Título del artículo:

Evidence of the effectiveness of median nerve glide for treatment of carpal tunnel syndrome

Objective: To determine the effectiveness of the median nerve glide for treatment of carpal tunnel syndrome. Search methods: A systematic review of the CENTRAL, MEDLINE, EMBASE, CINAHL, and PEDro data bases was conducted. The search included randomized, controlled trials with adult patients diagnosed of carpal tunnel syndrome. Studies published from January 2000 to February 2012 were included. Results of the search: Thirteen articles were located and reviewed. Finally, 6 studies that met the inclusion criteria of this study were analyzed. The neural glide techniques, conservative treatments (ultrasound, paraffin, tendon glide) and splinting were compared. Conclusions: There is moderate evidence supporting the use of median nerve glide techniques for the treatment of carpal tunnel syndrome. © 2012 Asociación Española de Fisioterapeutas.

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Fisioterapia

Título del artículo:

Aged garlic extract improves adiponectin levels in subjects with metabolic syndrome: A double-blind, placebo-controlled, randomized, crossover study

Background. Garlic (Allium sativum) has been shown to have important benefits in individuals at high cardiovascular risk. The aim of the present study was to evaluate the effects of the administration of aged garlic extract (AGE) on the risk factors that constitute the cluster of metabolic syndrome (MS). Methods and Design. Double-blind, crossover, randomized, placebo-controlled clinical trial to assess the effect of 1.2 g/day of AGE (Kyolic), for 24 weeks of treatment (12 weeks of AGE and 12 weeks of placebo), on subjects with MS. Results. The administration of AGE increased the plasma levels of adiponectin (P=0.027). No serious side effects associated with the intervention were reported. Conclusion. The present results have shown for the first time that the administration of AGE for 12 weeks increased plasma adiponectin levels in patients with MS. This suggests that AGE might be a useful, novel, nonpharmacological therapeutic intervention to increase adiponectin and to prevent cardiovascular (CV) complications in individuals with MS. © 2013 Diego Gómez-Arbeláez et al.

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Mediators of Inflammation

Título del artículo:

Relationship between the social participation of children with disabilities and the satisfaction of their parents

Objectives: to determine the association between the social participation of the children with disabilities and the satisfaction of their parents with it. Methods: cross-sectional study conducted in eighty 5 to 13 years-old children (9±2.7 years) with disabilities, who lived in the metropolitan area of Bucaramanga and conveniently selected. The life-habit scale assessment was used. Spearman\'s correlation coefficient was estimated (p). Results: the global scoring of social participation was 6±2.3 and of the satisfaction of the parents with their children\'s social participation was 3.6±0.7. The habit with the highest correlation coefficient was communication (p= 0.83) and that with the lowest coefficient was personal relationships (p= 0.44). In the global scoring, very good correlation was found between the social participation and the satisfaction of the parents with this participation (p= 0.82) Conclusions: at the time of putting forward objectives and treatments, both the social participation and the satisfaction of parents with it should be taken into consideration jointly rather than separately.

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Revista Cubana de Pediatria

Título del artículo:

Molecular characterization of cry1, cry2, cry3 y cry4 genes in bacillus thuringiensis isolates and determination of its bioinsecticide activity in Aedes aegypti larvae

Chemical insecticides can be toxic and cause environmental degradation. Therefore, biological control of insects represents an alternative of low ecological impact. Bacillus thuringiensis is a spore-forming Gram-positive bacterium that produces parasporal crystals of a proteic nature, formed by delta endotoxins that are toxic to a large number of insects and are biodegradable and innocuous to other species. In the present work 13 native strains of B. thuringiensis were isolated from soil samples and identified by selective methods and the BBL CRYSTAL method. In the molecular characterization utilizing specific primers for the identification of cry1, cry2, cry3 y cry4 genes, eight isolates presented the cry3 gene and two presented the cry2 gene. These two latter isolates were used in a bioassay on Aedes aegypti larvae to determine their toxic effect, showing that the preliminary toxicity essay of the BtUDES2 isolate presented a lethality of 56.67%. When determining the lethal concentration of this same isolate, an average lethal concentration of 11.4333ng·ml-1 and a total lethal concentration of 17.1542ng·ml-1 were found.

