Evolution of nutritional biochemical parameters in hemodialysis patients during a one-year follow-up period

La elevada supervivencia actual del paciente en hemodiálisis (52% hasta 5 años), ha hecho que se pongan de manifiesto complicaciones crónicas como la elevada prevalencia de malnutrición en los enfermos, así como la importancia de la situación nutricional en la morbi-mortalidad que presentan. La causa de desnutrición proteico-calórica es multifactorial, aunque procesos de inflamación crónica asociada a la técnica de diálisis cobran cada vez más relevancia. Se han evaluado las variaciones de distintos parámetros bioquímicos nutricionales (proteínas totales, albúmina plasmática, transferrina y colesterol total) de 73 pacientes en hemodiálisis durante un año de seguimiento. La edad media de los pacientes era de 53,3 ± 18,69 años, con 43 varones y 30 mujeres. El tiempo en programa de hemodiálisis ha sido de 43 ± 33 meses, con una duración media de la sesión de 246 ± 24 minutos y dosis media de hemodiálisis administrada de 1,37 ± 0,27 (KT/V) (Daurgidas 2ª generación). Se ha observado un descenso en todos los parámetros bioquímicos evaluados, con diferencias estadísticamente significativas: Proteínas totales (p < 0,001), albúmina (p < 0,00001), colesterol total (p < 0,05) y transferrina (p < 0,01). La evolución de los parámetros bioquímicos nutricionales evaluados mostró un importante deterioro nutricional de los pacientes estables con el tratamiento.Current high survival in hemodialysis patients (52% at 5 years) have made the chronic manifestations to emerge such as the high hyponutrition prevalence of these patients, as well as the importance of the nutritional status in their morbimortality. The reason for protein-caloric hyponutrition is multifactorial, although chronic inflammatory conditions associated to the dialysis technique are becoming more and more relevant. The variations in several nutritional biochemical parameters (total proteins, plasma albumin, transferrin, and total cholesterol) have been assessed in 73 hemodialysis patients for one year. The mean age of the patients was 53.3 ± 18.69 years (43 males and 30 females). The average on hemodialysis program was 43 ± 33 months, with a mean session duration of 246 ± 24 minutes, and mean hemodialysis dose administered of 1.37 ± 0.27 (KT/V) (second generation Daurgidas). A decrease in all the biochemical parameters assessed has been observed, with statistically significant differences: total proteins (p < 0.001), albumin (p < 0.00001), total cholesterol (p < 0.05), and transferrin (p < 0.01). The evolution of the nutritional biochemical parameters assessed showed an important nutritional deterioration of the patients remaining stable with the therapy

Resistance of hyperhomocysteinemia in renal patients to treatment with supra-physiological doses of parenteral folic acid

Los pacientes en hemodiálisis presentan un aumento de homocisteína plasmática (Hcy), debido a la alteración en la metilación causada por la uremia y déficit de los cofactores necesarios (vitamina B, ácido fólico). Esto se correlaciona con un mayor desarrollo de la enfermedad vascular prematura. El tratamiento, no está consensuado, siendo escasa la respuesta a la administración oral de dosis convencionales de ácido fólico. En este trabajo valoramos la respuesta de la hiperhomocisteinemia de 73 pacientes en programa de hemodiálisis periódica tras la administración de 50 mg de ácido folínico parenteral durante 18 meses. La homocisteína plasmática de los pacientes en el momento de inicio del estudio presentaba unos valores medios de 22,67 (μmol/l). Durante el primer año de suplementación mantuvieron el valor medio de 20 μmol/l. A partir del primer año de tratamiento, y hasta finalizar los 18 meses de observación, los niveles medios de homocisteína fueron de 19,58 μmol/l. Aunque con el tiempo de tratamiento encontramos una clara tendencia al descenso de sus valores plasmáticos, no existieron diferencias estadísticamente significativas. Los valores de homocisteína no se normalizaron en ninguno de los pacientes tratados.Hemodialysis patients present an increase in plasma homocysteine (Hcy) due to methylation impairment caused by uremia and the deficiency of the co-factors needed (vitamin B, folic acid). This correlates with a more common development of premature vascular disease. There is no consensus on the therapy, with a poor response to oral administration of conventional doses of folic acid. In this work, we assessed the response of hyperhomocysteinemia in 73 regular hemodialysis patients after the administration of 50 mg of parenteral folinic acid for 18 months. Plasma homocysteine of the patients at the time of the study beginning presented mean values of 22.67 (μmol/L). During the first year of supplementation the mean value was kept at 20 μmol/L. From the first year to the end of the 18-months observation period the mean homocysteine levels were 19.58 μmol/L. Although we found a clear trend towards a decrease in plasma homocysteine levels during the treatment period, there were no significant differences. Homocysteine levels did not come back to normal in none of the patients treated

