, gender was recorded. Ophthalmologic examination was performed under torchlight by an ophthalmologist in the Department of Ophthalmology from IMSS. Data was compiled and statistically analyzed using Fisher's exact test and Spearman correlation. Results A total of 3,081 SARS-CoV-2-positive patients were recorded, of which 318 (10.32%) met the inclusion criteria. Of them, 21 (6.60%) had ophthalmic manifestations and the female-to-male ratio was 1.6:1. The mean age (±SD) was 47.95±15.27 years and the median (interquartile range) time from the diagnosis of COVID-19, as defined by positive SARS-CoV-2 RT-PCR testing, to detection of the ophthalmic manifestation was 31 (142) days. The most common ocular manifestation was orbital mucormycosis (23.80%). Interestingly, the presence of ophthalmic manifestations was not associated with severe COVID-19 (p=0.665). Conclusions The ophthalmic manifestations are infrequent in patients recovered from severe COVID-19. Nevertheless, further large sample studies are needed to confirm these findings (AU)

Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation / Adaptación cultural y validación de la versión española del Teenagers’ Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel

Background Teenagers’ Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. Methods A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019–May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. Results Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test–retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. Conclusion Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases (AU)

Antecedentes Teenagers’ Quality of Life (T-QoL) es un cuestionario de calidad de vida específico para adolescentes con enfermedades cutáneas. Hasta el momento, no existe ningún método validado para este fin en español, por lo que presentamos la traducción, adaptación cultural y validación del T-QoL al español. Método Se diseñó un estudio prospectivo con 133 pacientes (entre 12-19 años), atendidos en el Servicio de Dermatología del Hospital Universitario de Toledo, España (septiembre 2019-mayo 2020). Para la traducción y adaptación cultural se utilizaron las guías de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR). Se evaluó la validez convergente con el Índice de Calidad de Vida en Dermatología (DLQI), el Índice de Calidad de Vida en Dermatología Infantil (CDLQI) y con una Pregunta Global (GQ) sobre la gravedad de la enfermedad autoevaluada. También se analizó la consistencia interna y la fiabilidad de la herramienta T-QoL, y se confirmó su estructura con un análisis factorial. Resultados Las puntuaciones globales de T-QoL se correlacionaron significativamente con el DLQI y el CDLQI (r=0,75) y con la GQ (r=0,63). El análisis factorial mostró un ajuste óptimo para el modelo bifactorial y un ajuste adecuado para el modelo de 3 factores correlacionado. Los indicadores de fiabilidad fueron altos (α de Cronbach=0,89; índice Lambda 6 de Guttman=0,91; Omega ω=0,91) y el test-retest mostró una alta estabilidad (ICC=0,85). Los resultados fueron consistentes con los encontrados por los autores de la prueba original. Conclusiones La versión española del T-QoL es un cuestionario válido y fiable para evaluar la calidad de vida de adolescentes hispanohablantes con enfermedades cutáneas (AU)

[Artículo Traducido] Traducción, adaptación cultural y validación de la versión española del Teenagers’ Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel / Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation

Antecedentes Teenagers’ Quality of Life (T-QoL) es un cuestionario de calidad de vida específico para adolescentes con enfermedades cutáneas. Hasta el momento, no existe ningún método validado para este fin en español, por lo que presentamos la traducción, adaptación cultural y validación del T-QoL al español. Método Se diseñó un estudio prospectivo con 133 pacientes (entre 12-19 años), atendidos en el Servicio de Dermatología del Hospital Universitario de Toledo, España (septiembre 2019-mayo 2020). Para la traducción y adaptación cultural se utilizaron las guías de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR). Se evaluó la validez convergente con el Índice de Calidad de Vida en Dermatología (DLQI), el Índice de Calidad de Vida en Dermatología Infantil (CDLQI) y con una Pregunta Global (GQ) sobre la gravedad de la enfermedad autoevaluada. También se analizó la consistencia interna y la fiabilidad de la herramienta T-QoL, y se confirmó su estructura con un análisis factorial. Resultados Las puntuaciones globales de T-QoL se correlacionaron significativamente con el DLQI y el CDLQI (r=0,75) y con la GQ (r=0,63). El análisis factorial mostró un ajuste óptimo para el modelo bifactorial y un ajuste adecuado para el modelo de 3 factores correlacionado. Los indicadores de fiabilidad fueron altos (α de Cronbach=0,89; índice Lambda 6 de Guttman=0,91; Omega ω=0,91) y el test-retest mostró una alta estabilidad (ICC=0,85). Los resultados fueron consistentes con los encontrados por los autores de la prueba original. Conclusiones La versión española del T-QoL es un cuestionario válido y fiable para evaluar la calidad de vida de adolescentes hispanohablantes con enfermedades cutáneas (AU)

