Risky alcohol use during youth: Impact on emotion, cognitive networks, and resting-state EEG activity.

The identification of the risk factors of alcohol consumption in youths is crucial for early interventions focused on reducing harmful alcohol use. In our study, 82 college students (40 healthy control (CO group) and 42 with risky alcohol use (RAU group) determined by AUDIT questionnaire) between the ages of 18 and 25 years underwent a comprehensive neuropsychological assessment covering emotional and cognitive functioning. Their resting-state activity was also recorded with an EEG for 10 min with their eyes open (EO) and 10 min with their eyes closed (EC) and analyzed using the Fitting Oscillations & One-Over-F (FOOOF) paradigm. After adjusting for sex, those in the RAU group had higher emotional dysregulation and impulsivity traits. The RAU girls presented more emotional regulation problems, such as dysregulation and negative urgency compared with the RAU boys. The RAU youths had significantly worse functioning in several cognitive domains, such as sustained attention, verbal memory, and executive functions. Cognitive network analysis revealed a different pattern of connections in each group showing that in the RAU group, the verbal memory domain had the highest connection with other cognitive functions. The EEG analyses did not reveal any significant differences between the CO and the RAU groups. However, we observed only in the EO condition that boys the from the RAU group displayed a higher theta/beta ratio than the RAU girls, whereas these differences were not observed within the CO group. Our findings highlight the need to explore more deeply the emotional, cognitive and brain changes underlying the RAU in young people.

Influence of docosahexaenoic acid on the interfacial behavior of cholesterol-containing lipid membranes: Interactions with small amphiphiles and hydration properties.

Cholesterol is known to significantly modify both the structural and the dynamical properties of lipid membranes. On one side, the presence of free cholesterol molecules has been determined to stiffen the membrane bilayer by stretching the hydrophobic tails. Additionally, recent experimental and computational findings have made evident the fact that cholesterol also alters the dynamics and the hydration properties of the polar head groups of DPPC model lipid membranes. In turn, we have recently shown that the Omega-3 fatty acid docosahexaenoic acid, DHA, counteracts the effect of cholesterol on DPPC membrane's mechanical properties by fluidizing the bilayer. However, such behavior represents in fact a global outcome dominated by the larger lipid hydrophobic tails that neither discriminates between the different parts of the membrane nor elucidates the effect on membrane hydration and binding properties. Thus, we now perform molecular dynamics simulations to scrutinize the influence of DHA on the interfacial behavior of cholesterol-containing lipid membranes by characterizing their hydration properties and their binding to amphiphiles. We find that while cholesterol destabilizes interactions with amphiphiles and slightly weakens the lipid's hydration layer, the incorporation of DHA practically restores the interfacial behavior of pure DPPC.

Survey of selected pathogens in free-ranging pinnipeds in Uruguay.

Marine mammals, regarded as sentinels of aquatic ecosystem health, are exposed to different pathogens and parasites under natural conditions. We surveyed live South American fur seals Arctocephalus australis and South American sea lions Otaria flavescens in Uruguay for Leptospira spp., canine distemper virus (CDV), Mycobacterium spp., Toxoplasma gondii, and Neospora caninum. Samples were collected from 2007 to 2013. The seroprevalence of Leptospira spp. was 37.6% positive, 50.9% negative, and 11.5% suspect for A. australis (n = 61) while for O. flavescens (n = 12) it was 67% positive, 25% negative, and 8% suspect. CDV RNA was not detected in any of the analyzed samples. Most animals tested seropositive to tuberculosis antigens by WiZo ELISA (A. australis: 29/30; O. flavescens: 20/20); reactivity varied with a novel ELISA test (antigens MPB70, MPB83, ESAT6 and MPB59). Seroprevalence against N. caninum and T. gondii was 6.7 and 13.3% positive for O. flavescens and 0 and 2.2% positive for A. australis respectively. To evaluate possible sources of infection for pinnipeds, wild rats Rattus rattus and semi-feral cats Felis catus were also tested for Leptospira spp. and T. gondii respectively. Water samples tested for Leptospira revealed saprofitic L. bioflexa. Pathogenic Leptospira were detected in the kidneys of 2 rats, and cats tested positive for T. gondii (100%). These results represent a substantial contribution to the study of the health status of wild pinnipeds in Uruguay.

