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Introduction: There is controversy over the effect of overweight and obesity in bone mineralization in adolescence., Objective: The aim of this study was to assess the level of bone mineral density (BMD) in a population of adolescents and study its relationship with body composition., Methods: The study population consisted of 157 adolescents (93 women and 64 men) of the province of Granada (Spain). The mean age was 14.22 ± 1.41 year. BMD was assessed by calcaneal osteosonography. The densitometric parameters were: Broadbandultrasound attenuation( BUA), T -score and Z -score. Body composition was determined with bio-electrical Impedance analyser., Results: The overweight and obese adolescents had higher values in the BUA versus normal-weighted adolescents (95.4 ± 17.77 and 90.0 ± 1.08 vs 81.1 ± 17.79), showing significant differences(p < 0.001 and p < 0.05, respectively). Even after adjustment for lean mass and fat mass, differences remained in overweight and obese subjects (p < 0.001 and p < 0.001). Correlation with lean mass was greater than with fat mass (B =, 402 p < 0.000 and B =, 228 p < 0.002)., Conclusions: Adolescents with overweight and/or obesity have higher levels of BMD even after adjustment for fat mass and muscle mass. Our results suggest that BMD increases in response to increased muscle mass in adolescents with overweight and/or obesity., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: Large researches have tried to verify the efficiency of the educational intervention in patients suffering from type 1 diabetes (T1D)., Objectives: Analyzing the initial knowledge about diet habits and physical exercise, confirming a possible improvement of the level of this knowledge after the educational intervention and verifying the acquisition of skills related to self-analysis and self-injection., Methodology: 32 subjects with T1D, from 4 to 14 years old in Melilla were included. The knowledge about diet and physical exercise were analyzed using a questionnaire. Diet habits were evaluated using the KrecePlus questionnaire. An educational intervention was offered and that knowledge was analysed again, as well as the skills acquired about self-analysis and self-injection with a new questionnaire., Results: After the intervention, the knowledge about diet and physical exercise significantly improved (p < 0,0001). The results also showed an improvement in diet habits and physical exercise. The study of self-analysis and self-injection skills evidenced that the subjects were independent in the processes of blood glucose self-analysis and insulin self-injection., Conclusion: An educational intervention developed by a nurse is an effective procedure to improve and increase the knowledge about diet, physical exercise and about the disease in diabetic type 1 diabetic, as well as an incentive to acquire healthy habits about diet and physical exercise., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Background: Cancer-related fatigue is the most common and distressing symptom among cancer survivors; physical activity has been proposed as a safe and effective intervention to control it., Objective: This study aimed to determine the effectiveness of supervised physical activity interventions for the management of cancer-related fatigue (CRF)., Methodology: Systematic review of randomized controlled trials. Adults (>20 years old) diagnosed with any type of cancer regardless of treatment or diagnosis stage. Physical activity interventions (aerobic and resistance training) supervised by health professionals. CRF was the primary outcome measure, whilst secondary outcomes included depression, the comparison between supervised and non-supervised interventions, physical and functional wellbeing. Risk of bias and methodological quality were evaluated using the PEDro scale., Results: Fourteen studies (n=14) were included (n=1638) with low risk of bias (PEDro mean score=6,5 ± 1). Supervised physical activity significantly improved CRF; similar results were found for resistance training. Further, supervised physical activity was more effective than conventional care for improving CRF among breast cancer., Conclusion: Supervised physical activity interventions provide an overall reduction on CRF. These findings suggest that guidelines of aerobic and resistance training should be included in oncologic rehabilitation programs., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Aims and Objectives: To evaluate at what age parous and nonparous women were diagnosed with breast cancer. Factors taken into account for parous women were whether they had breastfed their children, and if so, the length of the lactation period. Other factors considered for both groups were obesity, family histories of cancer, smoking habits and alcohol consumption., Background: Breast cancer is the most common form of cancer in younger women in Western countries. Its growing incidence as well as the increasingly early age of diagnosis led us to carefully analyse its possible causes and the preventive measures to be taken. This is a particularly important goal in epidemiological research., Design: A retrospective study of the clinical histories of patients diagnosed with breast cancer at the San Cecilio University Hospital in Granada (Spain)., Methods: In this study, we analysed 504 medical records of female patients, 19-91 years of age, who had been diagnosed and treated for breast cancer from 2004-2009 at the San Cecilio University Hospital in Granada (Spain). Relevant data (age of diagnosis, period of lactation, family history of cancer, obesity, alcohol consumption and smoking habits) were collected from the clinical histories of each patient and analysed. A conditional inference tree was used to relate the age of diagnosis to smoking habits and the length of the lactation period., Results: The conditional inference tree identified significant differences between the age of the patients at breast cancer diagnosis, smoking habits (p < 0·001) and lactation period if the subjects had breastfed their children for more than six months (p = 0·006), regardless of whether they had a family history of cancer., Conclusions: Our study concluded that breastfeeding for over six months not only provides children with numerous health benefits, but also protects mothers from breast cancer when the mothers are nonsmokers., Relevance to Clinical Practice: Nurses play a crucial role in encouraging new mothers to breastfeed their children, and this helps to prevent breast cancer., (© 2013 John Wiley & Sons Ltd.)

Background: Research confirms the existence of gender-based differences regarding the high-risk sexual behaviour (non-use of condoms and casual partners) of young men and women. The objectives were to provide evidence for this association; to analyse the reasons why both sexes have sexual relations with casual partners and to ascertain the motives for condom use or non-use during casual sex., Methods: A cross-sectional study was performed on a sample of 900 participants, 524 males and 376 females. All participants were 15-29 (20.93 ± 4.071) years of age and came from four different centres (a university, two secondary schools, and a military base) in Melilla (Spain). The participants were given a socio-demographic survey as well as a psychometric text on high-risk sexual behaviour., Results: The results found gender-based significant differences for sexual relations with penetration (p = 0.001), number of sexual partners (p = 0.001), and sexual relations with casual partners (p = 0.001). In all of these variables, male participants had higher percentages than female participants. Reasons for having casual sexual relations were also different for men and women, differences were found for the items, opportunity (p = 0.001), interest in knowing the other person (p = 0.015), physical excitement (p = 0.056) and drug consumption (p = 0.059). Regarding the reasons for consistent condom use with casual partners, there were differences for the item, my demand of a condom (p = 0.002). For the non-use of condoms with casual partners, differences were found for the items, I do not like to use condoms (p = 0.001) and condoms lessen sensitivity and reduce pleasure (p = 0.009)., Conclusions: Men and women were found to have different high-risk sexual behaviours and practices. Of the motives for having sexual relations with casual partners, male participants considered opportunity and interest in knowing the other person to be more important than the female participants. Regarding condom use, the female participants' demand to use a condom was a significant gender-based difference. In contrast to the young women, the male participants mostly justified not using a condom because it lessened sensitivity and reduced pleasure.

Background: Anxiety and depression are prevalent comorbidities in patients with COPD. Breathing techniques can improve anxiety and depression in patients hospitalized for COPD exacerbation., Methods: We conducted a randomized clinical study with 46 male subjects, 67-86 years old, hospitalized with acute COPD exacerbation. Subjects were randomly and equally divided into a control group and a controlled breathing intervention group. We measured baseline and post-intervention dyspnea, anxiety and depression, quality of life (with the St George's Respiratory Questionnaire and the European Quality of Life questionnaire), maximum inspiratory and expiratory pressure, hand-grip strength, and sleep quality. The cohort had high dyspnea and low overall quality of life., Results: Controlled breathing techniques significantly improved dyspnea, anxiety, and mobility. All the measured variables improved in the intervention group. The control group had poorer values in all the variables after the hospitalization period., Conclusions: Controlled breathing exercises improve anxiety and depression in patients hospitalized for COPD exacerbation. (ClinicalTrials.gov NCT01826682).

Unhealthy dietary habits are key determinants of obesity in adolescents. Assuming that dietary fat profile influences membrane lipid composition, the aim of this study was to analyze structural changes in the erythrocyte membrane of obese compared to normal-weight adolescents. The study was conducted in a group of 11 obese and 11 normal-weight adolescent subjects. The lipid profile, lipid peroxidation and acetylcholinesterase enzyme (AChE) activity were analyzed by conventional methods. The structural properties of reconstituted erythrocyte membrane were characterized by X-ray diffraction. Erythrocyte membrane from obese adolescents had a lipid profile characterized by a higher cholesterol/phospholipid ratio, an increase in saturated fatty acid and a decrease in monounsaturated and n-6 polyunsaturated fatty acid concentrations. Differences in lipid content were associated with changes in the structural properties of reconstituted membranes and the oxidative damage of erythrocyte membrane. The lower oxidative level shown in the obese group (0.15 ± 0.04 vs. 0.20 ± 0.06 nmol/mg for conjugated diene concentrations and 2.43 ± 0.25 vs. 2.83 ± 0.31 nmol/mg protein for malondialdehyde levels) was related to a lower unsaturation index. These changes in membrane structural properties were accompanied by a lower AChE activity (1.64 ± 0.13 vs. 1.91 ± 0.24 nmol AChE/[min mg protein]) in the obese group. The consequences of unhealthy dietary habits in adolescents are reflected in the membrane structural properties and may influence membrane-associated protein activities and functions.

Background: Recent studies suggest that the age at first pregnancy, number of children and the lapse between births may protect against breast cancer. Furthermore, serum levels of estrogen, prolactin and progesterone appear to contribute to the development of this tumors in obese women., Aim: To verify whether the variables age at first pregnancy, number of children, birth interval, hormone levels and nutritional status are associated with the age at diagnosis of breast cancer., Material and Methods: Retrospective analysis of medical records of 550 female patients, diagnosed and treated for breast cancer at a hospital in Spain between 2009 and 2012., Results: We found a significant and positive association between age at diagnosis of cancer and the variables age at first pregnancy, parity and interval between pregnancies. There was also a significant correlation (p < 0.000) between serum levels of estrogen, prolactin and progesterone and nutritional status of patients., Conclusions: In this sample, age at first pregnancy or number of children, hormone levels and nutritional status are related to the age of onset of cancer.

Objectives: The first objective of this study was to analyze the metabolic profile of the population to be studied. The second one was to ascertain whether there was a significant association between the nutritional status of the subjects and the serum level of C-reactive protein. Finally, the third objective was to discover whether there was a correlation between C-reactive protein serum levels and waist to hip ratio values., Sample and Methodology: The sample was composed of 1001 adolescents, 9-17 years of age, from 18 schools in the provinces of Granada and Almeria. Their nutritional status was determined by means of anthropometric evaluation. For the metabolic study, a blood sample was collected from each subject by venipuncture. An analysis was performed of C-reactive protein, basal glycemia, ceruloplasmin, glycated hemoglobin (HBA1c), basal insulin, serum levels of lipoprotein (a), and non-esterified fatty acids (NEFA)., Results: The biochemical study reflected a normal metabolic profile with serum levels of C-reactive protein, basal glycemia, ceruloplasmin, glycated hemoglobin, basal insulin, lipoprotein (a) and non-esterified fatty acids slightly higher in the male subjects. The results of our studied showed that there was a statistically significant association (p < 0.05; F = 3.701) between the nutritional status of the subjects and serum levels of C-reactive protein. A statistically significant association (F = 9.008; p < 0.005) was also found between serum levels of C-reactive protein and waist to hip ratio values., Conclusions: The C-reactive protein associated either with nutritional status or the waist to hip ratio is an effective biochemical marker of cardiovascular risk among the population of adolescents in our study., (Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Objectives: The aims of this study were: (i) to ascertain whether the nutritional status of a population of secondary school students had improved after an educational intervention; (ii) to analyze whether students had adopted healthier eating and exercise habits after participating in a health education intervention; (iii) to discover whether the students spent less time on sedentary leisure activities after the intervention., Sample and Methodology: The population of the sample consisted of 138 adolescents, age range was between 14-19 years old: 67 males (48.6%) and 71 females (51.4%). They were students at two public secondary schools in the city of Almería (Spain). In the first phase (15-30 September 2011) of this three-phase study, the nutritional status of the students was assessed by means of anthropometry. In the second phase (1 October 2012-15 June 2012), the students participated in an educational intervention that fomented awareness of the benefits derived from healthy eating habits and physical exercise. In the third and final phase (16-31 June 2012), the effectiveness of the intervention was evaluated., Results: After the intervention, statistically significant differences (p < 0.000) were found in relation to the nutritional status of all the students evaluated, regardless of their sex. In reference to the adoption of healthy habits after the intervention, statistical significant differences were observed in the Krece Plus test (p < 0.000) and in the practice of physical exercise (p = 0.006). In the case of sedentary leisure activities, there was also a statistically significant reduction (p < 0.000) in the number of hours spent watching television for both male and female subjects., Conclusion: The results of this study show the effectiveness of the contents, activities, and duration of this health education intervention to encourage the subjects to modify their dietary and exercise habits., (Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Objectives: The first objective of this study was to verify the existence of a significant association between the nutritional status of a sample of school children and the values of their waist-hip ratio. The second objective was to discover if there was a correlation between the values of their waist-hip ratio and levels of systolic and diastolic blood pressure., Sample and Methodology: The population sample consisted of 1001 children and adolescents, 9-17 years of age, from 18 elementary and secondary schools in the provinces of Granada and Almeria (Spain). As part of the study, a complete evaluation of the nutritional status of the subjects was performed by anthropometry. The blood pressure of all the students was also measured., Results: The results obtained confirmed that, regardless of age and gender, 85.01% of the subjects were normal weight, 9.99% were overweight, and 4.99% were obese. A significant association was found between the subjects’ nutritional status and its relation with the values of their waist-hip ratio (F = 118.060; p < 0.0001). Furthermore, there were also statistically significant differences between the waist-hip ratio and gender (F = 45.566; p < 0.0001). Finally, a significant association was found to exist between the waist-hip ratio and its relation with both systolic blood pressure (F = 3.068; p < 0.0001) and diastolic blood pressure (F = 4.382; p < 0.0001)., Conclusions: The waist-hip ratio is an accurate anthropometric indicator for the prediction of high blood pressure in overweight and obese children and adolescents., (Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Aims and Objectives: To ascertain whether inflammation markers also correlate with parameters related to insulin resistance and the metabolic syndrome in a group of adolescents., Background: Obesity is now considered a chronic low-grade inflammatory process, characterised by alterations in the systemic concentrations of some inflammation markers. Adiponectin, leptin and other inflammatory proteins have been shown to correlate with insulin resistance and the metabolic syndrome in adults., Design: Cross-sectional study in two groups of obese and normal weight adolescents., Methods: Serum levels of adiponectin, leptin, ceruloplasmin and insulin levels were determined and correlated among them and with anthropometric parameters, blood pressure body mass index and body mass index z-score., Results: Waist circumference, body mass index and blood pressure values correlated significantly with both homoeostasis model assessment for insulin resistance and insulin levels. Ceruloplasmin also correlated with both parameters with a high level of significance. However, leptin levels did not correlate with either homoeostasis model assessment for insulin resistance or insulin, and adiponectin correlated with homoeostasis model assessment for insulin resistance but not insulin. All inflammation markers studied correlated with the body mass index z-score. These correlations were stronger in the group of obese individuals compared to lean ones., Conclusions: We found a relationship between insulin resistance and some inflammation in adolescents, which was particularly strong in obese individuals and was associated with the development of metabolic syndrome. Among the inflammation markers studied, ceruloplasmin revealed as a potential string marker of insulin resistance in obese adolescents., Relevance to Clinical Practice: The results obtained in this study imply a significant advance in the field of clinical practice of nursing. The adequate understanding by nursing personnel of the inflammatory processes inherent to obesity constitutes a key factor for the prevention of the disease and its complications in adolescents., (© 2012 Blackwell Publishing Ltd.)

