AGRONOMIC EVALUATION AND CHEMICAL COMPOSITION OF AFRICAN STAR GRASS (Cynodon plectostachyus) IN THE SOUTHERN REGION OF THE STATE OF MEXICO

African Star Grass is one of the forage resources most commonly used by farmers in regions with warm-humid climates. This study was carried out to determine the nutritional and agronomic characteristics of African Star Grass (Cynodon plectostachyus) through the following variables: crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), organic matter digestibility (OMD), net forage accumulation (NFA), stem:leaf ratio, and live:dead matter ratio in the three pastures evaluated. The work took place from April 2007 to March 2008, with evaluations carried out on a monthly basis. The data were analyzed in a randomized block design in which the blocks were the pastures, and the treatments were the months of evaluation. There were no differences between the pastures evaluated for the NDF, ADF or OMD (P>0.05). Differences were found, however, in CP, while in the monthly evaluation, differences were found between the periods evaluated (P<0.05) for these variables. Differences were also found in the agronomic evaluation of pastures (P<0.05) among height of pasture, net forage accumulation (NFA), live matter, dead matter, leaf and stem, both among pastures and in the monthly evaluations. African Star Grass can therefore be considered a good choice for milk production systems in the southern region of the state of Mexico, due to its nutritional and agronomic characteristics

Lifestyle patterns and endocrine, metabolic, and immunological biomarkers in European adolescents: The HELENA study

Objective: To evaluate the association of lifestyle patterns related to physical activity (PA), sedentariness, and sleep with endocrine, metabolic, and immunological health biomarkers in European adolescents. Methods: The present cross-sectional study comprised 3528 adolescents (1845 girls) (12.5-17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study. Cluster analysis was performed by including body composition, PA by accelerometry, self-reported sedentary behaviors, and sleep duration. We also measured endocrine, metabolic, and immunological biomarkers. Results: Three-cluster solutions were identified: (a) light-PA time, moderate-vigorous-PA time and sedentary time, (b) light-PA time, moderate-vigorous-PA time, sedentary time and sleep time, (c) light-PA time, moderate-vigorous-PA time, sedentary time and body composition. In addition, each cluster solution was defined as: “healthy, ” “medium healthy, ” and “unhealthy” according to the presented rating. Analysis of variance showed that overall the healthiest groups from the three clusters analyzed presented a better metabolic profile. A decision tree analysis showed that leptin had a strong association with cluster 3 in both boys and girls, high-density lipoprotein cholesterol had the strongest association with clusters 1 and 3 in boys. Cortisol had the strongest association with cluster 1. HOMA index (homeostatic model assessment) and C3 showed a strong association with cluster 3 in girls. Conclusions: Our results support the existence of different interactions between metabolic health and lifestyle patterns related to PA, sedentariness, and sleep, with some gender-specific findings. These results highlight the importance to consider multiple lifestyle-related health factors in the assessment of adolescents'' health to plan favorable strategies

Design and evaluation of a treatment programme for Spanish adolescents with overweight and obesity. The EVASYON Study

<p>Abstract</p> <p>Background</p> <p>The prevalence of overweight and obesity (OW/OB) among adolescents worldwide has increased since the 60 s. Spain has reached one of the highest OW/OB prevalence rates among adolescents from European countries. The aim of this methodological paper is to describe the design and evaluation in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for adolescents with OW/OB: integral education on nutrition and physical activity).</p> <p>Methods/Design</p> <p>The EVASYON was planned by a multidisciplinary team to treat OW/OB in Spanish adolescents. The EVASYON is a multi-centre study conducted in 5 hospitals in 5 Spanish cities (Granada, Madrid, Pamplona, Santander and Zaragoza) and two hundred and four OW/OB Spanish adolescents were recruited for this intervention. The treatment was implemented for approximately one-year follow-up. The adolescents were treated in groups of a maximum of 10 subjects; each group had 20 visits during the treatment period in two phases: intensive during the first 2 months (1^stto 9^thvisits), and extensive during the last 11 months (10^thto 20^thvisits). In order to assess the efficacy of the treatment, 8 dimensions were measured: diet; physical activity and fitness; eating behaviour; body composition; haematological profile; metabolic profile; minerals and vitamins; immuno-inflammatory markers. Moreover, genetic polymorphisms were also determined.</p> <p>Discussion</p> <p>The treatment programme developed in the EVASYON study was designed as a national pilot study to be implemented as an effective treatment for adolescents with OW/OB into the Spanish Health Care Service.</p

Birth weight and blood lipid levels in Spanish adolescents: Influence of selected APOE, APOC3 and PPARgamma2 gene polymorphisms. The AVENA Study

