RESUMO

Venezuelan migrant and refugee women and girls (VMRWG) face risks of exposure to and infection from HIV and threats of multiple forms of violence (including GBV) during and after migration. Yet, there is a lack of evidence on barriers and facilitators to VMRWGs' access to HIV prevention and care services this population at all stages of their migration. We addressed this evidence gap by conducting a qualitative study composed of fifty-four semi-structured interviews with practitioners (n = 24) and VMRWG (n = 30) in the two largest receiving cities of migrants in Colombia. We sought to identify perceived barriers and facilitators to HIV prevention and care to inform policies and programmatic efforts. Analysis followed a theory-informed approach using the Socioecological Model. Findings describe multi-level barriers to access to HIV prevention and care related to discrimination, gender-based violence, rigid gender norms, lack of information and system fragmentation. Policies that integrate community-based networks and support intersectoral work are pivotal to breach the gaps between services and communities and develop a gender-sensitive approach that tackles the relationship between gender-based violence and HIV risk.

RESUMO

RESUMEN La declaración de Brighton de 1994 marcó un parteaguas para las mujeres en el deporte mundial. Auspiciada por la Asamblea de la Organización de las Naciones Unidas (ONU) y el Comité Olímpico Internacional (COI), facilitó a las mujeres que pudieran comunicar sus necesidades y construir una agenda inteligente, alcanzable, con objetivos precisos, igualitaria y equitativa. En el mismo sentido, la participación de mujeres en eventos internacionales y nacionales ha aumentado y se busca el equilibrio. El objetivo del presente trabajo fue identificar similitudes y diferencias textuales y conceptuales en los ejes, objetivos, estrategias y acciones de los 4 sexenios de gobiernos federales, desde la perspectiva comparativa cognoscitiva. Para ello, se revisaron los Planes Nacionales de Desarrollo, Planes Proigualdad/Equidad y Plan Nacional de Cultura Física y Deporte de 2000 a 2022. Con este trabajo, se puede reconocer la valía y la evolución de estos planes, para la transversalización de la perspectiva de género en el aparato gubernamental, las acciones estratégicas, la visibilización y mención en los documentos institucionales, la armonización de las leyes y normativas nacionales y estatales, así como, los llamamientos gubernamentales a la integración de las mujeres a la vida del deporte y toma de decisiones, y la vigilancia de los organismos internacionales, como la ONU y el COI. Este recorrido permite inferir que las políticas públicas desde 2000 a la fecha han fortalecido la participación deportiva de las mujeres y su llegada a puestos de toma de decisiones en el apartado institucional, pero no es concluyente en precisar, el peso de cada periodo, ni especificar la asociación del éxito con acciones ni programas. Lo verdaderamente útil, es reconocer el escalonamiento de acciones que tuvo cada periodo y como, eso visibiliza cada vez, la presencia de las mujeres deportistas en la programación pública.

ABSTRACT The 1994 Brighton declaration marked a turning point for women in world sport. Women were able to communicate their needs and develop an intelligent, achievable agenda with precise, egalitarian, and equitable objectives, held under the auspices of the United Nations Assembly (UN) and the International Olympic Committee (IOC). Likewise, women's participation in international and national events has increased and a balance is actively sought. The objective of this paper was to identify textual and conceptual similarities and differences in the axes, objectives, strategies, and actions of the 4 six-year terms of federal governments, employing a cognitive comparative perspective. For this, the National Development Plans, Pro-equality/equity Plans and the National Physical Culture and Sports Plan from 2000 to 2022 were reviewed. With this paper, the value and evolution of these plans can be recognized, for the following issues: mainstreaming of a gender perspective in the government structure, strategic actions, visibility and mention in institutional documents, harmonization of national and state laws and regulations, government calls for the integration of women into sports life and decision-making, and supervision by international organizations, such as the UN and the IOC. This path allows to infer that public policies from 2000 to date have strengthened women's sports participation and their arrival in decision-making positions in the institutional sector. However, it is not conclusive in specifying the weight of each period, nor specifying the association with actions or programs. What is useful is to recognize the gradual inclusion of actions in each period and how this generates an increasing visibilization and presence of women athletes in public programming.

