Aproximación a la calidad percibida de un servicio deportivo universitario. Un estudio de caso

La población joven y adulta de Chile presenta altos niveles de inactividad física y sedentarismo, lo que coincide con los rangos etarios de los estudiantes universitarios. En este sentido, es escasa la evidencia científica que ha estudiado la calidad de los servicios deportivos que entregan las instituciones de educación superior, tanto a nivel latinoamericano, como chileno. Por lo tanto, este estudio tuvo como objetivo evaluar la calidad del servicio de la Unidad de Deportes y Recreación de la Universidad Católica de la Santísima Concepción de Chile, mediante la percepción que manifiestan los estudiantes que asisten a los talleres deportivos y de actividad física. Se aplicó el cuestionario SERVPERF que mide cinco dimensiones: elementos tangibles, fiabilidad, capacidad de respuesta, seguridad y empatía, según el grado de satisfacción de los usuarios. La investigación tuvo un enfoque cuantitativo y de tipo descriptivo. La muestra fue de 70 participantes (55 mujeres y 15 hombres). En general, los resultados mostraron una buena percepción y evaluación de todas las dimensiones del cuestionario. La dimensión seguridad fue la mejor valorada y la dimensión Elementos tangibles fue la que mostró una más baja evaluación.

A população jovem e adulta do Chile apresenta altos níveis de inatividade física e estilos de vida sedentários, o que coincide com as faixas etárias dos estudantes universitários. Nesse sentido, há poucas evidências científicas que tenham estudado a qualidade dos serviços esportivos prestados pelas instituições de ensino superior, tanto na América Latina quanto no Chile. Portanto, o objetivo deste estudo foi avaliar a qualidade do serviço prestado pela Unidade de Esportes e Recreação da Universidad Católica de la Santísima Concepción, no Chile, por meio da percepção dos alunos que participam das oficinas de esportes e atividades físicas. Foi aplicado o questionário SERVPERF, que mede cinco dimensões: elementos tangíveis, confiabilidade, capacidade de resposta, segurança e empatia, de acordo com o grau de satisfação do usuário. A pesquisa teve uma abordagem quantitativa e descritiva. A amostra foi composta por 70 participantes (55 mulheres e 15 homens). Em geral, os resultados mostraram uma boa percepção e avaliação de todas as dimensões do questionário. A dimensão Segurança foi a mais bem avaliada e a dimensão Elementos tangíveis apresentou a avaliação mais baixa.

The young and adult population of Chile presents high levels of physical inactivity and sedentary lifestyle, which coincides with the age ranges of university students. In this sense, there is little scientific evidence that has studied the quality of sports services provided by higher education institutions, both at the Latin American and Chilean levels. Therefore, this study aimed to evaluate the quality of the service of the Sports and Recreation Unit of the Universidad Católica de la Santísima Concepción de Chile, through the perception expressed by students who attend sports and physical activity workshops. The SERVPERF questionnaire was applied, which measures five dimensions: tangible elements, reliability, response capacity, security and empathy, according to the degree of user satisfaction. The research had a quantitative and descriptive approach. The sample consisted of 70 participants (55 women and 15 men). In general, the results showed a good perception and evaluation of all the dimensions of the questionnaire. The security dimension was the best valued and the tangible elements dimension was the one that showed the lowest evaluation.

Efectos del entrenamiento de la fuerza en personas con diabetes mellitus tipo II: revisión sistemática / Effects of resistance training in people with Type II diabetes mellitus: systematic review / Efeitos do treinamento de resistência em pessoas com diabetes mellitus tipo II. revisão sistemática

El presente artículo busca analizar las evidencias aportadas del entrenamiento de la fuerza comprobando su influencia en la Diabetes Mellitus tipo II utilizando la literatura existente sobre este objeto de estudio. Se realizo una revisión sistemática siguiendo las directrices PRISMA donde el principal contexto fue el entrenamiento de la fuerza en pacientes con Mellitus II, siendo buscados en bases de datos Pubmed, Embase y Scopus donde fueron seleccionados 7 artículos. Los hallazgos señalan consistentemente que el entrenamiento de la fuerza bien programado incide gradualmente en algunos marcadores que identifican la diabetes Mellitus II al realizar intervenciones con sistemas de entrenamiento de la fuerza de forma positiva. Los autores recomiendan estudios con muestras mayores en lo posible de tipo control para verificar la incidencia del entrenamiento en las variables mencionadas en este estudio.

