Modified Talk Test: a Randomized Cross-over Trial Investigating the Comparative Utility of Two "Talk Tests" for Determining Aerobic Training Zones in Overweight and Obese Patients.

BACKGROUND: To validate the traditional talk test (TTT) and an alternative talk test (ATT; using a visual analog scale) in overweight/obese (OW-OB) patients and to establish its accuracy in determining the aerobic training zones. METHODS: We recruited 19 subjects aged 34.9 ± 6.7 years, diagnosed with overweight/obesity (BMI 31.8 ± 5.7). Every subject underwent incremental cycloergometric tests for maximal oxygen consumption, and TTT in a randomized order. At the end of each stage during the TTT, each subject read out loud a 40 words text and then had to identify the comfort to talk in two modalities: TTT which consisted in answering "Yes," "I don't know," or "No" to the question Was talking comfortable?, or ATT through a 1 to 10 numeric perception scale (visual analog scale (VAS)). The magnitude of differences was interpreted in comparison to the smallest worthwhile change and was used to determine agreement. RESULTS: There was an agreement between the power output at the VAS 2-3 of ATT and the power output at the ventilatory threshold 1 (VT1) (very likely equivalent; mean difference - 1.3 W, 90% confidence limit (CL) (- 8.2; 5.6), percent chances for higher/similar/lower values of 0.7/99.1/0.2%). Also, there was an agreement between the power output at the VAS 6-7 of ATT and the power output at the ventilatory threshold 2 (VT2) (very likely equivalent; mean difference 11.1 W, 90% CL (2.8; 19.2), percent chances for higher/similar/lower values of 0.0/97.6/2.4%). CONCLUSIONS: ATT is a tool to determine exercise intensity and to establish aerobic training zones for exercise prescription in OW-OB patients.

The Use of Concentrates Rich in Orange By-Products in Goat Feed and Its Effects on Physico-Chemical, Textural, Fatty Acids, Volatile Compounds and Sensory Characteristics of the Meat of Suckling Kids.

We analysed how replacing cereal concentrates with dehydrated orange pulp (DOP) in the diet of mother goats affects the meat quality of suckling kids. Three experimental diets for mother goats were designed. The DOP-0 diet contained commercial concentrates and alfalfa hay. In the DOP-40 and DOP-80 diets, 40% and 80% (respectively) of the cereal in the concentrate was replaced with pellets of DOP (the alfalfa hay component was unchanged). We evaluated the chemical composition, texture, water holding capacity, colour, fatty acids (FAs) profile, volatile compounds, and sensorial appraisal of the meat from 30 male suckling kids (cold carcass weight 4.74 kg, 4.82 kg, and 4.65 kg for DOP-0, DOP-40, and DOP-80, respectively) of the Payoya breed (n = 10 for each diet). Meat from kids in the DOP-40 and DOP-80 groups exhibited characteristics favourable for human health, including the meat's thrombogenicity index, PUFA/SFA ratio (0.60 index), and n-6 PUFA/n-3 PUFA ratio (approximately 7.50). The meat also exhibited reduced MUFA content (around 460 mg/100 g fresh meat). An increase in ethyl furan, dimethyl disulphide and heptane was observed in grilled meat from goats that were fed using DOP. The inclusion of DOP in goat feed improved consumers' sensory appreciation of the kid's meat.

Experiencia quirúrgica de 10 años de cáncer gástrico en un hospital de tercer nivel, 2007-2016 / Ten year surgical experience with gastric cancer at a third level of care hospital, 2007-2016

