Análisis bibliométrico de la producción científica cubana sobre asma en Scopus

Introducción: El asma es una entidad con alta prevalencia a nivel mundial y en Cuba, que ha suscitado nuevas investigaciones. Objetivo: Caracterizar la producción científica cubana sobre asma en la base de datos Scopus. Materiales y métodos: Se realizó un estudio observacional, descriptivo y bibliométrico de los artículos publicados sobre asma en Scopus con autores cubanos, desde 1973 hasta 2021. Para la recuperación de los registros se empleó una fórmula de búsqueda. Para el análisis de los datos se usaron los software Bibexcel y VOSviewer. Resultados: Se publicaron 154 investigaciones sobre asma, con predominio de artículos originales (136) y de revisión (12). Las áreas más productivas fueron Medicina (144) e Inmunología y Microbiología (34). Los artículos fueron publicados en 48 revistas; de ellas, 11 fueron cubanas, con la Revista Cubana de Medicina como la más productiva. México aportó el mayor número de colaboraciones (10). El Hospital Clínico Quirúrgico Docente General Calixto García (15) fue el más productivo. Se identificaron tres clústeres de palabras clave, con "human", "asthma" y "Cuban" como términos centrales y de mayor ocurrencia. Conclusiones: Existió una baja producción científica sobre asma, centrada principalmente en artículos originales, en el área de Medicina y en revistas nacionales. Se evidenció colaboración internacional. Los ejes principales de investigación fueron el diagnóstico, tratamiento, investigación básica en modelos animales, nuevas terapéuticas, factores de riesgo y prevención.

Introduction: Asthma is an entity with high prevalence worldwide and in Cuba, which has prompted new research. Objective: To characterize Cuban scientific production on asthma in the Scopus database. Materials and methods: An observational, descriptive and bibliometric study was carried out on articles on asthma published in Scopus by Cuban authors, from 1973 to 2021. A search formula was used to retrieve the records. Bibexcel and VOSviewer were used for data analysis. Results: 154 research papers on asthma were published; with a predominance of original (136) and review articles (12). The most productive areas were Medicine (144) and Immunology and Microbiology (34). Articles were published in 48 journals, of which 11 were Cuban, with the Revista Cubana de Medicina (Cuban Journal of Medicine) being the most productive. Mexico contributed the highest number of collaborations (10). The Teaching Hospital General Calixto García (15) was the most productive. 3 key word clusters were identified, with "human", "asthma" and "Cuban" as central and most occurring terms. Conclusions: There was a low scientific production on asthma, mainly focused on original articles, in the area of Medicine and in national journals. International collaboration was evident. The main areas of research were diagnosis, treatment, basic research in animal models, new therapeutics, risk factors and prevention.

Platelet-rich plasma on ankle sprains – efficacy on pain reduction and shorter return to play: A systematic review of available randomized control trials

Background@#The role of platelet-rich plasma (PRP) has been widely studied, but only recently did trials emerge that probed into its potential role in ankle sprains. With the limited available literature, most of the trials results showed that it might have a role in faster healing and pain reduction. @*Objectives@#The purpose of this review is to summarize available studies on ankle sprains in order to identify if there is good initial evidence of its role on return to play (RTP) among active individuals as well as pain reduction. It is also to identify if results were consistent among studies. @*Methodology@#A systematic search of available literature in online databases was done to compare results about outcome measures on pain score and RTP. Included studies are those with a population of 18 years and above treated with PRP with or without post-procedural immobilization. Outcome scorings that assessed pain as a parameter was also included. @*Results@#Three randomized controlled trials and two prospective studies were identified. Results showed an average of 8 weeks to RTP (p-value - 0.006) with decreased pain in ankle sprains treated with PRP and functional therapy. @*Limitation@#Only one randomized controlled trial (RCT) compared PRP with a placebo and a small population of all studies made available. More comparable RCTs are needed to strengthen results of the studies. @*Conclusion@#The use of PRP on ankle sprains may have a potential role in shorter time to RTP and pain reduction.

Highlighting early detection of thyroid pathology and gestational diabetes effects on oxidative stress that provokes preterm delivery in thyroidology: Does that ring a bell?

Abstract Objectives: Ad fontes, the status of the thyroid gland, and metabolic disturbance lead to the alteration of oxygenation. In pregnancy, it is particularly crucial to possess all predictive parameters. Methods: This cross-sectional study was conducted at the Clinic of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia, between 2017 and 2021 which study included a total of 99 women who had been admitted for preterm delivery and had undergone thyroid analysis, detected Hashimoto thyroiditis, and Oral Glucose Tolerance Test (OGTT) 40 days after delivery and had pathological Homeostatic Model Assessment for Insulin Response (HOMA IR) indices. In the group of urgent patients with preterm delivery, we looked after not only routine Doppler of the umbilical artery, but we measured specific ratios such as the Cerebroplacental ratio (CP). Results: The mean maternal age was 32.23 ± 5.96 years and the mean gestational age was detected as 35.40 ± 2.39 weeks. The delivery was completed vaginally in 77 women (78%) and surgically in 22 (22%). The Mean APGAR score was 8.44 ± 1.18, the mean birth weight was 2666.87 ± 622.17g and the cases undergoing cesarean section had significantly higher values of pulsatility index (1.85 ± 0.27 vs. 1.34 ± 0.31) and CP (1.22 ± 0.26 vs. 0.47 ± 0.17). Conclusions: The introduction of Doppler sonography for blood flow assessment helps to form a complete clinical description of the patient, particularly in conditions where oxidative stress became provocative by the thyroid gland antibodies and gestational diabetes in Thyroidology.

Intraoperative Blood Collection Without Fluid Replacement for Cardiac Surgery – A Retrospective Analysis

Background:Transfusion rates in cardiac surgery are high. Aim: To determine if intraoperative autologous blood removal without volume replacement is associated with fewer homologous blood transfusions without increasing acute kidney injury. Setting and Design: Retrospective, comparative study. Materials and Methods: Adult patients undergoing cardiac surgery, excluding those who underwent ventricular assist device surgery, heart transplants, or cardiac surgery without cardiopulmonary bypass were excluded, who had 1–3 units of intraoperative autologous blood removal were compared to patients without blood removal for determination of volume replacement, vasopressor support, acute kidney injury, and transfusions. Results: Autologous blood removal was associated with fewer patients receiving homologous transfusions: intraoperative red cell transfusions fell from 75% (Control) to 48% (1 unit removed), 40% (2 units), and 30% (3 units), P < 0.001. Total intraoperative and postoperative homologous RBC units transfused were lower in the blood removal groups: median (interquartile range) 3 (1, 6) in Control patients and 0 (0, 2), 0 (0, 2) and 0 (0, 1) in the 1, 2, and 3 units removed groups, P < 0.001. Similarly, plasma, platelet, and cryoprecipitate transfusions decreased. After adjustment for confounders, increased amounts of autologous blood removal were associated with increased intravenous fluids, only when 2 units were removed, and trivially increased vasopressor use. However, it was not associated with acidosis or acute kidney injury. Conclusions: Intraoperative autologous blood removal without volume replacement of 1–3 units for later autologous transfusion is associated with decreased homologous transfusions without acidosis or acute kidney injury.

Aspectos clínicos-epidemiológicos de la COVID-19 en pacientes de Pinar del Río / Clinical-epidemiological characteristics of COVID-19 patients from Pinar del Rio

RESUMEN Introducción: la COVID-19 es una enfermedad infecciosa causada por el virus SARS-CoV-2, que puede provocar un síndrome respiratorio agudo por lo que constituye en la actualidad una emergencia de salud pública internacional. Objetivo: identificar los factores clínicos epidemiológicos de la COVID-19 en el período de marzo de 2020 a mayo de 2021 en Pinar del Río. Métodos: se realizó un estudio transversal descriptivo en la provincia de Pinar del Río. Se exploraron los datos tomados de los informes estadísticos de la Unidad Provincial de Higiene y Epidemiología de los pacientes egresados por COVID-19. Se identificaron variables clínicas y epidemiológicas. Resultados: los grupos etarios de 41-50 años, 51-60 años representaron el 17,16 % para ambos seguido del grupo de 21-30 años que representó 16,23 %. El sexo masculino predominó sobre el femenino, para un 52,82 %. Predominaron los casos con evolución asintomática, lo que representó el 53,28 %. El curso sintomático fue mayor en los grupos etarios de 21-30 años y 51-60 años. Los síntomas predominantes fueron tos y fiebre, seguidos por rinorrea y odinofagia. La hipertensión arterial fue la enfermedad más frecuente seguida del asma y diabetes mellitus tipo 2. El municipio de Pinar del Río presentó el mayor número de casos positivos. Conclusiones: existió un ligero predominio de pacientes asintomáticos. La fiebre y los síntomas respiratorios fueron predominantes. Las enfermedades crónicas más frecuentes fueron la hipertensión arterial y el asma. El municipio Pinar del Río fue el más afectado.

ABSTRACT Introduction: COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, which can cause acute respiratory syndrome and is currently an international public health emergency. Objective: to identify the epidemiological clinical factors of COVID-19 in the period from March 2020 to May 2021 in Pinar del Rio. Methods: a descriptive cross-sectional study was conducted in Pinar del Rio province. Data collected from the statistical reports of the Provincial Unit of Hygiene and Epidemiology of COVID-19 discharged patients were explored. Clinical and epidemiological variables were identified. Results: the age groups 41-50 years, 51-60 years represented 17,16 % for both, followed by the group 21-30 years which represented 16,23 %. Male sex predominated over the female sex, representing 52,82 %. Cases with asymptomatic evolution predominated, representing 53,28 %. The symptomatic course of the disease predominated in the age groups 21-30 and 51-60 years old. The most predominant symptoms were cough and fever, followed by rhinorrhea and odynophagia. Hypertension was the most frequent disease followed by asthma and type 2 diabetes mellitus. The Pinar del Rio municipality presented the highest number of positive cases. Conclusions: there was a slight predominance of asymptomatic patients. Fever and respiratory symptoms prevailed. The most frequent chronic diseases were hypertension and asthma. Pinar del Rio municipality was the most affected region.

Infecciones en pacientes con inmunodeficiencias primarias en Pinar del Río / Infections in patients with primary immunodeficiencies in Pinar del Rio

RESUMEN Introducción: los errores innatos de la inmunidad son trastornos cuya causa es un defecto genético en uno o más componentes del sistema inmune. A pesar de que la forma de presentación varía según el defecto genético, la mayoría cursa con enfermedades infecciosas que presentan características de recurrencia y persistencia. Objetivo: determinar la prevalencia de los procesos infecciosos en los pacientes registrados con diagnóstico de Inmunodeficiencia Primaria en el Servicio de Inmunología del Hospital Pediátrico Provincial Docente "Pepe Portilla" de Pinar del Río, en el periodo comprendido de 1994 a marzo de 2021. Métodos: estudio transversal descriptivo. Se analizaron los registros médicos de 125 pacientes diagnosticados de inmunodeficiencias que aparecen registrados en la Base de Datos del Servicio de Inmunología del Hospital Pediátrico Provincial Docente "Pepe Portilla" de Pinar del Río. Resultados: el 85,6 % de pacientes presentaron diagnóstico de algún déficit predominante de anticuerpos. Predominó el sexo masculino, y el rango etario de 6 a 10 años. Las infecciones de mayor presencia fueron la faringoamigdalitis aguda catarral (77,6 %), seguido de la neumonía (58,4 %) y la amigdalitis (56 %). De los signos de alarma que se relacionan con infecciones solo cuatro se encontraron en los pacientes del registro. Conclusión: la susceptibilidad a infecciones no es necesariamente el rasgo clínico preponderante en las inmunodeficiencias primarias, pero el fenotipo infeccioso es el mejor indicador sugestivo para algún defecto de la inmunidad. Aunque es necesario plantear nuevos criterios de manifestaciones infecciosas que faciliten el diagnóstico probable de inmunodeficiencia de forma general y por grupos.

ABSTRACT Introduction: inborn errors of immunity are disorders whose cause is a genetic defect in one or more components of the immune system. Although the form of presentation varies according to the genetic defect, most of them present infectious diseases with recurrent and persistent characteristics. Objective: to determine the prevalence of infectious processes in patients registered with diagnosis of Primary Immunodeficiency in the Immunology Service at Pepe Portilla Provincial Pediatric Teaching Hospital, Pinar del Rio in the period from 1994 to March 2021. Methods: descriptive, cross-sectional study. The medical records of 125 patients diagnosed with immunodeficiencies registered in the database of the Immunology Service at Pepe Portilla Provincial Pediatric Teaching Hospital of Pinar del Rio were analyzed. Results: the 85,6 % of patients presented diagnosis of some predominant antibody deficit. The predominant sex was male and the age range was from 6 to 10 years old. The most frequent infections were acute catarrhal pharyngotonsillitis (77,6 %), followed by pneumonia (58,4 %) and tonsillitis (56 %). Of the alarm signs related to infections only 4 were found in the patients in the registry. Conclusions: susceptibility to infections is not necessarily the predominant clinical feature in primary immunodeficiencies, but the infectious phenotype is still the best suggestive indicator for a defect in immunity. Although it is necessary to propose new criteria for infectious manifestations that facilitate the probable diagnosis of immunodeficiency in general and by groups.

Enfermedades crónicas y tabaquismo en la infección por SARS-CoV-2 en Pinar del Río / Chronic diseases and smoking in SARS-CoV-2 infection in Pinar del Rio

RESUMEN Introducción: el mundo enfrenta una nueva pandemia ante el brote de SARS-CoV-2 iniciado en Wuhan, China en diciembre de 2019. Las diferencias genéticas del hospedero y factores de riesgo como: antecedentes personales, estilos de vida y factores ambientales pueden contribuir a la marcada variabilidad clínica interindividual en la COVID-19. Objetivo: identificar los antecedentes patológicos personales (enfermedades crónicas y tabaquismo) asociados a la infección por SARS-CoV-2. Métodos: estudio observacional analítico de casos y controles en Pinar del Río en el período comprendido entre marzo de 2020 a marzo de 2021. Se exploraron antecedentes personales de enfermedades crónicas y el antecedente de tabaquismo como factor ambiental. Resultados: los antecedentes patológicos personales de alergia y asma constituyeron factores de riesgo para desarrollar síntomas. Se presenta el antecedente de fumador activo como un factor de riesgo para la infección. Conclusiones: se demuestra la contribución de los antecedentes patológicos personales (alergia y asma), y ambientales (fumador activo) a la infección por SARS-CoV-2 y al desarrollo de síntomas en pacientes de COVID-19 en Pinar del Río.

ABSTRACT Introduction: the world deals with a new pandemic because of SARS-CoV-2 outbreak initiated in Wuhan, China in December 2019. Host genetic differences and risk factors such as: personal history, lifestyles and environmental factors may contribute to the marked inter-individual clinical variability in COVID-19. Objective: to identify personal pathological history (chronic diseases and smoking) associated with SARS-CoV-2 infection. Methods: analytical, observational study of cases and controls in Pinar del Rio in the period from March 2020 to March 2021. Personal history of chronic diseases and smoking as an environmental factor were explored. Results: personal pathological history of allergies and asthma constituted risk factors to develop symptoms. History of active smoking is presented as a risk factor for infection. Conclusions: the contribution of personal pathological history (allergy and asthma) and environmental (active smoking) to SARS-CoV-2 infection and to the development of symptoms in COVID-19 patients in Pinar del Rio is confirmed.

Modelo para historia clínica en inmunodeficientes primarios, Pinar del Río / Model for clinical history in primary immunodeficient patients, Pinar del Rio

RESUMEN Introducción: los errores innatos de la inmunidad o inmunodeficiencias primarias se caracterizan por susceptibilidad incrementada a infecciones por defectos del desarrollo o función del sistema inmune. Para el diagnóstico debe incluirse la evaluación clínica, la analítica inmunológica, la evaluación genética, el seguimiento rutinario, la rediscusión diagnóstica y del tratamiento clínico. No existe una guía clara respecto a este asunto en condiciones de recursos limitados. Objetivo: diseñar un modelo para la confección de historia clínica en el paciente con sospecha de error innato de la inmunidad. Métodos: se realizó un trabajo de revisión de síntomas a contemplar en la historia clínica de pacientes con errores innatos de la inmunidad. Se formaron grupos de trabajo entre miembros del grupo provincial de Inmunología de Pinar del Río, con la posterior discusión de los aspectos que se incluyen en la historia. Resultados: se diseñaron cinco tablas que recogen: consentimiento informado; antecedentes patológicos personales relacionados con 148 manifestaciones clínicas en correspondencia con los fenotipos alérgico, infeccioso, inflamatorio, autoinmune, no inmunológico, neoplásico y otros. Se exponen antecedentes patológicos familiares y árbol genealógico; el examen físico y el resumen de los fenotipos clínicos, discusión diagnóstica y clasificación del paciente. Conclusiones: el interrogatorio, el examen físico, los antecedentes patológicos personales y familiares, así como la confección adecuada de la historia clínica son elementos imprescindibles para la aproximación al diagnóstico de los errores innatos de la inmunidad. Se debe contar con un registro de pacientes que posibilite el diagnóstico precoz y el tratamiento oportuno de la inmunodeficiencia primaria.

ABSTRACT Introduction: inborn errors of immunity or primary immunodeficiencies are characterized by increased susceptibility to infections due to defects in the development or functioning of the immune system. Diagnosis should include clinical evaluation, immunological analysis, genetic evaluation, routine follow-up, diagnostic re-discussion and clinical management. There is no clear guidance on this issue under resource-limited conditions. Objective: to design a model for clinical history in patients with suspected inborn error of immunity. Methods: a review of symptoms to be considered in the clinical history of patients with inborn errors of immunity was carried out. Working groups were formed among members of the provincial group of Immunology in Pinar del Rio province, with the subsequent discussion of the aspects to be included in the history. Results: five tables were designed to collect: informed consent; personal pathological antecedents related to 148 clinical manifestations in correspondence with allergic, infectious, inflammatory, autoimmune, non-immune, neoplastic and other phenotypes. Family pathologic history and family tree; physical examination and summary of clinical phenotypes, diagnostic discussion and classification of the patient are presented. Conclusions: the interviews, physical examination, personal and family pathologic history, as well as the adequate design of the clinical history, are considered essential elements for the approach to the diagnosis of inborn errors of immunity. A patient registry should be available to enable early diagnosis and timely treatment of primary immunodeficiency.

Modelo de regresión logística binaria para el cálculo de riesgo de asma en Pinar del Río / Binary logistic regression model for calculating asthma risk in Pinar del Río

RESUMEN Introducción: se evidencian progresos metodológicos hacia la optimización de los diseños de estudio y métodos analíticos en las interacciones genoma-ambiente en el asma, entre ellos los modelos de regresión logística. Objetivo: determinar un modelo de regresión logística binaria para identificar el riesgo de asma en pacientes pediátricos. Métodos: se realizó un estudio observacional, analítico, de casos y controles en pacientes asmáticos en la provincia de Pinar del Río, Cuba, en el periodo 2015-2019. La muestra quedó constituida por 735 casos, estableciendo una proporción de casos/controles de 1:2. A partir de las variables genéticas, infecciosas y ambientales se realizó un modelo de regresión logística binaria. Resultados: se comprobó estadísticamente la correspondencia entre los valores reales y pronosticados de la variable dependiente (p=0,602). El R2 de Nagelkerke indicó que los predictores utilizados explican el 87 % de la variabilidad de la variable dependiente. El modelo estimado clasificó correctamente el 94 % de los casos, con una sensibilidad del 93 % y una especificidad de 95 %. El modelo resultó del empleo de 11 variables, de ellas, cuatro correspondieron a los antecedentes familiares de asma, cuatro a variables infecciosas y tres variables ambientales. Resultados: se comprobó estadísticamente la correspondencia entre los valores reales y pronosticados de la variable dependiente (p=0,602). El R2 de Nagelkerke indicó que los predictores utilizados explican el 87 % de la variabilidad de la variable dependiente. El modelo estimado clasificó correctamente el 94 % de los casos, con una sensibilidad del 93 % y una especificidad de 95 %. El modelo resultó del empleo de 11 variables, de ellas, cuatro correspondieron a los antecedentes familiares de asma, cuatro a variables infecciosas y tres variables ambientales Conclusiones: el análisis multivariado permitió la conformación de un modelo para el cálculo de la probabilidad de asma a partir de la utilización de las tablas de riesgo en Pinar del Río, lo que conduce a la implementación de la medicina personalizada y el perfeccionamiento de la medicina preventiva en la atención primaria de salud.

ABSTRACT Introduction: there is evidence of methodological progress towards the optimization of study designs and analytical methods in genome-environment interactions in asthma, including logistic regression models. Objective: to determine a binary logistic regression model to identify the risk of asthma in pediatric patients. Methods: an observational, analytical, case-control study was conducted in asthmatic patients in Pinar del Río province, Cuba, in the period 2015-2019. The sample comprised 735 cases, establishing a ratio of cases/controls of 1:2. From the genetic, infectious and environmental variables, a binary logistic regression model was completed. Results: the correspondence between the current and predicted values of the dependent variable was statistically proven (p=0.602). Nagelkerke's R2 indicated that the predictors used explained 87% of the variability of the dependent variable. The estimated model correctly classified 94% of the cases, with a sensitivity of 93% and a specificity of 95%. The model resulted from the use of 11 variables, of which four corresponded to family history of asthma, four to infectious variables and three to environmental variables. Conclusions: the multivariate analysis allowed designing a model for the calculation of the probability of asthma using the tables of risks in Pinar del Río, which leads to the implementation of personalized medicine and the improvement of preventive medicine in primary health care.

Diagnóstico para perfeccionar la fuerza especial en agua de polo acuático en Pinar del Río / Diagnóstico para aperfeiçoar a força especial na água em polistas de Pinar del Río / Diagnosis to perfect the special strength in water of Pinar del Río water polo players

Resumen El presente trabajo tuvo como objetivo caracterizar la situación actual de los atletas del equipo escolar masculino de polo acuático de la EIDE (Escuela de Iniciación Deportiva) de Pinar del Río, en relación con la fuerza especial en agua, para dar respuesta a una de las demandas tecnológicas que incide en el rendimiento de este deporte. Mediante los métodos empíricos como la observación, se constató que los atletas después de pasar del segundo tiempo de juego, no podían mantener el mismo rendimiento que en los dos primeros, notándose un gran desgaste físico en ellos, lo cual responde a la falta de fuerza especial en agua para soportar la resistencia al medio acuático y al forcejeo con el contrario. Se les aplicó encuestas a los entrenadores, las cuales reflejaron existen insuficiencias en la planificación de los entrenamientos, lo que incide en la preparación óptima de la fuerza especial en agua. Se realizó la revisión al Programa Integral de Preparación del Deportista del año 2016 y no se encontraron acciones metodológicas específicas para el trabajo de la fuerza especial en agua como guía para el trabajo de los entrenadores en el proceso de entrenamiento de esta capacidad. Se revisaron otros documentos que son utilizados por los entrenadores. Se realizaron mediciones para determinar el nivel de fuerza especial en agua de estos atletas escolares. Formó parte de este estudio el uso de los métodos teóricos como el histórico-lógico, inductivo-deductivo, análisis-síntesis y los estadísticos-matemáticos, específicamente la estadística descriptiva.

Resumo O presente trabalho teve o objetivo de caracterizar a situação atual dos atletas da equipe escolar masculino de polo aquático da EIDE (Escola de Iniciação Desportiva) de Pinar del Río, em relação à força especial na água, a fim de responder a uma das exigências tecnológicas que afetam o desempenho deste esporte. Através de métodos empíricos como a observação, verificou-se que os atletas, após a segunda metade do jogo, não conseguiam manter o mesmo desempenho que nas duas primeiras, sendo notado um grande desgaste físico neles, o que responde à falta de força especial na água para suportar a resistência ao meio aquático e a contenda com o adversário. Foram aplicadas pesquisas aos treinadores, que mostraram que havia falhas no planejamento das sessões de treinamento, o que afeta a preparação ótima da força especial na água. Foi realizada a revisão do Programa de Preparação Integral do Desportista 2016 e não foram detectadas acções metodológicas específicas para o trabalho da força especial na água como guia para o trabalho dos treinadores no processo de formação desta capacidade. Outros documentos que são utilizados pelos treinadores também foram revistos. Foram feitas medições para determinar o nível de força especial na água destes atletas escolares. O uso de métodos teóricos como histórico-lógico, indutivo-dedutivo, análise-síntese e estatístico-matemático, especificamente a estatística descritiva, também fez parte deste estudo.

Abstract The present work had the objective of characterizing the current situation of the Man water polo school team athletes of the EIDE (School of Sport base formation) of Pinar del Río, in relation to the special strength in water, in order to give an answer to one of the technological demands that affects the performance in this sport. By means of empirical methods such as observation, it was found that the athletes, after the second half of the game, could not keep the same performance as in the first two, and a great physical wear was noticed in them, which responds to the lack of special strength in water to support the endurance to the aquatic environment and the struggle with the opponent. Surveys were applied to the coaches, which reflected that there are deficiencies in the planning of the training sessions, affecting the optimal preparation of the special strength in water. The review of the Integral Program of Preparation of the athlete (2016) was carried out, not finding specific methodological actions for the work of the special strength in water as a guide for the work of the trainers in the process of training of this capacity, other documents that are used by the trainers were also reviewed. Measurements were made to determine the level of special strength in water of these school athletes. The use of theoretical methods such as historical-logical, inductive-deductive, analysis-synthesis, and statistical-mathematical methods, specifically descriptive statistics, were also part of this study.

Significance of the anterior tibial translocation sign in predicting the presence of anterior cruciate ligament tears in arthroscopically-proven cases

@#Anterior cruciate ligament (ACL) injury remains a common orthopedic case, especially in young adults with an active lifestyle. Activities of daily living and sports performance may be vastly compromised; thus, immediate diagnosis is essential. The researchers tested the diagnostic ability of the anterior tibial translocation sign (using the 5 mm cut-off) against the gold standard knee arthroscopy using cross-sectional study design. Analysis of the 23 magnetic resonance imaging (MRI) scans showed a sensitivity of 42.9% (true positives: 6 had ≥5 mm reading out of 14 positive arthroscopy fi ndings), specifi city of 77.8% (true negatives: 7 had <5 mm reading out of 9 negative arthroscopy fi ndings) and positive predictive value (PPV) of 75.0% (6 out of 8 positive arthroscopy fi ndings among ≥5 mm). In the sample data, 7 mm cut-off had the optimal trade-off between sensitivity and type I error, thus being the most predictive of ACL tear.

Five-year follow-up to assess long-term sustainability of changing clinical practice regarding anesthesia and regional analgesia for lower extremity arthroplasty / 대한마취과학회지

Background@#Long-term and sustainable clinical practice changes in anesthesia procedures have not previously been reported. Therefore, we performed a 5-year audit following implementation of a clinical pathway change favoring spinal anesthesia for total knee arthroplasty (TKA). We similarly evaluated a parallel cohort of patients undergoing total hip arthroplasty (THA), who did not undergo a clinical pathway change, and studied utilization rates of continuous peripheral nerve block (CPNB). @*Methods@#We identified all primary unilateral TKA and THA cases completed from January 2013 through December 2018, thereby including clinical pathway change data from one-year pre-implementation to 5-years post-implementation. Our primary outcome was the overall application rate of spinal anesthesia. Secondary outcomes included CPNB utilization rate, 30-day postoperative complications, and resource utilization variables such as hospital readmission, emergency department visits, and blood transfusions. @*Results@#The sample included 1,859 cases, consisting of 1,250 TKAs and 609 THAs. During the initial year post-implementation, 174/221 (78.7%) TKAs received spinal anesthesia compared to 23/186 (12.4%) cases the year before implementation (P < 0.001). During the following 4-year period, 647/843 (77.2%) TKAs received spinal anesthesia (P = 0.532 vs. year 1). The number of THA cases receiving spinal anesthesia the year after implementation was 78/124 (62.9%), compared to 48/116 (41.4%) pre-implementation (P = 0.001); however, the rate decreased over the following 4-year period to 193/369 (52.3%) (P = 0.040 vs. year 1). CPNB use was high in both groups, and there were no differences in 30-day postoperative complications, hospital readmission, emergency department visits, or blood transfusions. @*Conclusions@#A clinical pathway change promoting spinal anesthesia for TKA can be effectively implemented and sustained over a 5-year period.

Tareas para favorecer la percepción temporal en gimnastas de la categoría pioneril de gimnasia rítmica / Tasks to promote temporal perception in gymnasts of the pioneer category of rhythmic gymnastics

Resumen El proceso de Educación Musical en la gimnasia rítmica es importante para lograr altos resultados competitivos a partir de las exigencias actuales del código de puntuación. En su base, se encuentra la percepción especializada de tiempo y su estimación será diferente atendiendo a las características individuales del sujeto; aspecto que es entrenable en muchos casos, cuando no median las características temperamentales. Sin embargo, en la actualidad son insuficientes los procedimientos que sustentan el trabajo de las entrenadoras de la categoría pioneril en Matanzas para llevar a cabo este proceso, lo que se evidencia en los bajos resultados en la evaluación del componente artístico en el evento competitivo provincial, por falta de armonía entre la música y los movimientos. A partir de ello, la autora se propuso como objetivo formular tareas para favorecer la percepción temporal de gimnastas de la categoría pioneril de gimnasia rítmica de Matanzas. Durante la investigación se utilizaron métodos teóricos y empíricos, entre ellos el analítico sintético, inductivo deductivo y como método empírico fundamental la prueba de estimación del tiempo transcurrido. Se conformó la muestra con 36 gimnastas de dicha categoría. Como resultado fundamental se obtuvo las tendencias de las gimnastas, lo que constituye una herramienta para el trabajo de las entrenadoras y se proponen tareas para su educación en los entrenamientos. Se concluyó que la mayor cantidad de gimnastas están en el campo de la bradicronia, donde el 55,5 % de ellas estimaron el tiempo más lento y pudieran retrasarse en relación a la música interpretada.

Abstract The process of musical education in rhythmic gymnastics is important to achieve high competitive results from the current requirements of the score code. In its base it is the specialized perception of time, and its estimation will be different according to the individual characteristics of the subject; aspect that is trainable in many cases, when the temperamental characteristics do not mediate. However, at the present time the procedures that sustain the work of the trainers of the pioneer category in Matanzas to carry out this process are insufficient, what is evidenced in the low results in the evaluation of the artistic component in the competitive provincial event, due lack of harmony between the music and the movements. Based on this, the author proposed as an objective: to formulate tasks to favor the temporary perception of gymnasts of the pioneer category of rhythmic gymnastics of Matanzas. During the research, theoretical and empirical methods were used, among them: synthetic analytic, deductive inductive and as a fundamental empirical method the test of estimation of the elapsed time. The sample was made up of 36 gymnasts of this category. As a fundamental result, the tendencies of the gymnasts were obtained, which constitutes a tool for the work of the coaches and tasks are proposed for their education in the trainings. It was concluded that the greatest number of gymnasts are in the field of bradicrony, where 55.5 % of them estimated the slowest time and could be delayed in relation to the music performed.

Evaluación formativa en Educación Física, a escolares con discapacidad intelectual / Formative evaluation in Physical Education to school children with intellectual disabilities

Resumen En el presente artículo, se exponen los resultados de una investigación dirigida a la aplicación de la evaluación en Educación Física, en los escolares con discapacidad intelectual, al constatarse la pobre correspondencia entre los objetivos del programa que se imparte y los objetivos propuestos en el modelo de evaluación actual, a través de la resolución ministerial 238/2014. El objetivo se centra en proponer una metodología de evaluación formativa en Educación Física, en los escolares con discapacidad intelectual, en el municipio Pinar del Río. Para ello se aplicaron diferentes métodos de investigación como la observación a clases de Educación Física en diferentes momentos de la evaluación y encuesta a profesores de la asignatura que imparten clases a los escolares. Como resultado, se presenta una metodología donde se integran la evaluación de habilidades motrices y capacidades físicas y se potencian las acciones lúdicas en las que se estimulan aprendizajes prácticos y sociales, que influyen en el mejoramiento de su salud y preparación para una vida adulta e independiente de los escolares.

Abstract In the present article, the results of an investigation directed to the application of the evaluation in Physical Education are exposed, in the students with intellectual disability, when verifying the poor correspondence between the objectives of the program that is imparted and the objectives proposed in the model of current evaluation through ministerial resolution238 / 2014. The objective focuses on developing a methodology of formative assessment in Physical Education, in schoolchildren with intellectual disabilities, in the Pinar del Río municipality. To this end, different research methods were applied, such as observation of Physical Education classes, at different times of the evaluation, survey of teachers of the subject who teach classes to schoolchildren. As a result, a methodology is presented where the evaluation of motor skills and physical abilities are integrated, enhancing the playful actions in which practical and social learning are stimulated which influence the improvement of their health and preparation for an adult life and independent of the school.

Metodología para la familiarización de los niños del sexto año de vida con el ajedrez desde la Educación Física / A methodology for the children of 6 years of life to get familiar with Chess by means of Physical Education lessons

RESUMEN En la presente investigación, se diseñó una metodología para favorecer la familiarización de los niños de sexto año de vida con el ajedrez desde la Educación Física, lo que les permitirá arribar a la enseñanza primaria con algunos conocimientos de este deporte que recibirán por vez primera. El objetivo se centra en proponer una metodología para la familiarización de los niños del sexto año de vida con el ajedrez desde la Educación Física. Para el logro de este propósito se seleccionó una muestra de 693 niños del sexto año de vida y 48 maestras de este nivel de enseñanza, así como diez especialistas del ajedrez y expertos en la temática. En el proceso de recopilación de datos, se emplearon los métodos de investigación teóricos: el histórico-lógico, analítico-sintético, inductivo-deductivo, hipotético-deductivo y el sistémico-estructural-funcional. Con respecto a los métodos empíricos se utilizó el análisis de documentos, la entrevista, la encuesta, la observación y la triangulación metodológica. Además, se requirió aplicar el criterio de los especialistas, de los expertos y el experimento (preexperimento, en su variante de pretest y posttest para un grupo). Se procesaron estadísticamente los datos obtenidos a través de la prueba de McNemar. Como resultado de la investigación se elaboró una metodología para la familiarización de los niños del sexto año de vida con el ajedrez desde la Educación Física, que contribuye al desarrollo integral de los niños y les brinda una mejor preparación para su arribo a la enseñanza primaria con lo que se demuestra su validez y factibilidad.

ABSTRACT In this research it is designed a methodology to favor the process of identification of the Children of 6 years of life with Chess by means of Physical education lessons. This product will facilitate the preparation for the children before receiving this subject in primary schools. For the development if this research it was necessary to select a sample of some children of 6 year of life with the corresponding teachers as well as some experts and specialists on the topic. In the processing of information, it was used some methods, such as the historical logical, analytical syntetical, hypothetical deductive and the systemical structural functional. As empirical methods it was used documents, interviews, surveys and the observation. It was also employed the criteria of experts, the experiments and validated through the McNemar test. This methodology has been validated and put into practice with very positive results so far.

Propuesta metodológica sobre la evaluación en Educación Física en los escolares con discapacidad intelectual / Methodological proposal on the evaluation in Physical Education for students suffering intellectual disability

RESUMEN En esta investigación, se utiliza la metodología como aporte científico dada la necesidad que tiene la ciencia Educación Física de adquirir vías novedosas que permita al educador dirigir la apropiación del contenido de la asignatura en los escolares. El objetivo consiste en mejorar la evaluación de habilidades motrices y capacidades físicas en Educación Física a escolares con discapacidad intelectual en el municipio de Pinar del Río. La investigación se realiza en el centro de Educación Especial «28 de enero¼ en el municipio de Pinar del Río a escolares del segundo ciclo con discapacidad intelectual. Se emplearon los métodos teóricos, empíricos y estadísticos matemáticos. La metodología propuesta muestra como resultado que los aspectos sometidos a criterios de los expertos fueron evaluados en las categorías de muy adecuado y adecuado, sin embargo, los expertos consultados ofrecieron criterios y sugerencias dirigidas al perfeccionamiento de la metodología. Su puesta en práctica a través del aparato metodológico e instrumental se encuentra articulado por las diferentes etapas de la metodología y acciones, referente a la evaluación de habilidades motrices y capacidades físicas, en la que se potencia los juegos predeportivos correctivos compensatorios, lo que permite valorar la metodología propuesta como una evaluación integrada desde una atención físico educativa.

ABSTRACT In this investigation, it is used the methodology just like a given scientific contribution to the necessity that the science Physical Education has to acquire new ways of exploring and researching. It allows the educator to direct the appropriation of the content of the subject in those, in which is determined as objective: to improve the evaluation of motive abilities and physical capacities in Physical Education to school having intellectual disability in the municipality Pinar del Río. The present investigation is carried out in the center of Special Education «28 de enero¼ in the municipality Pinar del Río, Cuba at the school of the second cycle, counting on students having intellectual disability to develop the same one mathematical theoretical, empiric and statistical methods duly used. The proposed methodology shows as a result that the subjected aspects to the experts' approaches, were evaluated in the categories of very appropriate and appropriate, however, the consulted experts offered approaches and suggestions directed to the improvement of the methodology. Its setting in practice through the methodological and instrumental apparatus is articulated by the different stages of the methodology and actions, with respect to the evaluation of motive abilities and physical capacities, in the one that you power the games predeportive compensatory correctives, what allows to value the methodology proposed as an evaluation integrated from an educational physical attention.

Determination of nonalcoholic fatty liver disease in patients with pre-impaired glucose tolerance

INTRODUCTION: Pre-impaired  glucose  tolerance  (pre-IGT) or  compensated  hyperinsulinemia,  is  defined  as  normal glucose,  and  elevated  insulin  two  hours  after  a  75-gram oral glucose load.  It is characteristic of the early stages of diabetes  mellitus  (DM),  where  beta  cells  compensate  for  insulin resistance by increasing insulin secretion to maintain normoglycemia. With  continuing  beta  cell  failure,  insulin  secretion  eventually  fails,  leading  to  the  progression  to diabetes.    Nonalcoholic  fatty  liver  disease  (NAFLD),  a common feature of insulin resistance, is found in 50-75% and 42-55% of DM and pre-diabetes patients. We determined if NAFLD was present in patients with pre-IGT.METHOD: A study on the determination of NAFLD - diagnosed by liver ultrasound in pre-IGT patients at a university hospital.Descriptive statistics, Chi square test of independence, 2x2 Fischer  Exact  test,  Z  test  of  difference  in  proportion, were used  for  statistical  analysis  with  a  p-value  set  at  0.05?.IBMSPSS ver 21 was used as software.RESULTS:The mean age of 22 patients was 29.95 years, with average BMI of 25.73 kg/m2;77.3% were female.  Average lipid  panels  were  within  optimal  limits;  kidney  and  liver functions were normal.  The mean insulin level was 58.36 uIU/mL. NAFLD was identified in eight of the subjects. CONCLUSION: Although  pre-IGT  is  a  subclinical  phase  in  the  diabetes  spectrum,  36%  already  have  NAFLD.This prevalence  was  lower  compared  to  diabetics  and  pre-diabetics, but higher compared to the general population.There was a noticeable trend of increasing insulin levels with increasing severity of fatty liver.

Determination of nonalcoholic fatty liver disease in patients with pre-impaired glucose tolerance

INTRODUCTION: Pre-impaired  glucose  tolerance  (pre-IGT) or  compensated  hyperinsulinemia,  is  defined  as  normal glucose,  and  elevated  insulin  two  hours  after  a  75-gram oral glucose load.  It is characteristic of the early stages of diabetes  mellitus  (DM),  where  beta  cells  compensate  for  insulin resistance by increasing insulin secretion to maintain normoglycemia. With  continuing  beta  cell  failure,  insulin  secretion  eventually  fails,  leading  to  the  progression  to diabetes.    Nonalcoholic  fatty  liver  disease  (NAFLD),  a common feature of insulin resistance, is found in 50-75% and 42-55% of DM and pre-diabetes patients. We determined if NAFLD was present in patients with pre-IGT.METHOD: A study on the determination of NAFLD - diagnosed by liver ultrasound in pre-IGT patients at a university hospital.Descriptive statistics, Chi square test of independence, 2x2 Fischer  Exact  test,  Z  test  of  difference  in  proportion, were used  for  statistical  analysis  with  a  p-value  set  at  0.05?.IBMSPSS ver 21 was used as software.RESULTS:The mean age of 22 patients was 29.95 years, with average BMI of 25.73 kg/m2;77.3% were female.  Average lipid  panels  were  within  optimal  limits;  kidney  and  liver functions were normal.  The mean insulin level was 58.36 uIU/mL. NAFLD was identified in eight of the subjects. CONCLUSION: Although  pre-IGT  is  a  subclinical  phase  in  the  diabetes  spectrum,  36%  already  have  NAFLD.This prevalence  was  lower  compared  to  diabetics  and  pre-diabetics, but higher compared to the general population.There was a noticeable trend of increasing insulin levels with increasing severity of fatty liver.

Determination of nonalcoholic fatty liver disease in patients with pre-impaired glucose tolerance

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Pre-impaired  glucose  tolerance  (pre-IGT) or  compensated  hyperinsulinemia,  is  defined  as  normal glucose,  and  elevated  insulin  two  hours  after  a  75-gram oral glucose load.  It is characteristic of the early stages of diabetes  mellitus  (DM),  where  beta  cells  compensate  for  insulin resistance by increasing insulin secretion to maintain normoglycemia. With  continuing  beta  cell  failure,  insulin  secretion  eventually  fails,  leading  to  the  progression  to diabetes.    Nonalcoholic  fatty  liver  disease  (NAFLD),  a common feature of insulin resistance, is found in 50-75% and 42-55% of DM and pre-diabetes patients. We determined if <br />NAFLD was present in patients with pre-IGT.<br /><strong>METHOD:</strong> A study on the determination of NAFLD - diagnosed by liver ultrasound in pre-IGT patients at a university hospital.Descriptive statistics, Chi square test of independence, 2x2 Fischer  Exact  test,  Z  test  of  difference  in  proportion, were used  for  statistical  analysis  with  a  p-value  set  at  0.05?.IBMSPSS ver 21 was used as software.<br /><strong>RESULTS:</strong>The mean age of 22 patients was 29.95 years, with average BMI of 25.73 kg/m2;77.3% were female.  Average lipid  panels  were  within  optimal  limits;  kidney  and  liver functions were normal.  The mean insulin level was 58.36 uIU/mL. NAFLD was identified in eight of the subjects. <br /><strong>CONCLUSION:</strong> Although  pre-IGT  is  a  subclinical  phase  in  the  diabetes  spectrum,  36%  already  have  NAFLD.This prevalence  was  lower  compared  to  diabetics  and  pre-diabetics, but higher compared to the general population.There was a noticeable trend of increasing insulin levels with increasing severity of fatty liver.</p>

End-of-Life planning among older Filipinos

Purpose@#The number of older Filipinos continues to rise resulting in increasing numbers of people who live in a modernized world which offers numerous options to prepare for the End-of-Life (EoL). Henceforth, EoLplanning among older Filipinos and the factors which could potentially influence the propensity to plan ahead needs further investigation. This study ascertained the level of health, relationship, funerary, legal and financial-related EoL planning among older Filipinos, and established the association between EoL planning and sex, chronologic age, religious affiliation, ethnicity, health and financial status.@*Methods@#The study utilized a descriptive survey design, including 400 respondents, chosen through purposive sampling and met the inclusion of Filipino, Baguio residents, aged 60 and above, able to read and understand English, Filipino or Ilokano, and without psychological disturbances or cognitive deficits. The researchers used a self-made questionnaire after establishing validity (0.96) and reliability (0.82). The Saint Louis University Research Ethics Committee ensured the ethical conduct of this research. Data were treated with statistics using frequency, mean and Chi-square test.@*Findings@#The responses indicated moderate levels of EoL planning overall. Moreover, statistical tests revealed that only health status has a significant association with EoLplanning.@*Conclusions@#Based on the findings, the researchers conclude that EoL planning remains not widely used in the Philippines, thus, intensifying the call for more aggressive interventions to make EoL planning salient and acceptable to older people. In addition, health status affects EoL planning considerably, and that knowing the sex, chronologic age, religious affiliation, ethnicity and financial status did not help predict EoLplanning.