Comparative analysis of foetal and neonatal growth curves.

INTRODUCTION: Our aim was to determine which foetal or neonatal growth curves discriminate the probability of dying of newborns with low birth weight for their gestational age (small for gestational age, SGA) and sex (weight < 10th percentile) and to establish the curves that are presumably most useful for monitoring growth through age 10 years. MATERIAL AND METHODS: The analysis included every neonate (15 122) managed in our hospital (2013-2022) and all neonates born preterm before 32 weeks (6913) registered in the SEN1500 database (2019-2022). We considered most useful those curves with the highest likelihood ratio (LR) for dying with or without a history of SGA in each subgroup of gestational ages. Theoretically, the optimal curves for monitoring growth would be those with a higher R2 in the quantile regression formulas for the 50th percentile. RESULTS: The growth curves exhibiting the strongest association between SGA and hospital mortality are the Intergrowth fetal curves and the Fenton neonatal curves in infants born preterm before 32 weeks. However, the optimal curves for premature babies and neonates overall were those of Olsen and Intergrowth. The most useful curves to monitor anthropometric values alone until age 10 years of age are the longitudinal Intergrowth curves followed by the WHO standards, but if a single reference is desired from birth through age 10 years, the best option is the Fenton curves followed by the WHO standards. CONCLUSIONS: The Intergrowth reference provides the most discriminating foetal growth curves. In neonatal clinical practice, the optimal references are the Fenton followed by the WHO charts.

Social inequalities, advanced maternal age, and birth weight. Evidence from a population-based study in Spain.

OBJECTIVE: To examine whether advanced maternal age (≥40 years) is linked to an increased likelihood of low or high birth weight among native and foreign-born mothers giving birth in Spain. METHOD: A cross-sectional study was conducted using a novel database provided by the Spanish National Statistics Office which links the 2011 Census with information on individual births (2011-2015) from the Vital Statistics (Natural Movement of the Population). First, multinomial logistic regression models were used to estimate the potential association between maternal age and the likelihood of having a baby with low or high birth weight. Second, average adjusted predictions of giving birth to children with low, high, and adequate weight for the origin and the maternal age at birth were also calculated. RESULTS: Findings indicate that women with advanced maternal age showed an increased probability of giving birth to low birth weight infants. Conversely, mothers aged below <30 years had an elevated risk for high birth weight infants. When considering maternal migratory status, the findings were mixed. On one hand, foreign-born mothers showed a higher likelihood of delivering infants with high birth weight; on the other, they displayed a lower risk of low birth weight among newborns in comparison to Spanish natives. CONCLUSIONS: The study addresses two key aspects. First, it highlights the increased risk of low birth weight in mothers delivering at an advanced age. Second, it emphasizes the importance of accounting for maternal migratory status when investigating the association between age at birth and birth weight outcomes among immigrant mothers.

Interevaluator reliability of a tool for measuring body height in adult intensive care patients.

BACKGROUND: The calculation of body height in the intensive care unit is essential for obtaining the ideal body weight, which is used to program the tidal volume and establish objective and effective pulmonary ventilation. The objective of the study was to determine the interrater reliability of a tool for measuring body height in adult patients in an intensive care unit (ICU) in southwestern Colombia. METHODS: This cross-sectional observational study was conducted between January and May 2021, following the recommendations of the COSMIN protocol. Two physiotherapists in the roles of observer/evaluator measured the heights of 106 patients upon admission to the ICU with a previously designed. The sample size was calculated based on Pearson's correlation coefficient. For interrater reliability, the intraclass correlation coefficient (ICC) was used, and Bland-Altman analysis was used to assess concordance. The 95% confidence interval was established, and a P value <0.05 indicated statistical significance. RESULTS: A total of 106 individuals with a mean age of 59.3 years were included; the mean body height was 158.5 cm for women. The interrater reliability of the measurement of height was excellent (global ICC of 0.99, P = 0.000), and an almost perfect positive correlation was obtained between the raters for both women and men (R = 0.99). CONCLUSIONS: Excellent interrater/interobserver reliability was obtained for the measurement of body height in the ICU. This research highlights the importance of protocolizing the measurement of height in critical patients with valid and reliable instruments.

Obstrucción intestinal por hematoma intraabdominal: una complicación de la heparina de bajo peso molecular en el paciente pediátrico / Intestinal obstruction as a result of intra-abdominal hematoma: a complication of low molecular weight heparin in pediatric patients

Introducción: Los hematomas son una causa poco frecuente deobstrucción intestinal. La heparina subcutánea tiene riesgo de producirla punción directa de un asa intestinal, provocando un hematoma trau-mático que genere una obstrucción intestinal. Casos clínicos: Se describen tres casos de pacientes pediátricos conclínica de obstrucción intestinal en tratamiento con heparina subcutánea.Dos casos presentaron elevación de reactantes de fase aguda y signosradiológicos de sufrimiento intestinal por lo que se optó por tratamientoquirúrgico, con el hallazgo intraoperatorio de hematoma intramural. Eltercer caso fue manejado de manera conservadora con supresión de laanticoagulación y reposo intestinal, dado el adecuado estado generaly ausencia de hallazgos compatibles con isquemia o necrosis en laspruebas complementarias. Comentarios: La administración de heparina subcutánea puedeprovocar la aparición de hematomas de pared intestinal, tanto por suefecto anticoagulante, como por el riesgo de punción inadvertida deun asa intestinal.(AU)

Introduction: Hematomas are a rare cause of intestinal obstruc-tion. Subcutaneous heparin can bring about direct punctures on smallbowel loops, potentially leading to traumatic hematoma and intestinalobstruction. Case reports: We present three cases of pediatric patients withclinical signs of intestinal obstruction treated with subcutaneous heparin. Two cases had increased acute-phase reactants and radiological signsof intestinal suffering, so surgical treatment was decided upon, withintramural hematoma emerging as an intraoperative finding. The thirdcase was conservatively managed with anticoagulant discontinuationand gut rest, since the patient had an adequate general condition andno findings compatible with ischemia or necrosis were noted in thecomplementary tests. Discussion: The administration of subcutaneous heparin may causeintestinal wall hematomas due to its anticoagulating effect and to therisk of inadvertent punctures on small bowel loops.(AU)

Peso al nacer en el noroeste argentino. Comparación con una referencia nacional y un estándar internacional / Birth weight in the Northwest region of Argentina. Comparison with a national reference and an international standard

Introducción. El tamaño al nacer se encuentra sujeto a influencias genéticas y ambientales; la altura geográfica es muy influyente. El peso al nacer (PN) es el indicador más utilizado para evaluarlo; existen diferentes estándares y referencias. Debido a la variabilidad de la distribución del PN en relación con la altura en la provincia de Jujuy (Argentina), este trabajo analiza la distribución percentilar del PN para tierras altas (TA) y tierras bajas (TB) jujeñas según edad gestacional (EG) y sexo, y su comparación con una referencia nacional y el estándar internacional INTERGROWTH-21st (IG-21). Población y métodos. Se analizaron los registros de 78 524 nacidos vivos en Jujuy en el período 20092014. Utilizando el método LMS, se estimaron los percentiles 3, 10, 50, 90 y 97 de PN/EG por sexo, para TA (≥2000 msnm), TB (<2000 msnm) y el total provincial, y se compararon gráficamente con la referencia poblacional argentina de Urquía y el estándar IG-21. La significación estadística se determinó mediante la prueba de Wilcoxon. Resultados. El PN en Jujuy presentó distribución heterogénea, con diferencias estadísticamente significativas (p <0,05) entre TB y TA. Al comparar con la referencia nacional y el estándar IG-21, se observaron diferencias por altitud, principalmente en los percentiles 90 y 97 para ambas regiones, y en los percentiles 3 y 10 en TA comparados con el estándar. Conclusiones. Se observó variabilidad de la distribución del PN asociada a la altura geográfica, por lo que, para evaluar el crecimiento intrauterino, resulta fundamental incluir la EG y el contexto donde transcurre la gestación.