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Interciencia

Título del artículo:

Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome

The present document has been prepared by a group of experts, members of cardiology, endocrinology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of \'metabolic syndrome\' is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that \'metabolic syndrome\' is a useful nosographic entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particularly high-risk population, usually underestimated and undertreated. These recommendations result from presentations and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming knowledge, attitude and behavioural barriers, preventing both physicians and patients from effectively adhering to guideline recommendations. © 2013 Wolters Kluwer Health | Lippincott Williams Wilkins.

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Journal of Hypertension

Título del artículo:

Plants with photosensitizing activity and therapeutic potential in cutaneous leishmaniasis: Hypericin, a promising alternative

Leishmaniasis is a disease endemic to 98 countries, with over 350 million people at risk of acquiring the infection and 12 million people already infected. The numerous disadvantages associated with current treatments encourage a lack of adherence and even abandonment of the disease treatment, resulting in the emergence of drug-resistant strains. These factors have stimulated the search for therapeutic alternatives that are fast, safe, easy to administer and economical. This has resulted in the emergence of ethnobotany, which, along with phototherapy, could become an innovative strategy for finding naturally occurring compounds with leishmanicidal activity. In this context, products such as hypericin could be considered promising candidates in the discovery and development of new treatments. Hypericin is a naturally occurring molecule that has a high quantum yield in its triplet state and efficiently generates reactive oxygen species. These properties could make hypericin an effective leishmanicidal agent when applied over infected tissues and a potential healing agent that provides cosmetic effects favorable to lesion resolution. In addition, its significant advantages in terms of low cost and easy handling make hypericin a favorable alternative to other treatments for managing this disease. © 2013 ACIN.

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Infectio

Título del artículo:

Incretin analogs and inhibitors of DPP-4: Which is their role in the primary prevention of cardiovascular diseases?

Type 2 diabetes mellitus (T2DM) is a highly prevalent disease, which has shown a rapid increase in recent decades, doubling the number of people with this disease. Several epidemiological studies show that 70% of diabetes deaths are caused by cardiovascular events (coronary heart disease and stroke). Recently there has been an expansion in the discovery of drugs for the management of type 2 diabetes. These drugs must demonstrate additional cardiovascular system benefi ts before its introduction in the market. This paper aims to determine the role of new antidiabetic drugs that act on the incretin system and its effects on the primary prevention of cardiovascular events.

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Revista Colombiana de Cardiologia

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Histopathological and immunohistochemical profile in anaplastic gangliogliomas

Background: The anaplastic ganglioglioma (AG) is the high-grade counterpart of ganglioglioma, a rare mixed tumor composed of neuronal/ganglion and glial cells. Materials and methods: We describe the histopathology and immunohistochemistry in 7 cases of AG and correlate them with the clinical and radiological features. Results: Our AG patients correspond to 2.5% of the central nervous system tumor patients evaluated in our institution. The mean age at presentation was 25.7 years, with a male predominance. The most common clinical presentation was generalized tonic-clonic seizures (3/7 cases), in correlation with frequent cortical/subcortical location (6/7 cases). Histopathologically, all our cases showed high-grade features in glial (glial fibrillary acid protein-positive) and neuron-ganglion cells (synaptophysin, PGP-9.5, neurofilament, NSE and CD56-positive), as well as moderate cellularity, frequent mitotic figures and a Ki-67 labeling index >5%. All our patients had poor survival. Conclusion: We found that a typical histopathological and immunohistochemical profile is constant and can be useful in early diagnosis of these aggressive neoplasms. © 2013 Sociedad Española de Neurocirugía.

