Distorsión de la auto-imagen: factor de riesgo para la obesidad en niños y adolescentes

Introduction: Self-image is important in the behaviour and lifestyle of children and adolescents. Analysing the self-image they have and the factors that might influence their distortion, can be used to prevent problems of obesity and anorexia. The main objective of present publication was to analyse the risk factors that may contribute to self-image distortion. Material and Methods: A descriptive survey study was conducted among 659 children and adolescents in two social classes (low and medium-high), measuring height and weight, calculating BMI percentile for age and gender. Body image and self-perception were registered. Results: The percentage of overweight-obesity is higher in scholars (41.8% boys, 28.7% girls) than in adolescents (30.1% and 22.2% respectively), with no difference between socioeconomic classes. The multinomial logistic regression analysis gives a risk of believing thinner higher (p=0.000) among boys OR=2.9(95%CI:1.43-3.37), school (p=0.000) OR=2.42(95%CI:1.56-3.76) and much lower (p=0.000) between normally nourished OR=0.08(95%CI:0.05-0.13), with no differences according to socioeconomic status. The risk of believing fatter is lower (p=0.000) between boys OR=0.28(95%CI:0.14-0.57), school(p=0.072) OR=0.54(95%CI:0.27-1.6), and much higher among underweight (p=0.000) OR=9x108(95% CI:4x108-19x108). Conclusions: Are risk factors of believing thinner: males, being in a group of schoolchildren and overweight-obesity. Conversely, are risk factors of believing fatter: females, teen and above all, be thin.Introducción: La autoimagen es importante en el comportamiento y el estilo de vida de los niños y adolescentes. El análisis de la autoimagen que tienen y de los factores que pueden influir en su distorsión, puede ser utilizado para prevenir problemas de obesidad y anorexia. El principal objetivo de este estudio fue analizar los factores de riesgo que pueden contribuir a una distorsión de la autoimagen. Material y Métodos: Se estudiaron 659 niños y adolescentes en dos entornos socioeconómicos (bajo y medio-alto), midiendo altura y peso, calculando IMC y percentil según edad y sexo. Se preguntó a los sujetos cómo se consideraban: delgada/o, peso adecuado o gorda/o. Resultados: El porcentaje de sobrepeso-obesidad fue mayor en escolares (41,8% niños; 28,7% niñas) que en adolescentes (30,1% y 22,2% respectivamente), sin diferencias entre entornos socioeconómicos. El análisis de regresión logística multinomial ofreció un riesgo de creerse más delgados mayor (p=0,000) entre los chicos OR=2,19(IC95%:1,43-3,37), escolares (p=0,000) OR=2,42(IC95%:1,56-3,76), y mucho menor (p=0,000) entre normonutridos OR=0,08(IC95%:0,05-0,13), sin diferencias según estatus socioeconómico. El riesgo de creerse más gordo fue al contrario, menor (p=0,000) entre chicos OR=0,28(IC95%:0,14-0,57), escolares (p=0,072) OR=0,54(IC95%:0,27-1,06), y muchísimo mayor entre delgados (p=0,000) OR= 9x108(IC95%: 4x108-19x108). Conclusiones: Son factores de riesgo de creerse más delgados el sexo masculino, estar en grupo de escolares y en sobrepeso-obesidad. Contrariamente, son factores de riesgo de creerse más gordos el sexo femenino, adolescente y sobre todo estar delgados

Nontyphoidal Cardiac Salmonellosis: Two Case Reports and a Review of the Literature

Nontyphoidal Salmonella, especially Salmonella enterica, is a rare cause of endocarditis and pericarditis that carries a high mortality rate. Proposed predisposing conditions include immunodeficiency states, congenital heart defects, and cardiac valve diseases. We present 2 cases of cardiovascular salmonellosis. The first case is that of a 73-year-old woman with mechanical mitral and bioprosthetic aortic valves who died from sequelae of nontyphoidal Salmonella mitral valve vegetation, aortic valve abscess, and sepsis. The second case is that of a 62-year-old man with a recent systemic lupus erythematosus exacerbation treated with oral steroids, who presented with obstructive features of tamponade and sepsis secondary to a large S. enteritidis purulent pericardial cyst. He recovered after emergent pericardial drainage and antibiotic therapy. Identifying patients at risk of cardiovascular salmonellosis is important for early diagnosis and treatment to minimize sequelae and death. We reviewed the literature to identify the predisposing risk factors of nontyphoidal Salmonella cardiac infection

Physicochemical properties of cowpea (Vigna unguiculata L. Walp.) meals and their apparent digestibility in white shrimp (Litopenaeus vannamei Boone).

