Herramientas de Accesibilidad
Objective: To evaluate the effects of a program of functional muscles core training targeting women with fibromyalgia. Materials and methods: A quasi-experimental type trial was conducted, before and after an intervention, for 20 days, often three days/week, 60 minutes each session. In a single-group of eight women, changes in muscle strength, pain, quality of life related to health and physical activity were evaluated. Results: An increase in repetitions of the test trunk fexion, time on the left and right bridge testing lateral and prone bridge the test were found. All features of pain decreased, and, according to the S-FIQ, a decrease in morning fatigue, stiffness and anxiety was reported. Also Met’s/minute-weeks increased after intervention. Conclusion: These data suggest that functional program core muscle training is effective in increasing muscle strength, pain modulation, functional performance optimization, and increased levels of physical activity in women with fibromyalgia.
Revista Ciencias de la Salud
Objective: To determine the association between quality of life health-related (HRQL) and urinary incontinence (UI) in a population of overweight women in the urban area of Bucaramanga, Colombia. Materials and methods: An analytic cross-sectional study was conducted in March and May 2012. The sample consisted of 63 randomly selected women; median age was 46 years with a minimum of 18 and maximum of 65 years, 76% were overweight, and 24% obese. We assessed the HRQL with the SF-36 questionnaire and lower urinary tract symptoms quality of life questionnaire (ICIQ-FLUTSqol). Urinary incontinence was assessed using the International Consultation on Incontinence questionnaire, short form (ICIQ-IU Short Form). Results: The overall prevalence of UI was 39.7%; 28.6% was Stress UI, mixed UI 11.1%. There were no statistically signifcant differences in the eight dimensions of SF-36 in women with and without UI. The dimension with lowest score in women with IU was Energy-Fatigue (63.4). The HRQL scores assessed with ICIQ-FLUTSqol questionnaire was 27 with a minimum of 20 and a maximum of 55. Conclusion: In women with overweight, we do not found statistically signifcant differences in the eight dimensions of HR-QOL when comparing women with and without UI.
Revista Ciencias de la Salud
Introduction: Chronic hepatitis B virus (HBV) infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission. Objectives: Our aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI) among patients infected with HIV in a northeastern Colombian city. Methods: A cross-sectional study was conducted with 275 HIV-positive patients attending an outpatient clinic in Bucaramanga, Colombia during 2009-2010. Blood samples were collected and screened for serological markers of HBV (anti-HBs, anti-HBc and HBsAg) through ELISA assay. Regardless of their serological profile, all samples were tested for the HBV S gene by nested-PCR and HBV genotypes were determined by phylogenetic inference. Clinical records were used to examine demographic, clinical, virological, immunological and antiretroviral therapy (ART) variables of HIV infection. Results: Participants were on average 37±11 years old and 65.1% male. The prevalence of HIV-HBV coinfection was 12% (95%CI 8.4-16.4) of which 3.3% had active HBV infection and 8.7% OBI. The prevalence of HIV-HBV coinfection was associated with AIDS stage and ART treatment. Sequence analysis identified genotype F, subgenotype F3 in 93.8% of patients and genotype A in 6.2% of patients. A C149R mutation, which may have resulted from failure in HBsAg detection, was found in one patient with OBI. Conclusions: The present study found a high prevalence of HIV-HBV coinfection with an incidence of OBI 2.6-fold higher compared to active HBV infection. These findings suggest including HBV DNA testing to detect OBI in addition to screening for HBV serological markers in HIV patients.