Prevalence and clinical characteristics of pulmonary TB among pregnant and post-partum women.

SETTING: Antenatal care (ANC) and postpartum care (PPC) clinic in Manhiça District, Mozambique.OBJECTIVE: To estimate the prevalence of TB among pregnant and post-partum women and describe the clinical characteristics of the disease in a rural area of Southern Mozambique.METHODS: We conducted a cross-sectional TB prevalence study among pregnant and post-partum women recruited from September 2016 to March 2018 at the Manhiça Health Care Center (MHC). We recruited two independent cohorts of women consecutively presenting for routine pregnancy or post-partum follow-up visits.RESULTS: A total of 1,980 women from the ANC clinic and 1,010 from the PPC clinic were enrolled. We found a TB prevalence of 505/100,000 (95% CI: 242-926) among pregnant women and 297/100,000 (95% CI: 61-865) among post-partum women. Among HIV-positive pregnant women, TB prevalence was 1,626/100,000 (95% CI: 782-2,970) and among postpartum HIV-positive women, TB prevalence was 984/100,000 (95% CI: 203-2,848).CONCLUSIONS: The burden of TB was not higher in postpartum women than in pregnant women. Most TB cases were detected in HIV-positive women. TB screening and diagnostic testing among pregnant and postpartum women attending ANC and PPC clinics in Manhiça District is acceptable and feasible.

Variaciones en la incidencia de bronquiolitis tras la aparición del SARS-CoV-2 / Variations in the incidence of bronchiolitis after the onset of SARS-CoV-2

Introducción. Durante la temporada 2020-2021 se ha asistido a una disminución de la incidencia de hospitalizaciones por bronquiolitis. Los cambios en la evolución de la pandemia de SARS-CoV-2 y en la aplicación de medidas preventivas podrían relacionarse con un aumento de la incidencia de bronquiolitis grave durante la temporada 2021-2022. Objetivo. Determinar la incidencia de hospitalizaciones por bronquiolitis en un hospital terciario durante la temporada 2021-2022 y compararla con temporadas previas. Método. Estudio epidemiológico de tipo observacional, descriptivo y ambispectivo. A través de la base de datos de un hospital terciario, se compararon la incidencia, la etiología y los indicadores de gravedad de las hospitalizaciones por bronquiolitis. Se analizaron 3 cohortes en época epidémica: la temporada 2020-2021 y la 2021-2022 (prospectivas); y la temporada 2018-2019 (retrospectiva). También se analizó una cohorte prospectiva entre los meses de abril y octubre de 2021. Resultados. La incidencia acumulada de hospitalizaciones fue de 113,6/10.000 niños menores de 2 años en la temporada pre-covídica; de 3,6/10.000 en la temporada 2020-2021; y de 65,7/10.000 en la temporada 2021-2022. El porcentaje de ingresos en UCIP fue de 36,6%, 0 % y 30,8%, respectivamente. La incidencia acumulada de hospitalizaciones en el periodo no epidémico fue de 60,8/10.000, precisando ingreso en UCIP el 19%. El microorganismo más frecuente fue el virus respiratorio sincitial en todas las cohortes. Conclusiones. La incidencia durante los meses típicamente epidémicos de bronquiolitis bajó drásticamente la temporada en la que apareció el SARS-CoV-2, aumentando notablemente el año posterior, aunque sin alcanzar la incidencia previa a la pandemia. Se ha observado una incidencia alta de casos de bronquiolitis entre abril y octubre de 2021 (AU)