Introduction. Size at birth is subject to genetic and environmental influences; altitude is highly influential. Birth weight (BW) is the most widely used indicator to assess size at birth; different standards and references are available. Due to the variability in BW distribution in relation to altitude in the province of Jujuy (Argentina), the purpose of this study is to analyze the percentile distribution of BW in the highlands (HL) and the lowlands (LL) of Jujuy based on gestational age (GA) and sex and compare it with a national reference and the INTERGROWTH-21 st (IG-21) international standard. Population and methods. The records of 78 524 live births in Jujuy in the 2009­2014 period were analyzed. Using the LMS method, the 3 rd, 10 th, 50 th, 90 th, and 97 th percentiles of BW/GA by sex were estimated for the HL (≥ 2000 MASL), the LL (< 2000 MASL), and the total for Jujuy, and compared with the Argentine population reference by Urquía and the IG-21 standard using growth charts. The statistical significance was established using the Wilcoxon test. Results. BW in Jujuy showed a heterogeneous distribution, with statistically significant differences (p < 0.05) between the LL and the HL. When compared with the national reference and the IG-21 standard, differences in terms of altitude were observed, mainly in the 90 th and 97 th percentiles for both regions and the 3 rd and 10 th percentiles in the HL compared with the international standard. Conclusions. BW distribution varied in association with altitude; therefore, to assess intrauterine growth, it is critical to include GA and the environment in which the pregnancy takes place.

La mujer cubana en el levantamiento de pesas: una perspectiva metodológica

Uno de los deportes que más versatilidad representa es el levantamiento de pesas, pues su práctica no solo se reduce al deporte competitivo, sino es una actividad física que desarrolla la capacidad de fuerza, en el resto de los deportes. Esto constituye una realidad que se concreta en el rendimiento deportivo, sin embargo, las féminas que lo practican no cuentan con un tratamiento ajustado a su género, por lo que el objetivo de este trabajo consistió en determinar qué nivel de conocimientos poseen los entrenadores de levantamiento de pesas en Santiago de Cuba, para distribuir las cargas en el equipo femenino de este deporte. Para lograr este propósito, se implementaron métodos del nivel empírico como la observación científica aplicada a las +sesiones de entrenamiento y la encuesta a los entrenadores que atienden a estas atletas. Como resultado del diagnóstico, se declaró que existe un significativo desconocimiento sobre cómo distribuir las cargas en estas pesistas y se carece de una metodología para incrementar este conocimiento y mejorar los resultados competitivos del género femenino, en esta categoría.

Um dos esportes mais versáteis é o levantamento de peso, pois sua prática não se limita apenas ao esporte competitivo, mas é uma atividade física que desenvolve a capacidade de força em outros esportes. Essa é uma realidade que se reflete no desempenho esportivo, no entanto, as mulheres que o praticam não têm um tratamento ajustado ao seu gênero, por isso o objetivo deste estudo foi determinar qual o nível de conhecimento que os treinadores de halterofilismo em Santiago de Cuba têm para distribuir as cargas na equipe feminina desse esporte. Para atingir esse objetivo, foram utilizados métodos empíricos, como a observação científica aplicada às sessões de treinamento e uma pesquisa com os técnicos que treinam essas atletas. Como resultado do diagnóstico, constatou-se que há uma significativa falta de conhecimento sobre como distribuir as cargas nessas levantadoras de peso e que falta uma metodologia para aumentar esse conhecimento e melhorar os resultados competitivos do gênero feminino nessa categoria.

One of the sports that represents the most versatility is weightlifting, since its practice is not only reduced to competitive sports, but is a physical activity that develops strength capacity in the rest of the sports. This constitutes a reality that is reflected in sports performance, however, the women who practice it do not have treatment adjusted to their gender, so the objective of this work was to determine what level of knowledge lifting coaches have of weights in Santiago de Cuba, to distribute the loads in the women's team of this sport. To achieve this purpose, empirical level methods were implemented such as scientific observation applied to training sessions and surveys of coaches who care for these athletes. As a result of the diagnosis, it was declared that there is a significant lack of knowledge about how to distribute the loads in these weightlifters and there is a lack of a methodology to increase this knowledge and improve the competitive results of the female gender, in this category.

Kangaroo care: Benefits, challenges, and future perspectives in neonatal care. An integrative review / Método canguro: Beneficios, desafíos y perspectivas futuras en el cuidado neonatal. Una revisión integrativa / Cuidado canguru: benefícios, desafios e perspectivas futuras na assistência neonatal. Uma revisão integrativa

Objective: To review current scientific evidence on the physiological effects of kangaroo care, explore barriers and facilitators to its implementation, and identify areas requiring further research. Materials and methods: An integrative review was conducted using PubMed, Scopus, Web of Science, and Cochrane databases without language restrictions. Studies included quantitative and qualitative review studies. Critical appraisal of studies was performed using the Joanna Briggs Institute tool. Results: Sixteen studies were analyzed, providing heterogeneous support for the efficacy of kangaroo care  in improving various neonatal physiological parameters including heart rate, body temperature, and oxygen saturation. Major barriers to implementation included restricted visiting hours, healthcare staff workload, negative cultural beliefs, lack of information and empowerment for mothers, and limited involvement of fathers. Conclusions: kangaroo care positively impacts premature or low birth weight neonatal development, though implementation is influenced by sociocultural factors. Further research is needed to better assess real effects on neonatal physiological parameters. Additional qualitative studies could aid in developing culturally adapted strategies to optimize kangaroo care implementation across contexts by better understanding family and medical team perspectives.

Objetivo. El objetivo es revisar la evidencia científica actual sobre los efectos fisiológicos del método canguro, explorar las barreras y facilitadores para su aplicación, además de identificar áreas de conocimiento aún no exploradas. Materiales y métodos. Revisión Integrativa, que incluyó estudios de revisión cuantitativos y cualitativos, en las bases de datos PubMed, Scopus, Web of Science y Cochrane, sin restricción de idioma. La valoración crítica de los estudios se realizó con la herramienta del Joanna Briggs Institute. Resultados. Se analizaron 16 estudios, entre los cuales se encontró evidencia que respalda la eficacia del método canguro en la mejora de diversos parámetros fisiológicos del neonato. Entre estos parámetros se encuentran la frecuencia cardíaca, la temperatura corporal y la saturación de oxígeno. Sin embargo, los resultados son heterogéneos. Las principales barreras para la implementación del método canguro incluyen: restricciones de las horas de visita, carga de trabajo del personal sanitario, creencias culturales negativas, falta de información y empoderamiento de las madres, además de la limitada participación de los padres. Conclusiones. El método canguro tiene un impacto positivo en el desarrollo los neonatos prematuros o de bajo peso. Sin embargo, su implementación se ve afectada por diversos factores socioculturales. Futuras investigaciones deben identificar los efectos reales sobre los parámetros fisiológicos del neonato.  Se necesitan estudios cualitativos para comprender mejor las perspectivas de las familias, de los equipos médicos, y así desarrollar estrategias de adaptación cultural que optimicen la aplicación del este método en diferentes contextos.

