Translation and cross-cultural adaptation of the Get Active Questionnaire for Pregnancy in Colombian Spanish.

To ensure safe, optimal, and personalized physical activity, exercise, or sport during pregnancy, the Canadian Society for Exercise Physiology (CSEP), the Society of Obstetricians and Gynaecologists of Canada (SOGC), the College of Family Physicians of Canada, the Women's Health Division of the Canadian Physiotherapy Association, developed the Get Active Questionnaire for Pregnancy (GAQ_P) as a pre-assessment to identify women who may have a relative or absolute contraindication to prenatal exercise that requires further consultation with a health professional to determine if exercise can or should be continued or initiated during pregnancy. This study aims to translate and cross-culturally adapt the GAQ_P for use in Colombian Spanish. The original instrument was developed in English and French for the evaluation of the health of pregnant women before the beginning of physical activity and the guidelines for the same. Ten steps were followed according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Translation and Cultural Adaptation guidelines, with the participation of 4 experts. The comprehensibility of the instrument was 99% which shows a high percentage of intelligibility of the document. This article describes the translation and cross-cultural adaptation of the GAQ_P for use in Colombian Spanish, contributing positively to pre-exercise screening during pregnancy in Colombia.

Semiparametric modeling for the cardiometabolic risk index and individual risk factors in the older adult population: A novel proposal.

The accurate monitoring of metabolic syndrome in older adults is relevant in terms of its early detection, and its management. This study aimed at proposing a novel semiparametric modeling for a cardiometabolic risk index (CMRI) and individual risk factors in older adults. METHODS: Multivariate semiparametric regression models were used to study the association between the CMRI with the individual risk factors, which was achieved using secondary analysis the data from the SABE study (Survey on Health, Well-Being, and Aging in Colombia, 2015). RESULTS: The risk factors were selected through a stepwise procedure. The covariates included showed evidence of non-linear relationships with the CMRI, revealing non-linear interactions between: BMI and age (p< 0.00); arm and calf circumferences (p<0.00); age and females (p<0.00); walking speed and joint pain (p<0.02); and arm circumference and joint pain (p<0.00). CONCLUSIONS: Semiparametric modeling explained 24.5% of the observed deviance, which was higher than the 18.2% explained by the linear model.

Motor development in premature infants: Study protocol for an interdisciplinary hospital-home intervention.

BACKGROUND: Deviations occur in the neuropsychomotor development of premature infants; early interventions minimize delay motor. This study aimed to determine the effect of an interdisciplinary hospital-home intervention addressing motor development adaptation in premature infants in Colombia in comparison with traditional interventions. METHODS: This study was based on a parallel design, with two groups, namely, experimental and control. The experimental group, hospital-home intervention (HHI) performed in two settings (i.e., hospital neonatal care units and homes), and the control group, traditional intervention, (TI) performed in institutions for premature infants. The sample will be composed of 130 randomly-allocated infants, 65 in the experimental group (HHI) and 65 in the control group (TI) of moderate to late preterm infants (gestational age between 34 and 37 weeks), weighing more than or equal to 1.800 g, who are hemodynamically stable and reside in the cities of Tunja and Bogotá-Colombia recruited between 2021 and 2022. For the pre- and post-intervention assessments, the TIMPSI and the CapDMP are the instruments used to assess motor development and the degree of parents' or caregivers' knowledge about motor development. The HHI is composed of 10 intervention strategies based on stimulation of motor development, performed twice a day for 10 min for two months, in combination with calls to a mobile device, using software (Baby Motor Skills) and an instant messaging system (WhatsApp). RESULTS: This hospital-home intervention program proposes an approach focused on the motor development of premature infants, based on sensory and motor stimulation strategies, in addition to follow-up performed at home with the use of a mobile application that improves the motor development of premature infants. Register Clinical Trial: NCT04563364. CONCLUSION: The HHI provides the opportunity to determine whether the individualized four-week from admission to follow up at home with parent training will improve the motor skills of premature infants.

Rapid diagnostic tests and ELISA for diagnosing chronic Chagas disease: Systematic revision and meta-analysis.

