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This study aimed to compare the acute inflammatory response following high-intensity eccentric exercise between resistance-trained young and master athletes with similar performance levels. Resistance-trained young (n=8; 22±2 years) and master (n=8; 52±4 years) male athletes of a similar performance level performed a standardized high-intensity eccentric squat exercise protocol (10 sets of half-squats at 70% of 1-repetition maximum). The serum concentration of 20 biomarkers related to tissue damage, inflammation, remodeling, and repair was measured at baseline, immediately after exercise, and over a 72 h recovery period. Both groups experienced similar muscle damage as evidenced by a comparable increase in creatine kinase activity 24 h after exercise (p<0.001). Interleukin-6 (p=0.009) and growth hormone (p<0.001) increased immediately post-exercise in both groups. Monocyte chemoattractant protein-1 increased immediately post-exercise only in young athletes (p=0.003) and then decreased 24 h later. There were no significant differences for the remaining variables, including cell markers related to neutrophil/macrophage activation or pro/anti-inflammatory cytokines. Resistance-trained young and master athletes, matched for performance level, showed an overall similar inflammatory response to eccentric exercise, possibly reflecting regulatory mechanisms or immunological adaptations to chronic stimulation in master athletes.
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The aims of this study were to: 1) provide and compare the height achieved during Smith machine (SM) and free weight (FW) loaded jumps executed over a wide spectrum of loads (40-120% of body mass [BM]); and 2) test the difference between loaded and unloaded squat jump (SJ) and countermovement jump (CMJ) attempts in ten highly trained male sprinters. On the first visit, athletes performed unloaded SJ and CMJ, loaded SJ with loads corresponding to 40, 60, 80, 100, and 120% BM, and loaded CMJ at 100% BM using an Olympic barbell (FW). On the second visit, they performed loaded SJ and CMJ tests under the same loading conditions on the SM device and, subsequently, a half-squat one-repetition maximum (1RM) assessment. The relative strength (RS = 1RM/BM) of the athletes was 2.54 ± 0.15. Loaded SJ performance was similar between SM and FW, and across all loading conditions. Differences in favour of CMJ (higher jump heights compared with SJ) were superior in the unloaded condition but decreased progressively as a function of loading. In summary, sprinters achieved similar SJ heights across a comprehensive range of loads, regardless of the execution mode (FW or SM). The positive effect of the countermovement on jump performance is progressively reduced with increasing load.
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The aims of this study were to compare the outcomes and provide reference data for a set of barbell mechanical parameters collected via a linear velocity transducer in 126 male sprinters (n = 62), rugby players (n = 32), and soccer players (n = 32). Bar-velocity, bar-force, and bar-power outputs were assessed in the jump-squat exercise with jump-squat height determined from bar-peak velocity. The test started at a load of 40% of the athletes' body mass (BM), and a load of 10% of BM was gradually added until a clear decrement in the bar power was observed. Comparisons of bar variables among the three sports were performed using a one-way analysis of variance. Relative measures of bar velocity, force, and power, and jump-squat height were significantly higher in sprinters than in rugby (difference ranging between 5 and 35%) and soccer (difference ranging between 5 and 60%) players across all loads (40-110% of BM). Rugby players exhibited higher absolute bar-power (mean difference = 22%) and bar-force (mean difference = 16%) values than soccer players, but these differences no longer existed when the data were adjusted for BM (mean difference = 2.5%). Sprinters optimized their bar-power production at significantly greater relative loads (%BM) than rugby (mean difference = 22%) and soccer players (mean difference = 25%); nonetheless, all groups generated their maximum bar-power outputs at similar bar velocities. For the first time, we provided reference values for the jump-squat exercise for three different bar-velocity measures (i.e., mean, mean propulsive, and peak velocity) for sprinters, rugby players, and soccer players, over a wide range of relative loads. Practitioners can use these reference values to monitor their athletes and compare them with top-level sprinters and team-sport players.
