Percepción de riesgo en adolescentes relacionado con aborto

Resumen   Introducción: Los estudios realizados sobre la educación de la sexualidad han permitido constatar que aún son insuficientes los conocimientos que poseen los adolescentes sobre aspectos relacionados con el tema, en especial los riesgos del aborto y su repercusión de manera desfavorable en la salud sexual. Objetivo: Determinar la percepción de riesgo en adolescentes relacionado con aborto por embarazos no deseados. Métodos: Estudio observacional descriptivo, transversal y prospectivo, se utilizaron encuestas y entrevistas, así como métodos estadísticos para el procesamiento de la información. El universo estuvo conformado por 354 adolescentes pertenecientes a los consultorios médicos 20, 28 y 30 del Grupo Básico de Trabajo 2 del policlínico Pedro Borrás Astorga, la muestra de 190 adolescentes se encontraron entre las edades de 14 a 18 años. Resultados: Se evidenció una tendencia de los jóvenes a practicar conductas sexuales precoces y riesgosas, lo que favorece el aumento creciente de la práctica del aborto, con insuficientes conocimientos y percepción de riesgo sobre las consecuencias y riesgos de una interrupción de embarazo, donde se encuentran debilitados el rol de los padres y el papel del personal de salud de las áreas donde pertenecen. Conclusiones: Se demostró que el proceso de educación para la salud muestra insuficiencias en cuanto a la creación de programas educativos más creativos que fomentan actividades de promoción y prevención de salud dirigidos a los adolescente

Flavonoid Phloretin Inhibits Adipogenesis and Increases OPG Expression in Adipocytes Derived from Human Bone-Marrow Mesenchymal Stromal-Cells

Phloretin (a flavonoid abundant in apple), has antioxidant, anti-inflammatory, and glucose-transporter inhibitory properties. Thus, it has interesting pharmacological and nutraceutical potential. Bone-marrow mesenchymal stem cells (MSC) have high differentiation capacity, being essential for maintaining homeostasis and regenerative capacity in the organism. Yet, they preferentially differentiate into adipocytes instead of osteoblasts with aging. This has a negative impact on bone turnover, remodeling, and formation. We have evaluated the effects of phloretin on human adipogenesis, analyzing MSC induced to differentiate into adipocytes. Expression of adipogenic genes, as well as genes encoding OPG and RANKL (involved in osteoclastogenesis), protein synthesis, lipid-droplets formation, and apoptosis, were studied. Results showed that 10 and 20 µM phloretin inhibited adipogenesis. This effect was mediated by increasing beta-catenin, as well as increasing apoptosis in adipocytes, at late stages of differentiation. In addition, this chemical increased OPG gene expression and OPG/RANKL ratio in adipocytes. These results suggest that this flavonoid (including phloretin-rich foods) has interesting potential for clinical and regenerative-medicine applications. Thus, such chemicals could be used to counteract obesity and prevent bone-marrow adiposity. That is particularly useful to protect bone mass and treat diseases like osteoporosis, which is an epidemic worldwide

Demografia e imunologia de variantes fenotípicas da alergia em pacientes atópicos com idade entre 1 e 5 anos. Granma. 2012-2018