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Neurocirugia

Título del artículo:

Desmoplastic infantile ganglioglioma with late presentation: A clinical, radiological and histopathological analysis

Desmoplastic infantile ganglioglioma (DIG) is a rare supratentorial tumor in the central nervous system. Definitive diagnosis of this neoplasm is based on histopathologic analysis evaluating distinctive findings such as the fibroblastic differentiation. Here we present a clinical case of DIG with a long follow-up in an eight-year-old boy with a six-month history of recurrent emesis, psychomotor hyperactivity and generalized tonic-clonic seizures. Computed tomography scan and magnetic resonance imaging (MRI) showed a cystic, heterogeneous, mass on the right temporal uncus. A histopathological diagnosis of late presentation DIG was made. We documented the immunohistochemical expression of a molecular soft tissue / muscle differentiation marker (h-CaD) in addition to a low proliferative index (Ki-67) in this case. After surgical intervention, a control MRI showed changes of right frontal-temporal craniotomy and a persistent mass in the anterior and medial temporal lobe with basal extension. Further surgical intervention was performed, completely removing the tumor, which had the same characteristics. The patient is asymptomatic while receiving anticonvulsant therapy (phenytoin) with no evidence of tumor recurrence on MRI after a follow-up of five years. The low grade and soft tissue appearance in images are correlated with the histopathologic and immunohistochemical profile of this tumor, but the rarity of this tumor makes a presumptive diagnosis by images a challenge. The above-mentioned molecular markers or new ones could be used as molecular targets for molecular imaging studies to increase the probability of a pre-operative diagnosis based on molecular features through images.

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Neuroradiology Journal

Título del artículo:

Primary gliosarcoma of the brain: Radiologic and histopathologic features

Gliosarcoma is a rare central nervous system (CNS) neoplasm with biphasic glial and non-glial malignant components. Here we describe the radiologic and histopathologic features observed in five cases of primary gliosarcoma. The mean age at diagnosis in the studied patients was 54.2 years; these patients were predominantly males (male: female ratio = 4:1). At diagnosis all patients had several clinical deterioration. The most common symptoms of presentation were: headache (5/5 cases), seizures (4/5 cases) and hemiparesis (1/5 cases). All the tumors were large (mean major diameter= 4.12±1.64 cm) at diagnosis as evidenced in computer tomography (CT) scans and magnetic resonance images (MRIs), with preferential involvement of the temporal lobe and frequent associated deviation of the midline structures. Other common characteristics identified on CT scans and MRIs were partial contrast medium uptake with annular pattern (5/5 cases), peripheral edema (5/5 cases), and central calcification (3/5 cases). In additional a peak of dye uptake was observed (4/5 cases) on MRI spectrometry. In the histopathology, the glial component showed malignant astrocytes, with high Ki67 (>60%) and p53 positivity; the sarcomatous components displayed pleomorphic spindle cells similarly with p53 positivity and high Ki67 (75-90%) in all cases. Dedifferentiation to pleomorphic sarcoma (two cases), fibrosarcoma (one case), leiomyosarcoma (one case) and MPNST (one case) were documented. All patients received radiotherapy/chemotherapy and had a median overall survival of ten months. The study of radiologic and histopathologic features in primary gliosarcomas of the brain is a priority to achieve early diagnosis that can be translated to better outcomes. Here we describe the radiologic and histopathologic features observed in a group of gliosarcoma patients with variable histopathologic dedifferentiation.

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Neuroradiology Journal

Título del artículo:

Ambulatory monitoring of blood pressure versus measurement in the office what is better: The ideal or the possible well done?

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Revista Colombiana de Cardiologia

Título del artículo:

Characterization of the disability in a sample of children with Cerebral Palsy from Bucaramanga and its metropolitan area, Colombia