Introduction. A decrease has been observed during the 2020-2021 season in the incidence of hospitalizations for bronchiolitis. Changes in the evolution of the SARS-CoV-2 pandemic and in the application of preventive measures could be related to an increase in the incidence of severe bronchiolitis during the 2021-2022 season. Objective. To determine the incidence of bronchiolitis hospitalizations in a tertiary hospital during the 2021-2022 season and to compare it with previous seasons. Method. An observational, descriptive and ambispective epidemiological study. A tertiary hospital database was used to compare the incidence, etiology, and severity indicators of bronchiolitis hospitalizations. 3 cohorts were analyzed in epidemic times: the 2020-2021 season and the 2021-2022 season (prospective); and the 2018-2019 season (retrospective). A prospective cohort between the months of April and October 2021 was also analyzed. Results. The cumulative incidence of hospitalizations was 113.6/10,000 children under 2 years of age in the pre-covid season; 3.6/10,000 in the 2020-2021 season; and 65.7/10,000 in the 2021-2022 season. The percentage of admissions in PICU was 36.6%, 0% and 30.8%, respectively. The cumulative incidence of hospitalizations in the non-epidemic period was 60.8/10,000, with 19% requiring admission to the PICU. The most frequent microorganism was the respiratory syncytial virus in all cohorts. Conclusions. The incidence during the typically epidemic months of bronchiolitis drastically decreased the season in which SARS-CoV-2 appeared, noticeably increasing the next year, although without reaching the pre-pandemic incidence. A high incidence of bronchiolitis cases was observed between April and October 2021 (AU)

Factors associated with sepsis development in 606 Spanish adult patients with cellulitis.

BACKGROUND: Cellulitis, a frequent cause of admission of adult patients to medical wards, occasionally evolves to sepsis. In this study we analyze the factors related to sepsis development. METHODS: Prospective and observational study of 606 adult patients with cellulitis admitted to several Spanish hospitals. Comorbidities, microbiological, clinical, lab, diagnostic, and treatment data were analyzed. Sepsis was diagnosed according to the criteria of the 2016 International Sepsis Definitions Conference. Multiple logistic regression modelling was performed to determine the variables independently associated with sepsis development. RESULTS: Mean age was 63.4 years and 51.8% were men. Overall 65 (10.7%) patients developed sepsis, 7 (10.8%) of whom died, but only 4 (6.2%) due to cellulitis. Drawing of blood (P < 0.0001) or any (P < 0.0001) culture, and identification of the agent (P = 0.005) were more likely among patients with sepsis. These patients had also a longer duration of symptoms (P = 0.04), higher temperature (P = 0.03), more extensive cellulitis (P = 0.02), higher leukocyte (P < 0.0001) and neutrophil (P < 0.0001) counts, serum creatinine (P = 0.001), and CRP (P = 0.008) than patients without sepsis. Regarding therapy, patients with sepsis were more likely to undergo changes in the initial antimicrobial regimen (P < 0.0001), received more antimicrobials (P < 0.0001), received longer intravenous treatment (P = 0.03), and underwent surgery more commonly (P = 0.01) than patients without sepsis. Leukocyte counts (P = 0.002), serum creatinine (P = 0.003), drawing of blood cultures (P = 0.004), change of the initial antimicrobial regimen (P = 0.007) and length of cellulitis (P = 0.009) were independently associated with sepsis development in the multivariate analysis. CONCLUSIONS: Increased blood leukocytes and serum creatinine, blood culture drawn, modification of the initial antimicrobial regimen, and maximum length of cellulitis were associated with sepsis in these patients.

