Aplicación de redes para la gestión de antídotos en los servicios de farmacia hospitalaria

Este proyecto surge a raíz de la propuesta de una de las farmacéuticas adjuntas del Servicio de Farmacia Hospitalaria del Hospital Universitari Son Espases (HUSE). Inicialmente se perfila como una actividad para conocer la plataforma de la Red de Antídotos que posteriormente ha permitido conocer las características farmacológicas, presentaciones comerciales, indicaciones toxicológicas, usos terapéuticos y posologías de los antídotos que integran el botiquín de un centro hospitalario. También se ha participado activamente en la gestión del stock de antídotos de HUSE. Se ha replicado la actividad aprendida en otros hospitales de la isla de Mallorca, con el objetivo de cumplir con las recomendaciones de los antídotos que propone la Red, es decir, cuáles deberían estar presentes en los hospitales y en qué cantidad, en función del nivel de complejidad asistencial, así como revisar y actualizar las indicaciones toxicológicas de cada uno y las recomendaciones más consensuadas de posología tanto en adultos como niños. Finalmente el resultado radica en qué ventajas aporta el uso y la integración de plataformas web en los Servicios de Farmacia Hospitalaria, así como la farmacología de cada uno de los antídotos y la exposición de un caso clínico

Association of Adherence to Specific Mediterranean Diet Components and Cardiorespiratory Fitness in Young Adults

Objective: Cardiorespiratory fitness (CRF) and a healthy diet may be part of an overall healthy lifestyle. The association between cardiorespiratory fitness and adherence to an overall Mediterranean Diet (MedD) pattern and specific MedD foods has been assessed. Design: Subjects completed a lifestyle survey and dietary pattern, using the validated MedD Adherence 14-item questionnaire and two self-reported 24-h dietary recalls. Participants' height, body weight, waist circumference (WC), and CRF (maximum oxygen uptake, VO2max, ml/kg/min) were measured. Setting: University of Cadiz, Spain. Subjects: A sample of young adults (n = 275, 22.2 +/- 6.3 years). Results: Mean VO2max was 43.9 mL/kg/min (SD 8.5 mL/kg/min). Most participants had healthy CRF (75.9%). The average MedD score was 6.2 points (SD 1.8 points). Participants who consumed more servings of nuts had higher VO2max. Those who showed low CRF performed less physical activity (PA) and had a higher body mass index (BMI) and WC compared with those classified as having healthy CRF. Nut consumption was positively associated with VO2max (beta = 0.320; 95% CI 2.4, 10.7; p < 0.002), adjusting for sex, age, smoking PA, BMI, WC, and energy intake, showing the subjects who consumed more nuts were fitter than young adults who consumed less. Conclusions: CRF is positively associated with nut consumption but not with the overall MedD pattern and all other MedD foods in the young adults. The subjects who consumed more servings of nuts were fitter than young adults who consumed less. Moreover, fitter subjects performed more PA and had a lower BMI and WC than those who had lower fitness levels

Combined Body Mass Index and Waist-To-Height Ratio and Its Association With Lifestyle and Health Factors Among Spanish Children: The PASOS Study

[Abstract] Background and Aims: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-toheight ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. Methods: Cross-sectional analysis of 8–16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. Results: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% ‘increased risk’, 9.7% ‘high risk’, 14.3% ‘very high risk’). Participants in the ‘very high risk’ group were less likely to be females (odds ratio 0.63; 95% CI: 0.52–0.76) and adolescents (0.60; 95% CI: 0.49–0.72), to practice _60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57–0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49–0.76). Mothers of participants in the ‘very high risk’ group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the ‘increased’ and ‘high risk’ categories had mothers with normal weight and _60 min/day of MVPA. Participants in the ’high risk’ group did not achieve _60 min/day of MVPA and showed lower adherence to the Mediterranean diet. Conclusions: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring’s childhood and adolescence, is associated with low BMI-WHtR disease risk

Determinants of adherence to the Mediterranean diet in Spanish children and adolescents: the PASOS study

