Elaboración y validación de un nuevo cuestionario de hábitos alimentarios para pacientes con sobrepeso y obesidad

IntroductionWhen designing a comprehensive and personalized treatment for weight control, the information provided by obese patients on their dietary habits must be gathered correctly. Our objective was to develop and validate a new questionnaire on dietary habits for overweight and obese patients that could be used clinically.Material and methodsThe new questionnaire was developed and validated through a three-step process. Firstly, an existing questionnaire was reviewed. Secondly, a new questionnaire was developed, which included new items. Thirdly, scales to aid interpretation of the results in clinical practice were developed. Construct validity was assessed using factor analysis. The internal consistency reliability was analyzed.ResultsThe validity and reliability of the new questionnaire was confirmed. The values of the patients' responses to the new questionnaire were related to variables such as age, sex, body mass index, and whether or not the patients were under treatment for hypertension, diabetes mellitus or dyslipidemia.ConclusionThe validity and reliability of this questionnaire and the scales that aid their interpretation make it a useful tool for initial assessment and monitoring of changes in eating habits in response to treatment both individually and collectively in the Spanish population.     

Empleo de un nuevo protocolo de extracción y disminución de las falsas hiperprolactinemias

IntroductionNumerous authors have reported that prolactin measurement is influenced by several factors and consequently the values obtained may not faithfully reflect the physiological reality of the individual studied. Unless a series of measures is adopted, especially in the pre-analytic stage, values may be falsely elevated. The objective of the present study was to evaluate the extent to which optimization or non-optimization of the extraction procedure translates into higher results and how reports expressed in terms of monomeric (biologically active) prolactin could be crucial to adopt a diagnosis and therapeutic approach.Material and methodsWe performed two extractions in each woman (following the protocol universally used for this kind of analysis): one through direct puncture and another 60 min later without a new puncture (a catheter was inserted in the site of the first puncture and kept permeable by salinization). The monomeric fraction was then studied, if required.ResultsA statistically significant difference was observed between the 2 extractions. The monomeric fraction was three times lower in the second extraction than in the first.DiscussionThe results of this study justify systematic use of extraction techniques that avoid the stress of venous puncture, as well as the use of the term biologically active prolactin [monomeric (little) prolactin fraction] in reports.     

Forestiera ecuadorensis: Una nueva especie endémica de Oleaceae y un nuevo registro genérico para Ecuador

Se describeForestiera ecuadorensis, una nueva especie de árbol, endémica del bosque seco tropical al occidente de Ecuador, en la provincia del Guayas, la misma que también es un nuevo registro genérico para el país.Forestiera ecuadorensis es similar aForestiera rhamnifolia distribuida en Mesoamérica y el Caribe, y aForestiera eggersiana de las Islas Vírgenes, Haití y Puerto Rico, de las que difiere por tener por presentar hojas que alcanzan mayor dimensión, con distintivo ápice largoacuminado, mayor número de nervios laterales, estambres con filamentos más cortos y distinto patrón fitogeográfico. También se presenta una clave para todas las especies de Oleaceae reportadas hasta la fecha para Ecuador.     

Novedades taxonómicas del género <Emphasis Type="Italic">Schefflera</Emphasis> (Araliaceae) para Colombia

Three new species of Schefflera (Araliaceae) from the “Calyptrate” clade of the Andean region in Colombia are described and illustrated. Schefflera bifurcata is similar to S. cicatricata, but it differs by presenting a smaller number of flowers per umbel and fewer carpels. Schefflers brevirama differs from S. elachistocephala by having an arboreal habit and smaller leaflets. Schefflera connata is related to S. quinduensis, but it differs in the inflorescence being a panicle of umbels and the style connate. These species are distributed to the north of the Cordillera Central in the department of Antioquia, and S. connata also occurs to the north of the Cordillera Occidental in the departments of Antioquia and Chocó.     

Dos especies nuevas de <Emphasis Type=Italic>Borreria</Emphasis> (Rubiaceae), un nuevo registro de <Emphasis Type=Italic>Declieuxia</Emphasis> y observaciones taxonómicas

Two new species of Borreria are described: the first, Borreria johnwoodii from the Campo Cerrado area of the Noel Kempff Mercado National Park; the second, Borreria siberiana from the cloud forest of the Yungas, between 2600 and 3100 m above sea level. Declieuxia cordigera is recorded for the first time from Bolivia. Borreria nectarifera is shown to be synonymous with B. eryngioides var. affinis.     

Documento de consenso para la detección y manejo de la enfermedad renal crónica

Chronic kidney disease (CKD) is an important global health problem, involving to 10% of the Spanish population, promoting high morbidity and mortality for the patient and an elevate consumption of the total health resources for the National Health System. This is a summary of an executive consensus document of ten scientific societies involved in the care of the renal patient, that actualizes the consensus document published in 2007. The central extended document can be consulted in the web page of each society. The aspects included in the document are: Concept, epidemiology and risk factors for CKD. Diagnostic criteria, evaluation and stages of CKD, albuminuria and glomerular filtration rate estimation. Progression factors for renal damage. Patient remission criteria. Follow-up and objectives of each speciality control. Nephrotoxicity prevention. Cardio-vascular damage detection. Diet, life-style and treatment attitudes: hypertension, dyslipidaemia, hyperglycemia, smoking, obesity, hyperuricemia, anemia, mineral and bone disorders. Multidisciplinary management for Primary Care, other specialities and Nephrology. Integrated management of CKD patient in haemodialysis, peritoneal dialysis and renal transplant patients. Management of the uremic patient in palliative care. We hope that this document may be of help for the multidisciplinary management of CKD patients by summarizing the most updated recommendations.     

Esporotricosis: prevalencia,perfil clínico y epidemiológico en un centro de referencia en Colombia

BackgroundSporotrichosis is a subacute and chronic infection caused by Sporothrix schenckii, which affects humans and other mammals. Clinical and epidemiological information in Colombia is scarce.ObjectiveTo describe clinical and socio-demographic findings and diagnostic tests in patients with sporotrichosis from 1996 to 2005 in a national reference center in Colombia, and to determine the institutional prevalence from 2002 to 2005.Material and methodsThis was a prevalence study, including patients with clinical diagnosis of sporotrichosis and at least one of the following criteria: positive culture with S. schenckii, pathologic diagnosis suggestive of sporotrichosis, or response to treatment with potassium iodide.ResultsSixty cases were included, 67% were male, and 25% of them were farmers. The most affected anatomical areas were the forearms and hands (32.5% and 22.8% respectively). Most cases came from the Cundinamarca and Boyacá areas. The cases presented as fixed cutaneous sporotrichosis and lymphangitic sporotrichosis. Differential diagnoses with: leishmaniasis and chromoblastomycosis were performed in most of the cases. All patients were treated with potassium iodide. The prevalence for our center from 2002 to 2005 was 8 cases per 100,000 patients.ConclusionsThe characteristics of our patients are similar to those described in other populations, with some differences. The culture continues to be the gold standard for diagnosis purposes. Potassium iodide is the treatment of choice in our center.     

Hígado graso no alcohólico y su asociación con variables clínicas y bioquímicas en niños y adolescentes obesos: efecto de un año de intervención en el estilo de vida

ObjectiveTo study the frequency of non-alcoholic fatty liver disease (NAFLD), its relationship to clinical and biochemical variables, and the effect 12-month's lifestyle intervention in obese children and adolescents.MethodsThirty-six obese patients aged 7 to 18 years, 42% female and 58% male, 72.2% prepubertal and 27.8% pubertal, were selected. Anthropometric measurements and glucose, insulin (baseline and after a glucose load), lipid profile, C-reactive protein, and aminotransferase tests were performed before and 12 months after dietary and physical activity intervention. Liver ultrasound was performed to determine the presence of NAFLD.ResultsNAFLD was found in 66.7% (n = 24), and was mild in 30.6%, moderate in 27.8%, and severe in 8.3%. Subjects with NAFLD had higher body mass index (BMI, p = 0.007), waist (p = 0.005), fat area (p = 0.002), basal insulin (p = 0.01), and HOMA-IR (p = 0.008) values and lower QUICKI (p = 0.02) values than those with no NAFLD. After intervention, physical activity increased (p = 0.0001) and calorie intake remained unchanged. NAFLD disappeared in 9 patients (37.5%, p = 0.02) and disease severity decreased in 3 patients (12.5%). In addition, BMI Z-score (p = 0.005), fat area (p = 0.0001), basal insulin (p < 0.05), insulin resistance (p < 0.005), lipid profile (p < 0.03), and transaminases decreased. Weight loss was the main variable accounting for NAFLD improvement.ConclusionThis group of obese children and adolescents showed a high frequency of NAFLD. The lifestyle intervention with weight reduction is effective for the treatment of NAFLD.     

Evaluación pre-post de un programa intergeneracional para mejorar el bienestar en personas mayores y los estereotipos edadistas en alumnos de primaria y secundaria: proyecto CRENCO

ObjectiveThe present study aims to evaluate the effectiveness of the CRENCO project which was carried out during the COVID-19 pandemic including intergenerational activities shared by students from primary and secondary education and users of two centers for older adults and a day hospital in Catalonia. The effectiveness was assessed in terms of well-being in older adults and on negative stereotypes about the elderly in primary and secondary students.MethodsThree interventions were carried out in which 32 older persons (9 users of centers for older adults and 23 of a day hospital), 99 primary students and 56 secondary students participated. Participants answered a questionnaire before and after the interventions. Through multilevel linear models for repeated measures, changes in feelings of loneliness, social support, anxiety and depressive symptoms, self-reported health and health-related quality of life were evaluated in older people. In primary and secondary students, changes in age stereotypes were evaluated.ResultsHealth-related quality of life and self-reported health improved statistically after the interventions in older persons. Users of the day hospital also reported an improvement in social support. Primary school students improved their age stereotypes; no statistically significant changes were detected in secondary students.ConclusionThe results of the present study contribute to underlining the importance of intergenerational programs such as the one proposed by CRENCO, capable of improving well-being and providing a more realistic vision of the older adults. Our results suggest that these programs should be implemented during childhood in order to prevent the proliferation of ageist stereotypes in later life stages.