Role of educational level in the relationship between Body Mass Index (BMI) and health-related quality of life (HRQL) among rural Spanish women

BACKGROUND: The impact of obesity on health-related quality of life (HRQL) has been little explored in rural areas. The goal of this study is to ascertain the association between obesity and HRQL among Spanish women living in a rural area, and the influence of their educational level. METHODS: Cross-sectional study with personal interview of 1298 women (aged 18 to 60) randomly selected from the electoral rolls of 14 towns in Galicia, a region in the north-west of Spain. HRQL was assessed using the SF-36 questionnaire. The association between body mass index (BMI) and suboptimal scores in the different HRQL dimensions was summarised using odds ratios (ORs), obtained from multivariate logistic regression models. Separate analyses were conducted for women who had finished their education younger than 16 years old and women with secondary education to assess differences in the relationship between BMI and HRQL according to educational level. RESULTS: Among women with primary or lower education, obesity was associated with a higher prevalence of suboptimal values in the following dimensions: Physical functioning (OR: 1.97; 95%CI: 1.22-3.18); Role-physical (OR: 1.81; 95%CI: 1.04-3.14); General health (OR: 1.76; 95%CI: 1.10-2.81); and Role-emotional (OR: 2.52; 95%CI: 1.27-5.03). In women with higher education, physical functioning was the only dimension associated with obesity (OR: 2.02: 95%CI 0.83-4.97). CONCLUSION: The impact of obesity on women's HRQL is greater among those with a lower educational level. This group registered higher prevalence of obesity and poorer self-perceived health.This study was funded by the Instituto de Salud Carlos III (grant 001/05).S

Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Uso de inseticidas para o controle da traça-do-tomateiro e traça-das-crucíferas: um estudo de caso Use of insecticides for controlling the South American Tomato Pinworm and the Diamondback Moth: a case study

Em agosto de 1999, produtores de tomate e brássicas do Núcleo Rural da Taquara tiveram seus cultivos seriamente comprometidos devido à impossibilidade de controle da traça-do-tomateiro e da traça-das-crucíferas. Diversos inseticidas, alguns com o mesmo princípio ativo ou pertencentes ao mesmo grupo químico, eram aplicados de uma a sete vezes por semana sem qualquer eficiência no controle das pragas. Lavouras foram abandonadas em diferentes estádios de desenvolvimento. A fim de definir uma estratégia de controle que viabilizasse a produção de tomate e brássicas na região, foi avaliado em laboratório a eficiência da dose comercial de alguns inseticidas usados no controle das duas pragas. Para isso, foram coletadas duas populações de traça-do-tomateiro e uma população de traça-das-crucíferas. Para traça-do-tomateiro, cartap, abamectin, lufenuron, acefate e deltametrina causaram respectivamente 100, 90, 67, 2 e 0% de mortalidade das larvas. Para traça-das-crucíferas, B. thuringiensis, abamectin, cartap, acefate and deltametrina causaram 100; 96; 86; 79 e 5% de mortalidade respectivamente. De acordo com estes resultados foi recomendada a suspensão imediata do uso de piretróides e organofosforados para o controle das duas pragas. Abamectin e cartap foram recomendados para o controle da traça-do-tomateiro e B. thuringiensis para o controle de traça-das-crucíferas.<br>In August 1999, at the "Núcleo Rural da Taquara", Federal District, Brazil, tomato and brassica crops were severely damaged by the South American Tomato Pinworm (Tuta absoluta) and the Diamondback Moth (Plutella xylostella). During that time growers related that they had been spraying insecticides one to seven times per week without controlling the pests. In the fields it was observed that there were crops with different ages and levels of chemical residues which allowed the pests to multiplicate continuously. Then it was decided that the first step to solve the problem would be to evaluate the efficacy of the recommended field rate of some insecticides in laboratory bioassays. Two Brazilian Tomato Pinworm populations and one Diamondback Moth population were collected. Cartap, abamectin, lufenuron, acephate and deltamethrin caused 100, 90, 67, 2 and 0% of larval mortality to the South American Tomato Pinworm, respectively. B. thuringiensis, abamectin, cartap, acephate and deltamethrin caused 100; 96; 86; 79 and 5% of mortality to the Diamondback Moth, respectively. According to laboratory results it was recommended that the use of pyrethroid and organophosphorous compounds must be suspended immediately. Abamectin and cartap must be used to control the South American Tomato Pinworm and B. thuringiensis must be employed to Diamondback Moth control

Kombinacija fotodinamičke terapije i fototerapije u liječenju otvorenih kožnih rana pasa - prikazi slučajeva

The evolution of cutaneous open wounds was evaluated in five client-owned dogs treated with photodynamic therapy (PDT), mediated by methylene blue and phototherapy with light-emitting diodes (LED) as the light source. On the first day of treatment, the wound was irrigated with sterile 0.9% sodium chloride solution, the surface was dried, and 3% solution of hydrogen peroxide soaked for 1 minute. The hydrogen peroxide was mechanically removed and, immediately after, 0.01% methylene blue was used in the wound for five minutes, after which a cluster of red LEDs (650 - 670 nm wavelength, 350 mW power, and irradiance of 200 mW/cm2) was used. Subsequently, single phototherapy sessions, every 48 hours or more, were applied until wound healing. In general, 24J was used for PDT and 12J for phototherapy. In all cases, the cutaneous open wounds treated with PDT associated with phototherapy healed without complications, and it may be considered as a treatment option, especially for extensive lesions.U istraživanje je uključeno pet pasa s poznatim vlasništvom kod kojih je procijenjeno cijeljenje otvorenih kožnih rana. Psi su liječeni fotodinamičkom terapijom (PDT) uz primjenu metilnog modrila i fototerapijom uz primjenu svjetlećih dioda (LED) kao izvora svjetla. Prvi dan pokusa rana je tretirana sterilnom 0,9 %-tnom otopinom natrijeva klorida, njezina je površina posušena te je tijekom jedne minute vlažena 3 %-tnom otopinom hidrogen-peroksida. Odmah potom hidrogen-peroksid mehanički je uklonjen, zatim je tijekom pet minuta upotrijebljeno 0,01 %-tno metilno modrilo, a nakon toga više povezanih crvenih LED dioda (valne dužine 650 – 670 nm, snage 350 mW i zračenja 200 mW/cm2). Poslije toga primijenjena je fototerapija, svakih 48 sati ili u duljem intervalu, sve dok rane nisu zacijelile. Primijenjeno je 24 J za PDT i 12 J za fototerapiju. U svim su slučajevima otvorene kožne rane, koje su liječene kombinacijom PDT-a i fototerapije, zacijelile su bez komplikacija. Navedeno otvara mogućnosti primjene ovih metoda, posebice na ranama s velikim lezijama