Nutritional valuation of schoolchildren from three Ibero-American countries: A comparative analysis of the references proposed by International Obesity Task Force (IOTF) and World Health Organization (WHO)

Introducción: El índice de masa corporal (IMC) resulta un indicador útil para valorar la condición nutricional en la infancia y adolescencia. Si bien no existe consenso respecto a los valores o puntos de corte de IMC que deben utilizarse para la diagnosis del sobrepeso, la obesidad o la insuficiencia ponderal, las referencias propuestas por la Organización Mundial de la Salud (OMS) y la International Obesity Task Force (IOTF) son las más aceptadas. No obstante, existen discrepancias importantes en los resultados obtenidos en función de una u otra referencia. Objetivo: Analizar y comparar la condición nutricional de una muestra internacional a partir del IMC, mediante la aplicación simultánea de las referencias recomendadas por la IOTF y la OMS. Métodos: Se calculó el IMC de 1289 escolares de 10 a 13 años de México, Venezuela y España. A cada niño le fue atribuida una categoría nutricional (bajo peso, normopeso, sobrepeso y obesidad) utilizando el criterio de la IOTF (puntos de corte equivalentes a 18,5; 25 y 30 en adultos) y OMS (-1 DE: bajo peso + 1 DE: sobrepeso y +2 DE: obesidad). Las prevalencias de estado nutricional obtenidas por cada criterio fueron comparadas mediante la prueba de Chi-Cuadrado. Resultados: El porcentaje de escolares en cada una de las categorías nutricionales varió significativamente en función de la referencia empleada. La prevalencia de malnutrición por exceso o por defecto fue, en ambos sexos y en los tres países, superior al emplear los parámetros OMS. La referencia OMS evidenció un 10,9% menos de niños normonutridos y un 13,1% más de malnutridos que la IOTF. Discusión: Los resultados de esta investigación permiten inferir que la referencia propuesta por la OMS resulta ser más “preventiva” al momento de identificar individuos malnutridos. Se subraya la importancia de especificar los criterios empleados para la determinación del estado nutricional en los estudios de carácter epidemiológico, así como de contrastar las referencias empleadas para el diagnóstico. Conclusiones: Las referencias OMS para IMC sobrestiman la prevalencia de bajo peso, sobrepeso y obesidad en relación a los puntos de corte propuestos por el IOTF para el diagnóstico de la malnutrición.Introduction: Body Mass Index (BMI) is a useful tool for assessing nutritional status in childhood and adolescence. Although there is no consensus on BMI values or cutoffs to be used for the diagnosis of overweight, obesity and underweight references proposed by World Health Organization (WHO) and International Obesity Task Force (IOTF) are the most accepted. However, there are significant discrepancies in the results obtained in terms of either reference. Objective: To analyze and compare the nutritional status of an international sample from IMC, by simultaneous application of IOTF and WHO recommended references. Methods: 1289 schoolchildren’s BMI between 10 and 13 years of Mexico, Venezuela and Spain was estimated. Each child was assigned a nutritional category (underweight, normal weight, overweight and obese) using the IOTF criteria (points cut equivalent to 18,5, 25 and 30 in adults) and WHO (-1 SD: low weight +1 DE: overweight and +2 SD: obesity). The prevalence of nutritional status of each criterion was compared using the Chi-square test. Results: The percentage of students in each of the nutritional categories mottled significantly depending on the reference used. The prevalence of excess or defect malnutrition, in both sexes and in all three countries, was exceeded using the WHO parameters. WHO reference showed 10,9% less than well-nourished children and 13,1 % more malnourished than the IOTF. Discussion: The results of this research allow inferring that the reference proposed by WHO appears to be more “protecting” when identifying malnourished individuals. The importance of specifying the criteria for determination of nutritional status in epidemiologic studies, as well as to contrast the references used for diagnosis, is emphasized. Conclusions: The WHO BMI references overestimate the prevalence of underweight, overweight and obesity in relation to the cutoff points proposed by the IOTF for diagnosing malnutrition.Fil: Bergel Sanchís, María Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; ArgentinaFil: Cesani Rossi, María Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; ArgentinaFil: Cordero, Maria Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucuman. Instituto Superior de Estudios Sociales. Universidad Nacional de Tucuman. Instituto Superior de Estudios Sociales; ArgentinaFil: Navazo, Bárbara. Universidad Nacional de la Plata. Facultad de Cs.naturales y Museo. Departamento Científico de Antropología. Cátedra de Antropología Biológica Iv; ArgentinaFil: Olmedo, S.. Programa de Ecología Reproductiva del Gran Chaco Argentino. Formosa; ArgentinaFil: Quintero, F.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; Argentina. Universidad Nacional de la Plata. Facultad de Cs.naturales y Museo. Departamento Científico de Antropología. Cátedra de Antropología Biológica Iv; ArgentinaFil: Sardi, Marina Laura. Universidad Nacional de la Plata. Facultad de Cs.naturales y Museo. Departamento de Antropología; ArgentinaFil: Torres, María Fernanda. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras; ArgentinaFil: Arechiga, J.. Universidad Nacional Autónoma de México; MéxicoFil: Méndez de Pérez, B. Universidad Nacional de Venezuela; VenezuelaFil: Marrodán, M. D.. Universidad Complutense de Madrid; Españ