Objetivo: O objetivo deste estudo é revisar as evidências científicas atuais sobre os efeitos fisiológicos do Método Canguru, explorar as barreiras e facilitadores para sua aplicação, além de identificar áreas do conhecimento ainda não exploradas.Materiais e Métodos: Foi realizada uma Revisão Integrativa, incluindo estudos de revisão quantitativa e qualitativa, nas bases de dados PubMed, Scopus, Web of Science e Cochrane, sem restrição de idioma. A avaliação crítica dos estudos foi conduzida com a ferramenta Joanna Briggs Institute.Resultados: Foram analisados 16 estudos, nos quais foram encontradas evidências que sustentam a eficácia do Método Canguru na melhoria de diversos parâmetros fisiológicos do recém-nascido, tais como frequência cardíaca, temperatura corporal e saturação de oxigênio. No entanto, os resultados apresentaram heterogeneidade. As principais barreiras à implementação do Método Canguru incluem restrições nos horários de visita, carga de trabalho do pessoal de saúde, crenças culturais negativas, falta de informação e empoderamento das mães, além da participação limitada dos pais.Conclusões: O Método Canguru demonstrou ter impacto positivo no desenvolvimento de neonatos prematuros ou de baixo peso. Contudo, sua implementação é afetada por diversos fatores socioculturais. Pesquisas futuras devem identificar os reais efeitos nos parâmetros fisiológicos do neonato. Estudos qualitativos são necessários para melhor compreender as perspectivas das famílias e das equipes médicas, visando desenvolver estratégias de adaptação cultural que otimizem a aplicação deste método em diferentes contextos.

Renal deficit and associated factors in children born with low birth weight / Déficit renal e fatores associados em crianças nascidas com baixo peso

ABSTRACT Introduction: Kidney problems may be due to low birth weight alone or may occur in association with other conditions. The objective this study was to evaluate the association between maternal and birth characteristics, anthropometric measurements, and kidney function deficit in low birth weight infants. Methods: Cross-sectional study with children who were born weighing < 2500 grams and were under outpatient follow-up. Maternal factors investigated were prenatal care and presence of hypertension, diabetes, and infection during pregnancy. The children's variables were sex, gestational age, birth weight, Apgar score, use of nephrotoxic medications, age, body weight at the time of evaluation, height, and serum creatinine and cystatin C dosages. The glomerular filtration rate (GFR) was estimated with the combined Zapittelli equation. Multivariate logistic regression model was used for identification of associated factors, with renal function deficit (GFR < 60 mL/min/1.73 m2) as the dependent variable. Results: Of the 154 children evaluated, 34.42% had kidney function deficit. Most of them had a gestational age > 32 weeks (56.6%), a mean birth weight of 1439.7 grams, and mean estimated GFR of 46.9 ± 9.3 mL/min/1.73 m2. There was a significant association of GFR < 60 mL/min/1.73 m2 with children's current weight and use of nephrotoxic drugs. Discussion: Children born with low birth weight had a high prevalence of kidney function deficit and current normal weight was a protective factor while the use of nephrotoxic drugs during perinatal period increased the chance of kidney deficit. These findings reinforce the need to evaluate the kidney function in these children, especially those who use nephrotoxic drugs.

RESUMO Introdução: Problemas renais podem ser devido apenas ao baixo peso ao nascer ou podem ocorrer em associação com outras condições. O objetivo deste estudo foi avaliar a associação entre características maternas e de nascimento, medidas antropométricas e déficit da função renal em bebês de baixo peso ao nascer. Métodos: Estudo transversal com crianças que nasceram com peso < 2500 gramas e estavam sob acompanhamento ambulatorial. Os fatores maternos investigados foram cuidados pré-natal e presença de hipertensão, diabetes e infecção durante a gravidez. As variáveis das crianças foram sexo, idade gestacional, peso ao nascer, índice Apgar, uso de medicamentos nefrotóxicos, idade, peso corporal no momento da avaliação, altura e dosagens séricas de creatinina e cistatina C. A taxa de filtração glomerular (TFG) foi estimada com a equação combinada de Zapittelli. Utilizou-se um modelo de regressão logística multivariada para identificação de fatores associados, com déficit da função renal (TFG < 60 mL/min/1,73 m2) como variável dependente. Resultados: Das 154 crianças avaliadas, 34,42% apresentaram déficit da função renal. A maioria tinha idade gestacional > 32 semanas (56,6%), peso médio ao nascer de 1439,7 gramas, e TFG média estimada de 46,9 ± 9,3 mL/min/1,73 m2. Houve uma associação significativa da TFG < 60 mL/min/1,73 m2 com o peso atual das crianças e o uso de medicamentos nefrotóxicos. Discussão: Crianças nascidas com baixo peso apresentaram alta prevalência de déficit da função renal e o peso atual normal foi um fator de proteção, enquanto o uso de medicamentos nefrotóxicos durante o período perinatal aumentou a chance de déficit renal. Estes achados reforçam a necessidade de avaliar a função renal destas crianças, especialmente aquelas que usam medicamentos nefrotóxicos.

Approach to patients with diabetes and obesity in primary care / Abordaje de pacientes con diabetes y obesidad en atención primaria

Aims:The aim of this study is to analyse the effect of pharmacological and non-pharmacological treatment on weight control in patients with diabetes and obesity. Design: Epidemiological, descriptive, cross-sectional study. Site: Primary care. In 11 health centres in Málaga and Cádiz during April and October 2022. Participants: 281 patients over 18 years old with type 2 diabetes and obesity are included. Main measurements: Socio-demographics, clinical, treatment and lifestyle habits variables were obtained from medical records and personal interview. Descriptive statistics were obtained for continuous variables. Statistical tests were performed based on the nature of the variables. Results: Variables like marital status, level of education and occupation, and smoking habit, shows differences regarding the sex (p<0.05). 82.3% of those who received education lost weight, compared to 67.5% of lost weight who received no health education (p=0.004). GLP1 and SGLT2 were more commonly prescribed for women (p=0.048), and SGLT2 more commonly prescribed for men (p=0.047). Patients taking GLP1, SGLT2 or both, regardless of sex, weight loss during the study period was −3.1kg (SE: 0.60), while the loss of those who took other medications was −1.33kg (SE: 0.62). The mean difference was 1.75kg (p=0.046). Conclusions: In terms of weight loss, obese diabetics who took GLP1, SGLT2 or both were 2.5 times more likely to lose weight than those who did not. Healthy lifestyle choices are key to weight loss in obese diabetic patients.(AU)

Objetivo: Analizar el efecto del tratamiento farmacológico y no farmacológico en el control del peso en pacientes diabéticos obesos. Diseño: Estudio epidemiológico, descriptivo y transversal. Emplazamiento: Atención primaria: 11 centros de salud en Málaga y Cádiz durante abril y octubre de 2022. Participantes: Fueron incluidos 281 pacientes mayores de 18 años con diabetes tipo 2 y obesidad. Mediciones principales: Se obtuvieron variables sociodemográficas, clínicas, de tratamiento y de hábitos de vida a partir de registros médicos de entrevistas personales. Se obtuvieron estadísticos descriptivos para variables continuas. Se realizaron pruebas estadísticas en función de la naturaleza de las variables. Resultados: Variables como el estado civil, el nivel educativo, la ocupación y el hábito de fumar mostraron diferencias dependiendo del sexo (p<0,05). El 82,3% de los que recibieron educación sobre salud perdieron peso en comparación con el 67,5% de los que perdieron peso y no la recibieron (p=0,004). Los medicamentos GLP1 y SGLT2 se recetaron con mayor frecuencia a las mujeres (p=0,048), mientras que los SGLT2 se prescribieron más en hombres (p=0,047). Los pacientes que tomaron GLP1, SGLT2 o ambos, independientemente del sexo, perdieron 3,1kg durante el estudio (EE: 0,60), mientras que aquellos que tomaron otros medicamentos perdieron 1,33kg (EE: 0,62). La diferencia media fue de 1,75kg (p=0,046). Conclusiones: Los diabéticos obesos que tomaron GLP1, SGLT2 o ambos tenían 2,5 veces más probabilidades de perder peso que aquellos que no los tomaron. Un estilo de vida saludable es fundamental para la pérdida de peso en pacientes diabéticos obesos.(AU)

Less underestimaton of excess weight by the categorical than the visual method. Its determinants and feeding practices in Mexican mothers of children aged 2 to 12 years / Menor subestimación del exceso de peso por el método categórico que por el visual. Determinantes y prácticas de alimentación en madres mexicanas de niños de 2 a 12 años

Introduction: perceived body weight refers to the subjectively assessed weight, which may not correspond to the objectively measured weight.Statistics show that 14 % to 83 % of parents misperceive their children’s weight status, with a propensity for underestimation.Objective: we compared the accuracy of the visual versus the categorical method. We also identified factors and feeding practices associatedwith excess weight underestimation.Material and methods: we carried out a cross-sectional study in five states of Mexico with 1,845 mother-child dyads of children aged 2-12years. The mothers were interviewed about weight perception with two methods, visual and categorical. The Child Feeding Questionnaire identifiedmaternal feeding practices. Actual weight and height were categorized according to WHO criteria. Analysis consisted of Cohen’s kappa estimation,multivariate logistic regression, and Mann-Whitney tests.Results: more mothers correctly identified the weight of their children with the categorical than with the visual method (68 % vs 42 %, p <0.0001). The excess weight underestimation was lower (49 % vs 82 %, p < 0.0001) and the degree of agreement was higher with the cate-gorical method (kappa, 0.39 and 0.08). The better results remained regardless of age. Age 2-5 years increased the odds of overweight/obesityunderestimation. Feeding practices differed by weight perception category, child’s age, and method of assessment.Conclusions: the categorical method was more accurate. Recognition of correct weight perception is one of the first actions required forcontrolling childhood overweight/obesity.(AU)

Introducción: la percepción del peso corporal se refiere al peso evaluado subjetivamente, que puede no corresponder al peso medido objeti-vamente. Las estadísticas muestran que entre el 14 % y el 83 % de los padres tienen una percepción inadecuada del estado del peso de sushijos, predominando la subestimación.Objetivo: comparar la precisión del método categórico y la del visual e identificar los factores y prácticas de alimentación asociados a la sub-estimación del exceso de peso.Material y métodos: se realizó un estudio transversal en cinco estados de México con 1,845 díadas madre-hijo de niños de 2-11 años. Lasmadres fueron entrevistadas sobre su percepción del peso con un método visual y uno categórico. El Cuestionario de Alimentación Infantil iden-tificó las prácticas de alimentación. El peso y la altura se clasificaron con los criterios de la OMS. Se estimó la kappa de Cohen y se utilizaron laregresión logística multivariada y las pruebas de Mann-Whitney.Resultados: más madres identificaron correctamente el peso de sus hijos con el método categórico que con el visual (68 % vs. 42 %, p <0,0001). La subestimación del exceso de peso fue menor (49 % vs 82 %, p <0,0001) y el grado de concordancia mayor con el método categórico(kappa: 0,39 y 0,08). Los resultados se mantuvieron independientemente de la edad. La edad de 2-5 años aumentó la probabilidad de subestimarel sobrepeso/obesidad. Las prácticas de alimentación difirieron por categoría de percepción del peso, edad del niño y método de evaluación.Conclusiones: el método categórico fue más preciso. El reconocimiento de la correcta percepción del peso constituye una de las primerasacciones para el control del sobrepeso/obesidad infantil.(AU)

Intermittent hypoxia in sport nutrition, performance, health status and body composition / Hipoxia intermitente en nutrición deportiva, rendimiento, estado de salud y composición corporal

Intermittent hypoxia refers to the discontinuous use of low oxygen levels in normobaric environment. These conditions can be reproduced in hypoxic tents or chambers while the individual is training in different physical activity protocols. Intermittent hypoxia can affect several body systems, impacting nutrition, physical performance, health status and body composition. Therefore, it is necessary to assess protocols, regarding time and frequency of exposure, passive exposure or training in hypoxia, and the simulated altitude. At the molecular level, the hypoxia-inducible factor-1α is the primary factor mediating induction of target genes, including vascular endothelial growth factor and erythropoietin. The goal of these molecular changes is to preserve oxygen supply for cardiac and neuronal function. In addition, hypoxia produces a sympathetic adrenal activation that can increase the resting metabolic rate. Altogether, these changes are instrumental in protocols designed to improve physical performance as well as functional parameters for certain pathological disorders. In addition, nutrition must adapt to the increased energy expenditure. In this last context, performing physical activity in intermittent hypoxia improves insulin sensitivity by increasing the presence of the glucose transporter GLUT-4 in muscle membranes. These changes could also be relevant for obesity and type 2 diabetes treatment. Also, the anorectic effect of intermittent hypoxia modulates serotonin and circulating leptin levels, which may contribute to regulate food intake and favor body weight adaptation for optimal sport performance and health. All these actions suggest that intermittent hypoxia can be a very effective tool in sports training as well as in certain clinical protocols.(AU)

La hipoxia intermitente se refiere al uso discontinuo de bajas concentraciones de oxígeno en un entorno normobárico. Estas condiciones puedenser reproducidas en tiendas de hipoxia o en cámaras mientras el sujeto está entrenando diferentes protocolos de actividad física. La hipoxiaintermitente puede afectar a varios sistemas corporales, impactando sobre la nutrición, el estado de salud y la composición corporal. Por lotanto, es necesario establecer protocolos que consideren el tiempo y la frecuencia de exposición, exposición pasiva o entrenamiento en hipoxia,así como la altitud simulada. A nivel molecular, el factor inducible por hypoxia-1α es el primer factor que media la activación de genes diana,incluidos el factor de crecimiento del endotelio vascular y la eritropoyetina. La finalidad de estos cambios es preservar el aporte de oxígeno parala función cardiaca y neuronal. Además, la hipoxia produce activación simpático-adrenal, que puede incrementar el metabolismo basal. Todosestos cambios son necesarios en protocolos diseñados para mejorar el rendimiento físico al igual que parámetros funcionales para el tratamientode ciertas patologías. Además, la nutrición debe adaptarse al gasto energético incrementado. En este contexto, la ejecución de actividad físicaen hipoxia intermitente mejora la sensibilidad a la insulina incrementando la presencia del transportador de glucosa GLUT-4 en las membranasmusculares. Estos cambios podrían ser también relevantes para el tratamiento de la obesidad y la diabetes tipo 2. Además, el efecto anoréxicode la hipoxia intermitente modula los niveles de serotonina y leptina, contribuyendo a regular la ingesta de comida y favoreciendo una adaptaciónóptima del peso corporal para el desempeño deportivo y la salud. Todas estas acciones sugieren que la hipoxia intermitente puede ser una herramienta muy efectiva en entrenamiento deportivo, al igual que en ciertos protocolos clínicos.(AU)

Associação do comportamento alimentar com o estado nutricional de gestantes de alto risco internadas em um centro de referência no nordeste / Association of eating behavior with the nutritional status of high-riskpregnant women admitted to a reference center in the Northeast

Introduction: Pregnancy is a period of physical and physiological changes that progresses without complications when free from factors that can compromise maternal and fetal health. Diabetes mellitus, high blood pressure, obesity and inadequate weight gain are the most common causes of gestational risk, and these can be strongly associated with the nutritional status, eating habits and behavior of the pregnant woman. Objective: To describe and associate eating behavior with the nutritional status of high-risk pregnant women admitted to a reference center in the Northeast. Materials and methods: This is a cross-sectional study carried out with patients admitted to high-risk wards at the Instituto de Medicina Integral Prof. Fernando Figueira – IMIP (Recife-PE), anthropometric data and data related to eating behavior were collected (TEMS instrument). Results: Around 56,4% of pregnant women had a prepregnancy BMI classified as overweight or obese, with only 16% classified as underweight. The evaluation of the evolution of weight gain demonstrated that 66.4% had insufficient weight gain, while 12,8% had high gestational weight gain. Discussion: When analyzing eating behavior through the TEMS instrument, the relationship of giving a good image when eating had a significant value (p < 0,05) as well as considerations of choosing healthy foods and related to obtaining energy are directly associated with the current BMI, therefore, note- It is clear that emotional, social, physiological and economic factors influence the choice of food. Conclusion: The high prevalence of overweight and obesity found in this population demonstrates the influence of eating behavior on nutritional status. Reinforcing the importance of preventive measures to identify risk factors and obtain adequate nutritional monitoring during pregnancy with the aim of reducing damage to health and promoting autonomy to make more appropriate and healthy food choices.(AU)

Introdução: A gestação é um período de mudanças físi-cas e fisiológicas que evolui sem complicações quando isentade fatores que podem acarretar no comprometimento dasaúde materna e fetal. O diabetes mellitus, hipertensão arte-rial, obesidade, ganho de peso inadequado são as mais fre-quentes causadoras do risco gestacional, podendo estas serfortemente associadas com o estado nutricional, hábito ecomportamento alimentar da gestante. Objetivo: Descrever e associar o comportamento alimen-tar com o estado nutricional de gestantes de alto risco inter-nadas em um centro de referência no Nordeste. Materiais e métodos: Trata-se de um estudo do tipotransversal realizado com pacientes internadas nas enferma-rias de alto risco do Instituto de Medicina Integral Prof.Fernando Figueira – IMIP (Recife- PE), foram coletados dadosantropométricos, dados relacionados ao comportamento ali-mentar (instrumento TEMS). Resultados: Cerca de 56,4% das gestantes tinham IMCpré-gestacional classificados em sobrepeso ou obesidade sendo apenas 16% classificadas como baixo peso. A avalia-ção da evolução do ganho ponderal demonstrou que 66,4%apresentaram um ganho de peso insuficiente, enquanto12,8% tiveram um ganho de peso gestacional elevado. Discussão: Ao analisar o comportamento alimentar atravésdo instrumento TEMS, a relação de passar uma boa imagemao se alimentar teve valor significativo (p < 0,05) bem comoconsiderações de escolher alimentos saudáveis e relacionadosa obter energia estão diretamente associados com o IMCatual, assim sendo, nota-se que fatores emocionais, sociais, fi-siológicos, econômicos influenciam na escolha dos alimentos. Conclusão: A elevada prevalência do excesso de peso eobesidade encontrada nessa população demonstra a influência do comportamento alimentar no estado nutricional.Reforçando a importância de medidas preventivas para identificar fatores de risco e obter um acompanhamento nutricio-nal adequado durante a gestação com...(AU)

Evolución clínica y nutricional de pacientes sometidos a cirugía bariátrica en un hospital de referencia del estado de Pernambuco / Evolução clínica e nutricional de pacientes submetidos à cirurgia bariátrica em um hospital de referência do estado de Pernambuco / Clinical and nutritional evolution of patients undergoing bariatric surgery in a reference hospital in the state of Pernambuco

La obesidad es un factor de riesgo para enfermedades crónicas no transmisibles como Diabetes Mellitus 2, Hipertensión Arterial Sistémica, entre otras. La gastroplastia se encuentra entre las alternativas terapéuticas con buena respuesta a la pérdida de peso cuando el ejercicio físico y la dieta no fueron eficientes, resultando en un mejor control clínico de las comorbilidades asociadas. Por tanto, analizar la evolución clínica y nutricional de pacientes sometidos a cirugía bariátrica, 12 meses después del procedimiento, con el fin de observar los impactos de esta terapia. Se realizó una serie de casos, que incluyeron individuos sometidos a cirugía bariátrica y que presentaban alguna comorbilidad asociada al exceso de peso. La recolección de datos se realizó en Instituto de Medicina Integral Prof. Fernando Figueira – IMIP, ubicado en la ciudad de Recife-Pernambuco, período de mayo de 2021 a octubre de 2021. Se obtuvieron datos antropométricos, clínicos y bioquímicos. Se incluyeron en el estudio cuarenta personas con una edad media de 43 ± 11,7 años, siendo la técnica quirúrgica más utilizada el Bypass Gástrico (77,5%). Se observó una reducción de la Hemoglobina Glicada de 5,8% ± 0,5 en el preoperatorio a 5,1% ± 0,2 a los 12 meses (p = <0,001), y una reducción del Colesterol Total de 199,0 mg/dL a 167,0 mg/dL (p = <0,001) antes y 12 meses después de la gastroplastia, respectivamente. Además de estas, observamos una mejora estadísticamente significativa en todas las variables antropométricas y bioquímicas analizadas, excepto la glucemia en ayunas. Estos resultados pueden explicarse por cambios en la secreción de hormonas intestinales, que ayudan a mejorar el control de la glucosa, los lípidos y la presión arterial, además de la pérdida de peso. Por tanto, la cirugía bariátrica parece tener un impacto positivo en la evolución bioquímica y antropométrica en el primer año tras la cirugía.(AU)

Introdução: A obesidade é fator de risco para doençascrônicas não transmissíveis como Diabetes Mellitus tipo 2,Hipertensão Arterial Sistêmica, dislipidemias, entre outras. Agastroplastia está entre as alternativas terapêuticas com boaresposta sobre a perda ponderal quando exercício físico edieta não foram eficientes, resultando em melhor controle clí-nico de comorbidades associadas. Portanto, analisar a evolu-ção clínica e nutricional de pacientes submetidos à cirurgiabariátrica em um hospital de referência no estado dePernambuco, 12 meses após o procedimento, a fim de obser-var os impactos desta terapêutica. Material e métodos: Foi realizado uma série de casos,que incluiu indivíduos submetidos à cirurgia bariátrica e quepossuíam alguma comorbidade associada ao excesso ponde-ral. A coleta de dados foi realizada no ambulatório de nutri-ção do Instituto de Medicina Integral Prof. Fernando Figueira– IMIP, localizado na cidade de Recife-Pernambuco, períodode maio de 2021 a outubro de 2021. Sendo obtidos dados an-tropométricos, clínicos e bioquímicos. Resultados: Foram incluídos no estudo 40 indivíduos comidade média de 43 ± 11,7 anos, com predominância do sexo feminino (92,5%), sendo a técnica cirúrgica mais realizada oBypass Gástrico (77,5%). Foi observado redução daHemoglobina Glicada de 5,8% ± 0,5 no pré-operatório para5,1% ± 0,2 aos 12 meses (p = <0,001), e redução doColesterol Total de 199,0mg/dL para 167,0mg/dL (p = <0,001)antes e 12 meses após a gastroplastia, respectivamente. Alémdestas, observamos melhora estatisticamente significativa emtodas as variáveis antropométricas e bioquímicas analisadas,exceto a glicemia em jejum. Discussão: Tais resultados podem ser explicados a partirdas alterações da secreção de hormônios intestinais, que au-xiliam no melhor controle glicídico, lipídico e pressórico, alémda perda ponderal...AU)