PLoS ONE
Background: Wrestling was an important part of the ancient Olympic Games and is still one of the most popular events of the modern Olympic Games. Studies indicate that general physiologic profile of successful wrestlers is high anaerobic power and capacity, muscular strength, above average aerobic power, exceptional flexibility, fat free mass, and a mesomorphic somatotype. Objectives: The objective of the present study was to evaluate anthropometric characteristics and physical performance of elite male wrestlers. Patients and Methods: The Colombian Wrestling Team was evaluated while in preparation for the Olympic Games (n = 21; age, 27.9 ± 6.7 years). Athletes were tested on anthropometric and fitness parameters: body composition, somatotype distribution according to Heath-Carter, aerobic capacity, vertical jump, and anaerobic power. Results: The evaluations showed a mean body fat percentage of 13.6% ± 3.0% (95% CI, 12.2%-15%), muscle mass of 46.4% ± 2.2% (95% CI, 45.4%-47.4%), Ponderal index of 41.0 ± 1.8 (95% CI, 40.2-41.8), body adiposity index (BAI) 25.1 ± 3.6 (95% CI, 23.5-26.8), and somatotype distribution mesomorphic-ectomorph (5.3-1.6-3.8). Mean aerobic capacity was 45.9 ± 6.6 mL/kg/min (95% CI, 42.8-48.9), vertical jump was 36.4 ± 6.6 cm (95% CI, 11.8-16.6), and anaerobic power was 92.6 ± 19.5 kg/s (95% CI, 83.7-101.5). Conclusions: These results provided a profile of elite wrestlers that could be used as training targets for developing athletes. The results may also provide information for training and tactical planning.
Asian Journal of Sports Medicine
The FIFA 11+ is a simple, and easy to implement, sports injury prevention program comprising a warm up of 10 conditioning exercises. The aim of this systematic review was to evaluate the impact of the FIFA 11+ on injury incidence, compliance and cost effectiveness when implemented among football players. MEDLINE, EMBASE and Scopus databases were searched using the search terms “FIFA 11+”, “football”, “soccer”, “injury prevention”, and “The 11”. The titles and abstracts were screened by two independent reviewers and the data were filtered by one reviewer using a standardized extraction form and thereafter checked by another one. The risk of bias and the methodological quality of the studies were evaluated through the PEDro score and Critical Appraisal Skills Programme (CASP). A total of 911 studies were identified, of which 12 met the inclusion criteria of the review. The FIFA 11+ has demonstrated how a simpleexercise program completed as part of warm-up can decrease the incidence of injuries in amateur footba players. In general, considerable reductions in the number of injured players, ranging between 30% and 70%, have been observed among the teams that implemented the FIFA 11+. In addition, players with high compliance to the FIFA 11+ program had an estimated risk reduction of all injuries by 35% and show significant improvements in components of neuromuscular and motor performance when participating in structured warm-up sessions at least 1.5 times/week. Most studies had high methodological quality and a low risk of bias. Given the large number of people who play football at amateur level and the detrimental impact of sports injuries on a personal and societal level, the FIFA 11+ can be considered as a fundamental tool to minimize the risks of participation in a sport with substantial health benefits.
International Journal of Environmental Research and Public Health
Background: Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used to study communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluate features of the built environment of communities using a standard set of photos. In this report we describe the method of photo collection, photo analysis instrument development and inter-rater reliability of the instrument. Methods/Principal Findings: A minimum of 5 photos were taken per community in 86 communities in 5 countries according to a standard set of instructions from a designated central point of each community by researchers at each site. A standard pro forma derived from reviewing existing instruments to assess the built environment was developed and used to score the characteristics of each community. Photo sets from each community were assessed independently by three observers in the central research office according to the pro forma and the inter-rater reliability was compared by intra-class correlation (ICC). Overall 87% (53 of 60) items had an ICC of≥0.70, 7% (4 of 60) had an ICC between 0.60 and 0.70 and 5% (3 of 60) items had an ICC ≤0.50. Conclusions/Significance: Analysis of photos using a standardized protocol as described in this study offers a means to obtain reliable and reproducible information on the built environment in communities in very diverse locations around the world. The collection of the photographic data required minimal training and the analysis demonstrated high reliability for the majority of items of interest.
PLoS ONE
BACKGROUND: More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. METHODS: We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater risk-factor burden). Participants were followed for incident cardiovascular disease and death for a mean of 4.1 years. RESULTS: The mean INTERHEART Risk Score was highest in high-income countries, intermediate in middle-income countries, and lowest in low-income countries (P<0.001). However, the rates of major cardiovascular events (death from cardiovascular causes, myocardial infarction, stroke, or heart failure) were lower in high-income countries than in middle- and low-income countries (3.99 events per 1000 person-years vs. 5.38 and 6.43 events per 1000 person-years, respectively; P<0.001). Case fatality rates were also lowest in high-income countries (6.5%, 15.9%, and 17.3% in high-, middle-, and low-income countries, respectively; P = 0.01). Urban communities had a higher risk-factor burden than rural communities but lower rates of cardiovascular events (4.83 vs. 6.25 events per 1000 person-years, P<0.001) and case fatality rates (13.52% vs. 17.25%, P<0.001). The use of preventive medications and revascularization procedures was significantly more common in high-income countries than in middle- or low-income countries (P<0.001). CONCLUSIONS: Although the risk-factor burden was lowest in low-income countries, the rates of major cardiovascular disease and death were substantially higher in low-income countries than in high-income countries. The high burden of risk factors in high-income countries may have been mitigated by better control of risk factors and more frequent use of proven pharmacologic therapies and revascularization. Copyright © 2014 Massachusetts Medical Society.
New England Journal of Medicine
BACKGROUND: Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown. METHODS: We studied 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen and were used as surrogates for intake. We assessed the relationship between electrolyte excretion and blood pressure, as measured with an automated device. RESULTS: Regression analyses showed increments of 2.11 mm Hg in systolic blood pressure and 0.78 mm Hg in diastolic blood pressure for each 1-g increment in estimated sodium excretion. The slope of this association was steeper with higher sodium intake (an increment of 2.58 mm Hg in systolic blood pressure per gram for sodium excretion >5 g per day, 1.74 mm Hg per gram for 3 to 5 g per day, and 0.74 mm Hg per gram for <3 g per day; P<0.001 for interaction). The slope of association was steeper for persons with hypertension (2.49 mm Hg per gram) than for those without hypertension (1.30 mm Hg per gram, P<0.001 for interaction) and was steeper with increased age (2.97 mm Hg per gram at >55 years of age, 2.43 mm Hg per gram at 45 to 55 years of age, and 1.96 mm Hg per gram at <45 years of age; P<0.001 for interaction). Potassium excretion was inversely associated with systolic blood pressure, with a steeper slope of association for persons with hypertension than for those without it (P<0.001) and a steeper slope with increased age (P<0.001). CONCLUSIONS: In this study, the association of estimated intake of sodium and potassium, as determined from measurements of excretion of these cations, with blood pressure was nonlinear and was most pronounced in persons consuming high-sodium diets, persons with hypertension, and older persons. Copyright © 2014 Massachusetts Medical Society.
New England Journal of Medicine
BACKGROUND: The optimal range of sodium intake for cardiovascular health is controversial. METHODS: We obtained morning fasting urine samples from 101,945 persons in 17 countries and estimated 24-hour sodium and potassium excretion (used as a surrogate for intake). We examined the association between estimated urinary sodium and potassium excretion and the composite outcome of death and major cardiovascular events. RESULTS: The mean estimated sodium and potassium excretion was 4.93 g per day and 2.12 g per day, respectively. With a mean follow-up of 3.7 years, the composite outcome occurred in 3317 participants (3.3%). As compared with an estimated sodium excretion of 4.00 to 5.99 g per day (reference range), a higher estimated sodium excretion (≥7.00 g per day) was associated with an increased risk of the composite outcome (odds ratio, 1.15; 95% confidence interval [CI], 1.02 to 1.30), as well as increased risks of death and major cardiovascular events considered separately. The association between a high estimated sodium excretion and the composite outcome was strongest among participants with hypertension (P=0.02 for interaction), with an increased risk at an estimated sodium excretion of 6.00 g or more per day. As compared with the reference range, an estimated sodium excretion that was below 3.00 g per day was also associated with an increased risk of the composite outcome (odds ratio, 1.27; 95% CI, 1.12 to 1.44). As compared with an estimated potassium excretion that was less than 1.50 g per day, higher potassium excretion was associated with a reduced risk of the composite outcome. CONCLUSIONS: In this study in which sodium intake was estimated on the basis of measured urinary excretion, an estimated sodium intake between 3 g per day and 6 g per day was associated with a lower risk of death and cardiovascular events than was either a higher or lower estimated level of intake. As compared with an estimated potassium excretion that was less than 1.50 g per day, higher potassium excretion was associated with a lower risk of death and cardiovascular events. Copyright © 2014 Massachusetts Medical Society.
