Abstract Objective: to assess the evolution of adherence to Mediterranean diet and level of physical activity of university students of Health Sciences in Castilla-La Mancha during the COVID-19 lockdown and one year afterwards. Methods: a cross-sectional observational study using questionnaires on adherence to the Mediterranean diet and level of physical activity. A total of 893 students enrolled in Health Sciences degrees at the University of Castilla la Mancha participated, 575 in the first survey (during the lockdown) and 318 in the second (one year later). By sex, 672 women and 221 men (in the first survey 77.7 % were women and 22.3 % men while in the second survey these were 70.8 % and 29.2 %, respectively). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The level of physical activity was assessed with the Rapid Assessment of Physical Activity Scale (RAPA). Results: one year after the COVID-19 confinement, consumption of olive oil has almost tripled. Daily fruit consumption has also doubled. Similarly, the consumption of wine and alcoholic beverages has doubled. Conversely, there was a reduction in the consumption of butter and margarine, as well as of carbonated drinks and sweetened beverages. Likewise, the percentage of university students with high adherence to the Mediterranean diet increased significantly (from 26 % to 34.3 %). Regarding physical activity level, there was a significant increase in the percentage of university students who engaged in light, moderate and even intense physical activity on an irregular basis. This increase was not found in the case of muscular strength and flexibility training activities. Conclusion: the results of the study indicate that, although the levels of adherence to the Mediterranean diet and physical activity have improved after the COVID-19 confinement, adherence to Mediterranean diet and physical activity level among the university population analyzed is still low. It is necessary to implement strategies for the achievement or maintenance of a healthy lifestyle in this population.

Resumen Objetivo: valorar la evolución de la adherencia a la dieta mediterránea y el nivel de actividad física de los estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha durante la pandemia de COVID-19 y un año después de la misma. Método: estudio observacional transversal mediante cuestionarios sobre la adherencia a la dieta mediterránea y el nivel de actividad física. Participaron 893 alumnos matriculados en grados de Ciencias de la Salud de la Universidad de Castilla-La Mancha, 575 en la primera encuesta (durante la pandemia) y 318 en la segunda (un año después). Por sexos, 672 mujeres y 221 hombres (en la primera encuesta, el 77,7 % eran mujeres y el 22,3 % hombres, mientras que en la segunda lo eran el 70,8 % y 29,2 %, respectivamente). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario de Prevención con Dieta Mediterránea (PREDIMED), modificado. El nivel de actividad física se valoró con el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: tras un año desde el confinamiento por la COVID-19, el consumo de aceite de oliva casi se ha triplicado. Se ha duplicado también el consumo de frutas diario. De igual modo, se ha duplicado el consumo de vino y bebidas alcohólicas. Por el contrario, se encontró una reducción del consumo de mantequilla y margarina, al igual que de bebidas carbonatadas y azucaradas. Asimismo, aumentó significativamente el porcentaje de estudiantes universitarios con adherencia alta a la dieta mediterránea (del 26 % al 34,3 %). En cuanto al nivel de actividad física, ha aumentado significativamente el porcentaje de estudiantes universitarios que realizan actividad fisica ligera, moderada e incluso intensa de forma irregular. Este aumento no se ha encontrado en el caso de las actividades de fuerza muscular y flexibilidad. Conclusión: los resultados del estudio nos indican que, aunque los niveles de adherencia a la dieta mediterránea y de actividad física han mejorado tras el confinamiento por la COVID-19, la adherencia a la dieta mediterránea y el nivel de actividad física de la población universitaria analizada siguen siendo bajos. Es necesario aplicar estrategias para la consecución o mantenimiento de un estilo de vida saludable en dicha población.

Abstract Objective: this study analyzed the association between adherence to the Mediterranean diet and proxy-reported physical fitness among Spanish and Brazilian youths during the COVID-19 lockdown according to several inequality indicators. Methods: we conducted a cross-sectional study with parents and guardians of children and adolescents from Spain and Brazil. The evaluation process was through the use of online questionnaires. Adherence to the Mediterranean diet was assessed using the Mediterranean Diet Quality Index in Children and Adolescents. Proxy-reported physical fitness was determined using the International Fitness Scale. Inequality indicators (gender, nationality, socioeconomic status, and parents/guardians' education level) were evaluated with a survey completed by the participants' parents/guardians. Binary logistic regression models estimated the association between adherence to the Mediterranean diet and proxy-reported physical fitness, with stratification according to inequality variables. A total sample of 1099 Spanish and Brazilian individuals (47.6% girls, aged 3 to 17 years) were included in the analysis. Results: compared to the "improvement needed to Mediterranean diet" category, the "optimal Mediterranean diet" group was significantly associated with "very good" physical fitness in boys (OR = 1.5; 95 % CI: 1.0-2.1) and in participants with parents/legal guardians' education level without university studies (OR = 1.5; 95 % CI: 1.0-2.4). Conclusions: gender and parents/guardians' education level plays a significant role in the association between the "optimal Mediterranean Diet" and "very good" physical fitness level in Spanish and Brazilian children and adolescents. Future prospective studies are needed to investigate the role of inequality indicators in this relationship.

Resumen Objetivo: este estudio analizó la asociación entre la adherencia a la dieta mediterránea y la aptitud física autoinformada entre jóvenes españoles y brasileños durante el confinamiento de COVID-19 según varios indicadores de desigualdad. Métodos: se realizó un estudio transversal con padres y tutores de niños y adolescentes de España y Brasil. El proceso de evaluación fue a través del uso de cuestionarios online. La adherencia a la dieta mediterránea se evaluó mediante el Índice de Calidad de la Dieta Mediterránea en Niños y Adolescentes. La aptitud física declarada por los padres se determinó mediante la Escala Internacional de Aptitud Física. Los indicadores de desigualdad (género, nacionalidad, estatus socioeconómico y nivel educativo de los padres/tutores) se evaluaron con una encuesta completada por los padres/tutores de los participantes. Los modelos de regresión logística binaria estimaron la asociación entre la adherencia a la dieta mediterránea y la aptitud física informada por los progenitores, estratificando según las variables de desigualdad. Se incluyó en el análisis una muestra total de 1099 individuos españoles y brasileños (47,6 % niñas, de 3 a 17 años). Resultados: en comparación con la categoría de "necesidad de mejorar la dieta mediterránea", la de "dieta mediterránea óptima" se asoció significativamente con una aptitud física "muy buena" en los chicos (OR = 1,5; IC del 95 %: 1,0-2,1) y en los participantes con nivel educativo de los padres/tutores sin estudios universitarios (OR = 1,5; IC del 95 %: 1,0-2,4). Conclusiones: el género y el nivel educativo de los padres/tutores legales desempeñan un papel significativo en la asociación entre la "dieta mediterránea óptima" y el nivel de condición física "muy bueno" en niños y adolescentes españoles y brasileños. Se necesitan futuros estudios prospectivos para investigar el papel de los indicadores de desigualdad en esta relación.

ABSTRACT OBJECTIVE To verify whether parental physical activity and social support are associated with adolescents meeting physical activity recommendations. METHODS This is a cross-sectional study that selected 1,390 adolescents (59.6% girls) from Curitiba, Paraná, Brazil. The IPAQ (International Physical Activity Questionnaire), QAFA (Physical Activity Questionnaire for Adolescents), and ASAFA (Social Support for Physical Activity Practice in Adolescents) questionnaires were applied. Binary logistic regression was used to test the relationship among the study variables. RESULTS For boys, having parents who “always attend” (OR = 1.96; 95%CI: 1.16–3.32) and having parents or legal guardians who meet the PA recommendations (OR = 2.78; 95%CI: 1.76–4.38) were associated with meeting the PA recommendations. Odds were greater after adjusting for socioeconomic status (OR = 3.47; 95%CI: 1.73–6.96) and schooling level (OR = 4.20; 95%CI: 1.96–9.02). For girls, those with parents or legal guardians who “sometimes encourage them” (OR = 0.61; 95%CI: 0.37–0.98) had lower odds of meeting PA recommendations. These odds were higher after adjusting for socioeconomic status (OR = 2.11; 95%CI: 1.36–3.29) and schooling level (OR = 4.30; 95%CI: 2.41–7.69). CONCLUSIONS Boys and girls were more likely to meet PA recommendations daily by having parents who meet PA recommendations than by receiving parental social support. These results could help establish future interventions aimed at modifying behaviors related to PA in adolescents. crosssectional cross sectional 1390 1 390 1,39 59.6% 596 59 6 (59.6 Curitiba Paraná Brazil International Questionnaire, , Questionnaire) Adolescents, Adolescents Social applied variables boys always attend OR 1.96 196 96 95%CI 95CI CI 95 1.16–3.32 116332 16 3 32 2.78 278 2 78 1.76–4.38 176438 76 4 38 3.47 347 47 1.73–6.96 173696 73 4.20 420 20 1.96–9.02. 196902 1.96–9.02 . 9 02 1.96–9.02) sometimes them 0.61 061 0 61 0.37–0.98 037098 37 98 2.11 211 11 1.36–3.29 136329 36 29 4.30 430 30 2.41–7.69. 241769 2.41–7.69 41 7 69 2.41–7.69) 139 39 1,3 59.6 5 (59. 1.9 19 1.16–3.3 11633 2.7 27 1.76–4.3 17643 3.4 34 1.73–6.9 17369 4.2 42 19690 1.96–9.0 0.6 06 0.37–0.9 03709 2.1 21 1.36–3.2 13632 4.3 43 24176 2.41–7.6 13 1, 59. (59 1. 1.16–3. 1163 2. 1.76–4. 1764 3. 1.73–6. 1736 4. 1969 1.96–9. 0. 0.37–0. 0370 1.36–3. 1363 2417 2.41–7. (5 1.16–3 116 1.76–4 176 1.73–6 173 1.96–9 0.37–0 037 1.36–3 136 241 2.41–7 ( 1.16– 1.76– 17 1.73– 1.96– 0.37– 03 1.36– 24 2.41– 1.16 1.76 1.73 0.37 1.36 2.41 1.1 1.7 0.3 1.3 2.4

