Adherence to Mediterranean Diet Pattern among Spanish Adults Attending a Medical Centre: Nondiabetic Subjects and Type 1 and 2 Diabetic Patients

Objective. To identify adherence to Mediterranean diet among two groups of Spanish adults: diabetic patients and nondiabetic subjects. Methods. Adherence to Mediterranean diet was measured by a 14-item screener (scale: 0–14; ≤5: low, 6–9: moderate, and ≥10: high) in 351 volunteers. Results. Mean age was 50.97 ± 12.58 in nondiabetics (n=154) and 59.50 ± 13.34 in diabetics (n=197). The whole sample scored 8.77 ± 1.82. Score was 9.19 ± 1.84 in nondiabetic females (n=58) and 8.15 ± 1.79 in diabetic females (n=85) (p=0.003), due to lower consumption of olive oil (p=0.005) and nuts (p=0.000). Type 2 diabetic males (n=79; 8.76 ± 1.88) consumed less olive oil than healthy males (n=28; 9.36 ± 1.59) (p=0.046). Up to 30-year-old nondiabetics scored lower than more than 60-year-old nondiabetics (8.40 ± 1.5 versus 9.74 ± 2.03; p=0.047). The youngest ate less olive oil (p=0.002) and more pastries (p=0.007). Conclusions. The sample presented moderate adherence to Mediterranean diet in all subgroups. Scientific evidence about the benefits of Mediterranean diet, olive oil, and nuts supports the recommendation to increase consumption of olive oil and nuts in diabetic women and of daily olive oil in type 2 diabetic men, reducing consumption of red meat, butter, and pastries, and to promote Mediterranean diet among the youngest of the sample studied

Luces y sombras entre familias y escuelas : una relación protagónica en el escenario educativo actual

Fil: Ferreyra, Horacio Ademar. Universidad Católica de Córdoba. Facultad de Educación; ArgentinaFil: Bonetti, Olga Concepción. Universidad Católica de Córdoba. Facultad de Educación; ArgentinaFil: Di Francesco, Adriana Carlota. Universidad Católica de Córdoba. Facultad de Educación; Argentin

Luces y sombras entre familias y escuelas: una relación protagónica en el escenario educativo actual

Fil: Ferreyra, Horacio Ademar. Universidad Católica de Córdoba. Facultad de Educación; ArgentinaFil: Bonetti, Olga Concepción. Universidad Católica de Córdoba. Facultad de Educación; ArgentinaFil: Di Francesco, Adriana Carlota. Universidad Católica de Córdoba. Facultad de Educación; Argentin

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

Un supresor de ambigüedades léxicas mediante métodos estadísticos

Presentamos el trabajo realizado para conseguir un sistema que, integrado en el proyecto GALENA (Generador de Analizadores de LEnguajes NAturales), logre eliminar, de forma estadística, las ambigüedades que provocan las palabras al ser tratadas por el módulo de análisis léxico. El análisis léxico proporciona a las palabras unas etiquetas, es decir, descripciones que contienen toda la información (tipológica, morfológica...) necesaria para caracterizarlas en el conjunto del léxico de la lengua. A cada palabra aislada, fuera de contexto, pueden corresponderle varias etiquetas. Esta situación imposibilita el análisis sintáctico de los textos. Surge, por tanto, la necesidad de eliminar las ambigüedades en el proceso de etiquetación. El objetivo del presente trabajo es proveer de una única etiqueta a cada palabra, asignando la que en cada caso sea más probable según la historia del texto en estudio. Para ello, es necesario un análisis estadístico de textos del mismo estilo literario que el que va a ser tratado, y la aplicación de ese estudio al texto en cuestión. El supresor de ambigüedades que proponemos permite la selección, por parte del usuario, de la información léxica a utilizar en la desambiguación, y ofrece funcionalidades complementarias para el tratamiento de las matrices de aprendizaje

