Asociación entre consumo de alcohol y exceso de peso entre estudiantes universitarios de América Latina

Introducción: El sobrepeso y la obesidad son problemas de salud pública de nivel mundial. Si bien existe información respecto al consumo de alcohol en estudiantes universitarios durante la pandemia, pocos autores han señalado la asociación entre este hábito y el exceso de peso en esta población. El objetivo fue determinar la asociación entre el consumo de alcohol y el exceso de peso en estudiantes universitarios de 10 países de Latinoamérica durante la pandemia por COVID-19. Metodología: Se realizó un estudio transversal y multicéntrico con 4.539 estudiantes universitarios matriculados en diez países de América Latina. Para la valoración del consumo de alcohol se utilizó la pregunta ¿Consumes bebidas alcohólicas? (1 porción 1 vaso de 200 ml). El índice de masa corporal (IMC) se determinó a partir del peso y la altura auto informado. Para determinar si el exceso de peso (IMC ≥25 kg/m2 ) estaba asociado con el consumo de alcohol, se utilizó un análisis de regresión logística, ajustado por edad, sexo, año de estudio, nivel socioeconómico, actividad física y tabaquismo. Resultados: Entre los estudiantes con estado nutricional normal, un 59,6% no consumía alcohol, mientras entre los que presentaban un exceso de peso era un 55,1%. Los estudiantes que consumían 2 o más porciones de alcohol al día tenían 2,18 veces más riesgo de tener exceso de peso (OR: 2.18 [95% IC: 1,26 a 3,77]), comparado con aquellos que no consumían alcohol. Conclusión: Se observó que aquellos estudiantes que consumieron más alcohol tuvieron más probabilidades de tener exceso de peso. Palabras clave: Alcohol; Índice de masa corporal; Obesidad; Sobrepeso; Universitarios

Dietary Patterns and Dietary Recommendations Achievement From Latin American College Students During the COVID-19 Pandemic Lockdown

This study aimed to compare the diet quality of different dietary patterns among college students from Latin American countries, including vegetarians, vegans, and omnivores during the COVID-19 pandemic. A cross-sectional, observational, multicenter study was conducted including a non- probabilistic sample of university students from 10 countries. University students were invited to participate in the study through social network platforms. Participants were self-reported to have followed a specific dietary pattern; either the Prudent diet, Western diet, Ovo-dairy-vegetarian diet, Fish-vegetarian diet, Strict vegetarian diet (vegan) or other. The last three patterns (vegetarians and vegans) were grouped as following a plant-based diet. A self-assessment survey was used to evaluate healthy eating habits using a questionnaire with values between 1 (do not consume) and 5 (consume) for a total of 9–45 points (higher values represent better eating habits). Unhealthy habits were assessed with nine questions. A total of 4,809 students filled out the questionnaire, and the majority of them were females (73.7%). Murillo et al. College Dietary Patterns During COVID-19 A high percentage have been in lockdown for more than 5 months and were in lockdown when the survey was released. 74.3% were self-reported to follow a prudent diet, while 11.4% reported following a western dietary pattern and 8.8% a plant-based diet. When compliance with healthy and unhealthy dietary habits was analyzed, although all groups had low compliance, the plant-based diet group (56.09 ± 6.11) performed better than the Western diet group (48.03 ± 5.99). The total diet quality score was significantly higher for plant-based diet followers, who also tended to better achieve the recommendations than omnivorous students, especially the ones following a western diet. These results present evidence that young adults such as college-aged students have unhealthy dietary habits. However, the ones who follow a plant-based diet such as vegetarians and vegans exhibit better scores and healthier dietary conducts.UCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

The Continuous Residency Improvement Committee (CRIC) – A Novel Twist for Program Evaluation in an Academic Emergency Medicine Residency Program

