Conducta alimentaria y su relación con el estrés, la ansiedad, la depresión y el insomnio en estudiantes universitarios

Introduction: Introduction: there is growing evidence linking food consumption with psychological health of adult people. This association has not been well explored among university students. Objectives: the aims of this study were to analyze the diet quality in a university population, and to assess its association with prevalence of anxiety, stress, depression, and insomnia. Methods: cross-sectional study of a sample of 1055 university students. Three validated questionnaires were used: the Healthy Eating Index (HEI), the Depression Anxiety Stress Scales (DASS 21), and the Insomnia Severity Index. Results: The average HEI score was 68, 57±12, 17. Prevalence of unhealthy eating was 82, 3%, higher in women (84, 8% vs. 76, 4%). Unhealthy eating was significantly associated with prevalence of anxiety, depression, and stress. Excessive intake of sweets and low of dairy products were associated with higher prevalence of psychological and sleep disturbances. Conclusions: unhealthy eating patterns are common in university population and are related to anxiety, stress, and depression. Educational interventions to reduce unhealthy food consumption in university students can also result in psychological health improvements and/or vice versa.Introducción: Introducción: existe una evidencia creciente que relaciona la alimentación con la salud psicológica de la población adulta. Esta asociación no ha sido suficientemente explorada entre los estudiantes universitarios. Objetivos: los objetivos de este estudio fueron analizar la calidad de la dieta en una población universitaria y cuantificar su asociación con la prevalencia de ansiedad, depresión, estrés e insomnio. Métodos: estudio descriptivo transversal sobre una muestra de 1055 estudiantes universitarios. Tres cuestionarios validados fueron utilizados: el Índice de Alimentación Saludable (IAS), la escala breve de Depresión, Ansiedad y Estrés (DASS-21) y el Índice de Severidad del Insomnio. Resultados: la puntuación media del IAS fue de 68, 57±12, 17. La prevalencia de alimentación no saludable fue del 82, 3%, mayor en mujeres (84, 8% vs. 76, 4%). La alimentación no saludable se relacionó de forma significativa con la prevalencia de ansiedad, depresión y estrés. El consumo excesivo de dulces y el bajo de lácteos se asoció con una mayor prevalencia de alteraciones psicológicas y del sueño. Conclusiones: los patrones alimentarios no saludables son comunes en la población universitaria y se relacionan con la presencia de ansiedad, estrés y depresión. Las intervenciones educativas dirigidas a disminuir el consumo de alimentos no saludables en estudiantes universitarios pueden conllevar una mejora de la salud psicológica y/o viceversa

Evaluation of factors leading to poor outcomes for pediatric acute lymphoblastic leukemia in Mexico: a multi-institutional report of 2,116 patients

Background and aimsPediatric acute lymphoblastic leukemia (ALL) survival rates in low- and middle-income countries are lower due to deficiencies in multilevel factors, including access to timely diagnosis, risk-stratified therapy, and comprehensive supportive care. This retrospective study aimed to analyze outcomes for pediatric ALL at 16 centers in Mexico.MethodsPatients <18 years of age with newly diagnosed B- and T-cell ALL treated between January 2011 and December 2019 were included. Clinical and biological characteristics and their association with outcomes were examined.ResultsOverall, 2,116 patients with a median age of 6.3 years were included. B-cell immunophenotype was identified in 1,889 (89.3%) patients. The median white blood cells at diagnosis were 11.2.5 × 103/mm3. CNS-1 status was reported in 1,810 (85.5%), CNS-2 in 67 (3.2%), and CNS-3 in 61 (2.9%). A total of 1,488 patients (70.4%) were classified as high-risk at diagnosis. However, in 52.5% (991/1,889) of patients with B-cell ALL, the reported risk group did not match the calculated risk group allocation based on National Cancer Institute (NCI) criteria. Fluorescence in situ hybridization (FISH) and PCR tests were performed for 407 (19.2%) and 736 (34.8%) patients, respectively. Minimal residual disease (MRD) during induction was performed in 1,158 patients (54.7%). The median follow-up was 3.7 years. During induction, 191 patients died (9.1%), and 45 patients (2.1%) experienced induction failure. A total of 365 deaths (17.3%) occurred, including 174 deaths after remission. Six percent (176) of patients abandoned treatment. The 5-year event-free survival (EFS) was 58.9% ± 1.7% for B-cell ALL and 47.4% ± 5.9% for T-cell ALL, while the 5-year overall survival (OS) was 67.5% ± 1.6% for B-cell ALL and 54.3% ± 0.6% for T-cell ALL. The 5-year cumulative incidence of central nervous system (CNS) relapse was 5.5% ± 0.6%. For the whole cohort, significantly higher outcomes were seen for patients aged 1–10 years, with DNA index >0.9, with hyperdiploid ALL, and without substantial treatment modifications. In multivariable analyses, age and Day 15 MRD continued to have a significant effect on EFS.ConclusionOutcomes in this multi-institutional cohort describe poor outcomes, influenced by incomplete and inconsistent risk stratification, early toxic death, high on-treatment mortality, and high CNS relapse rate. Adopting comprehensive risk-stratification strategies, evidence-informed de-intensification for favorable-risk patients and optimized supportive care could improve outcomes

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Satisfacción del alumnado de enfermería frente a la implantación de un portafolio en la actividad docente

Objetive: This paper describes the process of creating an elec-tronic portfolio for students in the Bachelor of Nursing course care of the elderly, with the overall objectiveof guiding students in their activities and achieve their own perception of university academic. Method: A descriptive design with Degree Nursing students enrolled in the subject of Elder Care. Survey Likert about 23 individuals. In total there are 13 variables (12 related and one that assesses the questionnaire submitted). Results: The two variables that differ from this result are What I learn is important for my practice with a value of 5 (almost always) and Other students value my contribution where the value is 3 (Some time ). The results show that the median of the positive student ratings with respondents answering often. 39.1% of students surveyed valued with almost always learn what is important to their professional practice and that is related. Conclusions: The development of a blog is essential to the practice of professional nursing future, makes students remain critical thinking about their ideas and what they read. The tutor is key to learning and teaching system becomes critical pieceEste trabajo describe el proceso de creación de un portafolio electrónico para estudiantes del Grado de Enfermería de la asignatura de Cuidados del Anciano, con el objetivo general de valorar la incidencia de la aplicación de un portafolio en el proceso educativo de la asignatura y guiar a los estudiantes en su actividad y lograr la percepción de sus propios progresos académicos universitarios. Método: Diseño de nivel descriptivo, la población fueron los alumnos del grado de Enfermería y matriculados en la asigna-tura de Cuidados del Anciano. Encuesta tipo Likert sobre 23 individuos. En total tenemos 12 variables relacionadas entre sí. Resultados: Los hallazgos muestran que en relación al enunciado Lo que aprendo es importante para mi práctica profesional se obtuvo un valor de 5 (Casi siempre), y en relación al enunciado Otros estudiantes valoran mi contribución, se obtuvo un valor de 3 (Alguna vez). Los resultados muestran que la mediana de las valoraciones positivas respecto a las variables estudiadas de los alumnos encuestados responden con la afirmación: A menudo. El 39.1 % de los alumnos encuestados valoran Casi siempre que lo que aprenden es importante para su práctica profesional. Conclusiones: La elaboración de un blog es relevante para la práctica del futuro profesional de la enfermería, hace que los estudiantes mantengan un pensamiento crítico sobre sus ideas y sobre lo que leen. La figura del tutor es clave en el sistema de enseñanza aprendizaje y se convierte en pieza fundamental

Análisis bioético de la generación de “bebés medicamento”

Se denominan “bebés medicamento” a, los niños concebidos con el propósito de que sean donantes compatibles para salvar, por medio de la determinación del antígeno leucocitario humano (HLA) de embriones, a un hermano que sufre una enfermedad congénita inmunitaria. Toda esta situación actual genera varios interrogantes éticos sobre el “uso” o “utilidad” de estas nuevas técnicas, el presente estudio pretende analizar las cuestiones bioéticas generadas más relevantes.The so-called saviour sibling are those babys that were conceive with the purpose to become in compatible donor to save a sibling with immune congenital diseases through the identification of the human leukocyte antigen (HLA). In this entire new frame has born an ethical debate about the use of these techniques. This study tries to analyze the main bioethical question that this new situation provokes.Se denominan “bebés medicamento” a, los niños concebidos con el propósito de que sean donantes compatibles para salvar, por medio de la determinación del antígeno leucocitario humano (HLA) de embriones, a un hermano que sufre una enfermedad congénita inmunitaria. Toda esta situación actual genera varios interrogantes éticos sobre el “uso” o “utilidad” de estas nuevas técnicas, el presente estudio pretende analizar las cuestiones bioéticas generadas más relevantes