New England Journal of Medicine
International Journal of Cardiology
The aim of this study was to determine if month of birth affects performance in 3 tests of physical function in children and adolescents. We measured cardiorespiratory fitness, handgrip strength and lower-body power expressed them relative to (whole year) age then compared scores between calendar year birth-months. We also expressed test performance as the likelihood of achieving criterion-referenced fitness standards. There were significant main effects of birth-month for cardiorespiratory fitness (F=4.54, p<0.001), strength (F=6.81, p<0.001) and power (F=3.67, p<0.001). Children born in November were fitter and more powerful than those born at other times, particularly the summer months (April, May and June). October-born children were stronger than those born in all months except September and November. This relationship was evident despite controlling for decimal age and despite no significant inter-month differences in anthropometric characteristics. There is a clear physical advantage for those born in the autumn and this may explain some of the bias in sports selection attributed to the relative age effect, particularly when the British school-year (September) cut-off is used.
International Journal of Sports Medicine
Objectives A widely publicized study by Stamps, Bartoshuk and Heilman (2013) reported that a simple measure of left:right naris differences in the ability to detect the odor of peanut butter is a sensitive marker of Alzheimer\'s disease (AD). AD patients were said to have abnormal smell function on the left side of the nose and normal function on right side of the nose. In light of its implications for medical practice and the world-wide publicity that it engendered, we sought to replicate and expand this work. Methods Two studies were performed. In the first, 15 AD patients were tested according to the procedures described by Stamps et al. in which the nostril contralateral to the tested side was occluded by the patient using lateral pressure from the index finger. Since this can potentially distort the contralateral naris, we repeated the testing using tape for naris occlusion. In the second, 20 AD patients were administered 20 odors of the University of Pennsylvania Smell Identification Test (UPSIT) to each side of the nose, with the contralateral naris being closed with tape. In both studies, the order of the side of testing was systematically counterbalanced. Results No evidence of a left:right asymmetry on any test measure was observed. Conclusion Although hyposmia is well-established in AD, no meaningful asymmetry in smell perception is apparent. If olfactory function on the right side of the nose was normal as claimed, then AD patients should exhibit normal function when tested bilaterally, a phenomenon not seen in dozens of AD-related olfactory studies. © 2014 Elsevier B.V. All rights reserved.
Journal of the Neurological Sciences
Purpose: In youth, poor cardiorespiratory and muscular strength are associated with elevated metabolic risk factors. However, studies examining associations between strength and risk factors have been done exclusively in high income countries, and largely in Caucasian cohorts. The aim of this study was to assess these interactions in schoolchildren in Colombia, a middle income Latin American country. Methods: We measured body mass index, body composition, handgrip strength (HG), cardiorespiratory fitness (CRF) and metabolic risk factors in 669 low-middle socioeconomic status Colombian schoolchildren (mean age 11.52±1.13, 47% female). Associations between HG, CRF and metabolic risk factors were evaluated. Results: HG and CRF were inversely associated with blood pressure, HOMA index and a composite metabolic risk score (p<0.001 for all) and HG was also inversely associated with triglycerides and C-reactive protein (CRP) (both p<0.05). Associations between HG and risk factors were marginally weakened after adjusting for CRF, while associations between CRF and these factors were substantially weakened after adjusting for HG. Linear regression analyses showed inverse associations between HG and systolic BP (β = -0.101; p = 0.047), diastolic BP (β = -0.241; p> = 0.001), HOMA (β = -0.164; p = 0.005), triglycerides (β = -0.583; p = 0.026) and CRP (β = -0.183; p = 0.037) but not glucose (p = 0.698) or HDL cholesterol (p = 0.132). The odds ratios for having clustered risk in the weakest quartile compared with the strongest quartile were 3.0 (95% confidence interval: 1.81-4.95). Conclusions: In Colombian schoolchildren both poorer handgrip strength/kg body mass and cardiorespiratory fitness were associated with a worse metabolic risk profile. Associations were stronger and more consistent between handgrip and risk factors than between cardiorespiratory fitness and these risk factors. Our findings indicate the addition of handgrip dynamometry to non-invasive youth health surveillance programs would improve the accuracy of the assessment of cardiometabolic health. © 2014 Cohen et al.
