Validación de contenido y fiabilidad del instrumento "Conocimiento, actitud y comportamiento sobre hidratación y reposición de líquidos", en deportistas chilenos

Introducción: Existen estrategias direccionadas a mejorar el rendimiento de los deportistas, algunas estableciendo recomendaciones respecto a la hidratación y reposición de líquidos, con el propósito de asegurar un balance hídrico adecuado en todas las etapas de la práctica deportiva. Sin embargo, existe una carencia de instrumentos adecuados y confiables que permitan explorar esta temática. Objetivo: La presente investigación tiene como objetivo validar por contenido y evaluar la fiabilidad del instrumento "Conocimiento, actitud y comportamiento respecto a la hidratación y reposición de líquidos" en deportistas adolescentes y adultos jóvenes en Chile. Métodos: La adaptación cultural se realizó a través del método Delphi con un panel de expertos en el área, para la evaluación de la fiabilidad se aplicó el cuestionario de manera online a una muestra de 384 deportistas de diferentes disciplinas en dos oportunidades para determinar la estabilidad temporal. Resultados: Todos los ítems lograron porcentajes de acuerdo superior al 80% según el estadístico V de Aiken, en relación con la fiabilidad se obtuvo un Alfa de Cronbach de 0,78 lo que evidencia una consistencia interna aceptable, adicionalmente se obtuvo un Coeficiente de Correlación intraclase de 0,64 entre las dos aplicaciones del cuestionario presentando una fiabilidad regular a buena. Conclusión: Este cuestionario puede ser empleado como una herramienta confiable para ser utilizada en futuras investigaciones en el área de la nutrición deportiva, además como un instrumento que aporta al quehacer de distintos profesionales para apoyar a planificar y evaluar estrategias que propendan al mejoramiento del rendimiento deportivo.

Introduction: There are strategies aimed at improving the performance of athletes, some of which establish recommendations regarding hydration and fluid replacement, with the purpose of ensuring an adequate water balance at all stages of sports practice. However, there is a lack of adequate and reliable instruments to explore this issue. Objective: The present research aims to validate the content and evaluate the reliability of the instrument "Knowledge, attitude and behavior regarding hydration and fluid replacement" among adolescent and young adult athletes in Chile. Methods: The cultural adaptation was carried out through the Delphi method with a panel of experts in the area. For the evaluation of reliability, the questionnaire was applied online to a sample of 384 athletes from different disciplines on two occasions to determine temporal stability. Results: All items achieved percentages of agreement higher than 80% according to Aiken's V statistic, in relation to reliability a Cronbach's Alpha of 0.78 was obtained, which shows an acceptable internal consistency, additionally an intraclass Correlation Coefficient of 0.64 was obtained between the two applications of the questionnaire presenting a regular to good reliability. Conclusion: This questionnaire can be used as a reliable tool for future research around sports nutrition, as well as an instrument that contributes to the work of different professionals to support the planning and evaluation of strategies aimed at improving sports performance.

Gastrostomia endoscópica percutânea: análise do perfil epidemiológico, indicações e principais complicações em hospital terciário / Percutaneous endoscopic gastrostomy: review of epidemiological profile, indications and major complications in tertiary care hospital

Objetivos: descrever, analisar e avaliar o perfil epidemiológico dos pacientes que realizaram gastrostomia endoscópica percutânea no Serviço de Endoscopia do Hospital Regional do Mato Grosso do Sul Rosa Pedrosian, de 01 de janeiro de 2013 a 01 de janeiro de 2015, as indicações e complicações associadas ao procedimento. Materiais e métodos: foram analisados os dados coletados de prontuários de 108 pacientes que realizaram gastrostomia endoscópica percutânea pela técnica de tração (pull technique) descrita por Ponsky e Gauderer em 1981, com o aparelho de endoscopia Olympus Evis Exera II CV-180 e kits de gastrostomia endoscópica percutânea Percutaneous Endoscopic Gastrostomy feeding tube, Kit, 24 Fr O.D., Pull Method fornecido pela Boston Scientific®. Todos os pacientes receberam antibiótico profilaxia com cefazolina quando não estavam em uso de antibioticoterapia. Resultados: 62 pacientes eram do sexo feminino (57%) e 46 do sexo masculino (43%), com idade que variou entre 2 e 95 anos (média 69,05 anos). Acidente vascular encefálico foi a principal indicação do procedimento em 62 (57%) casos. Ocorreram 2 complicações maiores (6%) em pacientes que tiveram broncoaspiração durante o procedimento endoscópico e foram a óbito na sala de endoscopia. Em 30 (31%) pacientes houve complicações, sendo encontrada mais de uma complicação menor no mesmo paciente totalizando 33 complicações consideradas menores (94%). A principal complicação encontrada foi infecção periostomal em 11 (10%) pacientes. Conclusões: a gastrostomia endoscópica percutânea apresenta altos índices de sucesso e baixos índices de complicações, qualificando-a como método de escolha para obtenção de via alimentar definitiva em pacientes com incapacidade de alimentação por via oral.

Objective: to describe, analyze and evaluate the profile of patients submit percutaneous endoscopy gastrostomy at the Endoscopy Department of the Hospital Regional de Mato Grosso do Sul Rosa Pedrossian from 01 January 2013 to 01 January 2015, and the indications and complications related to the procedure. Materials and methods: the collected data were analyzed of 108 records patients to submit percutaneous endoscopy gastrostomy by pull technique described in 1981 by Ponsky and Gauderer, using Olympus Evis Exera II CV-180 endoscopy and Percutaneous Endoscopic Gastrostomy feeding tube, Kit, 24 Fr O.D., Pull Method provided by Boston Scientific®. Antibiotic prophylaxis with cefazolina was administered in all patients when not in use of antibiotic therapy. Results: 62 patients were women (57%) and 46 men (43%). Mean age was 69, 05 years old (2 to 95). Stroke was the most common indication for the procedure in 63 (57%) cases. Occurred 2 major complications (6%) in patients with aspiration and death in the endoscopy room. In 30 (31%) patients were complications, was found more than one minor complication in the same patient totalizing 33 minor complications (94%). The common complication was periostomal infection in 11 (10%) patients. Conclusions: the percutaneous endoscopy gastrostomy has high success rates and low complications, considering with gold standard method in patients with impaired dietary.

Identificação em larga escala de transcritos antisenso e genes com expressão alélica diferencial utilizando bancos de dados de SAGE E MPSS / High-throughput identification of natural antisense transcripts and genes displaying allelic differential expression using SAGE and MPSS databases

Recentes relatos vêm demonstrando a ocorrência de um número crescente de transcritos antisenso naturais (NATs) no genoma humano e a ocorrência de expressão alélica diferencial (ADE) em genes autossômicos não submetidos a imprinting. Devido aos diversos mecanismos pelos quais podem afetar a expressão gênica, alterações na transcrição dos NATs podem estar envolvidas no desenvolvimento de patologias, como o câncer... Neste trabalho apresentamos duas estratégias inéditas para identificar em larga escala novos transcritos antisenso e genes que apresentam expresssão alélica diferencial... A metodologia de GLGI-MPSS foi aplicada em 96 dessas 4.308 tags, permitindo a sua extensão em um fragmento maior de cDNA correspondente a extremidade 3’ do transcrito... Dessa maneira, foi possível inferir a expressão de cada um dos alelos de um gene a partir da freqüência das tags alelo específicas representadas nas diferentes bibliotecas de SAGE. Assim, de um total de 20.034 genes, 1.372 (6,85%) apresentaram tags alelo específicas e, de acordo com o padrão de expressão dessas tags, esses genes foram classificados em 3 categorias principais: a) 554 genes (40,4%) foram classificados com expressão alélica diferencial; b) 440 genes (20,8%) foram classificados com expressão monoalélica, dos quais 285 estavam representados em mais de 10 bibliotecas de SAGE; e por fim, b) 378 genes (32,0%) foram classificados com expressão bialélica. Nossos dados sugerem que pelo menos 60,0% (554+285/1.372) dos genes humanos apresentam expressão alélica diferencial... Em conjunto, nossos resultados demonstraram que a estratégia computacional utilizando os dados de MPSS foi eficaz para a identificação de novos transcritos antisenso no genoma humano e, ainda, que tags alelo específicas de SAGE podem ser eficientemente utilizadas na identificação de genes humanos que apresentam expressão alélica diferencial.

Recent reports have demonstrated the occurrence of an increasing number of natural antisense transcripts (NATs) in the human genome and the occurrence of allelic differential expression (ADE) in non-imprinted autosomal genes. Due to the diverse mechanisms by which NATs can affect gene expression, their abnormal expression may be involved in the development of pathological states, such as cancer. Similarly, genes displaying ADE have been associated with phenotypic variability and may also contribute to the development of complex genetic diseases. In this work, we present two unpublished strategies to high-throughput identification of new NATs and genes displaying ADE. The first strategy was based on the use of computational tools for the identification of MPSS tags that mapped on the opposite strand of known human genes represented by mRNA sequences, and for which the MPSS tag represents the only evidence of the existence of the NAT. Thus, from a total of 340,829 unique and distinct MPSS tags present in 41 MPSS libraries, 4,308 tags indicated the existence of a new NAT. The GLGI-MPSS methodology was applied for 96 out of these 4,308 tags, allowing their extension into a longer cDNA fragment corresponding to the 3' end of the transcript. The alignment of these fragments against the human genome sequence using BLAT, confirmed that 46/96 GLGI-MPSS fragments corresponded to 3' especific extensions with antisense orientation. Interestingly, we observed that 41.3% (19/46) of these GLGI-MPSS presented at their 3' end a poly(A) tail aligned to the human genome sequence. We demonstrated that a fraction of these transcripts are artifacts generated by internal priming in contaminating DNA and that another fraction of these transcripts are real and could be attributed to retroposition events in the human genome. The expression of the remaining 25/27 GLGI-MPSS fragments was evaluated by strand-specific RT-PCR, and the existence of 17/25 was confirmed by this methodology. The second strategy was based on the use of computational tools that allowed the integration of data from expressed sequences (mRNA and SAGE) and polymorphisms (SNPs) to the human genome sequence for the creation of a database containing allele-specific SAGE tags. In this way, it was possible to infer the expression of each allele of a gene from the frequency of each allelespecific tag represented in different SAGE libraries. So, from a total of 20,034 genes, 1,295 (6.46%) genes presented allele-specific SAGE tags and according to their expression pattern genes were classified into 3 major categories: a) 481 (37.2%) genes were classified with allelic differential expression; b) 442 (34.1%) genes were classified with monoallelic expression, of which 242 were represented in more than 10 SAGE libraries; and c) 372 (28.7%) genes were classified with bialleic expression. Twenty genes were chosen for experimental validation by gDNA and cDNA direct sequencing, of which 13 presented more than 5 individual heterozygotes. From these 13 genes, 10 (77%) demonstrated ADE in at least 20% of the heterozygotes evaluated. Interestingly, for PHC1 we observed monoallelic expression in all heterozygotes. Taking into account our experimental validation efficiency (77%), our analysis suggests that at least 43% of all human genes (481+242 x 0.77/1,295) display ADE. Taken together, our results demonstrated that the computational strategy using MPSS data was effective in the identification of new NATs in the human genome and that allele-specific SAGE tags can be efficiently used to expedite the identification of human genes displaying ADE.