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Introduction Childhood obesity is a public health problem with repercussions in later life. As tissue formation peaks in childhood we determined how weight status influences bone mineral content. Material and methods We studied 553 children aged 4–18 years over 10 years (46.8% girls). We measured age, weight, height and through bone densitometry (DXA), bone mineral content (BMC), bone mineral density (BMD), and waist, arm and hip circumferences. The patients were divided into groups using the body mass index z-score: underweight, normal weight, overweight, obese and very obese. Results BMC and BMD values were highest in the normal-weight and overweight groups. Logistic regression showed bone mineralization was inversely associated with waist circumference, the association being positive for weight and age. No differences were found according to sex. Discussion Studies of the relationship between weight and bone mineralization report contradictory results, often because of different study designs. Moreover, studies in children are either few or with small samples. Our findings in a large sample show the importance of weight status in bone mineralization given the risk of bone fractures or osteoporosis. Conclusions Weight status influenced bone mineralization. BMC and BMD decreased in children with a higher degree of obesity. Waist circumference correlated negatively with bone mineralization.

OBJECTIVES In recent years, a subgroup of individuals with obesity has been described as having a lower risk of metabolic and cardiovascular complications. These individuals have what is referred to as metabolically healthy obesity (MHO), which has a favorable metabolic profile and a lower probability of long-term complications. The definition of this subtype in children is not clear. The aim of the present study was to determine whether Homeostasis Model Assessment (HOMA) above a set threshold could be the marker of metabolically unhealthy obesity (MUO) in children, or a parameter that can be used in the overall assessment. It is intended to compare the International Diabetes Federation (IDF) criteria against HOMA in the diagnosis of MUO. METHODS This observational, retrospective, cohort study included children with obesity and analyzed their metabolic state by means of blood testing and dual-energy X-ray absorptiometry. RESULTS A total of 96 patients were included, 44.8% boys and 55.2% girls, ages 6-17 years. The patients with MHO according to the HOMA criterion were younger (P = 0.001), had a lower body mass index (BMI) z score (P = 0.006), waist-height index (P = 0.009), hip-height index (P = 0.010), blood glucose (P = 0.003), insulin (P

Sexuality is a component of great relevance in humans. Sexual disorders are a major public health problem representing a high prevalence in the general population. DSM-5 genito-pelvic pain/penetration disorder (GPPPD) includes dyspareunia and vaginismus (DSM-IV-TR). To assess the importance of research on these disorders in Spain, we evaluated the Spanish scientific publications of primary and community care. The objective was to quantify the magnitude of the publications of GPPPD in Spanish women in primary and community care. For this, we used the method of conducting a systematic review and meta-analysis of studies evaluating GPPPD. As main results, of the 551 items found, we selected 11 studies that met the inclusion criteria. In primary care in Spain, one in nine women has these disorders; the percentage of women with GPPPD in this study (raw data) was 11.23% (95% CI: 0–29%) (vaginismus 5%; penetration pain 8.33%; dyspareunia 16.45%). These percentages can differ of those from other countries, and they are at the top of the data of the European countries (9−11.9%). There is much variability in the studies found in the world with respect to the prevalence of these health problems.

Purpose In neonatal units, the use of peripheral venous catheters is a commonly used technique involving risks and local complications. Catheter duration and viability is limited and may involve multiple insertion attempts. Catheterization was considered successful when there were no local complications and the catheter was removed owing to completion of treatment. The aim of the study was to determine the optimal location and instruments to reduce the number of catheter insertion attempts and to increase time without complications. Design and methods A cross-sectional descriptive study was undertaken to analyze all the catheters inserted in the neonatal intermediate care unit of Vinalopo University Hospital (Elche, Spain). Between 2013 and 2017 the following variables were collected: sex, age, gestational age, and venipuncture site, as well as catheter type, number of insertion attempts, duration and complications. Results A total of 929 catheters were analyzed with a mean duration of 46.5 ± 33.9 h, and were removed upon completion of treatment (success 38.3%). The preferred site was the dorsal hand (48.2%) followed by the cubital fossa (20.1%). In both sites the success of the catheter and its duration was higher than the mean (42.4%; 43.9% and 49.4 ± 35.7; 50.3 ± 33.4 h respectively). The most frequent complications were extravasation (47.0%) and phlebitis (5.9%). Just one attempt was needed for 63.8% of cannulations of the dorsal hand, followed by 38.9% in the forearm. No significant differences were found in fixation type, sex, weight, gestational age or infusion type (continuous/intermittent). Conclusions The success of the technique is low. The preferred insertion sites with fewer complications, longer duration and fewer attempts were the dorsal hand and cubital fossa. With fewer attempts required for cannulation, better results were achieved on the dorsal hand.

