Pulses such as peas, beans or lentils are one of the most complete foods at the nutritional level; however, they are one of the most often neglected foods in the diets of university students. ...Entrance to university translates into a major lifestyle change for many young people, and the habits acquired or cemented at this time will remain into adulthood. The objective of this study is to analyse the association between personal/sociodemographic factors, dietary intake of other food groups and the consumption of pulses in first-year university students. This cross-sectional study is part of the UniHcos project, a multicentre study of multipurpose prospective cohorts in eleven Spanish universities. Data from 9862 university students were collected through an online self-questionnaire completed by all students who met the selection criteria and agreed to participate in the project during the 2011–2018 academic years. Of students, 75·8 % presented an inadequate (≤2 times/week) consumption of pulses. Living outside the family home in either a student residence (OR 0·76; 95 % CI 0·69, 0·84) or rental (OR 0·81; 95 % CI 0·70, 0·95) decreased the compliance with recommendations on the consumption of pulses. Low consumption of pulses is seemingly not restricted to a specific profile or dietary pattern among university students, and no specific focus group for intervention can be identified. Policies promoting the consumption of pulses among the university population as a whole are necessary to increase compliance rates with the dietary recommendations.
The aim of this paper is to make a descriptive analysis of Problematic Internet Use in college students, evaluating the possible association with health problems and addictive behaviors, as well as ...gender differences in user types. A total of 2,780 students participated in the study between 2011 and 2014, 29% of them being males (age 20.8 ± 5.1 years) and 71% females (age 20.3 ± 4.4 years). The prevalence of Problematic Internet Use (PIU) assessed by the Internet Addiction Test was 6.08%. Being under 21 years of age and studying for degrees in subjects other than the health sciences were associated factors with a higher frequency of this problem, no differences by gender or type of address were found. The results show a significant association with some health problems (migraines, back pain, excess weight or obesity, insufficient rest), psychological aspects (risk of eating disorders, risk of mental disorder, depression), family problems and discrimination; with no associations with substance use (alcohol, cannabis or tobacco) being found. Concerning the time of Internet use, weekly hours were significantly higher in women than in men, both the total time as for leisure. The analysis of the profile use in problematic users revealed that males are related to aspects of entertainment such as games or shopping online and females are related to aspects of socialization, such as chats and social networks.
rectal diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that is used to prevent pancreatitis in high-risk patients during endoscopic retrograde cholangiopancreatography (ERCP). The ...European Society of Gastrointestinal Endoscopy (ESGE) recommends the use of prophylaxis with indomethacin or diclofenac in all patients undergoing ERCP, including those at low or intermediate risk of pancreatitis. A study to investigate the efficacy of this recommendation was performed.
this was a mixed cohort study. A total of 1,512 ERCP procedures performed in our institution from January 2009 to July 2016 were included in the study. Until June 2012, 718 patients did not receive diclofenac. Subsequently, 794 patients without contraindications received 100 mg of rectal diclofenac at the onset of the procedure. Risk factors for post-ERCP pancreatitis (PEAP) and PEAP cases defined using consensus criteria were recorded.
a total of 47 PEAP events (3.1%) were reported, 3.4% in the diclofenac group and 2.8% in the non-diclofenac group (p = 0.554); 26.1% of patients had risk factors for PEAP. In the diclofenac group, PEAP developed in 4.4%, 0.5% and 2.6% of subjects with intact papillae, prior sphincterotomy and extended sphincterotomy, respectively. The results were similar for the non-diclofenac group: 4% with intact papillae, 0.9% with prior sphincterotomy, and 2.5% with extended sphincterotomy, respectively. PEAP severity was similar in both groups.
rectal diclofenac before ERCP did not prevent the development of post-ERCP acute pancreatitis in non-selected consecutive patients.
Zinc is an essential micronutrient for human beings and its deficiency affects their normal growth and development.
The main aim was to evaluate the effect of two doses of zinc supplementation (ZS) ...on the nutritional status in chronic kidney disease (CKD) children.
