Cardio-ankle vascular index (CAVI) measured by a new device: protocol for a validation study.

INTRODUCTION: Cardio-ankle vascular index (CAVI) is a new marker of arterial stiffness (AS) that can assess vascular wall stiffness in the aorta, femoral artery and tibial artery. CAVI is less affected by blood pressure at the time of measurement than the gold standard method (carotid-femoral pulse wave velocity (PWV)). Our group has developed a device called VOPITB (Velocidad Onda de Pulso Índice Tobillo Brazo) that uses the oscillometric method and easily and accurately measures the PWV in the arms and legs separately, allowing new AS indices to be studied. This article describes the research protocol to determine CAVI using VOPITB and to validate the device against a reference device (VaSera VS-1500) and assess its clinical utility. METHODS AND ANALYSES: A cross-sectional, descriptive and observational study will be conducted. In all, 120 subjects (a minimum of 40% of subjects from any one gender) will be evaluated. CAVI will be determined from the measurement by VOPITB and VaSera VS-1500. For each subject, the average of the three readings taken with each device will be calculated. The Bland-Altman plot will be used to determine whether any bias exists in the data-that is, a tendency of the size of the difference to vary with the mean. The participants will be divided roughly equally between the following age bands: <30, 30-60 and >60 years. ETHICS AND DISSEMINATION: The study has been approved by the ethics committee of the Hospital San Pedro de Alcántara, Cáceres, Spain. The participants will be required to sign an informed consent form before inclusion in the study, in accordance with the Declaration of Helsinki and WHO standards for observational studies. The dissemination plan of the research study results will be through presentations in relevant national and international conferences and scientific publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04303546.

Backpacks Effect on Foot Posture in Schoolchildren with a Neutral Foot Posture: A Three-Year Prospective Study.

BACKGROUND: There is a paucity of data on the relationship between backpack use and foot posture in children. The aim of this study was to assess the effects of a backpack on foot posture in children with neutral foot posture during three years of follow-up. METHODS: A prospective longitudinal observational study was conducted in a sample of 627 children with neutral foot. For each participant included in the study, age, sex, weight, height, body mass index, type of schoolbag (backpack or non-backpack), foot shape, metatarsal formula and type of shoes were recorded. Foot posture was described by the mean of the foot posture index (FPI) and reassessed after three years in a follow-up study. RESULTS: The average age of the children was 8.32 ± 1.32 years. A total of 458 used a backpack when going to school. Over the three-year follow-up period, 50 children who had neutral foot developed supinated foot (n = 18) or pronated foot (n = 32). Univariate and multivariate analysis showed that the children using a backpack were at a higher risk of developing pronated foot (adjusted Odds Ratio (aOR) = 2.05, 95% IC: 1.08-3.89, p = 0.028). Backpack use was not associated with the change from neutral foot to supinated foot. CONCLUSIONS: We found a positive association between using a backpack and the risk of developing pronated but not supinated foot. Clinical trials should be conducted to analyze the effect of backpack use on the foot among schoolchildren.

Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis.

Body roundness index (BRI) is a new anthropometric index developed to predict both body fat and the percentage of visceral adipose tissue. Our aim was to investigate whether BRI is superior to traditional anthropometric indices in predicting metabolic syndrome (MetS). This systematic review and meta-analysis was conducted using Pubmed, Scopus and Web of Sciences databases. The estimated pooled areas under curve (AUCs) for BRI predicting MetS was higher than body mass index (BMI), waist-to-hip ratio (WHR), body shape index (ABSI) and body adiposity index (BAI), similar to waist circumference (WC) and lower than waist-to-height ratio (WHtR). However, the difference between BRI and BMI, WC and WHtR predicting MetS was statistically non-significant. Similar results were found with the summary receiver operating characteristic curve (AUC-SROC). In addition, the non-Chinese population had pooled AUCs greater than the Chinese population for all indices. Pooled ORs showed that BRI is associated with an increased MetS risk. In conclusion, BRI had good discriminatory power for MetS in adults of both sexes from diverse populations (AUC > 0.7; AUC-SROC>0.7). However, WC and WHtR offer the best performance when screening for MetS, and non-significant differences were found with BRI. In contrast, BRI was superior to BMI, WHR, ABSI and BAI in predicting MetS.

Effects of Smoking and Physical Activity on the Pulmonary Function of Young University Nursing Students in Cáceres (Spain).

BACKGROUND: The simultaneous effect of physical activity (PA) and smoking on pulmonary function in young people remains unclear. PROPOSE: The aim of this study was to determine the influence of smoking and PA on pulmonary function in young university students in Cáceres, Spain. METHODS: A sample of 120 young nursing students was studied (60 smokers and 60 nonsmokers). All subjects underwent spirometry with a COPD-6 portable device, and their level of PA was quantified using the International Physical Activity Questionnaire. The influence of PA and smoking on pulmonary function was determined by comparing hypotheses. RESULTS: Significant differences were observed between smokers and nonsmokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and the difference between lung age and chronological age (LA-CA) in those who practiced mild PA. In the subjects who performed moderate and vigorous PA, these differences were not noted. In the intragroup analysis, significant differences were observed in smokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and LA-CA; however, in the control group, differences were only observed in terms of lung age and LA-CA. These findings were confirmed in the multivariate analysis. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Our findings confirmed a deterioration in pulmonary function in smokers who did not perform moderate or vigorous PA. The level of PA performed was positively related to pulmonary function in smokers, whereas in nonsmokers, improvements were only significant in LA-CA.