Introduction: Obesity is a risk factor for chronic non-com-municable diseases such as Type 2 Diabetes Mellitus, SystemicArterial Hypertension, dyslipidemia, among others. Gastroplast is among the therapeutic alternatives with a good response toweight loss when physical exercise and diet were not efficient,resulting in better clinical control of associated comorbidities. Therefore, analyze the clinical and nutritional evolution of pa-tients undergoing bariatric surgery in a reference hospital in thestate of Pernambuco, 12 months after the procedure, in orderto observe the impacts of this therapy. Material and methods: A series of cases was carried out,which included individuals who underwent bariatric surgeryand who had some comorbidity associated with excessweight. Data collection was carried out at the nutrition out-patient clinic of the Instituto de Medicina Integral Prof.Fernando Figueira – IMIP, located in the city of Recife-Pernambuco, period from May 2021 to October 2021.Anthropometric, clinical and biochemical data were obtained. Results: 40 individuals were included in the study with amean age of 43 ± 11.7 years, with a predominance of fema-les (92.5%), with the most common surgical technique beingGastric Bypass (77.5%). A reduction in Glycated Hemoglobinwas observed from 5.8% ± 0.5 in the preoperative period to5.1% ± 0.2 at 12 months (p = <0.001), and a reduction inTotal Cholesterol from 199.0mg/dL to 167.0mg/dL (p =<0.001) before and 12 months after gastroplasty, respecti-vely. In addition to these, we observed a statistically signifi-cant improvement in all anthropometric and biochemical va-riables analyzed, except fasting blood glucose. Discussion: These results can be explained based onchanges in the secretion of intestinal hormones, which helpwith better glucose, lipid and blood pressure control, in addi-tion to weight loss...(AU)

Análisis del estado nutricional en pacientes adultos mayoreshospitalizados por COVID-19 en unidades de cuidadosintensivos, Perú, 2020 / Analysis of nutritional status in older adult patients hospitalized for COVID-19 in intensive care units, Perú, 2020

Introducción: El estado nutricional es un indicador del estado de salud y es un elemento de resistencia del organismo frente a enfermedades intercurrentes, incluyendo la COVID-19. Objetivo: Analizar el estado nutricional en pacientes adultos mayores hospitalizados en UCI diagnosticados de COVID-19. Métodos: Se llevó a cabo un estudio transversal entre los meses abril y mayo de 2020. Se determinó y comparó el estado nutricional de un grupo de 83 pacientes adultos mayores con COVID-19. Los datos fueron analizados mediante pruebas de Chi-cuadrado y t-student, considerando un nivel de significancia del 5%. Resultados: Aproximadamente el 42,2% de los pacientes presentaban exceso de peso corporal. La anemia (46,9% vs. 9,8%, p < 0,001) y el riesgo de sarcopenia (45,7% vs. 33,3%, p = 0,011) fueron mayores en las mujeres en comparación a los hombres que presentaban COVID-19. También, los niveles de urea fueron significativamente más bajos en los pacientes con desnutrición en comparación con aquellos que no presentaban desnutrición (37,9 mg/dL vs. 44,1 mg/dL, p = 0,020). Del mismo modo, se encontró que la concentración de leucocitos estuvo más baja en los pacientes con COVID-19 que presentaban desnutrición 9,6 WBC (x10g

Background: Nutritional status is an indicator of healthstatus and an element of the body’s resistance to intercurrentdiseases, including COVID-19.Objective: To analyze the nutritional status in hospitalizedolder adult ICU patients diagnosed with COVID-19.Methods: A cross-sectional study was conducted in aNational Hospital in Metropolitan Lima during the months of April and May 2020. The nutritional status of a group of 83older adult patients with COVID-19 was determined and com-pared. The data were analyzed using Chi-square and t-stu-dent tests, considering a significance level of 5%. Results: Approximately 42.2% of the patients had ex-cess body weight. Anemia (46.9% vs. 9.8%, p < 0.001)and risk of sarcopenia (45.7% vs. 33.3%, p = 0.011) werehigher in women compared to men presenting COVID-19.Furthermore, urea levels were significantly lower in patientswith malnutrition compared to those without malnutrition(37.9 mg/dL vs. 44.1 mg/dL, p = 0.020). Similarly, leuko-cyte concentration was found to be lower in COVID-19 pa-tients with malnutrition 9.6 WBC (x10g

Factores asociados al abandono del Programa Madre Canguro entre los años 2019-2021 en Colombia / Factors associated with abandoning from the Kangaroo Mother Program between years 2019 and 2021

Fundamentos: el abandono del programa madre canguro es un problema de salud pública, que afecta la salud de los menores prematuros. El objetivo de este estudio fue determinar los factores asociados con el abandono de las madres o cuidadores de los menores prematuros en la primera etapa del programa madre canguro de una empresa promotora de salud (eps) del departamento de antioquia (colombia) entre 2019 y 2021. Métodos: se realizó un estudio observacional, transversal y analítico, donde se recopiló información de los ingresos al programa (n=1.344) entre 2019 y 2021. Se realizó la prueba chi-cuadrado, razón de verosimilitud con razón de prevalencias crudas, se aplicó un modelo lineal generalizado de varianza robusta con la razón de prevalencias ajustadas. Resultados: al ajustar el abandono con las variables independientes, se evidenció mayor probabilidad de abandono: con respecto al año 2020 (rp 2,44, ic 95%: 1,94-3,08, valor p=0,0001), estado civil sola con apoyo (rp 1,60, ic 95%: 0,84-3,04, valor p=0,147), nivel académico primaria completa o incompleta (rp 1,48, ic 95% 1,11-1,97, valor p=0,006), ingreso mensual menor al salario mínimo mensual legal vigente (smmlv) (rp 1,26, ic 95%: 1,00-1,59, valor p=0,004) y área de residencia vivir fuera de medellín (rp 1,25, ic 95%: 1,06-1,46, valor p=0,006). Conclusiones: los hallazgos de este estudio pueden ser muy útiles para realizar intervenciones en las familias pertenecientes de los programas canguro, con el objetivo de intervenir factores de riesgo que se asocian con el abandono del programa.(AU)