A randomized-trial multicentric study was conducted in 48 CKD (23 females) patients under 18-years-old, for a year. At random, participants took 30 or 15 mg/day of ZS, respectively. Anthropometric measurements and biochemical analysis were performed. Hypozincemia was determined by serum zinc concentration (SZC) using atomic absorption spectrophotometry. The positive or negative change in patients' body mass index (BMI) Z-score, serum albumin, zinc and C-reactive protein (CRP) levels were used to evaluate the effect of ZS.
Mean SZC was normal before and after ZS. Despite ZS, there were no significant changes in serum albumin, zinc and CRP levels. A positive and significant association was observed between SZC and serum albumin before (
= 0.000) and after (
= 0.007) ZS. In both groups of ZS, there was a small but positive and significant change in body mass and normalization in BMI Z-score, hypoalbuminemia, hypozincemia and high CRP, especially with 30 mg/day of ZS.
Zinc supplementation may be beneficial for nutritional status in children and adolescents with CKD.
Objective To estimate the attributable and targeted avoidable deaths (ADs; TADs) of outdoor air pollution by ambient particulate matter (PM10), PM2.5 and O3 according to specific WHO methodology. ...Design Health impact assessment. Setting City of Valladolid, Spain (around 300 000 residents). Data sources Demographics; mortality; pollutant concentrations collected 1999–2008. Main outcome measures Attributable fractions; ADs and TADs per year for 1999–2008. Results Higher TADs estimates (shown here) were obtained when assuming as ‘target’ concentrations WHO Air Quality Guidelines instead of Directive 2008/50/EC. ADs are considered relative to pollutant background levels. All-cause mortality associated to PM10 (all ages): 52 ADs (95% CI 39 to 64); 31 TADs (95% CI 24 to 39).All-cause mortality associated to PM10 (<5 years): 0 ADs (95% CI 0 to 1); 0 TADs (95% CI 0 to 1). All-cause mortality associated to PM2.5 (>30 years): 326 ADs (95% CI 217 to 422); 231 TADs (95% CI 153 to 301). Cardiopulmonary and lung cancer mortality associated to PM2.5 (>30 years): ▸ Cardiopulmonary: 186 ADs (95% CI 74 to 280); 94 TADs (95% CI 36 to 148). ▸ Lung cancer : 51 ADs (95% CI 21 to 73); 27 TADs (95% CI 10 to 41).All-cause, respiratory and cardiovascular mortality associated to O3 (all ages): ▸ All-cause: 52ADs (95% CI 25 to 77) ; 31 TADs (95% CI 15 to 45). ▸ Respiratory: 5ADs (95% CI −2 to 13) ; 3 TADs (95% CI −1 to 8). ▸ Cardiovascular: 30 ADs (95% CI 8 to 51) ; 17 TADs (95% CI 5 to 30). Negative estimates which should be read as zero were obtained when pollutant concentrations were below counterfactuals or assumed risk coefficients were below one. Conclusions Our estimates suggest a not negligible negative impact on mortality of outdoor air pollution. The implementation of WHO methodology provides critical information to distinguish an improvement range in air pollution control.
Background: Physical inactivity and sedentary lifestyle
are an emerging individual, familiar and social public
health problem. The aim of this work was to validate
a new questionnaire to know the ...attitude towards physical
activity and other habits in adolescents.
Methods: The Delphi method was used. It was developed
in three phases: an initial phase of selection of
the panel of experts, an exploratory phase in two rounds
of voting using a Likert scale of 1 to 5, and statistical and
qualitative analysis of the experts’ contributions. The criteria
for the choice of items were: average > 3.5 and factor
V of Aiken ≥ 0.7. Reliability was assessed with the
Cronbach alpha coefficient. A pilot test was carried out to
assess the understanding of the instrument.