Background: The occurrence of CP in industrialized countries ranges from 2 to 2.5 cases for every 1,000 live births, the prevalence of low birth weight, maternal conditions, obstetric and inbreeding have been decisive. This condition leads to limitations and restrictions in different roles an individual can play in society which can be facilitated or inhibited according to the different factors of the context in which it operates, therefore the condition of physical harm has to a disability. Objective. To determine the sociodemographic, neonatal history, disability status and level of gross motor function in children with cerebral palsy 2-12 years of Bucaramanga and its metropolitan area. Material and methods. We performed a cross-sectional study with a sample of 60 participants selected for convenience. The level of gross motor function was assessed using the classification system of the gross motor function (GMFCS). The analysis calculated absolute and relative frequencies. Results. The largest age group was between 6 and 12 years 61.6%, 50% were female and the majority belonged to the socioeconomic stratum 2 (43.3%), representing the lower class stratification as in Colombia; 56, 7% of children lived with both parents, found that 55% of households had >1 y <2 Current legal minimum monthly wage and the health system was the most common tax (65%). According to the classification with GMFCS, we found that 38.3% of children were at level V, 25.0% in Level I, Level IV 16.7%, 13.3% in level III and level II 6.7%. Body structures most affected were the central nervous system with 78.3%, followed by deficiencies in the structures for movement (upper and lower limbs) with 20.0%. Conclusion. It is found that the severity of gross motor function is directly related to functional abilities, the need for elements of support and caregiver.

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Revista Facultad de Medicina

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Association between obesity and low muscular and cardiorespiratory capacity, cardiometabolic risk factors in Colombian children

Objective: To examine the association between cardio respiratory and muscular fitness and the presence of obesity and other cardiovascular and metabolic risk factors in school children. Material and method: Cross-sectional study, conducted in 336 school children (boys and girls) in grade 5° and 6° of public schools in the city of Bucaramanga, Colombia. Results: Significant inverse correlations were found between body mass index (BMI) and grip strength adjusted for weight (-0532) (P <0.001), long jump (-0248) (P <0.001) and Yo-Yo test (-0.321) (P <0.001). The maximum grip strength was correlated inversely with systolic blood pressure (SBP) (-0115) (p <0.05). Conclusion: Obesity assessed by BMI and body fat percent is inversely related with muscular and cardio respiratory fitness in Colombian school children.

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Trauma (Spain)

Título del artículo:

Primary esophageal meningioma: First literature report

We have described a primary esophageal meningioma (MG) clinical case diagnosed in a 62-year-old woman; also, we review the literature about extracranial MGs. To our knowledge, this is the first case report of an extracranial MG occurring primarily in the esophagus. These are benign neoplasms reported classically in the central nervous system (CNS). The extrancranial MGs have histopathologic and inmunohistochemical features identical to those observed in CNS MGs; thus, the main diagnostic hurdle is to keep it in the differential for lesions occurring outside the CNS. © 2013 Lippincott Williams & Wilkins.

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Journal of Clinical Gastroenterology

Título del artículo:

Serological and molecular markers for Hepatitis B virus in university students

Introduction: Reports from the World Health Organization (WHO) show that the prevalence of hepatitis B virus (HBV) infections varies by geographical region and risk group. Purpose: The purpose of this study was to determine the prevalence of HBV infections, as well as the vaccination status, among university students from Bucaramanga. Methodology: This was a cross sectional study conducted in 2010 which included 1298 students from five universities. Serological markers for HBV infection were detected using ELISA. Viral genomes were detected with nested polymerase chain reaction (PCR). Results: Active infections were established in 0.15% of the study population, and this finding was confirmed by PCR. Resolved infections were identified in 0.60% of the population. Isolated anti-HBc antibodies were found, 30.2% of vaccinated individuals. 67.9% of the study population was susceptible. No occult HBV was detected. Conclusions: The low prevalence of HBV infections reported in this study contrasts with the intermediate epidemiological pattern described in the region. We found poor vaccination coverage and absence of occult hepatitis B among these university students. © 2012 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología.

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Revista Colombiana de Gastroenterologia

Título del artículo:

Environmental Profile of a Community\'s Health (EPOCH): An Ecometric Assessment of Measures of the Community Environment Based on Individual Perception