Objetivo. Caracterización de los pacientes con cáncer gástrico, evaluación del resultado quirúrgico y supervivencia. Materiales y métodos. Se trata de un estudio descriptivo, de tipo serie de casos, cuyos datos fueron recolectados y analizados en el programa SPSS™, versión 21. Resultados. Se incluyeron 358 pacientes. El síntoma más común fue la epigastralgia (72,9 %) y, según la clasificación macroscópica de Bormann, el tipo III fue el más frecuente (62,8 %). En el estudio de histopatología, predominó el tipo intestinal (52,2 %). En el 77,9 % de los casos, el procedimiento se practicó con laparotomía y, en el 22,1 %, con laparoscopia. Las intervenciones quirúrgicas fueron: gastrectomía total (36,9 %), gastrectomía subtotal (32,4 %), gastroyeyunostomía (8,9 %), laparotomía exploratoria (17 %) y laparoscopia diagnóstica (4,7 %). En 39 % de los pacientes se encontraron metástasis en otros órganos. Solo en 4,7 % se presentó alguna complicación intraoperatoria y, en 9,1 %, alguna posoperatoria. El promedio del tiempo quirúrgico fue de 122 minutos y la estancia hospitalaria fue de 8,7 días. Durante el seguimiento, fallecieron 131 (36,6 %) pacientes y 34,1% presentaron recaída. Mediante la prueba de ji al cuadrado, se encontró una relación estadísticamente significativa entre el tipo de cirugía y el estadio de la lesión (p=0,007), entre el tipo según la clasificación de Bormann y el grado de diferenciación (p=0,008), y entre según la clasificación de Bormann y la mortalidad (p=0,000). Se elaboró una curva de supervivencia mediante el método de Kaplan-Meier, obteniéndose un log rank de 0,010. Conclusiones. El cáncer gástrico sigue siendo muy común en nuestro medio. Se diagnostica en estadios muy avanzados, lo que imposibilita su manejo integral, disminuye la supervivencia y, en muchas ocasiones, imposibilita el manejo quirúrgico por compromiso tumoral avanzado

Objective: Observation of characterization of patients with gastric cancer, evaluation of surgical outcome and survival. Materials and methods: Descriptive study, observational, data collected and analyzed with the statistical program SPSS version 21. Results: We included 358 patients, the most common symptom being epigastric pain in 72.9%. The most common macroscopic classification was Bormann III, 62.8%. In the histopathology study the intestinal type predominated, with 52.2% of the cases. In 77.9% of the patients, the operative procedure was performed by laparotomy and in 22.1% by laparoscopy. The surgical interventions performed were: total gastrectomy 36.9%, followed by subtotal gastrectomy 32.4%, gastrojejunostomy 8.9%, exploratory laparotomy 17%, diagnostic laparotomy 4.7%. Metastases in other organs were encountered in 39%. An intraoperative complication occurred only in 4.7%, and some postoperative complication in 9.1% of the patients. The average operating time was 122 minutes, the hospital stay 8,7 days; 131 patients died during follow-up, corresponding to 36.6%, and 34.1% relapsed. Chi-square test was performed, finding a statistically significant relationship between the type of surgery and the stage of the lesion (p=0.007), between the Bormann classification and mortality (p=000), the degree of differentiation (p=0.008), Borman and mortality (p=0.000). A survival curve was performed according to the Kaplan Meier method obtaining a log rank of 0.010. Conclusions: Gastric cancer continues to be a very common pathology in our environment. It is diagnosed in advanced stages, which makes the integral management of this pathology impossible, decreasing survival and, in many cases, the impossibility of surgical management due to the advanced tumor compromise

Prevalence of catheter-related haemodialysis infections in Hospital Universitario San Rafael, Bogotá, Colombia / Prevaléncia de infección asociada a catéter de hemodiálisis en el Hospital Universitario Clínica San Rafael

Abstract Introduction: Catheter-associated infection is an entity with multiple complications, a condition that alters the quality of life of all patients on hemodialysis. The aim was to estimate the prevalence of infection associated with intravascular hemodialysis devices at the San Rafael Clinical University Hospital over a period of two years, as well as to evaluate the associated infectious complications, readmissions and death in the study population. Methodology: Cross-sectional study of association in which the totality of hemodialysis patients attended in the institution during 2015 and 2016 was included. The analysis is presented in descriptive terms and associations of demographic variables and other outcomes with infection. Results: The prevalence of catheter-associated infection was 5.62%. A total of 320 patients were included, 18 with catheter-associated infection. The most common germ was methicillin susceptible Staphylococcus aureus with 61.1% of cases. There is a statistically significant association with septic thrombosis and the need for admission to the ICU (p = 0.0000).

Resumen Introducción: la infección asociada a catéter es una condición con múltiples complicaciones y altera la calidad de vida de todo paciente en hemodiálisis. En este estudio, se pretendió estimar la prevalencia de infección asociada a dispositivos intravasculares de hemodiálisis en el Hospital Universitario Clínica San Rafael, en un periodo de dos años, y evaluar las complicaciones infecciosas asociadas, reingresos y muerte en la población en estudio. Metodología: estudio transversal de asociación en el que se incluyó la totalidad de pacientes en hemodiálisis atendidos en la institución durante los años 2015 y 2016. El análisis se presenta en términos descriptivos y asociaciones de variables demográficas y otros desenlaces con infección. Resultados: la prevalencia de infección asociada a catéter fue de 5,62 %. Se incluyeron 320 pacientes en total, 18 con infección asociada a catéter. El germen más común fue Estafilococo aureus metilcilino sensible, 61,1 % de los casos. Existe una asociación estadísticamente significativa entre la trombosis séptica y la necesidad de ingreso a UCI (p 0,0000).

Actualización de los hábitats larvarios de Aedes aegypti (Diptera: Culicidae) en Camagüey, Cuba / Updating the larval habitats of Aedes aegypti (Diptera: Culicidae) in Camagüey, Cuba

Resumen:Actualmente varias enfermedades de origen vectorial tienen una gran relevancia médico-veterinaria, debido a las adaptaciones que han desarrollado las especies involucradas en su transmisión. Se llevó a cabo una encuesta entomológica durante 2013 con el objetivo de actualizar los conocimientos ecológicos de las poblaciones de Aedes aegypti presentes en tres Áreas de Salud de Camagüey, Cuba. Se cuantificó en cada depósito o receptáculo positivo las larvas y pupas según ubicación en las viviendas, determinando el porcentaje de representatividad. Se calculó el Índice Pupal por Depósitos específicos (ÍPDe). Los totales de viviendas así como los depósito permanentes y útiles positivos fueron comparados entre estaciones climáticas, utilizando la prueba no paramétrica de Chi2 en tablas de contingencia de 2 X 2, mientras que la relación existente entre el total de viviendas positivas y los depósitos positivos permanentes y útiles, fue explorada a través del test de proporciones de hipótesis, con un nivel de significación de P ≤ 0.05. A. aegypti colonizó 73 tipos de depósitos siendo permanentes y útiles el 23.2 %. Este número incluyó el 76 % de los depósitos positivos. Hubo mayor colecta en el exterior en tanques bajos y toneles con importante producción pupal (ÍPDe = 3.04 y 1.75, respectivamente), así como diferencias significativas durante la estación lluviosa al comparar el número de viviendas positivas (PUIA: Chi2 = 32.89; P = 0.00; PUE: Chi2 = 127.44; P = 0.00 and PUJAM: Chi2 = 127.44; P = 0.00), y depósitos permanentes y útiles (PUIA: Chi2 = 30.37; P = 0.00; PUE: Chi2 = 37.26; P = 0.00 and PUJAM: Chi2 = 81.82; P = 0.00). Estos datos refuerzan la prioridad que tienen en las acciones de vigilancia y control, por la comunidad en sus respectivas viviendas.

Abstract:Several illnesses of vectorial origin have a great medical and veterinary relevance, due to the adaptations developed by the species involved in their transmission. To support preventive programs with updated ecological information of A. aegypti populations, an entomological survey was carried out in three Health Areas of Camagüey, Cuba, during low and high rain seasons of 2013. For this, we assessed the type and number of positive containers, quantified larvae and pupae in positive containers, according to the container location in or outside the house. Both the container representativeness percentage and the pupal index by specific containers were calculated (PIsC). The total of houses as well as the positive habitual-use and non-disposable containers were compared among weather seasons, using the non parametric Chi2 test. The existent relationship between the total of positive houses and the habitual-use and non-disposable container was explored through the test of proportions hypothesis, with a level of significance of P ≤ 0.05. A. aegypti colonized 73 different types of containers, being habitual-use and non-disposable a 23.2 %. This number included 76 % of the positive containers. The greatest larvae collections were obtained in exterior water tanks and barrels, with important pupal production (PIsC = 3.04 and 1.75, respectively), and as well as significant differences towards the rainy season respect to positive houses (PUIA: Chi2 = 32.89; P = 0.00; PUE: Chi2 = 127.44; P = 0.00 and PUJAM: Chi2 = 127.44; P = 0.00), and the habitual-use and non-disposable container (PUIA: Chi2 = 30.37; P = 0.00; PUE: Chi2 = 37.26; P = 0.00 and PUJAM: Chi2 = 81.82; P = 0.00). These data reinforce the priority given to the control and surveillance actions conducted by the community in their respective houses. Rev. Biol. Trop. 64 (4): 1487-1493. Epub 2016 December 01.