Objectives: The main research objective was to analyze the intake of macronutrients and micronutrients in a population of adolescents. The purpose of the study was to verify a significant correlation between the habit of breafasting at home each morning and the nutritional status of the sample population., Sample and Methodology: The sample population was composed of 100 adolescents, 12-15 years of age, who attended two public secondary schools in the city of Granada. The study conducted was descriptive, cross-sectional, and multi-centered, and involved a comprehensive evaluation of the nutritional status of the subjects by using anthropometry. The analysis of food intake and dietary habits was based on a 72-hour record of the subjects' food intake. The protocol used had previously been elaborated and validated by the research team., Results: For all subjects, the energy intake was found to be higher than the recommended dietary allowance (RDA). The female subjects had a mean protein intake of 16% in regards to total calorific value (TCV). In the case of the male subjects, the mean protein intake was 15%. The mean consumption of fats was 106.1 for the male subjects, whereas for the females, it was 110.4 grams. The females were found to ingest more carbohydrates at a rate of 297.4 grams per day in comparison to the male subjects, whose rate of carbohydrate ingestion was 251 grams per day. The ingestion of minerals varied in both sexes though in all cases it was lower than the RDA. However, the male subjects had a calcium and zinc intake higher than the RDA for these minerals. The vitamin intake was varied and balanced in both male and female subjects, and covered the requirements for both age and sex. Regarding the variable, breakfast, a significant relation was found (p < 0.0001) between the dietary habit of breakfasting at home before going to school and the nutritional status of the students., Conclusions: The results of this study showed that an optimal nutritional and health status requires a balanced food intake and healthy dietary habits., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Objectives: The first objective of this study was to evaluate the nutritional status and insulin resistance index in a population of adolescents as calculated by Homeostatic Model Assessment (HOMA). The second objective was to establish correlations between the nutritional status of the subjects, the possible existence of insulin resistance, and the risk of high blood pressure. POPULATION SAMPLE AND METHODOLOGY: The sample was composed of 1001 adolescents, 9-17 years of age, from 18 schools in the provinces of Granada and Almeria. Their nutritional status was determined by means of anthropometric evaluation. For the metabolic study, a blood sample was collected from each subject by venipuncture. An analysis was performed of the basal glucose and insulin levels as well as the Homeostatic Model Assessment- Insulin Resistance (HOMAIR) index. Also evaluated were the levels of glycosylated haemoglobin (HbA1c), serum lipoprotein (a), and non-esterified fatty acids (NEFAs). Insulin resistance was calculated with the formula, proposed by Matthews et al. (1985) : HOMA-IR = (insulin[mmol/L] x glucose[mU/L])/22.5., Results: The evaluation of the nutritional status of the subjects reflected a progressive increase in the values of anthropometric variables as the nutritional status of the subjects worsened. The results of this study showed, regardless of age and gender, 85.01% of the subjects were of normal weight, whereas 9.99% were overweight, and 4.99% were obese. The metabolic study reflected that in comparison to normal-weight and overweight students, obese students had significantly higher serum levels (p < 0,0001) of HbA1c, basal insulin, basal glycemia, basal NEFA, lipoprotein (a), and HOMA-IR., Conclusions: Obesity was found to be a serious health problem in the population of adolescents studied, especially given the high cardiovascular risk that is characteristic of this condition. As reflected in the results of this study, obesity led to the premature development of metabolic disorders, which generally do not appear until adulthood., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Obesity control and prevention is a complex task that requires a thorough understanding of the physiological basis and body composition. In Spain, as in most countries, anthropometric criteria, such as weight, height, body mass index, skinfold thickness and body circumferences have traditionally been used to define obesity and general eating disorders, but these variables have little sensitivity for monitoring response to treatment. This is why evaluation of body composition may qualify this process. The aim of this paper was to review some relatively simple techniques to assess body composition and their clinical value in patients., (Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.)

Obesity has become a serious health problem worldwide because it is closely related to the leading causes of morbidity and mortality, including diabetes mellitus, hypertension, atherosclerosis, and dyslipidemia. It is therefore imperative for the scientific community to understand the main environmental and social-cultural factors, as well as organic disorders arising from breakdown of the physiological mechanisms that control energy balance in our body, all of which are ultimately responsible for development of obesity. Adequate understanding of the mechanisms involved in regulation of energy balance is therefore essential to understand the pathogenesis and pathophysiology of the growing pandemic of obesity. This study was intended to review the main factors involved in development of obesity and advances in understanding of the mechanisms that regulate body weight and appetite and their pathophysiology., (Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.)

Background: Several studies have analyzed the relation between obesity and the hormonal imbalances generated by overweight and a family history of breast cancer. All of these factors are potentially implicated in the early development of breast cancer., Aim: To verify the existence of a significant relation between the nutritional status of breast cancer patients, their hormone serum levels (estrogens, prolactin, and progesterone), and the existence of a family history of breast cancer., Material and Methods: Retrospective data was collected from clinical records of 524 women diagnosed with breast cancer in a Spanish hospital., Results: There was a positive association between estrogen, progesterone and prolactin serum levels and body mass index. The elevations in hormone levels occurred earlier in life among women with a family history of breast cancer. A two way ANOVA found a significant association between progesterone and prolactin levels with the age at diagnosis of breast cancer., Conclusions: Extreme serum levels of these hormones appear to be related to the early development of breast cancer, which in turn is influenced by the existence of a family history of cancer among those women with normal or average hormone levels.

The aim of this study was to explore the effects of a multidisciplinary behavioral intervention including cognitive behavioral therapy, structured physical activity, and dietary counseling on impulsive personality and cognitive skills and subsequent BMI loss in excess weight adolescents. Forty-two adolescents with excess weight (14 males and 28 females, range 12-17 years), as defined by the International Obesity Task Force Criteria, participated in our study. We used a longitudinal observational design with two assessments: before and after treatment. We collected baseline measures of impulsive personality (UPPS-P scale), cognitive performance (letter number sequencing, Stroop and Iowa gambling task), and biometric parameters. After 12 weeks of intervention, parallel measures were used to determine whether treatment-induced changes in impulsivity and cognition predicted changes in BMI. BMI showed a statistically significant reduction after treatment [from mean (SD) 29.36 (4.51) to 27.31 (4.41), Cohen's d=0.5]. Greater reductions in negative urgency (negative-emotion-driven impulsivity) and greater improvement in cognitive inhibitory control skills were associated with greater reductions in BMI. Because the design was correlational and lacked a control group, future studies should clarify whether these associations reflect a causal effect or just overlapping improvements associated with a third variable (e.g. increases in attention procurement or motivation).

Adolescent obesity is increasingly viewed as a brain-related dysfunction, whereby reward-driven urges for pleasurable foods "hijack" response selection systems, such that behavioral control progressively shifts from impulsivity to compulsivity. In this study, we aimed to examine the link between personality factors (sensitivity to reward (SR) and punishment (SP), BMI, and outcome measures of impulsivity vs. flexibility in--otherwise healthy--excessive weight adolescents. Sixty-three adolescents (aged 12-17) classified as obese (n = 26), overweight (n = 16), or normal weight (n = 21) participated in the study. We used psychometric assessments of the SR and SP motivational systems, impulsivity (using the UPPS-P scale), and neurocognitive measures with discriminant validity to dissociate inhibition vs. flexibility deficits (using the process-approach version of the Stroop test). We tested the relative contribution of age, SR/SP, and BMI on estimates of impulsivity and inhibition vs. switching performance using multistep hierarchical regression models. BMI significantly predicted elevations in emotion-driven impulsivity (positive and negative urgency) and inferior flexibility performance in adolescents with excess weight--exceeding the predictive capacity of SR and SP. SR was the main predictor of elevations in sensation seeking and lack of premeditation. These findings demonstrate that increases in BMI are specifically associated with elevations in emotion-driven impulsivity and cognitive inflexibility, supporting a dimensional path in which adolescents with excess weight increase their proneness to overindulge when under strong affective states, and their difficulties to switch or reverse habitual behavioral patterns.

Objective: This study aimed to determine differences in sleep quality between patients with mechanical neck pain, patients with whiplash (WAD) pain, and healthy controls and to determine the relationship between the intensity of ongoing pain, disability, and sleep quality., Design: Nineteen patients with mechanical neck pain (4 men, 15 women; age, 40 ± 16 yrs), 22 with WAD (4 men, 18 women; age, 38 ± 15 yrs), and 18 comparable controls (4 men, 14 women; age, 41 ± 13 yrs) completed the Pittsburgh Sleep Quality Index to assess sleep quality. A numerical pain rate scale (0-10) and the Neck Disability Index (0-50) were collected for assessing neck pain and disability., Results: Significant differences in sleep quality (P < 0.001), sleep latency (P = 0.005), sleep efficiency (P = 0.002), sleep disturbances (P < 0.001), use of sleeping medication (P < 0.001), daytime dysfunction (P < 0.001), and total Pittsburgh Sleep Quality Index score (P < 0.001) but not for sleep duration (P = 0.096) were found; patients with mechanical neck pain and WAD pain exhibited higher scores in all components compared with healthy controls. Seventeen (77%) patients with WAD and 13 (68%) with mechanical neck pain reported poor sleep quality (Pittsburgh Sleep Quality Index score, >8). Significant positive correlations between mean intensity of ongoing pain with sleep quality (r(s) = 0.693; P < 0.001); sleep duration (r(s) = 0.433; P = 0.044); sleep efficiency (r(s) = 0.644; P = 0.001) and total Pittsburgh Sleep Quality Index score (r(s) = 0.643; P = 0.001) were found in patients with WAD pain; the higher the intensity of ongoing pain, the worse the sleep quality., Conclusions: Sleep disturbances are a common finding in individuals with neck pain and are associated with the intensity of ongoing pain in WAD. It seems essential to address the ongoing cycle of pain and sleep disturbances as an integral part of the treatment of patients with neck pain.

Introduction: The Metabolic Syndrome is one of the first health problems in the public health of the century. It's consider that the beginning of the syndrome is determined by numerous factors that developed two main metabolic disturbances: the insulin resistance and the central obesity. This relationship is concentrating the scientific world. As the cause-effect relationship has to be answered, the epidemiologic research has focused on without results., Material and Methods: 1,016 subjects were recruited in the sleep disorders laboratory in San Cecilio Hospital with sleep apnea suspicion., Results: Significant correlation (p < 0,001) was found between sleep apnea severity and nocturnal saturation values and the different metabolic disturbances related to the metabolic syndrome (Hypertension, Diabetes and obesity). By the contrary, we doesn't found significant differences between No-Sleep apnea group and moderate sleep apnea group in the majority of the variables., Conclusions: Subjects with sleep apnea have significantly more possibilities to develop metabolic syndrome, and cardiovascular pathology. These subjects had to be evaluated in this sense to reduce the impact associated to this pathology.

Introduction: Cutaneous candidiasis is a disease that affects children as well as adults. The presentation may be localized or systemic, and with multiple etiological agents. The most prevalent infecting species in children differs from that of the adult., Objective: A case is presented where a congenital cutaneous candidiasis was transmitted to the child during birth., Materials and Methods: A full term newborn was exposed to a subclinical vaginal candidiasis infection, and 24 hr after birth, developed congenital cutaneous candidiasis. The etiological agent was Candida albicans, and was associated with sepsis and respiratory distress. Blood cultures, cutaneous biopsy of vesicular lesions, blood tests and lumbar puncture were performed., Results: Biochemistry and blood count showed a CRP of 5.7 mg/dl, leukocytosis with left shift and mild anemia. After 24 hr, the blood analyses showed an increase in a CRP (7.8 mg/dl) and increased progressively for three days; consequently, a lumbar puncture was performed. Blood culture was positive for Staphylococcus aureus. Cutaneous biopsy confirmed the cutaneous candidiasis., Conclusions: The early diagnosis is essential to prevent complications derived by the Candida albicans in newborns.

Human obesity is a disorder of multifactorial origin in which genetic and environmental factors are involved. To understand the mechanisms regulating energy intake and fat accumulation in the body, it is important to study the genetic alterations causing monogenic obesity. Most of the genes involved in monogenic obesity are associated with the leptin-melanocortin system; hence the importance of studying this system by analysing natural mutations in mice. Previous studies have described mutations in leptin and its receptor, proopiomelanocortin and prohormone convertase 1 associated with human obesity of monogenic origin. The aim of this study is to provide an updated review of the main characteristics and functioning of the leptin-melanocortin system, and its implications and potentialities in regulating food intake and body weight.

There is a general consensus that obesity is an eminently inflammatory process. This is justified by alterations observed in obese patients, which affect the secretion of certain cytokines such as ceruloplasmin, leptin, adiponectin, and interleukin-6 (IL-6), among others. In a parallel way, other research has also pointed out alterations in the composition of fatty acids in the erythrocyte membrane of overweight adults. The results obtained in our study confirm the existence of a significant correlation between the serum levels of some of the cytokines studied and the nutritional state of the sample studied. This means that for the population of children evaluated in our study, the serum concentrations of these biomolecules can be an important tool for the prediction of cardiovascular risk when they become adults. Furthermore significant differences were found regarding the composition of saturated fatty acids in the erythrocyte membrane.

The International Task Force on Obesity (IOTF) and the World Health Organization (WHO) have defined obesity as a 21st century epidemic. In countries with economies in transition and even in some urban areas in developing countries, progressive increase in obesity has been reported to be an emerging problem in recent years. Its causes include lifestyle changing, particularly consumption of high-calorie food, as well as an increasingly sedentary lifestyle. However, the genetic origin of obesity is well known and currently proven. Obesity usually results from interaction of certain gene polymorphisms with environment. Moreover, only a small number of cases of obesity (5%) result from mutations in specific genes (monogenic obesity), causing in some cases Mendelian syndromes with a very low incidence in the population. One hundred and thirty genes related to obesity have been reported, some of which are involved in coding of peptide transmitting hunger and satiety signals, while others are involved in adipocyte growth and differentiation processes, and still others are involved in regulation of energy expenditure. In addition, obesity is a chronic inflammatory state. In this regard, altered expression of genes related to insulin metabolism and adipose tissue inflammation is a basic process which may explain the etiology of obesity., (Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.)

Background: The need to educate adolescents about healthy sexual behavior motivated the development of an education program on sexuality., Aim: To describe the knowledge of students about sexuality and the implementation of a sexual education project., Material and Methods: Sixty students aged 14 years (34 females), attending the third year of secondary education participated in dynamic workshops about healthy sexual behaviors., Results: The most common reactions of students when facing situations related to sexual behavior were shame, anxiety, fear and lack of knowledge. Group dynamics improved the practical knowledge of students about sexual behavior, allowing them to make informed decisions., Conclusions: These innovative educational techniques should be expanded to other students.

Numerous studies have focused on establishing a relation between the serum values of biomolecules such as leptin, ceruloplasmin, and lipoprotein (a), and the nutritional state and levels of diastolic and systolic blood pressure in subjects with problems of overweight or obesity. However, in many cases, the results obtained have not been conclusive. The results of our study confirm the existence of a statistically significant association between the serum levels of these biomolecules, the nutritional state of the subjects, and levels of diastolic and systolic blood pressure. For the population of overweight and obese adolescents studied, the evaluation of the serum concentrations of these biomolecules was found to be an important instrument that could be used to identify those subjects with an elevated risk of suffering cardiovascular disorders basically derived from a hypertensive status.

