Effects of a (poly)phenol-rich supplement on anthropometric, biochemical, and inflammatory parameters in participants with morbid obesity: Study protocol for a randomised controlled trial

Background: Morbid obesity (body mass index >= 40 kg/m2) represents a severe health risk and implies the need of urgent therapeutic action. (Poly)phenols may play a relevant role in the management of this disease modulating physiological and molecular pathways involved in energy metabolism and adiposity. The purpose of this double -blinded, placebo-controlled, randomised trial is to determine if (poly)phenol supplementation, in combination with a dietary intervention, can improve anthropometric and cardiometabolic parameters in participants with morbid obesity. Methods: Adults (n = 40) with morbid obesity, bariatric surgery candidates, will be recruited from the Bellvitge University Hospital, Spain, and randomly assigned (stratified by sex) to intervention (poly)phenol-rich supple-ment 1,200 mg/day + hypocaloric diet) or control group (placebo + hypocaloric diet) for 12 weeks. The primary outcome is body weight. Secondary outcomes are: other anthropometric markers and body composition measured through standardized methods and a bioimpedance analysis, cardiometabolic and inflammatory bio-markers, metabolic pathways, and gut microbiota diversity. Anthropometric parameters, dietary, physical ac-tivity and lifestyle questionnaires, blood pressure, and blood and urine samples will be collected at baseline, 6 weeks, and 12 weeks. Faecal samples will be collected at baseline and at 12 weeks. Informed consent of par-ticipants will be obtained before the start of the study.Discussion:: The present study is expected to provide evidence on the effects of a combination of (poly)phenols on several well-established obesity and cardiometabolic markers, and to unravel possible underlying mechanisms by metabolomic analyses. Gut microbiota diversity will be considered as a potential future endpoint. The study will contribute to future strategies for prevention or treatment of obesity and related conditions

Development and validation of a specific questionnaire to assess health-related quality of life in patients with home enteral nutrition: NutriQoL® development

Introduction: Home enteral nutrition (HEN) is indicated in patients with a functional gastrointestinal tract but who are unable to meet their nutritional requirements with normally consumed foodstuffs. HEN allows patients to remain in their social and family environment, thus reducing complications and costs associated with hospital admission, while increasing health-related quality of life (HRQoL). HRQoL in patients with HEN is mainly evaluated by generic instruments, which are not sensitive enough to identify certain specific patient-related outcomes of HEN. Objective: To develop a specific instrument to measure HRQoL in patients receiving HEN whose results allow interpretation regardless of the underlying disease and nutritional support administration route: the NutriQoL (R) questionnaire. Materials and methods: The development of the NutriQoL entailed a literature review, focus groups with experts, semistructured interviews with patients, an assessment of face validity and feasibility, and Rasch analysis conducted on data from a sample of 141 patients and 24 caregivers. Results: Of the 52 items initially proposed on the basis of the literature review, expert focus group, and semi-structured interviews with patients and caregivers, 17 items were finally selected through the development process to make up the final version of the NutriQoL, as well as a visual analog scale for global HRQoL scoring. The selected items were evaluated as adequate for frequency, importance, and clarity. Furthermore, they have been shown to be independent of the underlying condition and HEN administration route. Conclusion: A new instrument for measuring the HRQoL of patients with HEN in Spain has been developed, whose results are independent of the underlying condition and administration route. The next step will be the validation of the questionnaire to ensure that the instrument is valid, reliable, and sensitive to health status changes in patients, to be used periodically in usual clinical practice

Estudi sobre models de gestió comparats d'habitatge social i elaboració de propostes per a l'IMHAB

Sol·licitant de l’informe: Institut Municipal de l'Habitatge i Rehabilitació (Barcelona

Survival benefit of multidisciplinary care in amyotrophic lateral sclerosis in Spain: association with noninvasive mechanical ventilation

Purpose: Multidisciplinary care has become the preferred model of care for patients with amyotrophic lateral sclerosis (ALS). It is assumed that the sum of interventions associated with this approach has a positive effect on survival. The objective of the study was to evaluate the impact of a multidisciplinary care approach on the survival of patients with ALS. Patients and methods: We performed a retrospective review of prospectively collected data in a tertiary referral center in Spain. Participants were patients with definite or probable ALS managed in a multidisciplinary care program. We compared demographic and survival data of patients with definite or probable ALS treated in a referral center without and with implementation of a multidisciplinary care program. We performed time-dependent multivariate survival analysis of the use of noninvasive mechanical ventilation (NIMV) and gastrostomy. Results: We evaluated 398 consecutive patients, of whom 54 were treated by a general neurologist and 344 were treated in the multidisciplinary care clinic. Patients receiving multidisciplinary care were older (62 vs 58 years), tended to have bulbar onset disease (30% vs 17.7%), and were more likely to receive riluzole (88.7% vs 29.6%, p0.001), and nutrition via gastrostomy (32.3% vs 3.7%, p<0.01). Kaplan-Meier analysis showed a 6-month increase in survival (log-rank, 16.03, p<0.001). Application of the Andersen-Gill model showed that the variables associated with reduced mortality were reduced time to NIMV and gastrostomy and the duration of both, thus reflecting compliance. Conclusions: Multidisciplinary care increased the survival of ALS patients in our study population. Timely use of respiratory support and gastrostomy are fundamental aspects of this benefit

Propiedades psicométricas del Cuestionario de Evaluación de las Relaciones Familiares Básicas (CERFB)

El objetivo de este estudio fue analizar la estructura factorial y la consistencia interna del Cuestionario de Evaluación de las Relaciones Familiares Básicas (CERFB) a partir de una muestra de conveniencia no probabilística compuesta por 442 participantes (221 parejas). El análisis factorial exploratorio dio lugar a tres componentes. En un análisis factorial de segundo orden, los tres componentes se agruparon en dos factores: el factor Conyugalidad, que hace referencia a la manera cómo interactúan entre sí las personas que ejercen las funciones parentales (generalmente, la pareja parental) y el factor Parentalidad, que representa la manera cómo la pareja parental trata a sus hijos. Tanto los factores de primer orden como los de segundo orden obtuvieron unos índices de fiabilidad altos. Se concluye que el CERFB, compuesto por 25 ítems, posee propiedades psicométricas adecuadas, considerándose un instrumento válido para evaluar el modelo bidimensional de la teoría de las relaciones familiares básicasThe aim of this study was to analyze the factor structure and internal consistency of the Basic Family Relations Inventory (BFRI) in a non-probabilistic convenience sample of 442 participants (221 couples). Exploratory factor analysis resulted in three components. In a second-order factor analysis, the three components were grouped into two factors: the Conjugal factor, which refers to how the people who exercise the parental role interact with each other (generally, the parental couple), and the Parenting factor, which represents the way in which the parental couple treat their children. Both first- and second-order factors had high reliability indices. It was concluded that the 25-item BFRI is a valid instrument to evaluate the two-dimensional model of the basic family relations theor

Relaciones familiares básicas en familias con un hijo con trastorno de la conducta alimentaria

The aim of this study is to get to know and describe the Basic Famil yRelations, marital and parental functions, in families with a child with an eating disorder and control group families, as well as determine the discriminative cut-off points of the Basic Family Relations Inventory (BFRI) between them.The BFRI was applied to 688 participants of whom 338 (169 families) formed the clinical group and 350 (175 families) the control group. Results presented statistically significant differences in the scores of marital and parental functions between clinical and control families, being the valuation of both functions lower in the clinical group regarding the control group. In turn, the discriminative cut-off points of 55 for marital functions and 42 for parental functions were obtained between both groups of families. These results suggest that more work is still to be done to improve the BFRI’s empirical evaluative and discriminative capacity of the Basic Family Relations in families with a child with an eating disorder and control families as a relational diagnosis tool are discussed.El objetivo de este estudio es conocer y describir las Relaciones Familiares Básicas, Conyugalidad y Parentalidad, de las familias con un hijo con trastorno de la conducta alimentaria (TCA) y familias grupo control, así como determinar los puntos de corte del Cuestionario de Evaluación de las Relaciones Familiares Básicas (CERFB) discriminativos entre ellas. Se administró el CERFB a 688 participantes de los cuales 338 (169 familias) formaron el grupo clínico y 350 (175 familias) el grupo control. Los resultados presentaron diferencias estadísticamente significativas en las puntuaciones de Conyugalidad y Parentalidad entre las familias clínicas y control, siendo la valoración de ambas funciones menor por parte del grupo clínico en relación al grupo control. A su vez, se obtuvieron los puntos de corte discriminativos de 55 para Conyugalidad y de 42 para Parentalidad entre los dos grupos de familias. Se discuten estos resultados que apuntan que hay que seguir trabajando para mejorar la capacidad empírica del CERFB de evaluación y discriminación de las Relaciones Familiares Básicas de las familias con un hijo con TCA y familias control como instrumento de diagnóstico relacional

Genetic, molecular and cellular approaches to the analysis of maize embryo development

The development of embryo structures in plants is essential for the formation of the adult plant organs. In cereals, this process has distinct features which have attracted attention from different points of view. Differential gene expression analyses have been used in order to identify genes useful as molecular markers of certain physiological, molecular or developmental processes. Several maize mutants affected in embryo development have been isolated, but only a fraction of them have been characterized at the molecular level. Molecular markers can be useful in the characterization of embryo defective mutants. Here, we describe the different techniques used in the identification of molecular marker genes for embryo development. We describe in more detail some groups of genes coding for cell wall proteins. We also describe the application of these molecular markers in the characterization of some embryo mutants

Apo AIV and citrulline plasma concentrations in Short Bowel Syndrome patients: the influence of Short Bowel Anatomy

