Methodology review for writing and publishing case report: applications on the nutrition field

Introducción: en la actualidad, los casos clínicos suponen una importante herramienta docente con aplicaciones prácticas y contribuyen a la expansión del conocimiento de los profesionales de la salud. Objetivos: revisar la metodología de elaboración de casos clínicos, mostrando las similitudes y diferencias en los criterios de formato y contenido que son solicitados para que los reportes de casos sean publicados. Metodología: revisión bibliográfica en PubMed y Scielo entre 2005-2015, y rastreo manual de aquellas referencias más relevantes de los artículos seleccionados. Criterios de inclusión: artículos originales/revisiones bibliográficas en inglés/español/portugués publicados en cualquier país y que incluyan guías o recomendaciones sobre la redacción de casos clínicos. Resultados: se encontraron 131 artículos, de ellos, 20 cumplieron los criterios de inclusión, añadiendo cinco artículos por rastreo manual. Las variables descritas fueron: objetivo, recomendaciones y conclusiones, presentadas en tres tablas: 1. Publicaciones referentes internacionales; 2. Revistas internacionales y 3. Revistas latinoamericanas. Discusión: existen referentes internacionales que proporcionan directrices muy concretas cuando se precisa escribir y publicar un caso clínico. Tanto los referentes internacionales como las recomendaciones analizadas son coincidentes en su utilidad, aunque no existe una estandarización en su metodología. Son muy pocas las directrices que mencionan incluir el tratamiento dietético, el seguimiento y la evolución del mismo durante la situación clínica. Conclusiones: se recomienda a los autores interesados en describir un caso clínico cuyo tratamiento sea principalmente nutricional, seguir una guía ajustada a la situación clínica a presentar, siendo la guía CARE una buena opción.Introduction: currently, case reports are an important teaching tool with practical applications and contribute to the expansion of knowledge of health professionals. Objective: to review the methodology of developing case reports, showing similarities and differences in format and content criteria that are requested for case reports to be published. Methodology: literature review in PubMed and Scielo between 2005-2015 and manual tracing of the most relevant references of selected articles. Inclusion criteria: original articles / literature reviews in English / Spanish / Portuguese published in any country and include guidelines or recommendations for the drafting of clinical cases. Results: we found 131 articles, 20 met the inclusion criteria, adding 5 articles by manually tracing. The variables were described: objective, conclusions and recommendations presented in 3 tables; 1. International guide publication; 2. International journals and 3. Latin American journals. Discussion: there are international benchmarks that provide when required to write and publish a case report very specific guidelines. Both international benchmarks analyzed the recommendations are consistent in their usefulness but there is no standardization in its methodology. Very few guidelines mentioned include dietary management, monitoring and evolution in the clinical situation

Case Study: Body Composition Changes Resulting from a Nutritional Intervention on a Professional Vegan Powerlifter

Powerlifting is a weight-class strength sport where achieving low fat mass (FM) and high fat-free mass (FFM) is desirable to improve performance. Recent studies have evaluated the nutritional considerations of different eating patterns, such as vegan diets (VD), in athlete populations. VD are a challenge for athletes who want to attain body composition changes. The aim of this case study is to report on the body composition changes and subjective feelings of a male professional vegan powerlifter following VD for six weeks. The body mass of the powerlifter decreased from 79.3 to 77.4 kg (2.39%). Along with this, FM decreased from 15.0 to 11.4 kg (24%). Conversely, FFM increased from 64.3 to 66.0 kg (2.64%). Moreover, the powerlifter communicated no subjective feelings of low energy availability during training sessions. The VD might compromise adherence in a nutritional intervention which aims to improve body composition due to the nutritional requirements for fat loss. Therefore, more appropriate health assessments, including blood and psychological tests, are required for professional athletes. This short-term VD intervention was satisfactory for improving body composition and no adverse outcomes were reported

Amber imitation? Two unusual cases of Pinus resin-coated beads in Iberian Late Prehistory (3rd and 2nd millennia BC)

A group of beads from the artificial cave of La Molina (Lora de Estepa, Sevilla) and Cova del Gegant (Sitges, Barcelona) were made from a biogenic raw material and intentionally covered by a layer of resin. This is the first time this type of treatment has been documented on elements of adornment in the Late Prehistory of the Iberian Peninsula. The composition and nature of the coatings are analysed and the symbolic role of such alterations and imitations of prehistoric adornments is discussed.Ministerio de Economía y Competitividad HAR2012- 34620, HAR2017-83474-

Differences in Body Composition between Playing Positions in Men’s Professional Soccer: A Systematic Review with Meta-Analysis