Background: Public health research has turned towards examining upstream, community-level determinants of cardiovascular disease risk factors. Objective measures of the environment, such as those derived from direct observation, and perception-based measures by residents have both been associated with health behaviours. However, current methods are generally limited to objective measures, often derived from administrative data, and few instruments have been evaluated for use in rural areas or in low-income countries. We evaluate the reliability of a quantitative tool designed to capture perceptions of community tobacco, nutrition, and social environments obtained from interviews with residents in communities in 5 countries. Methodology/ Principal Findings: Thirteen measures of the community environment were developed from responses to questionnaire items from 2,360 individuals residing in 84 urban and rural communities in 5 countries (China, India, Brazil, Colombia, and Canada) in the Environmental Profile of a Community\'s Health (EPOCH) study. Reliability and other properties of the community-level measures were assessed using multilevel models. High reliability (>0.80) was demonstrated for all community-level measures at the mean number of survey respondents per community (n = 28 respondents). Questionnaire items included in each scale were found to represent a common latent factor at the community level in multilevel factor analysis models. Conclusions/ Significance: Reliable measures which represent aspects of communities potentially related to cardiovascular disease (CVD)/risk factors can be obtained using feasible sample sizes. The EPOCH instrument is suitable for use in different settings to explore upstream determinants of CVD/risk factors. © 2012 Corsi et al.

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PLoS ONE

Título del artículo:

Risk factors for preeclampsia in women from Colombia: A case-control study

Background: Preeclampsia (PE) is a multi-causal disease characterized by the development of hypertension and proteinuria in the second half of pregnancy. Multiple risk factors have been associated with the development of PE. Moreover, it is known that these risk factors vary between populations from developed and developing countries. The aim of this study is to identify which risk factors are associated with the development of preeclampsia (PE) among Colombian women. Methods: A multi-centre case-control study was conducted between September 2006 and July 2009 in six Colombian cities. Cases included women with PE (n = 201); controls were aged-matched pregnant women (n = 201) without cardiovascular or endocrine diseases for a case-control ratio of 1:1. A complete medical chart, physical examination and biochemical analysis were completed before delivery. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) of potential risk factors associated with PE. Results: The presence of factors present in the metabolic syndrome cluster such as body mass index >31 Kg/m2 (OR = 2.18; 1.14-4.14 95% CI), high-density lipoprotein <1.24 mmol/L (OR = 2.42; 1.53-3.84 95% CI), triglycerides >3.24 mmol/L (OR = 1.60; 1.04-2.48 95% CI) and glycemia >4.9 mmol/L (OR = 2.66; 1.47-4.81 95%CI) as well as being primigravidae (OR = 1.71; 1.07-2.73 95% CI) were associated with the development of PE, after adjusting for other variables. Conclusion: Factors present in the cluster of metabolic syndrome and primigravidity were associated with a greater risk of PE among Colombian women. Understanding the role of this cluster of risk factors in the development of PE is of crucial importance to prevent PE and remains to be determined. © 2012 Reyes et al.

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PLoS ONE

Título del artículo:

Angiogenic imbalance and plasma lipid alterations in women with preeclampsia from a developing country

Background: An imbalance between anti-angiogenic factors (e.g. soluble vascular endothelial growth factor receptor-1 (s-FLT1) and soluble endoglin (s-Eng)) and pro-angiogenic factors (e.g. placental growth factor (PlGF)) as well as increased oxidized low-density lipoprotein (ox-LDL) concentrations have been associated with preeclampsia (PE). Risk factors associated with the development of PE, however, are known to be different between developed and developing countries. The aim of the study was to determine the levels of s-FLT1, s-Eng, PIGF, and ox-LDL in women with PE from a developing country. Methods: A multi-center casecontrol study was conducted. One hundred and forty three women with PE were matched by age and parity with 143 healthy pregnant women without cardiovascular or endocrine diseases. Before delivery, blood samples were taken and serum was stored until analysis. Results: Women with PE had lower concentrations of PIGF (p < 0.0001) and higher concentrations of s-Eng (p = 0.001) than healthy pregnant women. There were no differences between the groups regarding ox-LDL or s-FLT1. Women with early onset PE had higher s-FLT1 concentrations (p = 0.0004) and lower PIGF concentrations (p < 0.0001) than their healthy pregnant controls. Women with late onset PE had higher concentrations of s-Eng (p = 0.005). Women with severe PE had higher concentrations of s-Eng (p = 0.0008) and ox-LDL (p = 0.01), and lower concentrations of PIGF (p < 0.0001). Conclusions: Women with PE from a developing country demonstrated an angiogenic imbalance and an increased rate of LDL oxidation. Findings from this study support the theory that PE is a multifactorial disease, and understanding differences in these subpopulations may provide a better target to approach future therapies. © 2012 Informa UK, Ltd.

