Valores normativos para la fuerza prensil manual en adultos mayores colombianos estimados mediante regresión cuantílica / Normative values for handgrip strength in Colombian older adults: Estimation by quantile regression

Introducción: La fuerza prensil manual (FPM) es un indicador robusto de la salud biológica de los adultos mayores. Objetivo: El objetivo de este estudio es doble: 1) estimar los valores normativos de la FPM absoluta y relativa, específicos de adultos mayores de 60 años en Colombia, mediante modelos de regresión cuantílica, 2) comparar los valores normativos de la FPM absoluta y relativa en adultos mayores colombianos con los de diferentes países. Métodos: Es un análisis transversal a una muestra de 5.377 adultos mayores. La FPM fue evaluada con un dinamómetro digital TKK 5101 (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). La FPM relativa se estimó a partir de la división por el peso en kilogramos. Los valores normativos de la FPM absoluta y de la relativa, fueron estimados por medio de modelos de regresión cuantílica para los percentiles P5, P10, P25, P50, P75, P90 y P95 desarrollados de manera independiente para cada sexo; todos los análisis fueron ajustados por el factor de expansión. Resultados: Los valores de la FPM absoluta fueron considerablemente mayores en los hombres (P50 60 a 64 años = 32,0kg, P50 > 85 años = 18,0kg) en comparación con las mujeres (P50 60 a 65 años = 19,0kg; P50 > 85 años = 12,0kg), en todos los grupos etarios; adicionalmente, a medida que aumenta la edad en ambos sexos, se presenta una disminución en los valores de la FPM absoluta y relativa. Conclusiones: Los valores normativos estimados en población colombiana fueron generalmente menores a los reportados en otros estudios en todo el mundo. Estos resultados podrían tener relación con la variabilidad en las metodologías utilizadas para evaluar la FPM y los métodos de estimación, los cuales podrían influir en las discrepancias entre los diferentes reportes.(AU)

Introduction: Handgrip strength is a robust indicator of the biological health of elderly. Objective: The purpose of this study is twofold: 1) estimate the normative values of absolute and relative handgrip strength, specific to adults over 60 years of age in Colombia, using quantile regression models: 2) compare the normative values of absolute and relative handgrip strength in Colombian older adults with those from different countries. Methods: A cross-sectional analysis of a sample of 5377 older adults. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). Relative handgrip strength was estimated by dividing by weight in kilograms. The absolute and relative handgrip strength normative values were estimated through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90 and P95, they were developed independently for each sex; all analyzes were adjusted for the expansion factor. Results: Absolute handgrip strength values were considerably higher in men (P50 60–64 years = 32.0 kg, P50 >85 years = 18.0 kg) compared to women (P50 60–65 years = 19.0 kg; P50 >85 years = 12.0 kg), in all age groups. Additionally, as age increases in both sexes, there is a decrease in the values of absolute and relative manual grip strength. Conclusions: The estimated normative values in the Colombian population were generally lower than those reported in other studies around the world. These results could be related with methodologies used variability to evaluate handgrip strength and the estimation methods, which could influence the discrepancies between the different reports.(AU)

[Normative values for handgrip strength in Colombian older adults: Estimation by quantile regression]. / Valores normativos para la fuerza prensil manual en adultos mayores colombianos estimados mediante regresión cuantílica.

INTRODUCTION: Handgrip strength is a robust indicator of the biological health of elderly. OBJECTIVE: The purpose of this study is twofold: 1) estimate the normative values of absolute and relative handgrip strength, specific to adults over 60 years of age in Colombia, using quantile regression models: 2) compare the normative values of absolute and relative handgrip strength in Colombian older adults with those from different countries. METHODS: A cross-sectional analysis of a sample of 5377 older adults. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). Relative handgrip strength was estimated by dividing by weight in kilograms. The absolute and relative handgrip strength normative values were estimated through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90 and P95, they were developed independently for each sex; all analyzes were adjusted for the expansion factor. RESULTS: Absolute handgrip strength values were considerably higher in men (P50 60-64 years = 32.0 kg, P50 >85 years = 18.0 kg) compared to women (P50 60-65 years = 19.0 kg; P50 >85 years = 12.0 kg), in all age groups. Additionally, as age increases in both sexes, there is a decrease in the values of absolute and relative manual grip strength. CONCLUSIONS: The estimated normative values in the Colombian population were generally lower than those reported in other studies around the world. These results could be related with methodologies used variability to evaluate handgrip strength and the estimation methods, which could influence the discrepancies between the different reports.

Niveles de inseguridad alimentaria y características asociadas en mujeres gestantes de Colombia en el 2015 / Food insecurity levels and associated characteristics in pregnant women in Colombia in 2015

Introducción La inseguridad alimentaria es la incapacidad que tienen los hogares para adquirir alimentos inocuos, nutricionalmente adecuados que satisfagan las necesidades fisiológicas de una vida sana y activa. Objetivo Describir los niveles de inseguridad alimentaria y factores asociados en mujeres gestantes de Colombia. Metodología Estudio transversal-analítico; es un análisis secundario de la Encuesta de Situación Nutricional de Colombia del año 2015. Se evaluaron 1393 gestantes de entre 12 y 48 años, mediante la Escala Latinoamericana y Caribeña de Seguridad Alimentaria. Se examinaron características sociodemográficas, antropométricas y micronutrientes. Se realizó la descripción de la distribución de la inseguridad alimentaria por cada una de las variables seleccionadas, a través de frecuencias absolutas y porcentuales. Para estimar la asociación entre las diferentes características de interés y la inseguridad alimentaria se utilizaron modelos de regresión de Poisson multivariados. Resultados El 60,4% (IC95% 55,6-64,7%) de las gestantes residían en hogares con algún grado de inseguridad alimentaria; severa: 9,4% (IC95% 7,4-11,9%); moderado: 17,6% (IC95% 13,5-22,8%) y leve del 33,2% (IC95% 28,9-37,8%). Se encontró que las gestantes en la categoría negra/mulata/afrodescendiente (RP 1,22 IC95% 1,01-1,47), pertenecer al cuartil 1 de riqueza (RP 2,23 IC95% 1,41-3,68) y residir en la región Atlántica (RP 1,34; IC95%; 1,08-1,67) se asociaba con algún grado de inseguridad alimentaria. Conclusión Se identificó una alta proporción de gestantes residentes de hogares con algún grado de inseguridad alimentaria. Las gestantes de los bajos niveles socioeconómicos y aquellas pertenecientes a la etnia negra/mulata/afrodescendiente mostraron ser las principales características asociadas con residir en hogares con algún grado de inseguridad alimentaria (AU)

ntroduction Food insecurity is the inability of households to acquire safe, nutritionally adequate food that meets physiological needs for leading a healthy and active life. Objectiv To describe the levels of food insecurity and associated factors in pregnant women in Colombia. Methodolog Cross-sectional-analytical study; is a secondary analysis of the 2015 Nutritional Situation Survey of Colombia. 1393 pregnant women between 12 and 48 years old were examined. Food insecurity was assessed using the Latin American and Caribbean Food Security Scale. Sociodemographic, anthropometric and micronutrient characteristics were evaluated. The description of food insecurity distribution was made for each of the selected variables, through absolute and percentage frequencies. To estimate the association between the different variables and food insecurity, we used multivariate Poisson regression models. Results 60.4% (CI95% 55.6%–64,7%) of pregnant women resided in homes with some degree of food insecurity; severe: 9.4% (CI95% 7.4%–11.9%), moderate: 17.6% (CI95% 13.5%–22.8%) and light: 33.2% (CI95% 28.9%–37.8%); we found that Black/Mulatto/Afro-descendant pregnant women (PR 1.22 CI95% 1.01–1.47), belong to quartile 1 of wealth (PR 2.23 CI95% 1.41–3.68), and residing in the región Atlántica (PR 1.34 CI95% 1.08–1.67), was associated with some food insecurity level. Conclusion A high proportion of pregnant women living in households with some food insecurity level. The pregnant women of low socioeconomic levels and those belonging to the black/mulatto/Afro-descendant ethnic group showed to be the main characteristics associated with residing in households with some degree of food insecurity (AU)

[Food insecurity levels and associated characteristics in pregnant women in Colombia in 2015]. / Niveles de inseguridad alimentaria y características asociadas en mujeres gestantes de Colombia en el 2015.

INTRODUCTION: Food insecurity is the inability of households to acquire safe, nutritionally adequate food that meets physiological needs for leading a healthy and active life. OBJECTIVE: To describe the levels of food insecurity and associated factors in pregnant women in Colombia. METHODOLOGY: Cross-sectional-analytical study; is a secondary analysis of the 2015 Nutritional Situation Survey of Colombia. 1393 pregnant women between 12 and 48 years old were examined. Food insecurity was assessed using the Latin American and Caribbean Food Security Scale. Sociodemographic, anthropometric and micronutrient characteristics were evaluated. The description of food insecurity distribution was made for each of the selected variables, through absolute and percentage frequencies. To estimate the association between the different variables and food insecurity, we used multivariate Poisson regression models. RESULTS: 60.4% (CI95% 55.6%-64,7%) of pregnant women resided in homes with some degree of food insecurity; severe: 9.4% (CI95% 7.4%-11.9%), moderate: 17.6% (CI95% 13.5%-22.8%) and light: 33.2% (CI95% 28.9%-37.8%); we found that Black/Mulatto/Afro-descendant pregnant women (PR 1.22 CI95% 1.01-1.47), belong to quartile 1 of wealth (PR 2.23 CI95% 1.41-3.68), and residing in the región Atlántica (PR 1.34 CI95% 1.08-1.67), was associated with some food insecurity level. CONCLUSION: A high proportion of pregnant women living in households with some food insecurity level. The pregnant women of low socioeconomic levels and those belonging to the black/mulatto/Afro-descendant ethnic group showed to be the main characteristics associated with residing in households with some degree of food insecurity.

Exposición al humo de segunda mano en adolescentes escolarizados de Tunja, Colombia, 2017 / Exposure to second-hand smoke in school adolescents from Tunja (Colombia), 2017

INTRODUCCIÓN: Los adolescentes expuestos al humo de segunda mano cuentan con mayor riesgo de morbilidad, convirtiéndose en uno de principales problemas de salud pública prevenibles en Latinoamérica. OBJETIVO: Determinar la prevalencia y los factores sociodemográficos asociados a la exposición de cigarrillos de segunda mano, en casa y fuera de ella, en adolescentes escolarizados de Tunja, Colombia. METODOLOGÍA: Estudio descriptivo transversal en 1.100 escolarizados de Tunja, Colombia, entre 11 y 19 años de edad. La información se tomó mediante una encuesta de forma autoadministrada y totalmente anónima. Para el análisis se estimaron proporciones de exposición durante todos los días y el promedio de días de exposición al humo de segunda mano durante una semana tradicional; para las asociaciones se realizaron modelos de regresión logística ordinal y regresión binomial negativa. RESULTADOS: La edad promedio de los participantes fue 14,5 años, con predominio del sexo femenino (59%). La exposición de humo del cigarrillo de segunda mano en casa mostró una prevalencia para todos los días del 4,9%, de 1 a 6 días del 14,7%, con un promedio de exposición de 0,7 días, DS 1,7. Adicionalmente, la prevalencia de exposición al humo de segunda mano fuera de casa reportó frecuencias superiores, donde para todos los días es del 8%, de uno a 6 días del 34,1%, con un promedio de exposición de 1,5 días, DS 2,2. CONCLUSIÓN: La prevalencia de exposición al humo de segunda mano en los adolescentes de Tunja fue alta; se recomiendan intervenciones a nivel escolar y familiar para contrarrestar este problema

INTRODUCTION: Adolescents exposed to second-hand smoke have a higher risk of morbidity. This is one of the main preventable public health problems in Latin America. OBJECTIVE: To determine the prevalence and sociodemographic factors associated with exposure to second-hand tobacco smoke at home and out-of-home, in school adolescents from Tunja-Colombia. METHODOLOGY: This cross-sectional study included 1100 school students, aged between 11 and 19 years. The information was obtained using a self-administered and totally anonymous questionnaire. For the analysis, the proportions of everyday exposure and the mean number of days of exposure to second-hand smoke during a regular week were estimated. For the associations, ordinal logistic regression and negative binomial regression models were performed. RESULTS: The average age of the participants was 14.5 years, with the majority (59%) being female. As regards second-hand tobacco smoke exposure at home, an everyday prevalence of 4.9% was found, from 1 to 6 days of 14.7%, with a mean exposure of 0.7 days (SD 1.7). Additionally, there was a higher prevalence of exposure to second-hand smoke out-of-home: every day 8%, from 1 to 6 days of 34.1%, with a mean exposure of 1.5 days (SD 2.2). CONCLUSION: The prevalence of exposure to second-hand smoke in adolescents of Tunja was high. Interventions at school and family level are recommended to counteract this problem

[Exposure to second-hand smoke in school adolescents from Tunja (Colombia), 2017]. / Exposición al humo de segunda mano en adolescentes escolarizados de Tunja, Colombia, 2017.

INTRODUCTION: Adolescents exposed to second-hand smoke have a higher risk of morbidity. This is one of the main preventable public health problems in Latin America. OBJECTIVE: To determine the prevalence and sociodemographic factors associated with exposure to second-hand tobacco smoke at home and out-of-home, in school adolescents from Tunja-Colombia. METHODOLOGY: This cross-sectional study included 1100 school students, aged between 11 and 19 years. The information was obtained using a self-administered and totally anonymous questionnaire. For the analysis, the proportions of everyday exposure and the mean number of days of exposure to second-hand smoke during a regular week were estimated. For the associations, ordinal logistic regression and negative binomial regression models were performed. RESULTS: The average age of the participants was 14.5 years, with the majority (59%) being female. As regards second-hand tobacco smoke exposure at home, an everyday prevalence of 4.9% was found, from 1 to 6 days of 14.7%, with a mean exposure of 0.7 days (SD 1.7). Additionally, there was a higher prevalence of exposure to second-hand smoke out-of-home: every day 8%, from 1 to 6 days of 34.1%, with a mean exposure of 1.5 days (SD 2.2). CONCLUSION: The prevalence of exposure to second-hand smoke in adolescents of Tunja was high. Interventions at school and family level are recommended to counteract this problem.

Síndrome de fragilidad y factores asociados en adulto mayor indígena de Nariño, Colombia / Frailty syndrome and associated factors in indigenous older adults of Nariño, Colombia

INTRODUCCIÓN: La identificación de adultos mayores con prefragilidad y síndrome de fragilidad es importante, debido a su asociación con el desarrollo de discapacidad, problema prioritario para los sistemas de salud y para su calidad de vida, y las vidas de los cuidadores y de las familias de ese grupo poblacional. OBJETIVO: Estimar la prevalencia y los factores asociados a la prefragilidad y el síndrome de fragilidad en indígenas adultos mayores de Colombia. MATERIAL Y MÉTODO: Estudio descriptivo transversal realizado con 540 indígenas, mayores de 60 años, que pertenecen a las 13 subregiones de la antigua provincia de Obando, en el departamento de Nariño. Se estimó la prevalencia de síndrome de fragilidad y prefragilidad; se evaluaron variables sociodemográficas, deterioro cognitivo, funcionalidad y la presencia de diferentes morbilidades; la asociación se estimó por medio de modelos multivariables de regresión logística multinomial. RESULTADOS: La edad promedio fue 70,68 (DE 6,86), se encontró una prevalencia del síndrome de fragilidad del 32,4 % y una prefragilidad del 58,7 %; quienes tenían síntomas depresivos, aquellos con dependencia funcional alterada de acuerdo con el índice de Barthel y los que acusaron tener artrosis o artritis mostraron asociación con el síndrome de fragilidad. CONCLUSIONES: En este análisis se muestra una alta prevalencia de fragilidad en la población de adultos mayores indígenas, similar a la registrada en otros países. La fragilidad tiene un gran impacto en la salud, debido a su fuerte asociación con enfermedades musculoesqueléticas, depresión y discapacidad

INTRODUCTION: The identification of pre-frailty and frailty syndrome in older adults is important due to its association with the development of disability. It is a priority problem for health systems and quality of life of older adults, caregivers, and relatives. OBJECTIVE: To determine the prevalence and associated factors of pre-frailty and frailty syndrome in indigenous older adults from Colombia. MATERIAL AND METHOD: A cross-sectional study was conducted that included 540 indigenous over 60 years of age who belong to the 13 sub-regions of the Obando province in Nariño, Colombia. The prevalence of frailty and pre-frailty syndrome was determined, we evaluated sociodemographic variables, cognitive deterioration, functionality, and the presence of different morbidities. Associations were estimated using multivariate multinomial logistic regression models. RESULTS: The mean age was 70.68 (SD 6.86). The prevalence of frailty syndrome was 32.4%, and pre-frailty syndrome was 58.7%. Having depressive symptoms, those with altered functional dependence according to the Barthel index, and those who reported having arthrosis or arthritis, showed an association with frailty syndrome. CONCLUSION: This analysis shows a high prevalence of frailty syndrome in the population of indigenous older adults. This was similar to that reported in other countries. Frailty has a great impact on health due to its strong association with musculoskeletal diseases, depression, and disability

[Frailty syndrome and associated factors in indigenous older adults of Nariño, Colombia]. / Síndrome de fragilidad y factores asociados en adulto mayor indígena de Nariño, Colombia.

INTRODUCTION: The identification of pre-frailty and frailty syndrome in older adults is important due to its association with the development of disability. It is a priority problem for health systems and quality of life of older adults, caregivers, and relatives. OBJECTIVE: To determine the prevalence and associated factors of pre-frailty and frailty syndrome in indigenous older adults from Colombia. MATERIAL AND METHOD: A cross-sectional study was conducted that included 540 indigenous over 60 years of age who belong to the 13 sub-regions of the Obando province in Nariño, Colombia. The prevalence of frailty and pre-frailty syndrome was determined, we evaluated sociodemographic variables, cognitive deterioration, functionality, and the presence of different morbidities. Associations were estimated using multivariate multinomial logistic regression models. RESULTS: The mean age was 70.68 (SD 6.86). The prevalence of frailty syndrome was 32.4%, and pre-frailty syndrome was 58.7%. Having depressive symptoms, those with altered functional dependence according to the Barthel index, and those who reported having arthrosis or arthritis, showed an association with frailty syndrome. CONCLUSION: This analysis shows a high prevalence of frailty syndrome in the population of indigenous older adults. This was similar to that reported in other countries. Frailty has a great impact on health due to its strong association with musculoskeletal diseases, depression, and disability.

LMS tables for waist circumference and waist-height ratio in Colombian adults: analysis of nationwide data 2010.