Results: 21 experts agreed to participate. Their participation
was 100% in the first round and 95.2% in the second
one. Seven items did not meet the criteria. The final
questionnaire included 93 questions and 11 dimensions:
data of the student, father, mother, physical activity in
the educational center, transportation, free time, psychosocial
aspects of physical activity, attitude towards physical
activity, food, other habits and health perception. A
Cronbach’s alpha of 0.974 was obtained.
Conclusions: The results support the reliability and
validity of the questionnaire. The Delphi method proved
to be a useful technique for the proposed objective.
Fundamentos: La inactividad física y el sedentarismo
son un problema de salud pública emergente, tanto
a nivel individual como familiar y social. El objetivo de
este estudio fue validar un nuevo cuestionario para conocer
la actitud ante la actividad física y otros hábitos de los
adolescentes.
Sujetos y métodos: Se utilizó el método Delphi. Se
llevó a cabo una fase inicial de selección del panel de expertos,
una fase exploratoria en dos rondas de votación
mediante escala tipo Likert (de 1 a 5), y un análisis estadístico
y cualitativo de las aportaciones de los expertos.
Los criterios para la elección de ítems fueron un promedio
mayor a 3,5 y V de Aiken mayor o igual a 0,7. La fiabilidad
se valoró con el coeficiente alfa de Cronbach. Se
realizó una prueba piloto para valorar la comprensión del
instrumento.
Resultados: Aceptaron participar 21 expertos. Su
participación fue del 100% en la primera ronda y del
95,2% en la segunda. Siete ítems incumplieron los criterios.
El cuestionario final contó con 93 preguntas y 11
dimensiones: datos sobre el alumno, el padre, la madre, la
actividad física en el centro educativo, en el transporte y
en el tiempo libre, sobre los aspectos psicosociales de la
práctica de actividad física, la actitud ante la actividad física,
la alimentación y otros hábitos, y sobre la percepción
de salud. Se obtuvo un alfa de Cronbach de 0,974.
Conclusiones: Los resultados avalan la fiabilidad y
validez del cuestionario. El método Delphi resultó ser una
técnica útil para el objetivo propuesto.
RESUMEN Objetivo: el diclofenaco rectal, un antiinflamatorio no esteroideo (AINE), se utiliza para prevenir la pancreatitis en pacientes de alto riesgo en la colangiopancreatografía retrógrada ...endoscópica (CPRE). La Sociedad Europea de Endoscopia Digestiva (ESGE) recomienda profilaxis con indometacina o diclofenaco a todos los pacientes a los que se les realice una CPRE, incluso en aquellos de riesgo medio-bajo de pancreatitis. Hemos realizado un estudio para investigar la eficacia de esta recomendación. Métodos: estudio de cohortes mixto. Se incluyeron 1.512 CPRE efectuadas en nuestro centro entre enero de 2009 y julio de 2016. Hasta junio de 2012, 718 pacientes no recibieron diclofenaco. Posteriormente, 794 pacientes sin contraindicaciones recibieron 100 mg rectales de diclofenaco al inicio del procedimiento. Se registraron los factores de riesgo para pancreatitis aguda post-CPRE (PAPC) y los casos de PAPC que se definieron por criterios de consenso. Resultados: hubo 47 PAPC (3,1%), un 3,4% de las cuales correspondió al grupo con diclofenaco y un 2,8%, al grupo no tratado (p = 0,554). El 26,1% de todos los pacientes presentaba factores de riesgo para PAPC. En el grupo con diclofenaco hubo un 4,4%, 0,5% y 2,6% de PAPC en papilas intactas, con esfinterotomía previa y con ampliación de la misma, respectivamente, similar al grupo no tratado (4% papila intacta, 0,9% esfinterotomía previa y 2,5% ampliación). La gravedad de la PAPC fue similar en los dos grupos. Conclusiones: en nuestro estudio, el diclofenaco rectal antes de la CPRE en pacientes consecutivos no seleccionados no previene la aparición de pancreatitis aguda post-CPRE.
Identify percutaneous catheter-related complications in preterm and term newborns.