Impacto de un programa de intervención destinado a la mejora de la prescripción potencialmente inapropiada en pacientes ancianos hospitalizados / Impact of an intervention program to improve potentially inappropriate prescription in hospitalized elderly patients

Introducción y objetivos: La prescripción potencialmente inapropiada (PPI) es frecuente en ancianos. Se ha convertido en un problema de salud pública mundial por su relación con efectos adversos a medicamentos (EAM), aumento de la morbimortalidad, visitas a urgencias y consumo de recursos. El objetivo principal de este estudio fue determinar si el uso de un programa de notificación de PPI en pacientes ancianos hospitalizados condujo a una reducción en su prescripción. Método: Se realizó un estudio quasi-experimental pre-post. La identificación de las PPI se llevó a cabo según los criterios de Beers (actualización 2012) y STOPP-START (versión 2008). Se elaboró un informe individualizado sobre PPI y se evaluó el efecto de esta intervención. Resultados: Se incluyeron 174 pacientes con 284 PPI. Se aceptaron el 54% (153) de las recomendaciones. La única variable que demostró contribuir a la presencia de modificaciones en la PPI fue el índice de Barthel. Los pacientes a los que se les modificó la PPI se caracterizaron por ser significativamente más dependientes (p=0,005), presentar deterioro cognitivo (p=0,001) y encontrarse más institucionalizados (p=0,039) que aquellos a los que no se les realizó ninguna modificación. Se produjeron menos reingresos, visitas a urgencias y menor mortalidad al comparar los pacientes con y sin modificaciones de PPI, pero sin diferencias significativas. Se identificaron 32 EAM, 29 relacionados con fármacos inapropiados. Los EAM se asociaron con PPI respecto a otros fármacos de manera significativa (p<0,001), odds ratio 242,5 (IC 95%: 56,9-1.023,6). Conclusiones: La revisión de la medicación en pacientes de edad avanzada, junto con el uso de herramientas que ayudan en la identificación de fármacos inapropiados, conlleva una reducción de la PPI y contribuye de manera significativa a la mejora continua de la medicación crónica en los ancianos

Introduction and objectives: Potentially inappropriate prescription (PIP) is common in elderly people. It has become a global public health problem due to its association with adverse drug effects (ADE), increased morbidity and mortality, emergency care visits and resource use. The main aim of this study was to determine whether the use of a notification program of PIP in elderly patients admitted in the hospital led to a reduction of their prescription. Method: A quasi-experimental before-after study was conducted. PIP were identified by using Beers (2012 update) and STOPP-START criteria (2008 version). An individualized report on PPI was prepared and the effect of this intervention was evaluated. Results: 174 patients were included who presented 284 PIP. 54% (153) of the recommendations were accepted. Barthel index was the only variable that proved to contribute to the presence of PIP modifications. The patients whose PIP drugs were modified were significantly more dependent (p=0.005), presented cognitive impairment (p=0.001) and were more institutionalized (p=0.039) than those without any modifications. There were fewer readmissions, emergency care visits and mortality within six months after intervention comparing patients with and without PIP modifications, but without significant differences. 32 ADE were detected, 29 related with PIP drugs. Adverse events were significantly associated with PIP drugs, versus other medications (p<0.001), odds ratio 242.5 (CI95%: 56.9-1023.6). Conclusions: Review of medication in elderly patients, along with the use of tools that help in the identification of dangerous drugs, entail a reduction of inadequate prescription and significantly contribute to the continuous improvement of chronic medication in elders

Impact of an intervention program to improve potentially inappropriate prescription in hospitalized elderly patients. / Impacto de un programa de intervención destinado a la mejora de la prescripción potencialmente inapropiada en pacientes ancianos hospitalizados.