BACKGROUND/OBJECTIVES: Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). These data are lacking for Colombian adults. This study aims at establishing smoothed centile charts and LMS tables for WC and WHtR; appropriate cutoffs were selected using receiver-operating characteristic analysis based on data from the representative sample. SUBJECTS/METHODS: We used data from the cross-sectional, national representative nutrition survey (ENSIN, 2010). A total of 83 220 participants (aged 20-64) were enroled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles calculated using the LMS method (L (curve Box-Cox), M (curve median), and S (curve coefficient of variation)). Receiver operating characteristics curve analyses were used to evaluate the optimal cutoff point of WC and WHtR for overweight and obesity based on WHO definitions. RESULTS: Reference values for WC and WHtR are presented. Mean WC and WHtR increased with age for both genders. We found a strong positive correlation between WC and BMI (r=0.847, P< 0.01) and WHtR and BMI (r=0.878, P<0.01). In obese men, the cutoff point value is 96.6 cm for the WC. In women, the cutoff point value is 91.0 cm for the WC. Receiver operating characteristic curve for WHtR was also obtained and the cutoff point value of 0.579 in men, and in women the cutoff point value was 0.587. A high sensitivity and specificity were obtained. CONCLUSIONS: This study presents first reference values of WC and WHtR for Colombians aged 20-64. Through LMS tables for adults, we hope to provide quantitative tools to study obesity and its complications.

Analysis and detection of functional outliers in water quality parameters from different automated monitoring stations in the Nalón river basin (Northern Spain).

The purposes and intent of the authorities in establishing water quality standards are to provide enhancement of water quality and prevention of pollution to protect the public health or welfare in accordance with the public interest for drinking water supplies, conservation of fish, wildlife and other beneficial aquatic life, and agricultural, industrial, recreational, and other reasonable and necessary uses as well as to maintain and improve the biological integrity of the waters. In this way, water quality controls involve a large number of variables and observations, often subject to some outliers. An outlier is an observation that is numerically distant from the rest of the data or that appears to deviate markedly from other members of the sample in which it occurs. An interesting analysis is to find those observations that produce measurements that are different from the pattern established in the sample. Therefore, identification of atypical observations is an important concern in water quality monitoring and a difficult task because of the multivariate nature of water quality data. Our study provides a new method for detecting outliers in water quality monitoring parameters, using turbidity, conductivity and ammonium ion as indicator variables. Until now, methods were based on considering the different parameters as a vector whose components were their concentration values. This innovative approach lies in considering water quality monitoring over time as continuous curves instead of discrete points, that is to say, the dataset of the problem are considered as a time-dependent function and not as a set of discrete values in different time instants. This new methodology, which is based on the concept of functional depth, was applied to the detection of outliers in water quality monitoring samples in the Nalón river basin with success. Results of this study were discussed here in terms of origin, causes, etc. Finally, the conclusions as well as advantages of the functional method are exposed.

Estado actual de la investigación y principales barreras para la práctica basada en evidencia en fisioterapeutas colombianos / Current status of research and barriers to evidence-based practice in Colombian physiotherapists

Introducción La práctica basada en la evidencia científica (PBE) se define como un proceso cuyo objetivo es la selección de los mejores argumentos científicos para la resolución de los problemas que se plantean en la práctica clínica. El propósito de este estudio fue evaluar el estado actual de la investigación y las principales barreras para la incorporación del uso de la PBE en fisioterapeutas colombianos. Materiales y métodos Estudio transversal, multicéntrico y descriptivo en 221 fisioterapeutas colombianos sin formación previa en PBE. Se aplicó una encuesta de 18 ítems divida en 3 apartados diferenciados: a) información de la titulación; b) aplicación de PBE, y c) áreas y líneas de desempeño profesional e investigativo. Adicionalmente, se reunieron datos de información sociodemográfica. Resultados El promedio de edad fue 26,6 ± 6,1 años; el 76% de los encuestados tenían titulación profesional y solo el 3,2% nivel de maestría. Un 43,4% de los encuestados buscan información en fuentes primarias y secundarias, mientras que el 28,5% respondió nunca hacerlo. El 55,7% usaban búsquedas mediante Altavista, Google, Hotbot y Lycos, y solo un 13% usaba Tesauros. El 48,9% respondía haber realizado estudios de tipo descriptivo, el 10,4% experimentales y el 3,2% de casos y controles. Un 10,9% de los encuestados desarrollaba proyectos en cuidado crítico, el 7,2% en enfermedad articular y el 4,5% en enfermedad neurológica. Conclusión El estudio confirma la escasa actividad científica y las barreras que limitan la inclusión de la PBE en profesionales de fisioterapia de Colombia. Múltiples estrategias de cambio serán necesarias para facilitar la inclusión de actividades encaminadas a la mejora de la competencia profesional en esta materia (AU)

Introduction Scientific evidence based practice (SEBP) is defined as a process whose objective is the selection of the best scientific arguments to solve the problems occurring in the clinical practice. This study has aimed to evaluate the current status of the investigation and the principal barriers existing for the Columbian physiotherapists to incorporate SEBP. Material and methods A cross-sectional, multicenter and descriptive study was performed in 221 Colombian physiotherapists with no previous training in SEBP. An 18-item survey divided into 3 differentiated sections was applied. These sections were: 1) degree information, 2) application of SEBP and 3) areas and lines of professional and investigational work. In addition, sociodemographic information data were collected. Results Average age was 26.6 ± 6.1 years; 76% of those surveyed had a professional degree and only 3.2% a master's degree. A total of 43.4% of those surveyed looked for information in primary and secondary sources while 28.5% stated they never did so. Searcy was performed in Altavista, Google, Hotbot, Lycos by 55.7% and only 13% used Tesauros. 48.9% stated they had carried out descriptive type studies, 10.4% experimental and 3.2% case-controls. Of those surveyed, 10.9% developed projected in critical care, 7.2% in articular disease and 4.5% in neurological disorder. Conclusion This study confirms the scarce scientific activity and barriers that limit including SEPB in physiotherapy professionals in Colombia. Multiple strategies of change will be necessary to facilitate the inclusion of activities aimed at the improvement of professional expertise in this material(AU)

Detection of outliers in water quality monitoring samples using functional data analysis in San Esteban estuary (Northern Spain).

Water quality controls involve large number of variables and observations, often subject to some outliers. An outlier is an observation that is numerically distant from the rest of the data or that appears to deviate markedly from other members of the sample in which it occurs. An interesting analysis is to find those observations that produce measurements that are different from the pattern established in the sample. Therefore, identification of atypical observations is an important concern in water quality monitoring and a difficult task because of the multivariate nature of water quality data. Our study provides a new method for detecting outliers in water quality monitoring parameters, using oxygen and turbidity as indicator variables. Until now, methods were based on considering the different parameters as a vector whose components were their concentration values. Our approach lies in considering water quality monitoring through time as curves instead of vectors, that is to say, the data set of the problem is considered as a time-dependent function and not as a set of discrete values in different time instants. The methodology, which is based on the concept of functional depth, was applied to the detection of outliers in water quality monitoring samples in San Esteban estuary. Results were discussed in terms of origin, causes, etc., and compared with those obtained using the conventional method based on vector comparison. Finally, the advantages of the functional method are exposed.

[Statistical analysis of the influence of the virus of papilloma human in the development of the vesical carcinoma]. / Análisis estadístico de la influencia del virus del papiloma humano en el desarrollo del carcinoma vesical.

INTRODUCTION: The bladder cancer is an important disease by its morbi-mortality and its multifactorialidad. At the moment, between the possible aetiology agents that they have been indicated is the infection by the virus of papilloma human (VPH). The objective study is to analyse, by meta-analysis, the relationship between bladder cancer and infection by human papillomavirus. MATERIAL AND METHODS: We made a search in the electronic data base MEDLINE of the articles published until September of the 2004 that relate the infection of the VPH to the bladder tumors. Of 414 listed articles, we selected 38 articles. RESULTS: The articles were classified in two groups, according to they use or non methods based on the detection of the DNA. In articles based on the detection of the DNA, it was that the global proportion from the cases that had contact with the virus, through the detection of the genome was of the 19.4% (95% CI 0.160 to 0.228). Of the total of studies based on the detection of the DNA 8 were selected, to show to a group defined control, in which, the OR was investigated. If we combined the ORs, we obtain an OR estimation of 3.2 (95% CI 1.19 to 8.60) and p = 0.02. CONCLUSIONS: Most of these studies showed the relation rose at the beginning of the study. Although the majority lacked a group defined control, is possible to analyze the value of the Odds global ratio due to the homogenous behaviour of the studies with defined cases and controls affluent. This demonstrated to association between VPH and the bladder cancer.

Análisis estadístico de la influencia del virus del papiloma humano en el desarrollo del carcinoma vesical / Statistical analysis of the influence of the virus of pailoma human in the development of the vesical carcinoma

Introducción: El carcinoma de vejiga es una enfermedad importante por su morbi-mortalidad y su multifactorialidad. Actualmente, entre los posibles agentes etiológicos que se han señalado, se encuentra la infección por el virus del papiloma humano (VPH). El objetivo del estudio es analizar, mediante la realización de un meta-análisis, la relación existente entre el cáncer vesical y la infección por el virus del papiloma humano. Material y métodos: Realizamos una búsqueda en la base de datos electrónica MEDLINE de los artículos publicados hasta septiembre del 2004 que relacionan la infección del VPH con los tumores vesicales. De los 414 artículos listados, seleccionamos 38 artículos. Resultados: Los artículos se clasificaron en dos grupos, según empleen o no métodos basados en la detección del ADN. En los artículos basados en la detección del ADN, resultó que la proporción global de los casos que tuvieron contacto con el virus, a través de la detección del genoma fue del 19,4% (IC 95%: 0,160-0,228). Del total de estudios basados en la detección del ADN se seleccionaron 8, por mostrar un grupo control definido, en los cuales, se investigó la OR. Si combinamos las ORs, obtenemos una OR estimada de 3,2 (IC al 95% de 1,19 a 8,60) y una p=0,02. Conclusiones: La mayor parte de estos estudios pusieron de manifiesto la relación planteada al inicio del estudio. Aunque la mayoría carecían de un grupo control definido, es posible analizar el valor de la Odds ratio global debido al comportamiento homogéneo de los estudios con casos y controles bien definidos. Esto demostró una asociación entre VPH y el cáncer de la vejiga

Introduction: The bladder cancer is an important disease by its morbi-mortality and its multifactorialidad. At the moment, between the possible aetiology agents that they have been indicated is the infection by the virus of papilloma human (VPH). The objective study is to analyse, by meta-analysis, the relationship between bladder cancer and infection by human papillomavirus Material and methods: We made a search in the electronic data base MEDLINE of the articles published until September of the 2004 that relate the infection of the VPH to the bladder tumors. Of 414 listed articles, we selected 38 articles. Results: The articles were classified in two groups, according to they use or non methods based on the detection of the DNA. In articles based on the detection of the DNA, it was that the global proportion from the cases that had contact with the virus, through the detection of the genome was of the 19.4% (95% CI 0.160 to 0.228). Of the total of studies based on the detection of the DNA 8 were selected, to show to a group defined control, in which, the OR was investigated. If we combined the ORs, we obtain an OR estimation of 3.2 (95% CI 1.19 to 8.60) and p=0.02. Conclusions: Most of these studies showed the relation rose at the beginning of the study. Although the majority lacked a group defined control, is possible to analyze the value of the Odds global ratio due to the homogenous behaviour of the studies with defined cases and controls affluent. This demonstrated to association between VPH and the bladder cancer

[Renal cell carcinoma in patient with situs inversus and Kartagener syndrome]. / Carcinoma de células renales en paciente con situs inversus y síndrome de Kartagener.

A case of a adenocarcinoma renal in a patient with situs inversus complete to which was associated bronchiectasis and chronic sinusitis (kartagener's syndrome) is reported. It is the third case described in the international literature of a renal cells carcinoma in a patient with situs inversus totalis and the first in patient the one which has the triada classic of the kartagener's syndrome plus sterility. The tumor was discovered in a way incidental upon accomplishing a TAC toracoabdominal and was solved through nefrectomia for lumbotomy approach.

Carcinoma de células renales en paciente con situs inversus y síndrome de Kartagener / Renal cell carcinoma in a patient with situs inversus and Kartagener's syndrome

Se presenta el caso de un adenocarcinoma renal en un paciente con situs inversus completo al que se asociaban bronquiectasias y sinusitis crónica (síndrome de Kartagener). Es el tercer caso descrito en la literatura internacional de un carcinoma de células renales en un paciente con situs inversus total y el primer en el que el paciente tiene la triada clásica del síndrome de Kartagener más esterilidad. El tumor se descubrió de forma incidental al realizar un TAC toraco-abdominal y se resolvió mediante nefrectomía por vía lumbotómica (AU)

[Bacterial content of the enucleated prostate gland]. / Contenido bacteriano de la glándula prostática enucleada.

OBJECTIVE: To determine the prevalence of prostatic colonization or infection in patients undergoing prostatic surgery for obstructive symptoms due to benign hyperplasia of the prostate (BPH), to identify and quantitate the microorganisms isolated in quantitative bacterial tissue cultures, and to determine the influence of open surgery vs endoscopy on the microbiological findings. METHODS: A prospective study was conducted on 175 patients undergoing surgery for BPH. All patients were entered into a study protocol that included quantitative bacterial cultures of prostatic tissue. Data of previously defined variables were entered into a data base for subsequent analysis comprised of redefinition of the variables and descriptive and analytical studies. RESULTS: 44 of the 175 patients (25.1%) had a positive bacterial culture of prostatic tissue. Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%), regardless of the presence or absence of bacteria. Of these 68 patients with histologically demonstrated prostatic inflammation, only 19 (27.9%) had a positive prostatic tissue culture. The incidence of granulomatous prostatitis was 1.1%. CONCLUSIONS: The presence of bacteria was demonstrated in prostates of a significant number of patients (25.1%) undergoing prostatectomy for BPH. The microorganisms most frequently isolated in the quantitative bacterial cultures were, by order of frequency, coagulase negative Staphylococci, Escherichia coli and Enterococcus faecalis, which were present in concentrations of at least 10(4) CFU/Gm in prostatic tissue of 79.6% of the cases. No differences were found between the type of procedure the patient underwent and the presence or absence of prostatic infection.