Background Teenagers’ Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. Methods A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019–May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. Results Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test–retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. Conclusion Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases (AU)

LOGOS, SÍMBOLOS Y LEYENDAS PRESENTES EN LOS RÓTULOS DE ALIMENTOS ENVASADOS: UN ANÁLISIS CRÍTICO DESDE LA LEGISLACIÓN VIGENTE EN ARGENTINA / LOGOS, SYMBOLS AND LEGENDS PRESENT ON PACKAGED FOOD LABELS: A CRITICAL ANALYSIS FROM THE CURRENT LEGISLATION IN ARGENTINA

Introducción: recientemente, se ha evidenciado una tendencia hacia estilos de vida y hábitos alimentarios saludables y un incremento de productos orientados para tal fin. Entre ellos se incluyen alimentos para veganos/vegetarianos, "naturales", aquellos que destacan la ausencia de aditivos o ingredientes de tipo "alérgenos". Estos productos envasados suelen presentar leyendas y/o logos que los caracterizan. El objetivo fue realizar un relevamiento de logos, sellos, frases en los rótulos de alimentos comerciales y analizar la información encontrada según la legislación vigente en Argentina. Materiales y Métodos: se relevaron al azar 151 alimentos comerciales en supermercados, dietéticas y páginas web de empresas (agosto-octubre de 2022). Los productos relevados fueron: farináceos (PF), bebidas vegetales (BV), análogos de cárnicos (AC), análogos de quesos (AQ) y otros. Los atributos buscados fueron veganos/vegetarianos (VV), natural/artesanal (NA), ausencia de aditivos (AA), ausencia de lactosa (ALA), ausencia de alérgenos (AAE). Resultados: el atributo VV se observó en el 68% de los productos relevados y prevaleció en los AC, PF y BV. El atributo NA se observó en 23% de los alimentos, principalmente en AC y PF. Para AA, que se presentó en 75% de los alimentos, los PF se destacaron. Los atributos ALA y AAE aparecieron en el 17% de los alimentos. Las BV fueron la categoría que más presentó el atributo ALA. En ellas se observó una alta prevalencia de AA y ALA. En los AC, el atributo que se destacó fue VV (92%). Dentro de PF, la mayor prevalencia fue del atributo AA (96%), seguido por VV (57%). En el grupo AQ, prevaleció el atributo VV (89%). Conclusiones: se observó una alta presencia de atributos en los rótulos, que en su mayoría carecen de una normativa nacional vigente que los avale. Ello se contrapone a la demanda del mercado actual y a consumidores más exigentes

Introduction: recently, there has been a trend towards healthy lifestyles and eating habits; therefore, there is an increase in products oriented for this purpose. Among these products we can find foods for vegans/vegetarians, "natural" foods, those that emphasize the absence of additives or "allergenic" type ingredients. These packaged products usually have legends and/or logos that characterize them. The objective was to carry out a survey of logos, seals and phrases in labels of commercial foods and analyze the information found according to current legislation in Argentina. Materials and Methods: 151 commercial foods were randomly surveyed in supermarkets, dietetics and company websites (August-October 2022). The surveyed products were: farinaceous (FP), vegetable drinks (VD), meat analogues (MA). , cheese analogues (CA) and others. The attributes sought were vegan/vegetarian (VV), natural/artisanal (NA), absence of additives (AA), absence of lactose (ALA), absence of allergens (AAE). Results: the VV attribute was observed in 68% of surveyed products and prevailed in MA, FP and VD. The NA attribute was observed in 23% of the foods, mainly in MA and PF. For AA, which was present in 75% of the food products analyzed, the FPs stood out. In the case of ALA and AAE attributes, they appeared in 17% of the foods. VD was the category that presented the ALA attribute in the highest percentage. A high prevalence of AA and ALA was observed in them. In the MA, the attribute that stood out was VV (92%). Within FP, the highest prevalence was of the AA attribute (96%), followed by VV (57%). In the CA group, the VV attribute prevailed (89%). Conclusions: a large presence of attributes was observed in the labels, which mostly lack current national regulations that endorse them. This contrasts with the demands of the current market and with demanding consumers

