Glucosa oral y leche materna como estrategia para reducción del dolor durante el procedimiento de punción del talón en recién nacidos

Introduction: This paper presents the results of a study on pain reduction in newborns that undergo painful medical procedures. This research analyzed the reactions of babies before and after the heel lance procedure, a diagnostic test performed to detect phenylketonuria. This test involved the extraction of a capillary blood sample with a heel lance, a medical procedure that is painful for neonates. Objective: The main objective of this research was to evaluate the effectiveness of a 24% oral glucose solution and breastfeeding during heal lance. Method: An experimental study was thus conducted on a sample of 93 newborns in the San Cecilio University Hospital in Granada in 2010. The babies in the sample were divided into three groups, depending on what they ingested during the heal lance. Results: The results obtained showed that there was an association between the difference in HR and the time before the newborn’s HR returned to normal after the heel lance (r = 0.562; p = 0.000). Moreover, a positive relation was found between the absolute difference in HR and the difference in oxygen saturation (OS) (r = 0.538; p = 0.000). Conclusion: The OS was found to be greater in the group of newborns that received breast milk.Introducción: Para la detección de la fenilcetonuria, se realiza la prueba diagnóstica que consiste en la extracción de una muestra de sangre capilar, mediante la punción del talón al recién nacido. Este proceder es muy doloroso para el neonato. Objetivo: Valorar la efectividad de la administración de glucosa oral al 24 % y lactancia materna durante la punción del talón en el recién nacido. Método: Se realizó un estudio experimental en una muestra de 93 recién nacidos del Hospital Clínico “San Cecilio” de Granada durante el año 2010. La muestra se distribuyó en tres grupos en función del tipo de ingesta administrada en la realización de la prueba del talón. Resultados: El estudio pone de manifiesto que existe asociación en la diferencia de la FC con el tiempo transcurrido hasta alcanzar la normalidad después de la punción (r = 0,562; p = 0,000). También se halló una relación positiva entre la diferencia absoluta en la FC y la diferencia en la Saturación de Oxígeno (SO) (r = 0,538; p = 0,000). Conclusión: La SO es mayor en el grupo de lactancia materna que en el resto; así como en el de glucosa oral 24% que en el de control

Obstetric complications and clinical presentation in first episode of psychosis

Objective: Psychotic disorders exhibit a complex aetiology that combines genetic and environmental factors. Among the latter, obstetric complications (OCs) have been widely studied as risk factors, but it is not yet well understood how OCs relate to the heterogeneous presentations of psychotic disorders. We assessed the clinical phenotypes of individuals with a first episode of psychosis (FEP) in relation to the presence of OCs. Methods: Two-hundred seventy-seven patients with an FEP were assessed for OCs using the Lewis–Murray scale, with data stratified into three subscales depending on the timing and the characteristics of the obstetric event, namely: complications of pregnancy, abnormal foetal growth and development and difficulties in delivery. We also considered other two groups: any complications during the pregnancy period and all OCs taken altogether. Patients were clinically evaluated with the Positive and Negative Syndrome Scale for schizophrenia. Results: Total OCs and difficulties in delivery were related to more severe psychopathology, and this remained significant after co-varying for age, sex, traumatic experiences, antipsychotic dosage and cannabis use. Conclusions: Our results highlight the relevance of OCs for the clinical presentation of psychosis. Describing the timing of the OCs is essential in understanding the heterogeneity of the clinical presentation

Obesity and its implication in breast cancer

La obesidad y el cáncer de mama constituyen dos patologías de extremada prevalencia en la actualidad y con un alto impacto en la sociedad. Numerosas investigaciones han intentado establecer una asociación entre ambos procesos, circunstancia que aún continúa en entredicho. Se llevó a cabo una recogida de datos a partir de las historias clínicas de 524 mujeres diagnosticadas y tratadas de cáncer de mama durante el período de enero de 2009 a septiembre de 2010. Los objetivos del estudio fueron verificar una posible asociación entre el estado nutricional de las mujeres y su relación con la edad de diagnóstico del tumor. En segundo lugar, determinar la posible implicación de la obesidad en relación con la edad de la menarquia y con ello en el diagnóstico de cáncer de mama. Se encontró una relación estadísticamente significativa entre el estado nutricional de las mujeres y la edad a la cual fueron diagnosticadas de cáncer de mama (p < 0,0001), así como una asociación estadísticamente significativa (p < 0,0001) entre la edad de la menarquia y el estado nutricional de las pacientes. Los resultados obtenidos en este estudio muestran que la obesidad se encuentra íntimamente asociada con el cáncer de mama.Obesity and breast cancer are two very frequent pathologies in the world today, which have a strong impact on society. Various research studies have tried linking the two. For this purpose, data was collected from the medical histories of 524 women who had been diagnosed and treated for breast cancer from January 2009 to September 2010. The objectives of the study were to find and verify a possible association between the nutritional state of these women and their age when they were diagnosed with the tumour (p < 0.0001) as well as a statistically significant association (p < 0.0001) between the age of the first menstruation and the nutritional state of the patients. The results obtained showed that obesity was closely related to breast cancer