Introduction: Several authors have found correlations between anthropometric parameters and blood pressure levels in overweight and obese subjects. This paper is an update on the potential of these parameters as a tool for predicting cardiovascular risk., Aims: to estimate the prevalence of overweight and obesity. Second verify the existence of a significant correlation between the main anthropometric indicators and the blood pressure levels., Sample: The population consisted of 977 children and adolescents between 9 and 17 years of age belonging to 13 schools in the province of Granada and city., Methodology: anthropometric evaluation in which they were assessed six skinfolds, waist circumference, hip and determination of blood pressure in three consecutive occasions. The anthropometric assessment phase began in March 2008 lasted until April 2009., Results: We found that the prevalence of overweight in girls varied between 18.3% and 32.2%. For its part, the prevalence among boys was between 10.9% and 26.1%. Regarding the prevalence of obesity, the girls had similar rates between 4.5% and 15.1%. Among boys the prevalence of obesity was similar, and found rates between 4.7% and 12.6%. Of all the parameters measured, body mass index and waist circumference were the anthropometric indicators that showed a better correlation to blood pressure., Conclusions: BMI and WC are useful anthropometric indicators to predict cardiovascular risk in non adults.

Use of subcutaneous reservoir has been extended in recent years in response to the need of chronic intravenous treatments. Some cancer patients and need to have a venous access maintained. In them is not advisable to use a peripheral vein, the sclerosing effect and/or irritating on the endothelium have many of the drugs administered, and the numerous venous punctures to which are often subjected. In this regard, the establishment of a permanent subcutaneous reservoir at the central level can obtain blood samples and administer all types of intravenous therapies. Although it also has the advantage of a low incidence of infections, the possibility of outpatient use and well accepted by patients. The system consists of a silicone venous catheter that is placed below the subcutaneous tissue and provides a vascular access, easy to find, secure and durable. Despite its frequent use today, this technique is not completely without risk, and among the possible complications of infectious diseases, thrombosis, catheter migration, occlusion, pneumothorax or vascular erosion. The aim of this study was to describe the protocol using the subcutaneous reservoir held in the unit of gynecologic oncology, University Hospital Virgen de las Nieves in Granada., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Liver steatosis, also called non-alcoholic fatty liver, is characterized by a pathological fat accumulation in the liver, leading to liver damage in the form of inflammation and fibrosis. These histological features are similar to those in alcoholic hepatitis. Obesity is known to be the most common cause of simple steatosis in the preadolescent and adolescent population with a consequent serious health risk. The aim of this study was to provide an update on the concepts, pathophysiology and clinical management of hepatic steatosis secondary to obesity at an early age., (Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.)

The excess weight that characterizes much of the population of the world today has led the World Health Organization to declare a obesity pandemic. The number of overweight and obese children in Spain is among the highest in Europe, and this number is even higher in Andalusia. The health consequences of excess weight for children are not as evident as for adults. However, child obesity is now being associated with pathologies, such as the metabolic syndrome, which were previously believed to be only found in adults. Resistance to insulin is an important risk factor in subjects with severe obesity, which along with visceral obesity, make postprandial triglyceridemia more severe. This increases cardiovascular risk. However, in our opinion, this phenomenon has not been adequately studied in children. The hearthealthy properties of olive oil, the main ingredient of the Mediterranean diet, have been clearly highlighted in various studies. These properties include an improved postprandial lipid pattern. In this context, the objective of this study was to determine the effects of a Mediterranean-diet breakfast on the postprandial lipid parameters in a study group of overweight and obese preadolescents (age 10-14) in comparison to a control group of subjects with no weight problems. The results obtained provide greater knowledge of the physiopathology of child obesity and contribute to the elaboration of dietary recommendations for the maintenance of child health. Additionally, our results give information regarding the development of atherogenesis during the postprandial period, which can begin at a very early age.

Introduction: Breast cancer is the most common gynecological tumor in young women in Western countries. Its profound implications for health and an increasingly early age of diagnosis have been carefully analyzed its causes and possible preventive measures, making their study in a primary goal of epidemiological research., Sample and Methods: We reviewed medical records pertaining to 504 female patients aged 19 to 91 years. All of them were diagnosed and treated for breast cancer between 2003-2008 at the Hospital Universitario "San Cecilio" of Granada (Spain)., Results: We found a significant correlation (p = 0.001) between the age of cancer diagnosis, length of breastfeeding, and the existence of personal and family history for cancer. By contrast, there were no statistically significant differences test (t-test) between the average age of diagnosis of cancer and having had offspring or not (t = 0.559, p = 0.576)., Conclusions: Breastfeeding for periods of longer than six months, not only provides children with many health benefits, but may also protect the mother from serious diseases, such as breast cancer.