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BACKGROUND: Controversy exists on the actual occurrence of exercise-induced cardiac fatigue (EICF) with ultraendurance exercise, as well as on whether factors such as age or training status might predispose to this condition. The present study aimed to assess the occurrence of EICF among recreational ultramarathon runners, as well as to determine potential predictive factors. METHODS: Nineteen male recreational runners (42 ± 12yrs) participated in a 55-km trial race at moderate altitude (1,800-2,500 m). Participants were evaluated before and after the race using Doppler echocardiography and myocardial deformation analysis. EICF was determined as a reduction >5% of either left ventricular global longitudinal strain (LVGLS) or right ventricular free wall strain (RVFWS). Demographical (age, body mass index), training (training experience, volume and intensity), competition (finishing time, relative intensity) and biochemical variables (blood lactate, creatine kinase [CK] and CK-MB) were assessed as predictors of EICF. RESULTS: A significant reduction in LVGLS (20.1 ± 2.1% at baseline vs. 18.8 ± 2.4% at post-race, p = 0.026), but not in RVFWS (27.4 ± 7.0 vs. 24.6 ± 5.3%, p = 0.187), was observed after the race. EICF was present in 47 and 71% of the participants attending to the decrease in LVGLS and RVFWS, respectively. No associations were found between any of the analyzed variables and EICF except for age, which was associated with the magnitude of decrement of RVFWS (r = 0.58, p = 0.030). CONCLUSIONS: Ultramarathon running at moderate altitude seems to induce EICF in a considerable proportion of recreational athletes.
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Resumen OBJETIVO Revisar la experiencia con el traje antichoque no neumático y su integración a los protocolos de atención médica de la paciente con hemorragia obstétrica. MÉTODO Estudio retrospectivo consistente en la búsqueda de artículos en español e inglés que aluden a la hemorragia obstétrica y al traje antichoque no neumático indizados en las bases de datos de PubMed, Cocharne, Embase, Ebsco y Lilacs que reunieran los siguientes requisitos: contenter los términos relacionados: traje antichoque no neumático, non-pneumatic anti-shock garment, hemorragia posparto, postpartum haemorrhage, hemorragia obstétrica, obstetric haemorrhage, choque hipovolémico, hipovolemic shock. CONCLUSIONES La hemorragia obstétrica sigue siendo una de las principales causas de morbilidad y mortalidad materna. La innovación e integración de fármacos y tecnologías, acompañadas de la acumulación de experiencia son decisivas en la resolución de las complicaciones maternas. Está ampliamente demostrada la efectividad y seguridad del traje antichoque no neumático en el tratamiento de la hemorragia obstétrica; sin embargo, hoy día poco se ha utilizado en México.
Abstract OBJECTIVE Conduct a review of the results of the NASG/TANN and its integration into the management of obstetric hemorrhage protocols. Disseminate knowledge of its effectiveness, characteristics, indications, and appropriate use through continuing medical education activities. METHOD Research was conducted on the existence of items that meet the following requirements: Reviewed both English and spanish terms associated with the non-pneumatic anti-shock suit (NASG/TANN). Postpartum Hemorrhage (PPH). Hemorragia postparto. Obstetric hemorrhage (HO). Hemorragia obstétrica. Hypovolemic shock, Choque hipovolémico, whether published in English or Spanish, with reference to human patients. Analysed all the items found in Spanish and English in the following search engines: PubMed, Cocharne, Embase, Ebsco, and Lilacs; and all that reveal a relation between obstetric hemorrhage and the non-pneumatic anti-shock costume. None has been published in a Mexican journal. CONCLUSIONS Obstetric hemorrhage continues to be one of the leading causes of morbidity and mortality. Innovation and integration of drugs and technology, accompanied by the acquisition of proficiency in their use, have been and are fundamental to the management of maternal complications. There is enough scientific evidence to demonstrate the effectiveness and safety of the non-pneumatic anti-shock garment in the management of obstetric hemorrhage; unfortunately, up to the present, little has been implemented in Mexico.
