The natural course of binge-eating disorder: findings from a prospective, community-based study of adults.

BACKGROUND: Epidemiological data offer conflicting views of the natural course of binge-eating disorder (BED), with large retrospective studies suggesting a protracted course and small prospective studies suggesting a briefer duration. We thus examined changes in BED diagnostic status in a prospective, community-based study that was larger and more representative with respect to sex, age of onset, and body mass index (BMI) than prior multi-year prospective studies. METHODS: Probands and relatives with current DSM-IV BED (n = 156) from a family study of BED ('baseline') were selected for follow-up at 2.5 and 5 years. Probands were required to have BMI > 25 (women) or >27 (men). Diagnostic interviews and questionnaires were administered at all timepoints. RESULTS: Of participants with follow-up data (n = 137), 78.1% were female, and 11.7% and 88.3% reported identifying as Black and White, respectively. At baseline, their mean age was 47.2 years, and mean BMI was 36.1. At 2.5 (and 5) years, 61.3% (45.7%), 23.4% (32.6%), and 15.3% (21.7%) of assessed participants exhibited full, sub-threshold, and no BED, respectively. No participants displayed anorexia or bulimia nervosa at follow-up timepoints. Median time to remission (i.e. no BED) exceeded 60 months, and median time to relapse (i.e. sub-threshold or full BED) after remission was 30 months. Two classes of machine learning methods did not consistently outperform random guessing at predicting time to remission from baseline demographic and clinical variables. CONCLUSIONS: Among community-based adults with higher BMI, BED improves with time, but full remission often takes many years, and relapse is common.

Implementation of a Ventilator-Associated Pneumonia Prevention Bundle in a Single PICU.

OBJECTIVE: Ventilator-associated pneumonia is considered the second most frequent infection in pediatric intensive care, and there is agreement on its association with higher morbidity and increased healthcare costs. The goal of this study was to apply a bundle for ventilator-associated pneumonia prevention as a process for quality improvement in the PICU of Hospital Italiano de Buenos Aires, Argentina, aiming to decrease baseline ventilator-associated pneumonia rate by 25% every 6 months over a period of 2 years. DESIGN: Quasi-experimental uninterrupted time series. SETTING: PICU of Hospital Italiano de Buenos Aires, Argentina. PATIENTS: All mechanical ventilated patients admitted to the unit. INTERVENTION: It consisted of the implementation of an evidence-based ventilator-associated pneumonia prevention bundle adapted to our unit and using the plan-do-study-act cycle as a strategy for quality improvement. The bundle consisted of four main components: head of the bed raised more than 30°, oral hygiene with chlorhexidine, a clean and dry ventilator circuit, and daily interruption of sedation. MEASUREMENTS AND MAIN RESULTS: Ventilator-associated pneumonia prevention team meetings started in March 2012, and the ventilator-associated pneumonia bundle was implemented in November 2012 after it had been developed and made operational. Baseline ventilator-associated pneumonia rate for the 2 years before intervention was 6.3 episodes every 1,000 mechanical ventilation days. ventilator-associated pneumonia rate evolution by semester and during the 2 years was, respectively, 5.7, 3.2, 1.8, and 0.0 episodes every 1,000 mechanical ventilation days. Monthly ventilator-associated pneumonia rate time series summarized in a 51-point control chart showed the presence of special cause variability after intervention was implemented. CONCLUSIONS: The implementation over 2 years of a ventilator-associated pneumonia prevention bundle specifically adapted to our unit using quality improvement tools was associated with a reduction in ventilator-associated pneumonia rate of 25% every 6 months and a nil rate in the last semester.

Sarcoidal granulomatous reaction due to tattoos: report of two cases.

Numerous infectious, inflammatory and neoplastic complications secondary to tattoo placement have been reported in the literature. Within inflammatory complications sarcoidal granulomatous reactions have been described. We report two cases, a 55-year-old woman with yellowish infiltrated plaques on bilateral ciliary region, 16 years after the placement of a permanent tattoo in the eyebrows, and a 20-year-old tattoo artist who developed orange papules on 3 of his tattoos. Histopathology in both cases confirmed diagnosis of sarcoidal granulomatous reaction due to tattoo pigment.

Sarcoidal granulomatous reaction due to tattoos: report of two cases

Abstract Numerous infectious, inflammatory and neoplastic complications secondary to tattoo placement have been reported in the literature. Within inflammatory complications sarcoidal granulomatous reactions have been described. We report two cases, a 55-year-old woman with yellowish infiltrated plaques on bilateral ciliary region, 16 years after the placement of a permanent tattoo in the eyebrows, and a 20-year-old tattoo artist who developed orange papules on 3 of his tattoos. Histopathology in both cases confirmed diagnosis of sarcoidal granulomatous reaction due to tattoo pigment.

