Clustering of Dietary Patterns and Lifestyles Among Spanish Children in the EsNuPI Study

Dietary patterns (DPs) are known to be tied to lifestyle behaviors. Understanding DPs and their relationships with lifestyle factors can help to prevent children from engaging in unhealthy dietary practices. We aimed to describe DPs in Spanish children aged 1 to <10 years and to examine their associations with sociodemographic and lifestyle variables. The consumption of toddler and young children milk formulas, enriched and fortified milk within the Spanish pediatric population is increasing, and there is a lack of evidence whether the consumption of this type of milk is causing an impact on nutrient intakes and if they are helping to reach the nutrient recommendations. Within the Nutritional Study in the Spanish Pediatric Population (EsNuPI), we considered two study cohorts and three different age groups in three year-intervals in each of them. The study cohort included 740 children in a representative sample of the urban non-vegan Spanish population and 772 children in a convenience cohort of adapted milk consumers (AMS) (including follow-on formula, toddler’s milk, growing up milk, and fortified and enriched milks) who provided information about sociodemographics, lifestyle, and dietary habits; a food frequency questionnaire was used for the latter. Principal component analysis was performed to identify DPs from 18 food groups. Food groups and sociodemographic/lifestyle variables were combined through a hierarchical cluster algorithm. Three DPs predominated in every age group and study sample: a palatable energy-dense food dietary pattern, and two Mediterranean-like DPs. However, children from the AMS showed a predominant dietary pattern markedly related to the Mediterranean diet, with high consumption of cereals, fruits and vegetables, as well as milk and dairy products. The age of children and certain lifestyle factors, namely level of physical activity, parental education, and household income, correlated closely with the dietary clusters. Thus, the findings provide insight into designing lifestyle interventions that could reverse the appearance of unhealthy DPs in the Spanish child populationThis research was funded by Instituto Puleva de Nutrición (IPN)S

Evidence-based maternal and perinatal healthcare practices in public hospitals in Argentina

Evidence-based medicine Maternal and perinatal health services Prevalence studies Use of maternal and perinatal health practices Objective: To investigate the use of beneficial maternal and perinatal healthcare practices in a network of public maternity hospitals in Argentina. Method: A multicenter, prospective, descriptive study of 6661 deliveries in 9 hospitals. The use of 5 obstetric care practices that reduce maternal and perinatal morbidity and mortality was evaluated. Results: Median use rates for the selected practices were: continuous support for women during childbirth (17.9%); corticosteroids for preterm birth (35.3%); avoidance of episiotomy in primiparous women (41.2%); iron and folate supplementation (52.5%); active management of third stage of labor (93.5%). Conclusion: There is limited use of the selected evidence-based maternal and perinatal practices in public hospitals in Argentina and a large variation in their use among and within hospitals. Efforts should be made to increase the use of these evidence-based practices

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Evaluación de la imagen corporal en mujeres con cáncer de mama: una revisión sistemática

Body image is the subjective representation of perception, evaluation, assessment and experience of the body that provides the sense of self as a whole. It is affected when passes through diseases, especially when implies physical changes like oncologic diseases.This systematic review identified instruments to assess body image in women with breast cancer, through the analysis of 34 articles published in English and Spanish during the 2004-2014 period in open access repositories. Instruments originated in Europe and the United States, with the psychometric properties of validity and reliability were found.The Body Image Scale of Hopwood and module QLQ BR 23 of the European Organization for Research and Treatment of Cancer were reported in studies in Latin American population. It is valued how the body image of women with breast cancer affects their sexuality, couple relationships, self-steem, coping styles and quality of life affects their sexuality, relationships, self-esteem, coping styles and quality of life.La imagen corporal (IC) es la representación subjetiva de la percepción, evaluación, valoración y vivencia del cuerpo que proporciona el sentido de sí mismo como una totalidad. Es afectada cuando existen enfermedades oncológicas que implican cambios corporales. En esta revisión sistemática se identificaron instrumentos susceptibles de usarse en Latinoamérica para evaluar la IC de mujeres con cáncer de mama, analizando 34 artículos publicados en inglés y español del periodo 2004-2014 en bases de libre acceso. Instrumentos originados en Europa y Estados Unidos, tales como la Escala de Imagen Corporal de Hopwood y el módulo QLQ BR 23, desarrollado por la Organización Europea para Investigación y Tratamiento en Cáncer (EORTC), con buenas características psicométricas de validez y confiabilidad, se han utilizado en población latinoamericana. Se valora cómo la IC de mujeres con cáncer de mama afecta su sexualidad, las relaciones de pareja, su autoestima, los estilos de afrontamiento y calidad de vida

Evaluación de la imagen corporal en mujeres con cáncer de mama: una revisión sistemática

Body image is the subjective representation of perception, evaluation, assessment and experience of the body that provides the sense of self as a whole. It is affected when passes through diseases, especially when implies physical changes like oncologic diseases.This systematic review identified instruments to assess body image in women with breast cancer, through the analysis of 34 articles published in English and Spanish during the 2004-2014 period in open access repositories. Instruments originated in Europe and the United States, with the psychometric properties of validity and reliability were found.The Body Image Scale of Hopwood and module QLQ BR 23 of the European Organization for Research and Treatment of Cancer were reported in studies in Latin American population. It is valued how the body image of women with breast cancer affects their sexuality, couple relationships, self-steem, coping styles and quality of life affects their sexuality, relationships, self-esteem, coping styles and quality of life.La imagen corporal (IC) es la representación subjetiva de la percepción, evaluación, valoración y vivencia del cuerpo que proporciona el sentido de sí mismo como una totalidad. Es afectada cuando existen enfermedades oncológicas que implican cambios corporales. En esta revisión sistemática se identificaron instrumentos susceptibles de usarse en Latinoamérica para evaluar la IC de mujeres con cáncer de mama, analizando 34 artículos publicados en inglés y español del periodo 2004-2014 en bases de libre acceso. Instrumentos originados en Europa y Estados Unidos, tales como la Escala de Imagen Corporal de Hopwood y el módulo QLQ BR 23, desarrollado por la Organización Europea para Investigación y Tratamiento en Cáncer (EORTC), con buenas características psicométricas de validez y confiabilidad, se han utilizado en población latinoamericana. Se valora cómo la IC de mujeres con cáncer de mama afecta su sexualidad, las relaciones de pareja, su autoestima, los estilos de afrontamiento y calidad de vida

Instrumentos para evaluar la personalidad en mujeres hispanohablantes con cáncer de mama

Breast cancer is a public health problem, according the high risk of morta lity because late diagnosis. Personality may influence the vulnerability orresilience in health risk situations. The aim of this study was to identifyavailable test for assessing personality in Spanish speaking women withbreast cancer. A systematic review was conducted, 11 papers published bet ween years 2003-2014 were analyzed according the inclusion criteria. Themost viable instruments reported were Type C Personality Questionnaireand Eysenck Personality Questionnaire (EPQ-R). EPQ-R has more studiesreporting its reliability and validity in cross-cultural adaptation. Personalitytraits associated with Type C, like suppression of emotionality and anger inLatin American oncology population were found, although there are con flicting data to determine if those traits whether consequence or precursorof cancer. The use of valid and reliable instruments could increase qualitystandards in psycho-oncology diagnosis and interventions evaluating theeectiveness of such careEl cáncer de mama es un problema de salud pública, dada la alta tasa de mortalidad por diagnósticos tardíos. La personalidad puede incidir en la vulnerabilidad o resistencia ante las situaciones de riesgo para la salud. El objetivo de investigación fue identificar instrumentos idóneos y disponibles para evaluar personalidad en mujeres con cáncer de mama de población hispanohablante. Se efectuó una revisión sistemática de investigaciones del periodo 2003-2014, analizando 11 artículos según los criterios de inclusión. Los instrumentos más viables para su utilización son el Cuestionario de Personalidad de Eysenck EPQ-R y Cuestionario de Personalidad Tipo C. El cuestionario EPQ-R tiene más estudios que reportan su contabilidad validez en adaptación transcultural. Se encuentran rasgos asociados con personalidad tipo C, como la supresión de la emocionalidad y la ira, en población oncológica latinoamericana, aunque hay datos contradictorios para determinar si son precursores o consecuencias del padecer cáncer. Utilizar instrumentos válidos y contables, incrementará las normas de calidad para programas de diagnóstico y atención psico-oncológica así como la evaluación de la efectividad de los mismos

Anti-carbamylated protein autoantibodies associated with mortality in Spanish rheumatoid arthritis patients

<div><p>Patients with rheumatoid arthritis (RA) have an increased mortality rate that is associated with the presence of RA-specific autoantibodies in many studies. However, the relative role of rheumatoid factor (RF), anti-CCP antibodies and the most recently established RA-autoantibodies, directed against carbamylated proteins (anti-CarP antibodies), is unclear. Here, we have assessed the role of these three antibodies in 331 patients with established RA recruited from 2001 to 2009 and followed until November 2015. During this time, 124 patients died (37.5%). This death rate corresponds to a mortality rate 1.53 (95% CI 1.26 to 1.80) folds the observed in the reference population. We used for analysis of all-cause mortality the Cox proportional hazard regression model with adjustment for age, sex and smoking. It showed a trend for association with increased mortality of each of the three RA autoantibodies in antibody-specific analysis (hazards ratio (HR) from 1.37 to 1.79), but only the HR of the anti-CarP antibodies was significant (HR = 1.79, 95% CI 1.23 to 2.61, p = 0.002). In addition, the multivariate analysis that included all autoantibodies showed a marked decrease in the HR of RF and of anti-CCP antibodies, whereas the HR of anti-CarP remained significant. This increase was specific of respiratory system causes of death (HR = 3.19, 95% CI 1.52 to 6.69, p = 0.002). Therefore, our results suggest a specific relation of anti-CarP antibodies with the increased mortality in RA, and drive attention to their possible connection with respiratory diseases.</p></div

Conditional analysis of the HR observed with the number of autoantibodies.

<p>The HR for the number of antibodies (# Ab) obtained in Cox proportional analysis was considered either on itself (to the left of the dotted vertical line) or conditional on the presence of each of the three specific autoantibodies (to the right of the dotted vertical line). The asterisks, *, denote significantly increased HR.</p