Epilepsia y gestación. Factores asociados con la presencia de crisis en la gestación / Epilepsy and pregnancy. Factors associated with epileptic seizures during pregnancy

Introducción: El manejo de la epilepsia durante la gestación requiere un control óptimo de las crisis, evitando los potenciales efectos teratogénicos del tratamiento antiepiléptico.ObjetivosDescribir las características clínicas y los resultados perinatales de las pacientes con epilepsia gestantes. Analizar los factores que se asocian a la presencia de crisis durante la gestación. Describir los fármacos antiepilépticos más utilizados y analizar los cambios en el régimen terapéutico en dos periodos: de 2000-2010 y 2011-2018.MétodosSe realizó un estudio prospectivo observacional de pacientes con epilepsia que notificaron su gestación en el periodo de 2000-2018. Se evaluó a las pacientes en el primer y segundo trimestre de gestación, tras el parto y al año. Se recogieron variables demográficas, relacionadas con la epilepsia, perinatales y obstétricas.ResultadosSe incluyeron 101 gestaciones. La edad media fue de 32,6 años, el 55,4% tenía una epilepsia focal, el 38,6% una epilepsia generalizada y el 5,9% indeterminada. Se registraron 90 nacidos vivos, nueve abortos espontáneos y cinco malformaciones congénitas, cuatro de ellas en monoterapia con valproato. En 40 gestaciones (39,6%) se registraron crisis, siendo tónico-clónicas generalizadas en 16 (40%). Las variables asociadas con la presencia de crisis durante el embarazo fueron el mal control el año previo a la gestación (66,7% vs. 15,1%, p < 0,001), el tratamiento con dos o más fármacos antiepilépticos (30% vs. 14,8% p < 0,001) y no recibir tratamiento (25% vs. 0% p < 0,001). Los fármacos antiepilépticos más utilizados en monoterapia fueron lamotrigina (n = 19, 27,1%), valproato (n = 17, 24,2%) y levetiracetam (n = 12, 17,1%). En el periodo más reciente (2011-2018) se encontró una mayor proporción de monoterapias (81,5% vs. 55,3%), además de un descenso en el uso de carbamazepina (23,1% vs. 2,3%) y valproato (30,8% vs. 20,5%); y un aumento marcado de levetiracetam (0% vs. 27,3%). (AU)

Introduction: The management of epilepsy during pregnancy requires optimal seizure control, avoiding the potential teratogenic effects of antiepileptic drugs.ObjectivesThis study aims to describe the clinical characteristics and perinatal outcomes of pregnant patients with epilepsy; to analyse the factors associated with seizures during pregnancy; to describe the most commonly used antiepileptic drugs in these patients; and to analyse changes in treatment regimens in 2 periods, 2000-2010 and 2011-2018.MethodsWe conducted a prospective observational study of patients with epilepsy who reported their pregnancy between 2000 and 2018. Patients were evaluated in the first and second trimesters of pregnancy, after delivery, and at one year. Data were collected on demographic variables, epilepsy, and perinatal and obstetric variables.ResultsA total of 101 pregnancies were included. Patients’ mean age was 32.6 years; 55.4% had focal epilepsy, 38.6% had generalised epilepsy, and 5.9% had undetermined epilepsy. We recorded 90 live births, 9 miscarriages, and 5 cases of congenital malformations, 4 of which were born to women who received valproate monotherapy. Forty patients (39.6%) presented seizures, with 16 (40%) presenting generalised tonic-clonic seizures. The variables associated with seizures during pregnancy were poor seizure control in the year prior to pregnancy (66.7% vs. 15.1%; P < .001), treatment with 2 or more antiepileptic drugs (30% vs. 14.8%; P < .001), and untreated epilepsy (25% vs. 0%; P < .001). The antiepileptic drugs most widely used in monotherapy were lamotrigine (n = 19; 27.1%), valproate (n = 17; 24.2%), and levetiracetam (n = 12; 17.1%). In the most recent period (2011-2018), we observed a greater proportion patients receiving monotherapy (81.5%, vs. 55.3%), as well as a decrease in the use of carbamazepine (2.3%, vs. 23.1%) and valproate (20.5%, vs. 30.8%); and a marked increase in the use of levetiracetam (27.3%, vs. 0%). (AU)

Aprendizaje cooperativo, necesidades psicológicas básicas e intencionalidad de mantenerse físicamente activo / Cooperative learning, basic psychological needs and intention to be physically active