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The aim of this work was to determine the genetic environment and transferability of blaKPC as well as the pulsotypes of KPC-producing Klebsiella pneumoniae strains isolated from clinical samples in Chilean hospitals. Seventeen strains, principally isolated in Santiago (the capital of Chile) during the years 2012 and 2013, were included. The genetic environment of blaKPC was elucidated by PCR mapping and sequencing. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Curing and conjugation experiments were performed with six strains of different sequence types (STs) and pulsotypes. Thirteen pulsotypes and six STs, mainly belonging to clonal complex 258, were found. In addition, seven strains belonged to a new ST assigned ST1161. The blaKPC sequence indicated that 16 strains had the KPC-2 variant; in only one strain (UC331) an amino acid change (R6P) was detected, corresponding to a new KPC variant designated KPC-24. Molecular characterisation of the blaKPC genetic environment revealed two distinct platforms, namely variant 1a and the Tn4401a isoform, with the first being the most common (11/17 strains). Mating experiments failed to produce transconjugants; however, loss of blaKPC was achieved by plasmid curing in all assayed strains. In conclusion, in Chilean strains of K. pneumoniae, blaKPC is primarily found associated with the variant 1a and is located in non-transferable plasmids. In addition, this study highlights the description of the new ST1161 and the new KPC-24 variant.
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Klebsiella pneumoniae/genética , beta-Lactamases/genética , Técnicas de Tipagem Bacteriana , Chile , Genes Bacterianos , Infecções por Klebsiella , Tipagem de Sequências Multilocus , Plasmídeos/genéticaRESUMO
Cesarean section has become the most performed surgery and it has been enhanced with the use of antibiotics and improvement in surgical techniques. The aim of this systematic review is to describe and clarify some historical and ethical characteristics of this surgery, pointing out some aspects about its epidemiological behavior, becoming a topic that should be treated globally, giving priority to the prevention and identification of factors that may increase the incidence rates. Today, this "epidemic" reported rates higher than fifty percent, so it is considered a worldwide public health problem. Consequently, in Mexico strategies aimed at its reduction have been implemented. However, sociocultural, economic, medicolegal and biomedical factors are aspects that may difficult this goal. As we decrease the percentage of cesarean section in nulliparous patients, we diminish the number of iterative cesarean and its associated complications. This aim must be achieved through the adherence to the guidelines which promote interest in monitoring and delivery care in health institutions of our country.
La operación cesárea es la cirugía mayor más frecuentemente practicada, y ha sido perfeccionada con el uso de antibióticos y mejores técnicas quirúrgicas. El objetivo de esta revisión sistemática es describir y precisar diversas características históricas y éticas con relación a esta intervención quirúrgica, señalando algunos aspectos inherentes a su comportamiento epidemiológico, siendo este último una problemática de actualidad y de suma importancia que debe tratarse de forma integral, dando prioridad a la prevención e identificación de los factores que hacen posible el aumento en las tasas de incidencia. Hoy en día, esta "epidemia" reporta tasas que superan el cincuenta por ciento, por lo que se ha considerado un problema de salud pública a nivel mundial. Consecuentemente, en México se han implementado estrategias tendentes a su disminución, no obstante, los factores socioculturales, económicos, médico-legales y biomédicos son aspectos que dificultan dicho objetivo. En la proporción en que se disminuya el porcentaje de cesárea en pacientes primigestas, disminuirá secundariamente el número de cesáreas iterativas y sus complicaciones asociadas, meta que debe alcanzarse mediante el apego a las guías que promueven el interés por la vigilancia y atención del parto en las instituciones de salud de nuestro país.
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Cesárea/história , Cesárea/ética , Cesárea/estatística & dados numéricos , Tomada de Decisão Clínica/ética , Feminino , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , História Medieval , Humanos , México , Participação do Paciente/história , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/história , GravidezRESUMO
BACKGROUND: Despite substantial advances in treatment, coronary atherosclerosis is a progressive disease, for this reason a second surgery is frequent. The left anterior small thoracotomy operation on a beating heart is an alternative with less morbidity and mortality than the conventional surgery. CASES REPORT: We report two cases of coronary surgery with limited access. The first corresponds to a 72-year-old man with diabetes, hypertension, dyslipidemia, obesity, with myocardial damage and bypass surgery to anterior descendent coronary artery and first diagonal coronary artery with saphenous vein graft performed 13 years ago. Due to unstable angina and positive test for myocardial ischemia, we performed bypass surgery of minimal access to the anterior descendent coronary artery and obtuse marginal coronary artery. The second case corresponds to a man with hypertension, diabetes, obesity, previous bypass surgery of two vessels performed 4 years ago, complicated with perioperative inferior myocardial infarction. Due to unstable angina and positive test for myocardial viability, we performed a re-do coronary artery bypass graft surgery to the left anterior descending artery and first diagonal coronary arteries through a minimal access incision. In both the clinical evolution was satisfactory, they were discharged 7 days after surgery and remain asymptomatic at one year of follow-up. CONCLUSION: The antero-lateral thoracotomy off-pump coronary bypass surgery is an alternative indicated in high risk patient with coronary revascularization.
