Ventilation and blood lactate in children during a maximal incremental cycling test

Este estudio analiza la respuesta ventilatoria en 46 niños varones (8,28 ± 1 años) durante una prueba máxima incremental en cicloergómetro y las concentraciones de lactato sanguíneo al final de la prueba. El incremento fue de 10 vatios cada minuto y se inició a 25 vatios. Durante la prueba el aire espirado se recolectó a través de una mascarilla facial y se analizó respiración a respiración. El segundo umbral ventilatorio (VT 2 ) se determinó según los métodos de intercambio de gases. Todos los niños alcanzaron una potencia máxima (P máx ) de 82,4 ± 1,6 W y un consumo pico de oxígeno (VO 2 ) de 44,69 ± 3,01 ml/kg/min. El VT 2 estaba en el 86,5% del VO 2pico . El lactato sanguíneo al final de la prueba fue de 9,65 ± 1,58 mM/l. Las concentraciones de lactato sanguíneo son mucho mayores que las registradas en la mayoría de los estudios previos y no parecen ser diferentes a las observadas en deportistas bien entrenados al final de una prueba similar. La ecuación que obtuvimos de la relación entre producción de dióxido de carbono (VCO 2 ) y ventilación (VE) fue lineal (y = 0,0324x - 0,008; R 2 = 0,999). En comparación con adultos evaluados previamente en nuestro laboratorio (y = 0,0347x + 0,1452; R 2 = 0,9854) fueron prácticamente idénticas. Esto puede ser un argumento válido para considerar que la capacidad de eliminar CO 2 en niños es tan alta como la de los adultos.This study analyzes the ventilatory response in 46 male children (8.28 ± 1 year) during a maximal incremental test in cycle ergometer and the blood lactate concentrations at the end of the test. The increase was 10 watts every minute starting at 25 watts. During the test the expired air was collected through a facial mask and analyzed breath by breath. The second ventilatory threshold (VT 2 ) was determined according to gas exchange methods. All children carried out a maximum power (P max ) of 82.4 ± 1.6 W and a peak oxygen consumption (VO 2 ) of 44.69 ± 3.01 mL/kg/min. The VT 2 was at 86.5% of peak VO 2 . The blood lactate at the end of the test was 9.65 ± 1.58 mM/L. The blood lactate concentrations are much higher than those reported in most studies and they do not seem to be different to those observed in well-trained sportsmen at the end of a similar test. We obtained the equation for the relationship between carbon dioxide production (VCO 2 ) and ventilation (VE) and it was linear (y = 0.0324x - 0.008; R2 = 0.999). When compared with adults previously assessed in our laboratory (y = 0.0347x + 0.1452; R 2 = 0.9854) they were practically identical. This may be a good argument to consider the ability for eliminating carbon dioxide in children as high as that in ad

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

Reporting of Perinatal Outcomes in Probiotic Randomized Controlled Trials. A Systematic Review and Meta-Analysis

The use of probiotic microorganisms in clinical practice has increased in recent years and a significant number of pregnant women are regular consumers of these products. However, probiotics might modulate the immune system, and whether or not this modulation is beneficial for perinatal outcomes is unclear. We performed a systematic review and meta-analysis to evaluate the reporting of perinatal outcomes in randomized controlled trials including women supplemented with probiotic microorganisms during pregnancy. We also analyzed the effects that the administration of probiotic microorganisms exerts on perinatal outcomes. In the review, 46 papers were included and 25 were meta-analyzed. Reporting of perinatal outcomes was highly inconsistent across the studies. Only birth weight, cesarean section, and weeks of gestation were reported in more than 50% of the studies. Random effects meta-analysis results showed that the administration of probiotic microorganisms during pregnancy did not have any a positive or negative impact on the perinatal outcomes evaluated. Subgroup analysis results at the strain level were not significantly different from main analysis results. The administration of probiotic microorganisms does not appear to influence perinatal outcomes. Nonetheless, future probiotic studies conducted in pregnant women should report probiotic strains and perinatal outcomes in order to shed light upon probiotics’ effects on pregnancy outcomes.Spanish Ministry of Science, Innovation, and Universities (Project FIS-ISCIII) P117/0230