[Updating the larval habitats of Aedes aegypti (Diptera: Culicidae) in Camagüey, Cuba]. / Actualización de los habitats larvarios de Aedes aegypti (Diptera: Culicidae) en Camagüey, Cuba.

Several illnesses of vectorial origin have a great medical and veterinary relevance, due to the adaptations developed by the species involved in their transmission. To support preventive programs with updated ecological information of Ae. aegypti populations, an entomological survey was carried out in three Health Areas of Camagüey, Cuba, during low and high rain seasons of 2013. For this, we assessed the type and number of positive containers, quantified larvae and pupae in positive containers, according to the container location in or outside the house. Both the container representativeness percentage and the pupal index by specific containers were calculated (PIsC). The total of houses as well as the positive habitual-use and non-disposable containers were compared among weather seasons, using the non parametric Chi2 test. The existent relationship between the total of positive houses and the habitual-use and non-disposable container was explored through the test of proportions hypothesis, with a level of significance of P ≤ 0.05. Ae. aegypti colonized 73 different types of containers, being habitual-use and non-disposable a 23.2 %. This number included 76 % of the positive containers. The greatest larvae collections were obtained in exterior water tanks and barrels, with important pupal production (PIsC = 3.04 and 1.75, respectively), and as well as significant differences towards the rainy season respect to positive houses (PUIA: Chi2 = 32.89; P = 0.00; PUE: Chi2 = 127.44; P = 0.00 and PUJAM: Chi2 = 127.44; P = 0.00), and the habitual-use and non-disposable container (PUIA: Chi2 = 30.37; P = 0.00; PUE: Chi2 = 37.26; P = 0.00 and PUJAM: Chi2 = 81.82; P = 0.00). These data reinforce the priority given to the control and surveillance actions conducted by the community in their respective houses.

Feasibility of use of fatty acid and triacylglycerol profiles for the authentication of commercial labelling in Iberian dry-cured sausages.

In the present study, fatty acid and triacylglycerol profiles were used to evaluate the possibility of authenticating Iberian dry-cured sausages according to their label specifications. 42 Commercial brand 'chorizo' and 39 commercial brand 'salchichón' sausages from Iberian pigs were purchased. 36 Samples were labelled Bellota and 45 bore the generic Ibérico label. In the market, Bellota is considered to be a better class than the generic Ibérico since products with the Bellota label are manufactured with high quality fat obtained from extensively reared pigs fed on acorns and pasture. Analyses of fatty acids and triacylglycerols were carried out by gas chromatography and a flame ion detector. A CP-SIL 88 column (highly substituted cyanopropyl phase; 50 m × 0.25 mm i.d., 0.2 µm film thickness) (Varian, Palo Alto, USA) was used for fatty acid analysis and a fused silica capillary DB-17HT column (50% phenyl-50% methylpolysiloxane; 30 m × 0.25 mm i.d., 0.15 µm film thickness) was used for triacylglycerols. Twelve fatty acids and 16 triacylglycerols were identified. Various discriminant models (linear quadratic discriminant analyses, logistic regression and support vector machines) were trained to predict the sample class (Bellota or Ibérico). These models included fatty acids and triacylglycerols separately and combined fatty acid and triacylglycerol profiles. The number of correctly classified samples according to discriminant analyses can be considered low (lower than 65%). The greatest discriminant rate was obtained when triacylglycerol profiles were included in the model, whilst using a combination of fatty acid and triacylglycerol profiles did not improve the rate of correct assignation. The values that represent the reliability of prediction of the samples according to the label specification were higher for the Ibérico class than for the Bellota class. In fact, quadratic and Support Vector Machine discriminate analyses were not able to assign the Bellota class (0%) when combined fatty acids and triacylglycerols were included in the model. The use of fatty acid and triacylglycerol profiles to discriminate Iberian dry-cured sausages in the market according to their labelling information is unclear. In order to ensure the genuineness of Iberian dry-cured sausages in the market, identification of fatty acid and triacylglycerol profiles should be combined with the application of quality standard traceability techniques.

[Data availability and morbidity profile in Colombia]. / Disponibilidad de datos y perfil de morbilidad en Colombia.

OBJECTIVE: To characterize morbidity in the Colombian population by diagnosis, sex, age, region, and health coverage system, and evaluate the availability and quality of information on diseases in the country. A descriptive, cross-sectional study to analyze morbidity treated in outpatient visits, hospitalization, and emergencies in Colombia during the 2004-2008 five-year period. METHODS: Based on Colombia's personal health records (Registro Individual de Prestación de Servicios-RIPS), diagnoses were classified according to World Health Organization cause groups. Each cause group for services utilization was differentiated by geographical region, sex, and type of affiliation to the health system. RESULTS: Communicable disease diagnoses were more concentrated in younger age groups, while noncommunicable diseases were more frequent in older age groups. External causes (accidents, self-inflicted injuries, and violence) were a major cause of morbidity and more frequently affected the population aged 5-44 years. Communicable diseases were more prevalent in females (39.98%) than in males (28%), while males were more affected by external causes than females (18.5% and 7.3%, respectively). CONCLUSIONS: Although diagnoses of noncommunicable diseases have increased in Colombia, infections continue to have an important presence in all age groups and health services delivery settings. This situation requires a review of health policies, not only to orient them toward improving the health of the population, but also toward bridging the services gap that exists among the country's different regions. Furthermore, although RIPS are a valuable source of health data, they need to be strengthened with a view to achieving information coverage for all or at least the vast majority of Colombians.

Disponibilidad de datos y perfil de morbilidad en Colombia / Data availability and morbidity profile in Colombia

OBJETIVO: Caracterizar la morbilidad de la población colombiana según causas diagnósticas, género, edad, región y régimen de cobertura en salud, evaluando al mismo tiempo la disponibilidad y la calidad de la información sobre enfermedades en el país. Estudio de tipo descriptivo, transversal, que analiza la morbilidad atendida en consulta externa, hospitalización y urgencias en Colombia durante el quinquenio 2004-2008. MÉTODOS: Se utilizaron los "Registros individuales de prestación de servicios" (RIPS) de Colombia, clasificándose los diagnósticos según los grupos de causas definidos por la Organización Mundial de la Salud. Cada grupo de causas para utilización de servicios se discriminó por región geográfica, género y régimen de afiliación al sistema de salud. RESULTADOS: Los diagnósticos de enfermedades transmisibles se encontraron más concentrados en los grupos de edad inferiores, mientras que las no transmisibles fueron más frecuentes en los grupos etarios superiores. Las externalidades (accidentes, lesiones autoinfligidas y violencia) fueron una causa importante de morbilidad y afectaron con más fuerza a la población de entre 5 y 44 años de edad. Las patologías transmisibles fueron más prevalentes en mujeres (39,98 por ciento) que en hombres (28 por ciento), en tanto que los hombres se vieron más afectados por las externalidades que las mujeres (18,5 y 7,3 por ciento, respectivamente). CONCLUSIONES: Si bien en Colombia han aumentado los diagnósticos de enfermedades no transmisibles, las infecciones siguen teniendo una presencia relevante en todos los grupos de edad y escenarios de prestación de servicios de salud. Tal situación exige revisar las políticas sanitarias para orientarlas no solo a mejorar la salud de la población sino también a reducir la brecha de servicios que existe entre las diferentes regiones del país. Por otro lado, aun cuando los RIPS constituyen una valiosa fuente de datos sanitarios, es preciso fortalecerlos...

