5 research outputs found
Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study
“This is an accepted version of an article published by Churchill Livingstone in Clinical Nutrition on April 2019, available at: doi: 10.1016/j.clnu.2018.02.032.”Background and 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 to 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.The study was supported by the Ministry of Health, Social Services and Equality via the Carlos III Institute of Health (FIS Grant
PI051080, PI051579). The EVASYON study received the award for
the best applied research project in 2009 from AESAN (Spanish
Agency for Food Safety and Nutrition from the Spanish Ministry of
Health and Consumer Affairs. The study was supported by Aragon's
Regional Government (DGA, Diputacion General de Arag on ) and
European Regional Development Fund
Guía de actuación en las anomalías de la diferenciación sexual (ADS) / desarrollo sexual diferente (DSD).
Disorders of Sex Development (DSD) include a wide range of anomalies among the chromosomal, gonadal, and phenotypic (genital) characteristics that define sexual differentiation. At present, a definition as Different Sexual Development (DSD) is currently preferred. They originate in the pre-natal stage, are classified according to the sex chromosomes present in the karyotype. The known genetic causes are numerous and heterogeneous, although, in some cases, they may be secondary to maternal factors and/or exposure to endocrine-disrupting chemicals (EDCs). The diagnosis and treatment of DSD always requires multidisciplinary medical and psychosocial care. An aetiological diagnosis needs the interaction of clinical, biochemical (hormonal), genetic, imaging and, sometimes, surgical examinations. The treatment should deal with sex assignment, the possible need for hormone replacement therapy (adrenal if adrenal function is impaired, and with sex steroids from pubertal age if gonadal function is impaired), as well as the need for surgery on genital structures (currently deferred when possible) and/or on gonads (depending on the risk of malignancy), the need of psychosocial support and, finally, an adequate organisation of the transition to adult medical specialties. Patient Support Groups have a fundamental role in the support of families, as well as the interaction with professional and social media. The use of Registries and the collaboration between professionals in Working Groups of national and international medical societies are crucial for improving the diagnostic and therapeutic tools required for the care of patients with DSD
Body composition changes during a multidisciplinary treatmentprogramme in overweight adolescents: EVASYON Study
Introduction: the main objectives of weight-loss interventions
are to decrease fat mass while maintaining fatfree
mass.
Objective: our aim was to address effectiveness body
composition changes in overweight adolescents assessed
by different body composition methods following an obesity
intervention programme.
Material and methods: the life-style intervention was
multi-disciplinary, with 13 months follow-up. Participants
were 13-to-16 year-old overweight, or obese, Spanish
adolescents. The adolescents (n = 156; 54.8% females)
had body composition measured with anthropometry,
dual-energy X-ray absorptiometry and air-displacement
plethysmography. All measurements were made at baseline,
and after 2- and 13-months. Repeated measures analysis
of covariance to compare mean anthropometric changes
over time and the Bonferroni correction were applied.
Imputation of anthropometric measures was performed.
Results: a high significant decrease in fat mass index
was achieved in males after 2-and 13-months of intervention
as measured by anthropometry (1.16 and 1.56 kg / m2,
respectively), X-ray absorptiometry (1.51 and 1.91 kg / m2)
and plethysmography (2.13 and 2.44 kg/m2). Moreover, a
short and long-term maintenance of fat-and fat-free mass
index was observed by X-ray absorptiometry in females
(0.94 and 0.68 kg/m2).Introducción: el principal objetivo de las intervenciones
de pérdida de peso es disminuir la masa grasa manteniendo
la masa libre de grasa.
Objetivo: evaluar la efectividad de una intervención
multidisciplinar en la composición corporal de adolescentes
con sobrepeso, evaluados mediante diferentes métodos
de composición corporal.
Material y métodos: la intervención fue multidisciplinar
sobre el estilo de vida, aplicada durante 13 meses.
Los participantes eran adolescentes entre 13 y 16 años
con sobrepeso y obesidad. Los adolescentes (n = 156;
54,8% mujeres) fueron evaluados mediante antropometría,
absorciometría dual de rayos X y pletismografía por
desplazamiento de aire. Todas las mediciones se realizaron
al inicio, a los 2 y a los 13 meses. Se aplicaron análisis
de la covarianza de medidas repetidas y la corrección de
Bonferroni. Se realizó la imputación de las medidas antropométricas.
Resultados: se logró una alta disminución significativa
en el índice de masa grasa en los hombres después de 2 y
13 meses de intervención, según antropometría (1,16 y
1,56 kg/m2, respectivamente), absorciometría de rayos X
(1,51 y 1,91 kg/m2) y pletismografía (2,13 y 2,44 kg/m2).
Por otra parte, el mantenimiento a corto y largo plazo de
la grasa y libre de grasa en el índice de masa fue observado
por absorciometría de rayos X en las mujeres (0,94 y
0,68 kg/m2)
Guía de actuación en las anomalías de la diferenciación sexual (ADS) / desarrollo sexual diferente (DSD)
Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort
Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective