Alergia a las Proteínas de Leche de Vaca. Inducción a la Tolerancia Oral.

El uso de la inducción a la tolerancia oral para la alergia a las proteínas de leche de vaca es una alternativa a tener en cuenta como medida terapéutica. Compararemos dos grupos de edad en los que se inició la ITO, siendo un primer grupo en menores de 1 año y el otros grupo aquellos mayores al año. Estudio descriptivo observacional centrado en una población de pacientes infantiles obtenidos de las consultas de Alergología del Hospital Infantil Miguel Servet de Zaragoza en relación con procesos de hipersensibilidad o alergia a las proteínas de leche de vaca (APLV) en los que se ha iniciado una pauta de inducción a la tolerancia oral (ITO) a las mismas. Se trata de un total de 53 pacientes divididos en dos grupos (menores y mayores a un año) con antecedentes de cuadro compatible con APLV en los que se inició la ITO y se describe la evolución en ciertos parámetros, como la tolerancia oral a las proteínas de leche tanto en el primer como segundo año, la evolución en los niveles de IgE específica a las distintas fracciones de las proteínas de leche de vaca (leche entera, alfalactoalbúmina, beta-lactoglobulina, caseína y en los casos en los que se dispone con leche de oveja y de cabra) y las sensibilizaciones concomitantes que pudieran existir, centrándonos en las proteínas del huevo por su aparición a dichas edades

Validation of the Spanish version of the electronic facial palsy assessment (eFACE)

Purpose The clinician-graded electronic facial paralysis assessment (eFACE) is a relatively new digital tool for assessing facial palsy. The present study aimed to determine the validity and reliability of the Spanish version of the eFACE. Methods Forward–backward translation from the original English version was performed. Videos and photographs from 65 adult patients with unilateral facial paralysis (any severity, time course, and etiology) were evaluated twice by fve otolaryngologists with varying levels of experience in facial palsy evaluation. Internal consistency was measured using Cronbach’s α and the intra- and inter-rater reliability were measured using intraclass correlation coefcient. Concurrent validity was established by calculating Spearman’s rho correlation (ρ) between the eFACE and the House–Brackmann scale (H–B) and Pearson’s correlation (r) between the eFACE and the Sunnybrook Facial Grading System (SFGS). Results The Spanish version of the eFACE showed good internal consistency (Cronbach’s α>0.8). The intra-rater reliability was nearly perfect for the total score (intraclass correlation coefcient: 0.95–0.99), static score (0.92–0.96), and dynamic score (0.96–0.99) and important-to-excellent for synkinesis score (0.79–0.96). The inter-rater reliability was excellent for the total score (0.85–0.93), static score (0.80–0.90), and dynamic score (0.90–0.95) and moderate-to-important for the synkinesis score (0.55–0.78). The eFACE had a very strong correlation with the H–B (ρ= – 0.88 and – 0.85 for each evaluation, p<0.001) and the SFGS (r=0.92 and 0.91 each evaluation, p<0.001). Conclusion The Spanish version of the eFACE is a reliable and valid instrument for assessment of facial function in the diagnosis and treatment of patients with facial paralysisThis research was funded by a grant (PI20/01032) from Programa Estatal de Generación de Conocimiento y Fortalecimiento del Sistema Español de I+D+I, Instituto de Salud Carlos III, Spain. The authors report no involvement in the research by the sponsor that could have infuenced the outcome of this wor

El efecto de la distribución a priori en modelos con frontera estocástica. Comparación con máxima verosimilitud.

Recoge los contenidos presentados a: ASEPELT España. Reunión anual (28. 2014. Málaga).En este trabajo se analizan y comparan las propiedades de los estimadores máximo verosímil y bayesiano en el modelo de producción con frontera estocástica a través de un estudio de tipo Monte Carlo. En el caso bayesiano, se presta especial atención al efecto que tiene la elección del hiperparámetro que determina la eficiencia mediana de la distribución a priori. Los resultados muestran un mejor comportamiento de la estimación bayesiana, salvo en el caso poco probable de que se asigne un hiperparámetro muy alejado del valor real de la población.In this paper, the maximum likelihood and the Bayesian methodologies are analysed and compared through a Monte Carlo study in the setting of half–normal stochastic frontier production models. In the Bayesian case, special emphasis is placed on the effect that the choice of the hyperparameter that determines the prior median efficiency has on the estimations. The results show a better behaviour of the Bayesian estimation, except in the unlikely case in which researchers assign a value to the aforementioned hyperparameter which greatly differs from its actual value

El efecto de la distribución a priori en modelos con frontera estocástica. Comparación con máxima similitud.