ABSTRACT OBJECTIVE To verify whether parental physical activity and social support are associated with adolescents meeting physical activity recommendations. METHODS This is a cross-sectional study that selected 1,390 adolescents (59.6% girls) from Curitiba, Paraná, Brazil. The IPAQ (International Physical Activity Questionnaire), QAFA (Physical Activity Questionnaire for Adolescents), and ASAFA (Social Support for Physical Activity Practice in Adolescents) questionnaires were applied. Binary logistic regression was used to test the relationship among the study variables. RESULTS For boys, having parents who “always attend” (OR = 1.96; 95%CI: 1.16–3.32) and having parents or legal guardians who meet the PA recommendations (OR = 2.78; 95%CI: 1.76–4.38) were associated with meeting the PA recommendations. Odds were greater after adjusting for socioeconomic status (OR = 3.47; 95%CI: 1.73–6.96) and schooling level (OR = 4.20; 95%CI: 1.96–9.02). For girls, those with parents or legal guardians who “sometimes encourage them” (OR = 0.61; 95%CI: 0.37–0.98) had lower odds of meeting PA recommendations. These odds were higher after adjusting for socioeconomic status (OR = 2.11; 95%CI: 1.36–3.29) and schooling level (OR = 4.30; 95%CI: 2.41–7.69). CONCLUSIONS Boys and girls were more likely to meet PA recommendations daily by having parents who meet PA recommendations than by receiving parental social support. These results could help establish future interventions aimed at modifying behaviors related to PA in adolescents.

Resumen Objetivo: el objetivo del presente estudio fue evaluar el nivel de actividad física y su asociación con la dieta mediterránea en estudiantes universitarios de ciencias de la salud de la Universidad de Castilla-La Mancha (España). Método:: se realizó un estudio transversal a través de una encuesta online. La muestra final estuvo formada por 555 estudiantes universitarios (78,2 % mujeres). La adherencia a la dieta mediterránea se evaluó mediante el evaluador de adherencia a la dieta mediterránea de 14 ítems (MEDAS). Para medir la actividad física se utilizó el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: de acuerdo con la actividad física, el 2,5 % de los participantes se consideraron activos y el 35,1 % realizaban actividades tanto de fuerza como de flexibilidad. Se observó una mayor asociación entre la ingesta de frutas (OR = 1,95; IC 95 %, 1,25-3,04), legumbres (OR = 1,51; IC 95 %, 1,00-3,20) y frutos secos (OR = 1,99; IC 95 %, 1,33-2,99) en aquellos considerados suficientemente activos. Asimismo, encontramos una relación significativa entre la ingesta de frutas (OR = 2,28; IC 95 %, 1,49-3,47), legumbres (OR = 1,41; IC 95 %, 1,00-2,08), frutos secos (OR = 1,96; IC 95 %, 1,34-2,86) y pescado/marisco (OR = 1,67; IC 95 %, 1,15-2,43), en aquellos que participaron en actividades de fuerza y flexibilidad. Conclusión: este estudio sugiere que el consumo de determinados alimentos mediterráneos se asocia con mayores niveles de actividad física en la muestra de universitarios españoles analizada.

Abstract Objective: the aim of the present study was to assess the level of physical activity and its association with Mediterranean dietary patterns in university students of health sciences at Universidad de Castilla-La Mancha (Spain). Method: a cross-sectional study was performed through an online survey. The final sample consisted of 555 university students (78.2 % females). Adherence to Mediterranean diet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). To measure physical activity, the Rapid Assessment of Physical Activity Scale (RAPA) questionnaire was used. Results: according to physical activity, 2.5 % of the participants were considered active and 35.1 % did both strength and flexibility activities. A greater association was seen between intake of fruits (OR = 1.95; 95 % CI, 1.25-3.04), pulses (OR = 1.51; 95 % CI, 1.00-3.20), and nuts (OR = 1.99; 95 % CI, 1.33-2.99) in those considered sufficiently active. Similarly, we found a significant relationship between the intake of fruits (OR = 2.28; 95 % CI, 1.49-3.47), pulses (OR = 1.41; 95 % CI, 1.00-2.08), nuts (OR = 1.96; 95 % CI, 1.34-2.86), and fish/seafood (OR = 1.67; 95 % CI, 1.15-2.43) in those who engaged in both strength and flexibility activities. Conclusion: this study suggests that consumption of certain Mediterranean foods was associated with higher levels of physical activity in a sample of Spanish university students.