An analytical study was carried out in the Allergy Service of the Ambulatory Medical Center of Granma, in the period 2012-2018, with the aim of demographically and immunologically characterizing the phenotypic variants of allergy in 224 patients from 1 to 5 years of age. Age, sex, IgA, IgG and IgE value, complement components C3 and C4, total leukogram value, and eosinophils in blood and nasal mucosa were studied, as well as the clinical diagnosis of each phenotypic variant of allergy. Statistical processing included descriptive statistics. In addition, inferential statistics was used in the performance of bivariate analyzes through CHI 2 to identify an association with p <0.05. There were no differences in terms of sex and children of 4 and 5 years of age predominated. The order of frequency of the different phenotypes of allergic diseases was, from highest to lowest, allergic rhinitis, bronchial asthma, allergic conjunctivitis and atopic dermatitis. In the patients studied, elevated IgE and eosinophil values predominated in nasal and blood cytology and normal IgA, IgG, C3, C4 and total leukocyte count.Se realizó un estudio analítico, en el Servicio de Alergia del Centro Médico Ambulatorio de Granma, en el periodo 2012-2018, con el objetivo de caracterizar demográfica e inmunológicamente las variantes fenotípicas de alergia en 224 pacientes de 1 a 5 años de edad. Se estudiaron: edad, sexo, valor de IgA, IgG e IgE, componentes C3 y C4 del complemento, valor de leucograma total, y eosinófilos en sangre y en mucosa nasal, así como el diagnóstico clínico de cada variante fenotípica de alergia. El procesamiento estadístico incluyó estadística descriptiva. Además, se empleó estadística inferencial en la realización de análisis bivariables a través de CHI2 para identificar asociación con p< 0,05. No existieron diferencias en cuanto a sexo y predominaron los niños de 4 y 5 años de edad. El orden de frecuencia de los diferentes fenotipos de enfermedades alérgicas fue, de mayor a menor, rinitis alérgica, asma bronquial, conjuntivitis alérgica y dermatitis atópica. En los pacientes estudiados predominaron los valores elevados de IgE y de eosinófilos en citología nasal y en sangre y normales de IgA, IgG, C3, C4 y la cuenta leucocitaria total.Foi realizado um estudo analítico no Serviço de Alergia do Centro Médico Ambulatorial de Granma, no período 2012-2018, com o objetivo de caracterizar demograficamente e imunologicamente as variantes fenotípicas da alergia em 224 pacientes de 1 a 5 anos de idade. Foram estudados idade, sexo, valor de IgA, IgG e IgE, componentes do complemento C3 e C4, valor total de leucograma e eosinófilos no sangue e mucosa nasal, além do diagnóstico clínico de cada variante fenotípica da alergia. O processamento estatístico incluiu estatística descritiva. Além disso, a estatística inferencial foi utilizada na realização de análises bivariadas através do CHI 2 para identificar uma associação com p <0,05. Não houve diferenças quanto ao sexo e predominaram crianças de 4 e 5 anos. A ordem de frequência dos diferentes fenótipos de doenças alérgicas foi, da mais alta à mais baixa, rinite alérgica, asma brônquica, conjuntivite alérgica e dermatite atópica. Nos pacientes estudados, os valores elevados de IgE e eosinófilos predominaram na citologia nasal e sanguínea e em IgA normal, IgG, C3, C4 e contagem total de leucócitos

Design, methods and demographic findings of the DEMINVALL survey: a population-based study of Dementia in Valladolid, Northwestern Spain

Producción CientíficaThis article describes the rationale and design of a population-based survey of dementia in Valladolid (northwestern Spain). The main aim of the study was to assess the epidemiology of dementia and its subtypes. Prevalence of anosognosia in dementia patients, nutritional status, diet characteristics, and determinants of non-diagnosed dementia in the community were studied. The main sociodemographic, educational, and general health status characteristics of the study population are described. Methods: Cross-over and cohort, population-based study. A two-phase door-to-door study was performed. Both urban and rural environments were included. In phase 1 (February 2009 – February 2010) 28 trained physicians examined a population of 2,989 subjects (age: ≥ 65 years). The seven-minute screen neurocognitive battery was used. In phase 2 (May 2009 – May 2010) 4 neurologists, 1 geriatrician, and 3 neuropsychologists confirmed the diagnosis of dementia and subtype in patients screened positive by a structured neurological evaluation. Specific instruments to assess anosognosia, the nutritional status and diet characteristics were used. Of the initial sample, 2,170 subjects were evaluated (57% female, mean age 76.5 ± 7.8, 5.2% institutionalized), whose characteristics are described. 227 persons were excluded for various reasons. Among those eligible were 592 non-responders. The attrition bias of non-responders was lower in rural areas. 241 screened positive (11.1%). Discussion: The survey will explore some clinical, social and health related life-style variables of dementia. The population size and the diversification of social and educational backgrounds will contribute to a better knowledge of dementia in our environment. Keywords: Dementia prevalence, Epidemiology, Undiagnosed dementia, Population-based survey, Seven-minute screen, Anosognosia, Nutritional assessmen