Pedagogical and scientific beliefs of future primary school teachers and university science education and science lecturers

11th Conference of the European Science Education Research Association (ESERA) 2015, 31/08-04/09, 2015, in Helsinki (Findland).The purposes of this study are: a) to investigate the pedagogical and scientific beliefs of primary school teachers in training (group 1, N= 60), and b) compare said beliefs with those of university lecturers in science education (group 2, N = 33) and science (group 3, N = 98). We applied the Inventory of Educational and Scientific Beliefs, INPECIP (Porlán, 1989), consisting of 51 items divided into three categories: Image of Science, Learning of Science and Science Teaching. The results show that science education lecturers are more “constructivist” in all categories than both their students and their science department peers. In the “Learning of Science” and “Science Teaching” categories, we can also see that students are more “constructivist” than science lecturers. We conclude that in order to help future teachers modify their beliefs, collaboration with science lecturers is indispensable. Keywords: pedagogical beliefs, image of science, teacher trainers.III Contrato Programa entre el Vicerrectorado de Política Científica e Investigación de la Universidad de Granda, y la Facultad de Educación y Humanidades, Campus de Melilla: Proyecto: Entrenamiento pedagógico y didáctico del profesorado de la Facultad de Ciencias.Universidad de Granada. Departamento de Didáctica de las Ciencias Experimentales.Instituto Andaluz de Ciencias de la Tierra (CSIC-UGR)Grupo de Investigación de excelencia de la Junta de Andalucía, Grupo de Investigación en Didáctica de las Ciencias Experimentales y de la Sostenibilidad (HUM613)

The association of energy poverty with health, health care utilisation and medication use in southern Europe

Energy poverty (EP) is defined as the inability of a household to secure a socially and materially required level of energy services in the home. The main objective of this study was to analyse the association between EP and distinct indicators of health status, health services utilisation and medication use in southern Europe, using the city of Barcelona as a case study. We conducted a cross-sectional study using the data of the Barcelona Health Survey for 2016 (n = 3519, 53.3% women). We calculated EP percentages according to age, country of birth and social class. We analysed the association between EP and 26 health-related indicators through prevalence ratios (PR), and quantified the impact of EP on health at the population level by calculating the percentage of population attributable risk (PAR%). In Barcelona, 13.3% of women and 11.3% of men experienced EP. The most frequently affected groups were people born in low- and middle-income countries, those from more disadvantaged social classes, and women aged 65 years and older. We found a strong association between EP and worse health status, as well as higher use of health services and medication. For example, compared with women without EP, those with EP reported poor mental health 1.9 (95% CI: 1.6-2.4) times more frequently. Compared with men without EP, those with EP reported poor mental health 2.1 (95% CI: 1.6-2.8) times more frequently. The combination of high EP prevalence and the strong association between EP and negative health outcomes resulted in high PAR%, indicating the striking impact of EP on health and health services at the population level. EP is an important public health problem in southern European urban contexts that should be included in policy priorities in order to address its structural causes and minimise its unfair and avoidable health effects