Abstract Objective: to assess the degree of adherence to the Mediterranean diet and the practice of physical activity in university Health Sciences students in Castile-La Mancha. Methods: this was a cross-sectional, observational study by means of a dietary and physical activity survey. The sample consisted of 575 university students (77.7 % women). An initial data collection survey was developed using the Google Forms platform (https://www.google.com/forms/about/). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The Rapid Assessment of Physical Activity Scale (RAPA) questionnaire was used to measure physical activity. Results: we found a 58.3 % adherence to Mediterranean diet among Health Sciences students, with 38.6 % of average adherence, and 5.0 % of poor adherence, with a low consumption of fruits with no gender differences, and a high consumption of red or processed meat and butter or cream with significant differences between women and men. There is also a high consumption of carbonated beverages (more frequent in women). Likewise, a high percentage of students (22.5 %) do practically no physical activity. As for physical exercise, it is always higher in men, with significant differences (p > 0.05). Conclusion: this study suggests that the sample of university Health Sciences students in Castile-La Mancha shows an acceptable adherence to the Mediterranean diet and insufficient levels of physical activity.

Resumen Objetivo: valorar el grado de adherencia a la dieta mediterránea y la práctica de actividad física en estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha. Método: estudio observacional transversal mediante encuesta alimentaria y de actividad física. La muestra contó con 575 estudiantes universitarios (77,7 % de mujeres). Se desarrolló una encuesta de recogida de datos inicial mediante la plataforma Google Forms (https://www.google.com/forms/about/). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario PREvención con DIeta MEDiterránea (PREDIMED), modificado. Para medir la actividad física se utilizó el cuestionario Rapid Assessment of Physical Activity Scale (RAPA), que valora la actividad física desempeñada. Resultados: se encontró en los estudiantes de Ciencias de la Salud una adherencia a la dieta mediterránea del 58,3 %, siendo la adherencia media del 38,6 % y la mala adherencia del 5,0 %, observándose un bajo consumo de frutas sin diferencias de sexo, un alto consumo de carne roja o procesada y de mantequillas o natas, con diferencias significativas entre mujeres y hombres. También hay un consumo alto de bebidas carbonatadas (más frecuente en mujeres). Asimismo, un porcentaje alto de estudiantes (22,5 % del total) no hace prácticamente ninguna actividad física. En cuanto al ejercicio físico, siempre es mayor entre los hombres, con diferencias significativas (p > 0,05). Conclusión: este estudio sugiere que la muestra de estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha presenta una aceptable adherencia a la dieta mediterránea y unos niveles de actividad física insuficientes.

Abstract Objective: the aim of this research was to explore the relationship between dietary pattern habits and compliance with screen-time guidelines in Spanish schoolchildren. Material and methods: a cross-sectional and associative study was performed in a total of 370 schoolchildren (44.9 % girls) aged 6-13 (8.7 ± 1.8) years. Results: for boys, those who did not meet these guidelines presented lower chances of eating vegetables regularly (OR = 0.50; 95 % CI = 0.28-0.89) or more than once a day (OR = 0.43; 95 % CI = 0.22-0.85). In girls, it was observed that those who did not meet the guidelines presented a lower probability of eating one piece of fruit (OR = 0.43; 95 % CI = 0.19-0.99) as well as a second piece (OR = 0.22; 95 % CI = 0.22-0.81), vegetables more than once a day (OR = 0.39; 95 % CI = 0.19-0.80), fish (at least 2-3 times/week) (OR = 0.40; 95 % CI = 0.20-0.78) and nuts (at least 2 or 3 times per week) (OR = 0.46; 95 % = 0.24-0.87). Conclusion: some healthy eating patterns, such as the consumption of fruits and vegetables, appeared to be more prevalent in those children who met the international screen-time guidelines.

Resumen Objetivo: el objetivo de esta investigación fue explorar la relación entre los hábitos de alimentación y el cumplimiento de las recomendaciones de tiempo de pantalla en escolares españoles. Material y métodos: se realizó un estudio transversal y asociativo con un total de 370 escolares (44,9 % niñas) de 6 a 13 años (8,7 ± 1,8). Resultados: en los niños, aquellos que no cumplían con las recomendaciones presentaron menos probabilidades de comer verduras regularmente (OR = 0,50; IC 95 % = 0,28-0,89) y de ingerirlas más de una vez al día (OR = 0,43; IC 95 % = 0,22-0,85). En las niñas se observó que las que no cumplían las recomendaciones presentaban una menor probabilidad de comer una pieza de fruta (OR = 0,43; IC 95 % = 0,19-0,99) así como una segunda pieza (OR = 0,22; IC 95 % = 0,22-0,81), verduras más de una vez al día (OR = 0,39; IC 95 % = 0,19-0,80), pescado (al menos 2-3 veces por semana) (OR = 0,40; IC 95 % = 0,20-0,78) y frutos secos (al menos 2 o 3 veces por semana) (OR = 0,46; IC 95 % = 0,24-0,87). Conclusión: algunos patrones de alimentación saludable, como el consumo de frutas y verduras, parecen ser más prevalentes en los niños que cumplen con las recomendaciones internacionales de tiempo de pantalla.