RESUMO

Chytridiomycosis is affecting amphibians worldwide, causing the decline and extinction of several amphibian populations. The disease is caused by the fungus Batrachochytrium dendrobatidis (Bd), a multihost pathogen living in freshwater habitats. While several environmental factors have been associated with the prevalence of Bd and its virulence, the effects of water quality on the pathogen are not clear yet. Some evidence suggests that water pollution may reduce amphibians' immune response and increase prevalence of Bd. To explore this hypothesis, we analyzed the relationship between water quality and the presence of Bd by using spatial data mining of 150 geolocations of Bd in amphibians from 9 families where Bd positive specimens have been previously reported, and water quality in 4,202 lentic and lotic water bodies in Mexico from 2010 to 2021. Our model showed that in the 3 main families where Bd was recorded, its presence is high in locations with low water quality, i.e., water polluted likely contaminated with urban and industrial waste. Using this model, we inferred areas suitable for Bd in Mexico; mainly in poorly studied areas along the gulf and on the pacific slope. We further argue that actions to reduce water pollution should become an integral part of public policies to prevent the spread of Bd and protect amphibians from this deadly pathogen.

Assuntos

Assuntos

RESUMO

SUMMARY: The present research corresponds to a cross-sectional descriptive study in the anthropometric field, which allows coaches to develop standards to identify talent and optimize training in the discipline of beach volleyball. Its objective was to define the anthropometric profile and body composition of the Mexican Olympic beach volleyball teams in both sexes. The participants were couples one and two of Mexico in both sexes (defined by FIVB ranking), 4 women and 4 men with average age of 30.25±6.85 and 27.25±7.36 years. The technique used was Heath-Carter´s somatotype method and the anthropometric profile restricted ISAK protocol. Among the findings resulting from the research, unification can be observed in the male morphological characteristics (triceps skinfold, front thigh skinfold, calf skinfold, circumference of relaxed and contracted arm, waist, hip, femur diameter and BMI), as for the somatotype, both sexes of Mexican couples are positioned in mesomorphs-balanced. In relation to other studies consulted, balance in somatotype and muscular development is observed with high performance teams. Weight and height, as well as age, are important variables for the selection of talent and future optimal performance in world and professional volleyball.

La presente investigación corresponde a un estudio descriptivo transversal en el campo antropométrico, que permite a los entrenadores desarrollar estándares para identificar talentos y optimizar el entrenamiento en la disciplina de voleibol de playa. Su objetivo fue definir el perfil antropométrico y la composición corporal de las selecciones olímpicas mexicanas de voleibol de playa en ambos géneros. Los participantes fueron las parejas uno y dos de México en ambos géneros (definidos por ranking Fédération Internationale de Volleyball), 4 mujeres y 4 hombres con edad promedio de 30.25±6.85 y 27.25±7.36 años. La técnica utilizada fue el método del somatotipo de Heath-Carter y el protoolo ISAK del perfil antropométrico restringido. Entre los hallazgos resultantes de la investigación, se puede observar una unificación en las carácteristicas morfológicas masculinas (pliegue cuatáneotricipital, pliegue cutáneo anterior del muslo, pliegue citáneo de la pantorrila, circunferencia del brazo relajado y contraído, cintura, cadera, diámetro del fémur e IMC), en cuanto al somatotipo, ambos sexos de las parejas mexicanas se posicionan en mesomorfos-equilibrados. En relación a otros estudios consultados, se observa equilibrio en somatotipo y desarrollo muscular con equipos de alto rendimiento. El peso y la altura, así como la edad, son variables importantes para la selección del talento y en el futuro desempeño óptimo en el voleibol mundial y profesional.

Assuntos

RESUMO

La terapia miofuncional orofacial (TMO) ha tenido un creciente desarrollo durante la última década, presentándose como una opción terapéutica en pacientes con AOS. Sin embargo, la evidencia es limitada y en Chile no hay mucho conocimiento al respecto. Se desarrolló una revisión sistemática en PubMed, MEDLINE, Embase, Web of Science, Lilacs y Scielo, que incluyó estudios primarios publicados en los últimos 10 años en idioma inglés, español o portugués y que utilizaran la TMO en pacientes adultos con AOS. Se excluyeron estudios que combinaran otras estrategias, con alteraciones miofuncionales secundarias a patologías concomitantes y con otro tipo de trastorno del sueño. La revisión consideró 9 artículos en su análisis; los resultados mostraron beneficios significativos a favor de la TMO en relación a disminución del índice de apnea-hipopnea, mejor calidad del sueño, nivel de somnolencia de Epworth, menor intensidad y frecuencia de los ronquidos, menor circunferencia del cuello, entre otros. Se concluye que la TMO genera beneficios en los pacientes con AOS, siendo una opción no invasiva y accesible.

Orofacial myofunctional therapy (OMT) has had a growing development during the last decade, presenting itself as a therapeutic option in patients with OSA. However, the evidence is limited and in Chile there is not much knowledge about it. A systematic review was developed in PubMed, MEDLINE, Embase, Web of Science, Lilacs and Scielo, which included primary studies published in the last 10 years in English, Spanish or Portuguese that used OMT in adult patients with OSA. Studies that combined other strategies, with myofunctional alterations secondary to concomitant pathologies and with another type of sleep disorder were excluded. The review considered 9 articles in its analysis; The results showed significant benefits in favor of OMT in relation to a decrease in the apnea-hypopnea index, better sleep quality, Epworth sleepiness level, less intensity and frequency of snoring, less neck circumference, among others. It is concluded that OMT generates benefits in patients with OSA, being a non-invasive and accessible option.

Assuntos

RESUMO

RESUMEN: El perfil antropométrico y el somatotipo son herramientas imprescindibles para monitorizar el rendimiento morfológico del atleta de alto rendimiento. El objetivo del presente estudio es la descripción del perfil antropométrico y el somatotipo dominante de atletas mexicanos de taekwondo (TKD) de alto rendimiento. El perfil antropométrico y el somatotipo fueron determinados en 16 atletas de TKD mexicanos [8 hombres, edad media 21,5 años (19,8-23,0, IC 95%); 8 mujeres, edad media 21,9 años (19,2-24,4, IC 95%)]. Una prueba T-Student para muestras independiente fue usada para comparar las medias entre ambos sexos (Hombres vs Mujeres). La estatura (P = 0,001), los pliegues del muslo anterior (p = 0,006) y pantorrilla (p = 0,049), la circunferencia del brazo flexionado (p = 0,047), los diámetros del húmero (p = 0,011) y fémur (p = 0,012), el área total y área muscular del brazo (p = 0,001) fueron significativamente diferentes entre hombres y mujeres. Un somatotipo ecto-mesomórfico predomino tanto en hombres (2,1-3,2-4,2) como en el grupal (2,4-3,1-3,8), pero ectomorfo-mesomórfico (2,8-3,2-3,4) para las mujeres. El somatotipo del atleta de TKD mexicano predominó por una mayor linearidad relativa seguido de una magnitud musculoesquelética y una menor adiposidad relativa. Los hallazgos de este estudio aportan evidencias morfológicas para monitorizar el rendimiento físico y nutricional del atleta de TKD.

SUMMARY: Body composition, somatotype and nutritional status are essential tools for monitoring the perfor- mance of high-performance athlete. The objective of the present study was to verify the body composition, the dominant somatotype and nutritional status of high-performance taekwondo athletes of the Mexican TKD team. The anthropometric profile, somatotype and nutritional status were determined in sixteen Mexican TKD athletes [8 men, mean age 21.5 yrs. (19.8-23.0 95% CI); 8 women, mean age 21.9 yrs. (19.2-24.4 95% CI)]. An independent-samples t-test was used to compare the means between both genders (Men vs. Women). The height (p = 0.001), the anterior thigh (p = 0.006) and calf (p = 0.049) folds, the flexed arm circumference (p = 0.047), the humerus (p = 0.011) and femur (p = 0.012) diameters, the fat free mass (p = 0.020) and arm total area (p = 0.049) and arm muscle area (p = 0.001) were significantly different between men and women. The percentage of body fat and arm fat area were not significant between both genders. A normal caloric reserve, but a slightly high percentage of body fat was observed for both genders. In addition, normal and high protein reserves were identified for men and women, respectively. An ecto-mesomorphic somatotype was highlighted in both men (2.1-3.2-4.2) and in the group (2.4-3.1-3.8), but ectomorphic- mesomorphic (2.8-3.2-3.4) to women. The somatotype of the Mexican TKD athlete predominated by a greater relative linearity followed by a musculoskeletal magnitude and a lower relative adiposity. The findings of this study provide morphological evidence to monitor the physical and nutritional performance of the high-performance TKD athlete.

Assuntos

RESUMO

The sustainability of the Universidad de Chile Clinical Hospital must be understood comprehensively; providing higher quality and safety for our patients, ensuring highest standards of medical care. The quality of care must be understood not only in complying with the minimum standards to accredit and grant GES benefits, establish agreements with health insurers and be financially competitive; It must be incorporated into its management the dimensions of quality - effectiveness, efficiency, accessibility, safety, equity and patient-centered care- minimizing the costs of non-quality work. Our Clinical Hospital, as our country's main training center in healthcare professions, must include training at the undergraduate students' curriculum in quality and patient safety issues. (AU)