Evolution of body parameters of an obese population under a nutritional intervetion with hipocaloric diet and nutritional

Introducción: Factores como la actividad física, el exceso de calorías de la dieta y la falta de educación nutricional pueden modificarse con el objeto de mejorar el pronóstico de la obesidad y comorbilidades asociadas. Material y método: Participaron 20 sujetos con sobrepeso u obesidad (IMC > 25kg/m2) con edades comprendidas entre los 28 y 62 años. La intervención tuvo una duración de 8 semanas, y consistió en una intervención nutricional y física saludable. Para evaluar los cambios producidos tras la intervención se realizaron mediciones de peso, IMC, diámetros de cintura y cadera y porcentajes de grasa y masa muscular. Los análisis estadísticos se realizaron a través del paquete estadístico SPSS 15.0. Se realizó la prueba T de muestras apareadas para la comparación entre pre-test y post-test. Resultados y conclusiones: Los resultados muestran descensos estadísticamente significativos para los parámetros peso (de 90,99 ± 17,27 a 82,69 ± 16,09), porcentaje graso (de 37,28 ± 5,97 a 33,73 ± 6,69), IMC (de 30,81 ± 5,92 a 27.98 ± 5,6), diámetros de cintura de (101,8 ± 16,5 a 95,23 ± 14,12) y cadera de (98,83 ± 14,11 a 95,7 ± 13,58). El parámetro porcentaje de masa muscular muestra un ascenso estadísticamente significativo tras la intervención. Conclusión: Podemos afirmar que intervenciones nutricionales y físicas pueden ayudar a prevenir enfermedades como la obesidad y patologías derivadas de la misma.Introduction: Factors such as physical activity, beyond calories diet and lack of nutrition education can be modified in order to improve the prognosis of obesity and associated comorbidities. Material and method: 20 subjects with overweight or obesity (BMI > 25kg/m2), aged between 28 and 62. The intervention lasted 8 weeks, following an intervention healthy nutrition intervention and physical activity. To evaluate the changes, weight, BMI, waste and hip sizes and percentages of fat and muscle mass were measured. Statistical analysis was performed through SPSS 15.0 statistical package. After verifying the normality of variables, paired samples T-test was made for comparison between pre-test and post-test, Results: The results showed statistically significant declines for the parameters weight (90.99 ± 17.27 to 82.69 ± 9.16), fat percentage (37.28 ± 5.97 to 33.73 ± 6.69), BMI (from 30.81 ± 5.92 to 27.98 ± 5.6), waist diameters (101.8 ± 16.5 to 95.23 ± 14.12) and hip (98.83 ± 14.11 to 95.7 ± 1358). The percentage of muscle mass parameter shows a statistically significant rise after intervention. Conclusion: we can say that physical and nutrition interventions can help prevent diseases such as obesity and disorders arising therefrom

La Oficina de Farmacia: una herramienta para conocer el grado de adherencia a la dieta mediterránea de la población