A scoring system to detect fixed airflow limitation in smokers from simple easy-to-use parameters

No validated screening method currently exists for Chronic Obstructive Pulmonary Disease (COPD) in smokers. Therefore, we constructed a predictive model with simple parameters that can be applied for COPD screening to detect fixed airflow limitation. This observational cross-sectional study included a random sample of 222 smokers with no previous diagnosis of COPD undertaken in a Spanish region in 2014–2016. The main variable was fixed airflow limitation by spirometry. The secondary variables (COPD factors) were: age, gender, smoking (pack-years and Fagerström test), body mass index, educational level, respiratory symptoms and exacerbations. A points system was developed to predict fixed airflow limitation based on secondary variables. The model was validated internally through bootstrapping, determining discrimination and calibration. The system was then integrated into a mobile application for Android. Fifty-seven patients (25.7%) presented fixed airflow limitation. The points system included as predictors: age, pack-years, Fagerström test and presence of respiratory symptoms. Internal validation of the system was very satisfactory, both in discrimination and calibration. In conclusion, a points system has been constructed to predict fixed airflow limitation in smokers with no previous COPD. This system can be integrated as a screening tool, though it should be externally validated in other geographical regions

The effect of early life events on glucose levels in first-episode psychosis

First episode of psychosis (FEP) patients display a wide variety of metabolic disturbances at onset, which might underlie these patients' increased morbidity and early mortality. Glycemic abnormalities have been previously related to pharmacological agents; however, recent research highlights the impact of early life events. Birth weight (BW), an indirect marker of the fetal environment, has been related to glucose abnormalities in the general population over time. We aim to evaluate if BW correlates with glucose values in a sample of FEP patients treated with different antipsychotics. Two hundred and thirty-six patients were included and evaluated for clinical and metabolic variables at baseline and at 2, 6, 12, and 24 months of follow-up. Pearson correlations and linear mixed model analysis were conducted to analyze the data. Antipsychotic treatment was grouped due to its metabolic risk profile. In our sample of FEP patients, BW was negatively correlated with glucose values at 24 months of follow-up [r=-0.167, p=0.037]. BW showed a trend towards significance in the association with glucose values over the 24-month period (F=3.22; p=0.073) despite other confounders such as age, time, sex, body mass index, antipsychotic type, and chlorpromazine dosage. This finding suggests that BW is involved in the evolution of glucose values over time in a cohort of patients with an FEP, independently of the type of pharmacological agent used in treatment. Our results highlight the importance of early life events in the later metabolic outcome of patients

The effect of early life events on glucose levels in first-episode psychosis

First episode of psychosis (FEP) patients display a wide variety of metabolic disturbances at onset, which might underlie these patients’ increased morbidity and early mortality. Glycemic abnormalities have been previously related to pharmacological agents; however, recent research highlights the impact of early life events. Birth weight (BW), an indirect marker of the fetal environment, has been related to glucose abnormalities in the general population over time. We aim to evaluate if BW correlates with glucose values in a sample of FEP patients treated with different antipsychotics. Two hundred and thirty-six patients were included and evaluated for clinical and metabolic variables at baseline and at 2, 6, 12, and 24 months of follow-up. Pearson correlations and linear mixed model analysis were conducted to analyze the data. Antipsychotic treatment was grouped due to its metabolic risk profile. In our sample of FEP patients, BW was negatively correlated with glucose values at 24 months of follow-up [r=-0.167, p=0.037]. BW showed a trend towards significance in the association with glucose values over the 24-month period (F=3.22; p=0.073) despite other confounders such as age, time, sex, body mass index, antipsychotic type, and chlorpromazine dosage. This finding suggests that BW is involved in the evolution of glucose values over time in a cohort of patients with an FEP, independently of the type of pharmacological agent used in treatment. Our results highlight the importance of early life events in the later metabolic outcome of patients

Prodromal symptoms and the duration of untreated psychosis in first episode of psychosis patients: what differences are there between early vs. adult onset and between schizophrenia vs. bipolar disorder?