Assuntos

RESUMO

RESUMEN: Determinar el perfil antropométrico y de composición corporal de los atletas ha sido -hasta hace poco- una herramienta fundamental para predecir el rendimiento deportivo y comportamiento biomecánico. Para este estudio, se evaluaron a 15 jugadores de la Selección Mexicana de Voleibol Varonil, con edad de 26,4 ± 4,73, previo a la XIV Copa Panamericana de Voleibol 2019. Se utilizó el protocolo ISAK para la toma antropométrica así como las ecuaciones de Carter & Heath para determinar el perfil antropométrico y somatotipo, el porcentajey kg de grasa, se calculó a partir de la ecuación de Durnin & Womersley, la masa muscular con el método De Rose y Gimares, y tejido óseo con la ecuación de Rocha. Resultados: el peso promedio fue de 85,45 kg (± 8,39), estatura 192,71 cm (± 7,15); somatotipo: endomorfo (2,3 ± 0,8), mesomorfo (4,0±1,4) y ectomorfo (3,6 ± 1,5). El % GC promedio fue de (3,6 ± 1,5), kg GC (11,2 ± 4,0), de % MM (43,8 ± 2,3), kg MM (37,3 ± 2,7), % TO (19,3 ± 1,8), KgTO (16,4 ± 1,2). Se concluye que la Selección Mexicana Varonil Mayor de Voleibol se encuentra dentro de los rangos competitivos de una Selección mayor; así como también muestra valores de referencia internacional. Presenta dos perfiles somatotípicos, endo-mesomórfico para jugadores defensivos y ecto-mesomórficos en jugadores ofensivos, beneficiando técnicamente su desempeño.

SUMMARY: Until recently, determining the anthropometric and body composition profile of athletes has been a fundamental tool for predicting sports performance and biomechanical behavior. For this study, 15 players form the Mexican Men`s Volleyball Team, aged 26.4±4.73, were evaluated prior to the beginning of the XIV 2019 Pan- American Volleyball Cup, using the ISAK protocol. As well as the Carter & Heath equation to determine the anthropometric profile and somatotype, the percentage and Kg of fat, with the Durnin & Womersley equation, the De Rose and Gimares muscle mass, and bone tissue with the Rocha equation. The average weight was 85.45 kg (± 8.39), height 192.71 cm (±7.15); somatotype: endomorphic (2.3 ± 0.8), mesomorphic (4.0 ± 1.4), and ectomorphic (3.6 ± 1.5). The overage % GC was (3.6 ± 1.5). kg GC (11.2 ± 4.0), de % MM (43.8 ± 2.3) kg MM (37.3 ± 2.7), % TO (19.3 ± 1.8), kg TO (16.4 ± 1.2). It is concluded that the Mexican Men`s Volleyball Team is within the competitive ranges of a larger international teams, in addition, and as international reference values, the Selection presents two somatotypes profile, endo-mesomorphic for defensive players and ecto-mesomorphic for offensive players, technically benefiting their performance.

Assuntos

RESUMO

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice for symptomatic choledocholithiasis during pregnancy. In pregnant patients, aside from the risks inherent in the procedure and sedation, there is the added concern of the potentially damaging effects of ionizing radiation on the fetus. AIM: To describe the maternal and fetal results of ERCP performed to resolve symptomatic choledocholithiasis in pregnant patients. MATERIALS AND METHODS: A retrospective, descriptive, observational, and cross-sectional study was conducted. It included pregnant patients with choledocholithiasis that underwent ERCP within the time frame of June 2017 and June 2018. RESULTS: The study included 9 pregnant patients, with a mean gestational age of 24.1 weeks, that underwent ERCP. There were no maternal or fetal complications associated with sedation, mean fluoroscopy time was 26.7seconds, and one patient (11.1%) presented with mild post-ERCP pancreatitis that was resolved through medical management. Pregnancy progression was normal in 100% of the cases, resulting in the birth of neonates with a normal Apgar score, a mean weight of 3,120g, a mean length of 49.94cm, and a mean gestational age of 38.37 weeks. At follow-up at 6 months, the infants had a mean weight of 7.1kg and a mean length of 66.94cm. CONCLUSIONS: The results from our hospital center were similar to those described in the international literature, showing that ERCP in our medical environment is a feasible, safe, and efficacious method for both the mother and fetus. When performed by an experienced endoscopist, it should be considered the treatment of choice for choledocholithiasis in pregnant patients.

RESUMO

INTRODUCCIÓN: La etapa prepuberal es un periodo crítico del desarrollo de la grasa corporal, en el cual la leptina y la resistencia a la insulina han sido asociados, sin embargo, hay pocos estudios en prepúberes normo- peso. OBJETIVO: Evaluar la relación de leptina con composición corporal y resistencia a la insulina en un grupo de prepúberes normopeso. PACIENTES Y MÉTODO: Estudio transversal analítico en 128 pre púberes saludables, normopeso, entre 6 y 10 años. Se midieron, talla, peso, índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), perímetro abdominal (PA) y perímetro de cadera (PC). Se determinó leptina (ng/ml) e Insulina (μU/L) en plasma por inmunoensayo y glicemia (mmol/L) por método enzimático. Se calculó HOMA-IR. Se hizo análisis de comparación y de correlación por sexo. RESULTADOS: Se confirmó en niñas un mayor nivel de leptina (6,8 ± 5 vs 3,3 ± 3,7; p = 0,000), insulina (7,1 ± 4,5 vs 5,2 ± 2,5; p = 0,016), PGC (22,4 ± 4,3 vs 18,6 ± 3,9; p = 0,000) y PC (67 ± 5,7 vs 65,0 ± 4,5; p = 0,019), y un menor índice cintura/cadera (0,84 ± 0,04 vs 0,88 ± 0,04; p = 0,000) comparado con varones. Las correlaciones de leptina con variables antropométricas fueron signifi cantes en ambos sexos, con mayor asociación en sexo femenino. La asociación del HOMA-IR con la leptina fue similar en ambos sexos. CONCLUSIONES: En prepúberes normopeso de 6 a 10 años, hay diferencias por sexo en adiposidad y en niveles de leptina, no asociadas con diferencias en el IMC ni en la resistencia a la insulina. La mayor asociación de leptina con adiposidad en las niñas podría estar relacionada con una elevada tasa de adipogénesis inducida por esta hormona.

INTRODUCTION: The prepubertal stage is a critical period of body fat development, in which leptin and insulin re sistance has been associated, however, there are few studies in normal-weight prepubescents. OBJECTIVE: To assess the relationship between leptin and body composition and insulin resistance in a group of normal-weight prepubescents. PATIENTS AND METHOD: Analytical cross-sectional study with 128 healthy prepubescents of normal weight, aged between 6 and 10 years. Height, weight, body mass index (BMI), body fat percentage (BFP), waist circumference (WC), and hip circumference (HC) were measured. Plasma leptin (ng/mL) and insulin (mU/L) were evaluated by immunoassay and glycemia (mmol/L) by enzymatic method. HOMA-IR was calculated. A comparison study and correlation analysis by sex were performed. RESULTS: Females presented higher values than males of leptin (6.8 ± 5 vs 3.3 ± 3.7; p = 0.000), insulin (7.1 ± 4.5 vs 5.2 ± 2.5; p = 0.016), BFP (22.4 ± 4.3 vs 18.6 ± 3.9; p = 0.000), and HC (67 ± 5.7 vs 65.0 ± 4.5; p = 0.019), and a lower waist/hip ratio (0.84 ± 0.04 vs 0.88 ± 0.04; p = 0.000). Leptin correlations with anthropometric variables were significant in both sexes, with greater association in females. The association of HOMA-IR with leptin was similar in both sexes. CONCLUSIONS: in normal-weight prepubescents aged between 6-10 years, there are sex differences in adiposity and leptin levels not associated with differences in BMI or insulin resistance. The greater association of leptin with adiposity in girls could be related to a high rate of adipogenesis induced by this hormone.

Assuntos

RESUMO

El presente trabajo corresponde a un estudio etnográfico clásico, que tiene como objetivo explorar el espacio de construcción de los nuevos estilos de vida y prácticas corporales en los jóvenes skaters urbanos de Colima. El estudio se realizó en un parque emblemático: La Piedra Lisa, localizado en la capital del estado de Colima, México. La unidad de observación la integraron 50 jóvenes, entre 12 y 20 años, que practican el skate durante la semana. El método utilizado fue el etnográfico, las técnicas de investigación fueron la observación participante ­durante un mes y medio­ y la entrevista informal; y como instrumento de registro se empleó el diario de campo. En la sistematización de la información y clasificación se usó la Guía de Murdock. El estudio describe aspectos identitarios de los jóvenes skaters, información acerca del desarrollo de habilidades físicas coordinativas, condicionales y de experticia skate, lugares de encuentro y apropiación de espacios públicos, clasificación de los skaters por grupos, el equipamiento utilizado, y la percepción social que se tiene de sí mismos, de la sociedad, la familia y de los amigos.

The present work corresponds to a classic ethnographic study, which aims to explore the construction space of new lifestyles and bodily practices in young urban skaters in Colima. The study was conducted in an emblematic park: La Piedra Lisa, located in the capital of the state of Colima, Mexico. The observation unit was made up of 50 young people between 12 and 20 years old, who skate during the week. The method used was ethnographic, the research techniques were participant observations ­for a month and a half­ and the informal interview, and the field newspaper was used as recording instrument. For the systematization of information and classification, the Murdock Guide was used. The study describes identity aspects of young skaters, information about the development of coordinative, conditional and skateboarding physical skills, meeting places and appropriation of public spaces, classification of skaters by groups, the equipment used, and the social perception that it has of itself, society, family and friends.