OBJECTIVE: To determine the diagnostic validity of the enzyme-linked immunosorbent assay (ELISA) and Rapid Diagnostic Tests (RDT) among individuals with suspected chronic Chagas Disease (CD). METHODOLOGY: A search was made for studies with ELISA and RDT assays validity estimates as eligibility criteria, published between 2010 and 2020 on PubMed, Web of Science, Scopus, and LILACS. This way, we extracted the data and assessed the risk of bias and applicability of the studies using the QUADAS-2 tool. The bivariate random effects model was also used to estimate the overall sensitivity and specificity through forest-plots, ROC space, and we visually assessed the heterogeneity between studies. Meta-regressions were made using subgroup analysis. We used Deeks' test to assess the risk of publication bias. RESULTS: 43 studies were included; 27 assessed ELISA tests; 14 assessed RDTs; and 2 assessed ELISA and RDTs, against different reference standards. 51.2 % of them used a non-comparative observational design, and 46.5 % a comparative clinical design ("case-control" type). High risk of bias was detected for patient screening and reference standard. The ELISA tests had a sensitivity of 99% (95% CI: 98-99) and a specificity of 98% (95% CI: 97-99); whereas the Rapid Diagnostic Tests (RDT) had values of 95% (95% CI: 94-97) and 97% (95% CI: 96-98), respectively. Deeks' test showed asymmetry on the ELISA assays. CONCLUSIONS: ELISA and RDT tests have high validity for diagnosing chronic Chagas disease. The analysis of these two types of evidence in this systematic review and meta-analysis constitutes an input for their use. The limitations included the difficulty in extracting data due to the lack of information in the articles, and the comparative clinical-type design of some studies.

Effect of 4-Allyl-1-hydroxy-2-methoxybenzene (eugenol) in the expression of genes involved in cellular cycle and apoptotic process in dental pulp fibroblasts.

OBJECTIVE: This study sought to evaluate the effect of eugenol on the cell morphology and expression of genes involved in the apoptotic process in human dental pulp fibroblasts (hDPFs) from deciduous teeth. MATERIALS AND METHODS: hDPFs were cultured with 4 concentrations of eugenol (0.06 nM, 0.6 nM, 6 nM, 12 nM) and compared with a control group. After a 72 h incubation period, the cytotoxic effect on cell morphology by optical microscopy and gene expression by RT-PCR were evaluated. RESULTS: At 0.06 nM and 0.6 nM eugenol concentrations, vacuolisation of the cytoplasm was observed with atypical granulation of the hDPFs, and, at 6 nM and 12 nM cytoplasmic extensions disappeared almost completely. Casp-3, Casp-9, and telomerase genes were not expressed at the concentrations evaluated nor in the control group. The relative expression responses of Bcl-2 and TGF-ß genes were overexpressed at the 4 concentrations. MAKP's 0.06 nM (p < .001), 0.6 nM (p < .05) and 12 nM (p < .05) and Cyclin 1 at 12 nM showed significant difference versus the control group (p < .05). CONCLUSION: Eugenol is capable of causing morphological changes in hDPFs in a dose-dependent manner, higher concentrations may promote overexpression of apoptotic genes.

Structures of Two Human Astrovirus Capsid/Neutralizing Antibody Complexes Reveal Distinct Epitopes and Inhibition of Virus Attachment to Cells.

Human astrovirus is an important cause of viral gastroenteritis worldwide. Young children, the elderly, and the immunocompromised are especially at risk for contracting severe disease. However, no vaccines exist to combat human astrovirus infection. Evidence points to the importance of antibodies in protecting healthy adults from reinfection. To develop an effective subunit vaccine that broadly protects against diverse astrovirus serotypes, we must understand how neutralizing antibodies target the capsid surface at the molecular level. Here, we report the structures of the human astrovirus capsid spike domain bound to two neutralizing monoclonal antibodies. These antibodies bind two distinct conformational epitopes on the spike surface. We add to existing evidence that the human astrovirus capsid spike contains a receptor-binding domain and demonstrate that both antibodies neutralize human astrovirus by blocking virus attachment to host cells. We identify patches of conserved amino acids which overlap or border the antibody epitopes and may constitute a receptor-binding site. Our findings provide a basis for developing therapies to prevent and treat human astrovirus gastroenteritis. IMPORTANCE Human astroviruses infect nearly every person in the world during childhood and cause diarrhea, vomiting, and fever. Despite the prevalence of this virus, little is known about how antibodies block astrovirus infection. Here, we determined the crystal structures of the astrovirus capsid protein in complex with two virus-neutralizing antibodies. We show that the antibodies bind to two distinct sites on the capsid spike domain, however, both antibodies block virus attachment to human cells. Importantly, our findings support the use of the human astrovirus capsid spike as an antigen in a subunit-based vaccine to prevent astrovirus disease.

Face validity of a simulated low back pain clinical case in physical therapy training / Validez aparente de un caso clínico simulado de dolor lumbar en formación en fisioterapia

Abstract Introduction: The use of clinical cases in simulated environments allows for a more realistic approach to the simulated health condition, which results in a more effective training experience for students, as they are immersed in situations they may encounter in their professional practice. Objective: To determine the face validity of a low back pain clinical case as a clinical simulation tool in the training of physical therapy students. Materials and methods: Study conducted to determine the face validity of a low back pain clinical case presented to physical therapy students. The case has 9 items, which were evaluated by 5 expert raters. Agreement between raters regarding the pertinence, relevance, coherence, clarity, and sufficiency of the case was established using the Fleiss' Kappa coefficient. Results: Fleiss ' Kappa for the simulated case was 0.67 (substantial agreement), and for items 1, 2, 4, and 9 was 0.97, 1.0, 0.89, and 1.0, respectively (almost perfect agreement). Furthermore, the percentage of case comprehensibility (9 items) was 95.2. Conclusion: The face validity of the low back pain clinical case was confirmed, so its use in clinical simulation practices in the physical therapy programs offered by the Universidad de La Sabana and Universidad de Boyacá in Colombia is valid.

Resumen Introducción. El uso de casos clínicos en ambientes simulados brinda un mejor acercamiento a la condición de salud que se intenta simular, lo que permite una mejor formación de los estudiantes al verse inmersos en situaciones a las que podrían enfrentarse en su práctica profesional. Objetivo. Determinar la validez aparente de un caso clínico de dolor lumbar como herramienta de simulación clínica en la formación de estudiantes de fisioterapia. Materiales y métodos. Estudio realizado para determinar la validez de apariencia de un caso clínico de dolor lumbar para ser abordado por estudiantes de fisioterapia, el cual presenta nue -ve elementos evaluados por cinco jueces expertos. La concordancia entre los jueces respecto a la pertinencia, relevancia, coherencia, claridad y suficiencia del caso se estableció mediante el coeficiente Kappa de Fleiss. Resultados. El Kappa de Fleiss para el caso simulado fue 0.67 (acuerdo sustancial), y para los elementos 1, 2, 4 y 9 fue 0.97, 1.0, 0.89 y 1.0, respectivamente (acuerdo casi perfecto). Además, el porcentaje de comprensibilidad del caso (9 ítems) fue 95.2. Conclusión. La validez aparente del caso clínico fue confirmada, por lo que su uso en prácticas de simulación clínica en los programas de fisioterapia de la Universidad de La Sabana y la Universidad de Boyacá en Colombia es válido.

Simulation in physiotherapy students for clinical decisions during interaction with people with low back pain: randomised controlled trial.

BACKGROUND: Low back pain (LBP) is a condition with a high global prevalence, which is getting health professionals' attention, including physiotherapists as they must have the skills to provide treatment that increases the patient's quality of life. Clinical simulations could be a pedagogic strategy that facilitates adequate training for students to acquire skills to improve their professional reasoning in this clinical situation. OBJECTIVE: This study sought to determine the effects of clinical simulations with simulated patients (SP) on the physiotherapy students' clinical decision-making within a role-playing (RP) scenario while caring of LBP patients. METHODS: This experimental study included 42 participants from two Colombian universities, randomized into two groups (SP, n = 21; RP, n = 21). The clinical skill of performing the Objective Structured Clinical Examination (OSCE-LBP) was evaluated while students cared for patients with LBP; after that, a pedagogical method was conducted that included clinical simulation and, finally, the OSCE-LBP was applied again to compare both groups. RESULTS: Changes occurred in the OSCE-LBP among both groups of students: the scores increased (0.66 and 0.59 in RP and SP, respectively), and neither of the two was superior (p value 0.01; 95%CI - 0.21 to 0.23). CONCLUSION: Both types of simulation favor decision-making in professional reasoning in physiotherapy students during interactions with individuals with LBP. Trial registration https://clinicaltrials.gov/ct2/show/NCT04428892 Identifying number: NCT04428892. It was retrospectively registered.

Condición física funcional de los adultos mayores en dos ciudades colombianas / Functional Physical Condition of Elderly Adults in Two Colombian Cities / Condição física funcional de idosos em duas cidades colombianas

Introducción: la optimización de la condición física en el adulto mayor disminuye los efectos del proceso de envejecimiento y las malas condiciones de vida en general. El objetivo es comparar la condición física funcional de adultos mayores en dos ciudades colombianas según variables sociodemográficas. Materiales y métodos: estudio de corte transversal en 428 adultos mayores asistentes a centros de atención al adulto mayor. Se indagaron características sociodemográficas. La condición física funcional se evaluó mediante la batería Senior Fitness. Se realizó una regresión logística bivariada estimando los odds ratio y su respectivo intervalo de confianza del 95 %. Resultados: los adultos mayores que viven en Tunja tuvieron mejores resultados, según la batería Senior Fitness, comparados con los de Barranquilla, tanto para hombres como para mujeres. En Tunja, las personas con edades entre 75 y 90 años tienen mayor riesgo de deficiencias en la resistencia aeróbica (or: 2.2; ic 95 %: 1.1-4.3). Se observa mayor probabilidad de disminución de la fuerza en miembros inferiores (or: 4.3; ic 95 %: 1.9-9.6), miembros superiores (or: 2.6; ic 95 %: 1.2-5.3) y de alteraciones del equilibrio (or: 2.1; ic 95 %: 1.1-4) en las personas que pertenecen al régimen subsidiado. En Barranquilla, la probabilidad de un imc alto es mayor en las mujeres que en los hombres (or: 2.2; ic 95 %: 1.1-4.4) y en los que no tienen una pareja (or: 2.6; ic 95 %: 1.2-5.6). Conclusión: las similitudes y diferencias encontradas en los sujetos de las dos ciudades plantean interrogantes que se deben resolver mediante estudios experimentales

Introduction: Optimization of physical condition in the elderly reduces, in general, the effects of aging and poor living conditions. The objective was to compare, using sociodemographic variables, the func-tional physical condition of older adults in two Colombian cities. Materials and Methods: A cross-sec-tional study was carried out, in both cities, of 428 older adults who attended elderly care centers. Their sociodemographic characteristics were investigated. Functional physical condition was evaluated by way of the Senior Fitness battery. A bivariate logistic regression was performed to estimate odds ratios and 95% confidence intervals. Results: For both men and women, according to the Senior Fitness battery, elderly living in Tunja had better results than those in Barranquilla. In Tunja, people belonging to the subsidized regime, and between 75 and 90 years old, had a greater risk of deficiencies in aerobic resis-tance (or: 2.2; ci 95%: 1.1­4.3), and a higher probability of decreasing strength in the lower limbs (or: 4.3; ci 95%: 1.9­9.6), upper limbs (or: 2.6; ci 95%: 1.2­5.3), and balance disturbances (or: 2.1; ci 95%: 1.1­4). In Barranquilla, the probability of a high body mass index was higher in women than in men (or: 2.2; ci95%: 1.1­4.4) and those who were not married (or: 2.6; ci 95%: 1.2­5.6). Conclusion: The similarities and differences found among the subjects of the two cities raise questions that must be addressed through experimental studies

Introdução: a otimização da condição física em idosos permite reduzir os efeitos do processo de envelhe-cimento e as precárias condições de vida em geral. O objetivo é comparar a condição física funcional de idosos em duas cidades colombianas segundo variáveis sociodemográficas. Materiais e métodos: estudo transversal com 428 idosos atendidos em Centros de Atenção ao Idoso das duas cidades. As caracterís-ticas sociodemográficas foram investigadas. A condição física funcional foi avaliada por meio da bate-ria Senior Fitness. Foi realizada regressão logística bivariada estimando o Odds Ratio e seu respectivo intervalo de confiança de 95%. Resultados: os idosos residentes em Tunja tiveram melhores resultados de acordo com a bateria Senior Fitness em comparação com os residentes de Barranquilla tanto para homens quanto para mulheres; em Tunja, pessoas com idades entre 75 e 90 anos têm um risco maior de deficiências na resistência aeróbia (or: 2,2; ic 95%: 1,1-4,3), se observa uma maior probabilidade de diminuição da força nos membros inferiores (or: 4,3; ic 95%: 1,9-9,6), membros superiores (or: 2,6; ic 95%: 1,2-5,3) e alterações de equilíbrio (or: 2,1; ic 95%: 1,1-4) em pessoas que pertencem ao regime subsidiado. Em Barranquilla, a probabilidade de um imc elevado é maior nas mulheres do que nos homens (or: 2,2; ic 95%: 1,1-4,4) e naqueles que não têm companheiro (or: 2,6; ic 95%: 1,2-5,6). Conclusão: as semelhanças e diferenças encontradas nos sujeitos das duas cidades levantam questões que devem ser resolvidas por meio de estudos experimentais

Aprendizaje basado en simulación: estrategia pedagógica en fisioterapia. Revisión integrativa / Learning based on simulation: Pedagogical strategy in physiotherapy. An integrated review

Los escenarios de simulación clínica han sido explorados en medicina y enfermería como estrategia de aprendizaje y han demostrado ser efectivos para la adquisición de competencias acercando a los estudiantes a su práctica clínica real. En fisioterapia, su utilización ha sido recientemente incluida y aún no se ha documentado su potencial como estrategia de fortalecimiento curricular. Este trabajo buscó revisar en la literatura el empleo de la simulación clínica como estrategia pedagógica para la fisioterapia. Para ello, se desarrolló un proceso integrativo con base en el análisis de competencias transversales o específicas. Sus resultados señalan que la simulación mejora la calidad y competencia del fisioterapeuta en formación; el dominio donde más se usa la simulación es el cardiovascular pulmonar, seguido del musculoesquelético. Sin embargo, en fisioterapia se requiere incrementar el uso de simulación en todos los dominios para poder cualificar aún más la formación

Clinical simulation scenarios have been explored in medicine and nursing as a learning strategy. They have shown to be effective for the acquisition of skills, bringing students closer to their actual clinical practice. Its use has recently been included in physiotherapy, but its potential as a curriculum strengthening strategy has not yet been documented. This work aims to carry out a review of the literature on the use of clinical simulation as a pedagogical strategy for physiotherapy. To do this, an integrated process was developed, based on the analysis of cross-sectional or specific skills. The results indicate that simulation improves the quality and skills of the physiotherapist in training. The domain where the simulation is most used is pulmonary cardiovascular, followed by the musculoskeletal system. However, in physiotherapy it is necessary to increase the use of simulation in all domains in order to qualify the training even more

Fiabilidad y validación del instrumento de conocimientos, actitudes y prácticas en la enfermedad de Chagas / Reliability and validation of an instrument to measure knowledge, attitudes and practices in response to Chagas disease

RESUMEN Introducción: La enfermedad de Chagas es de alta endemia en Colombia y es considerada un problema de salud pública por la morbilidad y mortalidad que ocasiona. Conocer la percepción de las comunidades frente a esta enfermedad es relevante en cuanto a las estrategias oportunas que se pueden establecer para su prevención. Objetivo: Evaluar la fiabilidad y validez de un instrumento que permita medir los conocimientos, actitudes y prácticas frente a la enfermedad de Chagas en comunidades endémicas. Métodos: Se desarrolló un estudio de corte transversal para la validación del contenido de un instrumento, diseñado con base en la literatura, el cual se sometió a la valoración por un panel de expertos que determinaron la eficiencia, relevancia, claridad y coherencia de cada uno de los ítems. Se determinó el índice Kappa de Randolph para evaluar concordancia. Luego se aplicó a 135 personas de áreas endémicas y se estableció el alfa de Cronbach para determinar consistencia interna. Resultados: El instrumento estudiado demostró concordancia según el índice de Randolph con una Kappa entre 0,7-0,8 para los ítems evaluados, con un alfa de Cronbach de 0,855 lo cual denota una consistencia adecuada. El cuestionario finalmente se estructuró con un total de 27 ítems que abordan: factores epidemiológicos y conocimientos de la enfermedad junto con actitudes y prácticas frente a esta. Conclusiones: El instrumento tiene un nivel adecuado de consistencia interna y concordancia, que permitiría su aplicación en áreas endémicas con poblaciones en riesgo a adquirir la enfermedad de Chagas.

ABSTRACT Introduction: Chagas disease is highly endemic in Colombia and considered to be a public health problem due to its morbidity and mortality. Learning about community perception of this disease is relevant to devise timely strategies for its prevention. Objective: Evaluate the reliability and validity of an instrument to measure knowledge, attitudes and practices in response to Chagas disease in endemic communities. Methods: A cross-sectional study was conducted to validate the content of a tool based on the literature and assessed by an expert panel to determine the efficiency, relevance, clarity, and coherence of each of its items. Determination was made of Randolph's kappa index to evaluate agreement. Then it was applied to 135 people from endemic areas and Cronbach's alpha was established to determine internal consistency. Results: The tool studied showed agreement by Randolph's index with a kappa between 0.7 and 0.8 for the items evaluated and a Cronbach's alpha of 0.855, denoting appropriate consistency. The questionnaire was finally structured with a total 27 items addressing epidemiological factors and knowledge about the disease as well as attitudes and practices in response to it. Conclusions: The tool has an adequate level of internal consistency and agreement, which makes its application advisable in endemic areas with populations at risk of acquiring Chagas disease.

Glucose Levels as a Mediator of the Detrimental Effect of Abdominal Obesity on Relative Handgrip Strength in Older Adults.

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (ß = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (ß = -0.003, 95%CI = -0.005 to -0.001), p < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (ß = -0.069, 95%CI = -0.082 to -0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect ß = -0.002, 95%CI = -0.004 to -0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass.

Muscle strength cut-offs for the detection of metabolic syndrome in a nonrepresentative sample of collegiate students from Colombia.