Es reproducción del documento publicado en http://dx.doi.org/10.1186/1471-2350-9-98Background: There is increasing evidence indicating that genes involved in certain metabolic processes of cardiovascular diseases may be of particular influence in people with low body weight at birth. We examined whether the apolipoprotein (APO) E, APOC3 and the peroxisome proliferator-activated receptor-gamma-2 (PPAR gamma 2) polymorphisms influence the association between low birth weight and blood lipid levels in healthy adolescents aged 13-18.5 years. Methods: A cross-sectional study of 502 Spanish adolescents born at term was conducted. Total (TC) and high density lipoprotein cholesterol (HDLc), triglycerides (TG), apolipoprotein (apo) A and B, and lipoprotein(a) [ Lp(a)] were measured. Low density lipoprotein cholesterol (LDLc), TC-HDLc, TC/HDLc and apoB/apoA were calculated. Results: Low birth weight was associated with higher levels of TC, LDLc, apoB, Lp(a), TC-HDLc, TC/HDLc and apoB/apoA in males with the APOE epsilon 3 epsilon 4 genotype, whereas in females, it was associated with lower HDLc and higher TG levels. In males with the APOC3 S1/S2 genotype, low birth weight was associated with lower apoA and higher Lp(a), yet this association was not observed in females. There were no associations between low birth weight and blood lipids in any of the PPAR gamma 2 genotypes. Conclusion: The results indicate that low birth weight has a deleterious influence on lipid profile particularly in adolescents with the APOE epsilon 3/epsilon 4 genotype. These findings suggest that intrauterine environment interact with the genetic background affecting the lipid profile in later life.Instituto de Salud Carlos III (FIS PI021830), the Spanish Ministry of Health, FEDER-FSE funds FIS n 00/0015, CSD grants 05/UPB32/0, 109/UPB31/03 and 13/UPB20/04, Ministerio de Educación (AP-2004-2745; EX2007-1124

Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: The HELENA study.

Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. A better insight in the clustering of those behaviors, could help to identify groups who are at risk in developing chronic diseases. This study examines the prevalence and clustering of physical activity, sedentary and dietary patterns among European adolescents and investigates if the identified clusters could be characterized by socio-demographic factors. METHODS: The study comprised a total of 2084 adolescents (45.6% male), from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Physical activity and sedentary behavior were measured using self-reported questionnaires and diet quality was assessed based on dietary recall. Based on the results of those three indices, cluster analyses were performed. To identify gender differences and associations with socio-demographic variables, chi-square tests were executed. RESULTS: Five stable and meaningful clusters were found. Only 18% of the adolescents showed healthy and 21% unhealthy scores on all three included indices. Males were highly presented in the cluster with high levels of moderate to vigorous physical activity (MVPA) and low quality diets. The clusters with low levels of MVPA and high quality diets comprised more female adolescents. Adolescents with low educated parents had diets of lower quality and spent more time in sedentary activities. In addition, the clusters with high levels of MVPA comprised more adolescents of the younger age category. CONCLUSION: In order to develop effective primary prevention strategies, it would be important to consider multiple health indices when identifying high risk groups.Peer Reviewe

Efficacy and safety of preoperative preparation with Lugol''s iodine solution in euthyroid patients with Graves’ disease (LIGRADIS Trial): Study protocol for a multicenter randomized trial

Background: Currently, both the American Thyroid Association and the European Thyroid Association recommend preoperative preparation with Lugol''s Solution (LS) for patients undergoing thyroidectomy for Graves’ Disease (GD), but their recommendations are based on low-quality evidence. The LIGRADIS trial aims to provide evidence either to support or refute the systematic use of LS in euthyroid patients undergoing thyroidectomy for GD. Methods: A multicenter randomized controlled trial will be performed. Patients =18 years of age, diagnosed with GD, treated with antithyroid drugs, euthyroid and proposed for total thyroidectomy will be eligible for inclusion. Exclusion criteria will be prior thyroid or parathyroid surgery, hyperparathyroidism that requires associated parathyroidectomy, thyroid cancer that requires adding a lymph node dissection, iodine allergy, consumption of lithium or amiodarone, medically unfit patients (ASA-IV), breastfeeding women, preoperative vocal cord palsy and planned endoscopic, video-assisted or remote access surgery. Between January 2020 and January 2022, 270 patients will be randomized for either receiving or not preoperative preparation with LS. Researchers will be blinded to treatment assignment. The primary outcome will be the rate of postoperative complications: hypoparathyroidism, recurrent laryngeal nerve injury, hematoma, surgical site infection or death. Secondary outcomes will be intraoperative events (Thyroidectomy Difficulty Scale score, blood loss, recurrent laryngeal nerve neuromonitoring signal loss), operative time, postoperative length of stay, hospital readmissions, permanent complications and adverse events associated to LS. Conclusions: There is no conclusive evidence supporting the benefits of preoperative treatment with LS in this setting. This trial aims to provide new insights into future Clinical Practice Guidelines recommendations. Trial registration: ClinicalTrials.gov identifier: NCT03980132. © 202

Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study

Background & aim: A diet quality index (DQI) is a tool that provides an overall score of an individual''s dietary intake when assessing compliance with food-based dietary guidelines. A number of DQIs have emerged, albeit their associations with health-related outcomes are debated. The aim of the present study was to assess whether adherence to dietary intervention, and the overall quality of the diet, can predict body composition changes. Methods: To this purpose, overweight/obese adolescents (n = 117, aged: 13–16 years; 51 males, 66 females) were recruited into a multi-component (diet, physical activity and psychological support) family-based group treatment programme. We measured the adolescents’ compliance and body composition at baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up. Also, at baseline, after 6 months, and at the end of follow-up we calculated the DQI. Results: Global compliance with the dietary intervention was 37.4% during the intensive phase, and 14.3% during the extensive phase. Physical activity compliance was 94.1% at 2-months and 34.7% at 13months and psychological support compliance were growing over the intervention period (10.3% intensive phase and 45.3% during extensive phase). Adolescents complying with the meal frequency criteria at the end of the extensive phase had greater reductions in FMI z-scores than those did not complying (Cohen''s d = 0.53). A statistically significant association was observed with the diet quality index. DQI-A variation explained 98.1% of BMI z-score changes and 95.1% of FMI changes. Conclusions: We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support

Communication in health practices: integrative literature review

Objectivethis study aims to describe the main thematic axes explored in the communication field in health practices in the scenarios of the Unified Health System (SUS). Methodintegrative literature review conducted by means of search for articles in the databases Latin American Literature on Health Sciences (LILACS), International Literature on Health Sciences (MedLine), and Science Direct, using the descriptors: health communication or communication. A crossing of the descriptors communication and health education was provided. Resultfour themes were constructed: 1) communication to establish relationships between health professionals and users; 2) (in)communication: barriers to the communicative act, 3) communication and health professional education; and 4) communicative health models: search for the dialogic model. Conclusionby understanding dialogic communication, which must be observed in communication, the new requirements posed by the legalization of SUS have shown weaknesses of the single-line and vertical communication model and the need to provide health professionals, since the undergraduate course, with knowledge that enable dialogic communication practices. The challenge of reflective and participatory experiences in the various health care settings still remains, in order to promote a sharing of knowledge that leads to understanding between the interlocutors involved in the communicative act.Objetivoeste artigo tem por objetivo descrever os principais eixos temáticos explorados no campo da comunicação nas práticas em saúde nos cenários do Sistema Único de Saúde (SUS). Métodorevisão integrativa da literatura realizada a partir da busca de artigos nas bases de dados Literatura Latino-Americana em Ciências da Saúde (Lilacs), Literatura Internacional em Ciências da Saúde (MedLine) e Science Direct, utilizando os descritores: comunicação em saúde ou comunicação. Procedeu-se ao cruzamento dos descritores comunicação e educação em saúde. Resultadoforam construídas quatro temáticas: 1) a comunicação no estabelecimento de relações entre profissionais da saúde e usuários; 2) (des)comunicação: barreiras ao ato comunicativo; 3) comunicação e formação do profissional da saúde; e 4) modelos comunicativos em saúde: a busca pelo modelo dialógico. Conclusãoa partir do entendimento da comunicação dialógica, que deve estar presente na comunicação, as novas demandas da legalização do SUS vêm mostrando fragilidades do modelo unilinear e verticalizado de comunicação e a necessidade de instrumentalizar os profissionais da saúde, desde a graduação, com saberes que proporcionem práticas comunicativas dialógicas. Persiste o desafio de vivências reflexivas e participativas nos vários cenários de assistência à saúde, de forma a promover um compartilhamento de saberes que conduza ao entendimento entre os interlocutores envolvidos no ato comunicativo.Universidade Federal de PernambucoUniversidade Federal de Pernambuco Departamento de FonoaudiologiaUniversidade Federal de São Paulo (UNIFESP) Centro de Desenvolvimento do Ensino Superior em SaúdeUniversidade Federal de Pernambuco Departamento de EnfermagemUNIFESP, Centro de Desenvolvimento do Ensino Superior em SaúdeSciEL

International lower limb collaborative (INTELLECT) study: a multicentre, international retrospective audit of lower extremity open fractures

Trauma remains a major cause of mortality and disability across the world1, with a higher burden in developing nations2. Open lower extremity injuries are devastating events from a physical3, mental health4, and socioeconomic5 standpoint. The potential sequelae, including risk of chronic infection and amputation, can lead to delayed recovery and major disability6. This international study aimed to describe global disparities, timely intervention, guideline-directed care, and economic aspects of open lower limb injuries