PLoS ONE
The recent Latin American and European guidelines published this year has proposed as a goal for blood pressure control in patients with diabetes type 2 a value similar or inferior to 140/90 mmHg. High blood pressure is the leading cause of cardiovascular diseases and deaths globally. Although once hypertension is detected, 80% of individuals are on a pharmacologic therapy only a minority is controlled. Diabetes also is a risk factor for other serious chronic diseases, including cardiovascular disease. Whether specifically targeting lower fasting glucose levels can reduce cardiovascular outcomes remains unknown. Hypertension is present in 20% to 60% of patients with type 2 diabetes, depending on age, ethnicity, obesity, and the presence of micro or macro albuminuria. High blood pressure substantially increases the risk of both macro and micro vascular complications, doubling the risk of all-cause mortality and stroke, tripling the risk of coronary heart disease and significantly hastening the progression of diabetic nephropathy, retinopathy, and neuropathy. Thus, blood pressure lowering is a major priority in preventing cardiovascular and renal events in patients with diabetes and hypertension. During many years the BP goals recommended in patients with diabetes were more aggressive than in patients without diabetes. As reviewed in this article many clinical trials have demonstrated not only the lack of benefits of lowering the BP below 130/80 mmHg, but also the J-shaped relationship in DM patients. Overall we discuss the importance of define the group of patients in whom significant BP reduction could be particularly dangerous and, on the other hand, those with a high risk of stroke who could benefit most from an intensive hypotensive therapy. In any case, the big challenge now is avoid the therapeutic inertia (leaving diabetic patients with BP values of 140/90 mmHg or higher) at all costs, as this would lead to an unacceptable toll in terms of human lives, suffering, and socioeconomic costs. © 2014 Lopez-Jaramillo et al.; licensee BioMed Central Ltd.
Diabetology and Metabolic Syndrome
Background: Household devices (e.g., television, car, computer) are common in high income countries, and their use has been linked to obesity and type 2 diabetes mellitus. We hypothesized that device ownership is associated with obesity and diabetes and that these effects are explained through reduced physical activity, increased sitting time and increased energy intake. Methods: We performed a cross-sectional analysis using data from the Prospective Urban Rural Epidemiology study involving 153 996 adults from high, upper-middle, lower-middle and low income countries. We used multilevel regression models to account for clustering at the community and country levels. Results: Ownership of a household device increased from low to high income countries (4% to 83% for all 3 devices) and was associated with decreased physical activity and increased sitting, dietary energy intake, body mass index and waist circumference. There was an increased odds of obesity and diabetes with the ownership of any 1 household device compared to no device ownership (obesity: odds ratio [OR] 1.43, 95% confidence interval [CI] 1.32-1.55; diabetes: OR 1.38, 95% CI 1.28-1.50). Ownership of a second device increased the odds further but ownership of a third device did not. Subsequent adjustment for lifestyle factors modestly attenuated these associations. Of the 3 devices, ownership of a television had the strongest association with obesity (OR 1.39, 95% CI 1.29- 1.49) and diabetes (OR 1.33, 95% CI 1.23-1.44). When stratified by country income level, the odds of obesity and diabetes when owning all 3 devices was greatest in low income countries (obesity: OR 3.15, 95% CI 2.33-4.25; diabetes: OR 1.97, 95% CI 1.53-2.53) and decreased through country income levels such that we did not detect an association in high income countries. Interpretation: The ownership of household devices increased the likelihood of obesity and diabetes, and this was mediated in part by effects on physical activity, sitting time and dietary energy intake. With increasing ownership of household devices in developing countries, societal interventions are needed to mitigate their effects on poor health. © 2014 Canadian Medical Association or its licensors.
CMAJ. Canadian Medical Association Journal
The present document has been prepared by a group of experts, members of Cardiology, Endocrinology, Internal Medicine, Nephrology 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 useful nosography 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 particular high- risk population, usually underestimated and undertreated. These recommendations results from presentation 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 both physicians and patients from effectively adhering to guideline recommendations. © 2013 Elsevier España, S.L. y SEA.
Clinica e Investigacion en Arteriosclerosis
The diagnosis of animal trypanosomiasis in field samples is currently based on clinical suspicion and less frequently on traditional parasitological methods characterized by their very low sensitivity, especially in the sub-acute and chronic phase of the infection. Molecular tools such as Polymerase Chain Reaction have been shown to reach the highest sensitivity percentages, but without good resolution for all of the South American circulating species (T. vivax, T. evansi and T. theileri) or with specificity for only one of these species. In this study, a new PCR-RFLP for species-specific diagnosis of Trypanosomiasis is presented. This method displayed good resolution, sensitivity and specificity for differentiation of the three aforementioned species identified from naturally infected Colombian bovines and water buffaloes. In addition, epidemiological and clinical data were also collected and analyzed from the sampled animals and significant associations were identified. © 2014 Science Publication.