BACKGROUND: Evidence shows an association between grip strength and health; however, grip strength cut-offs for the detection of metabolic syndrome (MetS) in Latin American populations are scarce. The purpose of this study was to determine cut-offs of normalized grip strength (NGS) for the detection of MetS in a large nonrepresentative sample of a collegiate student population from Colombia. METHODS: A total of 1795 volunteers (61.4% female; age = 20.68 ± 3.10 years, mean ± SD), ranging between 18 and 30 years of age participated in the study. Strength was estimated using a handheld dynamometer and normalized to body mass (handgrip strength (kg)/body mass (kg)). Anthropometrics, serum lipids indices, blood pressure, and fasting plasma glucose were measured. Body composition was measured by bioelectrical impedance analysis. MetS was defined as including ≥3 of the 5 metabolic abnormalities according to the International Diabetes Federation definition. A metabolic risk score was computed from the following components: waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and systolic and diastolic blood pressure. RESULTS: Receiver operating curve analysis showed significant discriminatory accuracy of NGS in identifying the thresholds and risk categories. Lower strength was associated with increased prevalence of MetS. In males, weak, intermediate, and strong NGS values at these points were <0.466, 0.466-0.615, >0.615, respectively. In females, these cut-off points were <0.332, 0.332-0.437, >0.437, respectively. CONCLUSION: Our sex-specific cut-offs of NGS could be incorporated into a clinical setting for identifying college students at cardiometabolic disease risk.

Funcionalidad De La Marcha En La Calidad De Vida Relacionada Con La Salud En Adultos Con Enfermedad Cerebro Vascular: Revisión Sistemática - Metaanálisis / Functionality Of The Gait In The Quality Of Life Related To Health In Adults With Stroke: Systematic Review - Metaanalysis

Resumen Introducción: La enfermedad cerebrovascular genera deficiencias que afectan el movimiento; entre ellas se encuentran el déficit en la función motora, la integridad refleja, la integridad sensorial, y la marcha. Objetivo: determinar el efecto de la funcionalidad de la marcha en la calidad de vida relacionada con la salud en adultos con enfermedad cerebrovascular. Método: se consultaron las bases de datos PUBMED/MEDLINE, EMBASE, LILACS, SCIELO, Registro Cochrane Central de Ensayos Controlados (CENTRAL), entre noviembre de 2016 y febrero de 2017, seleccionando artículos con diseño de ensayos clínicos aleatorizados randomizados. Para el análisis se evaluó la calidad metodológica mediante el Physiotherapy Evidence Database, puntuación PEDro y el Riesgo de sesgo con los criterios de Review Manger 5.3 (RevMan), este último, igual se empleó para análisis y la extracción de los datos según los criterios de elegibilidad. Resultados: El Lokomat como estrategia de rehabilitación para la funcionalidad de la marcha tiene un efecto positivo en la mejora de la calidad de vida en personas con enfermedad cerebrovascular. El análisis de los estudios incluidos mostró un bajo nivel de heterogeneidad estadística con base en el I2 y Chi2, para la escala global de la calidad de vida. Los resultados obtenidos para la calidad de vida relacionada con la salud, cuando la intervención propuesta se desarrolla con el uso de Lokomat y medida con la escala SF-36, se evidencia post- intervención un aumento de 1.83 puntos. Conclusiones: La rehabilitación de la funcionalidad de la marcha a través de diferentes protocolos y estrategias de intervención no presenta diferencias, debido a su variabilidad en cuanto a la técnica, método de aplicación, compromiso clínico de la enfermedad cerebrovascular y el tiempo de duración en su aplicación, no obstante, se observan cambios clínicos que favorecen la calidad de vida relacionada con la salud.

Abstract Introduction: Stroke causes deficiencies that affect movement; these include deficit in motor function, reflex integrity, sensory integrity, and gait. Objective: determine the effect of gait functionality on health-related quality of life in adults with Stroke. Method: databases PUBMED / MEDLINE, EMBASE, LILACS, SCIELO, Central Cochrane Registry of Controlled Trials (CENTRAL) were consulted between November 2016 and February 2017. Randomized clinical trials were selected. For the analysis, the methodological quality was evaluated using the Physiotherapy Evidence Database, PEDro score and the Risk of bias with the Review Manger 5.3 (RevMan) criterias, also RevMan was being used for analysis and data extraction according to the eligibility criteria. Results: Lokomat as a rehabilitation strategy for gait functionality has a positive effect on improving the quality of life in people with stroke. The analysis of the included studies demonstrated a low level of statistical heterogeneity based on I2 and Chi2, for the global scale of quality of life. The results obtained for quality of life related to health, when the proposed intervention is carried out with the use of Lokomat and measured with the SF-36 scale, an increase of 1.83 points. Conclusions: The rehabilitation of gait functionality through different protocols and intervention strategies does not present differences, due to its variability in terms of technique, application method, clinical involvement of stroke and the duration of its application. However, clinical changes that favor quality of life related to health are observed.

Handgrip strength attenuates the adverse effects of overweight on cardiometabolic risk factors among collegiate students but not in individuals with higher fat levels.

The aims of this study are to (i) examine a clustered metabolic syndrome composite score (MetScore) and fatness among college students across body mass index (BMI) categories, and (ii) determine whether fit individuals have lower MetScores, fewer individual metabolic syndrome components, and lower fatness than unfit individuals across BMI categories. A total of 1,795 participants aged  >18 years who participated in The FUPRECOL Study were selected for the present analyses. Handgrip strength was tested by a grip dynamometer and used to classify adults as fit or unfit. Among all participants, MetScore, percentage of body fat, and visceral adiposity increased linearly across the BMI categories among college students (all P < 0.001). Individuals who were overweight and fit had a lower MetScore (-0.6 SD; P = 0.02), body fat percentage (-2.6%; P < 0.001) and visceral adiposity (-0.2; P = 0.01) than unfit peers. Moderately fit obese individuals had significantly lower visceral fat levels than unfit obese peers (-3.0; P = 0.03). These results suggest that having adequate handgrip strength-a proxy of overall strength capacity-may attenuate obesity-related cardiometabolic risk. Moreover, weight loss should be recommended to all individuals with obesity, even among those who are currently considered fit.

Ideal Cardiovascular Health, Handgrip Strength, and Muscle Mass Among College Students: The FUPRECOL Adults Study.

Garcia-Hermoso, A, Correa-Bautista, JE, Izquierdo, M, Tordecilla-Sanders, A, Prieto-Benavides, D, Sandoval-Cuellar, C, González-Ruíz, K, and Ramírez-Vélez, R. Ideal cardiovascular health, handgrip strength, and muscle mass among college students: the FUPRECOL Adults study. J Strength Cond Res 33(3): 747-754, 2019-The American Heart Association established the 2020 Strategic Impact Goals to define the concept of ideal cardiovascular health (CVH) and the metrics needed to monitor it across populations. The purpose of this study was to investigate the relationship between handgrip strength, muscle mass, and ideal CVH among Colombian college students. Data from 1,835 college students were analyzed (1,128 female). Muscular strength was estimated using a hand-held dynamometer and normalized to body mass (normalized grip strength [NGS]). The percentage of body fat was determined for bioelectrical impedance analysis using tetrapolar whole-body impedance. Ideal CVH was defined as meeting the ideal levels of 4 behaviors (smoking, body mass index, physical activity, and diet adherence) and 3 factors (total cholesterol, fasting glucose, and blood pressure). Higher levels of NGS and muscle mass (relative to body mass) were associated with a higher number of ideal CVH metrics in both sexes (p for trend <0.001). For the total ideal CVH metrics scored on a continuous scale from 0 (all 7 poor) to 7 (all 7 ideal), a 1-metric increase was associated with reduced odds of weak NGS (33 and 36%) and low-medium muscle mass (28 and 34%) mass in men and women, respectively (all p < 0.001). This study indicates that in Colombian college students, both handgrip strength and muscle mass are positively associated with the ideal CVH metrics. To reduce the possible future public health burden of muscular weakness, health professionals need to encourage the public to optimize lifestyle-related risk factors during the young adult stage.

CD200 is a useful marker in the diagnosis of chronic lymphocytic leukemia.

BACKGROUND: The diagnosis of CLL is supported by a typical morphology and immunophenotype and usually does not present difficulties. Nevertheless, some patients with CLL can show an atypical phenotype, this raising the possibility of a lymphoproliferative disorder other than CLL. It has been recently shown that the expression of CD200 could be a rather consistent marker for CLL. METHODS: The expression of CD200 was investigated in 120 consecutive patients with B-cell chronic lymphoproliferative disorders (B-CLPD) (65 cases diagnosed as typical CLL, 16 atypical CLL, and 39 non-CLL before entering the study) by using multiparametric flow cytometry with four color combinations. CD200 was analyzed as percentage of positive cells (≥30%) and MFIR expression. ROC curves were used to determine the cut-off for the CD200 MFIR. Matutes score (MS) was used as comparator. RESULTS: All 81 (100%) patients classified as CLL and 25 of 39 (64.1%) classified as non-CLL expressed high CD200 expression (≥30%). CD200 expression showed a high sensitivity (100%) and a low specificity (35.9%), and the accuracy was similar to that of Matutes score markers (range: 79.2%-86.7%); except SmIg that was 59.1%. The addition of CD200 to the Matutes score correctly identified 74 of 81 (91.4%) CLL cases including 9 of 16 atypical CLL cases. As per non CLL cases, 37 of 39 (94.9%) were correctly diagnosed by the modified system. Altogether, CD200 improved the diagnostic accuracy of Matutes score from 86.7% to 92.5% (P < .01). CONCLUSION: These results show that CD200 is a valuable, albeit not specific, CLL diagnostic marker. © 2018 International Clinical Cytometry Society.