Comparative cross-section. Were included newborns whit percutaneous catheter insertion, blood culture results and ...distal catheter segment. Were formed two groups: Preterm and term.
Were analyzed the data of preterm (n = 50) and term (n = 50) newborn, the gestational age was 30 ± 3 and 40 ± 2 (p = 0.01). The frecuency in preterm and term newborn was respectively, sepsis catheter 36 and 18% (p = 0.02; OR: 2.56; 95% CI: 1.02-7.17), infected catheter 50 and 22% (p = 0.01; OR: 5.92; 95% CI: 1.66-23.12), colonized catheter of 24 and 14% (p = 0.01; OR: 3.58; 95% CI: 1.32-9.90), local infection 14 and 8% (p = 0.03; OR: 1.87; 95% CI: 1.45-8.29), infiltration 18 and 4% (p = 0.02; OR: 5.27; 95% CI: 1.17-59), accidental removal 6 and 22% (p = 0.02; OR: 0.23; 95% CI: 0.05-0.87) and catheter rupture 10 and 28% (p = 0.02; OR: 0.29; 95% CI: 0.08-0.98).
We found a higher association of infections and infiltrations by percutaneous catheter in preterm and term prevailed in accidental removal and catheter rupture.
Different measures are recommended to reduce pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). We conducted a study in patients with ERCP treated with rectal diclofenac or ...lactated Ringer's solution, or both interventions, to assess whether there is a decrease in the number of cases of post-ERCP pancreatitis.
A mixed cohort study involving 1,896 patients from 2009 to 2018. Up to June 2012 without treatment (Group I). Subsequently, 100mg of rectal diclofenac (Group II). Since 2016, lactated Ringer's solution 200ml/hour during the procedure and 4hours after it, in addition to 500ml over 30minutes when the pancreas was cannulated (Group III). Since 2017, lactated Ringer's solution plus Diclofenac (Group IV). There were 725 patients in group I, and 530, 227 and 414 patients in groups II, III and IV, respectively. Factors predisposing to post-ERCP pancreatitis and post-ERCP pancreatitis cases that were defined by consensus criteria have been collected.
There were 65 cases of post-ERCP pancreatitis (3.4%); 2.9%, 3.4%, 3.1% and 4.3% in groups I, II, III and IV, respectively (P=.640). In group I, there was 4.2% of post-ERCP pancreatitis in naïve papillae and 4%, 4.9% and 6.3% in groups II, III and IV, respectively (P=.585). The severity of post-ERCP pancreatitis and adverse effects were similar in all groups. 38.4% were high-risk patients. There were also no differences in post-ERCP pancreatitis in this group (P=.501).
In this work, no benefit was obtained with diclofenac plus hydration in reducing the number and severity of cases of post-ERCP pancreatitis nor with the other prophylactic measures.
care overload, aging of population, and increased chronic diseases lead to increased referrals from primary care, which may sometimes overload the health system. Thus, different interventions have ...been carried out attempting to improve these aspects.
to assess the most frequent causes of consultation of general physicians, both in joint consultations and clinical sessions held jointly with specialist consultant in primary care, in the urban and rural setting, and the influence on referrals to first consultations of gastroenterology.
a mainly training type of intervention was carried out, consisting of regular meetings in both urban and rural primary care center, to perform joint consultations and clinical sessions on patients and topics related to the specialty of gastroenterology. The intervention period (divided in two subperiods) was compared with a control period.
most reasons for consultation were those corresponding to lower gastrointestinal tract, followed by liver disease and upper gastrointestinal tract. Significant differences were only found in distribution of diagnoses between the two centers in joint consultations. There was a relative (percent) decrease in referrals at the global level in both subperiods, only significant in the first (51.45 %), as well as in rural setting (45.24 %).
common consultations motifs were similar in urban and rural settings, with some relevance of lower gastrointestinal tract disease. Most of them can be solved at primary care, with the help of consultant specialist. There is impact on referrals to the outpatient first consultations of gastroenterology, mainly in rural setting.