Consideraciones éticas acerca de la retirada del soporte vital: análisis de un caso

La bioética desempeña un papel fundamental en la resolución de dilemas que pueden surgir en el ámbito de la atención médica. Uno de los temas más complejos es el retiro del soporte vital en pacientes en estado crítico. Este se basa en una evaluación minuciosa del pronóstico del paciente y en la consideración de sus propios deseos cuando sea posible. La toma de decisiones en este ámbito suele ser el resultado de un proceso colaborativo que involucra a médicos, familiares y, en algunas ocasiones, comités de ética. Se presenta un caso clínico en el que el paciente se encontraba en una situación delicada de salud debido a una enfermedad respiratoria grave por lo que se mantuvo en soporte vital. Después de haberse agotado todas las opciones terapéuticas disponibles, se tomó la decisión de retirar el soporte vital. El retiro del soporte vital en pacientes en estado crítico es un proceso complejo que conlleva múltiples dimensiones.

Bioethics plays a fundamental role in resolving dilemmas that may arise in the field of healthcare. One of the most complex issues is the withdrawal of life support in critically ill patients. This is based on a thorough assessment of the patient's prognosis and consideration of their own wishes where possible. Decision making in this area is usually the result of a collaborative process that involves doctors, family members and, sometimes, ethics committees. A clinical case is presented in which the patient was in a delicate health situation due to a serious respiratory illness for which he was kept on life support. After all available therapeutic options had been exhausted, the decision was made to withdraw life support. The withdrawal of life support in critically ill patients is a complex process that involves multiple dimensions.

Variables de la condición física, predictores de los niveles de fragilidad en personas adultas mayores entre 60 y 64 años de Sabaneta, Antioquia / Physical condition variables, predictors of frailty levels in older adults between 60 And 64 Years Of Age from Sabaneta, Antioquia / Variáveis de condição física, preditores dos níveis de fragilidade em idosos entre 60 e 64 anos de Idade de Sabaneta, Antioquia

Resumen Introducción: El estudio examina la prevalencia y los factores asociados con la fragilidad en personas adultas mayores, destacando la escasez de investigaciones en América Latina y la necesidad de un enfoque integral de atención de salud para abordar esta creciente preocupación epidemiológica. Propósito: El objetivo de este estudio descriptivo transversal correlacional con fase multivariada fue determinar las variables de la condición física que predicen la fragilidad en las personas adultas mayores de entre 60 y 64 años del municipio de Sabaneta, Antioquia durante el primer semestre del 2021 con 125 personas sanas. Metodología: Para las variables cualitativas, el sexo y la fragilidad se relacionan de forma estadísticamente significativa. En las variables cuantitativas, "fuerza muscular de las piernas", "fuerza muscular de los brazos derecha e izquierda", "agilidad de marcha" y "resistencia aeróbica en marcha" se asociaron de forma estadísticamente significativa con la fragilidad. Resultados: En el modelo de regresión lineal, se evidenció que la variable "agilidad de la marcha" fue la predictora de fragilidad en la persona adulta mayor. Prevalencia de fragilidad en el 85.6 % de los casos, de los cuales el 48 % presentan condiciones de prefragilidad. Variables como la fuerza de los brazos, fuerza de las piernas, agilidad de la marcha y resistencia aeróbica en la marcha fueron estadísticamente significativas. Conclusiones: La agilidad de la marcha es un factor predictivo de riesgo de fragilidad en la persona adulta mayor. Las personas con disminución en la agilidad de la marcha tienen un 26 % más de probabilidades de ser frágiles.

Abstract Introduction: The study examines the prevalence and factors associated with frailty in older adults, highlighting the scarcity of research in Latin America and the need for a comprehensive healthcare approach to address this growing epidemiological concern. Purpose: The aim of this cross-sectional correlational descriptive study with a multivariate phase was to determine the physical fitness variables that predict frailty in older adults aged 60-64 years. It was conducted in Sabaneta, Antioquia during the first semester of 2021 with 125 healthy individuals aged 60-64 years. Methodology: For the qualitative variables, sex and frailty were statistically significantly related. For the quantitative variables, "leg strength", "right and left arm strength", "walking agility", and "aerobic walking endurance" were significant in relation to frailty. Results: In the linear regression model, it was found that the variable "walking agility" was the predictor of frailty in older adults. Prevalence of frail conditions in 85.6% of the cases, of which 48% had pre-frail conditions. Variables such as arm strength, leg strength, walking agility, and aerobic walking endurance were statistically significant. Conclusions: Walking agility is a predictive risk factor for frailty in older adults. Individuals with decreased walking agility have a 26% higher probability of being frail.

Resumo Introdução: O estudo examina a prevalência e os fatores associados à fragilidade em idosos, destacando a escassez de pesquisas na América Latina e a necessidade de uma abordagem abrangente de cuidados de saúde para enfrentar essa preocupação epidemiológica crescente. Objetivo: O objetivo deste estudo descritivo correlacional transversal com uma fase multivariada foi determinar as variáveis de aptidão física que predizem a fragilidade em idosos de 60 a 64 anos. Foi realizado em Sabaneta, Antioquia, durante o primeiro semestre de 2021 com 125 indivíduos saudáveis com idades entre 60 e 64 anos. Metodologia: Para as variáveis qualitativas, sexo e fragilidade estavam relacionados estatisticamente de forma significativa. Para as variáveis quantitativas, "força das pernas", "força dos braços direito e esquerdo", "agilidade ao caminhar" e "endurance aeróbico ao caminhar" foram significativas em relação à fragilidade. Resultados: No modelo de regressão linear, constatou-se que a variável "agilidade ao caminhar" foi o preditor de fragilidade em idosos. Prevalência de condições frágeis em 85.6% dos casos, dos quais 48% tinham condições pré-frágeis. Variáveis como força dos braços, força das pernas, agilidade ao caminhar e endurance aeróbico ao caminhar foram estatisticamente significativas. Conclusões: A agilidade ao caminhar é um fator de risco preditivo para fragilidade em idosos. Indivíduos com agilidade ao caminhar diminuída têm uma probabilidade 26% maior de serem frágeis.

Evaluación de la condición física en poblaciones de 6 a 14 años de México y Cuba

El presente estudio constituye un trabajo trascendente en el área del conocimiento de la condición física y representa el resultado de investigaciones realizadas en la República de Cuba y en los Estados Unidos Mexicanos como respuesta a la solicitud de ambos países. Fue diseñado estadísticamente, para representar datos oficiales y altamente confiables, con el objetivo de conocer el estado de la condición física de las dos naciones y valorar así, el efecto de los programas de Educación Física que se aplican. Se contó con el apoyo de las organizaciones deportivas y de cultura física al conformar los estudios, cuidadosamente tratados en el diseño de muestra, para ello se contó con un equipo de estadísticos especialistas que tuvieron a su cargo el procesamiento de la información. Los datos de este estudio se consideraron limitados para la publicación y una vez desclasificados se dan conocer. Se utilizaron iguales metodologías en su aplicación, lo que resulta una información valiosa para el perfeccionamiento de los planes y programas que en el campo de la Licenciatura en Cultura Física y se brinda una información que, en su comparación, llama a la reflexión de los especialistas de Educación Física, para continuar el perfeccionamiento de estas especialidades, en general.