The performance of male soccer players (MSPs) depends on multiple factors, such as body composition. It is understandable to think that, due to the physical demands and specific functions during play, body composition may vary depending on the playing position. The aim of this systematic review and meta-analysis was to describe the anthropometric, BC, and somatotype characteristics of professional MSPs and to compare the reported values according to playing position. We systematically searched Embase, PubMed, SPORTDiscus, and Web of Science following the PRISMA statement. Random-effects meta-analysis, a pooled summary of means, and 95% CI (method or equation) were calculated. Random models were used with the Restricted Maximum Likelihood (REML) method. Twenty-six articles were included in the systematic review and the meta-analysis. After comparing the groups according to the playing position (goalkeeper, defender, midfielder, and forward), significant differences were found in age, height, weight, the sum of skinfolds, kilograms of muscle mass, and kilograms of fat-free mass (p = 0.001; p < 0.0001). No significant differences were observed in fat mass, percentage of fat-free mass, percentage of muscle mass, bone mass, and somatotype. Despite the limitations, this study provides useful information to help medical–technical staff to properly assess the BC of professional MSPs, providing reference values for the different positions

Nutritional planning to run an Ultra-marathon, the Transvulcania: Case report

La Transvulcania es una competición individual de montaña con 74,6km, en la que se dispone de avituallamientos para cubrir las necesidades de alimentación e hidratación de los participantes. La importancia de la preparación dietético-nutricional radica en la prevención o disminución de problemas gastrointestinales, deshidratación, hiponatremia y fatiga, entre otros. El objetivo del presente informe es describir la planificación dietético-nutricional de un deportista que afronta este evento. Varón de 37 años con 10 años de experiencia deportiva, en el que se evaluaron los hábitos alimentarios, ingesta de suplementos, composición corporal. Para la planificación alimentaria de la Transvulcania, se tuvo en cuenta las recomendaciones dietético-nutricionales para deportistas en competición, tiempo medio, lugar de los avituallamientos y posible ingesta de alimentos/suplementos. La planificación dietético-nutricional en eventos de ultrarresistencia es un condicionante para realizar satisfactoriamente la prueba, tolerando e ingiriendo adecuadamente los alimentos/suplementos y evitando riesgos nutricionales como la deshidratación, fatiga, molestias gastrointestinales, etc.The Transvulcania is an individual mountain competition with 74,6km. The event has provisioning areas to meet the needs of nutrition and hydration of the participants. The importance of dietary-nutritional preparation is in preventing or reducing gastrointestinal problems, dehydration, hyponatremia, fatigue, among others. The aim is to describe the dietary and nutritional planning an athlete in this event. Eating habits, supplement intake and body composition were evaluated in a 37 years old male with 10 years of sports experience. Dietary and nutritional recommendations for athletes in competition, test time, refreshment areas and possible food intake/supplements were taken into account for dietary planning during the competition. The dietary and nutritional planning in ultra-endurance events is important to successfully perform the competition, tolerating and taking foods/supplements properly, and avoiding nutritional risk and dehydration, fatigue, gastrointestinal disturbances, etc

¿El problema es el euro o Europa?

Este trabajo aborda los problemas que ha tenido el euro desde su puesta en marcha en 1999 hasta la actualidad y trata de exponer los factores explicativos que condicionaron a la moneda única desde su creación. Para ello, analiza los distintos factores que influyeron en su diseño desde el Tratado de Maastricht y los desequilibrios que han aparecido en la estructura de la zona euro desde su implementación que han hecho que la recuperación en la eurozona haya sido más lenta que en el resto del mundo, otorgando una especial relevancia al impacto de los shocks asimétricos en la estructura europea y diferenciando dos ramas explicativas del actual funcionamiento del euro; la rama estructural, a partir del estudio de las condiciones necesarias para que una región sea considerada una zona monetaria óptima, y la rama política, mediante el análisis del desempeño de las instituciones europeas . Con esto, se tratará de resolver la incógnita de si los desequilibrios que ha presentado el euro desde el año 2008 sobre todo, se deben a la naturaleza económica de Europa o al erróneo diseño y funcionamiento de las instituciones europeas. <br /

Dietetic-nutritional planning for an ultra-trail of 115 km: case report

El ultra-trail es un deporte de resistencia que involucra caminar y correr un recorrido con cambios extremos de elevación por pistas y caminos no asfaltados, senderos, barrancos, etc. La importancia de la planificación dietético-nutricional radica en la prevención de problemas nutricionales como la deshidratación o hiponatremia, problemas gastrointestinales, fatiga e hipoglucemia. El objetivo es planificar e intervenir a nivel dietético-nutricional en un deportista para afrontar un ultra-trail de 115km. Se trata de un deportista de 26 años, con 3 años de experiencia deportiva. Acude al gabinete Alinua de la Universidad de Alicante, donde se recopilaron datos para realizar una intervención dietético-nutricional para mejorar su composición corporal y afrontar el ultratrail de Castelló-Penyagolosa el 21/04/2017. La planificación dietético-nutricional se dividió en tres fases: fase de acondicionamiento previo, fase de los días previos a la competición y fase del día de la competición, en las que se siguieron las recomendaciones dietético-nutricionales para deportistas de resistencia. El deportista realizó satisfactoriamente la prueba y se adhirió a la planificación, aunque realizó algunas modificaciones. Además, no manifestó ningún problema. El asesoramiento y planificación nutricional para afrontar la competición es clave para para cumplir el objetivo de finalizar la prueba sin poner en riesgo la salud del atleta. Se deben tener en cuenta factores como perfil del deportista, características del evento, avituallamientos, materiales deportivos, etc.The ultra-trail is an endurance sport that involves walking and running with extreme slope changes. The course of the competitions will be by tracks and unpaved roads, trails, ravines, etc. The importance of dietary-nutritional planning lies in the prevention of nutritional problems such as dehydration or hyponatremia, gastrointestinal problems, fatigue and hypoglycemia. The aim of the study is to plan the diet of an athlete to achieve the optimum nutritional levels to approach an ultra-trail of 115km. This case report presents 26-year-old mountain ultramarathon runner, resident in Alicante, with 3 years of experience in sport. He ask for a nutritional assessment at the nutritional service of the University of Alicante (Alinua), where dates were collected to perform a dietary-nutritional intervention to improve his body composition and cope with the mountain ultra-marathon in Castelló-Penyagolosa, which will take place on 04/21/2017. Dietary-nutritional planning was divided into three phases: pre-conditioning phase, pre-competition phase and competition phase, in which dietary-nutritional recommendations for endurance athletes were followed. The athlete successfully performed the event and adhered to the planning, with the exception of some modifications. Also, he did not manifest any problem. Nutritional counseling and planning are key to in meeting the target of the competition without endangering the health of the athlete. To improve the sporting results, several factors must be taken into account, as the profile of the athlete, the characteristics of the event, the provisioning opportunities, the sports equipment, etc

Undernutrition Risk Assessment in Elderly People: Available Tools in Clinical Practice

Undernutrition is a public health problem all over the world. More than 30 million people are currently affected by undernutrition in Europe, mainly hospitalized or elderly people. Undernutrition has several medical consequences and in the elderly can be associated with adverse clinical symptoms, contributing to frailty, morbidity, hospitalization, and mortality. These medical situations highlight the importance of an early detection and diagnosis, the objective being to prevent or treat undernutrition. This is why the implementation of a complete nutritional assessment in clinical practice is important. Nutritional screenings are essential tools to identify patients that will likely benefit from nutrition therapy. There are currently several screening methods to identify nutritional risk or malnutrition. However, the lack of a standard has aroused controversy about the best tool to use. Our objective is to describe the screening tools available for the elderly

3D printed personalized corneal models as a tool for improving patient’s knowledge of an asymmetric disease

Additive manufacturing is a vanguard technology that is currently being used in several fields in medicine. This study aims to evaluate the viability in clinical practice of a patient-specific 3D model that helps to improve the strategies of the doctor-patient assistance. Data obtained from a corneal topographer were used to make a virtual 3D model by using CAD software, to later print this model by FDM and get an exact replica of each patient’s cornea in consultation. Used CAD and printing software were open-source, and the printing material was biodegradable and its cost was low. Clinic users gave their feedback by means of a survey about their feelings when perceiving with their senses their own printed cornea. There was 82 surveyed, 73.8% (9.74; SD: 0.45) of them considered that the model had helped them a lot to understand their disease, expressing 100% of them their intention of taking home the printed model. The majority highlighted that this new concept improves both quality and clinical service in consultation. Custom-made individualized printed models allow a new patient-oriented perspective that may improve the communication strategy from the ophthalmologist to the patient, easing patient’s understanding of their asymmetric disease and its later treatment.This publication has been carried out in the framework of the Thematic Network for Co-Operative Research in Health (RETICS), reference number RD16/0008/0012, financed by the Carlos III Health Institute–General Subdirection of Networks and Cooperative Investigation Centers (R&D&I National Plan 2013–2016) and the European Regional Development Fund (FEDER)