[Abstract]: A progressive shift away from traditional healthy dietary patterns, such as the Mediterranean diet (MedDiet), has been observed in recent decades. The aim of this study was to assess determinants of optimal adherence to the MedDiet in Spanish children and adolescents. A cross-sec-tional analysis was included in the PASOS nationwide representative study in Spain. Participants were 3607 children and adolescents; 8–16 years old. Primary and secondary outcome measures of weight and height were measured. Adherence to the MedDiet, physical activity, and sedentary behavior in children and adolescents, as well as parental physical activity and dietary habits, were assessed. Optimal adherence to the MedDiet was observed in 45.5% of primary school students and 34.8% of secondary school students (OR: 0.65; 95%CI: 0.56–0.75). Optimal adherence to the MedDiet was higher in children/adolescents meeting daily recommended moderate and vigorous physical activity (OR: 2.39, 95%CI: 1.97–2.89) and in those meeting daily recommended screen time on week-days (OR: 2.05, 95%CI: 1.77–2.38) and weekends (OR: 1.76, 95%CI: 1.48–2.10). Participants with optimal adherence to the MedDiet were more likely to have mothers with a high-level education and high-tercile of SDQS, mothers who never smoked or were former smokers, and mothers who met the recommended physical activity and screen time. It can be concluded that a low prevalence of optimal adherence to the MedDiet was found among current Spanish children and adolescents. Optimal adherence to the MedDiet was associated with reaching the recommendations on physical activity and screen time, with the highest maternal educational level, and healthier maternal life-style

Determinants of adherence to the mediterranean diet in Spanish children and adolescents: the PASOS Study

A progressive shift away from traditional healthy dietary patterns, such as the Mediterranean diet (MedDiet), has been observed in recent decades. The aim of this study was to assess determinants of optimal adherence to the MedDiet in Spanish children and adolescents. A cross-sectional analysis was included in the PASOS nationwide representative study in Spain. Participants were 3607 children and adolescents; 8–16 years old. Primary and secondary outcome measures of weight and height were measured. Adherence to the MedDiet, physical activity, and sedentary behavior in children and adolescents, as well as parental physical activity and dietary habits, were assessed. Optimal adherence to the MedDiet was observed in 45.5% of primary school students and 34.8% of secondary school students (OR: 0.65; 95%CI: 0.56–0.75). Optimal adherence to the MedDiet was higher in children/adolescents meeting daily recommended moderate and vigorous physical activity (OR: 2.39, 95%CI: 1.97–2.89) and in those meeting daily recommended screen time on week-days (OR: 2.05, 95%CI: 1.77–2.38) and weekends (OR: 1.76, 95%CI: 1.48–2.10). Participants with optimal adherence to the MedDiet were more likely to have mothers with a high-level education and high-tercile of SDQS, mothers who never smoked or were former smokers, and mothers who met the recommended physical activity and screen time. It can be concluded that a low prevalence of optimal adherence to the MedDiet was found among current Spanish children and adolescents. Optimal adherence to the MedDiet was associated with reaching the recommendations on physical activity and screen time, with the highest maternal educational level, and healthier maternal life-styles.The PASOS study was funded by Fundación PROBITAS and the Gasol Foundation. Additional funds were received from the Barça Foundation, Banco Santander, IFA, Vienna and the Fundación Deporte Joven (no references are applicable). J.A.T., C.B., M.M.G., and M.M.B. were funded by CIBEROBN (CB12/03/30038) of the Institute of Health Carlos III (ISCIII), and co-funded by the European Regional Development Fund

Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up

Background: Metabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors. Objective: To assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial. Design: Prospective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55-75 years old) with overweight or obesity at baseline. Methods: The desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: >= 0.0 kg (T1, n = 1,638); 0.0 to -4.0 kg (T2, n = 1,903); <=-4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed physical activity. The Framingham equation assessed cardiovascular risks. The changes in the severity of MetS were also assessed. The Beck Depression Inventory assessed depressive symptoms and the SF-36 assessed health-related quality of life. Data were analyzed using general linear models. Results: BMI decreased at T2 and T3 (T1: 0.3, T2: -0.7, T3: -1.9). The most significant improvement in diet quality was observed at T3. Cardiovascular risk decreased at T2 and T3. Mean reductions in MetS severity score were: -0.02 at T1, -0.39 at T2 and -0.78 at T3. The perception of physical health increases in successive tertiles. Conclusions: In older adults with MetS, more ambitious desired weight loss goals were associated with improvements in diet, cardiovascular health and perceived physical health during the first year of a healthy lifestyle intervention programme. Weight dissatisfaction needs to be considered by health professionals

Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk

Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55-75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3-1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia

Defining body fatness in adolescents: a proposal of the AFAD-A classification.

