Long-Term Weight Loss Results, Remission of Comorbidities and Nutritional Deficiencies of Sleeve Gastrectomy (SG), Roux-En-Y Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) on Type 2 Diabetic (T2D) Patients

Producción CientíficaThis study aimed to compare the long-term weight loss results, remission of comorbidities and nutritional deficiencies of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and One-Anastomosis gastric bypass (OAGB) on type 2 diabetic (T2D) patients. Patients and Methods: A retrospective analysis of all the morbidly obese and diabetic patients undergoing SG, RYGB, and OAGB as primary bariatric procedures between February 2010 and June 2015 was performed. Anthropometric parameters, remission of comorbidities, nutritional deficiencies and supplementation requirements at 1, 2 and 5 years’ follow-up were monitored. Patients lost to follow-up 5 years after surgery were excluded from the analysis. Results: 358 patients were included. The follow-up rate was 84.8%. Finally, 83 SG, 152 RYGB, and 123 OAGB patients were included in the analysis. OAGB obtained significantly greater weight loss and remission of dyslipidemia than the other techniques. There was a trend towards greater T2D and hypertension remission rate after OAGB, while fasting glucose and glycated hemoglobin levels were significantly lower after OAGB. There were no significant differences in hemoglobin or protein levels between groups. SG obtained lower iron deficiencies than the other techniques, while there were no significant differences in other nutritional deficiencies between groups. Conclusion: OAGB obtained greater weight loss and remission of dyslipidemia than RYGB or SG. Excluding lower iron deficiency rates after SG, there were no significant differences in the development of nutritional deficiencies between groups

Changes in lipid profile, body weight variables and cardiovascular risk in obese patients undergoing one-anastomosis gastric bypass

Producción CientíficaMorbid obesity has a direct impact on the development of cardiovascular disease. One-anastomosis gastric bypass (OAGB) is an effective surgical technique for the control of body weight and the reduction of cardiovascular risk. This work examines the change in weight loss, lipid profile and cardiovascular risk in 100 patients (71 women, 29 men), mean age 42.61 ± 11.33 years at 3, 6, 9, 12, 18 and 24 months after OAGB. At 24 months post-surgery, mean body weight was significantly reduced compared to pre-operative values (116.75 ± 22.19 kg vs. 69.66 ± 13.07 kg), as were mean total cholesterol (201.86 ± 44.60 mg/dL vs. 172.99 ± 32.26 mg/dL), LDL (Low-Density Lipoprotein) cholesterol (126.90 ± 39.81 mg/dL vs. 96.28 ± 26.99 mg/dL), triglycerides (138.05 ± 78.45 mg/dL vs. 76.04 ± 30.34 mg/dL) and cardiovascular risk (total cholesterol/HDL (High-Density Lipoprotein) cholesterol: 4.32 ± 1.24 vs. 2.93 ± 0.71), while the mean HDL cholesterol concentration was significantly higher (49.09 ± 14.16 mg/dL vs. 61.98 ± 14.86 mg/dL) (all p < 0.001). In conclusion, OAGB surgery led to significant reductions in body weight, a significant improvement in the lipid profile, and a reduction in cardiovascular risk

Assessment of risk factors associated with cardiovascular diseases in overweight women

Producción CientíficaThe assessment of anthropometric variables has been shown to be useful as a predictor of cardiovascular risk in overweight and obese patients. The aim of this study was to determine the usefulness of the relationship between breast volume and body mass index as an indicator of cardiovascular risk in premenopausal women with overweight and mild obesity. A prospective observational study of 93 premenopausal women was performed. Evaluation of anthropometric measures included age, body mass index, waist and hip circumferences, breast projection, and ptosis. Cardiovascular risk factors were evaluated using the Framingham cardiovascular risk score, the triglycerides/HDL cholesterol ratio and the waist-hip ratio. Ninety-three women were included, with a mean 36.4 ± 7.5 years. Mean BMI was 27.3 ± 1.9 kg/m2, waist-to-Hip ratio was 0.8 ± 0.07, and mammary volume was 1045 ± 657.4 cm3. Mean body fat mass was 30.6 + 3.6% and mean visceral fat was 6.6 + 3.2%. The mean triglycerides to HDL ratio was 1.7 ± 0.8 and waist-to-hip ratio was 0.8 ± 0.07. Breast volume related to body mass index can be used as a predictor of cardiovascular risk in premenopausal women who are overweight and mildly obese

Implications of professional occupation related to obesity in patients undergoing bariatric surgery

Producción CientíficaObesity is an epidemic with severe consequences on the professional development of patients. Bariatric surgery has proven to be a safe treatment with effective results in weight control. The aim of this study is to assess the implications of professional occupation in relation to the development of obesity and weight changes after bariatric surgery. We analyzed 500 obese patients (77.8% women, 22.2% men) who underwent one anastomosis gastric bypass surgery at the Centre of Excellence for the Study and Treatment of Obesity and Diabetes (2014–2019), assessing the influence of professional occupation on body composition and evolution of weight loss up to two years after surgery. Preoperative obesity type III and IV was higher in men than in women (45.9–19.8% vs. 43.7–9.5%; respectively). Prevalent clinical history in women was depression (46.7%), varicose veins (35.6%), and thyroid disease (9.7%), while in men it was respiratory failure (98.2%), high blood pressure (56.8%), hepatic steatosis (82%). Postoperative weight loss was effective in every professional field, reaching normal weight values from 12 months after surgery