[Inflammatory changes in the obstructed prostate: the correlation between the bacteriological and histological findings]. / Cambios inflamatorios en la glándula prostática obstructiva: correlación entre los hallazgos bacteriológicos e histológicos.

OBJECTIVES: To analyze the incidence and nature of the prostatic inflammatory changes, to determine the prevalence of prostatic colonization or infection in patients undergoing surgery for benign hyperplasia of the prostate (BPH) and to correlate the inflammatory lesions with the bacteriological findings. METHODS: A prospective study was conducted on 175 patients undergoing surgery for BPH. All patients were entered into a study protocol that included quantitative bacterial cultures of the prostatic tissue and histological analyses of the surgical specimens. Data of previously defined variables were entered into a data base for subsequent analysis comprised of a descriptive and an analytical study. RESULTS: 44 of the 175 patients (25.1%) had a positive bacterial culture of prostatic tissue. Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%), regardless of the presence or absence of bacteria. Of these 68 patients with a histologically demonstrated inflammation of the prostate, only 19 (27.9%) had positive prostatic tissue cultures. The incidence of granulomatous prostatitis was 1.1%. CONCLUSIONS: Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%). The presence of bacteria was demonstrated in the prostates of a significant number of patients (25.1%) who underwent adenomectomy for BPH. No differences were found between the patients with a positive or negative bacterial culture and histological evidence of prostatitis.

[Relationship between preoperative urine cultures and prostatic gland cultures in patients treated for benign prostatic hyperplasia]. / Relación entre los cultivos de orina preoperatorios y los cultivos de la glándula prostática en pacientes intervenidos de HBP.

OBJECTIVES: 1.--Investigate the bacteriuria preoperative in patients who will be operate on for Being Prostatic Hyperplasia (BPH). 2.--Define the prevalence of the prostatic colonization or infection. 3.--Try to correlate the bacteriological findings of urine and prostate, and find the degree of concordance between the microorganisms which can be commonly found in urine and prostatic tissue. METHOD AND MATERIALS: Prospective series of 175 patients undergoing prostatectomy for obstructive symptoms. The protocol revealed, among others variables: the preoperative urine culture; the presence or the absence of catheter; and the quantitative bacteriological culture of prostatic tissue. The information could be analised and its results could be obtained later on. The analysis stages consisted of both a descriptive and an analytic study. RESULTS AND CONCLUSIONS: 1.--Only 36 patients (20.6%) presented bacteriological increase of microorganisms (> or = 10(4) UFC/ml) in the preoperative urine culture. The Escherichia coli was the most common microorganism, followed by the Enterococcus faecalis, coagulase-negative Staphylococcus and the Pseudomona aeruginosa. A single microorganism grew in 31 out of the 36 positive cultures. 2.--The prevalence of the infection or colonization of the prostatic tissue was 25.1% (44 patients). The most common isolated microorganism was the coagulase-negative Staphylococcus followed by the Escherichia coli and the Enterococcus faecalis, in concentrations of at least 10(4) UFC/gr of tissue in the 79.6%. A single microorganism was isolated in 32 out of 44 patients. 3.--The proportion of positive prostatic cultures, in patients with positive urine culture (38.3%), was significantly higher than the one obtained in patients with negative urine cultures (16.5%) (p < 0.0001). Nevertheless, 52.3% of the 44 patients with positive prostatic cultures had negative urine culture, and only 21 (58.3%) out of the 36 patients with positive urine cultures presented a bacteriological growth in prostate. The degree of concordance (Kappa index) between the microorganisms which were found in preoperative urine and prostatic tissue is low or none for the majority of them.

[Liposarcoma of the spermatic cord: a report of a new case and a review of the literature]. / Liposarcoma de cordón espermático: aportación de un nuevo caso y revisión de la literatura.

Malignant paratesticular tumors are uncommon. Of these, liposarcoma of the spermatic cord constitutes a rare tumor. Only a hundred cases have been reported. They are typically presented in elderly people. The usually have a good prognosis because of their low level of malignancy and their relapses tend to be localized. It has a high rate of survival over 5 years. Preoperative diagnosis is infrequent, it is suggested by the appearance of a progressively enlarging mass in the scrotum and the ultrasonography which shows a solid mass of the spermatic cord that is independent of the testicle. The choice treatment is radical orchidectomy, while long-term follow-up of these patients is mandatory because of local relapses. When local relapses become evident, the choice treatment is extensive local excision followed by adjuvant radiotherapy. In the present study we report a new case of a recurring, well differentiated spermatic cord liposarcoma of the type sclerotic, in a 50-year-old man. An exhaustive review of the literature has been made.