INTRODUCTION AND OBJECTIVES: Potentially inappropriate prescription (PIP) is common in elderly people. It has become a global public health problem due to its association with adverse drug effects (ADE), increased morbidity and mortality, emergency care visits and resource use. The main aim of this study was to determine whether the use of a notification program of PIP in elderly patients admitted in the hospital led to a reduction of their prescription. METHOD: A quasi-experimental before-after study was conducted. PIP were identified by using Beers (2012 update) and STOPP-START criteria (2008 version). An individualized report on PPI was prepared and the effect of this intervention was evaluated. RESULTS: 174 patients were included who presented 284 PIP. 54% (153) of the recommendations were accepted. Barthel index was the only variable that proved to contribute to the presence of PIP modifications. The patients whose PIP drugs were modified were significantly more dependent (p=0.005), presented cognitive impairment (p=0.001) and were more institutionalized (p=0.039) than those without any modifications. There were fewer readmissions, emergency care visits and mortality within six months after intervention comparing patients with and without PIP modifications, but without significant differences. 32 ADE were detected, 29 related with PIP drugs. Adverse events were significantly associated with PIP drugs, versus other medications (p<0.001), odds ratio 242.5 (CI95%: 56.9-1023.6). CONCLUSIONS: Review of medication in elderly patients, along with the use of tools that help in the identification of dangerous drugs, entail a reduction of inadequate prescription and significantly contribute to the continuous improvement of chronic medication in elders.

Synthesis and biological evaluation against Leishmania donovani of novel hybrid molecules containing indazole-based 2-pyrone scaffolds.

A series of novel indazole-pyrone hybrids were synthesized by a one pot reaction between N-alkyl-6(5)-nitroindazoles and 2-pyrone (4-hydroxy-6-methyl-2H-pyran-2-one) using indium or stannous chloride as the reducing system in the presence of acetic acid in tetrahydrofuran. The hybrid molecules were obtained in good to excellent yields (72-92%) and characterized by NMR and single crystal X-ray diffraction. Nineteen compounds were tested in vitro against both Leishmania donovani (MHOM/ET/67/HU3, also called LV9) axenic and intramacrophage amastigotes. Among all, five compounds showed anti-leishmanial activity against intracellular L. donovani with an IC50 in the range of 2.25 to 62.56 µM. 3-(1-(3-Chloro-2-ethyl-2H-indazol-6-ylamino)ethylidene)-6-methyl-3H-pyran-2,4-dione 6f was found to be the most active compound for axenic amastigotes and intramacrophage amastigotes of L. donovani with IC50 values of 2.48 ± 1.02 µM and 2.25 ± 1.89 µM, respectively. However, the cytotoxicity of the most promising compound justifies further pharmacomodulations.

Cellulitis in adult patients: A large, multicenter, observational, prospective study of 606 episodes and analysis of the factors related to the response to treatment.

BACKGROUND: Cellulitis is a frequent cause of hospital admission of adult patients. Increasing prevalence of multiresistant microorganisms, comorbidities, predisposing factors and medical and surgical therapies might affect cellulitis response and recurrence rate. METHODS: Prospective and observational study of 606 adult patients with cellulitis admitted to several Spanish hospitals. Comorbidities, microbiological, clinical, diagnostic, treatment (surgical and antibiotic) data were analyzed according to the cellulitis response. Good response implied cure. Poor response implied failure to cure or initial cure but relapse within 30 days of hospital discharge. RESULTS: Mean age was 63.3 years and 51.8% were men. Poor responses were significantly associated with age, previous episodes of cellulitis, prior wounds and skin lesions, venous insufficiency, lymphedema, immunosuppression and lower limbs involvement. No differences in ESR or CRP blood levels, leukocyte counts, pus or blood cultures positivity or microbiological or imaging aspects were observed in those with good or poor responses. Regarding antimicrobials, no differences in previous exposition before hospital admission, treatment with single or more than one antibiotic, antibiotic switch, days on antimicrobials or surgical treatment were observed regarding good or poor cellulitis response. Prior episodes of cellulitis (P = 0.0001), venous insufficiency (P = 0.004), immunosuppression (P = 0.03), and development of sepsis (P = 0.05) were associated with poor treatment responses, and non-surgical trauma (P = 0.015) with good responses, in the multivariate analysis. CONCLUSIONS: Prior episodes of cellulitis, non-surgical trauma, venous insufficiency, sepsis and immunosuppression were independently associated with treatment response to cellulitis, but not the causative microorganism, the number of antimicrobials administered or its duration.

