Sleep hours and nutritional habits against overweight in adolescents: Spain versus Argentina

Introducción: La prevalencia de la obesidad entre los adolescentes ha aumentado con el paso de los años, lo que supone un reto en salud pública.Objetivo: Determinar el grado de asociación de las horas de sueño y los hábitos alimentarios como factores determinantes de la obesidad enadolescentes de un país europeo y otro sudamericano. Materiales y métodos: Se estudió la duración del sueño, la adherencia a la dieta mediterráneamediante el índice KIDMED, los hábitos alimentarios y el estudio de antropometría para la composición corporal de 272 adolescentes. Resultados:De los 272 adolescentes, 164 eran españoles y 108 argentinos, con edades entre los 11-16 años. El 42% de la muestra argentina presentaba excesoponderal, el 53,3% normopeso y el 4,8% bajo peso. En España, el 39% sobrepeso u obesidad, el 54,3% normopeso y el 6,7% bajo peso. La muestraespañola presentaba mayor adherencia a la dieta mediterránea. Con respecto a la duración del sueño, se reflejaron diferencias significativas: un 18%de la muestra adolescente española y un 57% de Argentina llegaba a dormir 8h diarias. No se encontró relación estadísticamente significativa entrelas horas de sueño y la nutrición sobre el sobrepeso u obesidad de los adolescentes. Aquellos adolescentes que seguían unos hábitos alimentarios máscercanos a la Dieta Mediterránea presentaban mejores valores de IMC. Conclusiones: En general, los adolescentes argentinos tenían peores hábitosalimentarios y mayor exceso ponderal que la muestra española.Introduction: Obesity in adolescence has been increasing over the years, which is a challenge in public health. Objective: To determine the association degree of sleep and eating habits as determinants of obesity in adolescents in a European and South American country. Materials and methods: The study was conducted in a sample of 272 adolescents, 164 Spanish and 108 Argentines, aged 11-16 years. Sleep duration, adherence to the Mediterranean diet by KIDMED index, eating habits and anthropometry study for body composition was studied. Results: 42% of Argentina’s sample had excess weight, 53.3% normal weight and 4.8% underweight. In Spain, 39% was overweight or obese, 54.3% normal weight and 6.7% underweight. The Spanish sample had better adherence to the Mediterranean diet. Regarding sleep duration, significant differences were reflected: 18% of Spanish adolescents and 57% of Argentines came to sleep 8 hours a day. No statistically significant relationship between hours of sleep and nutrition in overweight or obese adolescents was found. Those who were closest to a Mediterranean diet eating habits had better BMI values. Conclusions: In general, Argentine teenagers had worse eating habits and greater excess weight than Spanish sample.Fil: San Mauro Martín, Ismael. Centros de Investigación en Nutrición y Salud; EspañaFil: Paredes Barato, Víctor. Centros de Investigación en Nutrición y Salud; EspañaFil: Lacunza, Ana Betina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; Argentina. Universidad Nacional de Tucumán. Facultad de Psicología; ArgentinaFil: Garicano Vilar, Elena. Centros de Investigación en Nutrición y Salud; EspañaFil: Brasero Escolano, Silvia. Centros de Investigación en Nutrición y Salud; EspañaFil: Sal, Francisco Javier. Universidad del Norte Santo Tomás de Aquino. Facultad de Ciencias de la Salud; ArgentinaFil: Díaz Molina,Paula. Centros de Investigación en Nutrición y Salud; EspañaFil: Cordobés Rol, Marta. Centros de Investigación en Nutrición y Salud; EspañaFil: Bermejo de las Heras, Sara. Centros de Investigación en Nutrición y Salud; EspañaFil: León, Joana. Centros de Investigación en Nutrición y Salud; EspañaFil: Ciudad Cabañas, María José. Universidad Complutense de Madrid; EspañaFil: Caballero, Silvina Valeria. Universidad Nacional de Tucumán; ArgentinaFil: Salazar Burgos, Ramiro Joaquín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; Argentina. Universidad Nacional de Tucumán; ArgentinaFil: Collado Yurrita, Luis. Universidad Complutense de Madrid; Españ

Clinical course and treatment of incidentally detected splanchnic vein thrombosis: an individual patient data meta-analysis

Background: The clinical relevance and management of incidental splanchnic vein thrombosis (SVT) remain poorly defined. Objectives: The objectives of this study were to evaluate the clinical course of incidental SVT in comparison with symptomatic SVT and assess the safety and effectiveness of anticoagulant treatment in incidental SVT. Methods: Individual patient data meta-analysis of randomized controlled trials or prospective studies published up to June 2021. Efficacy outcomes were recurrent venous thromboembolism (VTE) and all-cause mortality. The safety outcome was major bleeding. Incidence rate ratios and 95% CIs for incidental vs symptomatic SVT were estimated before and after propensity-score matching. Multivariable Cox models were used considering anticoagulant treatment as a time-varying covariate. Results: In total, 493 patients with incidental SVT and 493 propensity-matched patients with symptomatic SVT were analyzed. Patients with incidental SVT were less likely to receive anticoagulant treatment (72.4% vs 83.6%). Incidence rate ratios (95% CI) for major bleeding, recurrent VTE, and all-cause mortality in patients with incidental SVT compared with symptomatic SVT were 1.3 (0.8, 2.2), 2.0 (1.2, 3.3), and 0.5 (0.4, 0.7), respectively. In patients with incidental SVT, anticoagulant therapy was associated with a lower risk of major bleeding (hazard ratio [HR] 0.41; 95% CI, 0.21 to 0.71), recurrent VTE (HR 0.33; 95% CI, 0.18 to 0.61), and all-cause mortality (HR 0.23; 95% CI, 0.15 to 0.35). Conclusion: Patients with incidental SVT appeared to have a similar risk of major bleeding, a higher risk of recurrent thrombosis, but lower all-cause mortality than patients with symptomatic SVT. Anticoagulant therapy seemed safe and effective in patients with incidental SVT