Childhood Obesity and its Influence on Sleep Disorders: Kids-Play Study

Background: Sleep disorders are associated with overweight and obese children, and could decrease life quality with limitations to normal daily activities. The purpose of the study is to describe the prevalence of sleep disorders in a cohort of overweight/obese children using respiratory polygraphy. Methods: A descriptive cross-sectional study was conducted in Granada (Spain) on a sample of 98 children with overweight or obesity. The presence of sleep disorders was determined by respiratory polygraphy. Results: Regarding apnoea–hypopnea-index (AHI) results, 44% of a ected children had severe sleep apnoea–hypopnea syndrome (SAHS), and the remaining 56% had a mild form of the disorder. With respect to oxygen-desaturation index, 56% of the same group had severe SAHS, 32% had mild SAHS, and the remaining 12% did not su er from SAHS. Among participants, average scores of 13.8 obstructive apnoea, 7.7 central apnoea, and 13.6 hypopnoea were recorded. Conclusions: Respiratory polygraphy can provide conclusive results in the diagnosis of SAHS in overweight/obese children. Interventional programmes designed and implemented to reduce overweight and obesity can improve quality of sleep and life in children

Water Exercise and Quality of Life in Pregnancy: A Randomised Clinical Trial

Background: Physical exercise helps to maintain a healthy lifestyle and its practice is recommended for women during pregnancy as a means of limiting the negative effects on the body that may take place and to optimise well-being, mood and sleep patterns, as well as encouraging daily physical activity, enhancing the ability to work and preventing pregnancy-related complications. Aim: To analyse the quality of life in pregnancy for women who complete a programme of moderate physical activity in water, following a designed method that the woman can perform physical exercise safely during pregnancy called the SWEP (study of water exercise during pregnancy) method. Materials and methods: A randomised clinical trial was performed. One hundred and twenty-nine pregnant women were randomly assigned either to an exercise class following the SWEP method (EG, n = 65) or to a control group (CG, n = 64). The trial began in week 20 of pregnancy (May 2016) and ended in week 37 (October 2016). Heath-related quality of life (HRQoL) was evaluated with the SF36v2 health questionnaire at weeks 12 and 35 of pregnancy. Results: The HRQoL score decreased significantly between weeks 12 and 35 of gestation, except for the mental health component, which in the CG fell by -3.28 points and in the EG increased slightly (p > 0.05). Among the CG, the score for the mental health component at week 35 was <42, indicating a positive screening risk of depression (39.20 +/- 4.16). Conclusions: Physical activity programmes in water, such as SWEP, enhance the HRQoL of pregnant women

Measurement Units Used in Treatments to Reduce Weight and Obesity. Systematic Review

Existen diferentes tratamientos para reducir el sobrepeso y la obesidad; no obstante, los resultados de los tratamientos sobre la pérdida de peso tienen una expresión muy heterogénea. Objetivo: Determinar las unidades de medida más utilizadas en los tratamientos de pérdida de peso, mediante la revisión de artículos científicos. Método: Se ha realizado una revisión sistemática de los últimos 5 años en CINHAL, Proquest y Scopus. Se han seleccionado los artículos publicados en inglés, francés y español. Los criterios de inclusión han sido: artículos de tratamiento únicamente dietético del sobrepeso en humanos. Los criterios de exclusión: tratamientos no dietéticos, enfermedades metabólicas, menos de 50 pacientes y menos de 8 semanas de tratamiento. La revisión ha sido realizada por dos investigadores independientes. Resultados y discusión: De 854 artículos, sólo 61 cumplían con los criterios establecidos. Estos se agruparon en 5 subgrupos, según expresaban la pérdida, en kilos o en porcentajes. Los resultados muestran falta de homogeneidad en la expresión de dicha pérdida. Conclusiones: Existe una gran heterogeneidad en la expresión de los resultados de los tratamientos de pérdida de peso; la dieta es una de las herramientas menos usadas; el análisis de los ensayos clínicos de intervención refleja una alta calidad en los sujetos mayores de 18 años, destacando la carencia de este tipo de líneas de investigación en los menores de esa edad. Por ello, se deberían estandarizar las magnitudes de expresión del éxito de dichos tratamientos y aumentar las líneas de investigación sobre este tema.There are different parameters to express the loss of weight in the treatment of overweight and obesity: absolute loss, percentage of loss, decrease in BMI, etc. Objective: To determine the magnitudes more used in the bibliography in order to establish criteria for uniformity in the expression of those results. Methods: a systematic review of the last five years has made at Proquest, CINHAL, Scopus, with descriptors “body fat distribution” and “diet” and “diet, reducing” and “weight loss”. Articles published in English, French and Spanish were selected. Inclusion criteria were used: articles only dietary treatment of overweight in humans, and exclusion criteria: not dietary treatments, metabolic diseases, less than 50 patients and less than 8 weeks of treatment. Title, summary, methodology, results and discussion have been analysed by two researchers independently. Results and discussion: 854 items found, only 61 met the criteria. These were grouped into 5 subgroups, as they expressed the weight loss (weight or fat loss in kg; weight and fat loss in kg; weight or fat loss in %; weight loss in % and fat loss in kg or vice versa; weight and far loss in%). The results show a lack of homogeneity in the loss, being the percentage the most used expression. Conclusions: There is great heterogeneity in the expression of results of the treatments for weight loss; the diet is one of the least used tools; the analysis of clinical trials of intervention reflects a high quality in subjects older than 18 years, highlighting the lack of this type of research lines in children under 18 years. Therefore, it should standardize the magnitudes of expression of the success of these treatments and increase the lines of research on this topic

