Abstract This study aimed to assess the impact of the implementation of a rapid multiplex molecular FilmArray Respiratory Panel (FRP) on the medical management of immunocompromised patients from a community general hospital. We conducted a single-center, retrospective, and before-after study. Two periods were evaluated: before the implementation of the FRP (pre-FRP) from April 2017 to May 2018 and after the implementation of the FRP (post-FRP) from January to July 2019. The inclusion criteria were immunocompromised patients over 18 years of age with suspected acute respiratory illness tested by conventional diagnostic meth-ods (pre-FRP) or the FilmArray™ Respiratory Panel v1.7 (post-FRP). A total of 142 patients were included, 64 patients in the pre-FRP and 78 patients in the post-FRP. The positive detec-tion rate was significantly higher in the post-FRP (63% vs. 10%, p <0.01). There were more patients receiving antimicrobial treatment in the pre-FRP compared with the post-FRP period (94% vs. 68%, p <0.01). A decrease in beta-lactam (89% vs. 61%, p <0.01) and macrolide (44% vs. 13%, p < 0.01) prescriptions were observed in the post-FRP. No differences were observed in oseltamivir use (22% vs. 13%, p = 0.14), changes in antimicrobial treatment, hospital admission rate, days-reduction in droplet isolation precautions, hospital length of stay (LOS), admission to intensive care unit (ICU), LOS in ICU, treatment failure and 30-day mortality. The implementa-tion of the FRP impacted patient care by improving diagnostic yield and optimizing antimicrobial treatment in immunocompromised adult patients.

Resumen El objetivo de este estudio fue evaluar el impacto de la implementación del panel respiratorio FilmArray® (FRP), un sistema automatizado de PCR multiplex, en el estándar de cuidado de pacientes adultos inmunocomprometidos en un hospital general. Es un estudio retrospectivo de un único centro con diseno antes/después. Los periodos evaluados fueron abril 2017-mayo 2018, previo a la implementación del FRP (pre-FRP), y enero 2019-julio 2019, luego de la implementación (post-FRP). Los criterios de inclusión fueron pacientes mayores de 18 años inmunocomprometidos con sospecha de infección respiratoria aguda a los que se les realizó, en pre-FRP, diagnóstico por métodos convencionales, y en post-FRP, el panel respiratorio FRP versión 1.7. Se incluyeron un total de 142 pacientes, 64 en pre-FRP y 78 en post-FRP. La tasa de positividad fue significativamente mayor en post-FRP frente a pre-FRP (63 vs. 10%, p<0,01). Hubo más pacientes con tratamiento antimicrobiano en pre-FRP que en post-FRP (94 vs. 68%, p <0,01). En pre-FRP hubo más pacientes tratados con betalactámicos (89 vs. 61%, p <0,01) y macrólidos (44 vs. 13%, p < 0,01). No se observaron diferencias significativas en el uso de oseltamivir (22 vs. 13%, p = 0,14), cambios en los tratamientos, número de hospitalizaciones, uso de aislamientos, duración de la estadía hospitalaria, ingreso a la unidad de cuidados intensivos, estadía en dicha unidad, falla de tratamiento y mortalidad a 30 días. El uso de FRP contribuyó a la atención del paciente mejorando el rendimiento diagnóstico y optimizando la terapia antimicrobiana en pacientes adultos inmunocomprometidos.

Resumen Introducción Los estudiantes universitarios viven un escenario de acumulación de actividades académicas y sociales que generan gran ansiedad y estrés, afectándolos psicológica y físicamente. En este caso, los síntomas psicosomáticos, producto del estrés y la ansiedad, forman parte de una dolencia física y pueden vincular su aparición con el escenario y el tiempo que los presenta. Objetivo Determinar la asociación entre el nivel de ansiedad y el grado de manifestación psicosomática. Método Se desarrolló un estudio con diseño analítico transversal que incluyó un total de 352 estudiantes de medicina de la ciudad de Piura, Perú, a quienes se les aplicó mediante Google forms el test de PHQ-15. Se excluyeron a aquellos con diagnóstico psiquiátrico previo. Resultados Se encontró que las MS se ven influenciadas por el sexo femenino (RPa = 1.45, IC 95% = [1.23, 1.71], p ≤ .001), nivel de ansiedad leve (RPa = 1.11, IC 95% = [1.20, 1.63],p ≤ .001) y nivel de ansiedad moderada (RPa = 1.7 IC 95% = [1.24, 2.34]; p = .001). Discusión y conclusión Es necesario la presencia de una afección mental para la presencia de la MS. Estos factores estresantes generan alteraciones selectivas de redes cerebrales a gran escala implicadas en el control cognitivo, regulación y procesamiento de emociones, estrés y percepción somático-visceral. Se concluye que las manifestaciones psicosomáticas se encuentran en 75% y la ansiedad en 15% aproximadamente, en estudiantes de medicina. La ansiedad leve y moderada es un factor influyente en las manifestaciones psicosomáticas, así como el sexo femenino.