Introduction: Deep neck space abscesses in infants are clinical entities of great importance due to their severity and possible complications. The aim of the study is to review our experience in the diagnostic and therapeutic management of deep neck space abscesses, and compare it with published literature. Material and methods: Retrospective study was carried out on all patients diagnosed and treated for deep neck space abscesses over a 15-year period (2002–2016), including an analysis of the demographic, clinical, diagnostic and therapeutic characteristics. Results: A total of 72 cases were diagnosed. An increase was observed in their incidence in recent years. The most frequent locations were peri-tonsillar (30.6%), followed by swollen lymph nodes (18.1%), parapharyngeal (16.7%), and retropharyngeal (16.7%). The least frequent were submandibular abscesses (12.5%) and parotid abscesses (5.6%). The distribution was different according to age (P

Resumen: Introducción: Los abscesos cervicales profundos infantiles son entidades clínicas de gran importancia por su gravedad y sus posibles complicaciones. El objetivo del estudio es revisar nuestra experiencia en el manejo diagnóstico y terapéutico de los abscesos cervicales profundos infantiles, y compararla con la literatura publicada. Material y métodos: Estudio retrospectivo de todos los pacientes diagnosticados y tratados de abscesos cervicales profundos infantiles durante 15 años (2002-2016), analizando las características demográficas, clínicas, diagnósticas y terapéuticas. Resultados: Setenta y dos casos fueron diagnosticados. Se aprecia un incremento de su incidencia en los últimos años. La localización más frecuente han sido los abscesos periamigdalinos (30,6%), seguido de las adenopatías abscesificadas (18,1%), los abscesos parafaríngeos (16,7%) y los retrofaríngeos (16,7%). Las menos frecuentes han sido los abscesos submandibulares (12,5%) y parotídeos (5,6%). La distribución fue diferente según edad (p

Introduction. Overweight and obesity respond to socioeconomic, cultural and family factors, but there is no unanimity in the influence of rural-urban children on their habits and food consumption. For this reason, the objective is to study the frequency and possible difference of food consumption according to the residence environment. Material and methods. Observational, descriptive and cross-sectional study in children of 6th grade of an urban population (n=111) and another rural one (n=58). Anthropometric variables, nutritional habits and frequency of 24 food groups were obtained. Bivariate analysis of all variables according to environment and ordinal logistic regression was performed, adjusting by sex and age. The data was anonymised and carried out with the authorization of the pertinent Ethical Committee. Results. Of 111 childrens, 54.4% were girls and 10.9±0.5 years old mean age, without significant differences between both populations, as well as with anthropometric variables. In the bivariate analysis, only the consumption of industrial pastries is higher in the urban setting (p=0.004), this data is confirmed by the multivariate analysis when adjusting by sex and age (OR=3.34; 95% CI 1.46-7.63; p=0.004), which also shows significance for lower consumption of white bread in the urban environment (OR=0.53; 95% CI 0.29-0.97; p=0.037). In relation to the eating habits of breakfast and lunch in school cafeteria, no significant difference between both environments is observed. Conclusion. The habits and consumption of food is practically identical in urban and rural environment in children of sixth grade

Background. Pharmacological non-adherence in chronic diseases is 40–65%. No predictive profile of non-adherence exists in patients with multiple chronic diseases. Our study aimed to quantify the prevalence of non-adherence to pharmacological treatment and its associated factors in patients who visit pharmacies in Spain. Methods. This observational cross-sectional study included patients with one or more chronic diseases. The variables analyzed were demographics, diseases involved, self-medication, information about disease, and lifestyle. The main variable was adherence using the Morisky–Green test. A total of 132 pharmacies collaborated, providing 6327 patients representing all Spain regions (April–December 2016). Bivariate and multivariate analyses were performed and the area under the receiver operating characteristic (ROC) curve was calculated. Results. Non-adherence was 48.4% (95% confidence interval (CI): 47.2–49.7%). The variables that reached significance in the multivariate model were: difficulty in taking medication, self-medication, desire for more information, smoking, lower physical activity, younger age and number of chronic treatments. Discrimination was satisfactory (area under the ROC curve = 70%). Our study found that 50% patients was non-adherent and we obtained a profile of variables associated with therapeutic non-adherence. Conclusions. It is cause for concern that in patients with multiple diseases and taking multiple medications, there is an association between non-adherence, self-medication and worse lifestyle.

Obesity is caused by fat accumulation. BMI Z-score is used to classify the different degrees of weight status in children and adolescents. However, this parameter does not always express the true percentage of body fat. Our objective was to determine the degree of agreement between the fat mass percentage measured by DXA and the stratification of weight according to BMI Z-score in the pediatric age group. We designed a descriptive cross-sectional study. The patients were classified as underweight/normal weight with Z-scores between −2 and +0.99, overweight from 1 to 1.99, obese from 2 to 2.99, and very obese ≥3. We included 551 patients (47% girls), with a mean age of 11.5 ± 2.8 years (3.7–18 years). Higher BMI Z-scores were associated with a higher percentage of total fat (p &lt, 0.001). However, there were important overlaps between both parameters, such that the BMI Z-score classified patients with the same percentage of total fat mass as having a different nutritional status classification. In conclusion, the stratification of weight status according to BMI Z-score revealed that 46.7% of patients had a fat percentage that did not correspond to their classification. For a more accurate weight assessment in clinical practice, we recommend combining anthropometric indices with diagnostic tools that better correlate with DXA, such as electrical bioimpedance.

Este artículo se encuentra disponible en la siguiente URL: https://www.nature.com/articles/s41598-021-88823-2.pdf En este artículo también participan: Jose Maria Paredes-Arquiola, Maia Boscá-Watts, Jose Maria Huguet, Rafael Gil-Borrás y Josefa Rodríguez-Morales. Intestinal dysbiosis is key in the onset and development of Crohn’s disease (CD). We evaluated the microbiota changes in CD patients before and after a six-month anti-TNF treatment, comparing these changes with the microbiota of healthy subjects. This prospective multicenter observational study involved 27 CD patients initiating anti-TNF treatment and 16 healthy individuals. Inflammatory activity was determined at baseline, 3 and 6 months, classifying patients into responders and nonresponders. Fecal microbiota was analyzed by massive genomic sequencing thought 16S rRNA amplicon sequencing before and after six months of anti-TNF treatment. The CD cohort showed a decrease in genera of the class Clostridia, short-chain fatty acid producers, and an increase in the phylum Proteobacteria (p < 0.01) versus the healthy cohort. After anti-TNF treatment, the phylum Proteobacteria also increased in non-responders versus responders (13/27) (p < 0.005), with the class Clostridia increasing. In addition, alpha diversity increased in responders versus non-responders (p < 0.01), tending towards eubiosis. An association was found (p < 0.001) in the F.prausnitzii/E.coli ratio between responders and non-responders. The F/E ratio was the most accurate biomarker of anti-TNF response (area under the curve 0.87). Thus, anti-TNF treatment allows partial restoration of intestinal microbiota in responders and the F.prausnitzii/E.coli ratio can provide a reliable indicator of response to anti-TNF in CD.

Background: Crohn’s disease is believed to result from the interaction between genetic susceptibility, environmental factors and gut microbiota, leading to an aberrant immune response. The objectives of this study are to evaluate the qualitative and quantitative changes in the microbiota of patients with Crohn’s disease after six months of anti-tumor-necrosis factor (anti-TNFα) (infliximab or adalimumab) treatment and to determine whether these changes lead to the recovery of normal microbiota when compared to a control group of healthy subjects. In addition, we will evaluate the potential role of the Faecalibacterium prausnitzii/Escherichia coli and Faecalibacterium prausnitzii/Clostridium coccoides ratios as indicators of therapeutic response to anti-TNFα drugs. Methods/Design: This prospective multicenter observational study will comprise a total of 88 subjects: 44 patients with Crohn’s disease scheduled to start anti-TNFα treatment as described in the drug specifications to control the disease and 44 healthy individuals who share the same lifestyle and eating habits. The presence of inflammatory activity will be determined by the Harvey-Bradshaw index, analytical parameters in blood, including C-reactive protein, and fecal calprotectin levels at commencement of the study, at three months and at six months, allowing the classification of patients into responders and non-responders. Microbiota composition and the quantitative relationship between Faecalibacterium prausnitzii and Escherichia coli and between Faecalibacterium prausnitzii and Clostridium coccoides group as indicators of dysbiosis will be studied at inclusion and six months after initiation of treatment using ultra sequencing with Illumina technology and comparative bioinformatics analysis for the former relationship, and digital droplet PCR using stool samples for the latter. Upon inclusion, patients will complete a survey of dietary intake for the three days prior to stool collection, which will be repeated six months later in a second collection to minimize dietary bias. Discussion: In this study, massive sequencing, a reliable new tool, will be applied to identify early biomarkers of response to anti-TNF treatment in patients with Crohn’s disease to improve clinical management of these patients, reduce morbidity rates and improve efficiency.

Objective: studies have been published in Europe comparing the mean macronutrient and micronutrient intake values of the general population with those of the vegan population, but none has been conducted in a country that mainly follows the Mediterranean diet. Therefore, the aim of this study was to carry out this comparison in Spain. Methods: a cross-sectional study of a sample of Spanish vegans was designed in 2015. To compare the distribution of nutrients with those of the general population, we used data from the Spanish Agency for Food Safety and Nutrition, which was considered to be normally distributed as it was a large population with biological parameters. All participants were asked about their dietary intake for the previous day (24 hour reminder) and the nutrients were calculated using specialized software. The distributions were compared using the Kolmogorov-Smirnov test. Results: The sample comprised 102 vegans, 67 of whom were women. The vegan population consumed more carbohydrates and fiber, less total fat (women only), fewer saturated fatty acids, and more polyunsaturated fatty acids. They had much lower cholesterol intake, lower calcium and iodine intake, higher iron and folic acid intake, and much lower intake of vitamins B12 and D. Conclusions: Spanish vegans had nutritional deficiencies compared to the general population and should therefore ensure their diet includes the necessary supplements.Antecedentes: se han publicado en Europa estudios que comparan los valores medios de ingesta de macronutrientes y micronutrientes de la población general con los de la población vegana, pero ninguno se ha llevado a cabo en un país que sigue principalmente la dieta mediterránea. Por lo tanto, el objetivo de este estudio fue llevar a cabo esta comparación en España. Métodos: se diseñó un estudio transversal de una muestra de veganos españoles en 2015. Para comparar la distribución de nutrientes con los de la población general, utilizamos datos de la Agencia Española de Seguridad Alimentaria y Nutrición, considerando dichos datos como una distribución normal de parámetros biológicos al constituir una gran muestra. A todos los participantes se les preguntó sobre su ingesta dietética en el día anterior y los nutrientes se calcularon utilizando un software especializado. Las distribuciones se compararon mediante la prueba de Kolmogorov-Smirnov. RESULTADOS: La muestra comprendió 102 veganos, 67 de los cuales eran mujeres. La población vegana consumió más carbohidratos y fibra, menos grasa total (solo mujeres), menos ácidos grasos saturados y más ácidos grasos poliinsaturados. Tenían una ingesta mucho más baja de colesterol, una ingesta más baja de calcio y yodo, una mayor ingesta de hierro y ácido fólico, y una ingesta mucho más baja de vitaminas B12 y D. Conclusión: los veganos españoles tenían deficiencias nutricionales en comparación con la población general y, por lo tanto, deben asegurarse de que su dieta incluya los suplementos necesarios.

Background Studies validating indirect methods to identify nonadherence in chronic patients who visit pharmacies are lacking. The aim of this study was to validate self-reported adherence and assess the variables associated with both overestimation and underestimation of good adherence when using this method. Materials and methods An observational, cross-sectional study was undertaken to validate self-reported adherence in 132 community pharmacies throughout Spain in 6237 chronic patients. The Morisky-Green test was used as the validation method and through a 2 × 2 table, the validity indicators, predictive values, and likelihood ratios were calculated. To assess the variables associated with both overestimation and underestimation of good adherence, multivariate logistic regression analysis and calculation of the area under the ROC curve were used to evaluate discriminatory capacity. Results Sensitivity was 27.8% (95% CI: 26.2–29.4) and specificity was 93.9% (95% CI: 93.1–94.7). Discrepancy analysis obtained a significant overestimation of good adherence (p

Resumen: Introducción: Existen recomendaciones europeas de actividad física para la infancia. El principal objetivo de estudio era determinar los factores que podrían influir en el cumplimiento de las recomendaciones europeas de actividad física en la primera infancia. Métodos: Se incluyó a 136 niños (2-8 años), clasificados según su estado de peso medido con puntajes Z del IMC siguiendo los estándares de la Organización Mundial de la Salud. Se midió la actividad física durante 5 días consecutivos con acelerómetros y la ingesta diaria. Resultados: Una mayor actividad física se asoció con un menor estado de peso (B = −1,55; IC 95%: −2,02 a −1,08; p

Objective: The literature indicates a single universal cut-off point for weight loss after birth for the risk of hypernatremia, without considering other factors. The aim of this study was to construct and internally validate cut-off points for the percentage weight loss associated with the risk of hypernatremia, taking into account risk factors. Methods: A prospective study with a three-day follow-up was conducted in 165 neonates with a gestational age ≥35 weeks. The main outcome variable was mild or moderate hypernatremia (serum sodium ≥ 145 mmol/L). Secondary variables (risk factors) were maternal and infant variables. A multivariate logistic regression model was constructed to predict hypernatremia, obtaining its probability and the optimal discriminant cut-off point for hypernatremia (receiver operating characteristic analysis). Based on this point, threshold weight loss values were obtained according to the other variables. These values were internally validated by bootstrapping. Results: There were 51 cases (30.9%) of hypernatremia. The mean percentage weight loss for hypernatremic infants was 8.6% and 6.0% for the rest. Associated variables in the multivariate model included greater weight loss, male gender, higher education level, multiparity, and cesarean delivery. The model had an area under the receiver operating characteristic curve of 0.84 (sensitivity = 77.6%; specificity = 73.2%). Similar values were obtained in the bootstrapping validation. The lowest percentage weight loss was 4.77%, for cesarean delivery in male infants of mothers with a higher education level. Conclusions: The weight loss percentage values depended on the type of delivery, parity, newborn gender, and level of maternal education. External studies are required to validate these values. Resumo: Objetivo: A literatura indica um único ponto de corte universal na perda de peso após o nascimento para risco de hipernatremia, sem considerar outros fatores. Nosso objetivo foi criar e validar internamente pontos de corte para o percentual de perda de peso associado ao risco de hipernatremia considerando fatores de risco. Métodos: Foi feito um estudo prospectivo que incluiu 165 neonatos com idade gestacional ≥ 35 semanas, acompanhados por três dias. A principal variável de resultado foi hipernatremia leve ou moderada (sódio sérico ≥ 145 mmol/L). As variáveis secundárias (fatores de risco) foram variáveis maternas e dos neonatos. Um modelo multivariado de regressão logística foi criado para diagnosticar hipernatremia, obteve sua probabilidade e o ponto de corte discriminativo ideal para hipernatremia (análise da Característica de Operação do Receptor). Com base nesse ponto, obtivemos então os valores limites de perda de peso de acordo com as outras variáveis. Esses valores foram internamente validados por. Resultados: Há 51 casos (30,9%) de hipernatremia. O percentual de perda de peso para neonatos hipernatrêmicos foi 8,6% e 6,0% para o restante. As variáveis associadas no modelo multivariado incluíram maior perda de peso, sexo masculino, maior nível de escolaridade, multiparidade e cesárea. O modelo apresentou uma área sob a curva da Característica de Operação do Receptor de 0,84 (sensibilidade = 77,6%; especificidade = 73,2%). Valores semelhantes foram obtidos na validação da bootstrapping. O menor percentual de perda de peso foi 4,77% para cesárea em neonatos do sexo masculino de mães com maior nível de escolaridade. Conclusões: Os valores percentuais de perda de peso dependem do tipo de parto, paridade, sexo do recém-nascido e nível de escolaridade materna. São necessários estudos externos para validar esses valores. Keywords: Newborn, Dehydration, Hypernatremia, Weight loss, Palavras-chave: Recém-nascido, Desidratação, Hipernatremia, Perda de peso

Introduction and objective: In muscle dysmorphia (MD) the patient thinks he is smaller and less muscular than he really is. As in other addictive diseases, its prevention and early diagnosis are the key to avoid associated disorders. It is established as an objective to determine if there are associated socio-demographic factors. Material and methods: Cross-sectional observational study of 140 men, between 16-45 years old, who practice bodybuilding in gyms of different socioeconomic levels, at least 6 months prior to the study, 4 days / week, 1 hour / day, who signed the informed consent and without chronic illness. The main variable was the presence of symptoms of DM using the muscle appearance satisfaction scale (44 patients) and the secondary variables were age, coexistence, children, educational level and monthly income. Frequencies were used in the qualitative variables, and averages and standard deviations in the quantitative variables, in the bivariate analysis of the Chisquare test and the t-student test respectively and the binary logistic regression (presence / absence of MD) to eliminate confounding factors, the probabilities were calculated associated Results: The gymnasts have an average age of 26.1 (SD = 7.1) years; the majority live with their parents (56.4%); they do not have children (89.3%); the academic levels are balanced and the economic income is mostly low / medium (79.3%). In the bivariate analysis, is observed a higher risk at a younger age (p = 0.027) and when they live with their parents (limit of significance). Significance is not observed with the variables having children, educational level or economic income. In the binary logistic regression these meanings are lost, although the graphic representation of the probability in relation with age seems to be a risk factor, as well as living with the parents or as a couple. Conclusion: Among men who practice bodybuilding, it is usually a risk to suffer MD, to be younger, to live together as a couple and with parents, with no impact on the educational level or economic income.

Introducción: El período universitario suele ser el momento en que los estudiantes asumen por primera vez su propia alimentación y pueden adquirir hábitos que repercutirán en su futura salud. Se analiza la evolución del índice de masa corporal (IMC) y adherencia a la Dieta Mediterránea en estudiantes de Ciencias de la Salud estudiando los efectos de la formación recibida en el primer curso y en el segundo curso académico. Material y Métodos: Estudio piloto sobre el seguimiento de 124 estudiantes de Ciencias de la Salud de la Universidad CEU Cardenal Herrera (grados de Enfermería y Fisioterapia), mediante el cuestionario KIDMED en primer curso y durante el segundo curso académico, valorando los cambios en la adherencia a la Dieta Mediterránea y posibles factores asociados (sexo, grado de procedencia, comensalidad, estado de IMC y valoración de la adherencia previa). Resultados: Se encuentra buena correlación entre IMC inicial y final (r2=0,848; p

Anal fissures (AFs) are lesions located in the lower anal canal. They can be primary (chronic or acute) or secondary to a basic disease. There is high comorbidity of depression and anxiety in patients with chronic AF, with poorer quality of life (QoL) and sexual function. This is a case–control study carried out in the San Juan Hospital (Alicante, Spain). Sixty-seven participants were included in the study, including 35 cases and 32 controls: 36 males and 31 females. This study aims to investigate the association of presenting AFs with sexuality, quality of life, anxiety, depression, and anger. The instruments used were the Spanish validated versions of the validated original selected questionnaires. These instruments were used to assess health-related quality of life, anxiety, anger, depression, and sexual function. Results show higher values in cases than in controls with statistical significance in anxiety state and trait; anxiety and depression; bodily pain, general health, and vitality; and 10 of the 12 anger factors. Higher values in controls than in cases with statistical significance in sexuality and many of the QoL factors were found. Addressing these issues in AF surgical patients would be beneficial for their clinical assessment and intervention.

Aims. To assess the possible effect of polyphenol-rich olive extracts on lipid metabolism in medaka fish by quantifying the expression of lipogenic and lipolytic genes. Materials and methods. Adult medaka fish were maintained in tanks for five days with five extracts at 0.01% in water, causing obesity through a diet rich in carbohydrates, with a control group maintained in water with a normal diet. The extracts contained polyphenols ranging between 7 and 116 mg/g (oleuropein, hydroxytyrosol) with an antioxidant power of 2&ndash, 13 mmol of 2,4,6-tri(2-pyridyl)-1,3,5-triazine/100 g. After five days, the fish were sacrificed and the hepatic mRNA and its complementary DNA were extracted by reverse transcription. Complementary DNAs were quantified for three lipolytic and three lipogenic genes by real-time PCR. The relative gene expression was calculated from the amplification curves in reference to the control group. Results. The expression of genes involved in lipolysis, including peroxisome proliferator-activated receptor-&plusmn, acyl-CoA oxidase 1, and carnitine palmitoyltransferase 1, were clearly decreased in fish subjected to an obesogenic diet, and this situation could not be reversed in fish maintained with polyphenol-rich extracts. In contrast, lipogenic fatty acid synthase, acetyl-CoA carboxylase 1, and sterol regulatory element-binding protein 1 genes increased considerably with the obesogenic diet and reverted to the normal state with the olive extracts. The effect was not dependent on the total polyphenol content, the specific oleuropein or hydroxytyrosol concentration, or the antioxidant power, suggesting a synergistic effect. Conclusion. Olive polyphenols, acting as anti-lipogenic agents, have a positive effect on lipid metabolism, but their mechanism in each gene is different according to the extract, which supports synergistic mechanisms with the different proportions of polyphenols and accompanying phytochemicals in each extract.

Background and aim. Olive polyphenols have anti-inflammatory activity, prevent apoptosis by oxidative stress, promote neuroprotection and neurodevelopment, and have antiadipogenic effect in different cell models. The aim of this study was to analyze the possible antiadipogenic effect of olive polyphenols in zebrafish, measuring weight gain, cholesterol, triglycerides and fatty acids. Material and methods. Fertilized eggs were used and incubated in well plates with 26±1°C for 72 hours: Control group in water with dimethyl sulfoxide (0.1%); Intervention group, like the control group, but adding polyphenolic extract (concentration: 100 mg/l). After incubation we proceeded to measure body mass of dry larvae, proteins, total cholesterol, triglycerides and fatty acids. Results and discussion. No differences were shown between control and intervention group in all the analyzed parameters. These results were inconclusive possibly because we did not take into account that adipose tissue appears in zebrafish within 120 hours postfertilization This opens new perspectives to study our extract, as we showed its antiadipogenic effectiveness in the differentiation of mouse fibroblasts to adipocytes. Conclusion. New studies should be performed in order to confirm or exclude the effect of olive polyphenols on lipid metabolism. These studies should take into account normal physiological conditions of the animal model chosen.

BackgroundMaternal iodine deficiency is related to high neonatal thyroid-stimulating hormone (TSH) values, with the threshold of 5 mIU/L recommended as an indicator of iodine nutrition status. The objective of this study was to analyse possible risk factors for increased TSH that could distort its validity as a marker of iodine status. The clinical relevance of this research question is that if the factors associated with iodine deficiency are known, iodine supplementation can be introduced in risk groups, both during pregnancy and in newborns.MethodsA case-control study was carried out in a sample of 46,622 newborns in 2002-2015 in Spain. Of these, 45,326 had a neonatal TSH value ≥5 mIU/L. The main variable was having TSH ≥5 mIU/L and the secondary variables were: sex, gestational age, day of sample extraction and maternal origin. Associated factors were analysed through a logistic regression model, calculating the odds ratio (OR).ResultsThe factors associated with this outcome were: male sex (OR = 1.34, 95% CI: 1.20-1.50, pConclusionsThe risk of high neonatal TSH without congenital hypothyroidism is higher in males, decreases with a greater number of days from birth to extraction, and is dependent on maternal ethnicity but not on gestational age.

No validated screening method currently exists for Chronic Obstructive Pulmonary Disease (COPD) in smokers. Therefore, we constructed a predictive model with simple parameters that can be applied for COPD screening to detect fixed airflow limitation. This observational cross-sectional study included a random sample of 222 smokers with no previous diagnosis of COPD undertaken in a Spanish region in 2014–2016. The main variable was fixed airflow limitation by spirometry. The secondary variables (COPD factors) were: age, gender, smoking (pack-years and Fagerström test), body mass index, educational level, respiratory symptoms and exacerbations. A points system was developed to predict fixed airflow limitation based on secondary variables. The model was validated internally through bootstrapping, determining discrimination and calibration. The system was then integrated into a mobile application for Android. Fifty-seven patients (25.7%) presented fixed airflow limitation. The points system included as predictors: age, pack-years, Fagerström test and presence of respiratory symptoms. Internal validation of the system was very satisfactory, both in discrimination and calibration. In conclusion, a points system has been constructed to predict fixed airflow limitation in smokers with no previous COPD. This system can be integrated as a screening tool, though it should be externally validated in other geographical regions.

Objective: Although 2 screening tests exist for having a high risk of muscle dysmorphia (MD) symptoms, they both require a long time to apply. Accordingly, we proposed the construction, validation, and implementation of such a test in a mobile application using easy-to-measure factors associated with MD. Design: Cross-sectional observational study. Setting: Gyms in Alicante (Spain) during 2013 to 2014. Participants: One hundred forty-one men who engaged in weight training. Assessment of Risk Factors: The variables are as follows: age, educational level, income, buys own food, physical activity per week, daily meals, importance of nutrition, special nutrition, guilt about dietary nonadherence, supplements, and body mass index (BMI). A points system was constructed through a binary logistic regression model to predict a high risk of MD symptoms by testing all possible combinations of secondary variables (5035). The system was validated using bootstrapping and implemented in a mobile application. Main Outcome Measures: High risk of having MD symptoms (Muscle Appearance Satisfaction Scale). Results: Of the 141 participants, 45 had a high risk of MD symptoms [31.9%, 95% confidence interval (CI), 24.2%-39.6%]. The logistic regression model combination providing the largest area under the receiver operating characteristic curve (0.76) included the following: age [odds ratio (OR) = 0.90; 95% CI, 0.84-0.97, P = 0.007], guilt about dietary nonadherence (OR = 2.46; 95% CI, 1.06-5.73, P = 0.037), energy supplements (OR = 3.60; 95% CI, 1.54-8.44, P = 0.003), and BMI (OR = 1.33, 95% CI, 1.12-1.57, P < 0.001). The points system was validated through 1000 bootstrap samples. Conclusions: A quick, easy-to-use, 4-factor test that could serve as a screening tool for a high risk of MD symptoms has been constructed, validated, and implemented in a mobile application.

Este artículo se encuentra disponible en la página web de la revista en la siguiente URL: https://www.nutricionhospitalaria.org/articles/01403/show#! Introduction: interpretation of accelerometer-derived physical activity in preschool children is confounded by differences in cut-off points. Aim: the purpose of this study was to analyze physical activity in 2-to-7-year-old children to establish reference values for daily activity. Methods: observational study in children aged 2-7 years, without chronic diseases and whose parents provided informed consent. The main variable was physical activity, measured continuously over 120 hours (three workdays and two weekend days) by accelerometer. Secondary variables were weight status (body mass index [BMI] Z-score) and gender. The relationship between the main variable and secondary variables was determined through the t-test, ANOVA and the Pearson correlation coefficient. A multivariate model was used to obtain the standard deviation (SD) of all possible combinations of values, constructing percentiles of normality (x ± SD and x ± 2·SD). Results: one hundred and thirty-six children (35% of municipality children) were included in the study (54.4% of them were girls). Their weight status distribution was: 25 underweight (18.4%), 54 normal weight (39.7%), 12 risk of overweight (8.8%), 22 overweight (16.2%) and 23 obese (16.8%). The median age was 5.7 years and the mean physical activity was 592 counts/minute. The boys undertook more physical activity (p = 0.031) and the underweight and normal-weight children undertook more physical activity than the overweight and obese children (p = 0.012). There were no significant differences according to age. The multivariate analysis showed significant differences (p < 0.001) according to gender and weight status. In boys, physical activity decreased as weight status increased. In contrast, the girls in the extreme BMI groups obtained higher levels of physical activity. Conclusion: overweight and obese preschool children had lower levels of physical activity than normal weight children. Physical activity levels were higher in boys. / Introducción: la interpretación de la actividad física medida mediante actimetría en preescolares es confusa debido a los diferentes puntos de corte. Objetivo: el objetivo de este estudio fue analizar la actividad física en niños de dos a siete años para establecer valores de actividad física diaria. Método: estudio observacional en niños de dos a siete años, sin enfermedades crónicas y cuyos padres hubieran firmado el consentimiento informado. La variable principal fue la actividad física, medida durante 120 horas ininterrumpidas (tres días laborables y dos días festivos) mediante actímetros. Las variables secundarias fueron el estado de peso (puntaje z de índice de masa corporal [IMC]) y el sexo. La relación entre la variable principal y las variables secundarias fue determinada mediante el test-t, ANOVA y el coeficiente de correlación de Pearson. Se utilizó un modelo multivariable para obtener estándares de desviación en todas las posibles combinaciones de valores, construyendo percentiles de normalidad (x ± DE y x ± 2·DE). Resultados: participaron en el estudio 136 niños (35% de los niños del municipio); el 54,4% fueron chicas. La distribución de estado de peso fue: 25 niños con bajo peso (18,4%), 54 normopeso (39,7%), 12 en riesgo de sobrepeso (8,8%), 22 con sobrepeso (16,2%) y 23 con obesidad (16,8%). La media de edad fue 5,7 años y de actividad física, 592 cuentas/minuto. Los chicos realizaron mayor actividad física (p = 0,031) y los niños con bajo peso y normopeso realizaron mayor actividad física que los niños con sobrepeso y obesidad (p = 0,012). No hubo diferencias significativas respecto a la edad. El análisis multivariable mostró diferencias significativas (p < 0,001) respecto al sexo y el estado de peso. En los niños, la actividad física decreció cuando aumentó el peso. Por el contrario, las niñas en grupos de IMC extremos obtuvieron mayores niveles de actividad física. Conclusión: los preescolares en situación de sobrepeso y obesidad presentaron niveles menores de actividad física que los niños normopeso. Los niveles de actividad física fueron mayores en los chicos.