Obesidad monogénica humana: papel del sistema leptina-melanocortina en la regulación de la ingesta de alimentos y el peso corporal en humanos

La obesidad humana es un trastorno de origen multifactorial en el que intervienen factores tanto genéticos como ambientales. La existencia de alteraciones genéticas que dan origen a obesidades monogénicas resulta muy interesante para el estudio de los mecanismos que contribuyen a un aumento de la ingesta de energía y la acumulación de grasa en el cuerpo. La mayoría de los genes implicados en obesidad monogénica se relacionan con el sistema de la leptina-melanocortinas, de ahí la importancia de su estudio a través de mutaciones naturales en ratones. Así, se han descrito mutaciones relacionadas con obesidad humana de tipo monogénica en la leptina y su receptor, proopiomelanocortina y prohormona convertasa 1. El objetivo de este trabajo ha sido ofrecer una revisión actualizada acerca de las principales características y funcionamiento del sistema leptina-melanocortinas, así como de sus implicaciones y potencialidades en el proceso de regulación de la ingesta alimentaria y control del peso corporal.Human obesity is a disorder of multifactorial origin in which genetic and environmental factors are involved. To understand the mechanisms regulating energy intake and fat accumulation in the body, it is important to study the genetic alterations causing monogenic obesity. Most of the genes involved in monogenic obesity are associated with the leptin-melanocortin system; hence the importance of studying this system by analysing natural mutations in mice. Previous studies have described mutations in leptin and its receptor, proopiomelanocortin and prohormone convertase 1 associated with human obesity of monogenic origin. The aim of this study is to provide an updated review of the main characteristics and functioning of the leptin-melanocortin system, and its implications and potentialities in regulating food intake and body weight

