domingo, 6 de febrero de 2011

El 29,3 por ciento de los niños de entre 3 y 12 años tienen exceso de peso


EL 8,4% ENTRE 3 Y 5 ES OBESO

El 29,3 por ciento de los niños de entre 3 y 12 años tienen exceso de peso

Según los últimos datos del Programa Thao, recogidos durante el curso escolar 2009-2010, casi 1 de cada 3 niños -el 29,3 por ciento- de entre 3 y 12 años sufre exceso de peso, ya sea sobrepeso u obesidad. Además, el 8,4 por ciento de 3 a 5 años es obeso, lo que significa que este problema de salud se gesta desde la infancia. Estos resultados siguen la norma IOTF (International Obesity Task Force), referencia internacional en estudios europeos.
Redacción - Lunes, 7 de Febrero de 2011 - Actualizado a las 00:00h.
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La propuesta del Programa Thao-Salud Infantil se centra en enseñar a padres y educadores las formas de favorecer la adquisición de unos hábitos de alimentación saludables en la infancia para prevenir el sobrepeso y la obesidad en los niños españoles -quienes presentan uno de los índices de exceso de peso más elevados de Europa-. La necesidad de actuar desde edades tan tempranas responde al estudio realizado sobre el Índice de Masa Corporal (IMC) a 26.251 niños de 3 a 12 años en 29 ciudades españolas, que revela la alta prevalencia del sobrepeso y de la obesidad en la franja de 3 a 5 años. El análisis de esta muestra cuantitativa para determinar la prevalencia del exceso de peso infantil cuenta con la colaboración de la Fundación Española de la Nutrición (FEN).
Ante estas cifras en los primeros años de vida, Thao ha ampliado su franja de actuación, que en principio se desarrollaba entre los 3 y 12 años, desde los primeros meses de vida, con el Programa Thao-Pequeña Infancia, que cuenta con unos materiales específicos dirigidos a padres y madres, y a profesionales.
Actuación temprana
Rafael Casas, director científico del Programa Thao, explica que "de los estudios que hemos realizado en los últimos años se desprende que, para prevenir la obesidad infantil, debemos actuar cuanto antes. Pretendemos concienciar a los padres y madres de que los hábitos de vida saludables se instauran desde edades muy tempranas, como por ejemplo en la introducción de la alimentación complementaria y el aprendizaje de nuevos sabores". Esta iniciativa se centra en el vínculo afectivo entre las madres, padres y sus hijos e hijas, como principal factor para establecer unas pautas alimentarias saludables.
Para ello, se prevé la puesta en marcha de un taller de formación específico para los coordinadores locales de cada ciudad Thao, y un taller para los actores locales en contacto con los niños de 0 a 3 años, como los profesionales de jardines de infancia o enfermería pediátrica.

Música y cerebro


Música y cerebro imprimir
07/02/2011Redacción
El procesamiento neurocognitivo de la música supone una interacción de múltiples funciones neuropsicológicas y emocionales, que deben que actuar de forma paralela para que se produzca de manera correcta y el resultado sea el esperado.Según qué aspecto, cualidad o componente de la música que se esté analizando (tono, organización temporal, secuencia motora, canto, etc.), intervienen distintas áreas cerebrales tanto corticales como de los ganglios basales o el cerebelo. Por otro lado, la música, como estímulo emocional en sí mismo, puede activar zonas diferentes del cerebro según se trate de una música agradable (núcleo accumbens) o desagradable (amígdala).
Los trastornos musicales son poco conocidos, de hecho, las exploraciones neuropsicológicas habituales no incluyen la valoración de la función musical como otra función neurocognitiva más. Actualmente están clasificados según la tipología clásica de Brust, aunque no existen criterios diagnósticos específicos para cada una de estas alteraciones.
[Rev Neurol 2011]
Soria-Urios G, Duque P y García-Moreno JM
Palabras Clave: Alucinación musical. Amusia. Distonia del músico. Emoción. Interacción auditivomotora. Memoria musical

Conversión de las células del glioblastoma en vasos sanguíneos



Conversión de las células del glioblastoma en vasos sanguíneos

Comparación de la RCP estándar con la RCP con compresión/descompresión activa y aumento de la presión negativa intratorácica


REMI envía todos sus contenidos gratuitamente por correo electrónico a más de 8.900 suscriptores. [Suscripción]
Artículo nº 1598. Vol 11 nº 2, febrero 2011.
Autor: Ramón Díaz-Alersi

