El temps biològic. Els ritmes circadiaris i les seves implicacions en la salut

En el curs de l'evolució els éssers vius s'han hagut d'adaptar als canvis cíclics generats pels moviments de la Terra i, en conseqüència, presenten variacions diàries en la seva fisiologia i conducta. Els ritmes circadiaris de tots els òrgans i cèl·lules de l'organisme estan en perfecta sincronia produint una estructura orgànica ben definida en el temps. La ciència que estudia els ritmes biològics és la cronobiologia. La principal estructura que regula els ritmes circadiaris en els mamífers són els nuclis supraquiasmàtics, un conjunt de neurones a la base del cervell. La preferència de les persones a triar un horari determinat, el cronotip, ve donada per la genètica del rellotge intern, per l'edat i per la llum. Quan per determinades circumstàncies el rellotge intern es desajusta del temps extern es parla de desajust circadiari. La causa més típica de desajust circadiari són els treballs nocturns a torns, però també pot produir-se per il·luminació anòmala o per poca regularitat horària. El desajust circadiari és un risc per a la salut, i pot comportar més incidència d'alteracions metabòliques, com ara diabetis, malalties cardiovasculars i alteracions del son i la cognició. Actualment es van desenvolupant aparells automàtics de mesura contínua de variables biològiques que permeten valorar el patró circadiari i l'estabilitat rítmica. Els més emprats en les persones són els actígrafs que mesuren simultàniament l'activitat i la temperatura de la pell. El coneixement dels ritmes circadiaris introdueix el temps en la medicina i permet un estudi més integral de la fisiologia dels éssers vius

Un caso clínico sobre el consumo de riesgo de alcohol como herramienta de integración de conocimientos en el Grado de Farmacia

Grupo de Trabajo sobre el consumo de riesgo de alcohol como herramienta de integración de conocimientos en el grado de farmaciaPodeu consultar la versió catalana al camp recurs relacionat.[spa] El proyecto «Casos clínicos transversales» es una estrategia docente desarrollada en la Facultad de Farmacia de la Universidad de Barcelona, basada en la realización de casos clínicos. Su particularidad es que los casos se resuelven progresivamente en el contexto de varias asignaturas a lo largo del grado con el objetivo de favorecer la integración de conocimientos. El primer caso clínico diseñado fue sobre el consumo de riesgo de alcohol. El consumo de riesgo de alcohol es un tema de gran interés sanitario y resulta idóneo como caso clínico transversal, porque puede ser abordado desde un gran número de disciplinas. El caso se utiliza, desde cada una de las 14 asignaturas implicadas en el proyecto, como hilo conductor entre las distintas materias. De esta forma, a medida que se avanza en el grado, los estudiantes ven la evolución del personaje del caso clínico, las circunstancias de su proceso, su comportamiento y las consecuencias que de él se derivan en cuanto a la salud. En este cuaderno se presenta el proyecto docente, en general, y el caso clínico sobre el consumo de alcohol, en particular, en sus tres vertientes como herramienta: de integración de conocimientos, de coordinación de profesorado y de sensibilización social sobre el consumo de alcohol. A continuación, se presenta la problemática asociada al consumo de riesgo de alcohol sobre la salud y la metodología de implementación del caso clínico a lo largo del grado. Finalmente se muestra un resumen de los contenidos de las asignaturas que se han desarrollado durante el caso clínico. Esta actuación docente resulta de interés tanto por su metodología como por su contenido, lo que puede ser de utilidad en cualquier enseñanza en el campo de las ciencias de la salud.[eng] «Transversal clinical cases» is a teaching innovation project developed at the Faculty of Pharmacy and Food Sciences of the University of Barcelona based on the use of clinical cases as a tool to implement transversal education. With the aim of promoting integrated knowledge acquisition, the goal of the project is to resolve clinical cases with high prevalence in the population in a gradual manner during the Pharmacy degree. The first clinical case considered addressed risk alcohol consumption. Risk consumption of alcohol is a serious health and social problem that provides an ideal clinical case for students given that it can be approached from many disciplines. The case is specifically treated as a common thread in 14 subjects of the Pharmacy degree programme. Therefore, as the students advance in the curriculum programme of the degree, they will notice the evolution of the character of the clinical case, the circumstances of its evolution, its behaviour and the consequences that derive from these aspects in terms of health. This book presents the educational project and the case of alcohol consumption in three areas as a tool for: knowledge integration, teacher's coordination and social awareness of the alcohol consumption. Problems associated with alcohol abuse and the implementation methodology of the case are presented. Moreover, the level of alcohol intake in the student population, according to surveys conducted over the years the project took place, is presented as an example of casuistry consumption in students. Finally, a summary of the teaching contents developed in each subject of the project are also shown. This educational activity is of interest for both the methodology used and the content itself, which may be useful for improving teaching procedures in the field of Health Sciences

Un cas clínic sobre el consum de risc d'alcohol com a eina d'integració de coneixements en el Grau de Farmàcia

Podeu consultar la versió castellana al camp recurs relacionat.El projecte «Casos clínics transversals» és una estratègia docent desenvolupada a la Facultat de Farmàcia de la Universitat de Barcelona basada en la realització de casos clínics. La seva particularitat és que els casos es resolen progressivament en el context de diverses assignatures al llarg del grau amb l’objectiu d’afavorir la integració de coneixements. El primer cas clínic dissenyat va ser sobre el consum de risc d’alcohol. El consum de risc d'alcohol és un tema de gran interès sanitari i resulta idoni com a cas clínic transversal perquè pot ser abordat des d'un gran nombre de disciplines. El cas s'utilitza, des de cadascuna de les 14 assignatures implicades en el projecte, com a fil conductor entre les diverses matèries. D'aquesta manera a mesura que s'avança en el grau, els estudiants veuen l'evolució del personatge del cas clínic, les circumstàncies del seu procés, el seu comportament i les conseqüències que d'aquest se'n deriven pel que fa a salut. En aquest quadern es presenta el projecte docent, en general, i el cas clínic sobre consum d’alcohol, en particular, en les seves tres vessants: com a eina d’integració de coneixements, de coordinació de professorat i de sensibilització social sobre el consum d’alcohol. A continuació es presenta la problemàtica associada al consum de risc d’alcohol sobre la salut i la metodologia d’implementació del cas clínic al llarg del grau. Finalment es mostra un breu resum dels continguts de les assignatures que s’han desenvolupat durant el cas clínic. Aquesta actuació docent resulta d’interès tant per la seva metodologia com pel seu contingut, el qual pot ser d’utilitat en qualsevol ensenyament en el camp de Ciències de la Salut

Social jet lag associates negatively with the adherence to the Mediterranean Diet and Body Mass Index among young adults

Obesity and unhealthy eating habits have been associated with irregular sleep-wake patterns during the week, also known as social jet lag. The Mediterranean diet is a healthy pattern related with a better health and sleep quality. However, potential associations with social jet lag remain unexplored. The aim of this study was to examine whether higher social jet lag is linked to lower adherence to the Mediterranean diet and whether it is associated with BMI (Body Mass Index). This cross-sectional study included 534 young adults (18-25 years). Anthropometric parameters, adherence to the Mediterranean diet, chronotype and social jet lag were studied. Our results revealed that individuals with greater social jet lag showed lower adherence to the Mediterranean diet and had a higher BMI. Among the habits that characterized the Mediterranean dietary pattern, we observed that higher social jet lag was significantly associated with a lower intake of fruits and vegetables, as well as skipping breakfast. Hence, the promotion of regular sleep habits together with healthy dietary patterns should be considered for obesity prevention, especially among young adults. KEYWORDS: BMI; Mediterranean diet; Social jet lag; chronotype; young adult

Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) patients frequently show autonomic symptoms which may be associated with a hypothalamic dysfunction. This study aimed to explore circadian rhythm patterns in rest and activity and distal skin temperature (DST) and their association with self-reported outcome measures, in CFS/ME patients and healthy controls at two different times of year. Ten women who met both the 1994 CDC/Fukuda definition and 2003 Canadian criteria for CFS/ME were included in the study, along with ten healthy controls matched for age, sex and body mass index. Self-reported measures were used to assess fatigue, sleep quality, anxiety and depression, autonomic function and health-related quality of life. The ActTrust actigraph was used to record activity, DST and light intensity, with data intervals of one minute over seven consecutive days. Sleep variables were obtained through actigraphic analysis and from subjective sleep diary. The circadian variables and the spectral analysis of the rhythms were calculated. Linear regression analysis was used to evaluate the relationship between the rhythmic variables and clinical features. Recordings were taken in the same subjects in winter and summer. Results showed no differences in rhythm stability, sleep latency or number of awakenings between groups as measured with the actigraph. However, daily activity, the relative amplitude and the stability of the activity rhythm were lower in CFS/ME patients than in controls. DST was sensitive to environmental temperature and showed lower nocturnal values in CFS/ME patients than controls only in winter. A spectral analysis showed no differences in phase or amplitude of the 24h rhythm, but the power of the second harmonic (12h), revealed differences between groups (controls showed a post-lunch dip in activity and peak in DST, while CFS/ME patients did not) and correlated with clinical features. These findings suggest that circadian regulation and skin vasodilator responses may play a role in CFS/ME

Emotional eating is associated to sleep quality in Spanish young adults

Podeu consultar el III Workshop anual INSA-UB complet a: http://hdl.handle.net/2445/118993Sessió 1. Pòster núm. 1

Morningness and sleep quality improve adherence to Mediterranean Diet

Podeu consultar el III Workshop anual INSA-UB complet a: http://hdl.handle.net/2445/118993Sessió 2. Comunicació oral núm.

Eating jet lag: A marker of the variability in meal timing and its association with body mass index

The timing of food intake has been associated with obesity and adverse metabolic outcomes, independently of the amount or content of food intake and activity level. However, the impact of the variability in the timing of food intake between weekends and weekdays on BMI (body mass index) remains unexplored. To address that, we propose to study a marker of the variability of meal timing on weekends versus weekdays (denominated as 'eating jet lag') that could be associated with increments in BMI. This cross-sectional study included 1106 subjects (aged 18-25 years). Linear regression models were used to examine the associations of eating jet lag with BMI and circadian related variables (including chronotype, eating duration, sleep duration, and social jet lag). Subsequently, a hierarchical multivariate regression analysis was conducted to determine whether the association of eating jet lag with BMI was independent of potentially confounding variables (e.g., chronotype and social jet lag). Moreover, restricted cubic splines were calculated to study the shape of the association between eating jet lag and BMI. Our results revealed a positive association between eating jet lag and BMI (p = 0.008), which was independent of the chronotype and social jet lag. Further analysis revealed the threshold of eating jet lag was of 3.5 h or more, from which the BMI could significantly increase. These results provided evidence of the suitability of the eating jet lag, as a marker of the variability in meal timing between weekends and weekdays, for the study of the influence of meal timing on obesity. In a long run, the reduction of the variability between meal timing on weekends versus weekdays could be included as part of food timing guidelines for the prevention of obesity among general population

A new chronobiological approach to discriminate between acute and chronic depression using peripheral temperature, rest-activity, and light exposure parameters

Background: Circadian theories for major depressive disorder have suggested that the rhythm of the circadian pacemaker is misaligned. Stable phase relationships between internal rhythms, such as temperature and rest/activity, and the external day-night cycle, are considered to be crucial for adapting to life in the external environmental. Therefore, the relationship and possible alterations among (i) light exposure, (ii) activity rhythm, and (iii) temperature rhythm could be important factors in clinical depression. This study aimed to investigate the rhythmic alterations in depression and evaluate the ability of chronobiological parameters to discriminate between healthy subjects and depressed patients. Methods: Thirty female subjects, including healthy subjects, depressed patients in the first episode, and major recurrent depression patients. Symptoms were assessed using Hamilton Depression Scale, Beck Depression Inventory and Montgomery-Äsberg Scale. Motor activity, temperature, and light values were determined for 7 days by actigraph, and circadian rhythms were calculated. Results: Depressed groups showed a lower amplitude in the circadian rhythm of activity and light exposure, but a higher amplitude in the rhythm of peripheral temperature. The correlation between temperature and activity values was different in the day and night among the control and depressed groups. For the same level of activity, depressed patients had lowest temperature values during the day. The amplitudes of temperature and activity were the highest discriminant parameters. Conclusions: These results indicate that the study of rhythms is useful for diagnosis and therapy for depressive mood disorders