Asociación de polimorfismos de timidilato sintasa (TS) y factor inducible por hipoxia -1 (HIF -1 ) con el cáncer de páncreas

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, departamento de cirugia, Facultad de Medicina. Departamento de Cirugía. Fecha de lectura: 29 de Diciembre de 200

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

Impact of preoperative total proteins and glycated hemoglobin on recurrences after early colorectal cancer

Producción CientíficaBackground: The outcome of colorectal cancer is mostly based on TNM classification. There are several factors determining that patients with the same tumoral stage present different outcomes. The nutritional status has been related to the immunological response and may affect the oncologic results. The purpose of this study was to determine if preoperative nutritional parameters may predict the oncologic outcome in patients with early colorectal cancer. Methods: A prospective observational study of patients undergoing elective surgery for colorectal cancer was performed with stage I. Preoperative nutritional assessment included glycemic and lipid profiles, total proteins, and albumin levels. These parameters were correlated with tumoral recurrence during a follow-up of at least 24 months. Results: During the period of study, 744 patients were operated on and 228 (30.6%) followed the inclusion criteria for this study. Recurrence rate was 5.7% (13 patients). Patients with hypoproteinemia showed a 7.8-fold greater risk of recurrence during the first 24 months after surgery [OR 7.8 (CI95% 1.3–48), p = 0.012]. Patients with glycated hemoglobin levels (HbA1c) > 6.2% showed a 2.3 increased risk of recurrence [OR 2.3 (CI95% 1.1–4.7; p = 0.01]. Conclusions: Preoperative values of total proteins and HbA1c correlate with the recurrence rate in early colorectal cancer

Toxic Habits and Well-Being Measures in Spanish Healthcare University Students during the COVID-19 Pandemic

Background: Unhealthy lifestyles are strongly entrenched in healthcare universities and have sometimes been linked to stress or lack of sleep. This study investigated the prevalence of toxic habits (smoking, patterns of harmful alcohol use, and illicit drug use), stress levels, perceived health status, and sleep duration and assessed the connections between toxic habits and said well-being measures, as well as healthcare students’ perception of the influence of the COVID-19 pandemic on these health-related behaviors. Methods: In a cross-sectional study, healthcare students from Alfonso X University (Spain) completed a health survey composed of Alcohol Use Disorders Identification Test (AUDIT-C), Perceived Stress Scale (PSS-10), self-perceived health status, and the number of hours of sleep. Results: A total of 997 healthcare students completed the survey, of which 982 were analyzed. Being a smoker (32.2%) was associated with worse health status and insufficient sleep. Risk drinkers (33.2%) were associated with being female, and the consumption of cannabinoids (6.7%), with being male. These three toxic habits were related to each other. High levels of stress (28.2%) were correlated with worse ratings in the perception of health status (29.2%) and with insufficient sleep (45.8%), and all of them were associated with the female sex. Respectively, 49.3% and 44.2% of students recognized a worsening in their perception of stress and their sleep habits during the pandemic. Conclusion: Healthcare universities must carry out health promotion programs for stress management, sleep habits, and unhealthy lifestyles

Factor de riesgo para suicidio según dos cuestionarios y factores asociados en población estudiantil de una Universidad de Manizales, 2011

