Obesidad en la infancia y en la adolescencia

La obesidad se considera en la actualidad un problema de salud pública mundial debido al constante aumento de su prevalencia asociado a los cambios en los estilos de vida de la población, que incluyen la inactividad física y el incremento en el ingreso de calorías. Además, existe una baja percepción del problema por parte de las familias, sobre todo de aquellas que tienen más riesgo. La prevalencia actual en nuestro país se estima en un 14%. Determinados sujetos pueden tener una mayor predisposición genética a aumentar de peso, y los genes pueden no expresarse totalmente hasta la etapa adulta. En este artículo, se abordarán: la etiopatogenia y su clasifi cación, la elevada comorbilidad asociada, así como el abordaje diagnóstico y terapéutico. La base fundamental del tratamiento es la instauración de un programa multidisciplinar a largo plazo que asocie educación nutricional, aumento de la actividad física, restricción dietética y modifi caciones de la conducta de la población. Se debe iniciar la prevención en edades precoces; ya que, los hábitos de salud se establecen en la infancia y, posteriormente, será muy difícil modifi carlos. El pediatra tiene un gran protagonismo detectando los factores y poblaciones de riesgo, ejerciendo una acción educadora a nivel de las familias, sus hijos, la escuela y los ámbitos sociales y políticos.Obesity is now considered a global public health problem due to the constant increase in its prevalence associated with changes in the population’s lifestyles, including the reduction in physical inactivity and an increase in caloric intake. There is also a low awareness of the problem in families, especially those at higher risk. The current prevalence in Spain is estimated at 14%. Certain individuals may have a greater genetic predisposition to gain weight, and genes may not be fully expressed until adulthood. This article addresses: pathogenesis and its classifi cation, high comorbidity associated with obesity and its diagnostic and therapeutic approach. The basis of the treatment is to establish a multidisciplinary program that combines a long-term nutritional education, an increase in physical activity, a dietary restriction and certain behavioral modifi cations in the population. Prevention should be initiated at earlier ages, since health habits are established during childhood and are very complicated to change afterwards. Pediatricians play a major role in detecting factors and segments of the population at risk, ensuring the education in families, their children and in schools and other social and political environments

Delayed haemolysis after artesunate therapy in a cohort of patients with severe imported malaria due to Plasmodium falciparum

INTRODUCTION: Delayed haemolytic anaemia is one of the more frequent events after treatment with intravenous artesunate in patients with severe malaria. Little is known about its frequency and the outcomes of patients with this condition. METHODS: A retrospective study was conducted to describe the incidence of delayed haemolysis in a cohort of patients with severe malaria by Plasmodium falciparum treated with artesunate between August 2013 and July 2015. RESULTS: The study included 52 patients with malaria due to Plasmodium falciparum, with 21 having severe malaria. The majority were male (66.7%), and the median age was 43 years. Four patients (19%) presented post-artesunate delayed haemolysis 11-13 days from the initiation of treatment. Two patients required hospital admission and red blood cell transfusion. CONCLUSION: Post-artesunate delayed haemolysis is frequent in patients with severe malaria treated with intravenous artemisinins. These patients should be monitored for 4 weeks after treatment is started

Central and peripheral fatigue in recreational trail runners: A pilot study

[Abstract]: Background: Understanding fatigue mechanisms is crucial for exercise performance. However, scientific evidence on non-invasive methods for assessing fatigue in trail running competitions is scarce, especially when vertical kilometer trail running races (VK) are considered. The main purpose of this study was to assess the autonomic nervous system (ANS) activity (i.e., central fatigue) and the state of muscle activation (i.e., peripheral fatigue) before and after a VK competition. Methods: A cross-sectional pilot study was performed. After applying inclusion/exclusion criteria, 8 recreational male trail runners (31.63 7.21 yrs, 1.75 m 0.05 m, 70.38 5.41 kg, BMI: 22.88 0.48, running experience: 8.0 3.63 yrs, weekly training volume: 58.75 10.35 km) volunteered to participate and were assessed for both central (i.e., via heart rate variability, HRV) and peripheral (via tensiomyography, TMG) fatigue before and after a VK race. Results: After the VK, resting heart rate, RMSSD (p = 0.01 for both) and SDNN significantly decreased (p = 0.02), while the stress score and the sympathetic-parasympathetic ratio increased (p = 0.01 and p = 0.02, respectively). The TMG analyses suggest that runners already suffered peripheral fatigue before the VK and that 20–30 min are enough for muscular recovery after the race. In summary, our data suggest that participants experienced a pre-competition fatigue status. Further longitudinal studies are necessary to investigate the mechanisms underlying fatigue during trail running races, while training periodization and tapering strategies could play a key role for minimizing pre-competition fatigue status

Green light photoelectrocatalysis with sulfur-doped carbon nitride : using triazole-purpald for enhanced benzylamine oxidation and oxygen evolution reactions

Novel high performing materials will dictate the pace of reinventing industrial chemical processes to attain desired carbon neutrality targets. Regarding the urgency of exploiting solar irradiation long range visible-light photoelectrocatalysts from abundant resources will play a key role in the aforementioned effort. Anionic doping via co-polymerization and pre-organization of precursors results in tuneable and extrinsic semiconductors, making this a highly attractive methodology. Triazole derivative-purpald, an unexplored precursor but sulfur (S) container, combined with melamine during one solid-state polycondensation reaction with two thermal steps leads to S-doped carbon nitrides (C34). The series of S-doped/CN4-based materials demonstrated enhanced optical, electronic, structural, geometric, textural, and morphological properties and exhibited higher performance in organic benzylamine photooxidation, oxygen evolution, and similar storing energy (capacitor brief investigation) than references. Among the five composites, 50M-50P exhibited the highest photooxidation conversion yield (84±3%) of benzylamine to imine at 535 nm – green light for 48h, due to an extra discrete shoulder reaching ~700 nm, an unusual high sulfur content, preservation of crystal size, new intraband energy states, rare deep structural defects by layer distortion, hydrophobic surface, low porosity, and 10-16 nm pores. An in-depth analysis of S doping was investigated coupling x-ray photoelectron spectroscopy, transmission electron microscope, and elemental analysis, providing insights on bonds, distribution, and surface/bulk content. This work contributes to the development of amorphous photocatalysts with long-visible-light range for solar energy conversion and storage

Green Light Photoelectrocatalysis with Sulfur-Doped Carbon Nitride: Using Triazole-Purpald for Enhanced Benzylamine Oxidation and Oxygen Evolution Reactions

Materials dictate carbon neutral industrial chemical processes. Visible-light photoelectrocatalysts from abundant resources will play a key role in exploiting solar irradiation. Anionic doping via pre-organization of precursors and further co-polymerization creates tuneable semiconductors. Triazole derivative-purpald, an unexplored precursor with sulfur (S) container, combined in different initial ratios with melamine during one solid-state polycondensation with two thermal steps yields hybrid S-doped carbon nitrides (C3N4). The series of S-doped/C3N4-based materials show enhanced optical, electronic, structural, textural, and morphological properties and exhibit higher performance in organic benzylamine photooxidation, oxygen evolution, and similar energy storage (capacitor brief investigation). 50M-50P exhibits the highest photooxidation conversion (84 ± 3%) of benzylamine to imine at 535 nm – green light for 48 h, due to a discrete shoulder (≈700) nm, high sulfur content, preservation of crystal size, new intraband energy states, structural defects by layer distortion, and 10–16 nm pores with arbitrary depth. This work innovates by studying the concomitant relationships between: 1) the precursor decomposition while C3N4 is formed, 2) the insertion of S impurities, 3) the S-doped C3N4 property-activity relationships, and 4) combinatorial surface, bulk, structural, optical, and electronic characterization analysis. This work contributes to the development of disordered long-visible-light photocatalysts for solar energy conversion and storage

The role of red blood cell exchange for severe imported malaria in the artesunate era: a retrospective cohort study in a referral centre