Comparación de la RCP estándar con la RCP con compresión/descompresión activa y aumento de la presión negativa intratorácica
Artículo original: Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: a randomised trial. Aufderheide TP, Frascone RJ, Wayne MA, Mahoney BD, Swor RA, Domeier RM, Olinger ML, Holcomb RG, Tupper DE, Yannopoulos D, Lurie KG. Lancet 2011; 377(9762): 301-311. [Resumen] [Artículos relacionados]

Introducción: La PCR extrahospitalaria sigue siendo un grave problema de salud cuya tasa de supervivencia es muy baja. Se han investigado muchos métodos para intentar mejorar su pronóstico, pero solo unos pocos han conseguido resultados positivos, como la hipotermia terapéutica y el acceso público a los desfibriladores automáticos. Este artículo muestra los resultados de un ensayo clínico aleatorizado multicéntrico sobre la eficacia del uso conjunto de dos dispositivos de RCP.

Resumen: En un área de 2,3 millones de población, asistida por 46 servicios de emergencias médicas se enrolaron 1.653 de 2.470 pacientes elegibles que habían sufrido una PCR de origen presumiblemente cardiaco, los cuales fueron asignados aleatoriamente a dos grupos. Uno, fue reanimado con las medidas de RCP estándar y el otro con medidas activas de compresión-descompresión torácica (dando masaje mediante un dispositivo de ventosa aplicado al tórax) y aumento de la presión negativa intratorácica (mediante un dispositivo de umbral de impedancia que impide el paso pasivo del aire al tórax durante la descompresión). El desenlace principal fue la supervivencia al alta hospitalaria con buena función neurológica (≤ 3 puntos en la escala de Rankin modificada). Alcanzaron este desenlace el 6% de los pacientes del grupo control y el 9% de los del grupo de intervención (OR 1,58; IC 95% 1,07-2,36; P = 0,019). Al año (desenlace secundario) sobrevivieron  el 6% de los pacientes del grupo control y el 9% de los del grupo de intervención (P = 0,03), con funciones neurológica y psicológica equivalentes en los dos grupos. Los acontecimientos adversos (desenlace secundario) fueron semejantes en los dos grupos, salvo el edema pulmonar que fue más frecuente en el grupo de intervención (11% y 7% respectivamente; P = 0,015)

Comentario: El estudio se detuvo prematuramente por dificultad en el enrolamiento. El uso del dispositivo de umbral de impedancia pudo ser enmascarado, pero no la ventosa. Ambos dispositivos habían sido probados ya por separado, con resultados dispares. Una revisión sistemática  de los datos existentes del dispositivo de compresión-descompresión no encontró diferencias significativas en la mortalidad a corto plazo o en la supervivencia hospitalaria [1]. Mientras,  la revisión más reciente del umbral de impedancia muestra una mejoría significativa en la supervivencia y en la función neurológica a corto plazo, pero no a largo plazo [2]. El uso conjunto de ambos dispositivos puede tener un efecto mayor al actuar sinérgicamente, ya que se supone que la compresión-descompresión activa mejora la perfusión cerebral, pero esto probablemente no es así si el aire, entrando pasivamente durante la descompresión, anula la presión negativa intratorácica. Con estos resultados, junto con los de otros dos previos [3, 4], sobre todo si logran ser replicados en nuevos ensayos, podríamos estar ante una nueva arma para mejorar la supervivencia del PCR extrahospitalario.
Ramón Díaz-Alersi
Hospital U. Puerto Real, Cádiz
©REMI, http://remi.uninet.edu. Febrero 2011.

Enlaces:
  1. Active chest compression-decompression for cardiopulmonary resuscitation. Lafuente-Lafuente C, Melero-Bascones M. Cochrane Database Syst Rev 2004(2): CD002751. [PubMed]
  2. Impact of impedance threshold devices on cardiopulmonary resuscitation: a systematic review and meta-analysis of randomized controlled studies. Cabrini L, Beccaria P, Landoni G, Biondi-Zoccai GG, Sheiban I, Cristofolini M, Fochi O, Maj G, Zangrillo A. Crit Care Med 2008; 36(5): 1625-1632. [PubMed]
  3. Evaluation of an impedance threshold device in patients receiving active compression-decompression cardiopulmonary resuscitation for out of hospital cardiac arrest. Plaisance P, Lurie KG, Vicaut E, Martin D, Gueugniaud PY, Petit JL, Payen D. Resuscitation 2004; 61(3): 265-271. [PubMed]
  4. Comparison of standard cardiopulmonary resuscitation versus the combination of active compression-decompression cardiopulmonary resuscitation and an inspiratory impedance threshold device for out-of-hospital cardiac arrest. Wolcke BB, Mauer DK,  MF, Teichmann H, Provo TA, Lindner KH, Dick WF, Aeppli D, Lurie KG. Circulation 2003; 108(18): 2201-2205. [PubMed]
Búsqueda en PubMed:
  • Enunciado: Ensayos clínicos sobre la influencia de los dispositivos en el resultado de la RCP
  • Sintaxis: devices AND treatment outcome AND cardiopulmonary resuscitation AND Clinical Trial[ptyp]
  • [Resultados]
Palabras clave: Paro cardiaco extrahospitalario, Resucitación cardiopulmonar, Compresión-descompresión activa, Presión negativa intratorácica.