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Growth Factors

Título del artículo:

Is the angioimmunoblastic T-Cell lymphoma beneficial to avoid CD4 ⁺ lymphopenia and other AIDS manifestations in patients infected with human immunodeficiency virus?

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Clinical Lymphoma, Myeloma and Leukemia

Título del artículo:

Nutritional status among women with pre-eclampsia and healthy pregnant and non-pregnant women in a Latin American country

Aims: Pre-eclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. It has been proposed that, among other risk factors, the nutritional status of women can lead to the endothelial dysfunction that characterizes this entity. The aim of the present study was to compare the nutritional status of women with PE with healthy pregnant and non-pregnant women. Material and Methods: A multicenter case-control study was carried out. Between September 2006 and July 2009, 201 women with PE were compared with 201 pregnant, and 201 non-pregnant aged-matched women without cardiovascular or endocrine diseases. A clinical history and physical examination was performed. Fasting blood samples were drawn to measure serum glucose and lipid profile. The nutritional status of participants was assessed using a food frequency questionnaire. Results: The average age of womenwas 26.6 ± 7.2 years. Compared to healthy pregnant controls, women with PE had a higher body mass index, higher fasting blood glucose levels, higher triglycerides, and lower high-density lipoprotein cholesterol levels. Women with PE had a higher intake of carbohydrates, energy intake and cereal compared to healthy pregnant and non-pregnant controls. A conditional logistic regression demonstrated that carbohydrate and sodium intake are associated with PE development. Conclusions: Diets of women with PE were characterized by higher energy and carbohydrate intake compared to normal pregnant and non-pregnant women. This suggests that higher carbohydrate and sodium intake increases the risk of PE among women in Colombia. © 2012 Japan Society of Obstetrics and Gynecology.

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Journal of Obstetrics and Gynaecology Research

Título del artículo:

Complex choristoma of the lacrimal caruncle: A case report of an unusual congenital tumor with clinical and histopathological classification

Rare congenital tumors can be localized in the peribulbar area. Here we report an unusual case presented in a 3-year-old child with a history of a congenital tumor in the lacrimal caruncle of the right eye, associated with epiphora and constant discomfort. A surgical resection was performed, and the final histopathological diagnosis was lacrimal caruncle complex choristoma. Choristomas are growths of apparently normal tissue in an abnormal location, which can be situated anywhere in the body, including ocular and peribulbar structures. These almost unknown congenital tumors constitute the most common conjunctival tumors in children and can be interpreted clinically as different lesions, which are only differentiated through precise histopathological analysis. © 2012 Springer Science+Business Media B.V.

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International Ophthalmology

Título del artículo:

Integral Care Guidelines for the prevention, early detection and treatment of pregnancy, partum and puerperium complications: Section on toxoplasmosis in pregnancy

Toxoplasma infection was selected for the development of recommendations for its prevention, diagnosis and therapy as a part of the clinical practice guideline for the prevention, early detection and treatment of the complications of pregnancy, developed y sponsored by the Department of Science, Technology and Innovation, Colciencias and Health and Social Protection Ministry of Health in Colombia. Infection by Toxoplasma gondii that occurs during pregnancy may end up in serious complications for the fetus and important sequelae for the newborn. A clinical guideline based on the best available scientific evidence, with emphasis on Colombian references, was performed. Experts on parasitology, neonatology and infectious diseases (adult and pediatric) developed the recommendations. Recommendations are proposed to be followed by healthcare professionals in pregnancy care programs all around the country, with the aim of lowering the morbidity and mortality related to this disease. Specific recommendations for the diagnosis starting in first trimester of the pregnancy, recommendations for prevention in women not infected with the parasite, identification of infection in the fetus or the newborn and recommendations for treatment in those settings are done. © 2012 ACIN.