BACKGROUND: Intravenous artesunate has replaced quinine as the first-line therapy for severe imported malaria, given its anti-malarial superiority shown in clinical trials conducted in endemic countries. Evidence for red blood cell (RBC) exchange in patients with severe malaria treated with artesunate is lacking. This retrospective cohort study describes the experience at Hospital Clinic of Barcelona with the use of artesunate for severe malaria and the joint use of RBC exchange in selected cases. METHODS: Patients treated for severe malaria at Hospital Clinic of Barcelona between August 2013 and January 2015 were included in this retrospective study. Severe malaria was defined according to WHO criteria. Data were extracted from electronic hospital records. A log-linear mixed model approach was used to estimate parasite clearance times. RESULTS: Within the study period, 42 patients were diagnosed of malaria at this centre, of which 38 had Plasmodium falciparum (90.5 %). Sixteen patients (42 %) had severe malaria cases and were treated with intravenous artesunate. Four patients underwent RBC exchange within a period of 15 h after the first dose of artesunate (range 9-21 h). The procedure lasted a median of 2 h (IQR 1.8-2 h), using a median of 12 (IQR 11-14) units of packed RBCs to replace a median of 3794 ml (IQR 2977-4343). The technique was well-tolerated without haemodynamic complications. There were no deaths. The regression model showed an estimated time to 95 % decay of 21.6 h (95 % CI 17.3-28.8). When assessing effect modification by RBC exchange, there was no difference in the parasite elimination rate (p = 0.286). DISCUSSION AND CONCLUSION: In this study RBC exchange failed to show benefits in terms of parasite clearance probably due to the small number of patients analysed. The evidence for exchange transfusion remains limited

Morphological, Electrical, and Chemical Characteristics of Poly(sodium 4-styrenesulfonate) Coated PVDF Ultrafiltration Membranes after Plasma Treatment

A commercial ultrafiltration (UF) membrane (HFM-183 de Koch Membrane Systems) made of poly(vinylidene fluoride) (PVDF), was recovered with a negatively-charged polyelectrolyte (poly(sodium 4-styrenesulfonate)) (PSS), and the effects on its electric, chemical, and morphological properties were analyzed. Atomic force microscopy (AFM), liquid-liquid displacement porometry, Electrical Impedance Spectroscopy, X-ray photoelectron spectroscopy, and Raman spectroscopy were used to investigate the modifications induced by the deposition of PSS on the PVDF positively-charged membrane and after its treatment by a radio frequency Ar-plasma. These techniques confirmed a real deposition and posterior compaction of PSS with increasing roughness and decreasing pore sizes. The evolution of the electric resistances of the membranes confirmed crosslinking and compaction with shielding of the sulfonated groups from PSS. In this way, a membrane with a negatively-charged active layer and a pore size which was 60% lower than the original membrane was obtained. The composition of the additive used by manufacturers to modify PVDF to make it positively charged was obtained by different procedures, all of which depended upon the results of X-ray photoelectron spectroscopy, leading to fairly consistent results. This polymer, carrying positive charges, contains quaternary nitrogen, as confirmed by XPS. Moreover, Raman spectroscopy confirmed that PVDF changes from mostly the β to the α phase, which is more stable as a substrate for the deposited PSS. The aim of the tested modifications was to increase the retention of divalent anions without reducing permeability.Fil: Sandoval Olvera, Ivette G.. Universidad de Guanajuato; MéxicoFil: González Muñoz, Pilar. Universidad de Guanajuato; MéxicoFil: Diaz, Dario Ramón. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich". Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich"; ArgentinaFil: Maroto Valiente, Ángel. Universidad de Guanajuato; MéxicoFil: Ochoa, Nelio Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich". Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich"; ArgentinaFil: Carmona, Francisco J.. Universidad de Extremadura; EspañaFil: Palacio, Laura. Universidad de Valladolid. Facultad de Ciencias; EspañaFil: Calvo, José I.. Universidad de Valladolid. Facultad de Ciencias; EspañaFil: Hernández, Antonio. Universidad de Valladolid. Facultad de Ciencias; EspañaFil: Ávila Rodríguez, Mario. Universidad de Guanajuato; MéxicoFil: Prádanos, Pedro. Universidad de Valladolid. Facultad de Ciencias; Españ

Hypogonadotropic hypogonadism in Klinefelter syndrome and hypothalamic-pituitary tumor

El síndrome de Klinefelter es la causa más frecuente de hipogonadismo hipergonadotropo en el varón. La supresión en la respuesta al estímulo con hormona liberadora de la hormona luteinizante en estos pacientes debe hacer sospechar como posible etiología una tumoración a nivel hipotalámico. Se presenta el caso de un paciente diagnosticado a los 4 meses con síndrome de Klinefelter mediante cribado neonatal, con cariotipo 47 XXY, en el que se realizan controles clínicos y analíticos seriados y se encuentran, a los 17 años, valores suprimidos de hormona luteinizante y hormona folículo estimulante. Inicia, posteriormente, cefalea y amaurosis de ojo izquierdo, y se encuentra, en una resonancia magnética cerebral, un tumor germinal mixto a nivel hipotalámico, que precisa tratamiento quirúrgico, quimioterapia y radioterapia, con respuesta favorable. Klinefelter Syndrome is the most frequent cause of hypergonadotropic hypogonadism in men. A flat response at luteinizing hormone releasing hormone stimulation test could be the first sign of hypothalamic tumor in these patients. We report the case of a patient diagnosed by neonatal screening with Klinefelter Syndrome, 47 XXY, that at 17 years follow-up presents analytical modification of the response to luteinizing hormone releasing hormone stimulation test with suppressed luteinizing hormone and follicle-stimulating hormone values; lately he presents with headache and loss of left eye vision. A magnetic resonance imaging of the brain showed a mixed germ cell hypothalamus tumor, requiring surgery, chemotherapy and radiotherapy with optimal response

Monitoring the complex benthic habitat on semi-dark underwater marine caves using photogrammetry-based 3D reconstructions

Marine caves are dark environments considered a priority habitat for conservation included in the EU Habitats Directive (H8330). They harbor fragile benthic communities and represent a major reservoir of marine biodiversity. However, there is a lack of knowledge of these habitats due to the difficulties of creating detailed benthic maps and characterizing the biodiversity, structure, and dynamics of their communities. The uniqueness of marine caves fosters their popularity among recreational divers, who can cause disturbances through abrasion of the biota, resuspension of sediment, and accumulation of exhaled air bubbles in the caves' ceilings. This study aims to build a monitoring framework to characterize the structure and temporal dynamics of this complex habitat using Structurefrom- Motion (SfM) photogrammetry. SfM is a novel, non-invasive technique that allows a major advancement in the monitoring of changes in the cave’s community assemblages. This method relies on images acquired by 4K video footage to build fine-scaled 3D digital models of the substrate using overlapping imagery. For this study, we combined SfM photogrammetry and photo quadrats extracted from the video recordings. We evaluate the effectiveness of this methodology in a marine cave highly frequented by divers, located in Illa de l’Aire (Balearic Islands, Spain), and carried out two surveys before and after the diving season (2019-2021). As a result, we found a loss of 25 colonies of bryozoans with fragile skeletons, like Schizoretepora sp., and 8 individual sponges with globose morphotypes. Our results indicate that this methodology enables accurate and efficient monitoring of benthic communities in underwater caves that allow us to better understand their dynamics and, therefore, to develop the need management measures

Global hyperactivation of enhancers stabilizes human and mouse naïve pluripotency through inhibition of CDK8/19 Mediator kinases

Pluripotent stem cells (PSCs) transition between cell states in vitro and reflect developmental changes in the early embryo. PSCs can be stabilized in the naïve state by blocking extracellular differentiation stimuli, particularly FGF-MEK signaling. Here, we report that multiple features of the naïve state in human and mouse PSCs can be recapitulated without affecting FGF-MEK-signaling or global DNA methylation. Mechanistically, chemical inhibition of CDK8 and CDK19 kinases removes their ability to repress the Mediator complex at enhancers. Thus CDK8/19 inhibition increases Mediator-driven recruitment of RNA Pol II to promoters and enhancers. This efficiently stabilizes the naïve transcriptional program and confers resistance to enhancer perturbation by BRD4 inhibition. Moreover, naïve pluripotency during embryonic development coincides with a reduction in CDK8/19. We conclude that global hyperactivation of enhancers drives naïve pluripotency, and this can be achieved in vitro by inhibiting CDK8/19 kinase activity. These principles may apply to other contexts of cellular plasticity