AIMS: Body mass index (BMI) shows several limitations as indicator of fatness. Using the International Obesity Task Force (IOTF) reference and the World Health Organization (WHO) standard 2007 on the same dataset yielded widely different rates. At higher levels, BMI and the BMI cut-offs may be help in informing a clinical judgement, but at levels near the norm additional criteria may be needed. This study compares the prevalence of overweight and obesity using IOTF and WHO-2007 references and interprets body composition by comparing measures of BMI and body fatness (fat mass index, FMI; and waist-to-height ratio, WHtR) among an adolescent population. METHODS AND RESULTS: A random sample (n = 1231) of adolescent population (12-17 years old) was interviewed. Weight, height, waist circumference, triceps and subscapular skinfolds were used to calculate BMI, FMI, and WHtR. The prevalence of overweight and obesity were 12.3% and 15.4% (WHO standards) and 18.6% and 6.1% (IOTF definition). Despite that IOTF cut-offs misclassified less often than WHO standards, BMI categories were combined with FMI and WHtR resulting in the Adiposity & Fat Distribution for adolescents (AFAD-A) classification, which identified the following groups normal-weight normal-fat (73.2%), normal-weight overfat (2.1%), overweight normal-fat (6.7%), overweight overfat (11.9%) and obesity (6.1%), and also classified overweight at risk and obese adolescents into type-I (9.5% and 1.3%, respectively) and type-II (2.3% and 4.9%, respectively) depending if they had or not abdominal fatness. CONCLUSIONS: There are differences between IOTF and WHO-2007 international references and there is a misclassification when adiposity is considered. The BMI limitations, especially for overweight identification, could be reduced by adding an estimate of both adiposity (FMI) and fat distribution (WHtR). The AFAD-A classification could be useful in clinical and population health to identify overfat adolescent and those who have greater risk of developing weight-related cardiovascular diseases according to the BMI category

Alteraciones del peso, composición corporal y prevalencia del síndrome metabólico en una cohorte de mujeres menopáusicas residentes en Mallorca

[spa] Objetivo: evaluar hábitos alimentarios, estilo de vida, composición corporal y prevalencia del síndrome metabólico en mujeres menopáusicas según su índice de masa corporal.Métodos: estudio transversal (2011-2018) en una cohorte de mujeres menopáusicas residentes en Mallorca (n = 555) clasificadas según su índice de masa corporal (IMC): < 27,0, 27,0-29,9 y ≥ 30 kg/m2. Se evaluaron hábitos alimentarios, tóxicos y de estilo de vida, antecedentes de lactancia materna y de obesidad (en la infancia, tiempo de evolución y antecedentes familiares). Se realizó análisis de composición corporal por bioimpedancia eléctrica y se extrajo sangre en ayunas para los siguientes parámetros: glucosa, triglicéridos, colesterol total, colesterol-LDL y colesterol-HDL.Resultados: la prevalencia de sobrepeso de grado II fue 26,8 % y de obesidad, del 46,5 %. La prevalencia de síndrome metabólico fue 41,4 %. Los antecedentes familiares de obesidad, obesidad en la infancia y el tiempo de evolución (≥ 15 años con obesidad) fueron mayores en mujeres obesas. La práctica de actividad física regular fue deficiente (el 63 % de las mujeres con actividad física nula y el 33 %, escasa). Las mujeres obesas presentaron una prevalencia mayor de síndrome metabólico (55,8 %) y valores mayores de IMC, circunferencia abdominal, masa grasa, grasa visceral, obesidad abdominal, tensión arterial, glucosa y triglicéridos en sangre, y valores menores de c-HDL.Conclusiones: las mujeres menopáusicas estudiadas muestran hábitos dietéticos inadecuados, estilo de vida sedentario y una prevalencia elevada de obesidad y síndrome metabólico. Los factores que se asocian a dicha prevalencia son antecedentes familiares de obesidad, obesidad en la infancia, tiempo de evolución de la obesidad, sedentarismo, obesidad abdominal y localización visceral de la grasa

Prevalence (%) of normal-weight, overweight and obesity using different indicators for the condition in Balearic Islands’ adolescent population, Spain (2007–2008).

<p>Abbreviations: BMI, body mass index; FMI, fat mass index; WHtR, waist-to-height ratio; IOTF, International Obesity Taskforce; WHO, World Health Organization. Adolescents were classified on the basis of their BMI using the ¹WHO-2007 and ²IOTF international references. ¹WHO-2007 <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0055849#pone.0055849-DeOnis1" target="_blank">[4]</a> cut-offs: normal-weight, BMI-for age and sex 2IOTF <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0055849#pone.0055849-Cole1" target="_blank">[3]</a> cut-offs; normal-weight, BMI for age and sex <25 kg/m²; overweight, BMI-for age and sex ≥25-BMI-<30 kg/m²; obesity, BMI for age and sex ≥30 kg/m². Significant differences (boys vs. girls) by χ² using ³WHO-2007 and ⁴IOTF references. NS: not significant.</p