American Journal of Animal and Veterinary Sciences
Background: The current \"epidemic\" of childhood obesity is described as being driven by modern lifestyles with associated socioeconomic and environmental changes that modify dietary habits, discourage physical activity and encourage sedentary behaviors. Objective: To evaluate the association between household income and the availability of electronic devices and transport at home, and the values of waist circumference (WC), as an indicator of abdominal obesity, in children and adolescents from Bucaramanga, Colombia. Methods: Cross-sectional study of public elementary and high school population, of low-middle socioeconomic status. Results: A total of 668 schoolchildren were recruited. After adjusting for potential confounders, significant positive associations between waist circumference and higher household income (p = 0.011), and waist circumference and the availability of electronic devices and transport at home (p = 0.026) were found. Conclusions: In low-middle socioeconomic status schoolchildren in a developing country, those from relatively more affluent families had greater waist circumference, an association that is opposite to that observed in developed countries. This finding could be related to higher income family\'s ability to purchase electronic devices and motorized transport which discourage physical activity and for their children to buy desirable and more costly western fast food. © 2014 by the authors; licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research and Public Health
Global Health Perspectives in Prediabetes and Diabetes Prevention
The metabolic syndrome comprises a cluster of cardiometabolic risk factors, with insulin resistance and adiposity as its central features. Identifying individuals with metabolic syndrome is important due to its association with an increased risk of coronary heart disease and type 2 diabetes mellitus. Attention has focused on the visceral adipose tissue production of cytokines (adipokines) in metabolic syndrome and type 2 diabetes mellitus, as the levels of the anti-inflammatory adipokine adiponectin are decreased, while proinflammatory cytokines are elevated, creating a proinflammatory state associated with insulin resistance and endothelial dysfunction. In this review, we will give special attention to the role of the leptin/adiponectin ratio. We have previously demonstrated that in individuals with severe coronary artery disease, abdominal obesity was uniquely related to decreased plasma concentrations of adiponectin and increased leptin levels. Leptin/adiponectin imbalance was associated with increased waist circumference and a decreased vascular response to acetylcholine and increased vasoconstriction due to angiotensin II. Leptin and adiponectin have opposite effects on subclinical inflammation and insulin resistance. Leptin upregulates proinflammatory cytokines such as tumor necrosis factor-α and interleukin-6; these are associated with insulin resistance and type 2 diabetes mellitus. In contrast, adiponectin has anti-inflammatory properties and downregulates the expression and release of a number of proinflammatory immune mediators. Therefore, it appears that interactions between angiotensin II and leptin/adiponectin imbalance may be important mediators of the elevated risk of developing type 2 diabetes mellitus and cardiovascular diseases associated with abdominal obesity.
Hormone Molecular Biology and Clinical Investigation
Transcranial Magnetic Stimulation (TMS) is a non-invasive method for stimulation of brain that is based on the ability of a generated magnetic field to penetrate skull and brain meninges, inducing an electric current in the brain tissues that produces neuronal depolarization. TMS can be applied as single pulse of stimulation, pairs of stimuli separated by variable intervals to the same or different brain areas, or as trains of repetitive stimuli at various frequencies. Its mechanism of action is currently unknown. Repetitive TMS can modify the excitability of the cerebral cortex, and has been postulated as a diagnostic and therapeutic tool in the area of neuropsychiatry. The aim of this article is to review the knowledge of the TMS as regards its basic principles, pathophysiological mechanism, and its usefulness in clinical practice. © 2013 Asociación Colombiana de Psiquiatr?a. Published by Elsevier España, S.L. All rights reserved.