Objetivos: Evaluar el grado de adherencia a la dieta mediterránea y el IMC de individuos mayores de 40 años a través de las Oficinas de Farmacia y ver la influencia que tienen la edad, status socioeconómico y estado civil sobre el mismo. Métodos: 291 personas (130 hombres y 161 mujeres) distribuidos por intervalo de edad, en tres etapas de transición madura: 40-50 años (inicial), 50-60 años (media) y 60- 70 años (avanzada). Los datos fueron recolectados en unas oficinas de farmacia por medio de tres encuestas: aspectos sociodemograficos, variables antropométricas y valoración de la adherencia. Resultados: De acuerdo al IMC, el 62,4% de las personas encuestadas se clasificaron en situación de sobrepeso y el 37,6% en situación de normopeso. Las personas entre 40-50 años presentaban un valor medio de adherencia al patrón de dieta mediterránea de 7,8 (IC95%:7,7-7,9); los de 50-60 años de 8,3 (IC95%: 8,1-8,5) y los de 60-70 años de 11,4 (IC95%: 11,7-11,1). Conclusiones: No existen diferencias estadísticas significativas entre las condiciones socioeconómicas y estado civil en cuanto al IMC y grado de adherencia al patrón de dieta mediterránea. No sucede lo mismo en cuanto a la edad, entre 40-60 años no alcanzan las recomendaciones de consumo de la mayoría de los alimentos que constituyen la base de la alimentación mediterránea. El mayor grado de adherencia está en la población entre 60-70 años. El farmacéutico mediante unas sencillas encuestas puede detectar estas desviaciones y dar los consejos nutricionales adecuados para restablecer el patrón mediterráneo.Aim: To assess Mediterranean diet adherence and BMI in people over 40 years of age using a community pharmacy, and the influences of age, socioeconomic status and marital status. Methods: 291 people (130 men and 161 women) distributed in three age group: 40-50 years, 50-60 years and 60-70 years. The data were collected in several community pharmacies through three questionnaires about sociodemographic factors, anthropometric measurements and adherence to Mediterranean diet. Results: According to BMI, 62.4% of people were overweight and 37.6% normal weight. The mean Mediterranean diet adherence levels were 7.8 (95% CI :7,7-7,9) in the 40-50 year range, 8.3 (95% CI : 8,1-8,5) in the 50-60 year range and 11,4 (95% CI : 11,7-11,1) in the 60-70 year range. Conclusions: There are no statistically significant differences between socioeconomic status and marital status regarding BMI or Mediterranean diet adherence. However, this is not the case when the age variable is taken into account, as people in the 40-60 year range do not follow the recommendations of food consumption for the Mediterranean diet. The highest level of adherence is in people aged 60-70 years. Using simple questionnaires community pharmacists could reveal this low adherence and give adequate nutritional advice to reinforce Mediterranean diet adherence.El estudio se ha realizado con los medios habituales de que dispone el Departamento de Nutrición y Bromatología y a través de los recursos aportados por el Máster Universitario en Atención Farmacéutica (EuropharmNES) de la Universidad de Granada

Geographical inequalities in energy poverty in a Mediterranean city : Using small-area Bayesian spatial models

Altres ajuts: Ministerio de Economía y Competitividad; European Union, European Regional Development Fund (FEDER); CIBER Epidemiología Salud Pública (CIBERESP), sub-program "Energy Poverty and Health"; Fondo Social Europeo.Energy poverty (EP) is becoming an increasingly important problem in the urban contexts of southern Europe. In Barcelona, EP indicators are higher than those of the European Union and are strongly associated with poor health status and high use of health services and medication, becoming a major public health problem. EP is unevenly distributed in the population of Barcelona, according to axes of social stratification. However, its geographic distribution at the small-area level remains unknown because it cannot be directly estimated with the available information sources and commonly used methods. Therefore, the aim of this study was to analyze geographical inequalities in EP in Barcelona by estimating reliable small-area EP indicators and a composite indicator (index). We used a novel method that allowed us to obtain 6 EP indicators for the 73 Barcelona neighborhoods and an EP index from a principal component analysis of these indicators. We found major geographical inequalities in the distribution of EP in Barcelona. Many neighborhoods had significantly higher EP than the city average, and these areas made up 3 well-defined spatial clusters. Therefore, the estimated small-area indicators and index allowed identification of the most affected neighborhoods. These results indicate the need to prioritize these areas for local interventions to alleviate EP, and could also be used for policy making

The Association of Energy Poverty with Health and Wellbeing in Children in a Mediterranean City