Assuntos

RESUMO

So far, available evidence suggests that patients with inflammatory bowel disease (IBD) are not at greater risk for developing COVID-19 infection. In regard to patients with IBD remission: 5-aminosalycylates (5-ASAs) do not increase the risk for infection and should be continued. There is no need to suspend them or lower the dose. Immunomodulating drugs, such as thiopurines and methotrexate, should be continued, without modifying doses (even in patients with positive SARS-CoV-2 infection). No type of biologic therapy should be suspended, unless there are signs of COVID-19. Regarding patients with IBD activity: the oral and/or topical 5-ASA dose should be optimized in cases of disease relapse. Budesonide MMX should be considered in cases of mild-to-moderate activity, to avoid systemic steroid use. Systemic steroids should be avoided whenever possible because doses above 20mg per day have an immunosuppressive effect, which could increase susceptibility to any type of infection, including COVID-19. The combined use of thiopurines with steroids and/or tumor necrosis factor (TNF) monoclonal antibodies should also be avoided because those combinations can increase the risk for infections, including COVID-19. Finally, biologic treatment with anti-TNF-alpha agents or any other mechanism of action, such as anti-integrins or anti-interleukins, should be suspended if patients become infected with SARS-CoV-2. The drugs can be restarted once the infectious process is resolved.

Assuntos

RESUMO

Colour pattern is the main trait that drives mate recognition between Heliconius species that are phylogenetically close. However, when this cue is compromised such as in cases of mimetic, sympatric and closely related species, alternative mating signals must evolve to ensure reproductive isolation and species integrity. The closely related species Heliconius melpomene malleti and H. timareta florencia occur in the same geographical region, and despite being co-mimics, they display strong reproductive isolation. In order to test which cues differ between species, and potentially contribute to reproductive isolation, we quantified differences in the wing phenotype and the male chemical profile. As expected, the wing colour pattern was indistinguishable between the two species, while the chemical profile of the androconial and genital males' extracts showed marked differences. We then conducted behavioural experiments to study the importance of these signals in mate recognition by females. In agreement with our previous results, we found that chemical blends and not wing colour pattern drive the preference of females for conspecific males. Also, experiments with hybrid males and females suggested an important genetic component for both chemical production and preference. Altogether, these results suggest that chemicals are the major reproductive barrier opposing gene flow between these two sister and co-mimic species.

Assuntos

Assuntos

RESUMO

INTRODUCTION: The prepubertal stage is a critical period of body fat development, in which leptin and insulin re sistance has been associated, however, there are few studies in normal-weight prepubescents. Ob jective: To assess the relationship between leptin and body composition and insulin resistance in a group of normal-weight prepubescents. PATIENTS AND METHOD: Analytical cross-sectional study with 128 healthy prepubescents of normal weight, aged between 6 and 10 years. Height, weight, body mass index (BMI), body fat percentage (BFP), waist circumference (WC), and hip circumference (HC) were measured. Plasma leptin (ng/mL) and insulin (mU/L) were evaluated by immunoassay and glycemia (mmol/L) by enzymatic method. HOMA-IR was calculated. A comparison study and correlation analysis by sex were performed. RESULTS: Females presented higher values than males of leptin (6.8 ± 5 vs 3.3 ± 3.7; p = 0.000), insulin (7.1 ± 4.5 vs 5.2 ± 2.5; p = 0.016), BFP (22.4 ± 4.3 vs 18.6 ± 3.9; p = 0.000), and HC (67 ± 5.7 vs 65.0 ± 4.5; p = 0.019), and a lower waist/hip ratio (0.84 ± 0.04 vs 0.88 ± 0.04; p = 0.000). Leptin correlations with anthropometric variables were significant in both sexes, with greater association in females. The association of HOMA-IR with leptin was similar in both sexes. CONCLUSIONS: in normal-weight prepubescents aged between 6-10 years, there are sex differences in adiposity and leptin levels not associated with differences in BMI or insulin resistance. The greater association of leptin with adiposity in girls could be related to a high rate of adipogenesis induced by this hormone.