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Doença da Artéria Coronariana/cirurgia , Revascularização Miocárdica/métodos , Toracotomia , Idoso , Ponte de Artéria Coronária , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Despite substantial advances in treatment, coronary atherosclerosis is a progressive disease, for this reason a second surgery is frequent. The left anterior small thoracotomy operation on a beating heart is an alternative with less morbidity and mortality than the conventional surgery. CASES REPORT: We report two cases of coronary surgery with limited access. The first corresponds to a 72-year-old man with diabetes, hypertension, dyslipidemia, obesity, with myocardial damage and bypass surgery to anterior descendent coronary artery and first diagonal coronary artery with saphenous vein graft performed 13 years ago. Due to unstable angina and positive test for myocardial ischemia, we performed bypass surgery of minimal access to the anterior descendent coronary artery and obtuse marginal coronary artery. The second case corresponds to a man with hypertension, diabetes, obesity, previous bypass surgery of two vessels performed 4 years ago, complicated with perioperative inferior myocardial infarction. Due to unstable angina and positive test for myocardial viability, we performed a re-do coronary artery bypass graft surgery to the left anterior descending artery and first diagonal coronary arteries through a minimal access incision. In both the clinical evolution was satisfactory, they were discharged 7 days after surgery and remain asymptomatic at one year of follow-up. CONCLUSION: The antero-lateral thoracotomy off-pump coronary bypass surgery is an alternative indicated in high risk patient with coronary revascularization.
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Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Doença da Artéria Coronariana , Revascularização Miocárdica/métodos , Toracotomia , Ponte de Artéria CoronáriaRESUMO
Con el objetivo de actualizar la prevalencia de la resistencia inicial (RI) a drogas antituberculosas en Chile, en 1997 se realizó la última determinación nacional de acuerdo a un protocolo estándar recomendado por la Organización Mundial de la Salud (OMS). Se programó estudiar el 50 por ciento de la incidencia de ese año de casos nunca tratados, de tuberculosis pulmonar con baciloscopía positiva. Las pruebas de sensibilidad se realizaron en el Laboratorio de Referencia Nacional de Micobacterias del Instituto de Salud Pública, por el método de las proporciones. Se recibieron 908 cepas, que correspondieron a igual número de enfermos, provenientes de los 26 Servicios de Salud (SS) del país. Luego de excluir 27 cepas por diversas causas, quedaron 881 casos útiles, 732 (83,1 por ciento) nuevos y 149 (16,9 por ciento) con tratamiento previo. La prevalencia global de RI fue de 9,3 por ciento cifra inferior a la de las últimas cuatro determinaciones; su distribución por drogas y asociaciones resultó semejante a la de los estudios previos; la multirresistencia (MR) se encontró en 0,4 por ciento de los casos. La inclusión de 19 pacientes con serología positiva al VIH, no modificó significativamente las cifras. En los enfermos antes tratados se encontró un porcentaje de 18,1 por ciento de resistencia adquirida, semejante a la determinada para ese mismo año en la totalidad de las recaídas y abandonos. La muestra estudiada para RI resultó numérica y cualitativamente representativa de la situación nacional, lográndose así el objetivo de mantener la vigilancia actualizada de su prevalencia en todo el país
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Humanos , Antituberculosos/farmacologia , Resistência Microbiana a Medicamentos , Tuberculose Pulmonar/tratamento farmacológico , Técnicas Bacteriológicas , Chile/epidemiologia , Características de Residência , Incidência , Mycobacterium/efeitos dos fármacos , Mycobacterium/isolamento & purificação , Mycobacterium/patogenicidade , Recidiva , Recusa em Tratar , Escarro/microbiologiaAssuntos