Resumo Introdução A falta de atividade física, junto com o consumo inadequado de alimentos, tem sido um dos tópicos mais presentes em investigações sobre mortalidade e doenças crônicas não transmissíveis. Por isso, conhecer o nível de atividade física em escolares ostenta grande importância, posto que é possível empregar ações para diminuir os níveis alarmantes de sedentarismo, especialmente nas aulas de Educação Física. Objetivo Examinar sistematicamente o nível de atividade física auto-informado em crianças em idade escolar não isentos da participação em sessões de Educação Física. Método Revisão sistemática de estudos transversais que determinam o nível de atividade física auto-informado mediante o questionário PAQ-C. Resultados Identificou-se 23 artigos mediante a busca em cinco bases de dados distintas, entre 2014 e 2019. Para seleção dos artigos foi considerado o tipo de estudo e o lugar de realização, faixa etária analisada, assim como os não participantes de Educação Física. Conclusão A maioria dos estudos analisados mostraram níveis insuficientes de atividade física, não obstante, é necessário levar em consideração a realização de novas investigações relacionadas com o nível de atividade física auto-informado, para diagnosticar com maior precisão a realidade de crianças em idade escolar.

Abstract Introduction The lack of physical activity, together with inadequate food consumption, has been one of the most present topics in research on mortality and chronic non-communicable diseases. Therefore, knowing the level of physical activity in schoolchildren is of great importance, since actions could be deployed to reduce the alarming levels of sedentary life, especially from the subject of Physical Education. Objective To systematically examine the level of self-reported physical activity in schoolchildren not exempt from participation in Physical Education sessions. Method A systematic review of cross-sectional studies that determined the level of self-reported PAQ-C questionnaire. Results Twenty-three articles were identified by searching five different databases between 2014 and 2019. For the selection of the articles, it was necessary to consider the type of study and location, the age phase analyzed, as well as the non-participation in the Physical Education sessions. Conclusion Most of the studies analyzed indicate insufficient levels of physical activity; however, it is necessary to carry out more research related to the level of self-reported physical activity, enabling to diagnose with greater precision the reality of school-age children.

Resumen Introducción La falta de actividad física, junto con el consumo inadecuado de alimentos, ha sido uno de los tópicos más presentes en la investigación sobre mortalidad y las enfermedades crónicas no transmisibles. Por ello, conocer el nivel de actividad física en escolares ostenta gran importancia, puesto que podrían desplegarse acciones para disminuir los alarmantes niveles de sedentarismo, especialmente desde la asignatura de Educación Física. Objetivo Examinar sistemáticamente el nivel de actividad física autoinformado en escolares no exentos de la participación en las sesiones de Educación Física. Método Revisión sistemática de estudios transversales que determinaron el nivel de actividad física autoinformado a través del cuestionario PAQ-C. Resultados Se identificaron 23 artículos mediante la búsqueda en cinco bases de datos distintas, entre 2014 y 2019. Para la selección de los artículos, fue preciso considerar el tipo de estudio y lugar de realización, la fase etaria analizada, así como la no participación en las sesiones de Educación Física. Conclusiones La mayoría de estudios analizados señalan unos niveles insuficientes de la misma; no obstante, resulta necesario llevar a cabo más investigaciones relacionadas con el nivel de actividad física autoinformado, para diagnosticar con mayor precisión la realidad de los niños en edad escolar.

ABSTRACT The present study was focused on assessing the effect of diets formulated with different sources and levels of protein on the production response of white leg shrimp Penaeus vannamei farmed at low salinity (3 g L-1). The protein sources were: soy meal (SM) and fish meal (FM), included at three levels: low (22-25%), medium (32-35%), and high (41-45%). A bioassay of 49 days was done in experimental tanks of 100 L (three tanks per treatment). Juvenile P. vannamei having a mean weight of 1.41 ± 0.30 g were stocked at a density of 100 ind m-3. Shrimp fed diets formulated with FM recorded significantly higher weight gain, specific growth rate (SGR), and protein assimilation efficiency rate (PER). Additionally, it showed a higher concentration of essential amino acids like methionine and threonine, and higher ash, calcium, iodine, phosphorous, and sodium content, which could favor the growth and survival of shrimp. Regression analysis showed that the optimum protein levels for diets formulated with SM and FM were 34.8 and 29.3%, respectively. These findings may help shrimp farmers to implement better feeding strategies for P. vannamei farmed at low salinity and on the use of alternative ingredients to substitute fish meal in the formulated feed.

Abstract Objective: Ventricular fibrillation (VF)-related sudden cardiac death (SCD) is a leading cause of mortality and morbidity. Current biological and imaging parameters show significant limitations on predicting cerebral performance at hospital admission. The AWAKE study (NCT03248557) is a multicentre observational study to validate a model based on spectral ECG analysis to early predict cerebral performance and survival in resuscitated comatose survivors. Methods: Data from VF ECG tracings of patients resuscitated from SCD will be collected using an electronic Case Report Form. Patients can be either comatose (Glasgow Coma Scale GCS --- ≤8) survivors undergoing temperature control after return of spontaneous circulation (RoSC), or those who regain consciousness (GCS = 15) after RoSC; all admitted to Intensive Cardiac Care Units in 4 major university hospitals. VF tracings prior to the first direct current shock will be digitized and analyzed to derive spectral data and feed a predictive model to estimate favorable neurological performance (FNP). The results of the model will be compared to the actual prognosis. Results: The primary clinical outcome is FNP during hospitalization. Patients will be categorized into 4 subsets of neurological prognosis according to the risk score obtained from the predictive model. The secondary clinical outcomes are survival to hospital discharge, and FNP and survival after 6 months of follow-up. The model-derived categorisation will be also compared with clinical variables to assess model sensitivity, specificity, and accuracy. Conclusions: A model based on spectral analysis of VF tracings is a promising tool to obtain early prognostic data after SCD.

Resumen Objetivo: La muerte súbita (MS) por fibrilación ventricular (FV) es una importante causa de morbilidad y mortalidad. Los métodos biológicos y de imagen actuales muestran limitaciones para predecir el pronóstico cerebral al ingreso hospitalario. AWAKE es un estudio observacional, multicéntrico, con el objetivo de validar un modelo basado en el análisis espectral del elec- trocardiograma (ECG), que predice precozmente el pronóstico cerebral y la supervivencia en pacientes resucitados y en estado de coma. Métodos: Se recogerán datos de los ECG con FV de pacientes reanimados de MS. Los pacientes pueden ser tanto supervivientes en estado de coma (Glasgow Coma Scale GCS ≤ 8) sometidos a control de temperatura tras la recuperación de circulación espontánea (RCE), como aquellos que recuperan la consciencia (GCS = 15) tras RCE; todos ellos ingresados en unidades de terapia intensiva cardiológica de 4 hospitales de referencia. Los registros de FV previos al primer choque se digitalizarán y analizarán para obtener datos espectrales que se incluirán en un modelo predictivo que estime el pronóstico neurológico favorable (PNF). El resultado del modelo se comparará con el pronóstico real. Resultados: El objetivo principal es el PNF durante la hospitalización. Los pacientes se categorizarán en 4 subgrupos de pronóstico neurológico según la estimación de riesgo obtenida en el modelo predictivo. Los objetivos secundarios son supervivencia al alta hospitalaria, y PNF y supervivencia a los 6 meses. El resultado de este modelo también se comparará con el pronóstico según variables clínicas. Conclusiones: Un modelo basado en el análisis espectral de registros de FV es una herramienta prometedora para obtener datos pronósticos precoces tras MS por FV.

The quality of dietary fat critically influences health.In this consensus document the scientific evidence relatingeffects of dietary fat quantity and quality on cardiovascularrisk is reviewed and recommendations forthe Spanish adult population are issued. As a novelty innutrition guidelines, emphasis is made more on parentfoods than on fatty acids per se. In summary, replacingsaturated fatty acids (SFA) for monounsaturated fattyacids (MUFA) and polyunsaturated fatty acids (PUFA)reduces cardiovascular risk. Recent data suggest thatSFA proper may be harmful or not depending on the parentfood, a reason why an intake threshold is not established,but consumption of foods containing excess SFA,such as butter, some processed meats, and commercialconfectionery and fried foods is discouraged. The establishedthreshold of 1 % of energy intake as trans FA, well known to be harmful for cardiovascular risk, is fulfilledin Spain due in part to its present low levels in margarines.MUFA are beneficial or neutral for cardiovascularrisk depending on their dietary sources (virgin olive oilversus other fats), and no intake limitations are established.n-6 PUFA are cardioprotective and recommendedintakes (5-10% of energy) are not always fulfilled in theSpanish population, thus increased consumption of theirvegetable food sources (seeds, derived oils, and margarines)is encouraged. Marine n-3 PUFA are also cardioprotectiveand the recommendation stands to eat fatty fish ≥2 servings/weeks to reach intake levels of at least 250 mg/day. Increasing evidence suggests that alpha-linolenicacid (ALA), the vegetable n-3 PUFA, is also cardioprotective,but the parent foods (walnuts, soy products,green-leaf vegetables) may provide benefits beyond ALA itself. Finally, low-fat (high carbohydrate, particularlywhen having a high glycemic index) diets appear tolack cardiovascular preventive effects, while high-fat, high-vegetable fat dietary patterns such as the Mediterraneandiet, are protective, a reason why no upper limiton fat intake is established for the Spanish population. This position statement targets dietitians, nutritionistsand other health professionals involved in dietary counselso they can deliver it rightly and according to the lastscientific evidence.