Hard Superconducting Gap in InSb Nanowires

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Candida colonization and subsequent infections in critically ill surgical patients

OBJECTIVE. The authors determined the role of Candida colonization in the development of subsequent infection in critically ill patients. DESIGN. A 6-month prospective cohort study was given to patients admitted to the surgical and neonatal intensive care units in a 1600-bed university medical center. METHODS. Patients having predetermined criteria for significant Candida colonization revealed by routine microbiologic surveillance cultures at different body sites were eligible for the study. Risk factors for Candida infection were recorded. A Candida colonization index was determined daily as the ratio of the number of distinct body sites (dbs) colonized with identical strains over the total number of dbs tested; a mean of 5.3 dbs per patient was obtained. All isolates (n = 322) sequentially recovered were characterized by genotyping using contour-clamped homogeneous electrical field gel electrophoresis that allowed strain delineation among Candida species. RESULTS. Twenty-nine patients met the criteria for inclusion; all were at high risk for Candida infection; 11 patients (38%) developed severe infections (8 candidemia); the remaining 18 patients were heavily colonized, but never required intravenous antifungal therapy. Among the potential risk factors for candida infection, three discriminated the colonized from the infected patients--i.e., length of previous antibiotic therapy (p < 0.02), severity of illness assessed by APACHE II score (p < 0.01), and the intensity of Candida spp colonization (p < 0.01). By logistic regression analysis, the latter two who were the independent factors that predicted subsequent candidal infection. Candida colonization always preceded infection with genotypically identical Candida spp strain. The proposed colonization indexes reached threshold values a mean of 6 days before Candida infection and demonstrated high positive predictive values (66 to 100%). CONCLUSIONS. The intensity of Candida colonization assessed by systematic screening helps predicting subsequent infections with identical strains in critically ill patients. Accurately identifying high-risk patients with Candida colonization offers opportunity for intervention strategies

Formin Homology 2 Domain Containing 3 (FHOD3) Is a Genetic Basis for Hypertrophic Cardiomyopathy.

The genetic cause of hypertrophic cardiomyopathy remains unexplained in a substantial proportion of cases. Formin homology 2 domain containing 3 (FHOD3) may have a role in the pathogenesis of cardiac hypertrophy but has not been implicated in hypertrophic cardiomyopathy. This study sought to investigate the relation between FHOD3 mutations and the development of hypertrophic cardiomyopathy. FHOD3 was sequenced by massive parallel sequencing in 3,189 hypertrophic cardiomyopathy unrelated probands and 2,777 patients with no evidence of cardiomyopathy (disease control subjects). The authors evaluated protein-altering candidate variants in FHOD3 for cosegregation, clinical characteristics, and outcomes. The authors identified 94 candidate variants in 132 probands. The variants' frequencies were significantly higher in patients with hypertrophic cardiomyopathy (74 of 3,189 [2.32%]) than in disease control subjects (18 of 2,777 [0.65%]; p  FHOD3 is a novel disease gene in hypertrophic cardiomyopathy, accounting for approximately 1% to 2% of cases. The phenotype and the rate of cardiovascular events are similar to those reported in unselected cohorts. The FHOD3 gene should be routinely included in hypertrophic cardiomyopathy genetic testing panels

Characteristics, complications and outcomes among 1549 patients hospitalised with COVID-19 in a secondary hospital in Madrid, Spain: a retrospective case series study

Objectives To describe demographic, clinical, radiological and laboratory characteristics, as well as outcomes, of patients admitted for COVID-19 in a secondary hospital.Design and setting Retrospective case series of sequentially hospitalised patients with confirmed SARS-CoV-2, at Infanta Leonor University Hospital (ILUH) in Madrid, Spain.Participants All patients attended at ILUH testing positive to reverse transcriptase-PCR on nasopharyngeal swabs and diagnosed with COVID-19 between 1 March 2020 and 28 May 2020.Results A total of 1549 COVID-19 cases were included (median age 69 years (IQR 55.0–81.0), 57.5% men). 78.2% had at least one underlying comorbidity, the most frequent was hypertension (55.8%). Most frequent symptoms at presentation were fever (75.3%), cough (65.7%) and dyspnoea (58.1%). 81 (5.8%) patients were admitted to the intensive care unit (ICU) (median age 62 years (IQR 51–71); 74.1% men; median length of stay 9 days (IQR 5–19)) 82.7% of them needed invasive ventilation support. 1393 patients had an outcome at the end of the study period (case fatality ratio: 21.2% (296/1393)). The independent factors associated with fatality (OR; 95% CI): age (1.07; 1.06 to 1.09), male sex (2.86; 1.85 to 4.50), neurological disease (1.93; 1.19 to 3.13), chronic kidney disease (2.83; 1.40 to 5.71) and neoplasia (4.29; 2.40 to 7.67). The percentage of hospital beds occupied with COVID-19 almost doubled (702/361), with the number of patients in ICU quadrupling its capacity (32/8). Median length of stay was 9 days (IQR 6–14).Conclusions This study provides clinical characteristics, complications and outcomes of patients with COVID-19 admitted to a European secondary hospital. Fatal outcomes were similar to those reported by hospitals with a higher level of complexity

Modelos de administración y gestión, políticas y metodologías, en materia de e-learning para la enseñanza en la universidad pública española

Proyecto elaborado en el ámbito de la 'III convocatoria de ayudas a la innovación educativa: convocatoria para el desarrollo y participación en proyectos de innovación educativa y mejora de la calidad docente, curso 2007-2008'No existe un modelo estándar, ni aproximaciones pedagógicas, tecnológicas u organizativas únicas al e-learning. Por ello es necesario determinar cuáles son los elementos que definen la elección de un modelo u otro para su aplicación al ámbito de la educación superior. En este sentido se ofrece una aproximación a los distintos modelos existentes de e-learning para, a continuación, realizar un estudio sobre el aprendizaje derivado del uso de estos modelos: aprendizaje significativo, aprendizaje basado en problemas, aprendizaje basado en proyectos, y aprendizaje basado en casos. Por último, se ofrece un apartado en el que se describe la situación del e-learning en la Universidad pública española, se proponen modelos de evaluación del e-learning y se dan herramientas para la acción docente y para la gestión de modelos en el ámbito universitario.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

Delay in diagnosis of influenza A (H1N1)pdm09 virus infection in critically ill patients and impact on clinical outcome

Background: Patients infected with influenza A (H1N1)pdm09 virus requiring admission to the ICU remain an important source of mortality during the influenza season. The objective of the study was to assess the impact of a delay in diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection on clinical outcome in critically ill patients admitted to the ICU. Methods: A prospective multicenter observational cohort study was based on data from the GETGAG/SEMICYUC registry (2009–2015) collected by 148 Spanish ICUs. All patients admitted to the ICU in which diagnosis of influenza A (H1N1)pdm09 virus infection had been established within the first week of hospitalization were included. Patients were classified into two groups according to the time at which the diagnosis was made: early (within the first 2 days of hospital admission) and late (between the 3rd and 7th day of hospital admission). Factors associated with a delay in diagnosis were assessed by logistic regression analysis. Results: In 2059 ICU patients diagnosed with influenza A (H1N1)pdm09 virus infection within the first 7 days of hospitalization, the diagnosis was established early in 1314 (63.8 %) patients and late in the remaining 745 (36.2 %). Independent variables related to a late diagnosis were: age (odds ratio (OR) = 1.02, 95 % confidence interval (CI) 1.01–1.03, P < 0.001); first seasonal period (2009–2012) (OR = 2.08, 95 % CI 1.64–2.63, P < 0.001); days of hospital stay before ICU admission (OR = 1.26, 95 % CI 1.17–1.35, P < 0.001); mechanical ventilation (OR = 1.58, 95 % CI 1.17–2.13, P = 0.002); and continuous venovenous hemofiltration (OR = 1.54, 95 % CI 1.08–2.18, P = 0.016). The intra-ICU mortality was significantly higher among patients with late diagnosis as compared with early diagnosis (26.9 % vs 17.1 %, P < 0.001). Diagnostic delay was one independent risk factor for mortality (OR = 1.36, 95 % CI 1.03–1.81, P < 0.001). Conclusions: Late diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection is associated with a delay in ICU admission, greater possibilities of respiratory and renal failure, and higher mortality rate. Delay in diagnosis of flu is an independent variable related to death

Higher Fluid Balance Increases the Risk of Death from Sepsis: Results from a Large International Audit∗

Objectives: Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. Design: Observational cohort study. Setting: Seven hundred and thirty ICUs in 84 countries. Patients: All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. Measurements and Main Results: ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. Conclusions: In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death

Biodiversidad 2018. Reporte de estado y tendencias de la biodiversidad continental de Colombia

Las cifras y temáticas contenidos en el presente Reporte, aunque no son el panorama completo del estado del conocimiento de la biodiversidad en Colombia, son un compendio seleccionado de los temas que, desde el Instituto Humboldt, consideramos son relevantes y merecen ser discutidos por el público general. En muchos de los casos, las cifras no son esperanzadoras u son un llamado urgente a la acción. En otro casos son la evidencia de que se requieren acciones a nivel nacional, y más allá de esto, son muchas las iniciativas que están germinando desde los territorios, cada vez desde una mayor variedad de actores.Bogotá, D. C., Colombi