Beyond books: what it takes to be a 21st century librarian


Beyond books: what it takes to be a 21st century librarian

From connecting with people to keeping up with the latest technologies, there is a whole lot more to the job than stamping due dates
  • guardian.co.uk,

A healthy brain, as seen on an MRI scan. Photograph: Science photo library
Librarians provide training to show people how to search for information and evaluate what they find. Photograph: Science photo library

If we stopped the next person walking by on the street and asked them what our jobs as librarians involve, we'd be willing to bet that their first answer would be stamping books. This is because many people's experience of librarians is of the frontline, customer service staff. Have you ever considered how the books get on to the shelves and ready for you to borrow? Behind the scenes there are teams of librarians working to make this happen.
There are librarians who select the books for purchase, librarians who process the orders and librarians who create the bibliographic records that make it possible for you to find the book in the library catalogue and then on the shelves.
Books are only one aspect of what libraries and librarians are about. Librarianship is a people profession; a librarian's job is to connect people with the information they are seeking, whatever format that may take. At their heart, all library jobs have a central purpose: to help people access and use information, for education, for work, or for pleasure. In all library roles customer service and communication skills are important. If anyone ever thought they'd become a librarian because they liked books or reading, they would be sorely disappointed if they did not also like people too. Libraries of all kinds are keen to demonstrate their value to as wide an audience as possible, and to open up access to culturally significant resources that they hold.
In the digital age, when information is increasingly becoming available online, there is a propensity to say that libraries and librarians are redundant. This is not the case. Information available online is often of dubious origin and there is still a wealth of information behind paywalls that can only be accessed by those who have paid. We have helped many library users who have only been using search engines for their research and come to the library perplexed because they cannot find the information they want. If anything, the internet has added to the range of services libraries provide and in turn this has also increased the variety of roles available to librarians.
As well as being good communicators with people and active adopters and exploiters of technological developments, librarians need to have detailed specialist subject knowledge to pass on to library users. Librarians provide training to show people how to search for information and evaluate what they find. These information skills sessions are now expanding to include digital literacies such as how to stay safe online, the use of social media sites and online collaboration tools.
There is no standard route into librarianship: librarians have first degrees across the whole spectrum of subjects. To become a professionally qualified librarian you also need a masters qualification in librarianship or information science. An introduction to librarianship can be gained through a graduate trainee scheme. These are run by libraries in a variety of sectors with an aim to provide experience and training in a work-based context prior to the masters course. A year as a graduate trainee can be useful but it is not a requirement for a place on a postgraduate programme.
More information about the wide range of jobs undertaken by librarians can be found through the Library Day in the Life project. This is a biannual event that encourages librarians to blog about their working week. Round 6 of Library Day in the Life ran from 24 -30 January 2011.
If you are interested in finding out about how to embark on a career in librarianship, Ned Potter has summarised the ten things you need to know if you want to work in libraries. Many librarians have also written about their route into the profession through the Library Routes Project.