¿Ser taxista es un factor de riesgo cardiovascular? Análisis del perfil lipídico e IMC / Is being a taxi driver a cardiovascular risk factor? Analysis of the lipid profile and BMI

Contexto: existen múltiples factores de riesgo modificables involucrados en la aparición de eventos cardiovasculares, como los niveles de lipoproteína de baja densidad elevados, lipoproteína de alta densidad disminuida, la hipertensión arterial, el hábito tabáquico, consumo de alcohol y el sedentarismo. Objetivo: es relacionar el índice de masa corporal con el perfil lipídico en los conductores de taxi, además conocer los hábitos y prácticas de vida relacionados. Sujetos y métodos: estudio observacional, transversal, epidemiológico en el que se evaluó 112 participantes, 89 (70,46%) hombres y 23 (20.53%) mujeres, con una edad entre 19 y 68 años de edad; se midió peso, talla, IMC, presión arterial y se determinó el perfil lipídico. Resultados: 32 individuos tienen peso normal, mientras que 60 tienen obesidad, 19 obesidad tipo 1 y 1 obesidad tipo 2. Conclusión: los conductores de taxi tienen alta prevalencia de obesidad. Los resultados de este estudio servirán de base para el diseño de intervenciones educativas centradas en la motivación y el autocuidado para prevenir el sobrepeso y predecir el riesgo de padecer un evento cardiovascular. (AU)

Context: there are multiple modifiable risk factors involved in the onset of cardiovascular events, such as high levels of low density lipoprotein, decreased high density lipoprotein, high blood pressure, smoking, alcohol consumption and sedentary lifestyle. Objective: to relate the body mass index with the lipid profile in taxi drivers, in addition to knowing the habits and related life practices. Subjects and methods: observational, cross-sectional, epidemiological study in which 112 participants were evaluated, 89 (70.46%) men and 23 (20.53%) women, with an age between 19 and 68 years of age; weight, height, BMI, blood pressure were measured and the lipid profile was determined. Results: 32 individuals have normal weight, while 60 have obesity, 19 obesity type 1 and 1 obesity type 2. Conclusion: taxi drivers have a high prevalence of obesity. The results of this study will serve as a basis for the design of educational interventions focused on motivation and self-care to prevent overweight and predict the risk of suffering a cardiovascular event. (AU)

Promoción de alimentación saludable en hogares comunitarios infantiles del municipio de Sopó (Cundinamarca. Colombia) bajo la estrategia de Atención Primaria en Salud / Promoting healthy eating in community children's day care centers in the municipality of Sopo (Cundinamarca, Colombia) under the Primary Health Care strategy

Objetivo: Fortalecer hábitos saludables alimenticios en los hogares infantiles comunitarios y sus familias en el municipio de Sopó (Cundinamarca, Colombia) desde la Atención Primaria en Salud. Metodología: Investigación-acción participativa realizada con 67 niños de 5 hogares comunitarios, sus madres comunitarias, padres de familia y administración municipal durante el segundo semestre de 2014, mediante el abordaje de 3 ejes: 1. Conociendo sobre alimentación saludable, 2. Motivando sobre alimentación saludable y 3. Articulando a la comunidad. Resultados: Las madres comunitarias conocen la importancia de la alimentación saludable y el número de frutas y verduras que se deben consumir diariamente. Los padres de familia reconocen a sus hijos como agentes de cambios para mejorar la motivación en el hogar para el consumo de una alimentación saludable. Los niños han mejorado su consumo de frutas y verduras, aunque persiste la preferencia por alimentación no saludable. Por último, se pudo articular la propuesta con el sector salud y educación del municipio y se reconoció la importancia de trabajar colaborativamente para mejorar la salud de los niños. Conclusiones: Los niños demostraron que son capaces de reconocer que las frutas y las verduras son componentes fundamentales en su dieta para estar sanos y fuertes; además es importante resaltar que los niños se convirtieron en agentes de cambio respecto a la alimentación saludable en sus hogares involucrando a los padres y motivando a las madres comunitarias.

Objetive: To strengthen healthy eating habits in community children's day care centers and their families in the municipality of Sopo (Colombia) from the Primary Health Care. Methodology: Participatory Action Research conducted with 67 children of 5 community children's day care centers, their community mothers (teachers), parents and local government during the second half of 2014, by addressing three areas: 1. Knowing about healthy eating, 2. Motivating on healthy eating and 3. Articulating the community. Results: The community mothers know the importance of healthy eating, and know the number of fruits and vegetables should be consumed daily. Parents recognize their children as agents of change to improve the motivation at home to eating a healthy diet. Children have improved their consumption of fruits and vegetables, although the preference for unhealthy diet persists. Finally it was possible to articulate the proposal with the health and education sectors of the municipality, recognizing the importance of working collaboratively to improve the health of children. Conclusions: Children showed that they are able to recognize that fruits and vegetables are key components in your diet to be healthy and strong, it is also important to note that children become agents of change regarding healthy eating at home, involving parents, and motivating the community mothers.