Prenatal stimulation. Results in the peripartum period

Durante el proceso gestacional, el estrés prolongado y las preocupaciones que genera este período pueden alterar el desarrollo y la función del hemisferio derecho; de ahí la importancia que se atribuye a los distintos programas de estimulación temprana dirigido a las mujeres gestantes. Objetivos: Determinar los resultados perinatales en el momento del parto de las mujeres que recibieron el programa de estimulación prenatal. Material: Se realizó un estudio experimental en cinco áreas de salud del municipio de Cienfuegos (Cuba) para identificar los resultados perinatales en el momento del parto y de las mujeres que recibieron el programa de estimulación prenatal. Metodología: Se efectuó una muestra intencional de la totalidad del universo, correspondiente a una n = 200 embarazadas, entre las 20 y las 28 semanas de gestación. Las variables estudiadas fueron la duración del trabajo del parto, el peso del recién nacido, el apgar al nacimiento, el tipo de parto y la opinión que las mujeres estudiadas tenían sobre el programa. Resultados: En el 36% de la población estudiada, el trabajo del parto fue menor de 6 horas. En el 67,5%, el recién nacido tuvo un peso comprendido entre 2.500 y 3.000 gramos y para el 96,5% de los hijos de las madres estimuladas, el apgar al nacer fue evaluado entre 8 y 9. En el 68,5% de las mujeres que recibieron el programa de estimulación, su parto fue eutócico y el 96% de las mujeres participantes está satisfecha con el programa recibido. Conclusiones. Se ha demostrado que estos nuevos programas de estimulación prenatal son bien aceptadas por la embarazada.During pregnancy, the prolonged stress and worry felt by mothers can alter the development and function of the right brain hemisphere. For this reason, importance is given to prenatal stimulation programs for pregnant women. Objectives: To determine the perinatal results in the moment of childbirth in mothers who had participated in prenatal stimulation programs. Material. An experimental study was conducted in five health districts in the town of Cienfuegos (Cuba) with a view to identifying the perinatal results at the moment of childbirth in women that had participated in prenatal stimulation programs. Methodology: The study consisted of an intentional sampling of all of the subjects (n = 200 women who were 20-28 weeks pregnant). The variables studied were the following: duration of labor, baby’s birth weight, Apgar score at birth, type of childbirth, and opinion of the subjects about the prenatal stimulation program. Results: Of the population sample, 36% of the subjects gave birth in less than six hours; 67.5% had babies weighing 2,500-3,000 grams; and 96.5% had babies whose Apgar scores were between 8 and 9. Finally, 68.5% of the subjects had natural childbirths and 96% were satisfied with the prenatal stimulation program. Conclusions. The results obtained showed that these new prenatal stimulation programs were well received by the subjects in this study

Periodontal Disease as a risk factor for complications during pregnancy and childbirth

Introduction: Periodontal Disease during pregnancy can influence in maternal-fetal health. Two hypotheses have been established in relation to oral health and alterations in pregnancy. The first one determines that periodontal disease causes immunological changes, which causes complications during pregnancy. The second hypothesis proposes that oral bacteria colonize the placenta, cause inflammatory responses and result in preeclampsia and prematurity. Objective: To carry out a systematic review on periodontal disease and its relationship with complications during pregnancy. Methodology: A systematic review was carried out using PRISMA methodology. An electronic search was conducted in three databases (PUDMED, CINAHL and SCOPUS) for articles published in English. The keywords or search terms used were the following: Low birth weight / Low birth weight; Periodontal disease / Periodontal disease, pregnant / Pregnant women. Results: For this review, 19 specific articles on periodontal disease and its relation to pregnancy complications have been selected. Discussion / Conclusions: The publications analyzed in this study, according to their results, revealed that the association between periodontal disease and the health of the pregnant women and their baby is still contradictor

Anthropometric study and evaluation of the nutritional status of a population school children in Granada: comparison of national and international reference standards

Estudios recientes muestran un incremento alarmante en las tasas de sobrepeso y obesidad entre la población infantil y juvenil. Los objetivos de este trabajo fueron realizar una valoración del estado nutricional y composición corporal mediante antropometría en una población de escolares de Granada capital y provincia, así como comparar el estado nutricional de la población escolar estudiada con los estándares nacionales e internacionales de referencia. La prevalencia general de sobrepeso encontrado en ambos sexos fue del 22,03% y la tasa de obesidad del 9,12%. Se encontraron diferencias estadísticamente significativas entre la variable peso para la edad y el sexo (p < 0,05) y la variable estatura para la edad y sexo (p < 0,05). Respecto del índice de masa corporal, no se encontraron diferencias estadísticamente significativas para la variable sexo (p = 0,182) pero sí respecto de la variable edad (p < 0,05). Por último, cabe resaltar como los valores de antropometría estimados, se sitúan muy por encima de los estándares de referencia tanto nacionales como internacionales.Recent studies show an alarming increase in levels of overweight and obesity among children and adolescents. The main objectives of this research were the following: (i) to carry out an anthropometric evaluation of the nutritional status and body composition of school children in the city and province of Granada; (ii) to compare the nutritional status of this population sample with national and international reference standards. The results obtained in this study showed that the general prevalence of overweight in both sexes was 22.03% and that 9.12% of the children were obese. Statistically significant differences were found between the variable, weight for age and sex (p < 0.05) and the variable, height for age and sex (p < 0.05). Regarding the body mass index, no statistically significant differences were found for the variable, sex (p = 0.182). This contrasted with the variable, age, which did show statistically significant differences (p < 0.05). As a conclusion, the results of our study highlighted the fact that these anthropometric values were much higher than national and international reference standards