Assuntos

RESUMO

RESUMEN Introductión El síndrome de apneas e hipopneas obstructivas del sueño (SAHOS) afecta al 2%-4% de las personas adultas. El CPAP es la principal terapia en casos moderados y severos, pero sólo es tolerado en el 50%-70% de los pacientes. La terapia miofuncional orofaríngea (TMO) ayuda a reducir el colapso de la via aérea superior mediante ejercicios de fortalecimiento de la musculatura orofaríngea. En la última década ha demostrado una buena eficacia en grupos variados de pacientes con SAHOS. Objetivo Estudiar efectividad de la TMO en pacientes con SAHOS. Material y método Revisamos retrospectivamente 12 pacientes con SAHOS leve y moderado tratados con TMO. Los datos demográficos y polisomnográficos se analizaron antes y después de la terapia. Resultados Edad media: 65 ±9,0 años, el 58,3% eran mujeres, el 33,3% eran obesos. Observamos una disminución significativa del IAH (13,64 ±1,99 vs 10,13 ±2,09, p =0,008); una mejoría en la eficiencia del sueño, los porcentajes de etapas N3-REM y del índice de microdespertares. También observamos una reducción clínicamente significativa en las puntuaciones de la escala de somnolencia de Epworth, del Mallampatti y el perímetro cervical. Conclusión La TMO fue eficaz en la mayoría de los pacientes con SAHOS leve y moderado. Cada unidad de sueño en centros de salud públicos en Chile debe considerar este tratamiento.

ABSTRACT Introduction The obstructive sleep apnea syndrome (OSA) affects about 2%-4% of adults. CPAP is the first indication to treat moderate and severe cases, however the treatment is tolerated in only 50%-70% of patients. Therapy with myofunctional oropharyngeal (TMO) exercises helps to reduce upper airway collapsibility by strengthening the oropharyngeal musculature, and in the last decades had demonstrated good efficacy in variated groups of OSA patients. Aim: To study TMO effectivity in OSA patients. Material and method: We reviewed retrospectively the clinical records of 12 (7 female) mild and moderate unselected OSA patients. Clinical and polysomnographic data were analyzed before and after TMO. Results: The mean age of patients was 65.0 ±9.0 years and median BMI was 26.7 kg/m2. TMO was associated to a significant reduction in median of Epworth somnolence scale (11.0 vs. 7.0), median apnea hypopnea index (13.4 vs 9.0 events/h), and decrease in cervical circumference. There was a tendency to improve quality of NREM sleep with increases in N3 stage and decrease in arousal index. Conclusion: In a real clinical context, TMO reduced the severity of OSA in 41.6% in the studied patients. Because of its safety and low cost, TMO should be introduced as a therapeutic option in public sleep units in Chile.

Assuntos

RESUMO

Abstract: Introduction: The objective of this study was to retrospectively compare imaging techniques with histopathological findings from bone biopsy. Material and methods: Imaging techniques such as X-Ray, CT scan and MRI where compared with the histopathological findings from bone biopsy, in a population of 64 patients with bone tumors, with 64.1% of males and an age range of 5 to 79 years. Results: Histologically, 39.1% were malignant bone tumors, while 60.9% were benign. The X-ray showed 90% of diagnostic accuracy, with sensitivity of 92.9%, specificity of 87.5%, positive predictive value of 86.7% and negative predictive value of 93.3%. CT scan presented 75.9% of diagnostic accuracy, with 84.6, 68.8, and 84.6% of sensitivity, specificity, positive predictive value and negative predictive value, respectively. The MRI documented a diagnostic accuracy of 95.1%, with 94.4% os sensitivity, 95.7% of specificity, 94.4% of positive predictive value and 95.7% for negative predictive value. This showed a great agreement between the histology findings and those within the X-Ray and MRI (K = 0.8 and 0.9, respectively), but doesn't depreciate the value of bone biopsy in diagnosis of bone tumors. Conclusion: This data showed good correlation between imagenological and histopatologic techniques.

Resumen: Introducción: El objetivo de este estudio fue comparar retrospectivamente las técnicas de imagen con los hallazgos histopatológicos de la biopsia ósea. Material y métodos: Las técnicas de diagnóstico por imágenes como rayos X, tomografía computarizada y resonancia magnética fueron comparadas con los hallazgos histopatológicos de la biopsia ósea, en una población de 64 pacientes con tumores óseos, con 64.1% de los varones y un rango de edad de cinco a 79 años. Resultados: Histológicamente, 39.1% eran tumores óseos malignos, mientras que 60.9% eran benignos. Los rayos X mostraron un 90% de precisión diagnóstica, con una sensibilidad de 92.9%, especificidad de 87.5%, valor predictivo positivo de 86.7% y un valor predictivo negativo de 93.3%. La tomografía computarizada presentó 75.9% de la precisión diagnóstica, con 84.6, 68.8, y 84.6% de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo, respectivamente. La resonancia magnética documentó una precisión diagnóstica de 95.1%, con 94.4% de sensibilidad, 95.7% de especificidad, 94.4% de valor predictivo positivo y 95.7% para valor predictivo negativo. Esto mostró un gran acuerdo entre los hallazgos de histología y los que están dentro de la radiografía y la RMN (K=0.8 y 0.9, respectivamente), pero no deprecia el valor de la biopsia ósea en el diagnóstico de tumores óseos. Conclusiones: Estos datos mostraron una buena correlación entre técnicas imagenológicas e histopatológicas.