This Article Seeks analyzes the evidence provided by strength training, verifying its influence on Type II Diabetes Mellitus by using the existing literature on this subject of study. A systematic review was carried out following the PRISMA guidelines, where the main context was strength training in patients with Mellitus II. The search was carried out in Pubmed, Embase, and Scopus databases where 7 articles were selected. The findings consistently indicated that a well-structured strength training program gradually affected some markers that identify diabetes Mellitus II when performing interventions with strength training systems in a positive way. The authors recommend control-type studies with larger samples, if possible, to verify the incidence of training in the variables mentioned in this study.

Este artigo procura analisar as evidências fornecidas pelo treinamento de força, verificando sua influência no Diabetes Mellitus tipo II utilizando a literatura existente sobre este objeto de estudo. Foi realizada uma revisão sistemática seguindo as diretrizes PRISMA onde o principal contexto foi o treinamento de força em pacientes com Mellitus II, sendo pesquisada nas bases de dados Pubmed, Embase e Scopus onde foram selecionados 7 artigos. Os achados indicam consistentemente que o treinamento de força bem programado afeta gradualmente alguns marcadores que identificam o diabetes Mellitus II ao realizar intervenções com sistemas de treinamento de força de forma positiva. Os autores recomendam estudos do tipo controle com amostras maiores, se possível, para verificar a incidência de treinamento nas variáveis mencionadas neste estudo.

Relación entre características antropométricas, autopercepción del índice de masa corporal, condición física y hábitos alimentarios en estudiantes universitarios de salud y educación

Introducción: La etapa universitaria es un período de modificación en los estilos de vida. Los estudiantes de carreras de pedagogía y de la salud, adicionalmente, asumirán un rol de guías y modelos respecto a conductas saludables hacia sus estudiantes y pacientes respectivamente. Objetivo: Evaluar la relación entre las características antropométricas, la autopercepción del índice de masa corporal (IMC), la condición física y los hábitos alimentarios en estudiantes universitarios de carreras de pedagogía y de la salud. Materiales y método: Estudio descriptivo y correlacional. La muestra fue conformada por 158 estudiantes universitarios (edad, 22,5±2,5 años). Se evaluó las características antropométricas, autopercepción del IMC, condición física y hábitos alimentarios. Resultados: El IMC se correlacionó positivamente con el IMC percibido (r= 0.46, p= 0.012). El perímetro de cintura se correlacionó positivamente con el IMC percibido y la fuerza de prensión manual. El porcentaje de grasa corporal se correlacionó positivamente con el IMC percibido y negativamente con la condición física (potencia, prensión manual y flexibilidad). El área muscular del brazo se correlacionó con el IMC percibido, puntaje de IMC percibido y condición física. Los hábitos alimentarios presentaron una correlación negativa con el IMC percibido, pero no así con las características antropométricas. Conclusión: Los estudiantes universitarios de las carreras de salud y educación con mejor características antropométricas (menor IMC, perímetro de cintura y porcentaje de grasa y mayor área muscular del brazo), presentan una autopercepción mayor del IMC y un mejor rendimiento en las pruebas de condición física.

Introduction: The university stage is a period of modification in lifestyles. Pedagogy and health career students, additionally, will assume the role of guides and models regarding healthy behaviours towards their students and patients, respectively. Objective: To evaluate the relationship between anthropometric characteristics, self-perception of body mass index (BMI), physical condition and eating habits among pedagogy and health career university students. Materials and method: Descriptive and correlational study. The sample consisted of 158 university students (age 22.5 ± 2.5 years). Anthropometric characteristics, self-perception of BMI, physical condition and eating habits were evaluated. Results: BMI was positively correlated with perceived BMI (r= 0.46, p= 0.012). Waist circumference was positively correlated with perceived BMI and handgrip strength. The percentage of body fat was positively correlated with the perceived BMI and negatively with the physical condition (power, handgrip and flexibility). Arm muscle area was correlated with perceived BMI, perceived BMI score, and physical condition. Eating habits were negatively correlated with perceived BMI but not with anthropometric characteristics. Conclusion: University students from health and education careers with better anthropometric characteristics (lower BMI, waist circumference and fat percentage, and greater muscle area of the arm), have a higher self-perception of BMI and better performance in fitness tests physical.

Eficacia y seguridad de antipsicóticos y antidepresivos en el tratamiento de la anorexia nerviosa: revisión sistemática / Efficacy and Safety of Antipsychotics and Antidepressants in the Treatment of Anorexia Nervosa: a Systematic Review

RESUMEN Introducción: Las recomendaciones de las guías vigentes están basadas en evidencia de baja calidad. Se requiere su actualización periódica considerando la evidencia reciente. Objetivo: Sintetizar la mejor evidencia clínica disponible sobre eficacia y seguridad de antidepresivos y antipsicóticos de segunda generación en pacientes con anorexia nerviosa. Métodos: Revisión sistemática (CRD42020150577). Se buscaron en PubMed, SCOPUS, Ovid(Cochrane), EMBASE y LILACS los ensayos clínicos aleatorizados realizados en pacientes con anorexia nerviosa que evaluasen el uso de antipsicóticos de segunda generación o antidepresivos orales a cualquier dosis y por cualquier tiempo en el tratamiento ambulatorio y/u hospitalario tomando como resultados el peso (índice de masa corporal), las entidades psicopatológicas y la seguridad. Resultados: Se incluyeron 5 estudios, 4 catalogados como con alto riesgo de sesgo. La evidencia indica que los pacientes que reciben tratamiento con olanzapina o fluoxetina tienden a mantenerse por más tiempo dentro de los programas de tratamiento. La olanzapina mostró resultados favorables (un estudio) en cuanto al aumento de peso, pero no mostró los mismos resultados en psicopatología, donde la evidencia es contradictoria. Conclusiones: En concordancia con las revisiones anteriores, nuestro trabajo permite concluir que hay información contradictoria sobre la eficacia de los psicofármacos para la anorexia nerviosa. El trabajo futuro debe enfocarse en desarrollar ensayos clínicos de alta calidad metodológica.

ABSTRACT Introduction: The recommendations of the current guidelines are based on low quality evidence. Periodic updating is required, taking recent evidence into consideration. Objective: To synthesise the best available clinical evidence on the efficacy and safety of second-generation antidepressants and antipsychotics in patients with anorexia nervosa. Methods: Systematic review (CRD42020150577). We searched PubMed, SCOPUS, Ovid(Cochrane), EMBASE and LILACS for randomised clinical trials performed in patients with anorexia nervosa that evaluated the use of second-generation antipsychotics or oral antidepressants, at any dose and for any length of time, in outpatient and/or hospital treatment, taking weight (body mass index), psychopathological entities and safety as results. Results: Five studies were included, with four assessed as having a high risk of bias. The evidence indicates that patients receiving treatment with olanzapine or fluoxetine tend to stay in treatment programmes for longer. Olanzapine showed favourable results (one study) in terms of weight gain, but did not show the same results in psychopathology, where the evidence is contradictory. Conclusions: In accordance with previous reviews, our work allows us to conclude that there is contradictory information on the efficacy of psychotropic drugs in the treatment of anorexia nervosa. Future work should focus on developing clinical trials of high methodological quality.

Niveles de actividad física y tiempo sedente según ingreso económico en Chile: resultados de la Encuesta Nacional de Salud 2016-2017

Background: The Chilean population reports high levels of physical inactivity. The relationship between income level, physical activity (PA) and sedentary behaviors is not well known. Aim: To describe the levels of PA and sedentary time, according to income levels in the Chilean population. Material and Methods: Analysis of data from the Chilean National Health Survey 2016-2017, which included 5,130 participants (52.9% women). The levels of PA and sedentary time were measured by the Global Physical Activity Questionnaire. Income levels were established according to the self-reported income per capita of the households and presented as quintiles. PA levels according to income levels were estimated by linear regression analyses. Results: Transport-related PA was higher in the lowest income quintiles (p = 0.039). There were no trends for income levels and PA domains including moderate, vigorous, total, occupational and leisure PA. The prevalence of leisure and occupational physical inactivities were higher in the lowest quintiles of income. Sitting time was higher in the higher income levels (p < 0.01). Conclusions: People in the lowest quintile for income spent more time in transport-related PA and less time sitting. However, physical inactivity prevalence during leisure and work time were higher in people with lower income.

