Nutritional evaluation of adolescent students from Extremadura based on anthropometric measurements

Antecedentes y objetivos: Una correcta alimentación es uno de los pilares para un adecuado desarrollo corporal y un estado nutricional óptimo. Los métodos antropométricos son los más utilizados para el análisis de la composición corporal y constituyen una parte fundamental en la valoración del estado nutricional de individuos y poblaciones. Este estudio tiene como objetivo valorar el estado nutricional de adolescentes extremeños, determinar las variaciones en la composición corporal de acuerdo a los percentiles obtenidos, y proponer esos valores como referencia del estado nutricional de la población adolescente en Extremadura. Material y Métodos: Se realizó un estudio transversal analítico en la Comunidad Extremeña, incluyendo un total de 816 estudiantes de Educación Secundaria Obligatoria y Bachillerato, de ambos sexos y de todas las edades que comprende la adolescencia. Los centros educativos seleccionados pertenecían a poblaciones de diferentes tamaños (de menos de 5.000 a más de 60.000 habitantes). A partir de las medidas tomadas, se determinaron distintos índices antropométricos y se hallaron los percentiles 3, 10, 25, 50, 75, 90, 95 y 97 del peso, la talla y la complexión. Resultados y conclusiones: Se encontraron diferencias significativas en varios parámetros en función del sexo. Los chicos presentaban una mayor altura, peso y área muscular del brazo; por el contrario, el pliegue tricipital y el área grasa del brazo fue mayor en las chicas. Al comparar con estudios nacionales, la altura media de nuestra población era inferior en unos 3 cm en ambos sexos. El peso fue similar, pero presentaban una mayor proporción de grasa en el brazo. Las chicas extremeñas parecen tener un crecimiento más rápido, alcanzando la altura definitiva a una edad más temprana que la media nacional; sin embargo, la talla final es menor a la media. Los chicos presentaban un crecimiento más continuado en todas las edades, con medias en altura similares a las nacionales.Introduction and objectives: Nutrition is one of the pillars for proper body development and optimal nutritional status. Anthropometric methods are most commonly used for body composition analysis and are an essential part in the assessment of the nutritional status of individuals and population groups. This study aims to assess the nutritional status of adolescents from Extremadura (Spain); to determine variations in body composition according to the percentiles obtained; and to propose these values as a reference to the nutritional status of the adolescent population in Extremadura. Material and methods: A cross sectional study in the community of Extremadura was performed, including a total of 816 students of Secondary School Education of both sexes; and of all ages in the adolescence stage. The selected secondary schools belonged to populations of different sizes (less than 5,000 to more than 60,000 inhabitants). From the measurements taken, different anthropometric indices were determined and the percentiles 3, 10, 25, 50, 75, 90, 95 and 97 for weight, height and complexion were found. Results and conclusions: There were significant gender differences for height, weight, triceps skinfold, arm muscle area and arm fat area. Boys showed greater figures for height, weight and arm muscle area; however, the triceps skinfold and arm fat area was higher in girls. When compared to other national studies, the average height of our population was lower by about 3 cm in both sexes; the average weight was similar, but our adolescents had a higher proportion of fat in the arm. Extremadura girls seem to have a faster growth, reaching final height at an earlier age than the national average, although this height is below average. The boys had a continuous growth in all ages, maintaining national averagespeerReviewe

Estudio antropométrico y de ingesta de alimentos en adolescentes de Extremadura y factores asociados al desequilibrio ponderal

Programa de Doctorado en Ciencia de los Alimentos por la Universidad de Extremadura.El estudio de valoración del estado nutricional de los individuos es importante en cualquier etapa de la vida, pero durante la adolescencia desempeña un papel clave, ya que se producen grandes cambios que pueden conllevar a sobrepeso y obesidad en el adolescente, con graves repercusiones en la edad adulta. El objetivo de la presente Tesis Doctoral ha sido realizar un estudio antropométrico y de la ingesta de alimentos en adolescentes de Extremadura (España), analizarlos teniendo en cuenta diferentes factores y relacionarlos con la prevalencia de exceso de peso. También se planteó el análisis de sus hábitos alimentarios y estilo de vida. Al comparar los resultados de los parámetros antropométricos y de la prevalencia de exceso de peso de nuestra población con los de otros estudios, se pudo observar que nuestros adolescentes presentaban un mayor grado de adiposidad y exceso de peso. Por otra parte, los adolescentes de poblaciones urbanas presentaron peores valores que los de las zonas rurales. En cuanto a los hábitos saludables, los chicos dedicaban más tiempo a realizar actividad física y tenían mejores hábitos de desayuno. Por último, el análisis de las encuestas de consumo de alimentos reflejó que no cumplían las recomendaciones para algunos alimentos (productos ricos en grasas saturadas y azúcares y legumbres y verduras), aunque presentaban un consumo adecuado de otros productos (lácteos, huevos o pescado). Este trabajo será de utilidad para establecer pautas en los hábitos alimentarios y estilo de vida de adolescentes para prevenir el sobrepeso y la obesidad.The study of the nutritional assessment of individuals is important at any stage of life, but during adolescence, it plays a key role, since major changes occur that can lead to overweight and obesity in adolescents, with serious repercussions in adulthood. This Doctoral Thesis was aimed to carry out an anthropometric and food intake study in adolescents in Extremadura’s Region (Spain); to analyse them taking into account different factors, and to relate them to the prevalence of overweight. An analysis of their eating habits and lifestyle were also considered. When comparing the results of anthropometric parameters and the prevalence of overweight in our population with those of other studies, it was observed that our adolescents had a higher degree of adiposity and overweight. On the other hand, adolescents from urban populations presented worse values than those from rural areas. In terms of healthy habits, boys spent more time on physical activity and had better breakfast habits. Finally, analysis of the food consumption surveys showed that they did not follow the recommendations for some foods (products rich in saturated fats and sugars and pulses and vegetables), although they had an adequate consumption of other products (dairy products, eggs, and fish). This work will be useful in establishing guidelines for adolescents' eating habits and lifestyles to prevent overweight and obesity

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old