To assess the role of age (early onset psychosis-EOP &lt; 18 years vs. adult onset psychosis-AOP) and diagnosis (schizophrenia spectrum disorders-SSD vs. bipolar disorders-BD) on the duration of untreated psychosis (DUP) and prodromal symptoms in a sample of patients with a first episode of psychosis. 331 patients with a first episode of psychosis (7–35 years old) were recruited and 174 (52.6%) diagnosed with SSD or BD at one-year follow-up through a multicenter longitudinal study. The Symptom Onset in Schizophrenia (SOS) inventory, the Positive and Negative Syndrome Scale and the structured clinical interviews for DSM-IV diagnoses were administered. Generalized linear models compared the main effects and group interaction. 273 AOP (25.2 ± 5.1 years; 66.5% male) and 58 EOP patients (15.5 ± 1.8 years; 70.7% male) were included. EOP patients had significantly more prodromal symptoms with a higher frequency of trouble with thinking, avolition and hallucinations than AOP patients, and significantly different median DUP (91 [33–177] vs. 58 [21–140] days; Z = − 2.006, p = 0.045). This was also significantly longer in SSD vs. BD patients (90 [31–155] vs. 30 [7–66] days; Z = − 2.916, p = 0.004) who, moreover had different profiles of prodromal symptoms. When assessing the interaction between age at onset (EOP/AOP) and type of diagnosis (SSD/BD), avolition was significantly higher (Wald statistic = 3.945; p = 0.047), in AOP patients with SSD compared to AOP BD patients (p = 0.004). Awareness of differences in length of DUP and prodromal symptoms in EOP vs. AOP and SSD vs. BD patients could help improve the early detection of psychosis among minors

Screening Tool to Determine Risk of Having Muscle Dysmorphia Symptoms in Men Who Engage in Weight Training at a Gym

Objective: Although 2 screening tests exist for having a high risk of muscle dysmorphia (MD) symptoms, they both require a long time to apply. Accordingly, we proposed the construction, validation, and implementation of such a test in a mobile application using easy-to-measure factors associated with MD. Design: Cross-sectional observational study. Setting: Gyms in Alicante (Spain) during 2013 to 2014. Participants: One hundred forty-one men who engaged in weight training. Assessment of Risk Factors: The variables are as follows: age, educational level, income, buys own food, physical activity per week, daily meals, importance of nutrition, special nutrition, guilt about dietary nonadherence, supplements, and body mass index (BMI). A points system was constructed through a binary logistic regression model to predict a high risk of MD symptoms by testing all possible combinations of secondary variables (5035). The system was validated using bootstrapping and implemented in a mobile application. Main Outcome Measures: High risk of having MD symptoms (Muscle Appearance Satisfaction Scale). Results: Of the 141 participants, 45 had a high risk of MD symptoms [31.9%, 95% confidence interval (CI), 24.2%-39.6%]. The logistic regression model combination providing the largest area under the receiver operating characteristic curve (0.76) included the following: age [odds ratio (OR) = 0.90; 95% CI, 0.84-0.97, P = 0.007], guilt about dietary nonadherence (OR = 2.46; 95% CI, 1.06-5.73, P = 0.037), energy supplements (OR = 3.60; 95% CI, 1.54-8.44, P = 0.003), and BMI (OR = 1.33, 95% CI, 1.12-1.57, P < 0.001). The points system was validated through 1000 bootstrap samples. Conclusions: A quick, easy-to-use, 4-factor test that could serve as a screening tool for a high risk of MD symptoms has been constructed, validated, and implemented in a mobile application

Obesidad y su implicación en el cáncer de mama Obesity and its implication in breast cancer

La obesidad y el cáncer de mama constituyen dos patologías de extremada prevalencia en la actualidad y con un alto impacto en la sociedad. Numerosas investigaciones han intentado establecer una asociación entre ambos procesos, circunstancia que aún continúa en entredicho. Se llevó a cabo una recogida de datos a partir de las historias clínicas de 524 mujeres diagnosticadas y tratadas de cáncer de mama durante el período de enero de 2009 a septiembre de 2010. Los objetivos del estudio fueron verificar una posible asociación entre el estado nutricional de las mujeres y su relación con la edad de diagnóstico del tumor. En segundo lugar, determinar la posible implicación de la obesidad en relación con la edad de la menarquia y con ello en el diagnóstico de cáncer de mama. Se encontró una relación estadísticamente significativa entre el estado nutricional de las mujeres y la edad a la cual fueron diagnosticadas de cáncer de mama (p Obesity and breast cancer are two very frequent pathologies in the world today, which have a strong impact on society. Various research studies have tried linking the two. For this purpose, data was collected from the medical histories of 524 women who had been diagnosed and treated for breast cancer from January 2009 to September 2010. The objectives of the study were to find and verify a possible association between the nutritional state of these women and their age when they were diagnosed with the tumour (p < 0.0001) as well as a statistically significant association (p < 0.0001) between the age of the first menstruation and the nutritional state of the patients. The results obtained showed that obesity was closely related to breast cancer