Cambios en el índice de stress y presión inspiratoria pico posterior a neumoperitoneo en colecistectomía laparoscópica / Changes in Stress Index and Peak Inspiratory Pressure after Pneumoperitoneum in Laparoscopic Cholecystectomy

Introducción: es bien sabido que el neumoperitoneo en cirugía laparoscópica afecta tanto al sistema cardiovascular como al sistema respiratorio, pero no se entiende por completo el grado en el que debemos modificar los parámetros ventilatorios para mini-mizar las complicaciones debido a la insuflación del neumoperitoneo. Estos cambios in-cluyen disminución de la distensibilidad y mayores presiones inspiratorias pico.

Abstract Background: it is well known that pneumoperitoneum in laparoscopic surgery affects both cardiovascular and respiratory system, but it is not fully understood yet the degree in which we have to make changes in the ventilatory settings to minimize the complica-tions due to insufflation of peritoneum, changes including impaired compliance and hig-her peak inspiratory.

PROSPECTIVE CONTROLLED STUDY OF SPINAL SURGERY VERSUS PHYSICAL CAPACITY.

Objectives: Assess whether the spine surgical approach for degenerative diseases can influence the physical capacity of patients and its correlation with cardiorespiratory function. Methods: A prospective study was conducted on 9 patients of both genders, aged between eighteen and sixty, scheduled for spinal surgery for degenerative disease in the lumbar segment. Patients underwent treadmill stress test two times, fifteen days before and sixty days after the surgery. A cardiologist performed the test according to the Bruce protocol with a progressive increase in incline and speed. Results: There were no statistically significant differences between pre- and postoperative assessments for the parameters evaluated in the treadmill stress test. Forty-four percent of patients needed to interrupt the test postoperatively due to dyspnea (p=0.023). Conclusion: The improvement obtained with spinal surgery does not have statistically significant relevance in tiredness, pain, and fatigue in the lower limbs and low back pain. Some patients could not complete the examination after surgery due to poor physical conditioning, and it was necessary to interrupt the examination due to dyspnea. Level of Evidence II; Lesser quality RCT (eg, < 80% followup, no blinding, or improper randomization).

Objetivo: Avaliar se a abordagem cirúrgica da coluna vertebral para doenças degenerativas pode influenciar a capacidade física dos pacientes e sua correlação com a função cardiorrespiratória. Métodos: Um estudo prospectivo foi realizado em 9 pacientes, de ambos os sexos, com idade entre 18 e 60 anos, programados para cirurgia de coluna vertebral para doenças degenerativas no segmento lombar. Os pacientes foram submetidos a teste de esforço em esteira duas vezes, quinze dias antes do procedimento cirúrgico e sessenta dias após a cirurgia. O teste foi realizado por um cardiologista de acordo com o protocolo Bruce com aumento progressivo de inclinação e velocidade. Resultados: Não houve diferenças estatisticamente significativas entre as avaliações pré e pós-operatórias para os parâmetros avaliados no teste de esforço em esteira. Quarenta e quatro por cento dos pacientes precisaram interromper o teste no pós-operatório devido à dispnéia (p=0,023). Conclusão: A melhora obtida com a cirurgia da coluna vertebral não apresenta impactos estatísticos no cansaço, dor e fadiga relativos aos membros inferiores e dores lombares baixas. Alguns pacientes não puderam completar o exame após a cirurgia devido ao mau condicionamento físico, exigindo a interrupção do exame devido à dispnéia. Nível de Evidência II; ECRC de menor qualidade (por exemplo, < 80% de acompanhamento, sem mascaramento do código de randomização ou randomização inadequada).

Prospective controlled study of spinal surgery versus physical capacity / Estudo prospectivo controlado da cirurgia vertebral versus capacidade física

ABSTRACT Objectives: Assess whether the spine surgical approach for degenerative diseases can influence the physical capacity of patients and its correlation with cardiorespiratory function. Methods: A prospective study was conducted on 9 patients of both genders, aged between eighteen and sixty, scheduled for spinal surgery for degenerative disease in the lumbar segment. Patients underwent treadmill stress test two times, fifteen days before and sixty days after the surgery. A cardiologist performed the test according to the Bruce protocol with a progressive increase in incline and speed. Results: There were no statistically significant differences between pre- and postoperative assessments for the parameters evaluated in the treadmill stress test. Forty-four percent of patients needed to interrupt the test postoperatively due to dyspnea (p=0.023). Conclusion: The improvement obtained with spinal surgery does not have statistically significant relevance in tiredness, pain, and fatigue in the lower limbs and low back pain. Some patients could not complete the examination after surgery due to poor physical conditioning, and it was necessary to interrupt the examination due to dyspnea. Level of Evidence II; Lesser quality RCT (eg, < 80% followup, no blinding, or improper randomization).

RESUMO Objetivo: Avaliar se a abordagem cirúrgica da coluna vertebral para doenças degenerativas pode influenciar a capacidade física dos pacientes e sua correlação com a função cardiorrespiratória. Métodos: Um estudo prospectivo foi realizado em 9 pacientes, de ambos os sexos, com idade entre 18 e 60 anos, programados para cirurgia de coluna vertebral para doenças degenerativas no segmento lombar. Os pacientes foram submetidos a teste de esforço em esteira duas vezes, quinze dias antes do procedimento cirúrgico e sessenta dias após a cirurgia. O teste foi realizado por um cardiologista de acordo com o protocolo Bruce com aumento progressivo de inclinação e velocidade. Resultados: Não houve diferenças estatisticamente significativas entre as avaliações pré e pós-operatórias para os parâmetros avaliados no teste de esforço em esteira. Quarenta e quatro por cento dos pacientes precisaram interromper o teste no pós-operatório devido à dispnéia (p=0,023). Conclusão: A melhora obtida com a cirurgia da coluna vertebral não apresenta impactos estatísticos no cansaço, dor e fadiga relativos aos membros inferiores e dores lombares baixas. Alguns pacientes não puderam completar o exame após a cirurgia devido ao mau condicionamento físico, exigindo a interrupção do exame devido à dispnéia. Nível de Evidência II; ECRC de menor qualidade (por exemplo, < 80% de acompanhamento, sem mascaramento do código de randomização ou randomização inadequada).

Adaptability to social distancing due to COVID-19 and its moderating effect on stress by gender / Adaptabilidad al distanciamiento social debido al COVID-19 y su efecto moderador sobre el estrés según el género

Abstract Introduction The COVID-19 pandemic, originated in China, has affected millions of people worldwide, leading to various situations such as psychological disorders and diseases that affect people's physical and mental health, and disrupt their quality of life. Objective To analyze stress levels during social distancing due to COVID-19 by gender and to determine the moderating effect of adaptability to the situation. Method The study is cross-sectional and quantitative, with a descriptive-correlational scope. The sample consisted of 1,173 Mexican subjects (522 males [44.5%] and 651 females [22.5%]) with an average age of 25.99 years (DT = 11.19; range = 12 - 77 years). Adaptability and perceived stress were measured, obtaining reliability from appropriate instruments. Results The results indicated that the greater the number of weeks of social distancing, the higher the perceived level of stress. Also, the better people adapt to social distancing, the less stress occurs. Women were observed to have higher levels of stress compared to men. Discussion and conclusion The findings highlight the importance of adaptability to the stressful situation of the pandemic, because the effect of severe stress on women largely disappears when there is a high level of adaptability to the event.

Resumen Introducción La pandemia del COVID-19, originada en China, ha afectado a millones de personas en todo el mundo y ha provocado diversos problemas como trastornos y enfermedades psicológicas. Todo esto ha afectado la salud física y mental, la calidad de vida de las personas. Objetivo Analizar los niveles de estrés durante el distanciamiento social debido al COVID-19 en función del género y conocer el efecto moderador de la adaptabilidad a la situación. Método El estudio es de tipo transversal, cuantitativo y con alcance descriptivo-correlacional. La muestra estuvo conformada por 1,173 sujetos (522 varones [44.5%] y 651 mujeres [22.5%]) mexicanos con una media de 25.99 años de edad (DT = 11.19; rango = 12 - 77 años). Se midió la adaptabilidad y el estrés percibido, y se obtuvieron fiabilidades adecuadas de los instrumentos utilizados. Resultados Los resultados indicaron que el nivel de estrés percibido es más alto cuanto mayor es la cantidad de semanas en distanciamiento. Asimismo, cuanto mejor se adaptan las personas al distanciamiento social, menos estrés se presenta. Por otra parte, las mujeres fueron las que presentaron niveles más altos de estrés en comparación con los varones. Discusión y conclusión Los hallazgos destacan la importancia que tiene la adaptabilidad a la situación estresante de la pandemia, debido a que el efecto del estrés marcado en gran medida en las mujeres se pierde cuando el nivel de adaptabilidad ante el acontecimiento es alto.

Psychometric Properties of the Interpersonal Styles Questionnaire for Physical Education in a Mexican Sample.

During physical education classes, one of the contextual factors that can influence motivation is the teacher's interpersonal style. The aim of this study was to analyze the psychometric properties, structure, and factorial invariance across gender of the physical education teachers' Interpersonal Styles Questionnaire of Sonora, Mexico. The participants were 500 students (50.8% boys, 49.2% girls) aged between 9 and 13 years old (mean age (Mage) = 10.72; standard deviation (SD) = 0.74) from different elementary schools of Sonora, Mexico. In terms of measuring the teacher's interpersonal styles, the short version of the Learning Climate Questionnaire was used to measure autonomy support, whereas the Teacher Controllingness Scale was used to measure controlling style. The results support the structure and factorial invariance across gender groups of the Mexican version of the Interpersonal Styles Questionnaire for Physical Education (Cuestionario de Estilos Interpersonales en la Educación Física (CEI-EF, by its initials in Spanish)). In conclusion, the CEI-EF is a valid and reliable instrument that can be used to assess the teachers' interpersonal styles and draw comparisons between groups of boys and girls.

Influencia de la satisfacción, aburrimiento e importancia de la educación física en la intención de realizar actividad física extraescolar en adolescentes mexicanos / Influence of satisfaction, boredom and importance of physical education with the intention of performing extracurricular exercise amongst Mexican teenagers / Influência da satisfação, do aborrecimento e da importância da educação física na intenção de realizar atividade física extracurricular em adolescentes mexicanos

El objetivo de este estudio fue examinar el efecto de la satisfacción y/o aburrimiento en la clase de EF sobre la importancia que los estudiantes le otorgan a ésta y su relación con la intención de la práctica futura de la AF en el tiempo libre. Participaron 457 estudiantes (46 % chicos y 54% chicas) con edades entre 12 y 17 (M = 14,10; DT = 0,84) de la zona metropolitana de Monterrey. Se utilizaron tres instrumentos:1) Satisfacción Intrínseca en la Educación Física; 2) Importancia y Utilidad de la Educación Física y 3) Intención de Práctica Futura de Actividad Física en el Tiempo Libre (AFTL). El modelo propuesto se probó a través de una modelación de ecuaciones estructurales utilizando el LISREL 8.80. Se encontraron relaciones positivas y significativas de la satisfacción hacia la importancia de la EF (b = ,52, p < ,01), y la importancia de la EF con la intención hacia la práctica futura de la AFTL (b = ,44, p < ,01) y un efecto indirecto significativo de la satisfacción hacia la intención de la práctica futura de la AFTL (b = ,23, p < ,01). Los resultados obtenidos en el presente trabajo demuestran la importancia de diseñar sesiones de EF innovadoras, dinámicas y divertidas ya que, de esta forma, se consigue que los adolescentes valoren y den más importancia a la asignatura de EF, aumentando la probabilidad que desarrollen comportamientos activos en un futuro, o actividades extraescolares que refuercen los beneficios de la actividad física en esta población joven

The aim of this study was to examine the effect of the satisfaction and/or boredom of physical education class has over the importance that students give to the class and its relationships with the intention of the future practice of physical activity. 457 students (46% boys and 54% girls), with ages between 12 and 17 (M = 14,10; DT = 0,84) from metropolitan area of Monterrey participated in the study. Three instruments were used: 1) Intrinsic satisfaction in Physical Education, 2) Importance and utility of physical education and 3) Intention to partake in leisure-time physical activity (LTPA). The proposed model was tested through structural equation modeling using LISREL 8.80. Significant and positive relationships of the satisfaction towards the importance of P.E. (b = ,52, p < ,01), and the importance of PE with the intention towards future practice of the LTPA (b = ,44, p < ,01) and significant indirect effect of satisfaction towards intentional future practices of the LTPA (b = ,23, p < ,01). The results obtained in the present study demonstrates the importance of designing new and improved and dynamic PE sessions so that adolescents give value and importance to the PE class, increasing the probability to develop active habits in the future or extra-curricular activities that will reinforce the benefits of physical activity in this adolescent population

O objetivo desse estudo foi examinar o efeito da satisfação e/ou descontentamento na aula de EF sobre a importância que os estudantes atribuem a esta e sua relação com a intenção da prática futura da AF no tempo livre. Participaram 457 estudantes (46 % garotos e 54% garotas) com idades entre 12 e 17 (M = 14,10; DT = 0,84) da zona metropolitana de Monterrey. Se utilizaram três instrumentos: 1) Satisfação Intrínseca na Educação Física; 2) Importância e Utilidade da Educação Física e 3) Intenção de Prática Futura de Atividade Física no Tempo Livre (AFTL). O modelo proposto se provou através de uma modelação de equações estruturais utilizando o LISREL 8.80. Se encontraram relações positivas e significativas da satisfação em relação a importância da EF (b = ,52, p < ,01), e a importância da EF com a intenção de uma pratica futura da AFTL (b = ,44, p < ,01) e um efeito indireto significativo da satisfação sobre a intenção da prática futura da AFTL (b = ,23, p < ,01). Os resultados obtidos no presente trabalho demonstram a importância de desenhar seções de EF inovadoras, dinâmicas e divertidas já que, dessa forma, se consegue que os adolescentes valorizem e deem mais importância as aulas de EF, aumentando a probabilidade de que desenvolvam comportamentos ativos em um futuro ou atividades extraescolares que reforcem os benefícios da atividade física nessa população jovem

Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphene citrate as adjuvants to recombinant follicle-stimulating hormone in controlled ovarian hyperstimulation: a prospective, randomized, blinded clinical trial.

OBJECTIVE: To study the efficacy of the aromatase inhibitor letrozole as adjuvant to recombinant FSH (rFSH) in controlled ovarian hyperstimulation (COH). DESIGN: Prospective, randomized, and blinded clinical study. SETTING: Academic tertiary institute. PATIENT(S): Forty-one patients with unexplained infertility undergoing intrauterine insemination (IUI) therapy were randomized to receive either letrozole or clomiphene citrate (CC) as adjuvants to rFSH. INTERVENTION(S): From day 3 to 7 of the cycle 2.5 mg/d letrozole or 100 mg/d CC were administrated. All patients received 75 IU rFSH starting on day 7 of stimulation until the day of hCG administration. Ovulation was triggered with recombinant hCG (250 microg) when the leading follicle(s) reached 18 mm in diameter. A single IUI was performed 36 hours later. The luteal phase was supplemented with micronized progesterone vaginally. MAIN OUTCOME MEASURE(S): Ovarian stimulation response (E(2) levels and number of follicles) was our primary outcome. RESULT(S): There were no differences in demographic characteristics between groups. Although there was a significantly lower peak serum E(2) level in the group receiving letrozole + rFSH compared with CC + rFSH (914 +/- 187 vs. 1,207 +/- 309 pg/mL, respectively; P<.007), there were no differences in the number of mature (>16 mm) preovulatory follicles. A significantly higher endometrial thickness was observed at the time of hCG administration in patients that received letrozole (9.5 +/- 1.5 mm vs. 7.3 +/- 1.1 mm; P=.0001). The clinical pregnancy rate was similar between groups (23.8% vs. 20%, respectively). CONCLUSION(S): The aromatase inhibitor letrozole appears to constitute a good alternative to CC in patients with unexplained infertility undergoing gonadotropin-stimulated COH cycles combined with IUI therapy.