Sleep hours and nutritional habits against overweight in adolescents: Spain versus Argentina

Introduction: Obesity in adolescence has been increasing over the years, which is a challenge in public health. Objective: To determine the association degree of sleep and eating habits as determinants of obesity in adolescents in a European and South American country. Materials and methods: The study was conducted in a sample of 272 adolescents, 164 Spanish and 108 Argentines, aged 11-16 years. Sleep duration, adherence to the Mediterranean diet by KIDMED index, eating habits and anthropometry study for body composition was studied. Results: 42% of Argentina’s sample had excess weight, 53.3% normal weight and 4.8% underweight. In Spain, 39% was overweight or obese, 54.3% normal weight and 6.7% underweight. The Spanish sample had better adherence to the Mediterranean diet. Regarding sleep duration, significant differences were reflected: 18% of Spanish adolescents and 57% of Argentines came to sleep 8 hours a day. No statistically significant relationship between hours of sleep and nutrition in overweight or obese adolescents was found. Those who were closest to a Mediterranean diet eating habits had better BMI values. Conclusions: In general, Argentine teenagers had worse eating habits and greater excess weight than Spanish sample

Risk of recurrence after discontinuing anticoagulation in patients with COVID-19- associated venous thromboembolism: a prospective multicentre cohort studyResearch in context

Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain

Risk of recurrence after discontinuing anticoagulation in patients with COVID-19- associated venous thromboembolism: a prospective multicentre cohort studyResearch in context

Summary: Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain

Clinical Presentation and Short- and Long-term Outcomes in Patients With Isolated Distal Deep Vein Thrombosis vs Proximal Deep Vein Thrombosis in the RIETE Registry

International audienceImportance: Insufficient data exist about the clinical presentation, short-term, and long-term outcomes of patients with isolated distal deep vein thrombosis (IDDVT), that is, thrombosis in infrapopliteal veins without proximal extension or pulmonary embolism (PE).Objective: To determine the clinical characteristics, short-term, and 1-year outcomes in patients with IDDVT and to compare the outcomes in unadjusted and multivariable adjusted analyses with patients who had proximal DVT.Design, setting, and participants: This was a multicenter, international cohort study in participating sites of the Registro Informatizado Enfermedad Tromboembólica (RIETE) registry conducted from March 1, 2001, through February 28, 2021. Patients included in this study had IDDVT. Patients with proximal DVT were identified for comparison. Patients were excluded if they had a history of asymptomatic DVT, upper-extremity DVT, coexisting PE, or COVID-19 infection.Main outcomes and measures: Primary outcomes were 90-day and 1-year mortality, 1-year major bleeding, and 1-year venous thromboembolism (VTE) deterioration, which was defined as subsequent development of proximal DVT or PE.Results: A total of 33 897 patients were identified with isolated DVT (without concomitant PE); 5938 (17.5%) had IDDVT (mean [SD] age, 61 [17] years; 2975 male patients [50.1%]), and 27 959 (82.5%) had proximal DVT (mean [SD] age, 65 [18] years; 14 315 male patients [51.2%]). Compared with individuals with proximal DVT, those with IDDVT had a lower comorbidity burden but were more likely to have had recent surgery or to have received hormonal therapy. Patients with IDDVT had lower risk of 90-day mortality compared with those with proximal DVT (odds ratio [OR], 0.47; 95% CI, 0.40-0.55). Findings were similar in 1-year unadjusted analyses (hazard ratio [HR], 0.52; 95% CI, 0.46-0.59) and adjusted analyses (HR, 0.72; 95% CI, 0.64-0.82). Patients with IDDVT had a lower 1-year hazard of VTE deterioration (HR, 0.83; 95% CI, 0.69-0.99). In 1-year adjusted analyses of patients without an adverse event within the first 3 months, IDDVT was associated with lower risk of VTE deterioration (adjusted HR, 0.48; 95% CI, 0.24-0.97). By 1-year follow-up, symptoms or signs of postthrombotic syndrome were less common in patients with IDDVT (47.6% vs 60.5%).Conclusions and relevance: Results of this cohort study suggest that patients with IDDVT had a less ominous prognosis compared with patients with proximal DVT. Such differences were likely multifactorial, including the differences in demographics, risk factors, comorbidities, particularly for all-cause mortality, and a potential association of thrombus location with VTE deterioration and postthrombotic syndrome. Randomized clinical trials are needed to assess the optimal long-term management of IDDVT