Development and validation of a questionnaire to assess adherence to the healthy food pyramid in Spanish adults

We aimed to design and validate a new questionnaire of adherence to healthy food pyramid (HFP) (AP-Q), to improve previous instruments. The questionnaire was self-administered and included 28 questions from 10 categories (physical activity, health habits, hydration, grains, fruits, vegetables, oil type, dairy products, animal proteins, and snacks). A population of 130 Spanish adults answered it, obtaining scores from each category and a global score of HFP adherence (AP-Q score). Validation was performed through principal components analysis (PCA) and internal consistency by Cronbach’s alpha. AP-Q was also externally validated with Kidmed-test, answered by 45 individuals from the cohort. The global AP-Q score was 5.1 1.3, with an internal consistency of 64%. The PCA analysis extracted seven principal components, which explained 68.5% of the variance. The global AP-Q score was positively associated with Kidmed-test score. Our data suggest that AP-Q is a complete and robust questionnaire to assess HFP adherence, with several advantages: easy to complete, cost-e ective, timesaving and has the competency to assess, besides diet, several features a ecting health status, lacking in other instruments. We suggest that AP-Q could be useful in epidemiological research, although it requires additional calibration to analyze its reproducibility and validation in other populationsFinanced by Universidad Autónoma de Madrid-Khon Kaen University (KKU: 0514.7.I.12-1948

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Development and Validation of a Questionnaire to Assess Adherence to the Healthy Food Pyramid in Spanish Adults

We aimed to design and validate a new questionnaire of adherence to healthy food pyramid (HFP) (AP-Q), to improve previous instruments. The questionnaire was self-administered and included 28 questions from 10 categories (physical activity, health habits, hydration, grains, fruits, vegetables, oil type, dairy products, animal proteins, and snacks). A population of 130 Spanish adults answered it, obtaining scores from each category and a global score of HFP adherence (AP-Q score). Validation was performed through principal components analysis (PCA) and internal consistency by Cronbach&rsquo;s alpha. AP-Q was also externally validated with Kidmed-test, answered by 45 individuals from the cohort. The global AP-Q score was 5.1 &plusmn; 1.3, with an internal consistency of 64%. The PCA analysis extracted seven principal components, which explained 68.5% of the variance. The global AP-Q score was positively associated with Kidmed-test score. Our data suggest that AP-Q is a complete and robust questionnaire to assess HFP adherence, with several advantages: easy to complete, cost-effective, timesaving and has the competency to assess, besides diet, several features affecting health status, lacking in other instruments. We suggest that AP-Q could be useful in epidemiological research, although it requires additional calibration to analyze its reproducibility and validation in other populations

Validation of a score for predicting fatal bleeding in patients receiving anticoagulation for venous thromboembolism

BACKGROUND: The only available score to assess the risk for fatal bleeding in patients with venous thromboembolism (VTE) has not been validated yet. METHODS: We used the RIETE database to validate the risk-score for fatal bleeding within the first 3 months of anticoagulation in a new cohort of patients recruited after the end of the former study. Accuracy was measured using the ROC curve analysis. RESULTS: As of December 2011, 39,284 patients were recruited in RIETE. Of these, 15,206 had not been included in the former study, and were considered to validate the score. Within the first 3 months of anticoagulation, 52 patients (0.34%; 95% CI: 0.27-0.45) died of bleeding. Patients with a risk score of 4 points had a rate of 1.44%. The c-statistic for fatal bleeding was 0.775 (95% CI 0.720-0.830). The score performed better for predicting gastrointestinal (c-statistic, 0.869; 95% CI: 0.810-0.928) than intracranial (c-statistic, 0.687; 95% CI: 0.568-0.806) fatal bleeding. The score value with highest combined sensitivity and specificity was 1.75. The risk for fatal bleeding was significantly increased (odds ratio: 7.6; 95% CI 3.7-16.2) above this cut-off value. CONCLUSIONS: The accuracy of the score in this validation cohort was similar to the accuracy found in the index study. Interestingly, it performed better for predicting gastrointestinal than intracranial fatal bleeding