Abstract Introduction University students experience multiple academic and social activities that cause enormous anxiety and stress, affecting them psychologically and physically. In this case, the psychosomatic symptoms, resulting from stress and anxiety, are part of a physical ailment and their emergence can be linked to the setting and time when they occur. Objective To determine the association between anxiety levels and the degree of psychosomatic features (PF). Method A study with a cross-sectional analytical design was developed, which included a total of 352 medical students from the city of Piura, Peru, to whom the PHQ-15 test was administered through Google Forms. Those with a previous psychiatric diagnosis were excluded. Results It was found that PF are influenced by being female (RPa = 1.45, CI 95% = [1.23, 1.71], p ≤ .001), and having mild (RPa = 1.11, CI 95% = [1.20, 1.63], p ≤ .001) and moderate anxiety levels (RPa = 1.7, CI 95% = [1.24, 2.34], p = .001). Discussion and conclusion The presence of a mental condition is necessary for the presence of PF. These stressors create selective alterations of large-scale brain networks involved in the cognitive control, regulation and processing of emotions, stress, and somatic-visceral perception. The study concludes that psychosomatic features are found in approximately 75% of medical students and anxiety in approximately 15%. Mild and moderate anxiety is an influential factor in psychosomatic features, as is being female.

RESUMO Introdução: O objetivo deste estudo foi apresentar uma revisão sistemática e metanálise para comparar os efeitos de dois modelos de intervenção de treinamento sobre o consumo excessivo de oxigênio pós-exercício (EPOC) em indivíduos saudáveis em treinamento, e o objetivo secundário foi entender se o consumo de oxigênio depois de exercício realmente pode proporcionar ajuda substancial. Objetivo: Elaborar uma revisão de metanálise para comparar um modelo de treinamento de duas intervenções (experimental: treinamento intervalado de alta intensidade, e controle: contínuo de intensidade moderada) e o efeito sobre o EPOC total em indivíduos saudáveis. Participantes: Os 17 estudos foram considerados de boa qualidade metodológica e baixo risco de viés. Métodos: As buscas bibliográficas foram realizadas nos bancos de dados eletrônicos sem restrição de ano de publicação. Os descritores usados foram obtidos em MeSH (PubMed) e DeCS (Descritores em Ciências da Saúde da BIREME). Resultados: Os achados do presente estudo mostraram uma tendência (modelo de efeitos aleatórios: 0,87, IC 95% [0,35;1,38], I ² = 73%, p < 0,01) de aumento do EPOC quando as medidas foram realizadas depois de treinamento intervalado de alta intensidade. Conclusões: Nosso estudo concentrou-se na análise dos resultados de alta e moderada intensidade no consumo de oxigênio depois do exercício. Apesar da crescente popularidade do treinamento intervalado de alta intensidade, descobrimos que os benefícios agudos e crônicos permanecem limitados. Entendemos que a falta de um protocolo e variáveis padronizadas de treinamento fornecem consenso limitado para determinar a magnitude do EPOC. Sugerimos que estudos experimentais longitudinais podem fornecer conclusões mais robustas. Outro fator de confusão nos estudos investigados foi a magnitude (tempo em minutos) das medidas do VO2na avaliação do EPOC. Os tempos de medição variaram de 60 a 720 min. Estudos longitudinais e projetos experimentais controlados facilitariam medições mais precisas e números corretos de indivíduos forneceriam tamanhos de efeito precisos. Nível de evidência II; Revisão sistemáticabde Estudos.

ABSTRACT Introduction: The objective of this study was to present a systematic review and meta-analysis to compare total excess post-exercise oxygen consumption (EPOC) for two training intervention models in healthy individuals, and the secondary objective was to understand whether oxygen consumption after exercise could really promote a meaningful help. Design: To design a meta-analysis review to compare two training intervention models (experimental: high-intensity interval training; and control: continuous moderate-intensity) and their effects on total EPOC in healthy individuals. Participants: Seventeen studies were considered to be of good methodological quality and with a low risk of bias. Methods: Literature searches were performed using the electronic databases with no restriction on year of publication. The keywords used were obtained by consulting Mesh Terms (PubMed) and DeCS (BIREME Health Science Descriptors). Results: The present study findings showed a tendency (random-effects model: 0.87, 95%-CI [0.35,1.38], I2=73%, p<0.01) to increase EPOC when measured following high-intensity interval training. Conclusions: Our study focused on the analysis of high- and moderate-intensity oxygen uptake results following exercise. Despite the growing popularity of high-intensity interval training, we found that the acute and chronic benefits remain limited. We understand that the lack of a standard protocol and standard training variables provides limited consensus to determine the magnitude of the EPOC. We suggest that longitudinal experimental studies may provide more robust conclusions. Another confounding factor in the studies investigated was the magnitude (time in minutes) of VO2 measurements when assessing EPOC. Measurement times ranged from 60 min to 720 min. Longitudinal studies and controlled experimental designs would facilitate more precise measurements and correct subject numbers would provide accurate effect sizes. Systematic reviewb of Level II studies.