Background: The nurse training in subjects of the maternal and child area has as objectives of learning, the health of the child and adolescent, taking care of their needs, but the aspects of prevention of sexual and reproductive health in young people and adolescents are left aside. Methods: The various nurse training programs in Spain have been reviewed, as well as the current epidemiological data in which it shows that these diseases and abortions and pregnancies have increased in young people and adolescents, a situation that has motivated the research team to raise the need for modify the nurse training program, taking into account the epidemiological needs that affect this population, training to prevent situations in these ages that may affect their physical and emotional health in relation to sexuality, sexual health and reproductive health. Discussion: In our results of the needs detected in the bibliography and the contents of the curricula of the different nursing faculties are not in accordance with the epidemiological needs observed. It is proposed to define and extend the concept of health of the WHO, to adolescents and young people, since they have experiences of their own health to their environment, culture, political, economic and even moral conditions, which must be kept in mind at the time of offer training, prevention, assistance, emotional support and treatment. Conclusion: It is necessary to investigate the knowledge that students have about these aspects and propose modifications in the curriculum according to the detected needs, the importance of training in prevention and in emotional aspects of the adolescent's nursing consultation. Introducción: La formación enfermera en asignaturas del área materno-infantil tiene como objetivos de aprendizaje, la salud del niño y el adolescente, cuidando de sus necesidades, pero se dejan de lado los aspectos de prevención de la salud sexual y reproductiva en adolescentes y jóvenes. Métodos: Se han revisado los diversos programas de formación enfermera en España, así como los datos epidemiológicos actuales en los que demuestra que estas enfermedades y los abortos y embarazos se han incrementado en adolescentes y jóvenes, situación que ha motivado al equipo investigador a plantear la necesidad de modificar el programa de formación enfermera, atendiendo a las necesidades epidemiológicas que afectan a esta población, capacitando para prevenir en estas edades situaciones que puedan afectar su salud física y emocional con relación a la sexualidad, la salud sexual y la salud reproductiva. Discusión: En nuestros resultados de las necesidades detectadas en la bibliografía y los contenidos de los currículos de las distintas facultades de enfermería no están acordes con las necesidades epidemiológicas constatadas. Se plantean definir y ampliar el concepto de salud de la OMS, a los adolescentes y jóvenes, pues estos tienen vivencias de su salud propias a su entorno, cultura, condiciones políticas, económicas e incluso morales, que hay que tener presente a la hora de ofrecerles formación, prevención, asistencia, acompañamiento emocional y tratamiento. Conclusión: Es necesario investigar los conocimientos que sobre estos aspectos poseen los estudiantes y proponer modificaciones en el currículum acordes a las necesidades detectadas, a la importancia de formar en prevención y en aspectos emocionales de la consulta enfermería del adolescente.

Introducción: a pesar de que la obesidad infantil es un problema de salud serio, poco se sabe de los factores relacionados con esta en la primera infancia. Objetivo: evaluar qué factores maternos, cognitivos y del lactante influyen en la ingesta energética del lactante y si estos a la vez influyen en su estado nutricional antes del año. Métodos: estudio descriptivo de correlación. Participaron 267 diadas (madre/hijo). Los cuestionarios consistieron en cuatro instrumentos para las variables cognitivas de la madre (autoeficacia materna, actitud en la alimentación, percepción sobre señales de hambre, saciedad y peso del hijo), aporte energético mediante recordatorio de 24 horas y datos sociodemográficos y antropométricos de la madre y del niño, mediante los que se han calculado el índice de masa corporal (IMC) materno y Z-score de peso/talla del lactante. Resultados: el modelo fue significativo para la ingesta de kcal/kg peso (F = 8,624; p < 0,001; R2 = 0,104), correlacionando negativamente con la percepción materna del peso del hijo (B = -9,73; p = 0,002), las horas de sueño (B = -2,19; p = 0,044) y la edad del hijo (B = -2,26; p = 0,001). También para el Z-score (peso/longitud) (F = 68,979; p < 0,001; R2 = 0,564), y se explicó de manera positiva con percepción del peso del hijo (B = 1,133; p < 0,001) y edad del hijo (B = 0,054; p = 0,006) y negativamente con horas de sueño de la madre (B = -0,07; p = 0,040) e ingesta calórica (B = -0,004; p = 0,027). Conclusión: las madres de hijos lactantes que subestiman el peso de su hijo y duermen menos horas proporcionan más ingesta calórica y sus niños presentan mayor Z-score del peso/longitud. Introduction: despite the fact that childhood obesity is a serious health problem, little is known about its related factors in early childhood. Objective: to evaluate which maternal, cognitive and infant factors influence the infant’s energy intake and if these influence their nutritional status before the year. Methods: descriptive study of correlation. Two hundred and sixty-seven dyads (mother/child) participated. The questionnaires consisted of four instruments for the cognitive variables of the mother (maternal self-efficacy, attitude in the diet, perception of signs of hunger, satiety and weight of the child), energy intake through a 24-hour reminder and sociodemographic and anthropometric data of the mother and child, through which maternal body mass index (BMI) and Z-score of infant weight/height have been calculated. Results: the model was significant for the intake of kcal/kg weight (F = 8.624, p < 0.001, R2 = 0.104), negatively correlating with the maternal perception of the weight of the child (B = -9.73, p = 0.002), hours of sleep (B = -2.19, p = 0.044) and age of the child (B = -2.26, p = 0.001). Also for the Z-score (weight/length) (F = 68.979, p < 0.001, R2 = 0.564) and explained positively with perception of the weight of the child (B = 1.133, p < 0.001) and age of the child (B = 0.054, p = 0.006) and negatively with hours of sleep of the mother (B = -0.07, p = 0.040) and caloric intake (B = -0.004, p = 0.027). Conclusion: mothers of nursing infants who underestimate their child’s weight and sleep fewer hours provide more caloric intake and their children have a higher Z-score weight/length.