Estudio de la deformación plástica derivada del movimiento de dislocaciones en materiales metálicos

Los materiales metálicos policristalinos, formados por un gran número de granos, donde la existencia de dislocaciones permite conformarlos hasta alcanzar geometrías deseadas, representan el mayor porcentaje de aplicación en la manufactura de productos. En este trabajo se discute la deformación plástica en materiales metálicos convencionales (Cu, Sn, latón, acero 1045) y un acero avanzado de alta resistencia (TWIP), sometidos a ensayos de compresión. La microestructura y propiedades mecánicas fueron determinadas por microscopia óptica, microscopia electrónica de barrido y ensayos de dureza. Mediante la metodología desarrollada fue posible observar los efectos de la deformación plástica alcanzada a nivel microscópico, al identificarse líneas o bandas de deslizamiento inherentes al movimiento de dislocaciones, en planos y direcciones preferenciales, característicos de cada material. Los resultados han sido analizados y discutidos en términos de la teoría dinámica de dislocaciones.Polycrystalline metallic materials, formed by a large number of grains, where the existence of dislocations allows forming them until reaching desired geometries, represent major percentage of application in the manufacturing of products. In this work it is discussed plastic deformation in conventional metallic materials (Cu, Sn, brass, 1045 steel) and an advanced high strength (TWIP) steel, subject to compression tests. Microstructure and mechanical properties were determined throughout optical and scanning electron microscopy techniques and hardness tests. In general, through current experimental methodology it was possible to observe the effects of reached plastic deformation at the microscopic level, by identifying slip or shear bands inherent to dislocations motion, in preferential planes and directions, own of each material. So, results have been analyzed and discussed in terms of dynamics dislocation theory

Geoheritage as an educational resource and educational resources as heritage

El presente trabajo muestra una compilación de experiencias didácticas que emplean el patrimonio geológico como herramienta pedagógica en la enseñanza de las materias relacionadas con las Ciencias de la Tierra. El objetivo de todas ellas es acercar al alumnado al conocimiento y comprensión de los procesos que acontecen en nuestro planeta, con la finalidad de lograr un acercamiento y sensibilización hacia los mismos. Las seis propuestas seleccionadas presentan variedad en cuanto al contexto territorial de desarrollo de las actividades, a los contenidos y niveles trabajados (desde Enseñanza Secundaria hasta estudios universitarios) y a las metodologías utilizadas para la transmisión de dichos contenidos. Dentro de esta diversidad pueden distinguirse dos grupos de actividades diferentes. El primero de ellos se basa en el desarrollo de experiencias pedagógicas en localidades cuyas características geológicas resultan modélicas, únicas y/o espectaculares. Por el contrario, el segundo conjunto de actividades se centra en el trabajo de los recursos geológicos presentes en el entorno próximo del centro educativo. En ellas se explota su valor patrimonial, es decir, su potencial didáctico para abordar el estudio de la historia geológica del territorio. A través de las actividades incluidas en este compendio, se evidencia la validez de ambos tipos de aproximaciones y, al mismo tiempo, se debaten y realzan algunas de las virtudes más destacables de cada una de ellas. De esta manera, este catálogo podría resultar útil e inspirador para posibles planteamientos futuros.This manuscript presents a compilation of didactic experiences, which address the teaching of Earth Sciences through the knowledge of geological heritage. The aim of these proposals is to promote students’ comprehension of the Earth processes so that they may develop a positive attitude towards them. The six activities chosen offer a catalogue with a variety of sites, methodologies, contents and levels. Within this variety, the activities shown can be gathered into two separate groups. On the one hand, the first group collects experiences, which use geological heritage, i.e., the experiences are developed in places whose geological content is exemplary, unique and/or spectacular. On the other hand, the second group is focused on the geologic resources in the neighborhood of the school. These sites have heritage value, that is, an educational value for studying the geologic history of their territory. The activities drawn together show that both viewpoints are useful, and the benefits of each are pointed out. Consequently, this catalogue might be useful and inspiring for forthcoming attempts in this field

Extended use of dual antiplatelet therapy among older adults with acute coronary syndromes and associated variables: a cohort study