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RESUMEN El presente estudio tiene por objetivo determinar el nivel de conocimiento respecto a los antioxidantes y su relación con el estilo de vida. Estudio descriptivo, de corte transversal con la participación de 392 pobladores de la ciudad de Trujillo, que dieron respuesta a dos cuestionarios: uno para determinar el nivel de conocimiento respecto a los antioxidantes elaborado por la Dra. Carolina González, nutrióloga de la Clínica Alemana, que consta de cinco preguntas relacionadas a los antioxidantes y el cuestionario de estilo de vida promueve la salud elaborado por Walker, Sechrist y Pender, y modificado por Delgado, R; Reyna E y Diaz, R constituido por 25 preguntas, obteniendo información sobre conocimiento de antioxidantes y alimentación, ejercicio y actividad, estrés. Con los datos obtenidos se obtuvo la calificación respectiva y la escala de puntuación saludable y no saludable y si tiene conocimiento o no. De las encuestas procesadas, se evidenció mayor porcentaje de pobladores que no tenían conocimiento de antioxidantes 222 (56.64%) con predominio de los jóvenes 141 (35.97%), así como de un estilo de vida no saludable 285 (72.71%). Se presentó una relación entre nivel de conocimiento de antioxidantes y sexo, con la edad no hubo relación. Además, no hubo relación entre las variables sexo y edad con estilo de vida, teniendo en cuenta que si P > 0.05 no hay relación o diferencia significativa. Finalmente podemos concluir que la población en estudio no tenía conocimiento sobre antioxidantes y estilo de vida no adecuado.

ABSTRACT The objective of this study was to determine the level of knowledge about antioxidants and their relationship with lifestyle. A descriptive, cross-sectional study with the participation of 392 inhabitants of the city of Trujillo, who responded to two questionnaires: one to determine the level of knowledge about antioxidants prepared by Dr. Carolina Gonzalez, a nutritionist from Clínica Alemana, consisting of five questions related to antioxidants, and the other questionnaire of lifestyle promotes health elaborated by Walker, Sechrist and Pender, and modified by Delgado, R; Reyna E and Diaz, R constituted by 25 questions, obtaining information on knowledge of antioxidants and nutrition, exercise and activity, stress. With the obtained data the respective qualification and the healthy and unhealthy score scale and has knowledge or not was obtained. From the processed surveys, there was evidence of a higher percentage of people who had no knowledge of antioxidants 222 (56.64%) with a predominance of young people 141 (35.97%), as well as an unhealthy lifestyle 285 (72.71%). There was a relationship between the level of antioxidant knowledge and sex but there was no relationship with respect to age. In addition, there was no relationship between the variables sex and age with lifestyle, taking into account that if P > 0.05 there is no relationship or significant difference. Finally, we can conclude that the study population had no knowledge of antioxidants and inadequate lifestyle.

Resumen Antecedentes: Los déficits en el procesamiento de la información, la atención sostenida y la cognición social tienen implicaciones importantes para el funcionamiento diario de las personas con esquizofrenia. El presente estudio analizó la relación entre velocidad de procesamiento, atención sostenida, cognición social y funcionamiento en personas clínicamente estables con esquizofrenia. Método: Noventa personas con esquizofrenia y 100 controles sanos completaron una batería de pruebas para evaluar síntomas clínicos, velocidad de procesamiento, atención sostenida, cognición social y funcionamiento. Se utilizaron GLMM y SEM para evaluar las relaciones entre variables. Resultados: Las personas con esquizofrenia tuvieron un peor rendimiento en todos los resultados cognitivos. La velocidad de procesamiento y la atención sostenida, juntas en una variable latente, tuvieron un fuerte efecto sobre el funcionamiento (Beta = 0,32; p < 0,05). La cognición social también tuvo un fuerte efecto sobre el funcionamiento (Beta = 0,29; p < 0,001) en el modelo de mediación, que mostró mejores índices de ajuste que el modelo que incluía solo neurocognición (e.g. RMSEAbasic = 0.131 y RMSEAmediator = 0.054). Conclusiones: El efecto mediador de la cognición social sobre la relación entre la velocidad de procesamiento, la atención sostenida y el funcionamiento sugiere la importancia de incluir ambos dominios junto con la cognición social como objetivos de tratamiento en las intervenciones de rehabilitación.

Abstract Background: Deficits in information processing, sustained attention and social cognition have important implications for the daily functioning of people with schizophrenia. The present study analyzed the relationship between processing speed, sustained attention, social cognition, and functioning in clinically stable people with schizophrenia. Method: Ninety people with schizophrenia and 100 healthy controls completed a battery of measures to assess clinical symptoms, processing speed, sustained attention, social cognition, and functioning. GLMMs and SEM were used to assess the relationships between these variables. Results: People with schizophrenia had impaired performance in all cognitive outcomes compared to healthy controls. Processing speed and sustained attention, together in a latent variable, had a strong effect on functioning (Beta = 0.32; p < .05). However, social cognition had also a strong effect on functioning (Beta = 0.29; p <.001) in the mediation model, which exhibited better indices of fit than the model including neurocognition alone (e.g. RMSEAbasic = 0.131 and RMSEAmediator = 0.054). Conclusions: The mediating effect of social cognition on the relationship between processing speed, sustained attention, and functioning in people with schizophrenia suggests the importance of including both domains of neurocognition along with social cognition as treatment targets in rehabilitation interventions to optimize improvements in functioning in schizophrenia.

BACKGROUND: Body mass index (BMI) uses a person's weight and height to estimate body fat as an indication of an individual's health status. Several studies have suggested that BMI (calculated as weight in kilograms divided by the square of height in metres) was related to central corneal thickness (CCT) in non-emmetropic subjects; however, there is limited information about the possible correlation between BMI and the CCT in healthy emmetropic eyes. AIM: This study aimed to investigate the correlation between CCT and BMI in healthy emmetropic eyes. SETTING: The study was performed by the GIAVAL research group of the Faculty of Medicine and Odontology, University of Valencia, Spain. METHODS: The emmetropic eyes of 81 (mean age ± standard deviation [s.d.]: 21.8 ± 1.8 years) adults were included in this retrospective study. Ophthalmic CCT measurements were measured using non-invasive scanning-slit corneal topography. The height and weight of all subjects, using a standard tape measure and weight scale, were recorded, and BMI was calculated. RESULTS: There were no significant correlations between CCT and the BMI values in the 81 emmetropic adults (r = 0.16; p = 0.135), between CCT values and BMI (18.5 to < 25) (r = 0.21; p = 0.724) and between CCT values and BMI (25.0 to < 30) (r = -0.28; p = 0.465). In addition, no correlation occurs between the CCT values and BMI in both women (r = 0.22; p = 0.160) and men (r = -0.14; p = 0.412). A weak negative correlation does seem to present with age and CCT (r = -0.29; p < 0.05). However, the coefficient of determination suggests that only 8% (r² = 0.08) of the variance is shared between age and CCT. CONCLUSION: The results do not show a correlation between CCT and BMI values in young subjects with healthy emmetropic eyes. CONTRIBUTION: This study has revealed that the CCT values are not correlated with the BMI values in healthy emmetropic eyes of young subjects without obesity. In addition, normative data for the CCT in normal anatomic eyes has been reported, which will serve as a baseline for future comparative studies in non-emmetropic eyes.

Resumen Objetivo: El objetivo de este estudio es evaluar la asociación entre las complicaciones inducidas por dopaminérgicos y la satisfacción con la vida en pacientes con enfermedad de Parkinson. Métodos: Se realizó un estudio transversal. Los sujetos fueron reclutados de dos clínicas de trastornos del movimiento en México, de mayo a octubre de 2019. Las complicaciones inducidas por fármacos dopaminérgicos se evaluaron con la escala de calificación unificada de la enfermedad de Parkinson de la sociedad de trastornos del movimiento ítems 4.1 al 4.5. La variable desenlace se obtuvo por medio de la escala de satisfacción con la vida. Se utilizaron coeficientes de correlación. Resultados: 68 pacientes fueron incluidos en el estudio. La puntuación media de la escala de satisfacción con la vida fue de 25.7 (DE = 5.3), con un 66.1% de ellos con una puntuación superior a la media. Observamos que la edad al momento del diagnóstico (rs = 0.256, p = 0.035), educación (rs = 0.240, p = 0.048), región geográfica (r2 = 0.180, p = 0.034), escala unificada de calificación de la enfermedad de Parkinson, parte I (rs = −0.378, p = 0.002) y II (rs = −0.280, p = 0.021) y el estadio de Hoehn y Yahr (rs = −0.295, p = 0.015) se correlacionaron significativamente con las puntuaciones de la escala de satisfacción con la vida. El análisis del coeficiente de correlación parcial reveló una correlación estadísticamente significativa pero moderada entre las fluctuaciones motoras y las puntuaciones de la escala de satisfacción con la vida (rs = −0.408, p = 0.001). No se observó una correlación significativa con las discinesias. Conclusiones: Las fluctuaciones motoras, pero no las discinesias, tienen un efecto perjudicial sobre la satisfacción con la vida de los pacientes. Las estrategias para reducir las fluctuaciones motoras y comprender mejor la contribución de estas a la vida de los pacientes pueden ayudar a minimizar el impacto negativo de estas complicaciones en los pacientes con Parkinson.

Abstract Objective: The aim of this study was to assess the association between dopaminergic-induced complications and satisfaction with life in patients with Parkinson’s disease. Methods: A cross-sectional study was carried out. Subjects were recruited from two movement disorders clinics in Mexico, from May to October 2019. Dopaminergic drug-induced complications were assessed with the movement disorders society – unified Parkinson’s disease rating scale items 4.1-4.5 where satisfaction with life scale score was used as the outcome variable. Correlation coefficients were utilized. Results: Sixty-eight patients were included in the study. The mean satisfaction with life scale score was 25.7 (SD = 5.3), with 66.1% of them scoring higher than average scores. Age at diagnosis (rs = 0.256, p = 0.035), education (rs = 0.240, p = 0.048), geographic region (r2 = 0.180, p = 0.034), movement disorders society - unified Parkinson’s disease rating scale part I (rs = −0.378, p = 0.002) and II (rs = −0.280, p = 0.021), and Hoehn and Yahr stage (rs = −0.295, p = 0.015) were significantly correlated with satisfaction with life scale scores. Partial correlation coefficient analysis revealed a statistically significant but moderate correlation between motor fluctuations and satisfaction with life scale scores (rs = −0.408, p = 0.001). No significant correlation was observed with dyskinesias. Conclusions: Motor fluctuations but not dyskinesias have a detrimental effect on patients’ life satisfaction. Strategies to reduce motor fluctuations and better understanding the contribution of these to patients’ lives may help minimize the negative impact of these complications on patients with PD.

Resumen A pesar de la baja frecuencia de coinfecciones bacterianas asociadas al COVID-19, la tasa de uso de antibióticos (ATB) empíricos varía entre 70 y 90%. El objetivo primario del estudio fue evaluar el impacto de la implementación de un programa de optimización de antimicrobianos en pacientes con COVID-19 (PROA-COVID). Se realizó un estudio prospectivo de serie de tiempo interrumpida. Se evaluó la prevalencia, adecuación y consumo de ATB en adultos internados con COVID previo a la implementación del PROA-COVID (P1, junio 2020) y en tres períodos posteriores (P2 en agosto 2020, P3 en octubre 2020 y P4 en junio 2021). Se incluyeron 301 pacientes. Las formas clínicas moderadas-graves fueron más frecuentes en los P2, 3 y 4 (p < 0.001). La implementación del programa mostró una disminución significativa del uso de ATB (61% vs. 41% vs. 31.1% vs. 8.1%, p < 0.001), de la indicación de tratamiento combinado con macrólidos (17.3% vs. 19.2% vs. 10.8% vs. 1.4%, p = 0.03) y aumento del uso adecuado (37.5% vs. 46.9% vs. 69.9% vs. 66.6%, p = 0.039). El consumo de ATB en DDT (días de tratamiento) totales/1000 días paciente fue: 347.9 vs. 272.8 vs. 134.3 vs. 43.6 (p < 0.001). No hubo diferencias significativas en el pase a unidades de cuidados críticos ni en la mortalidad. La implementación del PROA-COVID fue una estrategia efectiva para reducir el uso de antibióticos y optimizar sus indicaciones sin impacto en la morbimortalidad.

Abstract In spite of the low frequency of COVID-19 associated bacterial coinfections, the rate of empiric an tibiotic use varies between 70% and 90%. The primary objective of this study was to evaluate the impact of an antimicrobial stewardship program (ASP) on COVID-19 patients. The study design was an interrupted time series, assessing prevalence of antibiotic use, adequacy of treatment and antimicrobial consumption in adult patients hospitalized with COVID before the COVID-ASP implementation in June 2020, and on three subsequent periods (P2 in August 2020, P3 in October 2020 and P4 in June 2021). One hundred and one patients were included. Moderate and severe disease was more frequent in P2, P3, and P4 periods (p < 0.001). After the implementation we observed a significant reduction on ATM use (61% vs. 41% vs. 31.1% vs. 8.1%, p < 0.001), and macrolid combination therapy (17.3% vs. 19.2% vs. 10.8% vs. 1.4%, p = 0.03), and an increase of adequate use (37.5% vs. 46.9% vs. 69.9% vs. 66.6%, p = 0.039). Antimicrobial consumption by period in days of therapy (DOT)/1000 patient-day was 347.9 vs. 272.8 vs. 134.29 vs. 43.6 (p<0.001). We did not find any difference in intensive care unit transfer or mortality. COVID-ASP implementation was an effective strategy to reduce antimicrobial consump tion and optimize antibiotic indications without affecting morbidity or mortality.

Resumen Introducción: Se ha informado que los veteranos de guerra están más expuestos a factores de riesgo cardiovascular. El objetivo del presente trabajo fue establecer los factores de riesgo, el perfil cardiometabólico y la prevalencia de enfermedad cardiovascular de un grupo de excombatientes de la Guerra de Malvinas (HdeM). Métodos: En un diseño caso-control se analizaron los datos de 799 HdeM y se compararon 799 controles de misma edad. La muestra se seleccionó de los participantes del Programa de Prevención de Salud Cardiovascular de la Fundación Favaloro, entre enero de 2017 y diciembre de 2019. Resultados: La edad promedio fue 56.9 ± 3.9 años. Se observó un aumento del peso entre los HdeM (91.3 ± 16.6 kg vs. 88.2 ± 14.7 kg; p = 0.0001). Se observó mayor frecuencia de hipertensión arterial en HdeM (42% vs. 34%; p < 0.001) y diabetes mellitus (15.1% vs. 10.4%; p < 0.005). El síndrome metabólico fue más prevalente en HdeM (49.2% vs. 39.7%; p = 0.0001). Se observó que el antecedente de infarto agudo de miocardio fue más frecuente entre los HdeM (3.6% vs. 2%; p < 0.05), con similar prevalencia de ACV (1.2% vs. 1%; p = ns), angioplastia corona ria (3.2% vs. 2.1%; p = ns) o cirugía de revascularización miocárdica (0.8% vs. 0.4%; p = ns). Discusión: Los HdeM mostraron mayor prevalencia de factores de riesgo, síndrome metabólico e infarto agudo de miocardio. Es importante tener en cuenta este aumento de riesgo para maximizar las estrategias de prevención cardiovascular en los excombatientes.

Abstract Introduction: It has been reported in different parts of the world that war veterans are more exposed to cardio vascular risk factors. The objective of this study was to establish the risk factors, the cardiometabolic profile and the prevalence of cardiovascular disease in a group of ex-combatants of the Malvinas War (HdeM). Methods: In a case-control design, data from 799 HdeM were analyzed and compared with 799 controls matched by age. The sample was selected from the participants of the Cardiovascular Health Prevention Program of the Favaloro Foundation, between January 2017 and December 2019. Results: The average age was 56.9 ± 3.9 years. An increase in weight was observed among the HdeM (91.3 ± 16.6 kg vs. 88.2 ± 14.7 kg; p = 0.0001). A higher frequency of arterial hypertension (42% vs. 34%; p < 0.001) and diabetes mellitus (15.1% vs. 10.4%; p < 0.005) was observed in HdeM. Metabolic syndrome was also more prevalent in HdeM (49.2% vs. 39.7%; p = 0.0001). It was observed that the history of acute myocardial infarction was more frequent among the HdeM (3.6% vs. 2%; p < 0.05), with a similar prevalence of stroke (1.2% vs. 1%; p = ns), coronary angioplasty (3.2% vs. 2.1%; p = ns) or myocardial revascularization surgery (0.8% vs. 0.4%; p = ns). Discussion: The HdeM showed an increase in the frequency of risk factors, metabolic syndrome and acute myocardial infarction. It is important to take this increased risk into account in order to maximize cardiovascular prevention strategies in ex-combatants.

ABSTRACT BACKGROUND: Many factors may negatively impact physical activity (PA), but studies lack evidence of individual predictors of perceived barriers to PA among adults in primary healthcare units. OBJECTIVE: To analyze associations between sociodemographic characteristics, health conditions, leisure-time physical activity (LTPA), PA counseling and perceived barriers to LTPA among adult patients in primary healthcare units of the National Health System in Brazil. DESIGN AND SETTING: Cross-sectional study on a representative sample of adults in primary healthcare units in São José dos Pinhais, Paraná, Brazil. METHODS: This study was conducted in 2019, among 779 adults (70% women). Barriers to LTPA, sociodemographic characteristics (sex, age, marital status, skin color, education and income), health conditions (body mass index, hypertension, diabetes, dyslipidemia, coronary disease and medications), LTPA level and PA counseling received were measured using validated, standardized procedures. The data were analyzed using chi-square and Mann-Whitney U tests. RESULTS: The most prevalent barriers were “feeling too tired” (53%) and “lack of time” (52%). PA counseling was inversely associated with “lack of time” (45% versus 57%; P < 0.001) but positively associated with “injury or disease” (38% versus 29%; P = 0.008). There was an inverse linear trend between the number of barriers and LTPA (walking and total) (P < 0.001). Most barriers differed in comparisons of sociodemographic characteristics, health conditions, LTPA and counseling (P < 0.05). CONCLUSIONS: The barriers vary according to the individual predictors. Counseling strategies need to be specific for each barrier and may be promising for promoting LTPA within primary healthcare.

Abstract Objective: We evaluated whether cholesteryl ester transfer protein (CETP) gene polymorphisms are associated with the presence of coronary artery disease (CAD) and/or restenosis in patients with coronary stent. Methods: Two polymorphisms of the CETP gene [−971 A/G (rs4783961), and Taq1B A/G (rs708272)] were genotyped by 5'exonuclease TaqMan assays in 219 patients with CAD (66 patients with restenosis and 153 without restenosis) and 607 control individuals. Results: The distribution of polymorphisms was similar in patients with and without restenosis. However, when the whole group of patients (with and without restenosis) was compared to healthy controls, under dominant model, the G allele of the Taq1B A/G polymorphism was associated with increased risk of CAD (odds ratio [OR] = 1.48, pCDom = 0.032). In the same way, under codominant, dominant, and additive models, the A allele of the −971 A/G polymorphisms was associated with an increased risk of developing CAD (OR = 2.03, pCCo-dom = 0.022, OR = 1.83, pCDom = 0.008, and OR = 1.39, pCAdd = 0.011, respectively). In addition, the linkage disequilibrium showed that the “AG” haplotype was associated with increased risk of developing CAD (OR = 1.28, p = 0.03). Conclusion: This study demonstrates that CETP Taq1B A/G and CETP −971 A/G polymorphisms are associated with an increased risk of developing CAD, but no association with restenosis was observed.

Resumen Objetivo: Evaluamos si los polimorfismos del gen CETP están asociados con la presencia de enfermedad arterial coronaria (EAC) y/o restenosis en pacientes con stent coronario. Métodos: En este estudio se genotiparon dos polimorfismos del gen CETP [−971 A/G (rs4783961) y Taq1B A/G (rs708272)] mediante ensayos de 5'exonucleasa TaqMan en 219 pacientes con EAC (66 pacientes con restenosis y 153 sin restenosis), y 607 individuos de control. Resultados: La distribución de polimorfismos fue similar en pacientes con y sin restenosis. Sin embargo, cuando se comparó todo el grupo de pacientes (con y sin restenosis) con controles sanos, bajo el modelo dominante el alelo G del polimorfismo Taq1B A/G se asocia con un mayor riesgo de EAC (OR = 1.48, pCDom = 0.032). De la misma manera, bajo los modelos co-dominante, dominante y aditivo, el alelo A de los polimorfismos −971 A/G se asocia con un mayor riesgo de desarrollar EAC (OR = 2.03, pCCo-dom = 0.022, OR = 1.83, pCDom = 0,008 y OR = 1.39, pCAdd = 0.011, respectivamente). Adicionalmente, el desequilibrio de ligamiento mostró que el haplotipo “AG” se asocia con un mayor riesgo de desarrollar EAC (OR = 1.28, p = 0.03). Conclusión: En resumen, este estudio demuestra que los polimorfismos CETP Taq1B A/G y CETP −971 A/G están asociados con un mayor riesgo de desarrollar CAD, pero no se observó asociación con restenosis.

Abstract At present there is a great advance in the use of organic substances as fertilizers; humic substances are one of them with various forms of extraction. This article evaluates the extraction yield of humic substances (humic acid and fulvic acid) from three raw materials and different basic extractants and acids. In the basic extraction of humic substances, the type of raw material significantly influences, to a p value equal to 5 %. The maximum extraction volumes of humic substances are with garden waste. The fractionation stage of the humic and fulvic acids (acid extraction) depends on the type of basic extractant. The alternative Vermicompost - NaOH - HCl is the most economic and technically feasible, with 38.53 % of extraction yield value of humic acid and 64.90 $/h of gross profit.

Resumen En la actualidad existe un gran avance en la utilización de sustancias orgánicas como fertilizantes; las sustancias húmicas son una de ellas con diversas formas de extracción. En este artículo se valora el rendimiento de extracción de sustancias húmicas a partir de tres materias primas y diferentes extractantes básicos y ácidos. En la etapa de extracción básica de las sustancias húmicas influye significativamente el tipo de materia prima, para un valor P igual 5 %. Los mayores volúmenes de extracción de sustancias húmicas son con el residuo de jardinería. El fraccionamiento de ácidos húmicos y fúlvicos depende del tipo de extractante básico. La alternativa Humus de lombriz - NaOH - HCl es la más factible desde el punto de vista técnico y económico, con un 38.53 % de rendimiento de extracción de ácido húmico y un beneficio bruto igual a 64.90 $/h.

Abstract Introduction: To describe and analyze the existing perception about job satisfaction (SL) and quality of life (QoL) of Spanish resident doctors in the months which follow the end of the state of alarm due to COVID-19 and one year after that. Method: A Descriptive-correlational study, being the Spanish residents the target population who was asked, using an online form, in two periods (1st from 11/01 to 12/31, 2020 and 2nd between 11/01 and 12/31, 2021). For SL, the Font-Roja questionnaire was used and for QoL, the WHOQOL-BREF (both using a 5-point Likert scale). Results: 404 residents responded (1st cut) and 411 (2nd cut). The results for the global SL showed Rho = 0.09; p = 0.081, without differences between their means (-0.07; p = 0.090). The global QoL, measured through the questionnaire, evinced a low correlation between both cut-offs (Rho = 0.10; p = 0.041), with variations between their means (-0.14; p < 0.001). Conclusions: In relation to SL, no association was revealed between the two periods studied. Regarding QoL, more positive data were found in the 2nd period, both in self-perceived QoL and in the global result of the questionnaire.

Resumen Introducción: Describir y analizar la percepción existente acerca de la satisfacción laboral (SL) y la calidad de vida (CV) de los/las médicos/as residentes españoles/as en los meses posteriores a la terminación del estado de alarma por la COVID-19 y al año de la misma. Método: Estudio descriptivo-correlacional, siendo la población diana los/las residentes españoles/as a quienes se preguntó, mediante formulario online, en dos cortes (1º de 01/11 al 31/12 de 2020 y 2º entre 01/11 y 31/12 de 2021). Para la SL se utilizó el cuestionario Font-Roja y para la CV el WHOQOL-BREF (ambos mediante escala Likert de 5 valores). Resultados: Respondieron 404 residentes (1er corte) y 411 (2º corte). Los resultados para a SL global mostraron Rho = 0,09; p = 0,081, sin diferencias entre sus medias (-0,07; p = 0,090). La CV global, medida a través del cuestionario, indicó baja correlación entre ambos cortes (Rho = 0,10; p = 0,041), con diferencias entre sus medias (-0,14; p < 0,001). Conclusiones: En relación a la SL no se constató asociación entre los dos periodos estudiados. Respecto a la CV se evidenciaron mejores datos, en el 2º corte, tanto en la CV autopercibida como en el resultado global del cuestionario.

Resumen El daño asociado al cuidado de la salud es relevante y altamente prevenible. El Global Trigger Tool es la principal metodología en uso para su cuantificación. Los objetivos del trabajo fueron cuantificar mediante dicha herramienta el daño asociado al cuidado durante la internación, caracterizar los tipos de daño involucrados, identificar los factores asociados y describir la utilización de la información recabada. Se trata de un estudio longitudinal retrospectivo. Se detectaron 266 eventos adversos totales entre los dos hospitales: 138 eventos en el Hospital A, y 128 eventos en el Hospital B. Esto es 61.3 eventos cada 1000 días paciente, y 62.5 eventos cada 1000 días paciente en A y B respectivamente, p = 0.3. En términos generales, construyendo una sola población de los dos hospitales, se hallaron 32 eventos adversos cada 100 admisiones, y 64.3 eventos cada 1000 días/pacientes. Los eventos estaban asociados en orden decreciente de frecuencia a: medicación (45.5%), infecciones (32.4%), procedimientos sin infección (15.2%), tromboembolismo pulmonar (4.8%), úlceras por presión (1.4%), dispositivos (0.7%). Las variables asociadas fueron polimedicación y polimorbilidad. Los factores asociados a la aparición de eventos adversos fueron el sexo femenino (OR: 2.1), la administración de medicamentos de alto riesgo (OR 2.3), la edad ≥ 80 años (OR 2.6) y el registro de ≥ 3 transferencias entre salas durante la internación (OR 2.9). Las tasas de daño observadas son comparables a las tasas evaluadas por el mismo método en estudios internacionales.

Abstract The damage associated with health care is relevant and highly preventable. The Global Trigger Tool is a leading methodology in use for its quantification. Our study aimed to quantify, through this tool, the damage associated with care during hospitalization, characterize the types of damage involved, identify the associated factors and describe the use of the information collected. We conducted a retrospective longitudinal study. A total of 266 adverse events were detected between the two hospitals: 138 events in Hospital A, and 128 in Hospital B, the patient days analyzed in each hospital were 2089 and 2046 respectively. This is 61.3 events every 1000 patient days, and 62.5 events every 1000 patient days in A and B respectively, p = 0.3. In general terms, constructing a single population of the two hospitals, 32 adverse events were found every 100 admis sions, and 64.3 events every 1000 days / patients. The events were associated in decreasing order of frequency with: medication (45.5%), infections (32.4%), procedures without infection (15.2%), pulmonary thromboembolism (4.8%), pressure ulcers (1.4%), devices (0.7%). The associated variables were polypharmacy and polymorbid ity. Factors associated with the occurrence of adverse events were female gender (OR: 2.1), administration of high-risk medications (OR 2.3), age ≥ 80 years (OR 2.6), and registration of ≥ 3 transfers between wards during hospitalization (OR 2.9). The observed damage rates are comparable to the rates evaluated by the same method in international studies.

ABSTRACT BACKGROUND: There are no studies on long-term bilateral calf stretching in relation to balance and plantar pressure. OBJECTIVES: To demonstrate that there is better control of posture and pressures after continuous stretching of the posterior calf muscles. DESIGN AND SETTING: Pre and post-intervention study conducted in a private clinic. METHODS: We measured static footprints and stabilometry before and after continuous passive plantar flexor stretching of duration 120 seconds, among 24 healthy subjects. RESULTS: We found differences in Y displacement with eyes closed (P = 0.010), but not among other variables with eyes closed: X displacement (P = 0.263); surface (P = 0.940); laterolateral speed displacement (P = 0.279); and anteroposterior speed displacement (P = 0.914). There were also no differences in eyes-open variables: X displacement (P = 0.341); Y displacement (P = 0.491); surface (P = 0.167); laterolateral speed displacement (P = 0.852); and anteroposterior speed displacement (P = 0.079). The plantar pressures in the heel (maximum pressure, P = 0.048; mean pressure, P = 0.001) and in the midfoot (maximum pressure, P = 0.004; mean pressure, P = 0.004) were reduced, but not in the forefoot (maximum pressure, P = 0.391; mean pressure, P = 0.225). The surface became larger in the forefoot (P = 0.000) and midfoot (P = 0.021). CONCLUSIONS: Continuous static stretching of plantar flexors for 120 seconds improved stance balance and reduced plantar pressures (maximum and mean) in the rearfoot and midfoot. It also increased the surface in the midfoot and forefoot. TRIAL REGISTRATION: at clinicaltrials.gov, under the number NTC03743168.