The effect of different feed processing methods on the physicochemical properties, and apparent digestibility of cowpea (Vigna unguiculata) meals as ingredients in diets for white shrimp ( Litopenaeus vannamei ) was investigated. Five experimental cowpea meals were prepared: whole raw (WRC), dehulled (DC), cooked (CC), germinated (GC) and extruded (EXC). The physicochemical properties of the meals were evaluated using differential scanning calorimetry. The meals were included at 15 % in diets for L. vannamei (15.4 g) to determine firmness of pellets and in vivo digestibility of nutrients by using chromic oxide as inert marker. Six diets were evaluated: a control diet, and five diets containing the different cowpea meals. Transition enthalpy significantly decreased after thermal treatment, from 6.1 J/g in WRC to 1.4 J/g in CC, and disappeared in EXC. Firmness of pellets varied from 1.1 N in the EXC diet to 2.8 N in the WRC diet. A significant negative correlation between transition enthalpy and carbohydrate digestibility was found. Dry matter, protein, carbohydrate and lipid digestibility of cowpea meals significantly increased after germinating, cooking or extruding. It is concluded that germinated, cooked and extruded cowpea meals are highly digestible for shrimp and that enthalpy of transition is negatively correlated with the digestibility of carbohydrates

Risk Factors for and Prediction of Post-Intubation Hypotension in Critically Ill Adults: A Multicenter Prospective Cohort Study

OBJECTIVE: Hypotension following endotracheal intubation in the ICU is associated with poor outcomes. There is no formal prediction tool to help estimate the onset of this hemodynamic compromise. Our objective was to derive and validate a prediction model for immediate hypotension following endotracheal intubation. METHODS: A multicenter, prospective, cohort study enrolling 934 adults who underwent endotracheal intubation across 16 medical/surgical ICUs in the United States from July 2015-January 2017 was conducted to derive and validate a prediction model for immediate hypotension following endotracheal intubation. We defined hypotension as: 1) mean arterial pressure \u3c 65 mmHg; 2) systolic blood pressure \u3c 80 mmHg and/or decrease in systolic blood pressure of 40% from baseline; 3) or the initiation or increase in any vasopressor in the 30 minutes following endotracheal intubation. RESULTS: Post-intubation hypotension developed in 344 (36.8%) patients. In the full cohort, 11 variables were independently associated with hypotension: increasing illness severity; increasing age; sepsis diagnosis; endotracheal intubation in the setting of cardiac arrest, mean arterial pressure \u3c 65 mmHg, and acute respiratory failure; diuretic use 24 hours preceding endotracheal intubation; decreasing systolic blood pressure from 130 mmHg; catecholamine and phenylephrine use immediately prior to endotracheal intubation; and use of etomidate during endotracheal intubation. A model excluding unstable patients’ pre-intubation (those receiving catecholamine vasopressors and/or who were intubated in the setting of cardiac arrest) was also developed and included the above variables with the exception of sepsis and etomidate. In the full cohort, the 11 variable model had a C-statistic of 0.75 (95% CI 0.72, 0.78). In the stable cohort, the 7 variable model C-statistic was 0.71 (95% CI 0.67, 0.75). In both cohorts, a clinical risk score was developed stratifying patients’ risk of hypotension. CONCLUSIONS: A novel multivariable risk score predicted post-intubation hypotension with accuracy in both unstable and stable critically ill patients. STUDY REGISTRATION: Clinicaltrials.gov identifier: NCT02508948 and Registered Report Identifier: RR2-10.2196/11101

The Eleventh and Twelfth data releases of the Sloan Digital Sky Survey: Final data from SDSS-III