Current guidelines recommend extending the use of dual antiplatelet therapy (DAPT) beyond 1 year in patients with an acute coronary syndrome (ACS) and a high risk of ischaemia and low risk of bleeding. No data exist about the implementation of this strategy in older adults from routine clinical practice. Methods We conducted a Spanish multicentre, retrospective, observational registry-based study that included patients with ACS but no thrombotic or bleeding events during the first year of DAPT after discharge and no indication for oral anticoagulants. High bleeding risk was defined according to the Academic Research Consortium definition. We assessed the proportion of cases of extended DAPT among patients 65≥years that went beyond 1 year after hospitalisation for ACS and the variables associated with the strategy. Results We found that 48.1% (928/1,928) of patients were aged≥65 years. DAPT was continued beyond 1 year in 32.1% (298/928) of patients≥65; which was a similar proportion as with their younger counterparts. There was no significant correlation between a high bleeding risk and DAPT duration. Contrastingly, there was a strong correlation between the extent of coronary disease and DAPT duration (p<0.001). Other variables associated with extended DAPT were a higher left ventricle ejection fraction, a history of heart failure and a prior stent thrombosis. Conclusion: There was no correlation between age and extended use of DAPT beyond 1 year in older patients with ACS. DAPT was extended in about one-third of patients≥65 years. The severity of the coronary disease, prior heart failure, left ventricle ejection fraction and prior stent thrombosis all correlated with extended DAPT

Criteria for admitting elderly patients with acute coronary syndrome to critical care units from Spanish hospital emergency departments: a LONGEVO-SCA cohort study

Objetivo: la información sobre los condicionantes de ingreso en unidades de críticos (UC) de pacientes ancianos con síndrome coronario agudo (SCA) es escasa. El objetivo de este estudio fue describir los factores asociados al ingreso en UC en una serie de ancianos no seleccionados con SCA en España. Métodos: el registro LONGEVO-SCA incluyó prospectivamente pacientes 80 años con SCA sin elevación del segmento ST (SCASEST), realizándose una valoración geriátrica intrahospitalaria y analizándose la evolución clínica a los 6 meses. Se analizaron los condicionantes de ingreso en UC mediante regresión logística binaria. Resultados: de un total de 508 pacientes (edad media 84,3 años), 150 (29,5%) fueron ingresados en UC. Los pacientes ingresados en UC presentaban menor edad, mayor proporción de insuficiencia cardíaca aguda, troponina positiva y peor función ventricular izquierda, así como puntuaciones superiores en las escalas de riesgo GRACE y ACTION-ICU. Estos pacientes presentaban, asimismo, una mejor situación funcional y una menor prevalencia de fragilidad, y fueron sometidos a coronariografía con mayor frecuencia (p < 0,001). No se apreciaron diferencias en mortalidad hospitalaria ni evolución a los 6 meses entre ambos grupos. Los predictores independientes de ingreso en UC fueron la ausencia de insuficiencia cardíaca previa, troponina positiva al ingreso, disfunción ventricular izquierda, valores elevados en la escala GRACE y en el índice de Charlson, y ausencia de fragilidad. Conclusiones: alrededor de un tercio de los ancianos con SCASEST son ingresados en UC. Los pacientes ingresados en UC presentan mayor perfil de riesgo al ingreso y menor prevalencia de síndromes geriátricos

UNICORSA: una experiencia de método del caso común y multidisciplinar para diez asignaturas de las ramas de ciencias sociales y jurídicas

El proyecto de innovación docente “UNICORSA: un método del caso común y multidisciplinar para diez asignaturas de las ramas de ciencias sociales y jurídicas”, fue una iniciativa común de cuatro departamentos y seis áreas de conocimiento de la rama de ciencias sociales y jurídicas de la Universidad de Córdoba orientado a aplicar en la práctica los conocimientos teóricos transmitidos por cada una de estas áreas. A tal fin, se creó una empresa ficticia, UNICORSA, que actuó como protagonista de todas las actividades prácticas planteadas por  el profesorado participante en sus respectivas asignaturas. Ello permitió un estudio multidisciplinar de las distintas vicisitudes por las que debía pasar dicha empresa en su vida económica, jurídica y social. UNICORSA: A SINGLE AND MULTIDISCIPLINARY CASE-STUDY METHOD FOR TEN SUBJECTS IN THE FIELD OF SOCIAL AND LEGAL SCIENCESThe teaching innovation project “UNICORSA: a single and multidisciplinary case-study method for ten subjects in the field of social and legal sciences”, was a joint initiative of four departments and six areas in the field of social and legal sciences of the University of Córdoba aiming to implement the technical knowledge transmitted by each of these areas. To this end, UNICORSA, a fictitious company, was created in order to play the main role of all the practical activities proposed by the participating teachers in their respective courses. This led to a multidisciplinary study of the various events that UNICORSA had to go through in its economic, legal and social life.At the end of the term, a seminar entitled “Board of directors of the UNICORSA company” was held and the students involved in the project participated by presenting the solutions (reports) to the cases raised by the teachers in the different subjects. As in any shareholders' meeting, the approval of each of the reports was put to a vote. Among the main results achieved, it is worth highlighting the visibility of the practical application of the theoretical skills and knowledge acquired by the participants, the integration of multidisciplinary knowledge and the improvement of skills when interacting with other people from different training disciplines to achieve a common goal