Fitness cardiorrespiratorio estimado mediante ecuación y su caracterización sociodemográfica en población chilena: Resultados de la Encuesta Nacional de Salud 2016-2017

Background: Cardiorespiratory fitness is a strong predictor of mortality and chronic diseases. However, its estimation is costly and time consuming which may limit it broad use in population-based studies. Aim: To estimate the cardiorespiratory fitness of the Chilean population by using equations and to characterize fitness levels of the Chilean population by sociodemographic factors. Material and Methods: This cross-sectional study included 5,958 adults from the Chilean Health Survey conducted between 2016 and 2017. Cardiorespiratory fitness was estimated from sex-specific equations for men and women and expressed as METs (Energy Metabolic Equivalent). Fitness levels were characterized by sociodemographics factors (age, sex, education, income and area of residency). Results: Fitness levels were higher in men (9.01 METs) than in women (6.76 METs) and in average decrease by 0.59 and 0.34 METs per each year increment in age for men and women, respectively. Fitness levels were 12.7 METs and 7.8 METs for 20-year-old men and women, respectively. However, fitness levels decreased to 7.8 METs and 4.3 METs in 90-year-old men and women, respectively. Fitness levels were also higher in individuals living in urban setting, those with higher education or income levels and lean individuals. Conclusions: This study reports fitness levels in a nationally representative sample of Chile. Fitness levels were higher in men than women however, its decline with age was more pronounce in men than women.

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.

Nivel educativo y su asociación con niveles de actividad física en Chile / Association of physical inactivity with low levels of education

Background: A higher educational level is associated with healthier lifestyles. Aim: To assess the association between the level of compliance with physical activity recommendations and years of formal education in Chilean adults. Material and Methods: Analysis include 6,174 participants from the National Health Survey 2016-2017. Physical activity levels were assessed through the Global Physical Questionnaire (GPAQ v2). Physical inactivity was defined as < 600 MET/minute/week. Results: Among subjects without education, 44% and 27% of women and men respectively, were physically inactive. Among women and men with the highest number of years of education (> 16) the figures for physical inactivity were 27% and 15% respectively. The odds for not meeting the physical activity recommendations was 2.3 [95% confidence intervals (CI): 1.57; 3.38] and 3.9 [95% CI: 2.27; 6.95] in women and men without any formal education respectively, as compared with those who reported 12 years of education. Women and men who reported a high level of education ≥ (16 years) did not show significant differences compared to the reference group. Conclusions: People with low levels of education are were likely to be physically inactive.

¿Cuál es la asociación entre el tiempo destinado a dormir y el desarrollo de deterioro cognitivo en adultos mayores chilenos? / Association between sleep duration and cognitive impairment in older people

Background Sleep duration may be a risk factor for cognitive impairment. Aim To investigate the association between sleep duration and cognitive function in Chilean older adults. Material and Methods We analyzed information from 1,384 participants aged > 60 years participating in the National Health Survey 2009-2010 who were assessed with the Mini Mental State Examination (MMSE) and self-reported their average daily sleep hours. Logistic regression analysis was performed to investigate the association between MMSE and sleep duration. Results Compared to those participants who reported sleeping 7 hours per day, those that reported sleeping < 5 hours had a higher odd for cognitive impairment (Odds ratio (OR): 3.66 [95% confidence intervals (CI: 1.69; 7.95], p < 0.01). Similarly, those who reported sleeping > 8 hours per day also showed a higher odd for cognitive impairment (OR: 2.56 [95% CI: 1.32; 4.95], p < 0.01). This association was even stronger for people who reported more than 10 hours of sleep per day (OR: 4.46 [95% CI: 1.32; 4.95], p < 0.01). Conclusions Long and short sleep duration is associated with cognitive impairment in older adults in Chile independent of major confounding factors.

Actividad física y tiempo sedente se asocian a sospecha de deterioro cognitivo en población adulta mayor chilena / Physical activity and sedentary behaviours are associated with cognitive impairment in Chilean older adults

Background: Lifestyle factors could promote healthy ageing. Aim: To investigate the association between physical activity (PA), sedentary behavior and cognitive impairment in Chilean older adults. Material and Methods: We included 1,390 participants from the National Health Survey (2009-2010). The Mini-Mental State Examination was used to diagnose cognitive impairment. Physical activity and sedentary behavior were assessed with the Global Physical Activity Questionnaire (GPAQ). Logistic regression was performed to investigate the associations. Results: Compared with older adults with lower levels of PA (< 48 min/day), those with middle (48-248 min/day) and higher (>248 min/day) levels of PA had lower odds for cognitive impairment (Odds ratio (OR): 0.57 [95% confidence intervals (CI): 0.33; 0.82], p < 0.01 and 0.58 [95% CI: 0.32; 0.83], p < 0.01, respectively). Participants who reported spending more than 8 hours/day sitting had a high odds for cognitive impairment compared to those who spent < 4 hours/day (OR: 3.70 [95% CI: 1.37; 6.03], p = 0.01). Conclusions: Both PA and sedentary behavior were independently associated with cognitive decline independent of major confounding factors in Chilean older adults.

Factores asociados al deterioro cognitivo en personas mayores en Chile / Factors associated with cognitive impairment in older adults in Chile

Background: The risk factors for the development of cognitive impairment are not well known. Aim: To identify socio-demographic, lifestyle and health-related factors associated with cognitive impairment in older Chilean adults. Material and Methods: Data analysis of 1,384 participants ≥ 60 years who participated in the National Health Survey of Chile 2009-2010. Sociodemographic, lifestyle and health-related factors were used as exposure variables of interest. Cognitive impairment was assessed using an abbreviated version of the Mini Mental test and defined as a score < 13 points of a maximum of 19. A logistic regression was used to identify factors associated with cognitive impairment. Results: In this sample, the prevalence of cognitive impairment was 11.6 [95% confidence intervals (CI): 8.8; 15.2]. The factors associated with cognitive impairment were age (Odds ratio (OR) for > 76 years: 4.89, p < 0.01), male sex (OR: 2.42, p = 0.02), lower education (OR: 21.6, p < 0.01), physical inactivity (OR: 2.07, p = 0.02), sedentary behavior (OR: 2.23, p = 0.01), sleeping > 9/hours/day (OR: 2.98, p = 0.01), consumption of < 5 portions/day of fruit and vegetables (OR: 2.02, p = 0.05), having an unhealthy lifestyle (OR: 6.10, p = 0.0001), being underweight (OR: 3.67, p < 0.01), obesity (OR: 3.32, p = 0.03), having hearing impairment (OR: 2.26, p = 0.02), having a visual impairment (OR: 3.89, p < 0.01), a history of depression (OR: 3.03, p = 0.01) and having a physical disability (OR: 5.63, p < 0.01). Conclusions: We identified 14 factors associated with cognitive impairment. Although some of these factors were non-modifiable such as age and sex, most of them could be modified by implementing prevention programs aiming to improve lifestyle behaviors in older adults in Chile.

Factores asociados a caídas en adultos mayores chilenos: evidencia de la Encuesta Nacional de Salud 2009-2010 / Factors associated with falls in older adults in chile: analysis of the National Health Survey 2009-2010

Background: A decrease in functional capacity due to ageing is one of the main risk factors for falls in older people. Aim: To investigate factors associated with falls in Chilean older adults. Material and Methods: We analyzed the self-reports of falls of 1,334 people aged ≥ 60 years who answered the National Health Survey 2009-2010. Falls during the last 12 months were recorded. Lifestyle, socio-demographic and health status were analyzed. A Poisson regression with robust variance estimates was performed to identify factors associated with falls. Results: Falls during the preceding year were reported by 37% of respondents (95% confidence intervals (CI): 32-42]. Fall frequency was higher in women (Prevalence ratio (PR):1.30 [95% CI:1.11; 1.53], p < 0.01) and those aged ≥ 75 years (PR:1.29 [95% CI:1.04; 1.61], p = 0.02). Hearing impairment (PR: 1.31 [95% CI: 1.07; 1.61], p < 0.01), impaired vision (PR:1.46 [95% CI:1.20; 1.77], p < 0.01), low self-reported wellbeing (PR: 1.41 [95% CI: 1.03; 1.94], p = 0.03) and disability (PR: 1.54 [95% CI:1.32; 1.79], p < 0.01) were associated with falls. However, multimorbidity (having ≥ 3 diseases) was negatively associated with falls (PR: 0.79 [95% CI: 0.63; 0.99], p = 0.04). Conclusions: Among older people, female sex, being aged > 75 years and having disability, hearing or vision impairment are risk factors for falls.

¿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.

Hemangioendotelioma kaposiforme torácico con respuesta favorable a sirolimus. Reporte de caso y revisión de la literatura / Thoracic kaposiform hemangioendothelioma with a good response to syrolimus. Case report and literature review

Se presenta el caso de una niña de 4 meses de edad que ingresa a la Unidad de Cuidados Intensivos (UCI) por presentar el Síndrome de Kasabach-Merritt asociado a un hemangioendotelioma kaposiforme. Luego de un mes de recibir tratamiento con vincristina, corticoides, propanolol y ácido acetilsalicílico, continúa con evolución desfavorable, incrementándose el tamaño de la lesión. Los exámenes de imágenes (tomografia axial computarizada y resonancia magnética nuclear) muestran compromiso de músculos intercostales, pleura, parénquima pulmonar y trombosis de venas cervicales. Posteriormente, llega a presentar cianosis y dificultad respiratoria por obstrucción de vías aéreas, requiriendo intubación y ventilación mecánica. Se inicia sirolimus, y en la segunda semana de tratamiento se evidencia mejoría de la lesión y de la analítica. Se brinda el alta hospitalaria a los 42 días de terapia con sirolimus, tratamiento que continúa recibiendo hasta un año después.

A 4-month girl was admitted to Pediatric Intensive Care Unit (PICU) due to a Kasabach-Merritt Syndrome associated to Kaposiform hemangioendothelioma. After 1-month of treatment with vincristine, steroids, propranolol, and acetylsalicylic acid; her progress was not good, and lesions became larger. Imaging studies (computed tomography and nuclear magnetic resonance) showed involvement of intercostal muscles, pleura, lung parenchyma, and cervical venous thrombosis. Afterwards, the patient developed cyanosis and dyspnea due to an upper airway obstruction, requiring intubation and ventilation support. Sirolimus was started and, on the second week of treatment, both lesion and laboratory parameters improved. The patient was discharged after 42 days of sirolimus therapy. One year later, she is still receiving this drug.

Relación entre niveles de actividad física y sedentarismo con síndrome metabólico. ENS Chile 2009-2010 / Relationship between levels of physical activity and sedentarism with metabolic syndrome. ENS Chile 2009-2010

Resumen: Objetivo: Asociar una nueva e integradora clasificación de actividad física (AF) y sedentarismo con riesgo de síndrome metabólico (SM) en una muestra representativa de adultos chilenos. Material y métodos: Se incluyeron 5040 participantes de la Encuesta Nacional de Salud de Chile 2009-2010. Fueron creadas cuatro categorías mediante una combinación entre niveles de AF y sedentarismo (SED) usando el cuestionario GPAQ. El SM fue definido según las normas del NCEP ATP-III. Resultados: Se observa una menor probabilidad de presentar SM sólo en las categorías que cumplen con las recomendaciones internacionales de AF (p<0.05), "activo y bajo-SED" (RM=0.72 [0.57 a 0.91]) y "activo y alto-SED" (RM=0.63 [0.49 a 0.81]). El nivel de sedentarismo (alto/bajo) no se asoció con una reducción significativa de SM en ninguno de los grupos. Conclusiones: Este tipo de clasificación demuestra que la principal estrategia para reducir el riesgo de SM debiera estar asociada con cumplir las recomendaciones de AF.