The third generation of the Sloan Digital Sky Survey (SDSS-III) tookdata from 2008 to 2014 using the original SDSS wide-field imager, theoriginal and an upgraded multi-object fiber-fed optical spectrograph, anew near-infrared high-resolution spectrograph, and a novel opticalinterferometer. All of the data from SDSS-III are now made public. Inparticular, this paper describes Data Release 11 (DR11) including alldata acquired through 2013 July, and Data Release 12 (DR12) adding dataacquired through 2014 July (including all data included in previous datareleases), marking the end of SDSS-III observing. Relative to ourprevious public release (DR10), DR12 adds one million new spectra ofgalaxies and quasars from the Baryon Oscillation Spectroscopic Survey(BOSS) over an additional 3000 deg2 of sky, more than triplesthe number of H-band spectra of stars as part of the Apache PointObservatory (APO) Galactic Evolution Experiment (APOGEE), and includesrepeated accurate radial velocity measurements of 5500 stars from theMulti-object APO Radial Velocity Exoplanet Large-area Survey (MARVELS).The APOGEE outputs now include the measured abundances of 15 differentelements for each star. In total, SDSS-III added 5200 deg2 ofugriz imaging; 155,520 spectra of 138,099 stars as part of the SloanExploration of Galactic Understanding and Evolution 2 (SEGUE-2) survey;2,497,484 BOSS spectra of 1,372,737 galaxies, 294,512 quasars, and247,216 stars over 9376 deg2; 618,080 APOGEE spectra of156,593 stars; and 197,040 MARVELS spectra of 5513 stars. Since itsfirst light in 1998, SDSS has imaged over 1/3 of the Celestial sphere infive bands and obtained over five million astronomical spectra.Fil: Alam, Shadab. University of Carnegie Mellon; Estados UnidosFil: Albareti, Franco D.. Universidad Autónoma de Madrid; EspañaFil: Prieto, Carlos Allende. Universidad de La Laguna; EspañaFil: Anders, F.. Leibniz Institute For Astrophysics Potsdam; AlemaniaFil: Anderson, Scott F.. University of Utah; Estados UnidosFil: Anderton, Timothy. University of Utah; Estados UnidosFil: Andrews, Brett H.. Ohio State University; Estados Unidos. University of Pittsburgh; Estados UnidosFil: Armengaud, Eric. Service de Physique Des Particules; FranciaFil: Aubourg, Éric. Université Paris Diderot - Paris 7; FranciaFil: Bailey, Stephen. Lawrence Berkeley National Laboratory; Estados UnidosFil: Basu, Sarbani. University of Yale; Estados UnidosFil: Bautista, Julian E.. Université Paris Diderot - Paris 7; FranciaFil: Beaton, Rachael L.. University of Virginia; Estados UnidosFil: Beers, Timothy C.. University of Notre Dame; Estados UnidosFil: Bender, Chad F.. Pennsylvania State University; Estados UnidosFil: Berlind, Andreas A.. Vanderbilt University; Estados UnidosFil: Beutler, Florian. Lawrence Berkeley National Laboratory; Estados UnidosFil: Bhardwaj, Vaishali. Lawrence Berkeley National Laboratory; Estados UnidosFil: Bird, Jonathan C.. Vanderbilt University; Estados UnidosFil: Bizyaev, Dmitry. Apache Point Observatory; Estados UnidosFil: Blake, Cullen H.. University of Pennsylvania; Estados UnidosFil: Blanton, Michael R.. New York University; Estados UnidosFil: Blomqvist, Michael. University of California at Irvine; Estados UnidosFil: Bochanski, John J.. University of Washington; Estados UnidosFil: Bolton, Adam S.. University of Utah; Estados UnidosFil: Bovy, Jo. Institute For Advanced Studies; Estados UnidosFil: Shelden, Bradley, A.. Apache Point Observatory; Estados UnidosFil: Brandt, W. N.. Pennsylvania State University; Estados UnidosFil: Brauer, D. E.. Leibniz Institute For Astrophysics Potsdam; AlemaniaFil: Nuza, Sebastian Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Astronomía y Física del Espacio. - Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Astronomía y Física del Espacio; Argentina. Institut Max Planck Fuer Gesellschaft. Max Planck Institute For Extraterrestrial Physics; AlemaniaFil: Scoccola, Claudia Graciela. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas; Argentin

