Actigraphic sleep and dietary macronutrient intake in children aged 6–9 years old: A pilot study

The objective of this study was to examine the relationship between different sleep parameters and energy and macronutrient intake in school-aged children. A total of 203 children 6 to 9 years of age participated in this cross-sectional study. Anthropometric measurements were taken first. Diet was assessed with 3-day food logs and sleep was measured with a questionnaire on sleep quality and a wrist actigraph worn for at least 7 days. A decrease of 165.45 kcal was observed per each additional hour of sleep during the week (β (95% CI) = −165.45 (−274.01, −56.88); p = 0.003). This relationship was also observed for fat (β (95% CI) = −11.14 (−18.44, −3.84); p = 0.003) and protein (β (95% CI) = −13.27 (−22.52, −4.02); p = 0.005). An increase in weekend sleep efficiencies for those under the recommended threshold of 85% also had a similar association with energy (β (95% CI) = −847.43 (−1566.77, 128.09); p = 0.021) and carbohydrate (β (95% CI) = −83.96 (−161.76, −6.15); p = 0.035)) intake. An increase in habitual sleep variability was related with a slight increase in protein intake (β (95% CI) = 0.32 (0.031, 0.62); p = 0.031). Children who slept less had a higher energy intake, especially from fat and protein and those who presented inefficient sleep had a higher carbohydrate intake. Strategies to enhance sleep quality and quantity combined with dietary recommendations could help to improve energy and macronutrient intake levels in children

Influence of depression on survival of colorectal cancer patients drawn from a large prospective cohort

Objective The prevalence of depressive symptoms immediately after the diagnosis of colorectal cancer (CRC) is high and has important implications both psychologically and on the course of the disease. The aim of this study is to analyse the association between depressive symptoms and CRC survival at 5 years after diagnosis. Methods This multicentre, prospective, observational cohort study was conducted on a sample of 2602 patients with CRC who completed the Hospital Anxiety and Depression Scale (HADS-D) at 5 years of follow-up. Survival was analysed using the Kaplan–Meier method and Cox regression models. Results According to our analysis, the prevalence of depressive symptoms after a CRC diagnosis was 23.8%. The Cox regression analysis identified depression as an independent risk factor for survival (HR = 1.47; 95% CI: 1.21–1.8), a finding which persisted after adjusting for sex (female: HR = 0.63; 95% CI: 0.51–0.76), age (>70 years: HR = 3.78; 95% CI: 1.94–7.36), need for help (yes: HR = 1.43; 95% CI: 1.17–1.74), provision of social assistance (yes: HR = 1.46; 95% CI: 1.16–1.82), tumour size (T3–T4: HR = 1.56; 95% CI: 1.22–1.99), nodule staging (N1–N2: HR = 2.46; 95% CI: 2.04–2.96), and diagnosis during a screening test (yes: HR = 0.71; 95% CI: 0.55–0.91). Conclusions There is a high prevalence of depressive symptoms in patients diagnosed with CRC. These symptoms were negatively associated with the survival rate independently of other clinical variables. Therefore, patients diagnosed with CRC should be screened for depressive symptoms to ensure appropriate treatment can be provided.Funding for open Access charge: Universidad de Málaga / CBUA. This study was supported by public grant from Instituto de Salud Carlos III (PI09/90397, PS09/00314, PS09/00746, PI09/90460, PI/0990490, PI13/01692, PI13/00013, PI18/01181, Pi18/01589) and was co-funded by the European Regional Development fund

Protocolo psicológico para la evaluación de candidatos a implante de neuroestimulador

This review article describes the Psychological Protocol for the evaluation of candidates for neuromodulation implant to be held in the Multidisciplinary Pain Treatment Unit at the University and Polytechnic Hospital "La Fe", in Valencia. Data on cognitive, emotional and sensory factors are collected. An initial opinion is made: positive, negative or partly negative. Patients with positive opinion make a therapy and highly structured group preparation form, accompanied by a collaborator already implanted in this Unity. In this therapy, aspects of pathophysiology of pain, psychological aspects of pain and technical issues are addressed. It impinges on all beliefs and expectations of the patient on the implant and proceeds to the second part, the Surgical Protocol, and to include in the operating room list. The protocol presented is proving to be a valuable tool to discriminate eligible patients, being particularly important psychological preparation.El presente artículo de revisión describe el Protocolo Psicológico para la evaluación de pacientes candidatos a implante de neuromodulación que se realiza en la Unidad Multidisciplinar de tratamiento del Dolor del Hospital Universitario y Politécnico la Fe de Valencia. Se recogen datos sobre factores cognitivos, emocionales y sensoriales. Se realiza un dictamen inicial: positivo, parcialmente negativo o negativo. Los pacientes con dictamen positivo realizan una terapia de preparación de modalidad grupal y muy estructurada, acompañados por un colaborador ya implantado en la Unidad. En esta terapia se abordan aspectos sobre fisiopatología del dolor, aspectos psicológicos del dolor y aspectos técnicos. Se incide sobre todas aquellas creencias y expectativas que tiene el paciente sobre el implante y se procede a la segunda parte, el protocolo quirúrgico, y a incluir en lista de quirófano. El protocolo presentado está demostrando ser un instrumento valioso para discriminar a pacientes idóneos, siendo de especial relevancia la preparación psicológica

Suspected-screening assessment of the occurrence of organic compounds in sewage sludge

The profiling of emerging organic pollutants present in sludge and generated during wastewater treatment is much more limited than in water. This is mainly due to the difficulty of sludge analysis because of its high content of organic matter and interfering compounds. In this study, a generic extraction method using a mixture of buffered water (pH 4.1) and solid phase extraction (SPE) clean-up was applied to samples of sludge obtained in different treatment plants. This extraction was followed by determination of the contaminants by ultra-high performance liquid chromatography coupled to high resolution mass spectrometry (UHPLC-HRMS), using suspected screening to detect the most relevant organic compounds that access the environment through sludge application. This screening (including >3000 substances, such as, pharmaceuticals, pesticides, metabolites and industrial chemicals) tentatively identified 122 compound and assigned most probable structure to 39. The set of compounds assigned to a probable structure was increased in 14 compounds by searching in a free database of metabolites. Fifteen compounds were unequivocally confirmed against the analytical standard. Pharmaceuticals and personal care products (PPCPs), with 31 substances identified and 8 confirmed were the main group of compounds. Compounds frequently detected in all sludge samples include nucleotides such as adenosine triphosphate, amino acids such as phenylalanine, or peptides such as leu-phe. Altogether, the results of this work highlight the interest of HRMS to draw the profile of organic compounds in complex matrices.R. Alvarez-Ruiz also acknowledges her pre-doctoral contract by the grant BES-2016-078612 funded by MCIN/AEI/10.13039/501100011033 and by “ESF Investing in your future”

Cefaleas en inmigrantes. Estudio de 1.043 casos. Análisis comparativo entre cefaleas en inmigrantes con Síndrome de Ulises y otros diagnósticos

Objectives: Comparative analysis of the prevalence of headache in immigrants attended in SAPPIR (Psychopathologycal and psychosocial to Immigrant and refugees Attention Service). Comparative study of Ulysses Syndrome and other diagnoses, as well their socio-demographic and familial characteristics. Methodology: from a sample of 1.043 attended immigrants, is studied the existence or not of clinically significant headaches. Was made personal interview by a psychiatrist that included the collection of demographic, familial and cultural data, and diagnostic assessment. The diagnosis was confirmed by a second specialist in psychiatry. Results: Immigrants with Ulysses Syndrome (149 cases) have 56,4% of chronic headaches compared to 36% of headaches of the other immigrants with other diagnoses in the sample Assembly (893). Conclusions: Immigrants with Ulysses Syndrome, a extreme migratory Syndrome (not a mental disorder) have a significant higher percentage of headaches than immigrants suffering from mental disorders. These data indicate the importance of taking into account the headache as an element of differential diagnosis on immigrants.Objetivos: Análisis comparativo de la prevalencia de cefaleas en inmigrantes atendidos por el SAPPIR (Servicio de Atención Psicopatológica y Psicosocial a inmigrantes y refugiados) Estudio comparativo entre Síndrome de Ulises y otros diagnósticos, así de sus características sociodemográficas y familiares. Metodología: a partir de una muestra de 1.043 inmigrantes encuestados se estudia la existencia ó no de cefaleas clínicamente significativas. Se les realizó una entrevista personal por un psiquiatra que incluía la recogida de datos sociodemográficos, familiares, culturales y la valoración diagnóstica. El diagnóstico fue confirmado por un segundo especialista en psiquiatría. Resultados: Los inmigrantes con Síndrome de Ulises (149 casos) tienen un 56,4% de cefaleas crónicas frente a un 36,4% de cefaleas del conjunto de los demás inmigrantes estudiados en la muestra (893). Conclusiones: Los inmigrantes con Síndrome de Ulises, cuadro de duelo migratorio extremo que no es un trastorno mental, tienen un significativo mayor porcentaje de cefaleas que los inmigrantes que padecen trastornos mentales. Estos datos nos indican la importancia de tener en cuenta la cefalea como elemento de diagnóstico diferencial en los inmigrantes