La calidad de la grasa dietética tiene una profundainfluencia sobre la salud. En este documento de consensose evalúa la evidencia científica relativa a los efectosde la cantidad y calidad de la grasa alimentaria sobrela salud cardiovascular y se emiten recomendacionespara la población española adulta. Como novedad enunas guías nutricionales, se hace menos hincapié en losácidos grasos per se que en los alimentos que los contienen. En resumen, sustituir ácidos grasos saturados (AGS) por monoinsaturados (AGM) y poliinsaturados(AGP) reduce el riesgo cardiovascular. Datos recientessugieren que la ingesta de AGS per se es nociva soloen función del alimento que los contiene, por lo que noparece oportuno establecer un umbral de ingesta, pero se desaconsejan alimentos que los contienen en exceso, como la mantequilla y algunos derivados cárnicos, bollería y fritos comercial 1% de la ingestade energía en forma de AG trans, nocivos para el riesgocardiovascular, se cumple en España en buena parte por su bajo nivel actual en las margarinas. Los AGM son beneficiososo neutros para el riesgo cardiovascular segúnsu fuente dietética (aceite de oliva virgen frente a otrasgrasas), y no se establecen limitaciones de ingesta. LosAGP n-6 son cardioprotectores y el nivel recomendablede ingesta (5-10 % de la energía) no siempre se cumpleen la población española, que debería aumentar el consumode sus fuentes vegetales (semillas, aceites derivadosy margarinas). Los AGP n-3 de origen marino soncardioprotectores y se recomienda consumir pescadograso ≥2 veces/semana para cumplir con la recomendaciónde al menos 250 mg/día. Existen evidencias crecientesde que el ácido alfa-linolénico (ALA), el AGP n-3 de origen vegetal, también es cardioprotector, pero losalimentos que lo contienen (nueces, soja, vegetales dehoja verde) pueden ser beneficiosos más allá del propio ALA. Finalmente, las dietas bajas en grasa (altas en hidratosde carbono, particularmente aquellas con un alto índiceglicémico) carecen de efecto preventivo cardiovascular,mientras que las altas en grasa de origen vegetal, como ladieta mediterránea, son protectoras, razón por la que enEspaña no parece necesario establecer un dintel superiorde ingesta de grasa. Este documento de consenso se dirigea dietistas, nutricionistas y otros profesionales que danconsejo dietético para que puedan hacerlo de una manerarazonada y acorde con la última evidencia científica.

O objetivo desse trabalho é de analisar a relação entre o construto otimista, a síndrome de burnout e o estado de humor em esportistas em situação pré-competitiva. A amostra foi constituída por 227 lutadores que participaram do Campeonato de Espanha de Lutas Olímpicas. Os instrumentos utilizados são o LOT-R adaptação espanhola de Otero, Luengo, Romero, Gómez e Catro (1998) do teste de Scheier e Carver (1985), em sua revisão Scheier, Carver e Bridges (1994) em o Inventário de Burnout para Esportistas (IBD). O IBD é uma adaptação para populações desportivas realizadas por Garcés de Los Fayos (1999) do Maslach Burnout Inventory (Maslach & Jackson, 1981) e o Profile of Mood States (POMS). Para a avaliação dos estados de humor foi aplicado de forma abreviada e adaptada por Fuentes, Balaguer, Meliá e García-Merita (1995), do instrumento original de McNair, Loor e Dropplemam (1971). Os questionários foram administrados durante o Campeonato de Espanha de Lutas Olímpicas, nos escalões Cadete e Sénior. Os resultados indicam uma relação entre otimismo e algumas dimensões do burnout como o esgotamento emocional e a despersonalização, assim como estados de humor como depressão, fadiga e cólera.

The aim of the present study is to analyse the relation between dispositional optimism, burnout syndrome and mood of athletes in a pre-competitive state. The sample was composed by 227 wrestling athletes who were competing in the National Wrestling Championship in Spain. The instruments used for this study were LOT-R a Spanish adaptation of Otero et al. (1998) of the Scheier and Carver (1985) test in the review of Scheier, Carver and Bridges (1994), and the Inventory of Burnout for Athletes (IBD). The IBD is an adaptation designed for populations involved in sports made by Garcés de Los Fayos (1999) of the Maslach Burnout Inventory (Maslach & Jackson, 1981) and the Profile of Mood States (POMS). To evaluate the profile of mood state a reduced and adapted version by Fuentes, Balaguer, Meliá and García-Merita (1995) of the original instrument of McNair, Loor and Dropplemam (1971) was used. The questionnaires were applied during the Wrestling National Championship in Spain, in the cadet and senior categories. The results indicate a relation between optimism and some dimensions of burnout, for example emotional exhaustion and despersonalization. Furthermore optimism was related with moods states like depression, exhaustion and anger.