Background: The abandonment of the Kangaroo Mother Program is a public health problem that affects the health of prema-ture infants. The objective of this study was to determine the factors associated with the abandonment of mothers or caregivers of premature infants in the first stage of the Kangaroo Mother Program of a Health Promoting Company (EPS) in the department of Antioquia (Colombia), between 2019 and 2021.Methods: An observational, cross-sectional, and analytical study was carried out, where information was collected on admissions to the program (N=1,344) between 2019 and 2021. The Chi-Square likelihood ratio test was performed with crude prevalence ratio, a genera-lized linear model of robust variance was applied with the adjusted prevalence ratio. Results: When adjusting for dropout with the independent variables, a higher probability of dropout was evidenced: with respect to the year 2020 (PR 2.44, 95% CI: 1.94-3.08, p-value=0.0001), marital status alone with support (PR 1.60, 95% CI: 0.84-3.04, p-value=0. 147), primary school completed or incomplete (PR 1.48, 95% CI 1.11-1.97, p-value=0.006), monthly income less than the current legal monthly minimum wage (CLMMW) (PR 1.26, 95% CI: 1.00-1.59, p-value=0.004) and area of residence living outside Medellin (PR 1.25, 95% CI: 1.06-1.46, p-value=0.006). Conclusions: The findings of this study can be very useful to carry out interventions in families belonging to Kangaroo Pro-grams, with the aim of intervening risk factors associated with program dropout.(AU)

Changes in Height and Body Weight Within a Time Period of 35 Years in Males of the Same Age / Cambios en la Altura y el Peso Corporal en un Período de 35 Años en Hombres de la Misma Edad

SUMMARY: Height and body weight measurements are among the most important anthropometric variables when assessing a population's growth, development and body composition. This study aimed to evaluate the height and body weight variability of male entities aged 17-18 years within 35 years. This goal was realized by comparing the height and body weight of the population of the same gender and age in three different time studies. The descriptive statistical parameters and T-test for independent groups show systematic and significant differences in measured variables between three measurements in different timelines. Both in body height and body weight, from measurement to measurement, significant systematic and statistically significant differences (p<0.01) have been identified (1985: BH= 172.8cm, BW= 61.7kg; 2004: BH=176.8 cm, BW=66.9 kg; 2019: BH=178.5 cm, BW=72 kg). The results of this study prove that the change in the socio-economic status of a population over a period time of 35 years can significantly affect the growth and development of children/adolescents.

Las medidas de altura y peso corporal se encuentran entre las variables antropométricas más importantes a la hora de evaluar el crecimiento, el desarrollo y la composición corporal de una población. Este estudio tuvo como objetivo evaluar la variabilidad de la altura y el peso corporal de entidades masculinas de 17 a 18 años dentro de 35 años. Este objetivo se logró comparando la altura y el peso corporal de la población del mismo sexo y edad en tres estudios temporales diferentes. Los parámetros estadísticos descriptivos y la prueba T para grupos independientes muestran diferencias sistemáticas y significativas en las variables medidas entre tres mediciones en diferentes líneas de tiempo. Tanto en la altura como en el peso corporal, de medición en medición, se han identificado diferencias significativas sistemáticas y estadísticamente significativas (p<0,01) (1985: BH= 172,8 cm, BW= 61,7 kg; 2004: BH=176,8 cm, BW=66,9 kg; 2019: BH=178,5 cm, BW=72 kg). Los resultados de este estudio demuestran que el cambio en el estatus socioeconómico de una población durante un período de 35 años puede afectar significativamente el crecimiento y desarrollo de niños/ adolescentes.

Prevalencia de osteopenia del prematuro antes y después de la implementación de una estrategia temprana de manejo fosfocálcico / Prevalence of osteopenia of prematurity before and after implementing an early strategy with the use of calcium and phosphate

Introducción. Con el uso de la nutrición parenteral agresiva en recién nacidos de muy bajo peso, se detectaron alteraciones del metabolismo fosfocálcico. En 2016 se implementó una estrategia de prevención a través del monitoreo fosfocálcico y su suplementación temprana. El objetivo fue estudiar si esta estrategia disminuye la prevalencia de osteopenia e identificar factores de riesgo asociados. Población y métodos. Estudio cuasiexperimental que comparó la prevalencia de osteopenia entre dos grupos: uno después de implementar la estrategia de monitoreo y suplementación fosfocálcica (01/01/2017-31/12/2019), y otro previo a dicha intervención (01/01/2013-31/12/2015). Resultados. Se incluyeron 226 pacientes: 133 pertenecen al período preintervención y 93 al posintervención. La prevalencia de osteopenia global fue del 26,1 % (IC95% 20,5-32,3) y disminuyó del 29,3 % (IC95% 21,7-37,8) en el período preintervención al 21,5 % (IC95% 13,6-31,2) en el posintervención, sin significancia estadística (p = 0,19). En el análisis multivariado, el puntaje NEOCOSUR de riesgo de muerte al nacer, recibir corticoides posnatales y el período de intervención se asociaron de manera independiente a osteopenia. Haber nacido luego de la intervención disminuyó un 71 % la probabilidad de presentar fosfatasa alcalina >500 UI/L independientemente de las restantes variables incluidas en el modelo. Conclusión. La monitorización y suplementación fosfocálcica precoz constituye un factor protector para el desarrollo de osteopenia en recién nacidos con muy bajo peso al nacer.

Introduction. With the use of aggressive parenteral nutrition in very low birth weight infants, alterations in calcium and phosphate metabolism were detected. In 2016, a prevention strategy was implemented through calcium phosphate monitoring and early supplementation. Our objective was to study whether this strategy reduces the prevalence of osteopenia and to identify associated risk factors. Population and methods. Quasi-experiment comparing the prevalence of osteopenia between two groups: one after implementing the calcium phosphate monitoring and supplementation strategy (01/01/2017­12/31/2019) and another prior to such intervention (01/01/2013­12/31/2015). Results. A total of 226 patients were included: 133 in the pre-intervention period and 93 in the post-intervention period. The overall prevalence of osteopenia was 26.1% (95% CI: 20.5­32.3) and it was reduced from 29.3% (95% CI: 21.7­37.8) in the pre-intervention period to 21.5% (95% CI: 13.6­31.2) in the post-intervention period, with no statistical significance (p = 0.19). In the multivariate analysis, the NEOCOSUR score for risk of death at birth, use of postnatal corticosteroids, and the intervention period were independently associated with osteopenia. Being born after the intervention reduced the probability of alkaline phosphatase > 500 IU/L by 71%, regardless of the other variables included in the model. Conclusion. Calcium phosphate monitoring and early supplementation is a protective factor against the development of osteopenia in very low birth weight infants.

Efecto de un programa de autocuidado en hábitos de vida saludable con relación a la obesidad en personal de salud de una institución de tercer nivel / Efeito de um programa de autocuidado nos hábitos de vida saudáveis em relação à obesidade em profissionais de saúde de uma instituição terciária / Effect of a self-care program on healthy lifestyle habits in relation to obesity in health personnel of a tertiary institution

Introducción. A nivel mundial, la obesidad es considerada como un problema de salud pública debido a que afecta a la población de todas las edades, incluso al mismo personal que trabaja en instituciones de salud, situación que repercute en su ámbito personal, familiar, pero sobre todo laboral, causando en el trabajador dificultad para realizar algunos procedimientos, ausentismo laboral, discapacidad parcial o total y/o necesidad de cuidado, entre otros.  Objetivo.  Evaluar el efecto de una intervención de autocuidado en hábitos de vida saludable con relación a la obesidad en personal de salud de una institución de tercer nivel.  Metodología. Estudio cuasi experimental, muestra 30 trabajadores con sobrepeso o algún grado de obesidad de una institución de salud de tercer nivel. Se impartieron 10 temas con relación a la obesidad, para cambiar hábitos deficientes por hábitos saludables, además de 10 sesiones de actividad física.    Resultados. Al final de la intervención, dos personas bajaron el nivel de su índice de masa corporal, una persona con obesidad grado III y una de grado II bajaron a peso normal. En cuanto a las medidas antropométricas posterior a la intervención, hubo reducción en cada uno de los parámetros, referente a la evaluación del cuestionario hábitos de vida saludable, relacionados con la obesidad posterior a la intervención, se encontraron cambios positivos en cada una de las dimensiones. Sin embargo, tanto en la reducción de IMC, así como en las dimensiones del cuestionario, la diferencia encontrada, no fue estadísticamente significativa.  Conclusiones. Los resultados sugieren que una intervención educativa en hábitos de vida saludable vinculados con la obesidad en personal de salud, son eficaces para contribuir al autocuidado de los trabajadores en el ámbito laboral