OBJECTIVE: To characterize morbidity in the Colombian population by diagnosis, sex, age, region, and health coverage system, and evaluate the availability and quality of information on diseases in the country. A descriptive, cross-sectional study to analyze morbidity treated in outpatient visits, hospitalization, and emergencies in Colombia during the 2004-2008 five-year period. METHODS: Based on Colombia's personal health records (Registro Individual de Prestación de Servicios-RIPS), diagnoses were classified according to World Health Organization cause groups. Each cause group for services utilization was differentiated by geographical region, sex, and type of affiliation to the health system. RESULTS: Communicable disease diagnoses were more concentrated in younger age groups, while noncommunicable diseases were more frequent in older age groups. External causes (accidents, self-inflicted injuries, and violence) were a major cause of morbidity and more frequently affected the population aged 5-44 years. Communicable diseases were more prevalent in females (39.98 percent) than in males (28 percent), while males were more affected by external causes than females (18.5 percent and 7.3 percent, respectively). CONCLUSIONS: Although diagnoses of noncommunicable diseases have increased in Colombia, infections continue to have an important presence in all age groups and health services delivery settings. This situation requires a review of health policies, not only to orient them toward improving the health of the population, but also toward bridging the services gap that exists among the country's different regions. Furthermore, although RIPS are a valuable source of health data, they need to be strengthened with a view to achieving information coverage for all or at least the vast majority of Colombians.

The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial.

STUDY DESIGN: Cluster randomized clinical trial. OBJECTIVE: To assess the efficacy of a short education program and short physiotherapy program for treating low back pain (LBP) in primary care. SUMMARY OF BACKGROUND DATA: There is sparse evidence on the effectiveness of education and physiotherapy programs that are short enough to be feasible in primary care. METHODS: Sixty-nine primary care physicians were randomly assigned to 3 groups and recruited 348 patients consulting for LBP; 265 (79.8%) were chronic. All patients received usual care, were given a booklet and received a consistent 15 minutes group talk on health education, which focused on healthy nutrition habits in the control group, and on active management for LBP in the "education" and "education + physiotherapy" groups. Additionally, in the "education + physiotherapy" group, patients were given a second booklet and a 15-minute group talk on postural hygiene, and 4 one-hour physiotherapy sessions of exercise and stretching which they were encouraged to keep practicing at home. The main outcome measure was improvement of LBP-related disability at 6 months. Patients' assessment and data analyses were blinded. RESULTS: During the 6-month follow-up period, improvement in the "control" group was negligible. Additional improvement in the "education" and "education + physiotherapy" groups was found for disability (2.0 and 2.2 Roland Morris Questionnaire points, respectively), LBP (1.8 and 2.10 Visual Analogue Scale points), referred pain (1.3 and 1.6 Visual Analogue Scale points), catastrophizing (1.6 and 1.8 Coping Strategies Questionnaire points), physical quality of life (2.9 and 2.9 SF-12 points), and mental quality of life (3.7 and 5.1 SF-12 points). CONCLUSION: The addition of a short education program on active management to usual care in primary care leads to small but consistent improvements in disability, pain, and quality of life. The addition of a short physiotherapy program composed of education on postural hygiene and exercise intended to be continued at home, increases those improvements, although the magnitude of that increase is clinically irrelevant.

Factores de riesgo de cardiopatía isquémica en la Isla de la Juventud / Ischemic cardiopathy risk factors in the Island of Youth

se realizó una investigación de caso y control en la Isla de la Juventud, durante el año 2005, con el objetivo de identificar la asociación entre los factores de riesgo no modificables, los establecidos y los probables con la cardiopatía isquémica. Material: Se seleccionaron 700 personas; 350 con cardiopatía isquémica y 350 del grupo control. Se emplearon datos de encuestas del Proyecto ISYS, procesamiento estadístico con EPI-INFO 6, Chi cuadrado, nivel de significación para p < 0.05 y estimación del riesgo relativo. Las variables empleadas fueron correspondientes a los riesgos no modificables, los establecidos y los probables. Conclusiones: La cardiopatía isquémica se observó asociada con la presencia de antecedentes patológicos en familiares de primer grado, aumenta con la edad (65-74 años), predominando el sexo femenino; la Diabetes Mellitus y el Sedentarismo, independientemente del sexo; la obesidad y el estrés, con los sexos masculino y femenino respectivamente. Existió relación causal de la hipertensión, la elevación de colesterol total, triglicéridos y LDLc y disminución de las HDLc(AU).