Epidemiología y manejo de la neumonía adquirida en la comunidad durante más de una década / Epidemiology and management of community acquired pneumonia: more than 10 years experience

Objetivo: Describir las características de los pacientes diagnosticados de neumonía adquirida en la comunidad (NAC) en nuestra zona básica de salud, su manejo, evolución y utilización de escalas pronósticas impulsados por los escasos estudios realizados desde Atención Primaria (AP) sobre estos aspectos. Material y métodos: Estudio observacional descriptivo transversal sobre la población de 3 centros de salud urbanos, diagnosticada de NAC en el periodo del 1/1/2000 al 31/7/2013, obteniéndose una muestra de 1.290 pacientes. Resultados: El 56,1% eran hombres y la edad media de la población era de 61,9 años. El 22,7% eran fumadores. El 59,9% presentaba patología existente en las escalas pronósticas, estando presente la diabetes mellitus en un 20%. El 36,1% tenía patología pulmonar (17,6% EPOC, 11,8% asma). En AP se diagnosticaron el 43,2% del total. La radiografía diagnóstica estaba presente en el 92,7% de los casos y la de control en el 59,4%. Se registraron escalas pronósticas en el 2% de los casos. Los antibióticos más utilizados fueron amoxicilina-clavulánico (30,7%) y levofloxacino (30,4%). Tener patología previa incrementa en 1,6 el riesgo de retratamiento [ICred 95% (1,1-2,2)]. El riesgo de mortalidad se multiplica por 5,3 en caso de presentar patología previa [ICred 95% (1,3-19,2]. Conclusiones: En nuestro medio la NAC es una enfermedad frecuente y potencialmente grave, la cual la presentan -en la mitad de los casos- pacientes con comorbilidad asociada. Si hablamos de tratamiento y manejo, cabe destacar el amplio uso que hacemos de amoxicilina-clavulánico frente a un uso escaso de amoxicilina, terapia combinada y escalas pronósticas

Objective: To describe the characteristics of patients diagnosed with Community Acquired Pneumonia in this basic health area, their management, outcomes, and use of prognostic scales driven by the few studies carried out from Primary Care on these aspects. Material and methods: Descriptive cross-sectional study on a population diagnosed with Community Acquired Pneumonia if three urban health centres, during the period January 2000 to 31 July 2103. Results: Out of a sample of 1,290 patients obtained, 56.1% were men, and the mean age of the population was 61.9 years. There were 22.7% smokers. More than half (59.9%) had a disease in the prognostic scales, with Diabetes Mellitus present in 20%, and 36.1% with pulmonary disease (17.6% COPD, 11.8% asthma). Just under half (43.2%) of the total patients were diagnosed in Primary Care. There was a diagnostic X-ray in 92.7% of the cases, and a follow-up X-ray in 59.4%. Prognostic scales were recorded in 2% of the cases. The most commonly used antibiotics were amoxicillin-clavulanic (30.7%) and levofloxacin (30.4%). Having prior disease increases the risk of re-treatment by 1.6 (95% CI; 1.1-2.2)]. The mortality risk is multiplied by 5.3 on having a previous disease (95% CI; 1.3-19.2). Conclusions: In the Primary Care setting, Community Acquired Pneumonia is a common and potentially serious disease which, in half the cases, occurs in patients with associated comorbidity. As regards treatment and management, is highlighted the wide use made of amoxicillin-clavulanic, compared to the low use of amoxicillin, combined therapy, and prognostic scales

[Epidemiology and management of community acquired pneumonia: more than 10 years experience]. / Epidemiología y manejo de la neumonía adquirida en la comunidad durante más de una década.