OBJETIVOS: La citología peritoneal es un método de amplio uso para detectar células atípicas en la cavidad abdominal. El objetivo de este estudio es evaluar el valor pronóstico de la citología peritoneal en el adenocarcinoma del sistema digestivo. MÉTODOS: Se realizó un estudio prospectivo y descriptivo de los pacientes con adenocarcinoma del sistema digestivo tratados quirúrgicamente en el Hospital Militar Dr. Carlos Arvelo de Caracas, entre noviembre de 1999 y mayo de 2001, a un grupo de 41 pacientes se les practicó la citología peritoneal al inicio y final de la intervención quirúrgica. RESULTADOS: Los carcinomas de estómago y colon resultaron los más frecuentes. La sensibilidad y especificidad del método fue de 36,4 % y 71,4 %, respectivamente. Se encontró una relación estadísticamente significativa entre la citología peritoneal positiva y el estadio de la enfermedad (ascitis, metástasis a vísceras e infiltración a órganos adyacentes), así como, en la tasa de sobrevida. La sobrevida en los pacientes con citología negativa a los 23 meses fue de 71,5 %, mientras que en los casos con citología positiva fue de 40,3 % (P= 0,003). CONCLUSIONES: La citología peritoneal en el cáncer del sistema digestivo es un factor pronóstico asociado a la extensión de la enfermedad. La sobrevida obtenida en forma global evidencia una alta mortalidad en los casos de la citología positiva.

OBJECTIVES: The peritoneal cytology is a method of wide use to detect atypical cells in the abdominal cavity. The objective of this study is to evaluate the prognosis value of the peritoneal cytology in adenocarcinoma of the digestive system. METHODS: A prospective and descriptive study of the patients with adenocarcinoma of the digestive system surgically treated was made in Military Hospital Dr. Carlos Arvelo of Caracas, between November of 1999 and May of 2001, to a group of 41 patients one practiced the peritoneal cytology at the beginning and end of the surgical procedure. RESULTS: The carcinomas of stomach and colon were most frequent. The sensitivity and specificity of the method were 36.4 % and 71.4 %, respectively. Was a statistically significant relation between positive the peritoneal cytology and the stage of the disease (ascites, visceral metastasis and infiltration to adjacent organs), as well as, in the survival rate. The survival in the patients with negative cytology to the 23 months of follow-up, was of 71.5 %, whereas in the cases with positive cytology it was of 40.3 % (P= 0.003). CONCLUSIONS: The peritoneal cytology in the cancer of the digestive system is a prognosis factor associated to the extension of the disease. The global survival rate obtained demonstrates the high mortality in the cases of the positive cytology.

A number of recommendations are provided regarding the detection, assessment and management in primary and secondary prevention, approaching hypercholesterolaemia from a multifactorial standpoint based on cardiovascular risk. Cardiovascular diseases are the leading cause of death in Spain. The major risks involved are coronary heart disease and cerebrovascular disease. The demographic, health-related and social impact thereof will be increasing over the coming decades. Controlling hypercholesterolaemia, in conjunction with eradicating the smoking habit and controlling hypertension, diabetes, obesity and physical inactivity comprise one of the main strategies for preventing cardiovascular diseases. Breaking down the risk of individuals based on the major cardiovascular risk factors is essential, given that these factors condition the frequency with which these individuals must be monitored and the type and degree of treatment entailed. Based on this breakdown, the priorities have been set for taking steps to prevent cardiovascular disease. In primary prevention, the therapeutic objective in high-risk persons (20% risk or higher or those persons involving two or more risk factors) has been established as LDL-cholesterol <130 mg/dl. In secondary prevention, drug treatment is indicated when LDL-cholesterol ³130 mg/dl and the therapeutic objective is LDL-cholesterol <100 mg/dl. Those patients having coronary heart disease must be included in secondary prevention programs that will ensure good, constant clinical and risk factor-related control.

Se presentan una serie de recomendaciones sobre detección, evaluación e intervención en prevención primaria y secundaria, abordando la hipercolesterolemia desde una perspectiva multifactorial basada en el riesgo cardiovascular. Las enfermedades cardiovasculares son la primera causa de muerte en España. Dentro de ellas las más importantes son la enfermedad isquémica del corazón y la enfermedad cerebrovascular. Su impacto demográfico, sanitario y social aumentará a lo largo de las próximas décadas. El control de la hipercolesterolemia, junto con la erradicación del tabaquismo y el control de la hipertensión arterial, la diabetes, la obesidad y el sedentarismo, es una de las principales estrategias para prevenir las enfermedades cardiovasculares. La estratificación del riesgo de las personas tomando en consideración los principales factores de riesgo cardiovascular es esencial, ya que condiciona la periodicidad del seguimiento y la modalidad e intensidad del tratamiento. Basándose en esta estratificación se han establecido las prioridades de la actuación preventiva cardiovascular. En prevención primaria, en las personas de riesgo alto (riesgo igual o superior al 20% o las que presentan dos o más factores de riesgo) el objetivo terapéutico se establece en un cLDL inferior a 130 mg/dl. En prevención secundaria el tratamiento farmacológico se instaurará con un cLDL> 130mg/dl y el objetivo terapéutico será cLDL <100mg/dl. Los pacientes con cardiopatía isquémica deben incluirse en programas de prevención secunadria que aseguren, de forma continuada, un buen control clínico y de los factores de riesgo.