Inactividad física versus sedentarismo: análisis de la Encuesta Nacional de Salud de Chile 2016-2017

Background: Physical inactivity and sedentariness are independent risk factors for mortality. Physical inactivity is defined as engaging in insufficient moderate/vigorous physical activity (i.e. not meeting the WHO's recommendations). Sedentariness is defined according to sedentary behavior; evidence suggests that > 8 h/d could serve to consider a person as sedentary. The Chilean National Health Survey 2016-2017 (NHS), using a single question (Question-NHS), considered as "sedentary" those who did not engage in sports or physical activity for ≥ 30 min, ≥ 3 times/wk. Thus, it attempted to estimate sedentariness without considering sedentary behavior. Aim: To determine the prevalence of physical inactivity and sedentariness in Chile, and to contrast such results with the Question-NHS. Material and Methods: We analyzed data from 5564 participants of the 2016-2017 NHS, aged ≥ 18 years. The Global Physical Activity Questionnaire was used to determine moderate/vigorous physical activity and sedentary behavior. We defined physical inactivity as having 8 h/d of sedentary behavior. Results: The prevalences [95% confidence intervals] of physical inactivity and sedentariness were 32% [29-34] and 6% [5-7] respectively, while 3% [2-4] were both physically inactive and sedentary. The Question-NHS classified 88% [86-89] as "sedentary", but among them, 35% were physically inactive and 6% were sedentary. Conclusions: One third of adults are inactive, one out of ten is sedentary, and one out of twenty is inactive and sedentary. The Question-NHS overestimates the population at risk.

¿Es suficiente la protección otorgada por gafas plomadas en cardiología intervencionista? / Protection against ionizing radiation by leaded glass googles during interventional cardiology

Background: It is not known whether leaded glass goggles with 0.25 mm Pb equivalency, used in interventional cardiology procedures, attenuate radiation below the levels established by the latest recommendation of the International Commission on Radiological Protection (ICRP). Aim: To assess ifthe degree of attenuation of the secondary ionizing radiation achieved by the use of 0.25 mm Pb leaded glass goggles, in occupationally exposed workers in interventional cardiology procedures, meets the latest ICRP recommendations. Material and Methods: A prospective investigation was carried out to compare the eye exposure to secondary ionizing radiation received by occupationally exposed personnel in a 9 months period. A set of two thermo luminescent dosimeters was arranged in the front and back of leaded glass goggles in a cohort ofseven members of an interventional cardiology service, exposed to 1057 consecutive procedures. Results: The monthly dose equivalent measurement performed in front ofthe goggles ranged between 1.1 and 6.5 mSv, for paramedics and interventional cardiologists. The radiation measured in the back of the glass varied between 0.66 and 2.75 mSv, respectively. The degree of attenuation of the dose at eye level ranged from 40% to 57.7%, respectively. The projected annual exposure would reach 33 mSvfor the interventional cardiologist. Conclusions: With a similar load ofwork and wearing 0.25 mm Pb equivalent glass goggles, interventional cardiologists will exceed the crystalline equivalent dose limit recommended by the ICRP (20 mSv/year averaged over the past 5 years).

Acrosin release and acrosin activity during incubation in capacitating media using fresh and frozen-thawed dog sperm

We evaluated the effect of time and temperature on acrosin release from the acrosomal cap and the activity of this enzyme during in vitro capacitation in fresh and frozen/thawed dog sperm. Sperm-rich fractions of six ejaculates from three dogs were processed as fresh and frozen samples. Each sperm sample was incubated in canine capacitation medium (CCM) for 0, 1, 2 and 3 h at 20°C and at 37°C. After incubation, the samples were assessed by the indirect immunofluorescent staining technique. The probability of having unlabeled sperm (PUS), indicating acrosin loss, was modelled by a binomial distribution using logistic regression. There was a linear relationship between PUS and time at both temperatures (p<0.001); however, a major percentage of unlabeled sperm was observed in frozen/thawed samples soon after incubation, indicating that the release of acrosin was affected by capacitation time, mainly in frozen samples. Temperature influenced acrosin release only in cryopreserved sperm (p<0.05). Acrosin activity was measured by digestion halos on slides coated with gelatin-substrate film during each time period; a significant increase in the number of large halos was observed in fresh samples throughout the experiment, whereas frozen/thawed sperm showed a decreased rate of halo diameters during culture. Thus, there appears to differences between fresh and frozen dog sperm in terms of acrosin release and the level of acrosin activity in the course of in vitro capacitation.

Alteraciones oculares por tamoxifen en pacientes con cáncer mamario / Ocular alterations induced for the tamoxifen in patients with breast cancer

Objetivo: Identificar las alteraciones oculares inducidas por el tamoxifen en pacientes con cáncer mamario. Diseño del estudio: transversal, analítico y observacional. Material y métodos: Se estudiaron 74 pacientes divididos en dos grupos, Grupo I (n = 37) pacientes que han tomado tamoxifen 20 mg diarios por 3 meses a 5 años y grupo II (n = 37) recibieron sólo quimioterapia. Se les realizó una exploración oftalmológica completa para identificar alteraciones oculares. Los resultados se analizaron con medidas de resumen de tendencia central y de dispersión. Análisis no paramétrico para determinar la diferencia en los grupos. Resultados: No se encontró diferencia significativa en la agudeza visual de ambos grupos (p > 0.05), 15 pacientes que tomaron tamoxifen presentaron disminución de la agudeza visual promedio de -X de 0.37 ñ 0.25. En tres pacientes (8 por ciento), se estableció el diagnóstico de retinopatía por tamoxifen caracterizada por disminución de la agudeza visual, edema macular bilateral y cristales paramaculares.Conclusiones: Toda paciente con cáncer mamario debe ser evaluada periódicamente. El tamoxifen a dosis de 20 mg diarios no se asocia con alteraciones oculares graves.

Síndrome de hombro doloroso / Shoulder pain syndrome

El síndrome de hombro doloroso es una patología no articular de presentación frecuente en la consulta general y reumatológica. El presente artículo señala las causas evolutivas y detalla la anatomía del hombro para señalar las posibilidades causales de este síndrome así como su diagnóstico semiológico y radiológico de acuerdo a la anatomía revisada. Se discuten además sus formas de presentación más frecuentes extendiéndose en sus características más saltantes, etiologías, actividad física determinante, edades de presentación, historia natural, diagnóstico basado en etiología y anatomía y formas de tratamiento.