Introduction. Worldwide, obesity is considered a public health problem because it affects the population of all ages, including the same personnel who work in health institutions, a situation that has repercussions in their personal and family environment, but above all at work, causing the worker difficulty in performing some procedures, absenteeism, partial or total disability and/or need for care, among others. Objective. To evaluate the effect of a self-care intervention on healthy life habits in relation to obesity in health personnel of a third level institution. Methodology. Quasi-experimental study, sample of 30 workers with overweight or some degree of obesity in a tertiary health institution. Ten topics related to obesity were taught in order to change deficient habits for healthy habits, in addition to 10 sessions of physical activity. Results. At the end of the intervention, two people lowered their body mass index level, one person with grade III obesity and one with grade II obesity lowered to normal weight. Regarding the anthropometric measures after the intervention, there was a reduction in each one of the parameters, regarding the evaluation of the healthy life habits questionnaire, related to obesity after the intervention, positive changes were found in each one of the dimensions. However, both in the reduction of BMI and in the dimensions of the questionnaire, the difference found was not statistically significant. Conclusions. The results suggest that an educational intervention on healthy lifestyle habits related to obesity in health personnel is effective in contributing to the self-care of workers in the workplace

Introdução. A nível mundial, a obesidade é considerada um problema de saúde pública porque afecta a população de todas as idades, incluindo o próprio pessoal que trabalha nas instituições de saúde, situação que tem repercussões no seu ambiente pessoal e familiar, mas sobretudo no trabalho, causando ao trabalhador dificuldade na realização de alguns procedimentos, absentismo, incapacidade parcial ou total e/ou necessidade de cuidados, entre outros. Objectivos. Avaliar o efeito de uma intervenção de autocuidado sobre hábitos de vida saudáveis em relação à obesidade em profissionais de saúde de uma instituição de cuidados terciários. Metodologia. Estudo quase-experimental, amostra de 30 trabalhadores com excesso de peso ou algum grau de obesidade numa instituição de saúde terciária. Foram ensinados dez temas relacionados com a obesidade, com o objetivo de mudar hábitos deficientes por hábitos saudáveis, além de 10 sessões de atividade física. Resultados. No final da intervenção, duas pessoas baixaram o índice de massa corporal, uma pessoa com obesidade de grau III e uma com obesidade de grau II passaram para o peso normal. Relativamente às medidas antropométricas após a intervenção, verificou-se uma redução em cada um dos parâmetros, e relativamente à avaliação do questionário de hábitos de vida saudáveis relacionados com a obesidade após a intervenção, verificaram-se alterações positivas em cada uma das dimensões. No entanto, tanto na redução do IMC como nas dimensões do questionário, a diferença encontrada não foi estatisticamente significativa. Conclusões. Os resultados sugerem que uma intervenção educativa sobre hábitos de vida saudáveis ligados à obesidade no pessoal de saúde é eficaz para contribuir para o autocuidado dos trabalhadores no local de trabalho

Tromboprofilaxis en COVID-19. Nuevas evidencias / COVID-19 thromboprophylaxis: New evidences

Recientes publicaciones han puesto en duda la eficacia de la utilización de dosis terapéuticas o intermedias de heparina de bajo peso molecular (HBPM) en pacientes COVID-19, especialmente en los pacientes más graves. Con el objetivo de actualizar estas recomendaciones se ha realizado una revisión no sistemática en las principales bases de datos médicas. Se seleccionaron un total de 14 ensayos clínicos aleatorizados, 14 metaanálisis y las recomendaciones de 12 sociedades científicas, estratificadas según el tipo de paciente (ambulatorio, hospitalizado, ingresado en cuidados críticos o post-alta). Se ha analizado la eficacia de HBPM y también de otras aproximaciones terapéuticas (rivaroxabán, apixabán, sulodexida, ácido acetilsalicílico e inhibidores P2Y12). Los hallazgos recomiendan utilizar dosis estándar de HBPM como tromboprofilaxis en los pacientes COVID-19 hospitalizados críticos y dosis terapéutica en hospitalizados no críticos si el riesgo de sangrado es bajo. En los pacientes ambulatorios y dados de alta del hospital podría utilizarse HBPM a dosis profiláctica si existen factores de riesgo trombótico y el riesgo hemorrágico es bajo. No se recomienda asociar antiagregantes plaquetarios a la HBPM salvo indicación previa.(AU)

Recent publications have questioned the efficacy of using therapeutic or intermediate doses of low molecular weight heparin (LMWH) in COVID-19 patients, especially in the most severe patients. In order to update these recommendations, a non-systematic review has been carried out in the main medical databases. A total of 14 randomized clinical trials, 14 meta-analyses and the recommendations of 12 scientific societies were selected, stratified according to the type of patient (outpatient, hospitalized, admitted to critical care or post-discharge). The efficacy of LMWH and other therapeutic approaches (rivaroxaban, apixaban, sulodexide, acetylsalicylic acid and P2Y12 inhibitors) has been analyzed. The findings recommend using standard doses of LMWH as thromboprophylaxis in critically hospitalized COVID-19 patients and therapeutic doses in non-critically hospitalized patients with low bleeding risk. In outpatients and those discharged from the hospital, LMWH could be used at a prophylactic dose if there are thrombotic risk factors, and the bleeding risk is low. It is not recommended to associate antiplatelet agents with LMWH unless previously indicated.(AU)

Approach to patients with diabetes and obesity in primary care.

AIMS: The aim of this study is to analyse the effect of pharmacological and non-pharmacological treatment on weight control in patients with diabetes and obesity. DESIGN: Epidemiological, descriptive, cross-sectional study. SITE: Primary care. In 11 health centres in Málaga and Cádiz during April and October 2022. PARTICIPANTS: 281 patients over 18 years old with type 2 diabetes and obesity are included. MAIN MEASUREMENTS: Socio-demographics, clinical, treatment and lifestyle habits variables were obtained from medical records and personal interview. Descriptive statistics were obtained for continuous variables. Statistical tests were performed based on the nature of the variables. RESULTS: Variables like marital status, level of education and occupation, and smoking habit, shows differences regarding the sex (p<0.05). 82.3% of those who received education lost weight, compared to 67.5% of lost weight who received no health education (p=0.004). GLP1 and SGLT2 were more commonly prescribed for women (p=0.048), and SGLT2 more commonly prescribed for men (p=0.047). Patients taking GLP1, SGLT2 or both, regardless of sex, weight loss during the study period was -3.1kg (SE: 0.60), while the loss of those who took other medications was -1.33kg (SE: 0.62). The mean difference was 1.75kg (p=0.046). CONCLUSIONS: In terms of weight loss, obese diabetics who took GLP1, SGLT2 or both were 2.5 times more likely to lose weight than those who did not. Healthy lifestyle choices are key to weight loss in obese diabetic patients.