An investigation with cases and control was done in the Island of Youth during 2005 to identify the association among non modifiable, established and probable risk factors with ischemic cardiopathy. Materials: 700 persons were selected, 350 with ischemic cardiopathy and 350 from the control group. Data from the interviews of the ISYS project were used, statistic procedure with EPI-INFO 6, quadrate chi, significant level for p< 0.05 and o-ration estimation. The used variables corresponded to non modifiable, established and probable risks. Conclusions: Ischemic cardiopathy was associated with pathologic antecedents in relatives, it increases with the age (65-75 years), predominating in female sex, Diabetes Mellitus and Sedentarism independently from the sex, the obesity and the stress in males and females respectively. There was causal relation with hypertension, high levels of total cholesterol, triglycerides and LDL and HDL(AU)

Metabolismo Lipoproteico. Estudio por el laboratorio clínico / Lipoprotein metabolism. Study of the clinical laboratory

Se realizó una revisión sobre los aspectos fundamentales del metabolismo lipídico; el ingreso de los distintos tipos de grasas al organismo y su ruta posterior mediante la integración a la formación de complejos macromoleculares. Se muestra el proceso de síntesis endógena de lipoproteínas, así como su maduración progresiva, que determina la transformación desde las lipoproteínas de muy baja densidad, hasta las de densidad intermedia y las de baja densidad, fenómeno que describe una profunda interrelación con las de alta densidad. Se precisa mecanismo de captación mediado por receptores para todos estos compuestos apolipoproteicos, por parte de hepatocitos y células periféricas, todo lo cual influye en la concentración de grasas en la sangre, células periféricas y en el endotelio, constituyendo factores de riesgo o de protección para la formación de placas de ateromas. Se precisan los procederes de laboratorio clínico disponibles para el estudio del metabolismo lipídico(AU)

The principal aspects about the metabolism of the lipids were reviewed; the intake of the different kinds of lipids and their routes in the organism in the conformation of macromolecular complexes. The endogen synthesis process of lipoproteins and their progressive maturation are showed, that determine the transformation from the very low density lipoproteins to low density lipoproteins that involves a big relation with the high density lipoproteins. A receptor-related-mechanism is present in the linking of all apolipoprotein compounds in the surface of hepatic and peripheral cells that determine the fats concentration in blood, and inside the peripheral and endothelial cells, which is regarded as a risk or protector factor in the apparition of the atherosclerotic plaques. The clinic laboratory procedures for studying the metabolism of the lipids are considered(AU).

Enfermedad cardiovascular como causa de ingreso en la unidad de cuidados intensivos de un hospital de campaña / Cardiovascular illness as cause of income in the unit of intensive cares of a field hospital

El 8 de octubre del 2005 la República Islámica de Pakistán sufrió un terremoto de gran intensidad que afectó 28 000 km2. Dejó un saldo de 73 000 muertos, 70 000 heridos graves, 59 000 heridos leves y 3,3 millones de personas sin hogar. La ayuda desinteresada de Cuba no tardó en llegar, se desplegó un Hospital Integral de Campaña en la ciudad de Muzaffarabad (Cachemira Pakistaní). Desde este entorno y sin una referencia previa se realizó este trabajo con el objetivo de determinar el comportamiento de las Enfermedades Cardiovasculares. Se incluyeron 58 pacientes admitidos con el diagnóstico de enfermedad cardiovascular, en el período comprendido entre el 3 de Diciembre de 2005 y el 12 de Mayo del 2006. Se determinó: grupo de edades, sexo, antecedentes patológicos personales, clasificación de la enfermedad, topografía de la cardiopatía isquémica y mortalidad. De los 214 pacientes atendidos, el 27,1por ciento sufrió algún tipo de enfermedad cardiaca, con sólo 15,5por ciento por encima de los 60 años. La cardiopatía isquémica (63,8por ciento) fue la afección más frecuentemente encontrada(AU)