O presente estudo constitui um trabalho transcendental na área do conhecimento da aptidão física e representa o resultado de uma pesquisa realizada na República de Cuba e nos Estados Unidos Mexicanos em resposta à solicitação de ambos os países. Foi projetado estatisticamente para representar dados oficiais e altamente confiáveis, com o objetivo de conhecer o estado da aptidão física em ambos os países e, assim, avaliar o efeito dos programas de Educação Física aplicados. As organizações esportivas e de cultura física foram apoiadas na elaboração dos estudos, cuidadosamente tratadas no desenho da amostra, com a ajuda de uma equipe de estatísticos especializados que foram responsáveis pelo processamento das informações. Os dados deste estudo foram considerados limitados para publicação e, uma vez desclassificados, são tornados públicos. Foram utilizadas as mesmas metodologias em sua aplicação, o que resulta em informações valiosas para o aprimoramento dos planos e programas no campo da cultura física e fornece informações que, em sua comparação, exigem a reflexão dos especialistas em educação física, a fim de continuar o aprimoramento dessas especialidades em geral.

The present study constitutes a transcendent work in the area of knowledge of physical condition and represents the result of research carried out in the Republic of Cuba and in the United Mexican States in response to the request of both countries. It was designed statistically, to represent official and highly reliable data, with the objective of knowing the state of the physical condition of the two nations and thus evaluating the effect of the Physical Education programs that are applied. It was had the support of sports and physical culture organizations when forming the studies, carefully treated in the sample design, for this it was had a team of specialist statisticians who were in charge of processing the information. The data from this study was considered limited for publication and will be released once declassified. The same methodologies were used in its application, which is valuable information for the improvement of plans and programs in the field of the Bachelor's Degree in Physical Culture and information is provided that, in comparison, calls for reflection by specialists. of Physical Education, to continue the improvement of these specialties, in general.

Effects of endurance training combined with blood flow restriction on functionality in older adults: a systematic review / Efeitos do treinamento de resistência combinado com restrição de fluxo sanguíneo na funcionalidade de idosos: uma revisão sistemática

The aim of this review was to verify the effects of aerobic exercise combined with blood flow restriction on older adult functionality. Systematic searches were performed in PubMed, Web of Science, and Embase between July and December 2023. Randomized studies with participants aged ≥ 60 years who were evaluated before and after the experimental protocols were included. We registered this systematic review at the International Prospective Register (PROSPERO CRD42022347205). The search strategy identified 2698 studies, four of which were included in the review, with 80 participants. The results suggested that aerobic exercise combined with blood flow restriction increased performance on specific functional tests. However, these results should be interpreted with caution due to the low-to-moderate study quality, as well as the low number of participants and studies. In conclusion, aerobic exercise and blood flow restriction may increase functional capacity in older adults. Further studies are needed to confirm such findings. (AU)

Rehabilitación Respiratoria con cánula nasal de alto flujo en pacientes con enfermedades respiratorias crónicas / Respiratory Rehabilitation with high-flow nasal cannula in patients with chronic respiratory diseases / Reabilitação Respiratória com cânula nasal de alto fluxo em doentes com doença respiratória crónica

Las enfermedades respiratorias crónicas, se incrementan a nivel mundial, destacándose EPOC, fibrosis pulmonar, bronquiectasia y sumándose la condición post COVID-19 asociadas a las vías respiratorias. Objetivo. Determinar los efectos de la rehabilitación respiratoria con cánula nasal de alto flujo en pacientes con enfermedades respiratorias crónicas. Material y método. Estudio realizado en un hospital militar peruano a una muestra constituida por 115 pacientes, quienes ingresaron a un programa de Rehabilitación Respiratoria de 12 semanas con la asistencia de la Cánula de alto flujo durante cada sesión y evaluados al inicio y al final mediante el test de pararse y sentarse en un minuto. El diseño fue pre experimental con pre y post test, corte longitudinal, de tipo aplicada. Se obtuvo la media y desviación estándar y se realizó la prueba de rangos con signo de Wilcoxon, se consideró una significancia del 95% y un valor p<0,05 como estadísticamente significativo. Resultados. La media de la edad fue de 58,30 ± 8,17; el 62,6% fue hombres y 37,4% mujeres; los pacientes con condición Post COVID-19 fueron el 71.30%, seguidos de fibrosis pulmonar con 12,17%; con 7,16±1,24 (p<0,000), en el número de repeticiones mediante pararse y sentarse durante un minuto, lo que mejoró principalmente la fatiga muscular (p<0,003). Conclusiones. Se determina como cambio, que se duplica lo mínimamente significativo mediante la prueba de pararse y sentarse durante un minuto. Además, se evidencia mejor respuesta al ejercicio, con menor disnea y fatiga muscular, por efecto de la presión positiva de la cánula de alto flujo.

Chronic respiratory diseases are increasing worldwide, with COPD, pulmonary fibrosis, bronchiectasis and post COVID-19 conditions associated with the respiratory tract standing out. Objective. To determine the effects of respiratory rehabilitation with high-flow nasal cannula in patients with chronic respiratory diseases. Method. Study carried out in a Peruvian military hospital on a sample of 115 patients, who entered a 12-week Respiratory Rehabilitation program with the assistance of the high-flow nasal cannula during each session and evaluated at the beginning and at the end by means of the test of standing up and sitting down in one minute. The design was pre-experimental with pre- and post-test, longitudinal cut, applied type. The mean and standard deviation were obtained and the Wilcoxon signed-rank test was performed, a significance of 95% and a value p<0.05 was considered statistically significant. Results. The mean age was 58.30±8.17; 62.6% were male and 37.4% female; patients with Post COVID-19 condition were 71.30%, followed by pulmonary fibrosis with 12.17%; with 7.16±1.24 (p<0.000), in the number of repetitions by standing and sitting for one minute, which mainly improved muscle fatigue (p<0.003). Conclusions. It is determined as a change, that the minimally significant is duplicated by the test of standing and sitting for one minute. In addition, a better response to exercise is evidenced, with less dyspnea and muscle fatigue, due to the effect of the positive pressure of the high flow cannula.

