Knowledge and Practice of Health Professionals in the Management of Dysphagia

Background: Dysphagia is associated with poor outcome in stroke patients. Studies investigating the association of dysphagia and early dysphagia screening (EDS) with outcomes in patients with acute ischemic stroke (AIS) are rare. The aims of our study are to investigate the association of dysphagia and EDS within 24 h with stroke-related pneumonia and outcomes. Methods: Over a 4.5-year period (starting November 2007), all consecutive AIS patients from 15 hospitals in Schleswig-Holstein, Germany, were prospectively evaluated. The primary outcomes were stroke-related pneumonia during hospitalization, mortality, and disability measured on the modified Rankin Scale >= 2-5, in which 2 indicates an independence/slight disability to 5 severe disability. Results: Of 12,276 patients (mean age 73 +/- 13; 49% women), 9,164 patients (74%) underwent dysphagia screening; of these patients, 55, 39, 4.7, and 1.5% of patients had been screened for dysphagia within 3, 3 to 72 h following admission. Patients who underwent dysphagia screening were likely to be older, more affected on the National Institutes of Health Stroke Scale score, and to have higher rates of neurological symptoms and risk factors than patients who were not screened. A total of 3,083 patients (25.1%; 95% CI 24.4-25.8) had dysphagia. The frequency of dysphagia was higher in patients who had undergone dysphagia screening than in those who had not (30 vs. 11.1%; p < 0.001). During hospitalization (mean 9 days), 1,271 patients (10.2%; 95% CI 9.7-10.8) suffered from stroke-related pneumonia. Patients with dysphagia had a higher rate of pneumonia than those without dysphagia (29.7 vs. 3.7%; p < 0.001). Logistic regression revealed that dysphagia was associated with increased risk of stroke-related pneumonia (OR 3.4; 95% CI 2.8-4.2; p < 0.001), case fatality during hospitalization (OR 2.8; 95% CI 2.1-3.7; p < 0.001) and disability at discharge (OR 2.0; 95% CI 1.6-2.3; p < 0.001). EDS within 24 h of admission appeared to be associated with decreased risk of stroke-related pneumonia (OR 0.68; 95% CI 0.52-0.89; p = 0.006) and disability at discharge (OR 0.60; 95% CI 0.46-0.77; p < 0.001). Furthermore, dysphagia was independently correlated with an increase in mortality (OR 3.2; 95% CI 2.4-4.2; p < 0.001) and disability (OR 2.3; 95% CI 1.8-3.0; p < 0.001) at 3 months after stroke. The rate of 3-month disability was lower in patients who had received EDS (52 vs. 40.7%; p = 0.003), albeit an association in the logistic regression was not found (OR 0.78; 95% CI 0.51-1.2; p = 0.2). Conclusions: Dysphagia exposes stroke patients to a higher risk of pneumonia, disability, and death, whereas an EDS seems to be associated with reduced risk of stroke-related pneumonia and disability. (C) 2016 S. Karger AG, Base

Cambios en la microbiota intestinal y el metaboloma fecal en función del daño de la mucosa intestinal

Resumen del trabajo presentado a la 16ª Reunión de la Red Española de Bacterias Lácticas (RedBAL), celebrada en Madrid los días 11 y 12 de mayo de 2023.RTI2018-098288-B-I00, MCIN/AEI/10.13039/501100011033/FEDER, “Una manera de hacer Europa”; AYUD/2021/50981, Principado de Asturias; S.R.-S., contrato predoctoral Severo Ochoa (2021- BP20-012), Principado de Asturias; S.A., contrato postdoctoral del ISPA; N.S., contrato RYC2021-033521-I, MCIN/AEI/ 10.13039/501100011033 y European Union NextGenerationEU/PRTR.N

Land inclination controls CO2 and N2O fluxes, but not CH4 uptake, in a temperate upland forest soil

Inclination and spatial variability in soil and litter properties influence soil greenhouse gas (GHG) fluxes and thus ongoing climate change, but their relationship in forest ecosystems is poorly understood. To elucidate this, we explored the effect of inclination, distance from a stream, soil moisture, soil temperature, and other soil and litter properties on soil–atmosphere fluxes of carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) with automated static chambers in a temperate upland forest in eastern Austria. We hypothesised that soil CO2 emissions and CH4 uptake are higher in sloped locations with lower soil moisture content, whereas soil N2O emissions are higher in flat, wetter locations. During the measurement period, soil CO2 emissions were significantly higher on flat locations (p<0.05), and increased with increasing soil temperature (p<0.001) and decreasing soil moisture (p<0.001). The soil acted as a CH4 sink, and CH4 uptake was not significantly related to inclination. However, CH4 uptake was significantly higher at locations furthest away from the stream as compared to at the stream (p<0.001) and positively related to litter weight and soil C content (p<0.01). N2O fluxes were significantly higher on flat locations and further away from the stream (p<0.05) and increased with increasing soil moisture (p<0.001), soil temperature (p<0.001), and litter depth (p<0.05). Overall, this study underlines the importance of inclination and the resulting soil and litter properties in predicting GHG fluxes from forest soils and therefore their potential source-sink balance

Eating Habits and Physical Activity of the Spanish Population during the COVID-19 Pandemic Period

Due to the pandemic situation caused by the COVID-19 infection, some governments have implemented house confinement measures. The objective of our study is to learn the dietary patterns, consumption, and physical activity of the Spanish population before and during the period of confinement by COVID-19. A cross-sectional descriptive study based on a questionnaire during May 2020, coinciding with the period of confinement and the step forward into Phase 1, is carried out. During confinement, the adherence to the Mediterranean Diet increases (8.0% versus 4.7%; p < 0.001). No socio-demographic variables show statistical significance (p < 0.05) regarding good adherence to the Mediterranean Diet (MD) before and during confinement. During confinement, consumption of homemade baking shows a higher increase (0.28% versus 4.60%; p = 0.004). During confinement, the number of subjects that practice exercise decreases (29.4% versus 28.8%; p = 0.004), as well as the time spent exercising (more than an hour, 26.6% versus 14.7%, p = 0.001). Mediterranean Diet adherence slightly increases during confinement, although consumption of ‘unhealthy’ food also increases. Moreover, the number of subjects that practice physical activity, as well as the time spent on it weekly, decreases.The authors received funding from Danone Nutricia to cover the costs for the publication of the article.Ye

Impact of xenobiotics derived from food processing and colorectal cancer risk

Resumen del trabajo presentado en la 3rd International Conference on Food Bioactives & Health, celebrada en Parma (Italia), del 21 al 24 de junio de 2022Although xenobiotics from food processing have gained support as possible drivers of the relationship between diet and colorectal cancer (CRC), there are few studies characterizing their intake. Aim: To describe the intake of heterocyclic amines (HAs), polycyclic aromatic hydrocarbons (PAHs), nitrates, nitrites, nitrosamines and acrylamide in the context of a regular diet to identify possible therapeutic targets in this disease. A sample of 84 volunteers, aged 39-73 years, were recruited in two public Hospitals of Asturias after colonoscopy and were classified into three groups of subjects: healthy (n=34), polyps (n=43) and CRC (n=7) based on anatomic-pathological analysis and clinical history. The study was approved by the Regional Ethical Committee of Asturias Public Health Service (nº 163/19). Intake was registered by means of food frequency questionnaire including cooking methods, temperature and degree of browning. The European Prospective Investigation into Cancer (EPIC) and the Computerized Heterocyclic Amines Resource for Research in Epidemiology of Disease (CHARRED) databases were used for xenobiotic estimation in conjunction with data from the European Food Safety Authority (EFSA) and the USA Food and Drug Administration (FDA). Differences in xenobiotic variables were analyzed by non-parametric tests and logistic regression models. Among the polyp conditions, 16.7% of volunteers presented hyperplastic polyps, 52.2% tubular adenoma, 16.7% tubulovillous adenoma, 2.4% sessile serrated adenoma (SSA), 7.1% high-degree dysplasia and 4.8% less severe conditions. Compared to the healthy group, polyps and neoplasia groups showed a lower intake of cereals and vegetables and higher amounts of white, red and processed meat and alcoholic beverages (only in polyps). Consequently, significant differences were found between the healthy and polyps group in the intake of dibenz[a,h]anthracene (Dib(a)A). The results obtained from logistic regression models adjusted by age and body mass index (BMI) revealed a higher risk of belonging to the polyps group (Exp(B)=4.372; p=0.034) in those subjects classified at the highest tertile of Dib(a)A) consumption (mean and median consumption of 0.36 and 0.17 µg/day, respectively). Non-significant increased consumption was detected for B(a)P, DiB(a)A, total PAH, MeIQx, DiMeIQx, NDMA in polyps and neoplasia groups. Further research may shed light on whether Dib(a)A intake moderation could be approached as a therapeutic target

Dietary Xenobiotics Derived from Food Processing: Association with Fecal Mutagenicity and Gut Mucosal Damage

Whereas the mechanisms underlying the association of toxic dietary xenobiotics and cancer risk are not well established, it is plausible that dietary pattern may affect the colon environment by enhancing or reducing exposure to mutagens. This work aimed to investigate the association between xenobiotics intake and different stages of intestinal mucosal damage and colorectal cancer (CRC) screening and examine whether these associations may be mediated by altered intestinal mutagenicity. This was a case control study with 37 control subjects, 49 patients diagnosed with intestinal polyps, and 7 diagnosed with CRC. Lifestyle, dietary, and clinical information was registered after colonoscopy. For xenobiotics intake estimation the European Prospective Investigation into Cancer (EPIC) and the Computerized Heterocyclic Amines Resource for Research in Epidemiology of Disease (CHARRED) databases were used. The mutagenicity of fecal supernatants was assayed by the Ames test and light microscopy was used for the presence of aberrant crypt formation. Among all the potential carcinogens studied, the polyp group showed higher intakes of ethanol and dibenzo (a) anthracene (DiB(a)A). Besides, intakes between 0.75 and 1.29 &micro;g/d of total polycyclic aromatic hydrocarbons (PAHs) were related with a higher risk of belonging to the polyp group. On the contrary, an intake of wholegrain cereals greater than 50 g/d was associated with a reduction in the relative risk of belonging to the polyp group. Heterocyclic amines (HAs) such as 2-amino-1-methyl-6-phenylimidazo (4,5,b) pyridine (PhIP) were associated with an increased level of mutagenicity in polyps. This study is of great interest for the identification of possible therapeutic targets for the early prevention of colon cancer through diet

Dieta y microbiota intestinal en función de la presencia del daño de la mucosa intestinal

Trabajo presentado al XIV WorkShop de la Sociedad Española de Microbiota, Probióticos y Prebióticos, celebrado en Pamplona (España) del 8 al 10 de marzo de 202

Mapeo de la situación y atención social de la infancia y el Programa CaixaProinfancia en once territorios del estado español. 2012-13

Esta publicación es el resultado de un estudio sobre pobreza y exclusión social infantil, los servicios de atención social y la incidencia del programa CaixaProinfancia (programa CPI) en en once ciudades del estado español. La investigación se realizó en el curso 2011-12 y fue actualizada en el curso 2013-14, bajo la dirección de Jordi Riera y Jordi Longás, del grupo de investigación Pedagogía, Sociedad e Innovación con el apoyo de las Tecnologías de la Información y la Comunicación (PSITIC) de la Universidad Ramon Llull, en el marco del convenio de colaboración establecido entre la Fundación “la Caixa” y la FPCEE Blanquerna para asesorar el programa CaixaProinfancia. En esta investigación colaboraron investigadores de diversas universidades españolas: Universidad de Deusto, Universidad de La Laguna (ULL), Universidad de Las Palmas de Gran Canaria (ULPGC), Universidad de Málaga (UMA), Universidad de Murcia (UM), Universidad de Zaragoza, Universitat de les Illes Balears (UIB), Universidad Pablo de Olavide de Sevilla (UPO), Universidad Pontificia Comillas de Madrid y Universitat Rovira i Virgili (URV). Las ciudades analizadas son Barcelona, Bilbao, Las Palmas de Gran Canaria, Madrid, Málaga, Murcia, Palma de Mallorca, Sevilla, Tenerife, Valencia y Zaragoza. El trabajo ha dado como resultado un mapa de la situación de la infancia y la atención social en dichas ciudades y áreas metropolitanas, y en el caso de las islas el análisis se ha extendido en otras poblaciones próximas a las capitales donde el programa CPI también se desarrolla