El objetivo de este estudio fue evaluarlos efectos de un programa de larga duración de Aprendizaje Cooperativo en las necesidades psicológicas básicas de los estudiantes y su intención de ser físicamente activos. Un total de 109 estudiantes (12-14 años) de cuatro clases diferentes de primer curso de Educación Secundaria Obligatoria aceptaron participar. Los estudiantes fueron organizados en un grupo experimental (n=56),que desarrolló un programa de intervención de Aprendizaje Cooperativo en Educación Física durante cinco meses (cinco unidades didácticas, 40 sesiones),y un grupo de control (n=53) que experimentó, durante el mismo periodo, las mismas unidades didácticas bajo un enfoque de Instrucción Directa. Se siguió un diseño cuasi-experimental de medidas repetidas, empleando una comparación de grupos pretest-postest. Los resultados evidenciaron mejoras estadísticamente significativas en la intención de ser físicamente activo y las necesidades psicológicas básicas de autonomía y relación solo en el grupo de alumnos que experimentaron el Aprendizaje Cooperativo. (AU)

The goal of this study was to assess the effects of a long-term Cooperative Learning programme in students’ basic psychological needs and their intention to be physically active. A total of 109 students (12-14 years old) enrolled in four different Year 8 classes of Secondary Education agreed to participate. Students were organised into an experimental group (n=56), who experienced a Cooperative Learning intervention programme in Physical Education for five months (five learning units, 40 sessions) and a control group (n=53) who experimented, during the same period, the same learning units under a Direct Instruction approach. A quasi-experimental repeated measure applying a pre-test, post-test comparison group design was followed. The results evidenced statistically significant improvements in the intention to be physically active and the basic psychological needs for autonomy and relatedness only in the group of students who experienced Cooperative Learning. (AU)

Cardioembolic ischemic stroke associated with undertreated atrial fibrillation: an observational study / Accidente cerebrovascular isquémico cardioembólico asociado con fibrilación auricular no tratada: estudio observacional

Objectives: To describe the characteristics of patients and to determine the risk factors associated with second Emergency Department visits at 30 and 180 days in sick people admitted to the Emergency Department for cardioembolic stroke with a previous diagnosis of atrial fibrillation.Methods: Retrospective, observational study of adult patients admitted to the Emergency Department at our institution for cardioembolic stroke from January 1, 2019 to December 31, 2019. All study participants had a previous diagnosis of Atrial Fibrillation, CHADs2-VASc ≥2, and no contraindications for anticoagulants. The patients were retrospectively identified through a database search. A univariate analysis was performed to assess variables potentially associated with readmission (any cause) at 30 and 180 days. All variables with a p<0.2 were included in a multivariate analysis.Results: During the study period, 547 patients presented to the ED with ischemic stroke and 113 (20.6%) met the study inclusion criteria. Of these, 53 patients (46.9%) did not receive anticoagulant therapy before the stroke and 28 (24.7%) were taking doses lower than recommended in the technical data sheet. The pharmacological stroke prevention strategy was modified in 44 patients (38.9%) at discharge. On the multivariate analysis, diabetes was the only risk factor significantly associated with early readmission to the ED.Conclusions: Most patients (71.6%) with a previous diagnosis of AF who presented to the emergency department for cardioembolic stroke had not received optimal anticoagulant preventive treatment before the event. Diabetes was the only risk factor associated with early readmission to the Emergency Department. (AU)

Objetivos: Describir las características de los pacientes y determinar los factores de riesgo asociados a las segundas visitas al Servicio de Urgencias a los 30 y 180 días en los enfermos ingresados en el Servicio de Urgencias por ictus isquémico cardioembólico con diagnóstico previo de fibrilación auricular.Métodos: Estudio retrospectivo y observacional de pacientes adultos ingresados en el Servicio de Urgencias del Hospital de la Santa Creu i Sant Pau (HSP) por un ictus cardioembólico desde el 1 de enero de 2019 hasta el 31 de diciembre de 2019. Todos los participantes en el estudio tenían un diagnóstico previo de fibrilación auricular, CHADs2-VASc ≥2, y no tenían contraindicaciones para los anticoagulantes. Los pacientes fueron identificados retrospectivamente mediante una búsqueda en una base de datos del hospital. Se realizó un análisis univariante para evaluar las variables potencialmente asociadas al reingreso (cualquier causa) a los 30 y 180 días. Todas las variables con una p <0,2 se incluyeron en un análisis multivariante.Resultados: Durante el periodo de estudio, 547 pacientes acudieron a urgencias con ictus isquémico y 113 (20,6%) cumplieron los criterios de inclusión del estudio. De ellos, 53 pacientes (46,9%) no recibían tratamiento anticoagulante antes del ictus y 28 (24,7%) tomaban dosis inferiores a las recomendadas en la ficha técnica. La estrategia de prevención farmacológica del ictus se modificó en 44 pacientes (38,9%) al alta. En el análisis multivariante, la diabetes fue el único factor de riesgo que se asoció significativamente con el reingreso temprano en urgencias.Conclusiones: La mayoría de los pacientes (71,6%) con diagnóstico previo de FA que acudieron a urgencias por ictus cardioembólico no habían recibido un tratamiento preventivo anticoagulante óptimo antes del evento. La diabetes fue el único factor de riesgo asociado al reingreso temprano en el servicio de urgencias. (AU)