Suicide is a conduct as a result of the interaction of many variables that lead a human being to end with his/her life through their own means. This study pretends to identify the suicidal risk factor and associated factors in undergraduate students of the Universidad de Manizales. This is a Cross-sectional study, of a probabilistic sample of 355 student of the undergraduate programs of the Universidad de Manizales. The student population that was studied consisted of three hundred and fifty five students. The Plutchik´s Scale and Beck´s Hopelessness Scale for suicide risk were employed, the associated factors also were measured. This study showed, according to Plutchik´s Scale, a suicide risk factor of 13.5%, and a 16.7% of a high and moderate suicide risk factor according to Beck´s scale. The study also threw out important associated factors on the Plutchik´s scale: socioeconomic stratum (p= 0,005), psychiatric diagnosis (p= 0,000), intake of alcohol (p= 0,000) and psychoactive substances consumption (p=0,000), family members with suicidal background (p=0,034), family functionality (p= 0,000), self-esteem levels (p= 0,000), anxiety (p= 0,000) and depression (p= 0,000). In relation to Beck´s scale, besides the factors that were previously mentioned, the following were found race (p=0,003), marital status (p= 0,007), spirituality (p= 0,000), and the undergraduate program that each student is part of (p= 0,000). Plutchik Risk factor for suicide, is similar to that found in others similar populations. Plutchik and Beck scales are not equivalent but related.El suicidio es una conducta producto de la interacción de muchas variables que llevan al ser humano a tratar de terminar con su vida  por sus propios medios. Este estudio pretende identificar el factor deriesgo suicida; además de factores asociados en los estudiantes de pregrado de la Universidad de Manizales. Es un estudio de corte transversal, en el cual se seleccionó una muestra probabilística de 355 alumnos de programas de dicha universidad y se aplicaron los cuestionarios de Beck y Plutchik para riesgo suicida y factores asociados. El estudio mostró un factor de riesgo para suicidio según la Escala de Plutchik de13,5% y según la Escala de Desesperanza de Beck entre riesgo suicida alto y moderado de un 16,7%. Y como factores asociados se encontraron significativos, según la Escala de Plutchik, el estrato socioeconómico (p=  0,005), presencia de un diagnóstico psiquiátrico (p=0,000), consumo de alcohol (p=0,000) y sustancias psicoactivas (p=0,000), antecedentes  familiares de suicidio (p=0,034), funcionalidad familiar (p=0,000), nivel de autoestima (p=0,000), ansiedad (p=0,000) y depresión  (p=0,000); según la Escala de Beck, además de los anteriores factores asociados, se encontró la asociación significativa con raza (p=0,003), estado civil  (p=0,007), espiritualidad (p=0,000) y el programa de pregrado que se encuentre cursando el estudiante (p=0,000). El Factor de Riesgo para Suicidio, según Escala de Plutchik, es parecido al encontrado en otras poblaciones análogas. Las escalas de Plutchik y de Beck, aunque relacionadas, no son equivalentes

Una mirada interdisciplinaria

Las enfermedades crónicas no transmisibles son, en la actualidad, uno de los temas de salud de mayor interés alrededor del mundo, dado el rápido crecimiento que han experimentado en las últimas décadas en países desarrollados y en vía de desarrollo y el alto impacto, no solo biológico, sino económico, sanitario y social que generan para el individuo y la sociedad. De acuerdo con la OMS, las enfermedades crónicas (patologías cardiovasculares, diabetes mellitus, todos los tipos de cáncer y las enfermedades respiratorias), son las principales causas de mortalidad en el mundo, ya que se les asigna un peso del 63% de las muertes a nivel global, con más de 36 millones de defunciones (71% en mayores de 60 años). Así las cosas, la diabetes mellitus se ha ido convirtiendo progresivamente en un problema de salud pública a nivel mundial, dada la estrecha relación que tiene con el sobrepeso y con el sedentarismo, fenómenos característicos del estilo de vida de gran parte de la población a nivel mundial. Este libro presenta de manera ordenada y didáctica información actualizada y práctica acerca de esta enfermedad, de tal forma que pueda ser utilizado como material de consulta y referencia por estudiantes y profesionales de la salud en el ejercicio académico y asistencial, desde una perspectiva práctica de naturaleza interdisciplinaria.Acciones mundiales, regionales y locales para reducir el impacto de la diabetes – Diabetes mellitus en la adolescencia – Alteraciones visuales y oculares en pacientes diabéticos – Diabetes mellitus tipo 2, obesidad y síndrome de apnea obstructiva del sueño – Pie diabético: una mirada desde las imágenes diagnosticas – Diabetes mellitus en el paciente quirúrgico – Diabetes mellitus: una mirada desde la medicina tradicional china – prevención de la diabetes mellitus: reflexiones desde la medicina familiar – Diabetes mellitus: prescripción de ejercicio y actividad física – Meta análisis y revisiones sistemáticas aplicadas en el campo de la diabetes melitus