Psychosocial and sociodemographic predictors of attrition in a longitudinal study of major depression in primary care: the predictD-Spain study

Few data exist on the psychosocial factors associated with attrition in longitudinal surveys. This study was undertaken to determine psychosocial and sociodemographic predictors of attrition from a longitudinal study of the onset and persistence of episodes of major depression in primary care

Spanish home enteral nutrition registry of the year 2014 and 2015 from the NADYA-SENPE Group

Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) del año 2014 y 2015 del Grupo NADYA-SENPE. Métodos: se recopilaron los pacientes introducidos en el registro desde el 1 de enero al 31 de diciembre de 2014 y la mismas fechas de 2015, y se procedió al análisis descriptivo y analítico de los datos. Resultados: en el año 2014, se registraron 3.749 pacientes y en 2015, 4.202; la prevalencia fue de 80,58 pacientes/millón de habitantes en el año 2014 y de 90,51 en 2015. Por sexos, hubo un 49,9% de mujeres en 2014 y un 50,3% en 2015. La edad media fue de 73 años (IIQ 59-83) en ambos años. Finalizaron 684 episodios de NED en 2014 y 631 en 2015, la causa principal fue el fallecimiento en el 54,9% y 50,4% de los casos, respectivamente. Los portadores de sonda nasogástrica presentan una edad media superior a los pacientes con cualquier otra vía (p < 0,001). Se registraron 67 pacientes pediátricos en 2014 (56,7% niñas) y 77 en 2015 (55,8% niñas). La vía principal de administración fue la gastrostomía en el 52,0% de los casos de 2014 y sonda nasogástrica en el 50,8% de los casos de 2015. La causa principal de fi nalización de la nutrición fue el fallecimiento (57,1% en 2014 y 38,5% en 2015). Se observó que los niños más pequeños eran los que se alimentaban preferentemente por SNG (p 0,004 vs. 0,002).Tanto en pacientes pediátricos como en adultos el diagnóstico principal que motivó la necesidad de NED fue la enfermedad neurológica que cursa con afagia o disfagia severa. Conclusiones: se ha incrementado el número de pacientes del registro, así como el número de centros participantes y el número medio de pacientes comunicados por cada centro respecto a años anteriores, sin que se hayan modificado sustancialmente las características de los pacientes, salvo mayor duración de los episodiosObjective: To present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2014 and 2015. Methods: From January 1st 2014 to December 31st 2015 the HEN registry was recorded and afterwards a further descriptive and analytical analysis was done. Results: In 2014, 3749 patients were recorded, and 4202 in 2015; prevalence was 80.58 patients/one million inhabitants in Spain in 2014 and 90.51 in 2015. There were 49.9% females in 2014 and 50.3% in 2015. Median age was 73 years (IQI 59-83) in 2014 as well as in 2015. 684 episodes fi nished in 2014 and 631 in 2015, with death as the main cause, in 54.9% and 50.4%, respectively. The ones who were fed through nasogastric tube had a mean age higher than the ones fed by any other route (p-value < 0.001). Sisty-seven paediatric patients were recorded in 2014 (56.7% females) and 77 in 2015 (55.8% females). Median age at the beginning of HEN among children was 5 months in 2014 and 5 months in 2015. The main route of administration was gastrostomy, in 52.5% in 2014 and nasogastric tube in 50.8% in 2015. 7 episodes fi nished in 2014 and 13 in 2015, having death as the main cause (57.1% in 2014 and 38.5% in 2015). It was found that were younger children the ones who were mainly fed by nasogastric tubes (p-value 0.004 vs. 0.002). Among paediatric patients as well as adults, the main diagnosis leading to HEN was neurological disease which gives aphagia or severe dysphagia. Conclusions: There has been an increase in the number of patients in the registry as well as the participating centers and the number of patients per center, without any signifi cant change in the characteristics of the patients other than longer duration of the episode