Revista Colombiana de Psiquiatria
Introduction Nutritional disorders in childhood may cause a decline in motor abilities and increased morbidity and mortality in adulthood. Objective To assess the association between nutritional status and motor abilities. Materials and methods A cross-sectional study was performed that included 12,872 children aged between 6 and 18 years who underwent a clinical evaluation and various physical tests. Results Among the children, 66% had a Tanner maturation stage 1 and 2, 6% were under-nourished, and 12.2% were at risk of overweight and obesity. The obese children had a decrease in aerobic power (in 2.72 mL O2 kg-1·min-1; 95% CI: 1.89 to 3.56; P <.001), speed (0.14 m·sec; 95% CI: 0.06 to 0.22; P <.001), explosive strength (0.10 m; 95% CI: 0.06 to 0.13; P <.001), agility, strength endurance and balance. Under-nourished children showed a decrease in speed (0.13 m·sec; 95% CI: 0.06 to 0.20; P <.001), explosive strength (0.04 m; 95% CI: 0.01 to 0 07; P <.004), and strength endurance. Conclusions There was an association between nutritional status and motor abilities in the children included in this study. Obese children showed the worst results in physical tests, and the under-nourished ones showed a decrease in speed, explosive strength and strength endurance.
Anales de Pediatria
The underlying mechanisms that lead to syncope are still unclear, especially in children. In this work, we applied a novel point-process model to study timevarying heartbeat dynamics and to characterize autonomic changes that occur prior to a syncopal event. Twentysix children with history compatible with neurocardiogenic syncope (NCS) and a positive head up tilt table test (HUT) were included in the study. ECG and blood pressure signals were recorded during rest and the diagnostic HUT. Using self-developed software, a decrease of > 30% of the median systolic blood pressure during HUT compared to rest was selected as the onset of the syncopal event. After ECG peak detection and correction of ectopic beats, we modeled the time between R-wave events as a history dependent inverse Gaussian (IG) and applied the pointprocess framework to compute several measures related with HRV. We tested for significant changes in these measures for three consecutive two-minute time intervals previous to the syncopal event. Of all measures, only the mean of the heart rate probability density function, μHR, and the scale parameter of the IG probability density function, ζ0(t), presented a statistically significant increase prior to syncope, providing novel features associated with the statistical properties of heartbeat generation that could be critical to predict and explain the occurrence of syncope.
Computing in Cardiology
Physical modalities are all the tools that the therapist has to intervene with curative intent; however, the increase of scientific publications has led to a need to know the effectiveness of these modalities for the treatment of pain. The purpose of this review was to provide the reader updated, referenced and evidenced on pain knowledge and clinical application of physical modalities for treatment. A search for the best available evidence was conducted to try to answer the research question, which is based on the paradigm that entails the application of physical modalities most used (Cryotherapy and Thermotherapy, Therapeutic Ultrasound, Laser therapy and electrotherapy). So far the number of clinical trials and systematic reviews to support the use of physical modalities for pain management is very limited, plus the low methodological quality of the available trials. Many of the underpinnings of the use of physical modalities are accompanied by diffuse physiological basis and scientific support demonstrations in vitro but not in vivo. To this is added a limited amount of information about the parameters that apply to pain management so it is not possible to draw conclusions on the recommendation of the clinical application of all physical modalities tested for pain management.
Salud Uninorte
Nutritional deficiencies are common among children in Colombia, and innovative strategies and supplements are needed in order to effectively address this problem. For example, in Colombia, when measured as ferritin, iron deposits are deficient in 58.2% of children between two and eight years of age. If a formulation is made with highly nutritional ingredients, cookies will have the potential to be used as supplements in children’s diets because of their simple manufacturing process, long shelf life, and high acceptability. This study aimed to develop biofortified cookies, based on a bean-cassava-wheat flour mix, for children. The methodology grouped several studies in order to define the best treatment for the production of bean flour and the flour mix to produce cookies, prioritizing the nutritional content and the microbiological and sensorial quality. A production procedure for bean-based flour, suitable for the production of cookies with adequate nutritional, sensorial and microbiological characteristics was obtained. Additionally, the rheological characteristics of the proposed flour mixes permitted other possible uses for the bread-making industry, substituting cereal flours with flours with higher micronutrient contents. However, further studies are needed to determine the nutritional effects of the regular ingestion of biofortified cookies on children.
Agronomia Colombiana
Universidad de Santander UDES. Vigilada Mineducación.
Resolución otorgada por el Ministerio de Educación Nacional: No. 6216 del 22 de diciembre de 2005 / Personería Jurídica 810 de 12/03/96.
Institución sujeta a inspección y vigilancia por el Ministerio de Educación Nacional. Resolución 12220 de 2016.
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