FUNCIONAMIENTO PSICOSOCIAL DE ESTUDIANTES UNIVERSITARIOS DURANTE LA EDUCACIÓN REMOTA POR COVID-19:

El confinamiento por la pandemia de Covid-19 modificó el estilo de vida, las relaciones sociales y tuvo efectos sobre la salud mental. El presente estudio exploró el funcionamiento psicosocial de un grupo de estudiantes universitarios durante el periodo de enseñanza remota. Mediante un diseño observacional, transversal, participó una muestra no probabilística de 41 estudiantes de la Ciudad de México. Se evalúo: Soledad, Apoyo Social, Depresión, Regulación Emocional, Alexitimia, Empatía y Reconocimiento Facial Emocional. Los resultados revelaron que aquellos que reportaron mayor percepción de soledad presentaron mayores niveles de depresión, alexitimia, y menor apoyo social. Se identificaron mayores errores en el reconocimiento de las expresiones faciales de asco y miedo, y ésta última se asoció inversamente con el puntaje de reevaluación cognitiva, y ésta a su vez, con la depresión. Los resultados sugieren diseñar estrategias de intervención psicosocial para el manejo de la soledad y la alexitimia

Informe del Comité Científico de la Agencia Española de Seguridad Alimentaria y Nutrición (AESAN) sobre el riesgo asociado a la presencia de ácidos grasos trans en alimentos

