¿Por qué debemos promover la protección de microbiota intestinal?

En el tracto intestinal de la especie humana habita un ecosistema microbiano que tiene elevada importancia para la salud por lo cual se realizó este trabajo con el objetivo de analizar aportes de la literatura científica sobre composición, fisiología y mecanismos de microbiota intestinal y así contribuir a la prevención de enfermedades. Fueron estudiadas e interpretadas 60 publicaciones sobre integrantes de esta población de microorganismos y algunos de sus mecanismos fisiológicos que impactan en el estado de salud. Este trabajo permitió desarrollar tres reflexiones: el equilibrio de la flora intestinal; la alimentación saludable; la actividad física y manejar el estrés, que son las bases de la conclusión siguiente: la literatura científica brinda informaciones y datos sobre microbiota intestinal que respaldan la importancia de proteger este ecosistema para prevenir enfermedades y aumentar la esperanza de vida con buena calidad.In the intestinal tract of the human species inhabits a microbial ecosystem that is highly important for health. Our objective is to analyze contributions of the scientific literature on composition, physiology, and mechanisms of the intestinal microbiota to contribute to the prevention of diseases. 61 publications on members of this population of microorganisms and some of their physiological mechanisms that impact health status were studied and interpreted. This work allowed us to develop three reflections that are the basis for the following conclusion: the scientific literature provides information and data on the intestinal microbiota that support the importance of protecting this ecosystem to prevent diseases and increase life expectancy with good quality

Asociaciones entre alimentos, flora intestinal y sistema nervioso central

  Existe un incremento del interés sobre posibles efectos de la alimentación en el funcionamiento del sistema nervioso central, aunque la importancia de esa influencia parece requerir mayores respaldos científicos. Estos señalamientos son motivos para   valorar, sobre la base de los aportes de otros autores, el posible significado de la relación de alimentos, flora intestinal y sistema nervioso. Para cumplir este objetivo fue necesario una búsqueda de informaciones científicas en la US National Library of Medicine sobre este tema, una selección de publicaciones relevantes y análisis de los datos encontrados. Según esas publicaciones, la protección de la inocuidad de los alimentos, probióticos y algunas sustancias químicas de la dieta tienen relación con la composición y funcionamiento de la flora intestinal que puede afectar el eje intestino cerebro y causar alteraciones en el funcionamiento del sistema nervioso central. Se acepta que son insuficientes las explicaciones sobre relaciones específicas entre componentes de la dieta y efectos en el sistema nervioso central de los consumidores de alimentos, incluyendo los posibles mecanismos de esas relaciones.   Palabras clave: alimentos, eje intestino cerebro, sistema nervioso central, microbiota intestinal.   Abstract   There is an increased interest in possible effects of food on the central nervous system functioning, although the importance of this influence seems to require more scientific support. These indications are reasons to value, based on the contributions of other authors, the possible meaning of the relationship of food with the intestinal flora and the nervous system. To accomplish this goal, a search of scientific information was necessary for the US National Library of Medicine on this topic, a selection of relevant publications and analysis of the data found. According to those publications, food safety, probiotics and some dietary chemicals has a relationship with to the composition and functioning of the intestinal microbiome that can affect the brain intestinal axis and cause alterations in the functioning of the central nervous system. It’s accepted that explanations about specific relationships between diet components and effects on the central nervous system of food consumers, including the possible mechanisms of these relationships, are insufficient.   Key words: food, intestine brain axis, central nervous system, nutrition, intestinal microbiota

Análisis del estilo de vida de los estudiantes universitarios ecuatorianos

os estilos de vida en la comunidad estudiantil universitaria tienen importantes implicaciones para la salud y el bienestar. El objetivo de este estudio fue analizar los estilos de vida y la salud de estudiantes universitarios ecuatorianos.  Se realizó mediante un estudio descriptivo-correlacional, de corte transversal. Fueron estudiados seis parámetros: socio-demografía, actividad física, consumo de alcohol, tabaco, manejo del estrés y horas de sueño. La encuesta fue aplicada en línea, a una muestra de 645 estudiantes. Se identificó que los hombres son más activos que las mujeres y que estas tienen mayor frecuencia de malos hábitos alimentarios. El consumo de alcohol es más frecuente en los estudiantes masculinos con mayor poder adquisitivo y en cuanto a los niveles elevados de estrés y menos horas de sueño fueron atribuidos a los estudiantes que asociaban alcohol y mala alimentación. Estos resultados permiten inferir que existe un elevado riesgo de padecer enfermedades crónicas no transmisibles sin una intervención oportuna. La Academia debe formular estrategias que promuevan que sus estudiantes desarrollen hábitos y estilos de vida saludables, toda vez que estos profesionales de la salud en formación serán el modelo a seguir por la población a la que prestaran sus servicios

Evaluación Nutricional en preescolares atendidos en el Hospital de Manglaralto, Santa Elena / Nutritional Evaluation of pre-school children attended in Manglaralto Hospital, Santa Elena province