Humanos , Antituberculosos/classificação , Resistência Microbiana a Medicamentos , Tuberculose Resistente a Múltiplos Medicamentos , Chile , Etambutol/farmacologia , Isoniazida/farmacologia , Pirazinamida/farmacologia , Resistência a Múltiplos Medicamentos , Rifampina/farmacologia , Estreptomicina/farmacologiaAssuntos
Humanos , Antituberculosos/uso terapêutico , Resultado do Tratamento , Tuberculose/tratamento farmacológico , Antituberculosos/farmacologia , Chile/epidemiologia , Estudos de Coortes , Alta do Paciente/estatística & dados numéricos , Recidiva , Recusa em Tratar , Falha de Tratamento , Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose/diagnósticoAssuntos
Humanos , Síndrome da Imunodeficiência Adquirida/classificação , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/etiologia , Síndrome da Imunodeficiência Adquirida/fisiopatologia , Síndrome da Imunodeficiência Adquirida/mortalidade , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/terapia , Tuberculose Pulmonar/classificação , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/etiologia , Tuberculose Pulmonar/mortalidade , Tuberculose Pulmonar/fisiopatologia , Tuberculose Pulmonar/terapiaRESUMO
Chile ha sido un país pionero en realizar estudios controlados para evaluar la eficacia de la quimioterapia abreviada antituberculosa. En esta revisión se analizan los estudios clínicos sobre quimioterapia efectuados en Chile por un período de 10 años a contar de 1978. El propósito de estos ensayos ha sido buscar el esquema más satisfactorio de quimioterapia en cuanto a eficacia, seguridad, aceptabilidad, aplicabilidad y bajo costo económico. Los estudios analizados se efectuaron en 6 áreas sanitarias diferentes de Santiago de Chile y el el área de Valparaíso, las cuales son cubiertas por el Sistema Nacional de Servicios de Salud. Los estudios fueron coordinados por un grupo de especialistas y un total de 3616 pacientes con tuberculosis pulmonar con baciloscopía positiva fue incorporada a 8 esquemas diferentes de quimioterapia. El éxito de los esquemas quimioterapéuticos analizados fluctuó entre 88.1 y 98.6 porciento, las recaídas entre el 0.7 y 10.9 porciento y los fracasos entre 0 y 1.8 porciento. Se obtuvo inactivación de la tuberculosis entre el 73 y el 87.4 porciento de los casos. Los efectos secundarios de las quimioterapias fluctuaron entre 0 y 7.2 porciento y los abandonos entre 8 y 22.1 porciento. La mortalidad fluctuó entre 1.1 y 4.1 porciento. El costo de las drogas admnistradas en cada tratamiento individual varió entre 32.60 y 65.90 dólares estadounidenses. Se concluye que con cualquiera de los dos siguientes esquemas de quimioterapia abreviada es posible obtener entre 97 y 98 porciento de eficacia: a) siete meses de quimioterapia, con un primer mes de tratamiento diario con Estreptomicina (S), Isoniacida (H), Rifampicina (R) y Pirazinamida (Z) seguido por H + R dos veces por semana (ISHRZ/6H2R2), o b) cinco meses de quimioterapia, con los dos primeros meses de tratamiento diario con la misma asociación de cuatro drogas seguido por 3 meses de H + R bisemanal (2SHRZ/9H2R2). Indudablemente el segundo esquema aumenta los costos y requiere el empleo de una mayor infraestructura en la fase diaria
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Esquema de Medicação , Tuberculose/tratamento farmacológico , Antibióticos Antituberculose/administração & dosagem , Tuberculose/epidemiologiaRESUMO
Se muestra la experiencia del Servicio de Cirugía del Hospital de Quilpué en 43 pacientes con derivaciones biliodigestivas realizadas entre enero de 1985 y enero de 1990; se tabula y analiza edad, sexo, antecedentes mórbidos, clínicos y de laboratorio, indicación de la intervención, técnicas usadas, complicaciones inmediatas y tardías, mortalidad y seguimiento. Se concluye que la indicación de la técnica, la predominancia del sexo femenino, la distribución por grupos etarios se ajustan a las cifras presentadas por otros autores. Las complicaciones inmediatas más relevantes fueron infección de herida operatoria (11,6%), cuadros respiratorios (27,8%), siendo la mortalidad operatoria de 6,9%