Quality of the diet and lifestyles in Health Sciences students

Objetivo: Evaluar los hábitos de alimentación de los estudiantes de la Universidad de Alicante de las titulaciones de Nutrición Humana y Dietética y Enfermería. Material y métodos: El estudio se realizó a 184 estudiantes de ambos sexos (96 de Nutrición Humana y Dietética y 88 de Enfermería) de la Universidad de Alicante. Se pesaron y tallaron para calcular el IMC; el consumo de alimentos se estimó mediante el recordatorio de 24 horas; la ingesta de macro y micronutrientes se calculó mediante el programa Easydiet. Se compararon los resultados obtenidos en ambas titulaciones y según estado de nutrición realizando el correspondiente análisis estadístico. Resultados: La mayoría de los estudiantes analizados son normopeso (80%). No se encontraron diferencias significativas en la calidad de la dieta entre ambas titulaciones, siendo las características de la misma: baja en carbohidratos y alta en proteínas. También se muestra un desequilibrio en el tipo de grasa ingerida, siendo mayor el consumo de saturada y menor el de poliinsaturada de lo recomendado. Así mismo, se analizó que los estudiantes de Nutrición realizan más ejercicio que los de Enfermería, aunque duermen menos horas y pasan más tiempo frente al ordenador y televisor. Conclusión: A pesar de que los niveles de sobrepeso y obesidad entre los universitarios es menor que el de la población general, existen desequilibrios en su alimentación, observándose que el consumo de macronutrientes se encuentra alejado de las recomendaciones, y que hay deficiencias en la ingesta de micronutrientes. Mostrándose que el tener conocimientos de nutrición, no influye en la toma de decisiones para una alimentación y estilo de vida saludables.Objective: To evaluate the eating habits of the students of the University of Alicante of the degrees of Human Nutrition and Dietetics and Nursing. Material and methods: The study was carried out to 184 students of both sexes (96 of Human Nutrition and Dietetics and Nursing 88) of the University of Alicante. Were weighed and carved to calculate BMI; food consumption was estimated by the reminder of 24 hours; intake of macro and micronutrients were calculated using the program Easydiet. Comparing the results obtained in both qualifications and according to nutritional status by performing the corresponding statistical analysis. Results: The majority of the students analyzed are normal weight (80%). There were significant differences in the quality of the diet both degrees, being the same characteristics: low in carbohydrates and high in protein. It also shows an imbalance in the type of fat consumed, with a higher consumption of saturated and less from polyunsaturated than recommended. Likewise, analyzed that nutrition students do more exercise than the nurses, although they sleep fewer hours and spend more time in front of the computer and TV. Conclusion: While the levels of overweight and obesity among students is less than that of the general population, there are imbalances in your diet, noting that consumption of macronutrients is located away from the recommendations, and that there are deficiencies in the intake of micronutrients. Showing that have knowledge of nutrition, does not affect healthy decision-making to a diet and lifestyle

Variations in Practice of Apnea Test for Brain Death: Review From a Multihospital Health Care System

Background: Ventilation encompasses both active and passive processes. Air is initially drawn into the lungs due to a negative intrathoracic pressure created using the respiratory muscles, most importantly the diaphragm. In contrast, expiration is the passive relaxation of the respiratory muscles. Oxygenation occurs when oxygen diffuses across the alveolar-capillary membrane. The ability to oxygenate without ventilation has been termed apneic diffusion oxygenation or apneic oxygenation. We believe it is crucial to keep alveoli open in order for adequate oxygenation to occur. This can be achieved with the aid of positive end-expiratory pressure (PEEP). We investigated this concept in patients who are brain-dead because they cannot ventilate. The stimulus to breathe originates from chemoreceptors in the brainstem. These cells respond to a decrease in pH by triggering the body to take a breath. A positive apnea test confirms that the patient has no functioning brainstem. Purpose: Determine the rate of pO2 and pCO2 changes during different methods of the apnea test and identify variations in practice within Aurora Health Care. Methods: Data were collected retrospectively on brain-dead patients older than 18 years. Data points pulled from Epic medical records included serial arterial blood gases (ABGs) that were completed during the apnea test and patient demographics. The rate of change in pCO2 and pO2 was evaluated using both Mann-Whitney and two-sample t-tests comparing a PEEP valve group to all other oxygenation methods. Results: Eight variations of the test were performed, with median starting CO2 for the oxygenation and PEEP group of 43 and 44 mmHg, respectively (95% confidence interval: 26–53, P = 0.6771). Oxygenation group had a mean CO2 increase of 2.95 mmHg/minute, whereas the PEEP valve group increased at 4.60 mmHg/minute. No statistical significance was found (P = 0.0508). Neither was there significant difference between the rate of desaturation between the oxygenation and PEEP valve group (6.53 mmHg vs 2.60 mmHg, respectively; P = 0.5536). Conclusion: We found no difference in the rate of CO2 increase comparing the oxygenation group to the PEEP valve group. This suggests that there is no significant component of CO2 washout in the lungs using the PEEP valve setup. A superior method of apneic oxygen was not able to be demonstrated with our results due to an insufficient sample size and practice variations. The most common method to perform the apnea test at our institutions is preoxygenation