As doenças respiratórias crónicas estão a aumentar em todo o mundo, com destaque para a DPOC, a fibrose pulmonar, as bronquiectasias e as doenças pós-COVID-19 associadas ao trato respiratório. Objetivo. Determinar os efeitos da reabilitação respiratória com cânula nasal de alto fluxo em doentes com doenças respiratórias crónicas. Método. Estudo realizado num hospital militar peruano com uma amostra de 115 pacientes, que entraram num programa de Reabilitação Respiratória de 12 semanas com a assistência da cânula nasal de alto fluxo durante cada sessão e avaliados no início e no fim através do teste de sentar e levantar de um minuto. O delineamento foi pré-experimental com pré e pós-teste, longitudinal, do tipo aplicado. Obteve-se média e desvio padrão e realizou-se o teste de Wilcoxon signed-rank, com 95% de significância e valor de p < 0,05 foi considerado estatisticamente significativo. Resultados. A média de idade foi de 58,30±8,17; 62,6% eram do sexo masculino e 37,4% do sexo feminino; pacientes com quadro pós COVID-19 foram 71,30%, seguido de fibrose pulmonar com 12,17%; com 7,16±1,24 (p<0,000), no número de repetições em pé e sentado por um minuto, que melhorou principalmente a fadiga muscular (p<0,003). Conclusões. Determina-se como mudança, que o minimamente significativo é duplicado pelo teste de estar de pé e sentado durante um minuto. Além disso, evidencia-se uma melhor resposta ao exercício, com menos dispneia e fadiga muscular, devido ao efeito da pressão positiva da cânula de alto fluxo.

Water quality of self-provided wells water in Haidian District in Beijing in 2018 - 2022 / 公共卫生与预防医学

Objective To investigate the water quality and sanitary conditions of rural self-provided wells water in Haidian District, Beijing, and to provide reference for strengthening water supply management of self-provided wells. Methods The water quality monitoring data of rural self-provided wells in Haidian District from 2018 to 2022 were analyzed. Results A total of 1 568 water samples were tested in 2018-2022 , of which 1 486 were qualified, with a qualified rate of 94.77%. The qualified rate in each year was 86.75% , 92.86% , 97.48% , 98.06% , and 99.34% , respectively , and the difference was statistically significant ( χ2= 75.296 , P＜0.05). The qualified rates of sensory traits and general chemical indexes, toxicological indexes and microbial indexes were 97.70%, 97.58% and 98.28%, respectively. There were statistically significant differences in the qualified rates among the three indexes in 2018, 2019 and 2021 (P < 0.05). The unqualified indicators included total hardness, total number of colonies, total coliform, fluoride, nitrate and turbidity, with a qualified rate of 97.96%, 98.41%, 99.17%, 99.11%, 98.47% and 99.94%, respectively. Conclusion The water quality of self-provided wells in rural Haidian District is good. Relevant departments should continue to strengthen the supervision of self-provided wells, such as the supervision of self-provided wells disinfection devices and water treatment equipment, to ensure the safety of drinking water for residents.

Study on the relationship between comorbidities of chronic diseases,phase angle,and muscle mass decline related to sarcopenia in the elderly / 上海交通大学学报（医学版）

Objective·To explore the correlation between comorbidities of chronic non-communicable diseases(chronic diseases),phase angle(PhA),and muscle mass decline associated with sarcopenia in the elderly,and the predictive value of chronic disease comorbidities and PhA in muscle mass decline in the elderly.Methods·By retrospectively screening inpatients aged≥60 years who were admitted to the Department of Geriatrics,Renji Hospital,Shanghai Jiao Tong University School of Medicine from August 1,2018 to July 31,2019,basic information and medical history of the patients(gender,age,number of medications used,number of comorbidities,presence of osteoporosis,smoking history,etc.)were collected,as well as laboratory examination indicators(hemoglobin,albumin,serum creatinine,serum uric acid,ferritin,vitamin D,triacylglycerol,total cholesterol,high-density lipoprotein,low-density lipoprotein,etc.).The age-adjusted Charlson comorbidity index(aCCI)was calculated.The InBody S10 bioelectrical impedance body composition detector was used to test the body composition.Body mass index(BMI),skeletal muscle mass index(SMI),and PhA were collected.Some patients underwent measurement of grip strength.Muscle mass decline was diagnosed by using the SMI values recommended by the 2019 Asian Working Group for Sarcopenia(AWGS)(≤7.0 kg/m2 for males and≤5.7 kg/m2 for females).According to the measured SMI values,patients were divided into a group with normal muscle mass and a group with muscle mass decline.Univariate and multivariate Logistic analyses were employed to investigate the risk factors associated with muscle mass decline related to sarcopenia in the elderly.Additionally,the receiver operator characteristic(ROC)curve and the area under the curve were utilized to predict the significance of these factors in muscle mass decline.Results·A total of 359 chronic disease patients were enrolled,including 226 males and 133 females.There were 241 cases in the normal muscle mass group and 118 cases in the muscle mass decline group.The incidence of muscle mass decline related to sarcopenia in the elderly was 32.9%.The univariate Logistic regression analysis showed that age(OR=1.036,95%CI 1.013?1.060),comorbidities(OR=1.117,95%CI 1.025?1.217),aCCI(OR=1.123,95%CI 1.031?1.222),and high-density lipoprotein(OR=3.688,95%CI 2.065?6.622)were positively correlated with the risk of muscle mass decline in the elderly.BMI(OR=0.514,95%CI 0.443?0.597),PhA(OR=0.195,95%CI 0.126?0.303),hemoglobin(OR=0.984,95%CI 0.972?0.996)and triacylglycerol(OR=0.606,95%CI 0.424?0.866)were negatively correlated with the risk of muscle mass decline in the elderly.Multivariate Logistic regression model indicated that PhA(OR=0.338,95%CI 0.119?0.959)and BMI(OR=0.634,95%CI 0.476?0.844)were negatively correlated with the risk of muscle mass decline in elderly.The area under the ROC curve for predicting muscle mass decline related to sarcopenia in elderly by using BMI and PhA was 0.893(95%CI 0.855?0.931)and 0.786(95%CI 0.736?0.837),respectively.The sensitivity was 0.724 and 0.676,respectively.The specificity was 0.916 and 0.762,respectively.When BMI combined with PhA predicted muscle mass decline in the elderly,the area under the ROC curve was 0.917(95%CI 0.883?0.951).The sensitivity was 0.867,and the specificity was 0.860.Conclusion·aCCI is correlated with muscle mass decline associated with sarcopenia in the elderly.As BMI and PhA decrease,the risk of muscle mass decline in the elderly increases.The combination of BMI and PhA has a high predictive value in muscle mass decline in the elderly.No predictive value of chronic diseases comorbidities in muscle mass decline related to sarcopenia in the elderly is found.