Children have been identified as being particularly vulnerable to energy poverty (EP), but little empirical research has addressed the effect of EP on children’s health and wellbeing, especially in southern Europe. In this work we aimed to provide an in-depth description of the distribution of EP by sociodemographic, socioeconomic and housing characteristics, as well as to analyse the association between EP and health and wellbeing in children in Barcelona. We performed a cross-sectional study using data from the Barcelona Health Survey for 2016 (n = 481 children under 15 years). We analysed the association between EP and health outcomes through prevalence differences and prevalence ratios (PR) and their 95% confidence interval (CI), using Poisson regression models with robust variance. In Barcelona, 10.6% of children were living in EP and large inequalities were found by sociodemographic, socioeconomic and housing characteristics. EP was strongly associated with poor health in children (PR (95% CI): 7.70 (2.86, 20.72)). Living in EP was also associated with poor mental health (PR (95% CI): 2.46 (1.21, 4.99)) and with more cases of asthma (PR (95% CI): 4.19 (1.47, 11.90)) and overweight (PR (95% CI): 1.50 (1.05, 2.15)) in children. It is urgent to develop specific measures to avoid such serious and unfair health effects on children

Proyecto Inés: Intervención nutricional educativa para una escuela saludable

Proyecto financiado por el Vicerrectorado de Innovación y prospectiva de la Universidad de Granada. Beca FPU 17/04913 del Ministerio de Educación, Cultura y Deporte.La Educación Nutricional, es una las funciones más importantes del Dietista Nutricionista y cuyo principal población diana son los niños y adolescentes. Sin embargo, es difícil que sepan desarrollarla con eficacia ya que no son capaces de identificarse como educadores de la salud y presentan una escasa o nula formación en didáctica de la nutrición, diseño y evaluación de materiales para conseguir un aprendizaje significativo. Por ello, con este proyecto, se pretende una colaboración entre estudiantes de Nutrición conjuntamente con los de Maestro en Educación Primaria e Infantil. Éstos últimos aportan sus conocimientos en didáctica y metodología para generar herramientas que promociona el procesos de enseñanza y aprendizaje a la par que los alumnos de Nutrición Humana y Dietética, podrán aportar sus conocimientos relacionados más estrictamente con la nutrición y dietética. De esta forma, se genera una visión conjunta más completa sobre la Educación Nutricional. El trabajo grupal de los futuros profesionales de la educación y la nutrición, favorecerá la adquisición de algunas competencias básicas y sobre todo específicas en nutrición al igual que en el grado en Educación que difícilmente pueden adquirirse durante las clases teóricas de los grados. Además, se les facilita la posibilidad de poder poner en práctica su trabajo en centros escolares y padres.Universidad de GranadaMinisterio de Educación, Cultura y Deport

Downregulation of hepatic lipopolysaccharide binding protein improves lipogenesis-induced liver lipid accumulation

Circulating lipopolysaccharide-binding protein (LBP) is increased in individuals with liver steatosis. We aimed to evaluate the possible impact of liver LBP downregulation using lipid nanoparticle-containing chemically modified LBP small interfering RNA (siRNA) (LNP-Lbp UNA-siRNA) on the development of fatty liver. Weekly LNP-Lbp UNA-siRNA was administered to mice fed a standard chow diet, a high-fat and high-sucrose diet, and a methionine- and choline-deficient diet (MCD). In mice fed a high-fat and high-sucrose diet, which displayed induced liver lipogenesis, LBP downregulation led to reduced liver lipid accumulation, lipogenesis (mainly stearoyl-coenzyme A desaturase 1 [Scd1]) and lipid peroxidation-associated oxidative stress markers. LNP-Lbp UNA-siRNA also resulted in significantly decreased blood glucose levels during an insulin tolerance test. In mice fed a standard chow diet or an MCD, in which liver lipogenesis was not induced or was inhibited (especially Scd1 mRNA), liver LBP downregulation did not impact on liver steatosis. The link between hepatocyte LBP and lipogenesis was further confirmed in palmitate-treated Hepa1-6 cells, in primary human hepatocytes, and in subjects with morbid obesity. Altogether, these data indicate that siRNA against liver Lbp mRNA constitutes a potential target therapy for obesity-associated fatty liver through the modulation of hepatic Scd1