Miocarditis y miocardiopatía inflamatoria confirmadas por biopsia endomiocárdica: perfil clínico y pronóstico / Endomyocardial biopsy-confirmed myocarditis and inflammatory cardiomyopathy: clinical profile and prognosis

Introducción y objetivos La biopsia endomiocárdica (BEM) es la única técnica capaz de establecer el diagnóstico etiológico de pacientes con miocarditis o miocardiopatía inflamatoria (MI). El objetivo de este estudio es conocer el perfil clínico, la evolución y los factores pronósticos de los pacientes con sospecha de miocarditis o MI sometidos a BEM. Métodos Se analizaron retrospectivamente las características clínicas, los hallazgos histológicos y la evolución de todos los pacientes con sospecha de miocarditis o MI sometidos a BEM entre 1997 y 2019 en un hospital terciario español. Se evaluó el rendimiento del diagnóstico histológico mediante los criterios de Dallas frente a los criterios inmunohistoquímicos (IHQ). Resultados Se realizó BEM a 99 pacientes (el 67% varones; edad, 42± 15 años; fracción de eyección media, 34±14%). El 28% presentaba miocarditis o MI confirmada por criterios de Dallas y el 54% aplicando los criterios IHQ (p <0,1). Se diagnosticaron 47 miocarditis linfocitarias, 6 miocarditis eosinofílicas, 3 sarcoidosis y 1 miocarditis de células gigantes. Tras una mediana de seguimiento de 18 meses, 23 pacientes (23%) precisaron trasplante cardiaco o asistencia ventricular o fallecieron. El 21% de los pacientes con miocarditis confirmada mediante IHQ precisó trasplante cardiaco o asistencia o falleció, frente al 7% de aquellos sin inflamación (p=0,056). La fracción de eyección ≤ 30%, un diámetro telediastólico del ventrículo izquierdo ≥60mm y una clase NYHA III-IV iniciales se asociaron con peor pronóstico, especialmente en presencia de inflamación. Conclusiones La BEM permite establecer un diagnóstico etiológico en más de la mitad de los casos de sospecha de miocarditis o MI cuando se emplean técnicas IHQ. La inflamación confirmada por IHQ añade valor pronóstico y permite identificar a los pacientes con mayor probabilidad de sufrir complicaciones (AU)

Introduction and objectives Endomyocardial biopsy (EMB) is the only technique able to establish an etiological diagnosis of myocarditis or inflammatory cardiomyopathy (ICM). The aim of this study was to analyze the clinical profile, outcomes, and prognostic factors of patients with suspected myocarditis/ICM undergoing EMB. Methods We retrospectively analyzed the clinical characteristics, histological findings, and follow-up data of all patients with suspected myocarditis or ICM who underwent EMB between 1997 and 2019 in a Spanish tertiary hospital. The diagnostic yield was compared using the Dallas criteria vs immunohistochemical criteria (IHC). Results A total of 99 patients underwent EMB (67% male; mean age, 42±15 years; mean left ventricular ejection fraction [LVEF], 34%±14%). Myocarditis or ICM was confirmed in 28% with application of the Dallas criteria and in 54% with the IHC criteria (P <.01). Lymphocytic myocarditis was diagnosed in 47 patients, eosinophilic myocarditis in 6, sarcoidosis in 3, and giant cell myocarditis in 1 patient. After a median follow-up of 18 months, 23 patients (23%) required heart transplant (HTx), a left ventricular assist device (LVAD), and/or died. Among the patients with IHC-confirmed myocarditis, 21% required HTx/LVAD or died vs 7% of those without inflammation (P=.056). The factors associated with a worse prognosis were baseline LVEF ≤ 30%, left ventricular end-diastolic diameter ≥ 60mm, and NYHA III-IV, especially in the presence of inflammation. Conclusions EMB allows an etiological diagnosis in more than half of patients with suspected myocarditis/ICM when IHC techniques are used. IHC-confirmed inflammation adds prognostic value and helps to identify patients with a higher probability of developing complications (AU)