[EN]:Nutritional recommendations include a reduction in the intake of saturated fatty acids and trans fatty acids (TFA) as there is sufficient evidence of their relationship with the development of cardiovascular disease. There is not yet any consensus on the definition of TFA. The World Health Organization excludes isomers of conjugated linoleic acid from the definition of TFA whereas some countries and/or agencies usually include them. TFA may occur naturally and can be formed by the catalytic hydrogenation of vegetable oils (CH TFA). Hydrogenation allows semi-solid fats of technological interest to be obtained for the production of various foodstuffs, but TFA are also found naturally in meat and in milk from ruminant animals. It is currently accepted that the adverse effects due to the intake of TFA begin with changes in the profile of serum lipoproteins, although the inflammatory response and the endothelial functions may also be affected. No definitive conclusions have been reached with respect to the threshold concentration of TFA above which adverse effects occur. The risk associated with the consumption of TFA depends on the foods contained in the diet, their TFA content and, mainly, the amount consumed by the individual or the population. In 1995, the European Commission funded the project for the “TRANSFAIR study: Intake of fatty acids in Western Europe with emphasis on TFA” with the aim of assessing the consumption of TFA in 97revista del comité científico nº 12 14 European countries. The mean values varied between the different countries (1.5 to 5.4 g/day) and the study concluded that, in general, the consumption of TFA in Europe was not a cause for concern.In Spain, the intake of TFA was then set at 2.1 g/day. Differences in TFA content were also confirmed even in a single food type, basically due to the industrial process, but also varied depending on the analytical method used. In recent years, the TFA content in foods in Europe has come down, due to modifications in the technological processes for the hydrogenation of oils and the recommendations made by the various competent bodies. Recent studies in our country by the National Food Centre of the Spanish Food Safety Authority to determine the profile of fatty acids in industrial bakery products, cereals, pickles, crisps, biscuits, chocolates, cocoa creams, margarines, pate and stuffed sausages, among others, detected TFA contents generally lower than 1% of the total of fatty acids, in line with the reduction in CH TFA contents in hydrogenated fats as documented in other countries. In products of animal origin analyzed, such as butter and meals prepared with the meat of ruminants, the TFA contents varied between 2% and 3% of the total of fatty acids. Nonetheless, it has now been well established that the intake of CH TFA is associated with an increase in cardiovascular risks, but this effect has not been demonstrated in TFA of natural origin. On the basis of data about Spanish diet and the current TFA contents in food, it can be said that the estimated intakes of CH TFA are lower than those mentioned in the European TRANSFAIR project. The World Health Organization recommends that consumption of TFA should not exceed 1% of the total energy intake; the Food and Drug Administration recommends the lowest possible intake of TFA; and in Europe, some countries in Scandinavia have established their own rules and recommendations (a maximum of 2% of CH TFA in oils and processed fools).[ES]: Las recomendaciones nutricionales incluyen la disminución de la ingesta de los ácidos grasos saturados y ácidos grasos trans (AGt) ya que existe suficiente evidencia de su relación con el desarrollo de enfermedades cardiovasculares. No existe consenso en la definición de AGt. La Organización Mundial de la Salud (OMS) excluye a los isómeros del ácido linoleico conjugado de la definición de AGt mientras que algunos países y/o agencias los suelen incluir. Los AGt se pueden producir de forma natural y pueden formarse por hidrogenación catalítica de los aceites vegetales (AGtHC). La hidrogenación permite obtener grasas semisólidas de interés tecnológico para la elaboración de distintos alimentos, pero los AGt también se encuentran de forma natural en la carne y la leche procedentes de los rumiantes. Actualmente se admite que los efectos adversos debidos a la ingesta de AGt se inician mediante cambios en el perfil de las lipoproteínas séricas, aunque también se pueden afectar la respuesta inflamatoria y la función endotelial. No se ha llegado a conclusiones definitivas respecto a la concentración umbral de AGt por encima de la cual se producen efectos adversos. El riesgo asociado al consumo de AGt depende de los alimentos que forman la dieta, de su contenido en AGt y principalmente, de la cantidad consumida por el individuo o la población. La Comisión Europea financió en 1995 el proyecto “TRANSFAIR study: Intake of trans fatty acids in Western Europe with emphasis on trans fatty acids” cuyo objetivo fue valorar el consumo de AGt en 14 países europeos. Los valores medios variaron entre los diferentes países (1,5 a 5,4 g/día) y el estudio concluía que en general el consumo de AGt en Europa no era preocupante. En España la ingesta de AGt se situó entonces en 2,1 g/día. También se constataron las diferencias en el contenido de AGt incluso en un mismo tipo de alimento, debidas fundamentalmente al proceso industrial, pero también variaba dependiendo del método analítico utilizado. En los últimos años, el contenido de AGt en los alimentos en Europa ha disminuido, debido a las modificaciones realizadas en los procesos tecnológicos de hidrogenación de aceites y a las recomendaciones hechas por los diferentes organismos revista del comité científico nº 12 96 competentes. En nuestro país en estudios recientes realizados por el Centro Nacional de Alimentación perteneciente a la Agencia Española de Seguridad Alimentaria y Nutrición, en los que se determinó el perfil de ácidos grasos de productos de bollería, cereales, aperitivos, patatas fritas, galletas, chocolates, cremas de cacao, margarinas, paté y embutidos entre otros, se detectaron contenidos de AGt en general inferiores al 1% del total de ácidos grasos, en línea con la disminución de los contenidos de AGtHC de las grasas hidrogenadas documentado en otros países. En productos analizados de origen animal como mantequilla y preparados con carne de rumiantes, los contenidos en AGt oscilaron entre el 2-3% del total de ácidos grasos. No obstante, ahora está bien establecido que la ingesta de AGtHC se asocia a un incremento de riesgos cardiovasculares, pero ese efecto no está demostrado en AGt de origen natural. En base a datos de la dieta española y los contenidos de AGt actuales en alimentos se puede señalar que las ingestas estimadas de AGtHC son inferiores a las mencionadas en el proyecto europeo TRANSFAIR. La Organización Mundial de la Salud recomienda que el consumo de AGt no supere el 1% de la ingesta energética total, la Food and Drug Administration (FDA) recomienda una ingesta en AGt tan baja como sea posible y en Europa algunos países como los nórdicos han dado sus propias normas y recomendaciones (un máximo de 2% de AGtHC en aceites y alimentos procesados).Peer reviewe

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization