Tendencia de consejerías en actividad física y enfermedades cardiometabólicas en el Maule, Chile: estudio previo a pandemia por COVID-19 entre 2012 y 2019 / Trend in Physical Activity Counseling and Cardiometabolic Diseases in Maule, Chile: COVID-19 Pre-Pandemic Study between 2012 and 2019

BACKGROUND: Physical activity (PA) practice reduces the adverse effects of COVID-19. PA counseling promotes healthy lifestyles and prevents cardiometabolic diseases. AIM: To assess the trend in cases of PA counseling and the cardiometabolic disease between 2012 and 2019 (before COVID-19) in a southern Chilean region. MATERIAL AND METHODS: Records of Maule Region Health Service for 731.163 men, and 829.097 women aged < 10 to ≥ 65 years were analyzed. The average annual percentage change (AAPC) during the study period and the annual percentage change (APC) during intermediate periods, were calculated. RESULTS: There was a significant decrease in PA counseling in women in the study period (AAPC: −13.6%). In the 2012-2017 period a significant decrease in counseling for total, men and women were observed (APC: −18.1, −16.5 and −19.1%, respectively). Obesity increased significantly in total, men and women in the 2012-2019 period (AAPC: 10.1, 8.5 and 10.7%, respectively). The same trend was observed for hypertension (AAPC: 8.1, 8.5 and 7.6% respectively) and elevated blood glucose (AAPC: 10, 11.5 and 9.6%, respectively). CONCLUSIONS: In the study period PA counseling decreased along with an increase in obesity, hypertension and high blood glucose. Increasing PA counseling is a mainstay in the prevention of cardiometabolic diseases and probably to prevent contagion and complement the treatment of COVID-19.

Asociación del fitness cardiorrespiratorio con marcadores de adiposidad corporal: estudio de corte transversal de la Encuesta Nacional de Salud Chile 2016-2017 / Association of cardiorespiratory fitness with adiposity markers

BACKGROUND: Cardiorespiratory fitness (CRF) is inversely associated with metabolic diseases and adiposity markers. Aim: To assess the association of CRF with body mass index (BMI), waist circumference (WC) and obesity in a representative sample of the Chilean population. MATERIAL AND METHODS: Data from 5,958 participants in the Chilean National Health Survey 2016-1027 aged 15 years or above were analyzed. CRF was estimated by an equation that included sociodemographic, anthropometric and health-related data and expressed in metabolic equivalent units (METs). The association between CRF and adiposity was assessed using linear and Poisson regression models and the results were presented as Prevalence Ratio (PR). RESULTS: One MET increment in CRF was associated with a 3.27 kg/m2 (95% confidence intervals (CI): -3.35; -3.2) and 4.56 kg/m2 (95% CI: -4.67; -4.46) lower BMI in men and women, respectively. Waist circumference was 6.7 cm [95% CI: -6.98; -6.42] and 9 cm [95% CI: -9.33; -8.67] lower per 1-MET increment in CRF. With one MET increment, the probability of being obese was 34% (PR = 0.66 [95%CI: 0.63; 0.69]) and 36% (PR = 0.64 [95%CI: 0.61; 0.67]) lower in men and women, respectively. The probability of having a central obesity was 26% (PR = 0.74 [95%CI: 0.71; 0.77]) and 30% (PR = 0.70 [95%CI: 0.68; 0.73]) lower in men and women, respectively. Conclusions: A higher estimated CRF was associated with lower adiposity levels and a lower risk of being obese in both men and women. Public health policies aiming to increase physical activity are needed to increase the CRF of the Chilean population.

Prevalence of responders of a school intervention at physical fitness and mental health of children: a quasi-experimental study

Abstract Aim: to verify the effect of a physical education program at school on physical fitness and mental health in children and to determine the individual prevalence of responders. Methods: This is a quasi-experimental study, developed with 67 children aged between 6 and 11 years old. (8.09 ± 1.81). A 21-week intervention was performed, that intervention condition (IC) consisted of sports and circuit training, and nutritional education. For the control condition (CC) classes followed to the Common Curricular National Base. The following variables were evaluated at baseline and post-intervention: physical fitness and mental health through the strength and difficulties questionnaire. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. Results: The main results indicate that there were improvements in the IC in the components of physical fitness (cardiorespiratory fitness, speed, and agility) and mental health indicators (total difficulties, emotional symptoms, problems with peers, and prosocial behavior) after a school physical education program in comparison with the CC. Concerning the prevalence of responders between groups, it was found differences in cardiorespiratory fitness (CC: 33.33%; IC: 65.38%), agility (CC: 36.66%; IC: 73.07%), speed (CC: 43.33%; IC: 79.16%), emotional symptoms (CC: 28.57%; IC: 50.00%), and prosocial behavior (CC: 17.14%; IC: 46.87%). Conclusion: It is reinforced that well-planned physical education classes and simple intervention programs can be adopted at the school level and are capable of promoting children's physical and mental health.

Miastenia gravis como síndrome paraneoplásico en un tumor de ovario. Reporte de caso y revisión de la bibliografía / Myasthenia gravis as a paraneoplastic syndrome in a ovarian tumor. Case report and review of the literature

Resumen INTRODUCCIÓN: Los síndromes paraneoplásicos son manifestaciones a distancia de las neoplasias, que se originan por mecanismos secundarios pero no por invasión tumoral. Son poco frecuentes, anteceden a la manifestación propia del tumor y desaparecen con su curación. Si bien la miastenia gravis tradicionalmente se ha relacionado con timomas, aquí se busca reportar un caso de miastenia gravis como síndrome paraneoplásico de un tumor de ovario y hacer una revisión de la bibliografía disponible referente a su diagnóstico. CASO CLÍNICO: Paciente de 46 años, con múltiples episodios de debilidad generalizada e insuficiencia ventilatoria que requirió ventilación mecánica y estancia en cuidados intensivos. Se estableció el diagnóstico clínico de miastenia gravis. A pesar del adecuado tratamiento y de la timectomía, las crisis persistieron. Al poco tiempo se le diagnosticó un adenocarcinoma seroso de ovario que se trató con cirugía y quimioterapia. Con esto desaparecieron los síntomas neurológicos, con una remisión total después de cuatro años de seguimiento, sin tratamiento médico. Para la revisión bibliográfica se emprendió una búsqueda en Medline, Cochrane, LILACS, Google Scholar y literatura gris con los términos "myasthenia gravis AND ovarian cancer". Se encontraron 18 artículos de los que se incluyeron solo dos publicaciones para la revisión completa. CONCLUSIONES: Los síndromes neurológicos, entre estos la miastenia gravis, asociados con tumores de ovario a modo de síndromes paraneoplásicos son poco frecuentes y plantean la necesidad de incluir el estudio ginecológico en pacientes con miastenia gravis de manifestación atípica.

Abstract BACKGROUND: Paraneoplastic syndromes are distant manifestations of neoplasms originated by secondary mechanisms but not by tumor invasion. They are infrequent, precede the manifestation of the tumor itself and disappear when the tumor is cured. Although myasthenia gravis has traditionally been related to thymomas, here we report a case of myasthenia gravis as a paraneoplastic syndrome of an ovarian tumor and review the available literature on its diagnosis. CLINICAL CASE: 46-year-old patient with multiple episodes of generalized weakness and ventilatory failure requiring mechanical ventilation and intensive care stay. The clinical diagnosis of myasthenia gravis was established. Despite adequate treatment and thymectomy, the crises persisted. Soon after, she was diagnosed with serous adenocarcinoma of the ovary, which was treated with surgery and chemotherapy. With this, the neurological symptoms disappeared, with total remission after four years of follow-up, without medical treatment. For the literature review a search was undertaken in Medline, Cochrane, LILACS, Google Scholar and grey literature with the terms "myasthenia gravis AND ovarian cancer". Eighteen articles were found of which only two publications were included for the full review. CONCLUSIONS: Neurological syndromes, among this myasthenia gravis, associated with ovarian tumors as paraneoplastic syndromes are rare and raise the need to include gynecological study in patients with myasthenia gravis of atypical manifestation.

Dynamic circadian fluctuations of glycemia in patients with type 2 diabetes mellitus

BACKGROUND: Diabetes mellitus (DM) has glucose variability that is of such relevance that the appearance of vascular complications in patients with DM has been attributed to hyperglycemic and dysglycemic events. It is known that T1D patients mainly have glycemic variability with a specific oscillatory pattern with specific circadian characteristics for each patient. However, it has not yet been determined whether an oscillation pattern represents the variability of glycemic in T2D. This is why our objective is to determine the characteristics of glycemic oscillations in T2D and generate a robust predictive model. RESULTS: Showed that glycosylated hemoglobin, glycemia, and body mass index were all higher in patients with T2D than in controls (all p < 0.05). In addition, time in hyperglycemia and euglycemia was markedly higher and lower in the T2D group (p < 0.05), without significant differences for time in hypoglycemia. Standard deviation, coefficient of variation, and total power of glycemia were significantly higher in the T2D group than Control group (all p < 0.05). The oscillatory patterns were significantly different between groups (p = 0.032): the control group was mainly distributed at 2-3 and 6 days, whereas the T2D group showed a more homogeneous distribution across 2-3-to-6 days. CONCLUSIONS: The predictive model of glycemia showed that it is possible to accurately predict hyper- and hypo-glycemia events. Thus, T2D patients exhibit specific oscillatory patterns of glycemic control, which are possible to predict. These findings may help to improve the treatment of DM by considering the individual oscillatory patterns of patients.

COVID-19 en el adulto mayor: características clínicas e impacto sobre la salud mental / COVID-19 in the elderly: clinical features and impact on mental health

El propósito de esta revisión fue analizar la literatura existente con el fin de identificar los principales aspectos de la en- fermedad ocasionada por el SARS-CoV-2, así como su impacto en la salud mental del adulto mayor y su relación con la mortalidad en esta población en riesgo. Se revisó la información a partir de artículos de revistas electrónicas a través de las bases de datos Pubmed, Medline, Scopus y Google Scholar para el período julio 2020 a junio 2021. Entre los aspectos relevantes se encontró da- tos alarmantes, los pacientes con comorbilidades en este grupo de edad tenían 6 veces más probabilidad de ser hospitalizados y 12 veces más probabilidad de morir que una persona sin comorbili - dades. La salud mental es un importante factor en esta pandemia, se ha demostrado deterioro en estado general y enfermedades mentales debido a la ansiedad y aislamiento social secundario a la pandemia en este grupo...(AU)

Memoria episódica posterior a cirugía de epilepsia del lóbulo temporal / Episodic memory after temporal lobe epilepsy surgery

RESUMEN INTRODUCCIÓN: La cirugía resectiva del lóbulo temporal anterior con amigdalo-hipocampectomía es un tratamiento efectivo para la epilepsia farmacorresistente del lóbulo temporal con esclerosis hipocampal. Sin embargo, este procedimiento conlleva riesgo de deterioro de la memoria episódica verbal y no verbal postoperatoria, dependiendo de la dominancia hemisférica para la memoria y el lenguaje. OBJETIVO: Explorar el desenlace de la memoria episódica posterior a la cirugía resectiva mediante lobectomía temporal anterior con amigdalo-hipocampectomía. MÉTODOS: Se analizó retrospectivamente la memoria episódica verbal y no verbal mediante pruebas neurop-sicológicas de 51 pacientes consecutivos sometidos a lobectomía temporal anterior con amigdalo-hipocampectomía del lado izquierdo y derecho. Todos los pacientes fueron sometidos a resonancia magnética cerebral preoperatoria, video-electroencefalografía y evaluaciones neuropsicológicas. A 12 pacientes (24 %) no se les realizó el test de Wada. RESULTADOS: Hubo disminución en la memoria episódica verbal postoperatoria con diferencias respecto a la preoperatoria, en la subprueba de textos II recuerdo de la escala de memoria de Wechsler III (p = 0,035). El resultado en la memoria episódica visual se mantuvo igual, no hubo diferencias en el grupo de lobectomía temporal estándar. CONCLUSIÓN: La lobectomía temporal anterior más amigdalo-hipocampectomía izquierda afecta levemente el desempeño de la memoria episódica postoperatoria, que clínicamente no es significativo en pacientes con epilepsia del lóbulo temporal mesial farmacorresistente.

SUMMARY INTRODUCTION: Resective surgery of the anterior temporal lobe with amygdalohippocampectomy is an effective treatment for drug-resistant epilepsy of the temporal lobe with hippocampal sclerosis. However, this procedure carries a risk of post-operative episodic verbal and nonverbal memory impairment depending on the hemispheric dominance for memory and language. OBJECTIVE: To explore the outcome of episodic memory after resective surgery by means of anterior temporal lobectomy with amygdalohippocampectomy. METHODS: Verbal and non-verbal episodic memory was retrospectively analyzed by neuropsychological tests of 51 consecutive patients undergoing anterior temporal lobectomy with amygadalohyppocampectomy on the left and right sides. All patients underwent preoperative brain MRI, video electroencephalography, and neuropsychological evaluations. 12 patients (24%) did not undergo the Wada test. RESULTS: There was a decrease in postoperative verbal episodic memory with differences compared to preoperative, in the text II subtest recall of the Wechsler III memory scale (p = 0.035). The result in visual episodic memory remained the same, there were no differences in the standard temporal lobectomy group. CONCLUSION: Anterior temporal lobectomy plus left amygadalohyppocampectomy slightly affects the performance of postoperative episodic memory, which is clinically not significant in patients with drug-resistant mesial temporal lobe epilepsy.

Asociación entre el tiempo de comunicación verbal entre padres e hijos y los niveles de adiposidad de preescolares chilenos / Association between parents-children verbal communication time and the adiposity levels of chilean pre-schoolchildren

RESUMEN Objetivos Determinar la asociación entre el tiempo de comunicación verbal de padres e hijos en etapa preescolar y sus niveles de adiposidad; en segundo lugar, se busca describir las variables sociodemográficas y de composición corporal de dichos preescolares en relación con la comunicación verbal entre padres e hijos. Materiales y Métodos Estudio descriptivo, transversal y de carácter multicéntrico en el que participaron 70 preescolares. Las variables medidas fueron "niveles de adiposidad de los preescolares", variables sociodemográficas de padres y tiempo de comunicación verbal "entre padres e hijos". Resultados Con base en el tiempo de comunicación entre padres e hijos (se consideró como "bajo tiempo de comunicación" un tiempo de menos de 100 min/día y como "elevado tiempo de comunicación", uno que fuera mayor o igual a 100 min por día), se hallaron diferencias significativas en las variables peso en la clasificación nutricional de obesidad (TC<100 min/día 20.6±4 vs. TC≥100 min/día 18.4±3 kg, P=0.039), zpeso/talla (TC<100 min/día 1.791±8 vs. TC≥100 min/día 1.010±4, P=0.030), masa grasa en kg (TC<100 min/día 7.5±3 vs. TC≥100 min/día 6.3±2 kg, P=0.046), masa grasa en % (TC<100 min/día 36.3±2 vs. TC≥100 min/día 33.9±3%, P<0.05). La talla y la razón peso/talla no presentaron asociación significativa mediante el estado nutricional y las categorías de diferentes tiempos de comunicación verbal entre padres e hijos por día. Además, la masa muscular fue asociada significativamente al tiempo de comunicación verbal entre padres e hijos en las categorías de obesidad (TC<100 min/día 5.7±3 vs. TC≥100 min/día 5.1±3 kg, P=0.047) y masa magra del tronco (TC<100 min/día 5.2± 4 vs. 4.6±3 kg, P=0.039). Conclusiones El tiempo diario de comunicación verbal entre padres e hijos se asocia significativamente a mayores niveles de adiposidad mediante el peso, zpeso/talla y masa grasa. Estos hallazgos requieren de mayor y más compleja investigación para corroborarse.

ABSTRACT Objective To determine the association between the time of verbal communication parents-children with the adiposity levels of pre-schoolchildren, and secondly to describe the socio-demographic, and body composition outcomes of pre-schoolchildren by the verbal communication parents-children time. Materiales y Methods A descriptive, cross-sectional study of multi-centric application, with participation of (n=70) pre-scholars. The outcomes described were the adiposity, socio-demographic data of parents and the time of verbal communication parents-children. Results Considering a low (<100 min/day) versus a high (≥100 min/day) time of verbal communication parents-children, there were significant differences in the weight of the obesity classification "total communication/day" [TC] (TC<100 min/day 20.6±4 vs. TC≥100 min/day 18.4±3 kg, P=0.039), zweight/height (TC<100 min/day 1.791±8 vs. TC≥100 min/day 1.010±4, P=0.030), lean mass in kg (TC<100 min/day 7.5±3 vs. TC≥100 min/day 6.3±2 kg, P=0.046), body fat in % (TC<100 min/day 36.3±2 vs. TC≥100 min/day 33.9±3%, P<0.05). The height and ratio weight/height do not showed significant association with the time of verbal communication parents-children. Additionally, muscle mass (TC<100 min/day 5.7±3 vs. TC≥100 min/day 5.1±3 kg, P=0.047), and trunk lean mass (TC<100 min/day 5.2± 4 vs. 4.6±3 kg, P=0.039) were significantly associated with the main outcome. Conclusions The daily time of verbal communication parents-children is significantly associated with higher levels of adiposity by the weight, zweight/height, and body fat in pre-schoolchildren. These findings require major and more complex research for corroborating.

Effect of warm-up on hand grip strength in sedentary overweight women / Efecto del calentamiento en la fuerza de agarre de mano en mujeres sedentarias con sobrepeso

Abstract Introduction: In recent years, handgrip strength assessment has gained special relevance in health. However, a standardized application protocol that includes warm-up procedures is required to measure it. Objective: To compare the acute effects of four warm-up strategies on maximal handgrip strength (MHS) in sedentary overweight women. Materials and methods: Single-blind, randomized, crossover study in which MHS was measured in 12 overweight women under the following conditions: i) no warm-up (control condition), ii) static stretching warm-up, iii) strength-based warm-up (i.e., resistance band exercise), and iv) isometric squeezing-ball warm-up for the forearm muscles. A Jamar dynamometer was used for the measurements, which were taken on four different days, at 48-hour rest intervals; three measurements were made per hand. Results: MHS mean values were 23.8 and 24.9 kg without warm-up, 20.3 and 21.4 kg after stretching warm-up, 20.9 and 22.9 kg after strength-based warm-up, and 22.0 and 23.0 kg after squeezing-ball warm-up for non-dominant and dominant hand, respectively. No significant differences (p>0.05; one-way ANOVA) were observed between protocols, nor were there differences in MHS in relation to nutritional status, lean mass, or fat mass. Conclusion: Warm-up is not required to measure MHS in overweight sedentary women when three measurements are made.

Resumen Introducción. En los últimos años se ha dado una mayor importancia a la medición de la fuerza máxima de agarre de mano, sin embargo para hacer esta medición se requiere un protocolo estandarizado de aplicación, incluyendo procedimientos de calentamiento. Objetivo. Comparar los efectos agudos de cuatro tipos de calentamiento en la fuerza máxima de agarre de mano de mujeres sedentarias con sobrepeso. Materiales y métodos. Estudio ciego, aleatorizado y cruzado en el que se midió la fuerza máxima de agarre de mano de 12 mujeres con sobrepeso bajo las siguientes condiciones: i) sin calentamiento (condición de control), ii) con calentamiento de estiramiento estático, iii) con calentamiento basado en la fuerza (p. ej., ejercicios con banda elástica) y iv) con calentamiento con bola terapéutica de compresión para los músculos del antebrazo. Para las mediciones se utilizó un dinamómetro Jamar y estas se realizaron en cuatro días diferentes y en intervalos de 48 horas de descanso; además, se hicieron tres intentos de medición por mano. Resultados. Los valores promedio de fuerza máxima de agarre para la mano no dominante y dominante fueron 23.8kg y 24.9kg sin calentamiento, 20.3kg y 21.4kg con estiramiento, 20.9kg y 22.9kg con banda elástica y 22.0kg y 23.0kg con bola terapéutica, respectivamente. No hubo diferencias significativas (p>0.05; ANOVA de una vía) entre los protocolos, ni diferencias en la fuerza máxima de agarre de mano en relación con estado nutricional, masa magra o masa grasa. Conclusión. No se requiere una sesión de calentamiento para medir la fuerza máxima de agarre de mano en mujeres sedentarias con sobrepeso cuando se realizan tres intentos de medición.

Auto reporte de la velocidad de marcha y su asociación con marcadores de adiposidad y riesgo cardiovascular en Chile / Association of self-reported walking speed with markers of adiposity and cardiovascular risk in Chile

Background Walking speed is a strong predictor of non-communicable diseases and mortality. Aim To investigate the association of self-reported walking pace with adiposity, metabolic and cardiovascular markers in the Chilean population. Material and Methods Analysis of data from 5,077 participants of the 2009-2010 National Health Survey (ENS 2009-2010). Walking speed was self-reported as average or slow pace. Body mass index (BMI), waist circumference (WC), blood pressure, blood glucose, glycosylated hemoglobin and lipid profile were the outcome. Results In Chile, 11% (95% confidence intervals [CI]: 10.0; 12.7) of the population reported a slow walking pace. Compared with average walking people, those reporting a slow pace had a higher body weight (difference (∆) 5.65 kg [95% CI: 3.22; 8.09], p < 0.01), BMI (D 2.48 kg/m 2 [95% CI: 1.53; 3.44], p < 0.01), WC (D 6.23 cm [95% CI: 4.12; 8.34], p < 0.01), serum triglycerides (D 30,9 mg/dl [95% CI: 5,31; 57,5], p = 0.018), and lower HDL cholesterol (D -2.32 mg/dl [95% CI: -4,24; -0,34], p = 0.022). Those reporting a slow pace had also a higher odd of being obese (odds ratio (OR): 2.46 [95% CI: 1.82; 3.33], p < 0.01), being diabetic (OR: 1.54 [95% CI: 1.02; 2.40], p = 0.018) and having metabolic syndrome (OR: 2.03 [95% CI: 1.30; 3.18], p = 0.002). Conclusions In Chilean adults, slow walking pace is associated with and unfavorable adiposity and lipid profile, including a higher probability of being obese, diabetic and having metabolic syndrome.

Comparación de los niveles de actividad física medidos con cuestionario de autorreporte (IPAQ) con medición de acelerometría según estado nutricional / Comparison between self-reported and device measured physical activity according to nutritional status

Background: It is unknown if nutritional status could influence the accuracy of self-reported physical activity (PA) levels. Aim: To compare PA measured using the international physical activity questionnaire (IPAQ) and by accelerometry (ActiGraph) according to nutritional status in Chilean adults. Material and Methods: This is an observational cross-sectional study that used information from the GENADIO project carried out in Chile between 2009-2011. The sample consisted of 322 people. PA levels and sitting time were determined through the IPAQ self-report questionnaire and ActiGraph accelerometers (GTM1). The nutritional status was determined according to body mass index (BMI). Results: Compared with the measurement made with accelerometry, the IPAQ self-report questionnaire underestimated the levels of light PA, total PA and sedentary time in −171.5, −54.8 and −40.6 min / day, respectively. However, IPAQ overestimated the levels of moderate PA and vigorous PA in 91.0 and 47.3 min/day respectively, compared with accelerometry. Compared with normal weight, obese subjects reported higher levels of moderate PA (105.5 and 48.9 min/day, respectively) and vigorous PA (54.1 and 38.3 min/day respectively). Total PA had a greater delta of underestimation between IPAQ and accelerometer measurements in normal weight than in obese subjects (-122.1 vs −16.5 min/day, respectively). Conclusions: The measurement of PA by means of a self-report questionnaire was discrepant with its objective measurement with an accelerometer. The discrepancy is even higher in obese people.

Importancia de los alérgenos de ácaros domésticos en el diagnóstico de la rinitis alérgica con síndrome de apnea-hipopnea del sueño / Importance of household mite allergens in the diagnosis of allergic rhinitis with sleep apnea-hypopnea syndrome

Los ácaros Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney (Ds) y Blomia tropicalis (Bt), constituyen la herramienta fundamental para diagnóstico e inmunoterapia de rinitis alérgica (RA), que en muchas ocasiones se asocia al síndrome apnea-hipopnea obstructiva del sueño (SAHOS). Para diagnosticar SAHOS se seleccionaron 465 individuos del registro de alergia del Policlínico Previsora, Camagüey, Cuba, con diagnóstico presuntivo de RA. Se descartaron aquellos con prueba cutánea Prick test negativa a Dp, Ds y Bt y sin poligrafía cardio-respiratoria (PCR), quedando para estudio 236 pacientes entre 8 y 70 años de edad: 102 casos (43,2 por ciento) definidos como aquellos con respiración oral y ronquidos y 134 controles (56,7 por ciento) sin respiración oral ni ronquidos. La PCR se realizó utilizando el marcaje automático de eventos del dispositivo ApneaLink AirTM (Resmed Corp., RFA). La media del tamaño del habón fue de 5,9 mm en los casos (p=0,02). El índice de apnea e hipopnea (IAH) fue positivo en 129 pacientes (54,6 por ciento); de ellos, 97 casos (41,1 por ciento) y 32 controles (13,5 por ciento). Los pacientes con IAH˃20/h predominaron en los casos con 21 individuos (8,8 por ciento) (p꞊0,048). La sensibilidad del PCR fue del 95,10 por ciento, su especificidad del 76,12 por ciento. Los valores predictivos positivos y negativos del 75,19 por ciento y 95,33 por ciento respectivamente. Se estimó en 3,98 la razón de verosimilitud positiva y de 0,06 la negativa. Los pacientes con SAHOS en los casos y controles presentan incremento con predominio para casos (p=0,002). La PCR con el dispositivo ApneaLink permite hacer el diagnóstico de SAHOS en RA(AU)

The mites Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney (Ds) and Blomia tropicalis (Bt) are the primary tool for the diagnosis and immunotherapy of Allergic Rhinitis (AR), which is often associated with the Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS). To diagnose OSAHS, 465 individuals were selected from the allergy registry of the Previsora Polyclinic, Camagüey, Cuba, with presumptive diagnosis of AR. Those with a skin test (Prick test) negative to Dp, Ds and Bt, and without a previous Cardiorespiratory Polygraphy (CRP) were discarded, leaving 236 patients between 8 and 70 years old: 102 cases (43.2 percent) those with oral breathing and snoring and 134 controls (56.7 percent) without oral breathing or snoring. The CRP data analysis was performed using the automatic algorithm of the ApneaLink AirTM device (Resmed Corp., Germany). The average size of the wheal was 5.9 mm in cases (p = 0.02). The Apnea Hypopnea Index (AHI) was greater than 5 events/hour in 129 patients (54.6 percent); of those, 97 cases (41.1 percent) and 32 controls (13.5 percent). Patients with AHI˃20/h predominated in cases with 21 individuals (8.8 percent) (p꞊0.048). The sensitivity of the PCR was 95.10 percent, its specificity 76.12 percent. The positive and negative predictive values were 75.19 percent and 95.33 percent respectively. The positive likelihood ratio was 3.98 and the negative one was 0.06. The prevalence of OSAHS was significantly higher in cases compared to controls (p =0.002). The CRP with the ApneaLink device allows the diagnosis of SAHOS in AR(AU)

Caracterización de los estilos de vida en dueñas de casa chilenas: análisis de la Encuesta Nacional de Salud 2009-2010 / Lifestyles of Chilean housewives: analysis of the 2009-2010 Chilean Health Survey

Background: Housewives represent a important proportion of the Chilean population. However, there is limited evidence about their lifestyles. Aim: To characterize lifestyles and determine the level of compliance with healthy lifestyles guidelines of housewives in Chile. Material and Methods: Housewives from the 2009-2010 National Health Survey were included. The variables studied included levels of physical activity (PA), sedentary behavior, diet, hours of sleep and smoking. Compliance with healthy lifestyle behaviors was evaluated through logistic regression, granting a value of 1 for compliance and 0 for non-compliance. A healthy lifestyle was defined as meeting at least four healthy behaviors. Results: Housewives aged > 55 years had a higher BMI and waist circumference compared to those aged < 40 years. Housewives were also more likely to report moderate alcohol consumption and were more likely to meet a healthier lifestyle score (Odds ratio = 1.52 [95% confidence intervals: 1.09 to 2.11], p = 0.013). No significant age trends were observed for other lifestyle behaviors. Conclusions: Housewives had high levels of central obesity, excess body weight and high levels of salt intake but low alcohol intake. Their healthy lifestyles behaviors increased along with increasing age.

¿Cuál es la prevalencia de obesidad metabólicamente saludable en población chilena? / What is the prevalence of metabolically healthy obesity in Chile?

RESUMEN La obesidad es un importante factor de riesgo cardiovascular. No obstante, no todas las personas obesas tienen un perfil metabólico alterado ni todas las personas normo-peso poseen un perfil metabólico normal. Objetivo: determinar la prevalencia de diferentes fenotipos metabólicos asocia-dos al estado nutricional en Chile. Métodos: se incluyeron 1.733 participantes de la Encuesta Nacional de Salud 2009-2010. El estado nutricional (obesidad o normo-peso) fue determinado a través del IMC mientras que la condición metabólica (saludable o no) en base a cuatro parámetros: glicemia, presión arterial, colesterol HDL y triglicéridos. Con estos parámetros de determinaron 4 fenotipos, entre ellos, MUNO: metabólicamente no saludable no obeso y MHO: obeso metabólicamente saludable. Resultados: La prevalencia de MHO fue de 3,3% mientras que un 17,4% presentaba MUNO. Adicionalmente, la prevalencia de MHO disminuyó en la medida que aumentó la edad y la mayor proporción de individuos metabólicamente saludables se encontraba en el grupo de altos ingresos y con un nivel educacional superior (técnico-universitario). Conclusión: Se evidencia una baja prevalencia de MHO, así como también una alta prevalencia de individuos MUNO en la población chilena. Futuras acciones preventivas deberían no sólo considerar el estado nutricional sino también la condición metabólica de la población.

ABSTRACT Obesity is an important cardiovascular risk factor. However, not all obese individuals have an unhealthy metabolic pro-file and vice versa. Therefore, the aim of this study was to determine the prevalence of different metabolic phenotypes by nutritional status in Chile. Methods: 1,733 individuals from the National Health Survey 2009-10 were included in this study. Nutritional status (obesity or normal-weight) was determined by BMI whereas metabolic profile was determined through four parameters: Glycaemia, blood pressure, HDL cholesterol and triglycerides. Four metabolic phenotypes were derived, among them: MUNO: metabolically unhealthy and non-obese and MHO: metabolically healthy obesity. Results: The prevalence of MHO in the Chilean population was 3.3% while the prevalence of MUNO was 17.4%. Moreover, the prevalence of MHO decreased as age increased and a greater proportion of metabolically healthy individuals were in the highest gross income group and in the technical-university educational level. Conclusion: This study shows a low prevalence of MHO and a higher prevalence of MUNO in the Chilean population. Future preventive actions should take into account not only the nutritional status, but also the metabolic profile of the population.

Influencia de la edad sobre el cumplimiento de las recomendaciones de actividad física: Resultados de la Encuesta Nacional de Salud en Chile 2009-2010 / Adherence to physical activity recommendations across age categories: Findings from the 2009-2010 Chilean National Health Survey

RESUMEN A pesar de que la actividad física (AF) es un factor protector contra las enfermedades crónicas no transmisibles, un gran porcentaje de la población no cumple los niveles mínimos recomendados. El objetivo fue investigar como varían los niveles de práctica de AF entre los diferentes grupos etarios en la población chilena. Se incluyeron 5.133 participantes de la Encuesta Nacional de Salud 2009-2010. La AF fue determinada utilizando el cuestionario GPAQ. La inactividad física fue definida como <600 MET/min/semana de AF moderada a vigorosa. La asociación entre AF y edad fue investigada por sexo mediante regresión logística. Las mujeres presentaron una mayor probabilidad de ser físicamente inactivas en comparación a los hombres (p<0,0001). Al analizar la prevalencia de inactividad física por sexo y grupo etario, esta cambió ligeramente entre los 20 a 59 años, pero a partir de los 60 se observó un incremento importante en la prevalencia llegando a 63% y 56% para mujeres y hombres >80 años, respectivamente. Los resultados obtenidos confirman la necesidad de seguir fomentando la práctica regular de AF física a través de todo el ciclo vital, pero en especial sobre los 60 años, ya que este grupo presenta una mayor probabilidad de ser físicamente inactivo.

ABSTRACT Although physical activity (PA) is a protective factor against non-communicable diseases, there is an important proportion of the population who do not meet PA guidelines. Our aim was to investigate how adherence to PA guidelines varies across different age groups in the Chilean population. 5,133 participants from the 2009-2010 Chilean Health Survey were included in this study. PA was measured using the Global Physical Activity Questionnaire (GPAQ). Physical inactivity was defined as <600 MET/min/week of moderate to vigorous intensity PA. Logistic regression was used to investigate the association of PA with age. The main finding of this shows that women were more likely to be inactive than men (p<0.0001). Physical inactivity prevalence varied slightly between 20 and 59 years. However, among those individuals aged >60 years the prevalence increased markedly, reaching 63% and 56% for women and men aged >80 years, respectively. These findings confirm the necessity of promoting PA across the lifespan, but more importantly, these results suggest that more promotion and opportunities for engaging in PA should be created especially for older adults, who are more likely to be physically inactive.

Body composition of male and female Chilean powerlifters of varying body mass

Aim: To examine body composition of Chilean powerlifters according to body mass and sex. Methods: Fifty-six male and female powerlifters were recruited from one national competition. Aside from the official weight categories, males were classified as the lightweight, middleweight, and heavyweight classes. Similarly, females were classified as lightweight and middle-heavyweight classes. Nineteen anthropometric measures were assessed, with lean mass as the main outcome. A one-way ANOVA was used to compare groups. Results: Male lightweight class lifted less (p<0.01) total load (417±30.9 kg) compared to heavier male classes (524±66.7 kg, middleweight; 581±131 kg, heavyweight), and female classes lifted less (p<0.01) total load (221±33.8 kg, lightweight; 254±48.3 kg, middleweight-heavyweight) compared to all male classes. Regarding lean-mass in trunk, arms and legs, total body protein, water, and mineral mass, all male groups had greater (p<0.01) values than the groups of females, while lightweight males had lower (p<0.01) values than the rest of male groups, and heavyweight males had greater (p<0.01) values than the total sample of males (except for legs lean mass, and total bone mineral content). In females, no significant differences were observed between classes, or in total load lifted or in body composition. Conclusion: Heavier male lifters had significantly greater lean mass than lighter athletes. Therefore, powerlifting performance was affected by anthropometric measures, as corroborated by 1-RM scores. However, there was a general lack of differences in body composition between female weight classes, and, as a result, a lack of differences in 1RM performance.(AU)

Asociación de un índice de estilos de vida saludable con factores de riesgo cardiovascular en población chilena / Association of a healthy lifestyle index with cardiovascular risk factors in Chileans adults

Background: Healthy lifestyles are associated with a better metabolic and cardiovascular health profile. Aim: To investigate the association between a lifestyle score and cardiovascular risk in Chilean adults. Material and Methods: A healthy lifestyle score was derived for 2,774 participants in the Chilean National Health Survey 2009-2010 and based on seven modifiable behaviors (salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviors). A high score represented a healthier lifestyle whereas a low score represents an unhealthy lifestyle. The association between the lifestyle score and cardiovascular risk factors (obesity, hypertension, diabetes, dyslipidemia and metabolic syndrome), was explored using logistic regression models. Results: One quartile increment in the healthy lifestyle score was associated with a lower risk for obesity (Odds ratio (OR): 0.82 [95% confidence intervals (CI): 0.75 to 0.90], p < 0.01), central obesity (OR: 0.88 [95% CI: 0.81 to 0.96], p < 0.01), diabetes (OR: 0.84 [95% CI: 0.75 to 0.95], p < 0.04) and dyslipidemia (OR: 0.90 [95% CI: 0.83 to 0.98], p = 0.01). These results were independent of major confounding factors. Conclusions: The adherence to a healthy lifestyle is associated with lower cardiovascular risk.

Association of maximal voluntary isometric handgrip strength with age, gender and handedness in older people / Fuerza de agarre isométrica máxima en relación a la edad, sexo y dominancia de mano

ABSTRACT Background: Maximal voluntary isometric handgrip strength (MVIHS) is influenced by age, sex, and handedness. Aim: To assess the association of MVIHS with age, sex, and handedness in older adults. Material and Methods: MVIHS was measured using a digital dynamometer in 60 men and 60 women aged 73 ± 6 years. Weight, height and handedness were also recorded. For analysis purposes, participants were divided into two age groups (65 to 70.9 years of age and ≥ 71 years). Results: A negative correlation was observed between age and MVIHS in the non-dominant (r = −0.65 and −0.59 in men and women, respectively) and dominant hands (r = −0.71 and −0.64 in men and women, respectively). When age and MVIHS were correlated in the group aged 65-70 years, a significant correlation was observed in the non-dominant (r = −045 and −0.61 in men and women, respectively) and dominant hands (r = −0.47 and −0.64 in men and women, respectively). In the group aged ≥ 71 years, a stronger correlation with age was also observed in the non-dominant (r = −0.92 and −0.90 in men and women, respectively) and dominant hands (r = −0.95 and −0.90 in men and women, respectively). MVIHS was 2.8 to 8.9% lower in the non-dominant than in the dominant hand in all age groups. MVIHS was lower in women than in men in both age groups. Conclusions: MVIHS declines with age (especially after 71 years of age), is higher in men than women, and higher in the dominant than the non-dominant hand.

Antecedentes: La fuerza de agarre isométrica voluntaria máxima (FAIVM) puede verse influenciada por la edad, el sexo y la dominancia. Objetivo: Describir la FAIVM y su relación con la edad, el sexo y la dominancia en adultos mayores. Material y Métodos: La FAIVM, la masa corporal, la talla, y la dominancia fueron medidas mediante protocolos estandarizados en 60 hombres e igual número de mujeres que fueron divididos en dos grupos acorde a su edad (65 a 70,9 años, y ≥ 71 años, respectivamente). Resultados: Se observó una correlación entre la edad y la FAIVM de mano no-dominante (hombres: r = −0,65; mujeres: r = −0,59) y dominante (hombres: r = −0,71; mujeres: r = −0,64). Al correlacionar la FAIVM y la edad en el grupo de 65-70 años, una correlación significativa fue observada en la mano no-dominante (hombres, r = −0,45; mujeres, r = −0,61) y mano dominante (hombres, r = −0,47; mujeres, r = −0,64). En el grupo ≥ 71 años, la edad tuvo una mayor correlación con la FAIVM de la mano no-dominante (hombres, r = −0,92; mujeres, r = −0,90) y mano dominante (hombres, r = −0,95; mujeres, r = −0,90). Comparada con la mano dominante, la mano no-dominante presentó menores valores de FAIVM en todos los grupos, variando entre −2,8 a −8,9%. Comparadas con los hombres, las mujeres presentaron menor FAIVM en mano dominante y no-dominante, en ambos grupos de edad. Conclusión: La FAIVM disminuye con la edad, especialmente desde los 71 años; es mayor en hombres comparados con mujeres y es mayor en mano dominante comparada con mano no-dominante.