El insomnio y la pobre calidad de sueño se asocian a un mal control de crisis en pacientes con epilepsia / Insomnia and poor sleep quality are associated with poor seizure control in patients with epilepsy

Objetivos: Evaluamos la presencia de trastornos del sueño en pacientes con epilepsia y analizamos su asociación con el control de las crisis.MétodosSe realizó un estudio transversal de pacientes con epilepsia reclutados consecutivamente entre septiembre de 2017 y diciembre de 2018. Los pacientes se clasificaron en 2 grupos según el control de crisis (buen control: pacientes sin crisis en las últimas 4 semanas) o mal control (pacientes con una crisis o más en las últimas 4 semanas). Se compararon variables demográficas y clínicas; insomnio, medido por el Índice de Severidad del Insomnio (ISI); somnolencia diurna excesiva, medida por la Escala de Somnolencia de Epworth (ESS); calidad del sueño, medida por el Índice de Calidad del Sueño de Pittsburgh (PSQI); depresión, medida por el Inventario de Depresión de Beck-II (BDI-II); y calidad de vida, medida por el test de Calidad de Vida en Epilepsia (QOLIE-10).ResultadosSe incluyeron 123 pacientes. El 31,7% tenía somnolencia diurna excesiva (ESS ≥ 10), el 50,4% insomnio (ISI ≥ 10) y el 53,6% mala calidad del sueño (PSQI ≥ 5). Los factores asociados con la presencia de crisis fueron el desempleo (odds ratio [OR] = 4,7; intervalo de confianza del 95% [IC 95%]: 1,36-19,2; p = 0,02), un mayor número de fármacos antiepilépticos (OR = 5,87; IC 95%: 1,81-27,1; p < 0,001), insomnio (OR = 1,9; IC 95%: 1,1-9,3; p = 0,04) y mala calidad del sueño (OR = 2,8; IC 95%: 1,9-10,32; p = 0,01).ConclusionesLos trastornos del sueño son frecuentes en pacientes con epilepsia. El insomnio y la mala calidad del sueño se asociaron con un peor control de crisis. Estos hallazgos apoyan que los trastornos del sueño son una comorbilidad frecuente en epilepsia, especialmente en pacientes con peor control de crisis. (AU)

Objectives: This study aimed to assess the presence of sleep disorders in patients with epilepsy and to analyse their association with seizure control.MethodsWe performed a cross-sectional study of patients with epilepsy, recruited consecutively between September 2017 and December 2018. Patients were classified as having good seizure control (no seizures in the last 4 weeks) or poor seizure control (at least one seizure in the last 4 weeks). We performed intergroup comparisons for demographic and clinical data, insomnia (Insomnia Severity Index [ISI]), excessive daytime sleepiness (Epworth Sleepiness Scale [ESS]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), depression (Beck Depression Inventory-II [BDI-II]), and quality of life (Quality of Life in Epilepsy Inventory-10 [QOLIE-10]).ResultsThe sample included a total of 123 patients, of whom 31.7% had excessive daytime sleepiness (ESS ≥ 10), 50.4% had insomnia (ISI ≥ 10), and 53.6% had poor sleep quality (PSQI ≥ 5). According to our multivariate analysis, presence of seizures was associated with unemployment (odds ratio [OR] = 4.7; 95% confidence interval [CI], 1.36-19.2; P = .02), a higher number of antiepileptic drugs (OR = 5.87; 95% CI, 1.81-27.1; P < .001), insomnia (OR = 1.9; 95% CI, 1.1-9.3; P = .04), and poor sleep quality (OR = 2.8; 95% CI, 1.9-10.32; P = .01).ConclusionsSleep disorders are common in patients with epilepsy. Insomnia and poor sleep quality were associated with poor seizure control. These findings support the hypothesis that sleep disorders constitute a significant comorbidity of epilepsy, especially in patients with poor seizure control. (AU)