ABSTRACT: Audience: The continuous residency improvement committee (CRIC) innovation is designed for residency program leadership and residency program coordinators. Introduction: The Accreditation Council for Graduate Medical Education (ACGME) requires residency- training programs to perform ongoing self-study in order to maintain accreditation status and to engage in continuous program improvement.1 Standard evaluation constructs for self-study often fail to capture input from non-traditional stakeholders and do not always result in actionable recommendations for program improvement. We developed the CRIC process to address the need for a user-friendly evaluation construct that yields actionable recommendations for programmatic improvement from a variety of stakeholders and aligns with the ACGME-prescribed continuous self-study process. Objectives: The purpose of this innovation was to develop a novel approach to continuous program evaluation and improvement using a multisource feedback design to improve resident satisfaction with the program’s responsiveness to feedback while addressing the ACGME mandate for self-study. Methods: A committee of rotating reviewers systematically evaluates resident educational rotations over a 12-month period. Reviews focused on obtaining input from both traditional and non-traditional stakeholders in a multisource model in order to document and address deficiencies identified within the rotations. Topics: ACGME self-study, 360-evaluation, program evaluation, program evaluation committee

The Continuous Residency Improvement Committee (CRIC) – A Novel Twist for Program Evaluation in an Academic Emergency Medicine Residency Program

ABSTRACT: Audience: The continuous residency improvement committee (CRIC) innovation is designed for residency program leadership and residency program coordinators. Introduction: The Accreditation Council for Graduate Medical Education (ACGME) requires residency- training programs to perform ongoing self-study in order to maintain accreditation status and to engage in continuous program improvement.1 Standard evaluation constructs for self-study often fail to capture input from non-traditional stakeholders and do not always result in actionable recommendations for program improvement. We developed the CRIC process to address the need for a user-friendly evaluation construct that yields actionable recommendations for programmatic improvement from a variety of stakeholders and aligns with the ACGME-prescribed continuous self-study process. Objectives: The purpose of this innovation was to develop a novel approach to continuous program evaluation and improvement using a multisource feedback design to improve resident satisfaction with the program’s responsiveness to feedback while addressing the ACGME mandate for self-study. Methods: A committee of rotating reviewers systematically evaluates resident educational rotations over a 12-month period. Reviews focused on obtaining input from both traditional and non-traditional stakeholders in a multisource model in order to document and address deficiencies identified within the rotations. Topics: ACGME self-study, 360-evaluation, program evaluation, program evaluation committee

Caracterización del patrón alimentario de las personas mayores de Iberoamérica en tiempos de pandemia por COVID 19

"Objetivo: Caracterizar el perfil alimentario de las Personas Mayores de Iberoamérica en tiempos de pandemia por COVID 19. Material y métodos: Estudio multicéntrico en 12 países de Iberoamérica, se aplicó una encuesta en línea que incluyó preguntas sociodemográficas y un cuestionario de Ingesta de Alimentos que incluyo la frecuencia de consumo para verduras, bebidas azucaradas, legumbres, lácteos y porción de los alimentos. Resultados: La muestra quedó conformada por 624 participantes, 72,1% (n= 450) de mujeres. El 54,7% de mujeres no consume bebidas azucaradas, en cambio en hombres un 54% consume al menos un vaso al día (p=0,012). El 35,6% de hombres consumieron ≥3 por semana legumbres versus el 23% mujeres (p=0,020). El 37,3% de las mujeres consumen ≥2 porciones diarias de lácteos, en hombres solo un 28,1% (p= 0,030). Las mujeres presentan un mayor consumo de verduras (44,7%, n= 201) respecto de los hombres (28,7%), (p=0,001). El 17,4% de la muestra total aumentó el tamaño de la porción de alimentos, sin do mayor en mujeres (p=0.005). Conclusión: Las mujeres presentan hábitos alimentarios más saludables que los hombres en base a frutas, verduras, por otra parte, la variación del tamaño se observa un incremento en especial en mujeres lo que puede relacionarse con el aumento de la obesidad.

CD68+ tumor-associated myeloid cells as the target of adenosine-induced gene products and predictor of response to adenosine blockade with ciforadenant (cifo) in renal cell cancer (RCC)