The Fourteenth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the extended Baryon Oscillation Spectroscopic Survey and from the second phase of the Apache Point Observatory Galactic Evolution Experiment

The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) has been in operation since July 2014. This paper describes the second data release from this phase, and the fourteenth from SDSS overall (making this, Data Release Fourteen or DR14). This release makes public data taken by SDSS-IV in its first two years of operation (July 2014-2016). Like all previous SDSS releases, DR14 is cumulative, including the most recent reductions and calibrations of all data taken by SDSS since the first phase began operations in 2000. New in DR14 is the first public release of data from the extended Baryon Oscillation Spectroscopic Survey (eBOSS); the first data from the second phase of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE-2), including stellar parameter estimates from an innovative data driven machine learning algorithm known as "The Cannon"; and almost twice as many data cubes from the Mapping Nearby Galaxies at APO (MaNGA) survey as were in the previous release (N = 2812 in total). This paper describes the location and format of the publicly available data from SDSS-IV surveys. We provide references to the important technical papers describing how these data have been taken (both targeting and observation details) and processed for scientific use. The SDSS website (www.sdss.org) has been updated for this release, and provides links to data downloads, as well as tutorials and examples of data use. SDSS-IV is planning to continue to collect astronomical data until 2020, and will be followed by SDSS-V.Comment: SDSS-IV collaboration alphabetical author data release paper. DR14 happened on 31st July 2017. 19 pages, 5 figures. Accepted by ApJS on 28th Nov 2017 (this is the "post-print" and "post-proofs" version; minor corrections only from v1, and most of errors found in proofs corrected

Nutrición parenteral domiciliaria en España, 2019: informe del Grupo de Nutrición Artificial Domiciliaria y Ambulatoria NADYA

RESUMEN Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadyasenpe.com) del año 2019. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE desde el 1 de enero al 31 de diciembre de 2019. Resultados: se registraron 283 pacientes (51,9 %, mujeres), 31 niños y 252 adultos procedentes de 47 hospitales españoles, lo que representa una tasa de prevalencia de 6,01 pacientes/millón de habitantes/año 2019. El diagnóstico más frecuente en los adultos fue “oncológico paliativo” y “otros” (21,0 %). En los niños fue la enfermedad de Hirschsprung junto a la enterocolitis necrotizante, las alteraciones de la motilidad intestinal y la pseudoobstrucción intestinal crónica, con 4 casos cada uno (12,9 %). El primer motivo de indicación fue el síndrome del intestino corto tanto en los niños (51,6 %) como en los adultos (37,3 %). El tipo de catéter más utilizado fue el tunelizado tanto en los niños (75,9 %) como en los adultos (40,8 %). Finalizaron 68 episodios, todos en adultos: la causa más frecuente fue el fallecimiento (54,4 %). Pasaron a la vía oral el 38,2 %. Conclusiones: el número de centros y profesionales colaboradores con el registro NADYA va incrementándose. Se mantienen estables las principales indicaciones y los motivos de finalización de la NPD

Uncovering Ecosystem Service Bundles through Social Preferences

Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem’s capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem’s capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area) have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis). We found a clear trade-off among provisioning services (and recreational hunting) versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs

Decisions of refusal Intensive Care Units' admission as a measure of limitation of life support treatments: geographical variability in Spain

From a post hoc analysis of the ADENI-UCI study (multicenter, observational, cohort, prospective study, with a follow-up period of 13 months, in 62 Intensive Medicine Services in Spain. geographical differences in the reason for denial of income in UCI as a LTSV measure are analyzed. A total of 2284 with an average age of 75.25 (12.45) years were included. 59.43% male. By means of multinominal regression adjusted by age, sex, APACHE and SOFA, was evident (by choosing the northern for reference) that age in the south was a less significantly exposed reason (OR: 0.48 (IC95%: 0.35-0.65). p