Case studies

Kate Smyth, project officer for children and young people, Oldham library and information service
Kate works closely with teenage volunteers who run Warhammer, Lego and Yu-Gi-Oh (toy and game) clubs in Oldham's libraries, and also with younger children as the organiser of sessions for young carers and library sleepovers for Scout groups. In the past year she has organised two gigs in the children's library as part of the Get It Loud in Librariesproject and is currently working on the library's first Battle of the Bands. Kate's focus on the personal relationships central to library work continues with her role as administrator for the library's Twitter, Flickr and Facebook accounts, and she is also responsible for the library content on the Go Oldham website.
Emma Cragg, academic support librarian, University of Warwick
Emma acts as the liaison between the university library and the business school at the University of Warwick. Many of the resources used by business students come in digital form, as online journals, databases, or ebooks. Although they are online, these resources are not free: access is paid for by the library for its users. Emma is responsible for selecting which resources to buy for the business and management subject areas. She also provides training to help staff and students make the most of the resources available. Her technological skills and interests extend to the use of social media for education and professional development.
Michael Cook, library manager, NHS Bolton library (based at Bolton central library)
The library serves 1,600 local primary care trust (PCT) staff as well as health students, social care staff and the general public. Michael's daily work involves looking after the physical library space and helping readers with the systematic searches of health and medical literature necessary for research and good treatment practice. This he does in the library but also on visits to outreach teams, teaching them how to find the information they need using specialised databases and websites. He also manages the public health section of the PCT website, trains and manages other library staff, and works on collaborative projects with NHS teams and public libraries to improve access to health and mental health resources for the general public.
Katie Birkwood, Hoyle Project associate, St John's College library, University of Cambridge
Kate is cataloguing the papers of 20th-century scientist Sir Fred Hoyle (1915-2001). Although much of her time is spent producing detailed descriptions of Hoyle's autograph manuscripts and letters that will be used by academic researchers, a major focus of her work is organising and running events for the general public. These events open up the library and display and interpret its treasures for people of all educational levels and backgrounds. She also works with schools and other special interest groups to supplement and broaden curricula and informal learning programmes. Librarian for her means teacher, curator, creative designer and tour guide.
Emma Cragg and Katie Birkwood are academic librarians and participants of the Library Day in the Life project

Diario Pediátrico en español

Diario Pediátrico en español


ncbi.nlm.nih.gov - AbstractBACKGROUND: Emesis can be triggered by cough in children, and cough is a common symptom of asthma.OBJECTIVE: To explore the association between posttussive emesis and asthma in the pediatri..

ENUMERATE: A European Survey for Statistical Intelligence on Digitization, Digital Preservation and Online Access...

ENUMERATE: A European Survey for Statistical Intelligence on Digitization, Digital Preservation and Online Access...

Enterovirus infection and type 1 diabetes mellitus: systematic review and ..

Enterovirus infection and type 1 diabetes mellitus: systematic review and ..
.

Pielonefritis aguda: ¿Tratamiento inicial oral o parenteral?

Pielonefritis aguda: ¿Tratamiento inicial oral o parenteral?


 