Mechanism of Chinese medicine for promoting blood circulation and removing blood stasis combined with platelet-rich plasma to improve steroid-induced necrosis of the femoral head / 中国组织工程研究

BACKGROUND:At present,it is found that both Chinese medicine for activating blood circulation and removing blood stasis and platelet-rich plasma technology can repair damaged blood vessels,promote vascular regeneration,rebuild blood supply in the femoral head,restore normal blood supply,and further promote osteogenesis.Both of them have certain advantages in early intervention of steroid-induced necrosis of femoral head.It can also further understand the mechanism of blood activating and stasis removing herbs and platelet-rich plasma technology in improving steroid-induced necrosis of the femoral head,and provide new ideas for future treatment. OBJECTIVE:To review the research progress of the mechanism of the combination of blood activating and blood stasis removing herbs and platelet-rich plasma technology on steroid-induced necrosis of the femoral head according to the related literature at home and abroad. METHODS:PubMed,Web of Science,Metstr,CNKI and WanFang databases were searched for relevant articles."Traditional Chinese medicine,signal pathways,steroid induced necrosis of femoral head,vascular endothelial growth factor,platelet rich plasma"were used as the Chinese and English search terms separately.The time limit for searching the literature was from January 2000 to July 2022,and 75 related articles were finally included. RESULTS AND CONCLUSION:Both Chinese medicine for activating blood circulation and removing blood stasis and platelet-rich plasma technology have certain advantages in intervening the early stage of steroid-induced necrosis of femoral head.For traditional Chinese medicine,both single and compound drugs can effectively alleviate the further development of steroid-induced necrosis of the femoral head.The specific mechanism is as follows:(1)The traditional Chinese medicine for activating blood circulation and removing blood stasis has a significant anticoagulation effect,which can antagonize the abnormal(hypercoagulable)state of blood caused by hormone drugs,and further restore the normal blood supply in the femoral head.(2)Traditional Chinese medicine for activating blood circulation and removing blood stasis can repair damaged vascular endothelium,regenerate blood vessels and remodel blood supply in the femoral head by activating vascular endothelial growth factor.(3)The traditional Chinese medicine of promoting blood circulation and removing blood stasis has the obvious effect of removing blood stasis,which can reduce the accumulation of fat cells in the bone marrow cavity and relieve the pressure in the femoral head.(4)Traditional Chinese medicine for promoting blood circulation and removing blood stasis can regulate relevant signal pathways,maintain bone metabolism,promote the differentiation and balance of osteoblasts and osteoclasts,and effectively reduce steroid-induced necrosis of the femoral head.In addition,platelet-rich plasma contains a large amount of high concentration of cell growth factor,which plays a positive role in osteogenesis and vascular regeneration,and can also improve the abnormal state of the blood.Traditional Chinese medicine for activating blood circulation and removing blood stasis combined with platelet-rich plasma technology can play their biological roles,and the intervention effect is more significant.

Ethylene oxide residue detection method based on multi-component medical devices / 医疗卫生装备

Objective To establish a stable and reliable method for the determination of ethylene oxide residue,and to analyze ethylene oxide residue in multi components made of different materials involved in some medical devices,so as to provide references for sample selection and ethylene oxide residue detection of multi-component medical device kits.Methods A method for the determination of ethylene oxide residue of multi-component medical devices was developed using headspace-gas chromatography and DB-WAX column under the conditions of headspace extraction with equilibration at 80℃ for 20 min,and the weighing mass,linearity,limit of detection,limit of quantification,precision and recovery of the method were determined.Trials of the method were carried out on the items undergoing ethylene oxide sterilization,including disposable perineal care kit,disposable gynecological examination kit,disposable suture dressing kit,disposable debridement kit and the components contacting human body in the disposable dialysis kit,and the abilities of different materials of the components were analyzed in absorbing,retaining and releasing ethylene oxide.Results The method showed high linearity(r=0.999 8)in the range of ethylene oxide mass concentration from 0.4 to 16.0 μg/mL with a weighing mass of 1.00 g,which had the limit of detection being 0.11 μg/mL,the limit of quantification being 0.37 μg/mL and the relative standard deviations(RSDs)for the precision from 0.35％to 1.52％.The average recoveries of different spiked amounts of ethylene oxide in the three blank matrices ranged from 92.68％to 101.42％with the relative standard deviations(RSDs)from 2.46％to 7.59％,which all satisfied the detection requirements.The components made of rubber and acrylonitrile-butadiene-styrene copolymer(ABS)in multi-component medical device kits had the highest ethylene oxide residues,followed by the components made of wood,degreased cotton,polypropylene and polystyrene.Conclusion The method proposed gains advantages in easy operation and high specificity,quantification and reproducibility,which can be used for the determination of ethylene oxide residue in the multi-component medical device kit undergoing ethylene oxide sterilization.References are provided for sample selection of multi-component medical devices.[Chinese Medical Equipment Journal,2024,45(1):56-61]

Exploration on the Paths of Traditional Chinese Medicine Constitution Intervention to Improve the Quality of Life：Based on the Perspective of Configuration / 中医杂志

ObjectiveTo adapt to the dynamic multidimensional changes in traditional Chinese medicine （TCM） constitution， the paths of improving the quality of life through TCM constitution intervention are proposed from a configuration perspective. MethodsFive hundred and nine subjects were included in the study， all of whom voluntarily participated in and completed TCM constitution interventions， and completed 60-item Constitution in Chinese Medicine Questionnaire （CCMQ） （including 9 subscales： neutral type， qi deficient type， yang deficient type， yin deficient type， phlegm-dampness type， damp-heat type， blood stasis type， qi stagnation type， and special constitution type） to evaluate the TCM constitution， and the Short Form Health Questionnaire （SF-36） in Chinese version （including overall， physical component scores （PCS）， and mental component scores （MCS）） before and 6 months after the intervention to evaluate the quality of life. The necessary condition analysis （NCA） and fuzzy set qualitative comparative analysis （fsQCA） were used to explore the necessary conditions and advantage configurations for improving the overall， physical and mental quality of life of TCM constitution dimension changes. ResultsThe results of NCA showed that the changes in the scores of neutral type and qi stagnation type can serve as necessary conditions for improving the SF-36 overall quality of life scores （P＜0.05）. The changes in the scores of neutral type and blood stasis type can serve as necessary conditions for improving PCS scores. The changes in scores of the other 7 types can serve as necessary conditions for improving MCS scores. The fsQCA results showed that the necessary consistency of a change in a particular physical subscale score alone did not reach to a necessary condition for a change in SF-36 total score， PCS score， and MCS score （consistency ＜ 0.9 for all）， so the results of NCA were considered. The results of configuration analysis found that 6 configurations were included in increasing the overall quality of life scores and PCS scores， and 7 in increasing the MCS scores， with overall consistency ＞ 0.7. Improving the overall quality of life scores required a focus on lowering the qi deficient type scores， or reducing the yang deficient type scores while increasing the neutral type scores； reducing the scores of phlegm-dampness type and qi stagnation type is beneficial for improving the PCS scores； increasing the neutral type scores and reducing the scores of deficient type， yang deficient type， phlegm-dampness type， and stagnation type is beneficial for increasing MCS scores. ConclusionTCM constitution interventions can improve physical， mental and overall quality of life， and its improvement in the mental domain of quality of life is closely related to the paths of overall quality of life. In order to improve the quality of life， in addition to increasing the tendency of the neutral type， more focused and targeted measures should also be taken to decrease the degrees of qi deficient type， yang deficient type， qi stagnation type， and phlegm-dampness type.