Abstract: Objective: To use a new methodology to classify the level of physical activity (PA) by combining the levels of PA and sedentary time (SED) in order to establish its association with metabolic syndrome (MS). Materials and methods: A representative sample of Chilean adults (≥18 years old) who participated in the National Health Survey (ENS 2009-2010) was included in this study (n=5 040). Four categories were created using a combination of PA and SED levels through the GPAQ questionnaire. MS was defined according to the norms established by NCEP ATP-III. Results: A lower probability of MS was observed only in the categories that comply with the international recommendations of PA, "active and low-SED" (OR=0.72 [0.57 to 0.91]) and "active and high-SED" (OR=0.63 [0.49 to 0.81]). While the level of SED (high/low) was not associated with a significant reduction of MS in any of the groups. Conclusions: This type of classification demonstrates that the main strategy to reduce the risk of MS should be associated with compliance with the recommendations of PA.

Hemangioma infantil: diagnóstico y manejo / Infantile hemangioma: diagnosis and management

El hemangioma infantil es el tumor de partes blandas más frecuente de la infancia; aparece durante las primeras semanas de vida. La fase de crecimiento progresivo ocurre durante el primer año de edad y la fase involutiva, hasta los 7 años. Puede ser único o múltiple, afectar un segmento del cuerpo o asociarse a otras anomalías en otros órganos. El tratamiento de elección para los hemangiomas que amenazan la vida o la función es el propranolol bajo un adecuado monitoreo médico; sin embargo, existen otras alternativas terapéuticas tanto para detener su crecimiento como para las secuelas. El manejo integral del hemangioma infantil varía de acuerdo a su presentación en cada paciente, de ahí la importancia de conocer su comportamiento para un adecuado diagnóstico, tratamiento y pronóstico. Este artículo brinda un enfoque práctico para el diagnóstico del hemangioma infantil, así como pautas y recomendaciones para el tratamiento sobre la base de la literatura.Palabras clave: atenolol, diagnóstico clínico, hemangioma, propranolol

Infantile hemangioma is the most frequent soft tissue tumor of childhood. It appears during the first weeks of life with a progressive growth during the first year of age and a regression phase until the seventh year of age. It can be single or multiple, affect one segment of the body or be associated with other abnormalities in other organs. Propranolol is the treatment of choice for hemangiomas that threaten life or function under adequate medical monitoring, however there are other therapeutic alternatives both to stop the proliferative phase and for the sequels. The integral management of the infantile hemangioma varies according to the presentation in each patient, hence the importance of knowing its behavior for an adequate diagnosis, treatment and prognosis. This article provides a practical approach for the diagnosis of infantile hemangioma, as well as guidelines and recommendations for treatment based on the literature

Asociación entre diabetes mellitus tipo 2, historia familiar de diabetes y deterioro cognitivo en adultos mayores chilenos / Risk of cognitive impairment among older people with diabetes or family history of the disease

Background: Although cardiovascular risk factors are associated with an impaired cognitive function, the impact of diabetes on cognitive function in Chilean adults is unknown. Aim: To investigate the association of diabetes or family history of the disease with cognitive impairment in older adults. Materials and Methods: Data from the 2009-2010 Chilean National Health Survey including 1,384 participants aged ≥ 60 years were included in this study. A score below 13 points for the Mini Mental State Examination (MMSE) was considered an indication of cognitive impairment. Logistic regression analyses were performed to assess the association between MMSE, diabetes and family history of the disease. Results: Cognitive impairment increased with age (Odds ratio (OR): 1.83 [95% confidence intervals (CI): 1.53; 2.19], p < 0.01, per 5 years increment in age). This trend was greater in individuals with diabetes (OR: 2.37 [95% CI: 1.68; 3.35], p < 0.01) compared to those without the disease. A similar trend was identified among individuals with a family history of diabetes compared to those without. Conclusions: Older adults with diabetes are more susceptible to develop cognitive impairment.

Asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad en población adulta chilena / Association between FTO (ns9939609) genotype and adiposity markers in Chilean adults

Background: Numerous studies have identified the role of Fat-mass-associated-gene (FTO) in the development of obesity. Aim: To investigate the association of FTO gene with adiposity markers in Chilean adults. Material and Methods: 409 participants were included in this cross-sectional study. The association between FTO (rs9939609) genotype and adiposity markers was determined using linear regression analyses. Adiposity markers included were: body weight, body mass index, fat mass, waist circumference, hip circumference and waist/hip ratio. Results: A fully adjusted model showed a significant association between FTO genotype and body weight (2.16 kg per each extra copy of the risk allele [95% confidence intervals (CI): 0.45 to 3.87], p = 0.014), body mass index (0.61 kg.m-2 [95% CI: 0.12 to 1.20], p = 0.050) and fat mass (1.14% [95% CI: 0.39 to 1.89], p = 0.010). The greater magnitude of association was found between the FTO gene and fat mass when the outcomes were standardized to z-score. Conclusions: This study confirms an association between the FTO gene and adiposity markers in Chilean adults, which is independent of major confounding factors.

No cumplir con las recomendaciones de actividad física se asocia a mayores niveles de obesidad, diabetes, hipertensión y síndrome metabólico en población chilena / Association of physical inactivity with obesity, diabetes, hypertension and metabolic syndrome in the chilean population

Background: Physical inactivity is an important cardiovascular risk factor. Aim: To investigate the association of physical inactivity with obesity, metabolic markers, type 2 diabetes mellitus, hypertension and metabolic syndrome in Chilean adults. Material and Methods: Participants from the National Health Survey 2009-10 (n = 5,157) were included in this study. Body mass index, waist circumference, metabolic markers (blood glucose, glycosylated hemoglobin and lipid profile) were the outcomes. Type 2 diabetes, hypertension and metabolic syndrome were determined using international criteria. Physical activity levels were determined using the Global Physical Activity Questionnaire and physical inactivity was defined as < 600 METs/minutes/week. Results: Compared to their physically active peers, inactive men and women had a higher odds ratio (OR) for obesity (OR: 1.77 [95% confidence intervals (CI): 1.29-2.42], p < 0.01 and 1.25 [95% CI: 102-1.54], p < 0.035, respectively), diabetes (OR: 2.47 [1.80-3.38], p < 0.01 and 1.72 [1.35-2.19], p = 0.002, respectively) and hypertension (OR: 1.66 [1.31-2.09], p < 0.01 and 1.83 [1.54-2.18] respectively. An association of physical inactivity with central obesity and metabolic syndrome was observed only in men (OR: 1.92 [1.42- 2.58], p < 0.01 and 1.74 [1.23-2.47], p < 0.01, respectively). Conclusions: Not meeting the physical activity recommendations is associated with obesity, diabetes, hypertension and metabolic syndrome, which are important cardiovascular risk factors.

Tiempo destinado a estar sentado y niveles de adiposidad ¿Cuál es su efecto sobre el desarrollo de diabetes mellitus tipo 2? / The joint effect of sitting time and obesity on the odds of developing type 2 diabetes

Background: Obesity and sedentary behavior are risk factors acting independently in the development of type 2 diabetes. Aim: To investigate whether the association between diabetes and obesity is modified by the levels of sitting time (ST) in the Chilean population. Material and Methods: We included 4,611 participants from the cross-sectional 2009-2010 Chilean National Health Survey in this study. Diabetes was determined as fasting glucose levels ≥126 mg/dl. Body mass index (BMI) and waist circumference (WC) were measured using standardized protocols. Sitting time was assessed using the Global Physical Activity Questionnaire. The association among diabetes, obesity and ST was determined using logistic regression. Results: The odds for diabetes increased by 3.1-fold in people with high levels of ST and obesity in comparison to those with low levels of ST and normal BMI (Odds ratio (OR): 4.17 [95% confidence intervals (CI): 2.87 to 6.05], P < 0.01). The odds for diabetes increased by 2.7- fold in highly sedentary subjects with central obesity (OR: 3.73 [95% IC: 2.61 to 5.33], P < 0.01) in comparison to those with low levels of ST and normal WC. Conclusions: Elevated levels of sitting time and obesity are associated with a higher odds of developing diabetes.