Estudio sociodemográfico de los inmigrantes con síndrome de Ulises: Estudio sobre 1.110 inmigrantes atendidos en el SAPPIR in Barcelona

The article examines the sociodemographic characteristics of 1110 immigrants attended at SAPPIR (Service Psychopathological and Psychosocial for Immigrants and Refugees) with a comparison of the general group of cases attended with immigrants suffering the Ulysses Syndrome. The results show that immigrants with Ulysses Syndrome are predominantly Latin American or Subsaharians, between 30 and 45 years old, take between 2 and 5 years in Spain, and dominates the child elderly. In terms of gender differences are not significatives.El artículo estudia las características sociodemográficas de 1110 inmigrantes atendidos en el SAPPIR (Servicio de Atención Psicopatológica y Psicosocial a Inmigrantes y Refugiados) comparando el conjunto de los casos atendidos con los inmigrantes que padecen el Síndrome de Ulises. Los resultados muestran que el prototipo de inmigrante con Síndrome de Ulises es un latinoamericano o subsaharianos, de entre 30 y 45 años, lleva entre 2 y 5 años en España, y es el/la hijo mayor. A nivel de género, no se encuentran diferencias significativas

Valor de la biopsia en el arteritis de la temporal

Temporal Artery Biopsy Value Giant Cell Arteritis (GCA) is a middle and large vessel inflammatory disease, usually of cranial branches. Temporal artery biopsy is frequently used to aid its diagnosis, and is performed by the Otolaryngology Department in our hospital premises. The purpose of this study was to assess the prognostic value and optimal technique of the procedure. Materials and methods: Temporal artery biopsies performed in the 2002 - 2011 ten year period were analyzed into a retrospective study, comparing the presence or absence of disease with the following variables: age, sex, signs and symptoms, referral medical department, previous steroidal treatment, Erythrocyte Sedimentation Rate (ESR) and biopsy length. The disease was defined by the presence of three out of the five diagnostic criteria defined by the American College of Rheumatology. Results: A total of 125 patients were identified (78 females, 47 males, mean age, 74 years). Headache, temporal scalp sensitivity and diminished temporal pulses were the symptoms statistically associated with GCA diagnosis, while high ESR was the only laboratory alteration related to the disease. 0,5 cm length specimen is needed to have 100% specificity and positive predictive value for the diagnosis (p < 0,05). Conclusions: Temporal artery biopsy had in our study high specificity and positive predictive value if given enough specimen length; also, if the patient presents with temporal symptoms and high ESR, results helpful in leading to the diagnosis. Previous steroidal use does not seem to deviate the disease diagnosis.La Arteritis de Células Gigantes (ACG) es una patología inflamatoria de arterias de mediano y gran calibre, típicamente ramas craneales. En su diagnóstico, resulta de vital importancia la biopsia de la arteria temporal, técnica que en nuestro hospital es realizada por el servicio de ORL. Nos planteamos un estudio para valorar la rentabilidad de esta técnica y los parámetros implicados en su correcta realización. Material y métodos: Realizamos un estudio retrospectivo sobre las biopsias realizadas en nuestro servicio desde el año 2002 hasta el 2011, comparando variables clínicas, analíticas, el tratamiento corticoideo previo y la longitud de la pieza con el diagnóstico definitivo de enfermedad. La enfermedad fue definida por presencia de tres de los cinco criterios diagnósticos establecidos por el American College of Rheumatology. Resultados: 125 pacientes (78 mujeres, 47 varones, edad media, 74 años) fueron analizados. La cefalea, sensibilidad al tacto del cuero cabelludo, disminución de pulsos temporales y la elevación de la VSG muestran relación con el diagnóstico de enfermedad. Una longitud de biopsia mayor a 0,5 cm tuvo relación con su utilidad. El tratamiento previo con esteroides no afectó al resultado de la biopsia o el diagnóstico definitivo (p < 0,05). Discusión y conclusiones: La biopsia presenta en nuestro estudio gran especificidad y valor predictivo positivo para el diagnóstico de la enfermedad, si se obtiene longitud suficiente de muestra, y en presencia de clínica en la región temporal con elevación de la VSG resulta de utilidad para dirigir el diagnóstico. El uso previo de esteroides no parece afectar al diagnóstico de la enfermedad