Introduction Parenteral nutrition (PN) dependence in short bowel syndrome (SBS) patients is linked to the functionality of the remnant small bowel (RSB). Patients may wean off PN following a period of intestinal adaptation that restores this functionality. Currently, plasma citrulline is the standard biomarker for monitoring intestinal functionality and adaptation. However, available studies reveal that the relationship the biomarker with the length and function of the RSB is arguable. Thus, having additional biomarkers would improve pointing out PN weaning. Aim By measuring concomitant changes in citrulline and the novel biomarker apolipoprotein AIV (Apo AIV), as well as taking into account the anatomy of the RSB, this exploratory study aims to a better understanding of the intestinal adaptation process and characterization of the SBS patients under PN. Methods Thirty four adult SBS patients were selected and assigned to adapted (aSBS) and non-adapted (nSBS) groups after reconstructive surgeries. Remaining jejunum and ileum lengths were recorded. The aSBS patients were either on an oral diet (ORAL group), those with intestinal insufficiency, or on oral and home parenteral nutrition (HPN group), those with chronic intestinal failure. Apo AIV and citrulline were analyzed in plasma samples after overnight fasting. An exploratory ROC analysis using citrulline as gold standard was performed. Results Biomarkers, Apo AIV and citrulline showed a significant correlation with RSBL in aSBS patients. In jejuno-ileocolic patients, only Apo AIV correlated with RSBL (rb = 0.54) and with ileum length (rb = 0.84). In patients without ileum neither biomarker showed any correlation with RSBL. ROC analysis indicated the Apo AIV cut-off value to be 4.6 mg /100 mL for differentiating between the aSBS HPN and ORAL groups. Conclusions Therefore, in addition to citrulline, Apo AIV can be set as a biomarker to monitor intestinal adaptation in SBS patients. As short bowel anatomy is shown to influence citrulline and Apo AIV plasma values, both biomarkers complement each other furnishing a new insight to manage PN dependence

Is Trabecular Bone Score Valuable In Bone Microstructure Assessment After Gastric Bypass In Women With Morbid Obesity?

Introduction: The effects of bariatric surgery on skeletal health raise many concerns. Trabecular bone score (TBS) is obtained through the analysis of lumbar spine dual X-ray absorptiometry (DXA) images and allows an indirect assessment of skeletal microarchitecture (MA). The aim of our study was to evaluate the changes in bone mineral density (BMD) and alterations in bone microarchitecture assessed by TBS in morbidly obese women undergoing Roux-en-Y gastric bypass (RYGB), over a three-year follow-up. Material/Methods: A prospective study of 38 morbidly obese white women, aged 46.3 +/- 8.2 years, undergoing RYGB was conducted. Biochemical analyses and DXA scans with TBS evaluation were performed before and at one year and three years after surgery. Results: Patients showed normal calcium and phosphorus plasma concentrations throughout the study. However, 25-hydroxyvitamin D (25(OH)D-3) decreased, and 71% of patients had a vitamin D deficiency at three years. BMD at femoral neck and lumbar spine (LSBMD) significantly decreased 13.53 +/- 5.42% and 6.03 +/- 6.79%, respectively, during the three-year follow-up; however Z-score values remained above those for women of the same age. TBS was within normal ranges at one and three years (1.431 +/- 106 and 1.413 +/- 85, respectively), and at the end of the study, 73.7% of patients had normal bone MA. TBS at three years correlated inversely with age (r = -0.41, p = 0.010), body fat (r = -0.465, p = 0.004) and greater body fat deposited in trunk (r = -0.48, p = 0.004), and positively with LSBMD (r = 0.433, p = 0.007), fat mass loss (r = 0.438, p = 0.007) and lean mass loss (r = 0.432, p = 0.008). In the regression analysis, TBS remained associated with body fat ( = -0.625, p = 0.031; R-2 = 0.47). The fracture risk, calculated by FRAX((R)) (University of Sheffield, Sheffield, UK), with and without adjustment by TBS, was low. Conclusion: Women undergoing RYGB in the mid-term have a preserved bone MA, assessed by TBS

Espais agraris, assentaments andalusins i la ciutat de Tortosa (Baix Ebre)

La distribució dels assentaments rurals andalusins al Baix Ebre, a l'entorn de Madîna Turtûša (Tortosa), així com el desenvolupament de la ciutat estan estretament vinculats a la creació d'espais de cultiu en els marges del riu. Els llocs d'habitació ocupen petits pujols o se situen en la terrassa fluvial, preferentment en els esperons que forma aquesta a la desembocadura dels torrents de muntanya i a la vora dels espais de cultiu. Aquests es caracteritzen per ocupar les zones de deposició de sediments fluvials o dels torrents on, eventualment s'utilizaven pous i sínies per regar, o bé s'hi van realitzar operacions de drenatge. Madîna Turtûša estava vinculada a dos espais, un d'horta, al nord, regat també amb sínies, i un dedicat sobretot al cereal, al sud, on es va realitzar una operació de drenatge de l'aiguamoll fluvial.The distribution of rural islamic settlements in the Baix Ebre (the final stretch of Ebro River), nearby Madîna Turtûša (Tortosa), and the development of the city are closely connected with the construction of cultivation areas in both riversides. The inhabited nucleus are located on the fluvial terrace or in small hills, always nearby the cultivation areas. At the mouth of these torrents and in areas of fluvial sediment deposition we find the cultivation areas where wells and water elevation wheels were used to irrigate. There are also, wetlands that had been drained by means of channels. Madîna Turtûša had an orchard area northwards, irrigated by means of wells and water elevation wheels and a drained area southwards where cereals were grown