5025 Background: Adenosine in the tumor microenvironment (TME) is immunosuppressive and may play a role in resistance to immunotherapy. We described an adenosine induced gene expression signature (AS, Fong, Cancer Disc 2020) that correlates with response to therapy with cifo, an adenosine A2A receptor antagonist, as monotherapy or in combination with atezolizumab in refractory RCC. These genes express chemokines that signal through CCR2 and CXCR2 to recruit myeloid cells including immunosuppressive tumor associated-M2 macrophages, which are thought to mediate resistance to anti-PD(L)1 treatment. We now identify tumor infiltrating CD68+ myeloid cells as the effector cell for adenosine mediated immunosuppression. Methods: 82 RCC pts have been treated in an ongoing Phase 1/1b trial evaluating cifo (100mg po bid) monotherapy or combination with atezolizumab (840mg IV q 2 weeks). Tumor biopsies, obtained at screening and on therapy, are available for analysis in 32 pts to date. RNA expression was measured in tumors using Nanostring. Immunohistochemistry (IHC) for CD68 was performed on biopsies with CD68+ tumors defined as > 4% tumor area containing CD68+ cells. Results: Pt characteristics are median age 63; median prior therapies 3, with 72% failing prior anti-PD(L)1. Gene expression of M2 markers consisting of CD68 (p = 0.0008) and CD163 (p = 0.03) was higher in baseline samples from AS+ compared to AS- pts. By IHC, 10 pts had CD68+ cells infiltrating the tumor; 9 of 10 AS+. Tumor regression was observed in 6 of 10 CD68+ pts (N = 3 monotherapy and 3 combination) including 4 partial responses (PR, RECIST). No PRs and 2 minor responses were seen in 22 pts who were CD68- (p < 0.005). Median time to progression was not reached for CD68+ vs 2 mo for CD68-. Paired biopsies showed a significant reduction in infiltrating CD68+ cells (p = 0.03) with treatment including 2 of 2 evaluable PRs. Conclusions: Adenosine immunosuppression is mediated by M2 macrophages, which can be reversed by cifo. Enumerating tumor infiltrating CD68+ cells may be a valuable biomarker for identifying pts that will respond to adenosine blockade. Clinical trial information: NCT02655822

Quality of the diet during the COVID-19 pandemic in 11 Latin-American countries

BACKGROUND AND OBJECTIVES: The confinement by COVID-19 has affected the food chain and environments, which added to factors such as anxiety, frustration, fear and stress have modified the quality of the diet in the population around the world. The purpose of this study was to explore diet quality during the COVID-19 pandemic in 11 Latin American countries. METHODOLOGY: Multicentric, cross-sectional study. An online survey was applied to residents of 11 Latin-American countries, during April and May 2020, when confinement was mandatory. Diet quality was evaluated using a validated questionnaire. RESULT: 10,573 people participated in the study. The quality of the food by country shows that Colombia presented the best quality, while Chile and Paraguay presented the lowest. When comparing the overall results of diet quality by gender, schooling and age, women, people with more schooling and people under 30 years of age, presented better diet quality. The regression model showed that the variables associated with diet quality were: age (df = 3, F = 4. 57, p < 0.001), sex (df = 1, F = 131.01, p < 0.001), level of education (df = 1, F = 38.29, p < 0.001), perception of weight change (df = 2, F = 135.31, p < 0.001), basis services (df = 1, F = 8.63, p = 0.003), and quarantine (df = 1, F = 12.14, p = 0.001). CONCLUSION: It is necessary for governments to intervene to reverse these indicators, considering that inadequate feeding favors the appearance of no communicable diseases, which favor a higher risk of infection and worse prognosis with COVID-19

Psychological factors of diet quality among rural populations of Latin America during the COVID-19 pandemic: a cross-sectional study

INTRODUCTION: This study aimed to determine the relationship between symptoms of anxiety and/or anhedonia (inability to feel pleasure) and diet quality during confinement due to COVID-19 in rural populations in Latin America. METHODS: This was a multicentric, cross-sectional study. An online survey was applied, which included the Beck Anxiety Inventory, Snaith-Hamilton Pleasure Scale for assessing the presence of anhedonia, the Food Intake Questionnaire and sociodemographic questions. RESULTS: The study included 10 552 people from 11 countries; 708 participants were living in rural areas. More than half of the participants were quarantined at the time of the survey. Diet quality was inversely associated with anhedonia (p<0.001) and anxiety (p=0.003). In addition, a healthier diet was associated with being female (p=0.030), having a higher level of education (p=0.008) and country of residence (p=0.001). CONCLUSION: Among the rural population during the COVID pandemic, this study found a worse diet quality was associated with symptoms of anhedonia and anxiety, as well as lower level of education and being male. Proposals to improve the quality of the diet could include interventions aimed at people's mental health