Hematological Indicators of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in Malaria-Infected Individuals

@#Introduction: Malaria, a life-threatening infectious disease caused by Plasmodium parasites, continues to be a major global health concern, particularly in regions with high transmission rates. This retrospective cohort study aimed to investigate the hematological indicators of G6PD deficiency in individuals infected with malaria. The study utilized medical records and laboratory test results to analyze the hematological parameters and markers in individuals with confirmed malaria and G6PD deficiency. Methods: Data were collected from the laboratory unit of Mosul Teaching Hospitals in Ninevah Province, Iraq, from March 2021 to November 2022. The study population consisted of individuals diagnosed with malaria and with available G6PD deficiency test results. G6PD deficiency was determined by measuring the G6PD enzyme activity in the patient’s blood. Hematological parameters, including complete blood counts, platelet counts, and red blood cell indices, were recorded using a laboratory information system. Results: The study population exhibited a relatively low prevalence of G6PD deficiency, with no significant differences observed in age or gender distribution between individuals with and without G6PD deficiency. The distribution of malaria types did not differ significantly between the two groups. However, patients with G6PD deficiency showed a significantly higher monocyte count, indicating a potential association between G6PD deficiency and altered monocyte response during malaria infection. The clinical significance of this finding requires further investigation. Conclusion: This study sheds light on the hematological indicators of G6PD deficiency in individuals infected with malaria. The findings suggest a potential relationship between G6PD deficiency and altered monocyte response during malaria infection.

Relationship between serum procalcitonin level and severity and prognosis in patients with traumatic brain injury in plateau areas / 中华危重病急救医学

Objective:To analyze the changes rule of serum procalcitonin (PCT) levels in patients with traumatic brain injury in plateau areas, and to evaluate its value in assessing the severity and prognosis of the patients.Methods:A prospective cohort study was conducted. The patients with traumatic brain injury admitted to the critical care medicine departments of Xining Third People's Hospital (at an altitude of 2 260 metres) and Golmud City People's Hospital (at an altitude of 2 780 metres) from May 2018 to September 2022 were enrolled. According to the Glasgow coma scale (GCS) score at admission, the patients were divided into mild injury group (GCS score 13-15), severe injury group (GCS score 9-12), and critical injury group (GCS score 3-8). All patients received active treatment. Chemiluminescence immunoassay was used to measure the serum PCT levels of patients on the 1st, 3rd, 5th, and 7th day of admission. The Kendall tau-b correlation method was used to analyze the correlation between serum PCT levels at different time points and the severity of the disease. The patients were followed up until October 30, 2022. The prognosis of the patients was collected. The baseline data of patients with different prognosis were compared. The Cox regression method was used to analyze the relationship between baseline data, serum PCT levels at different time points and prognosis. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of serum PCT levels at different time points for death during follow-up.Results:Finally, a total of 120 patients with traumatic brain injury were enrolled, including 52 cases in the mild injury group, 40 cases in the severe injury group, and 28 cases in the critical injury group. The serum PCT levels of patients in the mild injury group showed a continuous downward trend with the prolongation of admission time. The serum PCT levels in the severe injury and critical injury groups reached their peak at 3 days after admission, and were significantly higher than those in the mild injury group (μg/L: 3.53±0.68, 4.47±0.63 vs. 0.40±0.14, both P < 0.05), gradually decreasing thereafter, but still significantly higher than the mild injured group at 7 days. Kendall tau-b correlation analysis showed that there was a significant positive correlation between serum PCT levels on days 1, 3, 5, and 7 of admission and the severity of disease ( r value was 0.801, 0.808, 0.766, 0.528, respectively, all P < 0.01). As of October 30, 2022, 92 out of 120 patients with traumatic brain injury survived and 28 died, with a mortality of 23.33%. Compared with the survival group, the GCS score, serum interleukin-6 (IL-6) levels, white blood cell count (WBC) in peripheral blood, and PCT levels in cerebrospinal fluid at admission in the death group were significantly increased [GCS score: 5.20±0.82 vs. 4.35±0.93, IL-6 (ng/L): 1.63±0.45 vs. 0.95±0.27, blood WBC (×10 9/L): 14.31±2.03 vs. 11.95±1.98, PCT in cerebrospinal fluid (μg/L): 11.30±1.21 vs. 3.02±0.68, all P < 0.01]. The serum PCT levels of patients in the survival group showed a continuous downward trend with prolonged admission time. The serum PCT level in the death group peaked at 3 days after admission and was significantly higher than that in the survival group (μg/L: 4.11±0.62 vs. 0.52±0.13, P < 0.01), gradually decreasing thereafter, but still significantly higher than the survival group at 7 days. Cox regression analysis showed that serum IL-6 levels [hazard ratio ( HR) = 17.347, 95% confidence interval (95% CI) was 5.874-51.232], WBC in peripheral blood ( HR = 1.383, 95% CI was 1.125-1.700), PCT levels in cerebrospinal fluid ( HR = 1.952, 95% CI was 1.535-2.482) at admission and serum PCT levels on admission days 1, 3, 5, and 7 [ HR (95% CI) was 6.776 (1.844-24.906), 1.840 (1.069-3.165), 3.447 (1.284-9.254), and 6.666 (1.214-36.618), respectively] were independent risk factors for death during follow-up in patients with traumatic brain injury (all P < 0.05). ROC curve analysis showed that the AUC of serum PCT levels on days 1, 3, 5, and 7 for predicting death during follow-up in patients with traumatic brain injury was all > 0.8 [AUC (95% CI) was 0.898 (0.821-0.975), 0.800 (0.701-0.899), 0.899 (0.828-0.970), 0.865 (0.773-0.958), respectively], indicating ideal predictive value. The optimal cut-off value for serum PCT level at 3 days of admission was 1.88 μg/L, with the sensitivity of 78.6% and specificity of 88.0% for predicting death during follow-up. Conclusions:Abnormal expression of serum PCT levels in patients with traumatic brain injury on the 3rd day of admission was found. The serum PCT levels greater than 3 μg/L may be related to severe illness. The serum PCT levels greater than 1.88 μg/L can predict the poor prognosis of patients. Dynamic observation of changes in serum PCT levels has good evaluation value for the severity and prognosis of patients with traumatic brain injury in plateau areas.

Thermal dose of experimental animals exposed in electromagnetic field / 中国医学物理学杂志

The study explores the thermal dose of experimental animals exposed in electromagnetic field.The simulation environment containing electromagnetic and thermal doses is established based on the bioheat equation and the three-dimensional rat model,and the effects of specific absorption rate,metabolic rate and boundary condition on temperature distribution and variation are assessed.The result shows that the core temperature rises with increasing whole body average specific absorption rate(WBASAR).At WBASAR of 4 W/kg,the midbrain and testes have higher specific absorption rates due to the skin effect,resulting in a more significant temperature rise in organ tissues than in the core;and at WBASAR of 0.4 W/kg,the temperature variation of the shallow organs caused by the sudden changes of metabolic and external environment reaches 1℃,which is much larger than that of the core.The experiment demonstrates target organs such as the head and testicles as critical subjects in thermal dose assessment.The experimental conditions should be regulated to reduce the effects of metabolic rate and boundary condition on thermal dose.The study has guiding significance for bioelectromagnetic experimental design and effect evaluation on thermal dose.

Interplay of interleukins (IL6, IL10) and 25 hydroxycholecalciferol in asthmatic subjects with chronic post-COVID condition (PCC)

@#The study aimed to compare and correlate serum levels of IL-6, 10, and 25-hydroxycholecalciferol in individuals with asthma with and without post-COVID condition (PCC). The study was designed to investigate the inflammatory response and serum 25-hydroxycholecalciferol status in asthmatics with and without PCC. A cross-sectional study of 252 subjects (128 asthmatics and 124 non-asthmatic subjects) was carried out. Interleukins and 25-hydroxycholecalciferol levels were estimated on ELISA. The principle findings were that IL-6 and 25-hydroxycholecalciferol levels were significantly increased (p<0.001), while IL-10 levels were non-significant in asthmatics with PCC compared to those without PCC. However, 25-hydroxycholecalciferol levels were significantly increased, but no significant change was observed in IL-6, and IL-10 levels in non-asthmatics with and without chronic PCC. A significant positive correlation (r = 0.258) was found between 25-hydroxycholecalciferol and IL-6 but a significant negative correlation (r = -0.227) with IL-10 in asthmatics with PCC. Similarly, a significant negative correlation (r = -0.285) was found between 25-hydroxycholecalciferol and IL-10 but was non-significant with IL-6 in asthmatics without PCC. The correlation of 25-hydroxycholecalciferol with IL-10 was significant (0.683), but IL-6 was non-significant in non-asthmatics with PCC. Multiple regression analysis showed that age, IL-6, gender, and PCC were significantly related in adjusted values to 25-hydroxycholecalciferol. This study sheds light on the complex liaison between 25-hydroxycholecalciferol levels and inflammatory responses in asthmatics, especially those with PCC. The findings suggest that although asthmatics with PCC maintain sufficient levels of 25-hydroxycholecalciferol, they show a substantial increase in the proinflammatory response. This suggests that PCC exacerbates the pro-inflammatory response in asthma. Moreover, the study reveals that asthmatics, whether with or without PCC, display a negative correlation between 25-hydroxycholecalciferol and the anti-inflammatory response. This emphasizes the main influence of asthma on the overall inflammatory response. These findings reveal a complex interplay between vitamin D levels and inflammatory mediators in asthmatic individuals with and without PCC.

Self-rated health and sociodemographic inequalities among Venezuelan adults: a study based on the National Survey of Living Conditions (ENCOVI 2021) / Autoevaluación de salud y desigualdades sociodemográficas entre los venezolanos: un estudio basado en la Encuesta Nacional de Condiciones de Vida (ENCOVI 2021) / Autoavaliação de saúde e desigualdades sociodemográficas entre adultos venezuelanos: um estudo com base na Pesquisa Nacional de Condições de Vida (ENCOVI 2021)

Abstract: Self-rated health is an indicator that can be easily identified in health surveys, widely used to measure physical, social, mental, and health aspects of the population, and predict premature mortality. In Venezuela, this information only began to be collected recently, in the National Survey of Living Conditions (ENCOVI). In this context, our study aims to analyze the demographic and socioeconomic factors associated with non-positive self-rated health among Venezuelan adults. The ENCOVI 2021 (n = 16,803) was used as a data source, assessing a probability stratified sample with questions about health, education, emigration, and other social and economic aspects. Crude and adjusted prevalence ratio analyses were performed using Poisson regression models with robust variance. The prevalence of fair/bad self-rated health among Venezuelans was 17.8%. The results indicated a strong association between outcome prevalence and age group, 3.81 times higher (95%CI: 3.29-4.41) among individuals aged 60 or more when compared to individuals aged 18 to 29 years. Also, participants experiencing severe food insecurity had a prevalence 2 times higher (95%CI: 1.61-2.47) than those who did not have any level of food insecurity. Factors such as poverty, education, recent emigration of family members, and sex also showed a significant influence, also when analyzed independently. The results show that special attention should be dedicated to the health of individuals facing hunger and of the older people.

Resumen: La autoevaluación de salud es un indicador de simple captación en encuestas de salud, muy utilizado en investigaciones para medir aspectos físicos, sociales, mentales y de salud de la población, además de predecir la mortalidad precoz. En el caso de los venezolanos, esta información recién comenzó a recopilarse en la Encuesta Nacional de Condiciones de Vida (ENCOVI). En este contexto, el objetivo del estudio es analizar los factores demográficos y socioeconómicos asociados con la autoevaluación de salud no positiva entre los venezolanos adultos. Se utiliza la ENCOVI 2021 como fuente de datos (n = 16.803), que tiene una muestra probabilística y estratificada, además de preguntas sobre salud, educación, migración y otros aspectos sociales y económicos. Se realizaron análisis de la razón de prevalencia crudos y ajustados, estimados a través de modelos de regresión de Poisson con varianza robusta. La prevalencia de la autoevaluación de salud regular/mala entre los venezolanos fue del 17,8%. Los resultados mostraron una fuerte asociación entre la prevalencia del resultado y el grupo de edad, siendo 3,81 veces mayor (IC95%: 3,29-4,41) entre las personas con 60 años o más, en comparación con las de 18 a 29 años. Además, los participantes en situación de inseguridad alimentaria grave presentaron una prevalencia 2 veces mayor (IC95%: 1,61-2,47) que aquellos que no enfrentaron ningún nivel de inseguridad alimentaria. Factores como pobreza, escolaridad, emigración reciente de familiares y género también demostraron una influencia significativa, aun cuando analizados de manera independiente. Los resultados resaltan la necesidad de prestar especial atención a la salud de los que enfrentan hambre y de las personas mayores.

Resumo: A autoavaliação de saúde é um indicador de simples captação em inquéritos de saúde, amplamente utilizado em pesquisas para medir aspectos físicos, sociais, mentais e de saúde da população, além de predizer a mortalidade precoce. No caso venezuelano, apenas recentemente começou a se coletar essa informação por meio da Pesquisa Nacional de Condições de Vida (ENCOVI). Nesse contexto, o estudo tem por objetivo analisar os fatores demográficos e socioeconômicos associados à autoavaliação não positiva da saúde entre adultos venezuelanos. Utiliza-se como fonte de dados a ENCOVI 2021 (n = 16.803), cuja amostra é probabilística e estratificada, apresentando perguntas sobre saúde, educação, migração e outros aspectos sociais e econômicos. Foram realizadas análises brutas e ajustadas de razão de prevalência, estimadas por meio de modelos de regressão de Poisson com variância robusta. A prevalência de autoavaliação da saúde regular/ruim entre venezuelanos foi de 17,8%. Os resultados indicaram uma forte associação entre a prevalência do desfecho e a faixa etária, sendo 3,81 vezes maior (IC95%: 3,29-4,41) entre os indivíduos com 60 anos ou mais, em comparação àqueles com idade de 18 a 29 anos. Além disso, os participantes em situação de insegurança alimentar severa apresentaram uma prevalência 2 vezes maior (IC95%: 1,61-2,47) do que aqueles que não enfrentaram nenhum nível de insegurança alimentar. Fatores como pobreza, escolaridade, emigração recente de familiares e sexo também demonstraram influência significativa, mesmo quando analisados independentemente. Os resultados destacam a necessidade de atenção especial à saúde daqueles que enfrentam fome e dos idosos.

Sociodemographic and nutritional situation of children under six years of age in the Nasa Indigenous Reservation, Iquira, Colombia / Situación sociodemográfica y nutricional de menores de seis años del Resguardo Indígena Nasa, Iquira, Colombia

Abstract Objectives: identify the sociodemographic conditions of the community and determine the prevalence of the nutritional status of children under six years of age in the Nasa Paéz Indigenous Reserve, Rionegro-Huila, Colombia. Methods: cross-sectional descriptive study whose data was obtained from two databases, one of sociodemographic conditions and other anthropometric measurements of children under six years of age. The sample corresponded to the total population of less than six years. The data was analyzed using descriptive statistics using the R Studio 3.4 software. Results: 98.6% of the population is enrolled in the health system. Water consumption comes from 71.6% of non-potable sources. 25.5% of the population has access to wastewater disposal systems. Regarding nutritional status, the prevalence of delay in growth and risk of delay in growth is 43.3% in the population under six months and 69.4% in those aged between six months and six years. Furthermore, 34.3% of children under six months of age are at risk of being overweight. Conclusions: sociodemographic conditions are determined by different inequities, low education levels, inadequate housing, drinking water consumption, as well as a high prevalence of child malnutrition.

Resumen Objetivos: identificar las condiciones sociodemográficas de la comunidad y determinar la prevalencia del estado nutricional de niños menores de seis años en el Resguardo Indígena Nasa Paéz, Rionegro-Huila, Colombia. Métodos: estudio descriptivo transversal cuyos datos se obtuvieron de dos bases de datos, una de las condiciones sociodemográficas y otra de medidas antropométricas de niños menores de seis años. La muestra correspondió a la totalidad población menor seis años. Los datos se analizaron mediante estadística descriptiva utilizando el software R Studio 3.4. Resultados: el 98,6% de la población está inscrito en el sistema de salud. El consumo de agua proviene en un 71,6% de fuentes no potables. El 25,5% de la población tiene acceso a sistemas de eliminación de aguas residuales. En cuanto al estado nutricional, la prevalencia de retraso en el crecimiento y riesgo de retraso en el crecimiento es del 43,3% en la población menor de seis meses y del 69,4% en edad entre los seis meses a seis años. Además, el 34,3% de los niños menores de seis meses estaban en riesgo de tener sobrepeso. Conclusiones: las condiciones sociodemográficas están determinadas por diferentes inequidades, bajos niveles de educación, vivienda inadecuada, consumo de agua no potable, así como por una alta prevalencia de malnutrición infantil.

Correlation analysis of cardiopulmonary exercise test indices and conditions of overweight patients with obstructive sleep apnea: a retrospective study

ABSTRACT BACKGROUND: The cardiopulmonary function of patients with obstructive sleep apnea (OSA) is significantly lower than that of patients with simple snoring and is significantly related to the severity of OSA. Currently, only a few studies have been conducted on cardiopulmonary exercise testing in overweight patients with OSA. OBJECTIVE: To analyze the correlation between cardiopulmonary exercise test (CPET) indices and the condition of overweight patients with OSA. DESIGN AND SETTING: Retrospective study in Guangdong Provincial Hospital of Chinese Medicine. METHODS: This study included 73 hospitalized overweight patients. The patients were divided into no, mild, moderate, and severe OSA groups. Differences in the CPET indices among the four groups were compared. The correlation between the CPET indices and conditions was analyzed. RESULTS: No, mild, moderate, and severe OSA groups had 18 men and 5 women, 11 men and 3 women, 12 men and 2 women, and 21 men and 1 woman, respectively (P > 0.05). No significant difference was observed in resting pulmonary function among the four groups (P > 0.05). In the CPET, the anaerobic threshold, maximum oxygen uptake, and oxygen pulse were significantly lower in the severe OSA group than those in the normal OSA group (P < 0.05). Moreover, CPET indices negatively correlated with the apnea-hypopnea index. CONCLUSION: Changes in CPET indices occurred earlier than changes in resting pulmonary function in patients with OSA. CPET might be a potential method for evaluating the severity of OSA combined with overweight status.

Variables de condición física predictivas de sintomatología depresiva en estudiantes universitarios de Cali, Colombia

Objetivo: Determinar las variables de condición física saludable predictoras de sintomatología depresiva en jóvenes universitarios. Método: Este estudio presenta un diseño observacional descriptivo de corte transversal con una fase multivariada, que utilizó el cuestionario autoadministrado BECK (BDI-2) con el objetivo de determinar sintomatología depresiva, en una muestra de 344 estudiantes universitarios entre 18 y 39 años, matriculados en cuatro diferentes universidades de la ciudad de Santiago de Cali, Colombia. La condición física relacionada con la salud se valoró a partir de la batería Alpha Fit Adultos; con los análisis correlacionales se construyó un modelo de regresión logística binario que pudiera establecer cuáles variables de condición física se asocian a una sintomatología depresiva en este tipo de población. Resultados: Correlaciones inversas y estadísticamente significativas fueron observadas entre el puntaje de depresión del inventario de Depresión de Beck-II, con los indicadores de condición física aeróbica r = -0,202, p=0,000; fuerza prensil media r =-0,113, p=0,036; salto alto r =-0,177, p=0,000; flexión de brazos r =-0,158, p=0,003; y test de figura en 8 r =-0,146, p=0,006). Universitarios con mayores niveles de sintomatología depresiva presentan un fenotipo de menor condición física, principalmente en el indicador de resistencia cardiorrespiratoria (ß=-0,059; p<0,004 Exp (B) 0,942). Conclusiones: Los resultados obtenidos en el presente estudio muestran que un fenotipo asociado a menor condición física cardiorrespiratoria se asocia con mayores niveles de sintomatología depresiva.

Objective: To determine healthy physical condition variables predictive of depressive symptomatology in young university students. Method: This study presents a cross-sectional descriptive observational design with a multivariate phase, which used the self-administered BECK questionnaire (BDI-2) to assess depressive symptomatology in a sample of 344 university students between 18 and 39 years of age, enrolled in four different universities in the city of Santiago de Cali, Colombia. Health-related physical fitness was assessed from the Alpha Fit Adult battery; with the correlational analyses, a binary logistic regression model was constructed to determine which physical fitness variables are associated with depressive symptomatology in this type of population. Results: Inverse and statistically significant correlations were observed between the Beck Depression Inventory-II depression score with aerobic fitness indicator r =0,202, p=0,000; mean prehensile strength r =0,113, p=0,036; high jump r =0,177, p=0,000; push-up r =0,158, p=0,003; and figure-8 test r =0,146, p=0,006). University students with higher levels of depressive symptomatology presented a lower physical fitness phenotype, mainly in the cardiorespiratory endurance indicator (ß=-0,059; p<0,004 Exp (B) 0,942). Conclusion: The results obtained in the present study show that a phenotype associated with lower cardiorespiratory fitness is associated with higher levels of depressive symptomatology.

Efectos del ciclismo en la composición corporal e indicadores de riesgo metabólico / Effects of cycling on Body Composition and Metabolic Risk Indicators

Introducción: El ciclismo es una actividad física que se practica de forma recreativa y como actividad laboral, en base a esto los beneficios en la salud varían. Sus efectos pueden extenderse en la regulación de la expresión de citocinas proinflamatorias en la obesidad; sin embargo, se deben estudiar detalles en los indicadores clínicos asociados a otras enfermedades crónico-degenerativas. Objetivo: Identificar los cambios en los parámetros clínicos que sirven como indicadores de riesgo metabólico en personas que realizan ciclismo como ejercicio habitual y como actividad laboral. Métodos: Se realizó una investigación de diseño transversal, descriptivo en el Estado de México, México. Se formaron 3 grupos de 16 participantes provenientes de Toluca y municipios aledaños. Se realizaron mediciones de composición corporal y análisis bioquímicos para identificar las diferencias entre los grupos a través de la prueba t- student y el análisis de varianza ANOVA. Resultados: Los análisis estadísticos reportaron diferencias significativas en las concentraciones de lipoproteínas de alta densindad y triglicéridos. Para el grupo de los conductores de bicitaxi fue más favorable, se detalla como el tiempo de la actividad ayuda a mantener los parámetros de composición corporal como el porcentaje del tejido muscular y adiposo. Conclusiones: Los beneficios del ciclismo se presentaron con diferentes grados de eficiencia de acuerdo con la modalidad en la que se practican. Las variables no cambian de forma significativa en ningún grupo, pueden ser dependientes de otras variables como la alimentación(AU)

Introduction: Cycling is a physical activity, which is practiced recreationally and as a work activity. Its effects may extend to the regulation of the expression of proinflammatory cytokines in obesity; however, details should be studied in the clinical indicators associated with other chronic-degenerative diseases. Objective: To identify changes in clinical parameters that serve as indicators of metabolic risk in people who perform cycling as a regular exercise and as a work activity. Methods: A cross-sectional and descriptive design research was carried out in the State of Mexico, Mexico. Three groups of 16 participants were formed from Toluca and surrounding municipalities. Body composition measurements and biochemical analyzes were performed to identify differences between groups through Student's t test and ANOVA analysis of variance. Results: Statistical analyzes reported significant differences in HDL and triglyceride concentrations. For the group of pedicab drivers it was more favorable, it is detailed how the time of the activity helps to maintain body composition parameters such as the percentage of muscle and adipose tissue. Conclusions: The benefits of cycling were presented with different degrees of efficiency according to the modality in which they are practiced. The variables do not change significantly in any group and may be dependent on other variables such as diet(AU)

Lesiones por presión: la incidencia en el paciente crítico con neumonía por SARS-CoV-2, en respuesta a la estrategia del decúbito prono durante la pandemia COVID-19 / Pressure lesions: incidence in critical patient with pneumonia due to SARS-CoV-2, in response to decubitus prone position during COVID-19 pandemic

Introducción: Se suele aplicar en pacientes con SARS-CoV-2 el decúbito prono (DP) prolongadamente, pues ha demostrado beneficios para solventar la falta de equipos de ventilación mecánica; sin embargo, también tiende a producir lesiones por presión (LPP) en regiones anatómicas no experimentadas en otras prácticas. Objetivo: Calcular la incidencia de LPP en el paciente crítico de COVID-19 en DP, describir características de los pacientes y las lesiones. Metodología: Estudio observacional, descriptivo, de carácter transversal con enfoque retrospectivo. La recolección de datos se realizó en un hospital de tercer nivel de la Ciudad de México, incluyó 230 pacientes que desarrollaron LPP posterior a su ingreso. Se analizó el expediente electrónico y los registros de la clínica de heridas, la recolección de datos se generó en Excel y el análisis estadístico en el programa SPSS. Resultados: La incidencia fue de 18.05%, las LPP con esfacelo corresponden al 33.9% y las de necrosis al 40%. La localización anatómica en pabellón auricular, pómulos y tórax fue de 36.1% y 46.5% fueron lesiones de categoría III con afectación de las estructuras musculares. La correlación con el IMC demostró que pacientes con sobrepeso presentaron mayor incidencia de LPP con fibrina y esfacelo en un 60.3%. Limitación del estudio: No se consideraron variables como la carga de trabajo de enfermería. Originalidad: Esta investigación no ha sido postulada previamente en ningún órgano editorial. Conclusiones: La incidencia coincide con estudios en otros países, por lo que es necesario estandarizar las acciones para la prevención de LPP y reducir su incidencia.

Introduction: Prolonged prone decubitus (PD) is usually applied in patients with SARS­CoV­2, as it has shown benefits to solve the lack of mechanical ventilation equipment; however, it also tends to produce pressure injuries (PI) in anatomical regions not experienced in other practices. Objective: To calculate the incidence of PI in the critical patient of COVID-19 in PD, describe patient characteristics and injuries. Methodology: Observational, descriptive, cross-sectional study with retrospective approach. Data collection was performed in a tertiary level hospital in Mexico City, including 230 patients who developed PI after admission. The electronic file and wound clinic records were analyzed, data collection was generated in Excel and statistical analysis in the SPSSs program. Results: The incidence was 18.05%, PI with slough corresponded to 33.9% and those with necrosis to 40%. The anatomical location in the pinna, cheekbones and thorax was 36.1% and 46.5% were category III lesions with involvement of muscular structures. Correlation with BMI showed that overweight patients had a higher incidence of PI with fibrin and sphacel in 60.3%. Limitation of the study: variables such as nursing workload were not considered. Originality: This research has not been previously postulated in any editorial body. Conclusions: The incidence coincides with studies in other countries, so it is necessary to standardize actions for the prevention of PI and reduce its incidence.