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Infectio

Título del artículo:

The influence of cardiac rehabilitation on acute myocardial infarction patients\' readmission rate in Santander, Colombia

Objective Estimating the effect of post-infarction cardiac rehabilitation (CR) on readmission/re-hospitalization rates according to intervention level. Method This was a prospective cohort study of patients diagnosed as suffering acute myocardial infarction (AMI). Data concerning infarction severity, previous illness, medical history, hospital course, Killip classification, length of hospital stay and condition on discharge. Medical records and telephone contact were used to confirm whether a patient had received CR and ascertain pertinent components. Follow-up was extended to one year. Results 96 AMI patients of both genders were included; information about CR was available for 72 of them,5 of whom had received CR based only on physical activity. 49 patients received complete CR based on education, physical activity, psychological and nutritional assessment. 18 patients had not received CR. One death and 10 new admissions/hospitalizations were recorded during follow-up. A Poisson regression model showed that patients who had received CR based only on physical activity presented significantly higher re-hospitalization rates than patients who had received a complete CR scheme (rate ratio 5.89:1.14-30.4995 % CI; p=0.04). Conclusions A multidisciplinary approach must bead opted to CR involving physical activity, education and psychological and nutritional assessment.

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Revista de Salud Publica

Título del artículo:

Prevalence and characterization of the population in condition of disability in los santos (Santander, Colombia), 2011

Objective: To determine the prevalence and characterize the condition of disabled people in the municipality Los Santos, Santander in 2010 and 2011. Materials and methods: A descriptive study was conducted using the tool of record \"Survey of Persons with Disabilities and its attendant\". Physiotherapy and bacteriology students from University of Santander (UDES), previously trained, collected the information by interview. We use descriptive statistics applying central tendency measures and absolute and relative frequencies. Results: We found 108 people with disabilities; the prevalence of disability in this population was 1.3% (95% CI 1.1 -1.6), the place with the highest prevalence was Los Teres (9.4%; 95% CI 5.1-15.5). Of the 108 disabled people, 48% were female and 47.2% were between 15 and 44 years old. The body structure more impairment was nervous system with a 64.8% and general tasks and demands were the most affected (57.4%). Problems with services, transport systems and policies, social security, health, and education were the main facilitator (57.4%). Conclusion: Disability as a public health problem affecting the activities, participation and performance of the people with disabilities decreasing their individual development and opportunities for integration into society.

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Salud Uninorte

Título del artículo:

Fibromyalgia is characterized by altered frontal and cerebellar structural covariance brain networks

Altered brain morphometry has been widely acknowledged in chronic pain, and recent studies have implicated altered network dynamics, as opposed to properties of individual brain regions, in supporting persistent pain. Structural covariance analysis determines the inter-regional association in morphological metrics, such as gray matter volume, and such structural associations may be altered in chronic pain. In this study, voxel-based morphometry structural covariance networks were compared between fibromyalgia patients (N = 42) and age- and sex-matched pain-free adults (N = 63). We investigated network topology using spectral partitioning, which can delineate local network submodules with consistent structural covariance. We also explored white matter connectivity between regions comprising these submodules and evaluated the association between probabilistic white matter tractography and pain-relevant clinical metrics. Our structural covariance network analysis noted more connections within the cerebellum for fibromyalgia patients, and more connections in the frontal lobe for healthy controls. For fibromyalgia patients, spectral partitioning identified a distinct submodule with cerebellar connections to medial prefrontal and temporal and right inferior parietal lobes, whose gray matter volume was associated with the severity of depression in these patients. Volume for a submodule encompassing lateral orbitofrontal, inferior frontal, postcentral, lateral temporal, and insular cortices was correlated with evoked pain sensitivity. Additionally, the number of white matter fibers between specific submodule regions was also associated with measures of evoked pain sensitivity and clinical pain interference. Hence, altered gray and white matter morphometry in cerebellar and frontal cortical regions may contribute to, or result from, pain-relevant dysfunction in chronic pain patients.

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NeuroImage: Clinical