Uso de la crioterapia en la fatiga muscular post esfuerzo en individuos que realizan práctica deportiva: revisión sistemática / Use of cryotherapy in post-effort muscle fatigue in individuals who practice sports: systematic review / Uso da crioterapia na fadiga muscular pós-esforço em indivíduos que realizam prática esportiva: revisão sistemática

Introducción. En la práctica deportiva, la fatiga muscular es un factor de riesgo para lesión muscular, constituyéndose en un problema que aparece cuando la carga mecánica a la cual se somete un músculo o grupo muscular es superior a la resistencia de este. Objetivo. Describir las intervenciones con crioterapia en Fatiga Muscular post esfuerzo, en individuos que realizan práctica deportiva, a través de una Revisión Sistemática. Método. Se realizó la búsqueda en bases de datos PUBMED/MEDLINE, EMBASE, LILACS, SCIELO, SCIENCE DIRECT, Registro Cochrane Central de Ensayos Controlados con la estrategia de búsqueda: Sports Medicine, Cryotherapy, Muscle Fatigue, Recovery of Function, Physical Exertion, Muscle Damage. La identificación y detección de las referencias fueron exportadas al gestor de referencias MENDELEY. La evaluación del Riesgo de Sesgo se realizó con el uso del software Review Manager y la calidad metodológica con lo reportado por la Base de Datos PEDro. Resultados. Se evaluaron 19 ensayos clínicos aleatorizados en los cuales se evidencia que la crioterapia reporta cambios en la fatiga muscular desde la disminución del dolor y biomarcadores. La inmersión en agua fría fue la modalidad más efectiva para acelerar la cinética de recuperación 72 horas después del ejercicio; demostró menor dolor y mayores niveles de recuperación, percibidos a lo largo de 24 a 48 horas después del ejercicio. Conclusión. De la totalidad de modalidades de crioterapia, la inmersión en agua fría es la que reporta mejores resultados en el proceso de recuperación de la fatiga muscular.

Introduction. In sports practice, muscle fatigue is a risk factor for muscle injury becoming a problem that appears when the mechanical load to which a muscle or muscle group is subjected is greater than its resistance. Objective. Describe post-effort Muscular Fatigue in active Men and Women who perform sports practice against interventions with cryotherapy, through a Systematic Review. Method. PUBMED / MEDLINE, EMBASE, LILACS, SCIELO, SCIENCE DIRECT, Central Cochrane Registry of Controlled Trials with the search strategy were searched: Sports Medicine, Cryotherapy, Muscle Fatigue, Recovery of Function, Physical Exertion, Muscle Damage The identification and detection of references were exported to the MENDELEY reference manager. The Bias Risk assessment was performed with the use of Review Manager software and methodological quality as reported by the PEDro Database. Results. 19 randomized clinical trials were evaluated in which it is evident that cryotherapy reports changes in muscle fatigue since the decrease in pain, and biomarkers. Cold water immersion was the most effective modality to accelerate recovery kinetics 72 hours after exercise; showed less pain and higher levels of recovery perceived over 24 to 48 hours after exercise. Conclusion. Of all the cryotherapy modalities, the immersion in cold water is the one that reports the best results in the process of recovery of muscular fatigue.

Introdução. Na prática esportiva, a fadiga muscular é um fator de risco para a lesão muscular, tornando- se um problema que ocorre quando a carga mecânica à qual um músculo ou grupo muscular é submetido é superior à resistência do músculo. Objetivo. Descrever as intervenções com crioterapia na fadiga muscular pós-esforço, em indivíduos que realizam prática esportiva, por meio de uma revisão sistemática. Método. Foi realizada uma busca nas bases de dados PUBMED/MEDLINE, EMBASE, LILACS, SCIELO, SCIENCE DIRECT, Registro Central Cochrane de Ensaios Controlados com a estratégia de busca: Medicina Esportiva, Crioterapia, Fadiga Muscular, Recuperação da Função, Esforço Físico, Dano Muscular. A identificação e detecção das referências foram exportadas para o gerenciador de referência do MENDELEY. A avaliação do risco de viés foi realizada com o uso do software Review Manager de revisão e qualidade metodológica com a relatada pelo banco de dados PEDro. Resultados. Dezenove ensaios clínicos randomizados foram avaliados nos quais se evidencia que a crioterapia relata alterações na fadiga muscular desde a diminuição da dor e dos biomarcadores. A imersão em água fria foi a modalidade mais eficaz para acelerar a cinética de recuperação 72 horas após o exercício; demonstrou menos dor e níveis mais altos de recuperação, percebidos entre 24 e 48 horas após o exercício. Conclusão. De todas as modalidades de crioterapia, a imersão em água fria é a que proporciona os melhores resultados no processo de recuperação da fadiga muscular.