Del Hospital Municipal de Trujillo y del cese de las Hermanas Amantes de Jesús / O Hospital Municipal de Trujillo ea cessação de amantes Irmãs de Jesus / Municipal Hospital of Trujillo and the cessation of Lovers Sisters of Jesus

Los objetivos del estudio fueron realizar una descripción del hospital municipal y de las obras acometidas, exponer las condiciones del convenio entre el Ayuntamiento y las religiosas y describir los cambios que se producen durante 1894. Se ha realizado un estudio histórico-documental durante los años 2014-2015 de los legajos depositados en el Archivo Municipal de Trujillo. El Hospital de la ciudad de Trujillo estaba destinado a la atención de ciudadanos, militares y transeúntes enfermos. La atención a los enfermos fue realizada por las Hermanas Amantes de Jesús y María Inmaculada desde el año 1890. En la labor asistencial, las religiosas fueron ayudadas por una enfermera y un enfermero contratados por el Ayuntamiento. Durante 1894 se produjeron una serie de cambios, promovidos por la Corporación Local de la ciudad, que provocaron que las religiosas cesaran su labor asistencial. Estos cambios se vieron motivados por las quejas recibidas por los enfermos ingresados y por lo costoso que la atención resultaba para el Ayuntamiento. El cese de las hermanas llevaría a que el Ayuntamiento tuviera la necesidad de estudiar una nueva organización a nivel de régimen y administración (AU)

O alvo de este estudo foi a descrição do hospital e das obras de remodelação do mesmo, assim como expor as condições do contrato entre as religiosas e a Câmara. Descrevem-se também as alterações producidas durante 1894. Em 2014 e 2015 realizou-se un trabalho de investigação dos documentos depositados no Arquivo Municipal da cidade de Trujillo. O Hospital Municipal da cidade de Trujillo, estava destinado ao atendimento de cidadãos, militares e transeuntes doentes. O tratamento dos doentes foi realizado pelas Irmãs Amantes de Jesus e Maria Imaculada desde o ano 1890. Para dar assistência às irmãs seriam contratados uma enfermeira e um enfermeiro, pagos pela Câmara Municipal. Durante 1894 a Câmara Municipal efetuou uma série de alterações que produziram a cessação da tarefa assistencial das raligiosas. Esatas alterações foram originadas pelas queixas de alguns dos doentes e pelas elevadas despesas que a Câmara Municipal tinha que pagar pela manutenção do hospital. Com a cessação da atividadde das irmãs a Câmara começou a estudar uma nova organização do regime e da administração da instituição (AU)

The objectives were to make a description of the hospital and the works undertaken, exposing the conditions of the agreement between the city and religious and describe changes that occur during 1894. There has been a historical documentary study during the years 2014-2015 of the files deposited in the Municipal Archives of Trujillo. The Municipal Hospital in the city of Trujillo, was destined to service citizens, sick soldiers and bystanders. The Sisters Lovers of Jesus and Mary Immaculate performed treatment of patients since the year 1890. To assist the sisters would be hired a nurse and a nurse, paid by the city. During 1894 the City Council performed changes that produced the cessation of the assistance service of religious. The changes originated by the complaints of some patients and the high costs that the City Council had to pay for hospital maintenance. With the cessation, the religious began to study a new organization of the regime and the management of the institution (AU)

Treatment of subclinical hypothyroidism does not affect bone mass as determined by dual-energy X-ray absorptiometry, peripheral quantitative computed tomography and quantitative bone ultrasound in Spanish women.

INTRODUCTION: The results of studies examining the influence of subclinical hypothyroidism (SCH) and levothyroxine (L-T4) replacement therapy on bone have generated considerable interest but also controversy. The present research aims to evaluate the effects of L-T4 treatment on different skeletal sites in women. MATERIAL AND METHODS: A group of 45 premenopausal (mean age: 43.62 ±6.65 years) and 180 postmenopausal (mean age: 59.51 ±7.90 years) women with SCH who were undergoing L-T4 replacement therapy for at least 6 months were compared to 58 pre- and 180 postmenopausal women with SCH (untreated) matched for age. The mean doses of L-T4 were 90.88 ±42.59 µg/day in the premenopausal women and 86.35 ±34.11 µg/day in the postmenopausal women. Bone measurements were obtained using quantitative bone ultrasound (QUS) for the phalanx, dual-energy X-ray absorptiometry (DXA) for the lumbar spine and hip, and peripheral quantitative computed tomography (pQCT) for the non-dominant distal forearm. RESULTS: No differences were observed between patients and untreated controls in these bone measurements except in the bone mineral density (BMD) of the spine (p = 0.0214) in postmenopausal women, which was greater in treated women than in untreated controls. CONCLUSIONS: Our results indicate that adequate metabolic control through replacement treatment with L-T4 in pre- and postmenopausal women does not affect bone mass.

Intoxicación por insecticidas organofosforados. Epidemiología y prevención / Intoxication by organicphosphate insecticide. Its epidemiology and prevention

En el medio agrario la exposición a insecticidas anticolinesterásicos es un potencial problema de salud pública. La intoxicación aguda o crónica puede ocasionar problemas sanitarios importantes por su frecuencia o su severidad. Extremadura es, como otras Comunidades españolas, de población preferentemente rural, lo que implica una especial relevancia de este problema. Se evalúa la incidencia de intoxicaciones, la validez de medidas tomadas y se exponen los programas de educación sobre este problema. Se revisan las bases fisiopatológicas de la intoxicación, los síntomas y el tratamiento. Se exponen los resultados obtenidos en una encuesta aplicada a una población de agricultores en Extremadura. Además se proporciona información a los profesionales sanitarios responsables del tratamiento y prevención de esta intoxicación; considerando la educación sanitaria, especialmente en el medio agrícola, una de las acciones más importantes para prevenir y reducir la mortalidad y manifestaciones crónicas debidas a la exposición a estos agentes (AU)