Caídas en ancianos válidos institucionalizados, prevalencia y factores asociados

OBJETIVO: Estimar la prevalencia de caídas en ancianos válidos institucionalizados. MÉTODO: Estudio descriptivo trasversal, mediante muestreo aleatorio simple. Escalas utilizadas: MEC-35 1979 y Cuestionario de caídas OMS (1989). Dictamen favorable del CEICA. A todas las personas del centro se les informó y entregó consentimiento informado. La recogida de datos fue entre octubre de 2012 hasta febrero de 2013. Las entrevistas se realizaron preservando la intimidad de los participantes. RESULTADOS: Los participantes del estudio fueron 51 residentes. Se produjeron 21 caídas, lo que implica una prevalencia de caídas del 41,17%. 8 caídas se produjeron en varones (38,09%) y 13 en mujeres (61,91%). El 72,54% de los ancianos/as padecían enfermedades cardiovasculares. El 52,9% de los participantes tomaban fármacos sedantes. De las 21 caídas producidas, se observó que 16 ancianos que se cayeron tomaban fármacos sedantes, mientras que 5 ancianos no los tomaban y sufrieron una caída. Mediante Chi-Cuadrado y un Test de Fisher, se obtuvo que la probabilidad de caídas tomando sedantes era del 84,19%. Tras Anova se obtuvieron diferencias significativas del 5% entre fármacos y caídas. Por tanto, a mayor número de fármacos mayor número de caídas. CONCUSIONES: El registro de caídas ha permitido conocer la prevalencia y los factores asociados. Se hace necesario valorar los patrones de sueño de nuestros ancianos para conocer la necesidad o no de ingesta de fármacos sedantes, ya que es un factor muy relacionado. Con una efectiva valoración y prevención se mejorará la calidad de vida de nuestros mayores, y además, disminuir el gasto sociosanitario. Abstract: OBJECTIVE: To estimate the prevalence of falls in elderly institutionalized valid. METHOD: A cross by simple random sampling. Scales used: MEC-35 Questionnaire fall 1979 and WHO (1989). Assent of CEICA. To all the people downtown were informed and gave informed consent. Data collection was from October 2012 to February 2013. Interviews were conducted preserving the privacy of the participants. RESULTS: Study participants were 51 residents. Were 21 falls, implying falls prevalence 41,17%. Falls occurred 8 males (38,09%) and 13 females (61.91%). The 72,54% of the elderly / as suffering from cardiovascular diseases. 52,9% of participants were taking sedative drugs. Of the 21 falls produced, it was observed that 16 elders fell taking sedative drugs, while not taking 5 seniors and suffered a fall. By Chi-square and Fisher test, we found that the likelihood of falls was taking sedatives of 84,19%. After Anova significant difference of 5% between drugs and falls were obtained. Therefore, a greater number of drugs more falls. CONCLUSIONS: Fall Registration has shown the prevalence and associated factors. It is necessary to assess the sleep patterns of our seniors to know whether or not the intake of sedative drugs, as it is a closely related factor. With effective prevention assessment and quality of life of our seniors will be improved, and also decrease the socio spending. Palabra Clave: Ancianos; Caídas; Prevalencia; Factores de riesgo; Consecuencias. Key Words: Elderly; Falls; Prevalence; Risk factors; Consequences

Acoustic contamination assessment during the transition between the COVID-19 restrictions and reactivation: A exploratory analysis in Guayaquil

Noise pollution is becoming a critical health risk for city life. In 2020, the COVID-19 pandemic forced many cities to implement several mobility restrictions. These restrictions changed human activity patterns and decreased the noise levels and noise pollution that often affect urban settings. As the number of infections decreased, so did the outdoor activities, influencing the population’s perception of noise. This paper aims to evaluate the changes in noise levels associated with mobility restrictions between 2020 and 2021 in Guayaquil, Ecuador. This study used crowdsourcing with the help of smartphones and mobile applications to collect geo-referenced environmental noise data. The data was used to generate noise maps in different time frames. Finally, noise level maps were created using GIS-based tools to identify the urban areas that experienced the highest noise level variation during the study period. The results show that the most significant noise increase occurred at night. Furthermore, when analyzing noise level changes in different urban areas, the western area of Guayaquil was the one that experienced the most significant noise level variation. Findings inform the perception of noise pollution and could potentially serve as a reference for decision-makers during the proposal of public policies that ensure a better quality of life for its citizens