Con el objetivo de analizar los hábitos alimentarios, actividad física y estado nutricional de 514 niñas y niños en edades de 3 a 5 años, se realizó una investigación de corte transversal descriptiva, no experimental, y documental con técnicas cualitativas y cuantitativas para la descripción de los datos e informaciones encontradas, la cual permitió construir la labor técnica Se trabajó con encuestas, mensuraciones antropométricas e investigaciones bioquímicas (hemoglobina) en una muestra de la población atendida en la consulta ambulatoria del Hospital Manglaralto, provincia de Santa Elena, Ecuador, 2014. Se clasificó a los preescolares en desnutridos, normopeso, sobrepeso y obeso, además de identificar la existencia de anemia. Se buscó la asociación con los hábitos alimentarios, acceso y disponibilidad de alimentos, el nivel de cultura alimentaria y escolar, pobreza económica y educación sanitaria de las familias de los preescolares. Se encontró un 44.5% de desnutridos y 0,7% con sobrepeso, además de 81.7% con anemia. Se detectó asociación entre desnutrición y anemia en más de la tercera parte de la población estudiada, además de estar asociada la presentación de Infección Respiratoria Aguda y Enfermedad Diarreica Aguda con la desnutrición y la anemia. En la población estudiada existe correspondencia entre el estado nutricional y los determinantes estudiados. AbstractA cross-sectional descriptive piece of research was conducted in order to document the eating habits, physical activity and nutritional status of 514 children aged 3-5 years. Both Qualitative and quantitative techniques were used to describe the data and information found; surveys, anthropometric evaluations and biochemical investigations (hemoglobin) were carried out on a sample of the population treated at the outpatient clinic of Manglaralto Hospital in Santa Elena province, Ecuador during 2014. Preschool children were classified as malnourished, normal weight, overweight and obese, and the existence of anemia was also identified. The data was studied to observe associations between eating habits, access to and availability of food, the level of culture in terms of diet and education, economic poverty and health education for families of preschoolers. It was found that 44.5% of the group were malnourished, 0.7% overweight, and 81.7% suffered from anemia. An association was found between malnutrition and anemia in more than a third of the population studied, with a further association between both conditions and acute respiratory infections and diarrheal disease. In the population there is a relationship between nutritional status and determining variables studied

Alimentación no saludable-sedentarismo-estrés asociados con HTA e IAM: Reporte de casos

La complejidad de la aplicación de conocimientos sobre factores de riesgo del infarto agudo de miocardio (IAM) y la hipertensión arterial (HTA) motivó realizar esta investigación para identificar características de la prevención de estas enfermedades por hombres con diagnósticos de HTA e IAM. Se realizó un estudio de casos a través de entrevistas en profundidad a cuatro enfermos del género masculino sobre sus experiencias en la protección de su salud. Los entrevistados tenían conocimientos sobre los riesgos de la mala alimentación, el sedentarismo y el estrés en relación con la HTA y el IAM, pero no aplicaron medidas de prevención hasta sufrir un IAM. Los antecedentes patológicos personales o familiares y conocimientos sobre HTA e IAM parecen necesarios, pero son insuficientes, para mejorar la alimentación, el sedentarismo y la atención al estrés. La experiencia individual de eventos de enfermedades con compromiso para la vida, pueden estimular la realización de estos cambios.The complexity of applying knowledge on risk factors for acute myocardial infarction (AMI) and high blood pressure (BP) motivated this research to identify characteristics of the prevention of these diseases from men with BP and AMI diagnoses. A case study was conducted through in-depth interviews to four male patients about their experiences in protecting their health. Interviewees had knowledge of the risks of a poor diet, sedentary lifestyle, and stress in relation to BP and AMI but did not implement prevention measures until they suffered from an AMI. Personal or family pathological history and knowledge about BP and AMI seem necessary, but are insufficient, to improve nutrition, sedentary lifestyles, and attention to stress. Individual experience from events of life-threatening diseases can stimulate the development of these changes

Reflexiones y aportaciones metodológicas

los aportes reunidos en esta obra, provienen de experiencias previas de trabajo profesional y de investigación, lo cual es resultado de distintos enfoques y vivencias de los grupos de investigación aquí involucrados, los que han interactuado en distintos eventos académicos y específicamente, en seminarios que propiciaron la producción que se reúne en esta publicación colectiva. Finalmente, esta experiencia acumulada es una de las mejores recomendaciones para la lectura por demás interesante y propositivo.El presente libro, identifica los aportes metodológicos del trabajo cotidiano en diferentes capítulos para integrarlos a los propios de las disciplinas del diseño. Asimismo, uno de los capítulos aborda la necesidad de estudiar un contexto de referencia que el destinatario pueda interpretar, entre un canal físico y una conexión psicológica a modo de estrategia interpretativa individual y colectiva. Este discurso, sostienen los coautores, se enmarca en la hermenéutica y dentro de lo colectivo, ya que este proceso se estudia desde las aportaciones del interaccionismo simbólico. Se abandona la construcción de las utopías, a la vez que busca soluciones diseñísticas, actuales y novedosas. Es así que el sentido del mensaje del objeto de diseño como texto conlleva un discurso que no “es realizado por el emisor, sino por el receptor y es la enunciación, narración y reconfiguración de los textos, en donde el discurso conforma una determinada idea de la realidad”

Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study

Background The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae. Methods Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months. Findings Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01). Interpretation Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis