The effect of orlistat on postprandial hypertriglyceridemia by oral fat loading test. A systematic review

Orlistat induces weight loss by blocking hydrolysis of triglyceride in the intestine, and has thereby been associated with favorable changes in postprandial triglycerides (ppTGL). Some epidemiological studies have identified ppTGL concentrations as a significant risk factor for cardiovascular disease. Oral fat loading test (OFLT) has been used for screening of elevated levels of ppTGL. The objective of the present systematic review is to present available data on the effects of orlistat on OFLT. We found 11 studies, seven of which studied the effect of a single dose of orlistat on OFLT in three healthy volunteers, one with obesity, two with type-2 diabetes and one with hyperlipidemic patients. The other four studied the effect of orlistat on OFLT, but after a previous period of time with daily treatment with orlistat: 1 healthy volunteer, 2 obese volunteers, and one patient with hyperlipidemia. Our systematic review suggests that orlistat can help to reduce postprandial hypertriglyceridemia in obese, dyslipemic and type-2 diabetic patients. Regarding free fatty acids, they could be reduced but not all the authors have found the same results. In relation to type-2 diabetic patients, we have found three studies with conflicting results on the immediate effect of orlistat on the postprandial GLP-1 response. In conclusion, orlistat can help to reduce postprandial plasmatic TGL, especially in patients with postprandial hypertriglyceridemia related to obesity, dyslipidemia or type-2 diabetes

Accommodation Response Variations in University Students under High Demand for Near-Vision Activity

The objective of this study was to investigate accommodation changes and visual discomfort in a university student population after a period of high demand for near-vision activity. A total of 50 university students aged between 20 and 22 years were recruited. The tests performed involved positive relative accommodation (PRA), negative relative accommodation (NRA), accommodation amplitude (AA), and monocular and binocular accommodative facility (MAF and BAF). Visual discomfort was measured on a scale involving a visual discomfort questionnaire (VDQ). All accommodative variables underwent changes during the exam period; specifically, regarding NRA and PRA, 30.4% and 15.1% of the studied population, respectively, appeared to be below average. Moreover, 42.3% of the population exhibited values below average in the second measure of AA. On the other hand, a small percentage of the population was below average in MAF and BAF measurements: 3% in the monocular right eye test, 6% in the left eye test, and 9.1% in the binocular facility test. Finally, the VDQ score did not reveal a statistically significant difference between the two measurements. Prolonged near-distance work, such as a university exams period, changed all accommodation systems (amplitude of accommodation, relative accommodation, and accommodation facility). These changes influence an accommodation excess that results in blurred vision, headache, and problems with focusing

Validación del Cuestionario de Preferencias de Soporte Vital (LSPQ) para su uso en la población española

ObjetivoValidar el Cuestionario de Preferencias de Soporte Vital (LSPQ) para su uso en población española.DiseñoEstudio realizado en tres fases: a) traducción y adaptación idiomática; b) evaluación de su validez, y c) validación de sus propiedades psicométricas.EmplazamientoEl estudio se ha llevado a cabo en 9 consultas de enfermería de atención primaria y en 2 aulas universitarias de Granada.ParticipantesSe incluyeron pacientes mayores de edad y estudiantes universitarios de primer y segundo cursos, sin deterioro cognitivo.Mediciones principalesEquivalencia de la traducción con el original verificada por bilingües. Corrección lingüística y gramatical evaluada por expertos en lengua española. Validez del cuestionario evaluada por 15 jueces-expertos y 20 pacientes.Complejidad lingüística (índice de Szigriszt). Estabilidad temporal (test de McNemar). Consistencia interna (alfa de Cronbach).Resultadosa) 2 personas bilingües realizaron una traducción que fue revisada por 6 expertos en lengua española. Tras las modificaciones que sugirieron, las personas bilingües aseguraron su equivalencia con el original; b) 15 expertos afirmaron que cada ítem era buen indicador de las preferencias de cuidado al final de la vida; c) 20 usuarios confirmaron la aceptabilidad y comprensibilidad del cuestionario; d) en relación con la fiabilidad, completaron el cuestionario 299 participantes (de los 369 inicialmente seleccionados), y e) la estabilidad del cuestionario es de 0,92 y su consistencia interna de 0,85.ConclusiónEl cuestionario LSPQen español (LSPQ-e) es una herramienta fiable diseñada para ayudar a los pacientes a clarificar sus preferencias de cuidado y tratamiento al final de la vida.ObjectiveTo validate the Life-Support Preferences Questionnaire (LSPQ) for its use in Spain.DesignThree-stage study: a) translation and linguistic adaptation; b) evaluation of its validity; and c) validation of its psychometric properties.SettingNine primary care nursing clinics and 2 university classes in Granada, Spain.ParticipantsPatients who were of age and were first- or second-year university students, without any cognitive deterioration.Main measurementsThe equivalence of the translation and the original was checked by bilingual people; its linguistic and grammatical standard was appraised by experts in Spanish. The validity of the questionnaire was evaluated by 15 judges-experts and 20 patients; linguistic complexity (Szigriszt index); stability in time (McNemar test); internal consistency (Cronbach's alpha).Resultsa) 2 bilingual people did a translation that was reviewed by 6 experts in Spanish. After alterations suggested by the experts, the bilingual people ratified its equivalence with the original; b) 15 experts affirmed that each item was a good indicator of care preferences atthe end of life; c) 20 users confirmed the acceptability and comprehensibility of the questionnaire; d) reliability: 299 participants out of the 369 initially selected filled in the questionnaire; and e) its stability was 0.92; and its internal consistency, 0.85.ConclusionThe LSPQ questionnaire in Spanish (LSPQ-e) is a reliable tool, designed to help patients to clarify their care and treatment preferences at the end of their lives

Accommodation Response Variations in University Students under High Demand for Near-Vision Activity

The objective of this study was to investigate accommodation changes and visual discomfort in a university student population after a period of high demand for near-vision activity. A total of 50 university students aged between 20 and 22 years were recruited. The tests performed involved positive relative accommodation (PRA), negative relative accommodation (NRA), accommodation amplitude (AA), and monocular and binocular accommodative facility (MAF and BAF). Visual discomfort was measured on a scale involving a visual discomfort questionnaire (VDQ). All accommodative variables underwent changes during the exam period; specifically, regarding NRA and PRA, 30.4% and 15.1% of the studied population, respectively, appeared to be below average. Moreover, 42.3% of the population exhibited values below average in the second measure of AA. On the other hand, a small percentage of the population was below average in MAF and BAF measurements: 3% in the monocular right eye test, 6% in the left eye test, and 9.1% in the binocular facility test. Finally, the VDQ score did not reveal a statistically significant difference between the two measurements. Prolonged near-distance work, such as a university exams period, changed all accommodation systems (amplitude of accommodation, relative accommodation, and accommodation facility). These changes influence an accommodation excess that results in blurred vision, headache, and problems with focusing

Diez líneas verdes

Se desarrolla un proyecto de innovación educativa que pretende fomentar el respeto y cuidado medioambiental, creando y desarrollando la conciencia y sensibilidad. Se desarrolla a lo largo del curso 2006-2007 para todos los ciclos de Educación Infantil y Educación Primaria, se integra en el currículo y se trabaja por ciclos y asambleas las actividades del seminario. La metodología empleada en la práctica del proyecto se basa en la observación, experimentación y expresión de lo vivido en un clima de sensibilización hacia el medio ambiente. Se realizan talleres escolares, salidas a la naturaleza, fabricación de instrumentos con materiales de desecho, disfraces y plantación de plantas en un huerto entre otras actividades. Se realiza una evaluación continua de las actividades llevadas a acabo y al final se pasa una encuesta a los padres, profesorado y alumnado para realizar un sondeo de las opiniones de las tareas realizadas en el proyecto de innovación educativa. La mayoría del alumnado ha mejorado sus hábitos tanto dentro como fuera del colegio, ha aprendido a reciclar y han transmitido a sus familias estas nuevas conductas aprendidas. El profesorado y los padres opinan que el proyecto es muy útil y positivo para el alumnado. Se ha conseguido implicar a la comunidad educativa, haciendo efectiva su participación en la Red de Centros Comprometidos con el Medio Ambiente. En general el proyecto de innovación educativa es de fácil aplicación en el aula, genera hábitos y cambios de conducta medioambiental y por ello es conveniente darle continuidad en el centro para afianzar los hábitos creados.Castilla y LeónConsejería de Educación. Dirección General de Universidades e Investigación; Monasterio de Nuestra Señora de Prado, Autovía Puente Colgante s. n.; 47071 Valladolid; +34983411881; +34983411939ES

Non-invasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea.

Non-invasive ventilation (NIV) is an effective form of treatment in patients with obesity hypoventilation syndrome (OHS) who have concomitant severe obstructive sleep apnoea (OSA). However, there is a paucity of evidence on the efficacy of NIV in patients with OHS without severe OSA. We performed a multicentre randomised clinical trial to determine the comparative efficacy of NIV versus lifestyle modification (control group) using daytime arterial carbon dioxide tension (PaCO2) as the main outcome measure. Between May 2009 and December 2014 we sequentially screened patients with OHS without severe OSA. Participants were randomised to NIV versus lifestyle modification and were followed for 2 months. Arterial blood gas parameters, clinical symptoms, health-related quality of life assessments, polysomnography, spirometry, 6-min walk distance test, blood pressure measurements and healthcare resource utilisation were evaluated. Statistical analysis was performed using intention-to-treat analysis. A total of 365 patients were screened of whom 58 were excluded. Severe OSA was present in 221 and the remaining 86 patients without severe OSA were randomised. NIV led to a significantly larger improvement in PaCO2 of -6 (95% CI -7.7 to -4.2) mm Hg versus -2.8 (95% CI -4.3 to -1.3) mm Hg, (p NIV is more effective than lifestyle modification in improving daytime PaCO2, sleepiness and polysomnographic parameters. Long-term prospective studies are necessary to determine whether NIV reduces healthcare resource utilisation, cardiovascular events and mortality. NCT01405976; results