Assuntos

RESUMO

INTRODUCTION: The objective of this study was to retrospectively compare imaging techniques with histopathological findings from bone biopsy. MATERIAL AND METHODS: Imaging techniques such as X-Ray, CT scan and MRI where compared with the histopathological findings from bone biopsy, in a population of 64 patients with bone tumors, with 64.1% of males and an age range of 5 to 79 years. RESULTS: Histologically, 39.1% were malignant bone tumors, while 60.9% were benign. The X-ray showed 90% of diagnostic accuracy, with sensitivity of 92.9%, specificity of 87.5%, positive predictive value of 86.7% and negative predictive value of 93.3%. CT scan presented 75.9% of diagnostic accuracy, with 84.6, 68.8, and 84.6% of sensitivity, specificity, positive predictive value and negative predictive value, respectively. The MRI documented a diagnostic accuracy of 95.1%, with 94.4% os sensitivity, 95.7% of specificity, 94.4% of positive predictive value and 95.7% for negative predictive value. This showed a great agreement between the histology findings and those within the X-Ray and MRI (K = 0.8 and 0.9, respectively), but doesnt depreciate the value of bone biopsy in diagnosis of bone tumors. CONCLUSION: This data showed good correlation between imagenological and histopatologic techniques.

INTRODUCCIÓN: El objetivo de este estudio fue comparar retrospectivamente las técnicas de imagen con los hallazgos histopatológicos de la biopsia ósea. MATERIAL Y MÉTODOS: Las técnicas de diagnóstico por imágenes como rayos X, tomografía computarizada y resonancia magnética fueron comparadas con los hallazgos histopatológicos de la biopsia ósea, en una población de 64 pacientes con tumores óseos, con 64.1% de los varones y un rango de edad de cinco a 79 años. RESULTADOS: Histológicamente, 39.1% eran tumores óseos malignos, mientras que 60.9% eran benignos. Los rayos X mostraron un 90% de precisión diagnóstica, con una sensibilidad de 92.9%, especificidad de 87.5%, valor predictivo positivo de 86.7% y un valor predictivo negativo de 93.3%. La tomografía computarizada presentó 75.9% de la precisión diagnóstica, con 84.6, 68.8, y 84.6% de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo, respectivamente. La resonancia magnética documentó una precisión diagnóstica de 95.1%, con 94.4% de sensibilidad, 95.7% de especificidad, 94.4% de valor predictivo positivo y 95.7% para valor predictivo negativo. Esto mostró un gran acuerdo entre los hallazgos de histología y los que están dentro de la radiografía y la RMN (K=0.8 y 0.9, respectivamente), pero no deprecia el valor de la biopsia ósea en el diagnóstico de tumores óseos. CONCLUSIONES: Estos datos mostraron una buena correlación entre técnicas imagenológicas e histopatológicas.

Assuntos

RESUMO

BACKGROUND AND PURPOSE: SPAST mutations are the most common cause of hereditary spastic paraplegia (SPG4-HSP), which is characterized by progressive lower limb weakness, spasticity and hyperreflexia. There are few studies about non-motor manifestations in this disease and none about autonomic involvement. Therefore, the aim was to determine the frequency and pattern of autonomic complaints in patients with SPG4-HSP, as well as to determine the clinical relevance and the possible factors associated with these manifestations. METHODS: Thirty-four molecularly confirmed SPG4 patients were recruited in a multicenter cross-sectional study, of whom 26 underwent detailed neurophysiological testing (heart rate variability, sympathetic skin response and the Quantitative Sudomotor Axonal Reflex Test). The Scales for Outcomes in Parkinson's Disease - Autonomic Questionnaire (SCOPA-AUT) was applied to quantify the severity of autonomic symptoms. Results were compared with 44 age- and gender-matched healthy controls using non-parametric tests. P values <0.05 were considered significant. RESULTS: In the SPG4-HSP group, there were 18 men with a mean age of 47.7 ± 12.6 years. SCOPA-AUT scores were similar between patients and controls (P = 0.238). Only the urinary domain subscore was significantly higher amongst patients (4 vs. 2.5, P = 0.05). Absent sympathetic skin response in the hands and feet was more frequent amongst patients (20% vs. 0%, P < 0.001, and 64% vs. 0%, P = 0.006, respectively). Quantitative Sudomotor Axonal Reflex Test responses were also smaller throughout all recording regions in the SPG4-HSP group. CONCLUSION: Our results indicate that SPG4-HSP patients have sudomotor dysfunction caused by damaged small post-ganglionic cholinergic fibers. Damage in SPG4-HSP extends to the peripheral nervous system.

Assuntos