Cirugía de urgencia en un hospital cubano integral de campaña en una zona de desastre / Surgery of urgency in an integral Cuban hospital of campaign in a zone of disaster

El 8 de octubre del 2005 La República Islámica de Pakistán sufrió un terremoto de gran intensidad que afectó 28 000 km2. Dejó un saldo de 73 000 muertos, 70 000 heridos graves, 59 000 heridos leves y 3,3 millones de personas sin hogar. Se realizó un estudio prospectivo, observacional, descriptivo, cuantitativo, de 108 pacientes tratados por Cirugía de Urgencia en un Hospital Cubano Integral de Campaña ubicado en Upper Chatter, ciudad de Muzaffarabad, Cachemira, Pakistán, en el período comprendido entre el 3 de diciembre del 2005 y el 12 de mayo del 2006, con el objetivo de determinar el comportamiento de este tipo de cirugía en una zona de desastre. Las afecciones más frecuentemente tratadas fueron el abdomen agudo quirúrgico, las complicaciones obstétricas que necesitaron cesárea y los lesionados de extremidades. La situación extrema de trabajo en condiciones de campaña no ocasionó un incremento de la morbilidad y mortalidad en la cirugía de urgencia (AU)

La sepsis como motivo de ingreso en una unidad de cuidados intensivos de un hospital de campaña en una ciudad devastada / The sepsis like entrance reason in an unit of intensive cares of a campaign hospital in a desolated city

En los Estados Unidos se presentan 750 000 casos de sepsis grave anualmente, de los cuales 225 000 fallecen, con un costo de 16,7 billones de dólares. Alrededor de 3 400 millones de personas viven en áreas donde al menos un desastre natural puede afectar de forma grave a sus vidas, según el informe Natural Disaster Hotspots: A Global Risk Analysis. Se realizó un estudio prospectivo, observacional, descriptivo, cuantitativo, en el cual se incluyeron todos los pacientes atendidos en la Unidad de Cuidados Intensivos de un Hospital cubano integral de Campaña ubicado en Upper Chatter, Ciudad de Muzaffarabad, Cachemira, Pakistán, en el período comprendido entre el 3 de diciembre del 2005 y el 12 de mayo del 2006, tras un terremoto de gran intensidad, con el objetivo de determinar el comportamiento de la sepsis en este tipo de escenario. La muestra estuvo constituida por los 87 pacientes con diagnóstico como causa del ingreso de algún tipo de sepsis. Se estudiaron diferentes variables como grupo de edades, sexo, sitio de la infección, complicaciones, antimicrobianos más utilizados y mortalidad. Los pacientes más afectados fueron los menores de 15 años y la sepsis respiratoria resultó la de mayor frecuencia, la insuficiencia respiratoria fue la complicación más encontrada y sólo el 14,9 por ciento de los casos sépticos fallecieron(AU)

Morbimortalidad en una unidad de cuidados intensivos de un hospital de campaña en una zona de desastre / Morbimortalidad in an unit of intensive cares of a campaign hospital in a disaster area

Se realizó un estudio prospectivo, observacional, descriptivo y cuantitativo, con 214 pacientes atendidos en la Unidad de Cuidados Intensivos de un hospital integral de campaña ubicado en Upper Chatter, ciudad de Muzaffarabad, Cachemira, Pakistán, en el período comprendido entre el 3 de Diciembre del 2005 y el 12 de Mayo del 2006, tras un terremoto de gran intensidad. El objetivo fue determinar la morbimortalidad en este tipo de unidad de atención al grave. Fueron utilizadas diferentes variables como grupo de edades, sexo, principales diagnósticos al ingreso, procedencia y mortalidad. Los menores de 15 años fueron los de mayor ingreso y los mayores de 65 años sólo aportaron el 7,9 por ciento, la sepsis fue la causa más frecuente (40.7 por ciento) que obligó al ingreso y los ingresos provenientes del servicio de urgencias se correspondieron con el 48.1 por ciento. Se destaca que el 20 por ciento se recibieron de otras instituciones médicas, lo que consolida el criterio de hospital referencial. La mortalidad bruta de la muestra estudiada fue de 8,4 por ciento(AU)