Effect of Adherence to the Mediterranean Diet on Maternal Iron Related Biochemical Parameters during Pregnancy and Gestational Weight Gain

Gestation is a crucial life stage for both women and offspring, and outcomes are affected by many environmental factors, including diet. The Mediterranean dietary pattern (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy. Meanwhile, iron deficiency anemia is one of the most frequent complications related to pregnancy. This study aimed to evaluate how the level of adherence to the MD influences maternal gestational weight gain and specific iron-related maternal biochemical parameters during the pregnancy. Accordingly, an observational, population-based study using data from pregnant women conducted over the entire course of their pregnancy was carried out. Adherence to the MD was assessed once using the MEDAS score questionnaire. Of the 506 women studied, 116 (22.9%) were classified as demonstrating a high adherence, 277 (54.7%) a medium adherence, and 113 (22.3%) a low adherence to the MD. No differences were observed in gestational weight gain among the MD adherence groups but the adequacy of weight gain did vary among the groups, with the proportions of inadequate (insufficient or excessive) weight gain presenting the most notable differences. Total anemia prevalence was 5.3%, 15.6%, and 12.3%, respectively, during the first, second, and third trimesters. For iron-related biochemical parameters, no differences are observed among the adherence groups during pregnancy. With high adherence to the MD as the reference group, the crude odds of iron deficiency diagnosis are significant in the first trimester for both the medium [OR = 2.99 (1.55–5.75)] and low [OR = 4.39 (2.15–8.96)] adherence groups, with deficient adherence to the Mediterranean dietary pattern being responsible for 66.5% (35.5–82.6) and 77.2% (53.5–88.8) of the risk of iron deficiency diagnosis for medium and low adherence, respectively. However, adjusted odds ratios were not significant, possibly due to the small sample size. Our data suggest that MD adherence could be related to gestational weight gain adequacy and that optimal adherence could reduce iron deficiency and/or anemia during pregnancy in the studied population

Síndrome metabólico en pacientes con cardiopatía isquémica. Resultados obtenidos con la utilización de diferentes criterios

Carecemos de un criterio único para definir el síndrome metabólico, considerado como aglutinador del riesgo cardiovascular. Con objeto de comparar su prevalencia en pacientes con cardiopatía isquémica, utilizando los criterios del Grupo Europeo de Resistencia a la Insulina y los del National Colesterol Education Program, se diseñó un estudio observacional, transversal, de los factores integrantes del síndrome metabólico en pacientes con cardiopatía isquémica. Se estudió a 169 pacientes (129 varones y 40 mujeres) con edades entre 35 y 79 años. La prevalencia del síndrome metabólico con los criterios del grupo europeo fue del 43,7% y con los del grupo americano, del 40,8% (sin diferencias significativas). La prevalencia del síndrome metabólico entre pacientes con cardiopatía isquémica es elevada. Los criterios diagnósticos utilizados son similares y sin diferencias significativas entre ellos, aunque la concordancia diagnóstica fue del 50%

Quantum Molecular Resonance Radiofrequency Disc Decompression and Percutaneous Microdiscectomy for Lumbar Radiculopathy

Within the practice of pain management, one of the most commonly encountered events is low back pain. Lumbar radiculopathy (LR) is a pain syndrome caused by the compression or irritation of the nerve roots in the lower back due to lumbar disc herniation, vertebra degeneration, or foramen narrowing. Symptoms of LR include low back pain that propagates toward the legs, numbness, weakness, and loss of reflexes. The aim of this study is to assess the long-term effectiveness of quantum molecular resonance disc decompression and its combination with a percutaneous microdiscectomy using Grasper© forceps (QMRG) in patients with persistent lumbar radiculopathy (LR) in relation to patient physical stress status. The main outcome measures of this prospective observational study were DN4, NRS, ODI, SF12, PGI, CGI, and MOS Sleep Scale. An improvement 12 months post-intervention was observed in patients without physical stress, presenting better overall results. The mean change was over the minimal clinically important difference in 64.3% of outcome measures studied for the whole sample. QMRG appears to be an effective treatment option for LR, but a reduction in physical stress is needed to ensure long-term effectiveness