Recoge los contenidos presentados a: ASEPELT España. Reunión anual (28. 2014. Málaga).En este trabajo se analizan y comparan las propiedades de los estimadores máximo verosímil y bayesiano en el modelo de producción con frontera estocástica a través de un estudio de tipo Monte Carlo. En el caso bayesiano, se presta especial atención al efecto que tiene la elección del hiperparámetro que determina la eficiencia mediana de la distribución a priori. Los resultados muestran un mejor comportamiento de la estimación bayesiana, salvo en el caso poco probable de que se asigne un hiperparámetro muy alejado del valor real de la población.In this paper, the maximum likelihood and the Bayesian methodologies are analysed and compared through a Monte Carlo study in the setting of half–normal stochastic frontier production models. In the Bayesian case, special emphasis i placed on the effect that the choice of the hyperparameter that determines the prior median efficiency has on the estimations. The results show a better behaviour of the Bayesian estimation, except in the unlikely case in which researchers assign a value to the aforementioned hyperparameter which greatly differs from its actual value

An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition

[ENG]Importance Strategies targeting body composition may help prevent chronic diseases in persons with excess weight, but randomized clinical trials evaluating lifestyle interventions have rarely reported effects on directly quantified body composition. OBJECTIVE To evaluate the effects of a lifestyle weight-loss intervention on changes in overall and regional body composition. DESIGN, SETTING, AND PARTICIPANTS The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of the intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. The trial reported herein is an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, and data analysis was conducted from February 1 to November 30, 2022. Of 6874 total PREDIMED-Plus participants, a subsample of 1521 individuals, coming from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. INTERVENTION Participants were randomly allocated to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. MAIN OUTCOMES AND MEASURES The outcomes (continuous) were 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models. Clinical relevance of changes in body components (dichotomous) was assessed based on 5% or more improvements in baseline values, using logistic regression. Main analyses were performed in the evaluable population (completers only) and in sensitivity analyses, multiple imputation was performed to include data of participants lost to follow-up (intention-to-treat analyses). RESULTS A total of 1521 individuals were included (mean [SD] age, 65.3 [5.0] years; 52.1% men). In comparison with the control group (n=761), participants in the intervention arm (n=760) showed greater reductions in the percentage of total fat (between group differences after 1-year, −0.94% [95% CI, −1.19 to −0.69]; 3 years, −0.38% [95% CI, −0.64 to −0.12] and visceral fat storage after 1 year, -126 g [95% CI, −179 to −73.3 g]; 3 years, −70.4 g [95% CI, −126 to −15.2 g] and greater increases in the percentage of total lean mass at 1 year, 0.88% [95% CI, 0.63%-1.12%]; 3-years 0.34% [95%CI, 0.09%-0.60%]). The intervention group was more likely to show improvements of 5% or more in baseline body components (absolute risk reduction after 1 year, 13% for total fat mass, 11% for total lean mass, and 14% for visceral fat mass; after 3-years: 6% for total fat mass, 6% for total lean mass, and 8% for visceral fat mass). The number of participants needed to treat was between 12 and 17 to attain at least 1 individual with possibly clinically meaningful improvements in body composition. CONCLUSIONS AND RELEVANCE The findings of this trial suggest a weight-loss lifestyle intervention based on an energy-reduced MedDiet and physical activity significantly reduced total and visceral fat and attenuated age-related losses of lean mass in older adults with overweight or obesity and metabolic syndrome. Continued follow-up is warranted to confirm the long-term consequences of these changes on cardiovascular clinical end points.S