Raw Milk Cheesemakers Fret Over Possible New Rules


Raw Milk Cheesemakers Fret Over Possible New Rules

Federal regulators are considering whether to tighten food safetyrules for cheese made with unpasteurized milk — and the possibility has cheesemakers and foodies worried that the result will be cheese that is less tasty and not much safer.
Herb Swanson for The New York Times
Mateo H. Kehler, a co-owner at Jasper Hill Farm in Greensboro, Vt., making a batch of Winnimere cheese, which uses raw milk.
Herb Swanson for The New York Times
Bill Desrochers, left, and Riley Tetreault wash rounds of Von Trapp Homestead Oma cheese at Jasper Hill Farm.
The new proposals, which are expected in the next several months, come after a very tough year for this country’s fast-growing gourmet cheese industry, marked by recalls and two multistate E. coli outbreaks that sickened nearly 50 people.
Unpasteurized milk, often called raw milk, is prized by many cheesemakers, who say that it adds a special richness of flavor.
The debate focuses on a federal rule that requires cheese made from raw milk to be aged for 60 days before it is deemed safe to eat. Raw milk has not been heated to kill harmful bacteria, a process known as pasteurization. So aging allows the chemicals in cheese, acids and salt, time to destroy harmful bacteria.
Scientists have found, however, that 60 days of aging is an overly simplistic guideline, in part because there are so many types of cheese and different ones may require different safeguards.
The Food and Drug Administration began a comprehensive review of the 60-day aging rule in 2009. Officials said the review was done and was awaiting approval before release.
The F.D.A. has not tipped its hand, but some in the industry fear that raw milk cheese could be banned altogether or that some types of cheese deemed to pose a higher safety risk could no longer be made with raw milk. Others say they believe the aging period may be extended, perhaps to 90 days. That could make it difficult or impossible for cheesemakers to continue using raw milk for some popular cheese styles, like blue cheese or taleggio-type cheeses, that may not lend themselves to such lengthy aging.
“A very important and thriving section of the American agricultural scene is in danger of being compromised or put out of business if the 60-day minimum were to be raised or if raw milk cheeses were to be entirely outlawed,” said Liz Thorpe, a vice president of Murray’s Cheese, a Manhattan retailer where about half the cheese is made with raw milk.
Mateo H. Kehler, a co-owner of Jasper Hill Farm in Greensboro, Vt., makes cheese from both raw and pasteurized milk but he considers raw milk essential for some of his most popular cheeses. “We’re afraid that we’re going to lose the opportunity to produce some of the products that we make even though we’re doing it in the most responsible possible way,” Mr. Kehler said.
The F.D.A. has been here before. It began a review of raw milk cheeses more than a decade ago but the work was shelved before the agency reached any conclusions. Still, it caused a wave of concern over imported raw milk cheeses that many cheese fanciers feared would be banned.
Today, with the artisan cheese industry booming, the focus is on homegrown cheesemakers.
Cheesemakers say pasteurizing milk destroys enzymes and good bacteria that add flavor to cheese. Raw milk cheese, they say, has flavors that derive from the animals and the pastureland that produced the milk, much as wine is said to draw unique flavors from individual vineyards.
Cheese made with pasteurized milk can also present food safety hazards if it becomes contaminated after the pasteurization step — during production or aging, for example. Last year, at least nine domestic cheesemakers issued major recalls. Five used pasteurized milk and four used raw milk.
But two of the raw milk cheese recalls came after the cheese was linked to outbreaks of a highly toxic form of E. coli bacteria.
In one outbreak, 38 people in five states became sick from raw milk gouda made by Bravo Farms of Traver, Calif., and sold through Costco. In another outbreak, eight people in four states were sickened by bacteria traced to soft cheeses made by Sally Jackson, a pioneering cheesemaker in Oroville, Wash.
Investigators have not said whether the contamination in those cases has been traced to the unpasteurized milk used to make the cheese. Neither case, however, appears to provide clear insight into the effectiveness of the 60-day rule.


In Ms. Jackson’s case, investigators documented unsanitary conditions that could have played a role in making the cheese unsafe. And in the Bravo case, investigators charged the company with packaging cheese for sale before the required 60-day aging was complete.
The timing of the outbreaks could not have been worse for cheesemakers.
“The stakes are high,” said Neville McNaughton, president of CheezSorce, a cheesemaking consultant who said the industry needed to make significant improvements in food safety that went beyond aging. That includes testing of raw milk and finished products and improved hygiene. “The reason this industry could lose the right to produce raw milk cheese is because they failed to prove it to be consistently safe.”
All the fuss is over a rule that some experts say is a blatant anachronism.
The aging rule was created in the late 1940s in response to outbreaks of typhoid fever linked to cheese.
Scientists knew then that hard cheeses, like cheddar, dried out as they aged, making them less hospitable to bacteria.
So regulators decided that if cheese was not made with pasteurized milk, it should be aged. But the choice of 60 days as the necessary threshold was a fairly arbitrary one, according to Dennis J. D’Amico, senior research scientist of the Vermont Institute for Artisan Cheese of the University of Vermont.
Since then, many things have changed. The primary pathogens that now cause illness associated with cheese, like toxic forms of E. coli and listeria, were either unknown in the 1940s or not of great concern. And artisan cheesemakers today are making many cheeses whose chemistry varies greatly from the basic hard cheddar of six decades ago.
“The 60-day rule wasn’t based on real science,” Dr. D’Amico said. “The pathogens have changed and the cheeses have certainly changed. But the rule has not.”
Dr. D’Amico and Catherine W. Donnelly, co-director of the Vermont institute, published a paper late last year showing that toxic E. coli could survive in cheese for more than a year.
Another study, which they published in 2008, showed that listeria levels increased in soft cheeses, like brie, as they aged, making them potentially more dangerous. Those cheeses have a higher moisture content and become less acidic as they age, conditions that can favor bacterial growth.
Dr. D’Amico said that aging could be effective as a safeguard in hard cheeses if it were combined with careful control of milk quality, improved sanitation and testing in cheese plants.
David Gremmels, the chairman of the American Cheese Society, a trade group, said the industry needed to prove to regulators that it would do more to enhance safety.
“Raw milk cheese is here to stay,” said Mr. Gremmels, who is a co-owner of Rogue Creamery in Central Point, Ore.
“It’s vital that we all accept milk testing, environmental testing and product testing to assure that the cheeses in distribution are safe,” Mr. Gremmels said.