OBJECTIVE: To describe the characteristics of patients diagnosed with Community Acquired Pneumonia in this basic health area, their management, outcomes, and use of prognostic scales driven by the few studies carried out from Primary Care on these aspects. MATERIAL AND METHODS: Descriptive cross-sectional study on a population diagnosed with Community Acquired Pneumonia if three urban health centres, during the period January 2000 to 31 July 2103. RESULTS: Out of a sample of 1,290 patients obtained, 56.1% were men, and the mean age of the population was 61.9 years. There were 22.7% smokers. More than half (59.9%) had a disease in the prognostic scales, with Diabetes Mellitus present in 20%, and 36.1% with pulmonary disease (17.6% COPD, 11.8% asthma). Just under half (43.2%) of the total patients were diagnosed in Primary Care. There was a diagnostic X-ray in 92.7% of the cases, and a follow-up X-ray in 59.4%. Prognostic scales were recorded in 2% of the cases. The most commonly used antibiotics were amoxicillin-clavulanic (30.7%) and levofloxacin (30.4%). Having prior disease increases the risk of re-treatment by 1.6 (95% CI; 1.1-2.2)]. The mortality risk is multiplied by 5.3 on having a previous disease (95% CI; 1.3-19.2). CONCLUSIONS: In the Primary Care setting, Community Acquired Pneumonia is a common and potentially serious disease which, in half the cases, occurs in patients with associated comorbidity. As regards treatment and management, is highlighted the wide use made of amoxicillin-clavulanic, compared to the low use of amoxicillin, combined therapy, and prognostic scales.

[Impact of chronic illness on hospital nursing workloads]. / Impacto de la cronicidad en las cargas de trabajo de la enfermería hospitalaria.

OBJECTIVES: To evaluate the short-term impact of chronic illness in hospital units and to establish a method that allows nursing workloads to be adapted according to the care needs of patients. METHODS: A descriptive study of the evolution of workloads of nursing staff associated with the care needs of patients between 1 July 2014 and 30 June 2016, in a county hospital. The care needs of the patients were assessed daily using an adaptation of the Montesinos scheme. The estimated times of nursing care and auxiliary nursing required by the patients, based on their level of dependence for time distribution, were based on the standards and recommendations of the Ministry of Health, Social Services and Equality. RESULTS: During the study period, there was a change in the patient care needs, with no increase in activity, which resulted in an increase in the nursing staffing needs of 1,396 theoretical hours per year. This increase implies an increase in the workforce of 5 nurses in the second period. CONCLUSIONS: In the study period, the needs for direct nursing care increased by 7%, this increase is not related to the increase in activity, but to the level of dependency of the patients with chronic diseases. This increase occurred in both medical and surgical units.

Omega-3 versus isoflavones in the control of vasomotor symptoms in postmenopausal women.

Determine the efficacy and tolerability of omega-3 fatty acids versus soybean isoflavones in reducing the vasomotor symptoms (VMSs) frequency in postmenopausal women. A randomized, prospective, two-arm study was performed in healthy postmenopausal women aged 45-65. The two arms were: two capsules/day of omega-3 (425 mg of omega-3/capsule) administered orally (n = 38) and two tablets/day of soybean isoflavones (54.4 mg of isoflavones/tablet) (n = 30), over 16 weeks. The mean baseline frequency of moderate and severe VMSs per week in the omega-3 group was 24.56 and 23.90, respectively, and 19.65 and 19.51 in the isoflavone group. After 4 months, the reduction in moderate and severe hot flashes with omega-3 was significant (p < .001), whereas in the case of isoflavones, there was a significant difference in severe (p = .02) hot flashes after 4 months, but not in moderate hot flashes (p = .077). Omega-3 did not demonstrate significant efficacy differences versus isoflavones over time. The use of omega-3 has a beneficial effect on hot flash reduction after 4 months of treatment. This is comparable to the benefits found with soybean isoflavones after 3-4 weeks and after 4 months in severe hot flash women, but higher than those found with soybean isoflavones in moderate symptom women.