Evaluation of the Effectiveness of Geogrids Manufactured from Recycled Plastics for Slope Stabilization-A Case Study.

This study aimed to investigate the sustainable use of recycled plastics, specifically polypropylene (PP) and high-density polyethylene (HDPE), in the manufacture of geogrids for geotechnical and civil engineering applications. Plastics were collected from a recycling center, specifically targeting containers used for food, cleaning products, and other domestic packaging items. These plastics were sorted according to the Möbius triangle classification system, with HDPE (#2) and PP (#5) being the primary categories of interest. The research methodologically evaluates the mechanical properties of PP/HDPE (0/100, 25/75, 50/50, 75/25 and 100/0% w/w) composites through tensile and flexural tests, exploring various compositions and configurations of geogrids. The results highlight the superiority of pure recycled HDPE processed into 1.3 mm thick laminated yarns and hot air welded for 20 to 30 s, exhibiting a deformation exceeding 60% in comparison to the PP/HDPE composites. Through SolidWorks® Simulation, it was shown that the adoption of a trigonal geogrid geometry optimizes force distribution and tensile strength, significantly improving slope stabilization efficiency. Based on the results obtained, a laboratory-scale prototype geogrid was developed using an extrusion process. The results underscore the importance of careful composite design and yarn configuration selection to achieve the desired mechanical properties and performance in geogrid applications. It emphasizes the potential of recycled plastics as a viable and environmentally friendly solution for stabilizing slopes, contributing to the reduction in plastic waste and promoting sustainable construction practices.

Validation of the Scale of Perceived Risk of Sexually Transmitted Infections in Middle-aged and Older Adults

Background: Middle-aged and older adults often mistakenly underestimate the risk to which they are exposed when they engage in risky sexual behaviors. Furthermore, a reliable and valid measurement of the construct is necessary to capture its scope and meaning. Objective: To validate the structure of the Perceived Risk Scale for STIs in middle-aged and older adults, identify their perceived risk of STIs, and identify their relationship with some sociodemographic characteristics. Methods: The sample was composed of 295 middle-aged and older adults. A virtual online sampling was used. Males and females aged 50 years and older, sexually active in the last 12 months, were included. To measure the perceived risk of STIs, the scale of perceived risk for human immunodeficiency virus (HIV) was adapted, and a confirmatory factor analysis of the proposed three-factor structure was carried out. Results: The proposed structure of the scale was found to present acceptable adjustment rates (X 2= 48.283, p <.001; CFI = .962, RMSEA = .079, GFI = .963, TLI = .938). 28.1% of the participants presented low perceived risk; 46.8%, medium perceived risk; and 25.1%, high perceived risk. Association between marital status and perceived risk of STIs was identified. Conclusion: The Perceived Risk Scale for STIs is a reliable and valid instrument for capturing perceived risk of STIs in middle-aged and older adults. An appropriate measurement is considered important to accurately examine the relationship between perceived risk and behavior.

Antecedentes: Los adultos de mediana y tercera edad suelen subestimar erróneamente el riesgo al que se exponen cuando realizan conductas sexuales de riesgo, además, es necesaria una medición fiable y válida del constructo para captar su alcance y significado. Objetivo: Validar la estructura de la Escala de Riesgo Percibido a las ITS en adultos de mediana y tercera, identificar su riesgo percibido a las ITS e identificar su relación con algunas características sociodemográficas. Métodos: La muestra estuvo compuesta por 295 adultos de mediana y tercera edad. Se utilizó un muestreo virtual en línea. Se incluyeron hombres y mujeres de 50 años o más, se-xualmente activos en los últimos 12 meses. Para medir el riesgo percibido a las ITS se adaptó la escala de riesgo percibido al Virus de Inmunodeficiencia Humana (VIH) y se realizó un análisis factorial confirmatorio de la estructura propuesta conformada por tres factores. Resultados: Se comprobó que la estructura propuesta de la escala presentaba mostró índices de ajuste aceptables (X2 = 48.283, p <.001; CFI = .962, RMSEA = .079, GFI = .963, TLI = .938). El 28.1% de los participantes presentó un riesgo percibido bajo, el 46.8% un riesgo percibido medio y el 25.1% un riesgo percibido alto. Se identificó la asociación entre el estado civil y el riesgo percibido de ITS. Conclusiones: La Escala de Riesgo Percibido de ITS es un instrumento fiable y válido para captar el riesgo percibido a las ITS en adultos de mediana y tercera edad. Se considera importante una medición adecuada para examinar con precisión la relación entre el riesgo percibido y la conducta.

Prevalencia y análisis de factores de infección de sitio quirúrgico en clínica de heridas / Prevalence and Analysis of Surgical Site Infection Factors in Wound Clinic

Introducción: La infección de herida quirúrgica causa altas tasas de morbilidad y repercute sobre los índices de mortalidad. Constituye la primera infección intrahospitalaria entre pacientes quirúrgicos del total de infecciones nosocomiales y la primera entre los pacientes quirúrgicos. Existen factores de riesgo como la clasificación ASA, la diabetes mellitus, la hipertensión arterial y los días de estancia hospitalaria, los cuales influyen en su desarrollo. Objetivo: Determinar la prevalencia de infecciones de sitio quirúrgico por cirugías realizadas en el Hospital Dr. Carlos Canseco de Tampico, ciudad del estado mexicano de Tamaulipas. Métodos: Diseño observacional, analítico, transversal y retrospectivo de 54 pacientes con diagnóstico de infección de sitio quirúrgico. Las variables de estudio se clasificaron como dependientes (género, edad, lugar de origen, días de estancia hospitalaria, peso, índice de masa corporal) e independientes (diagnóstico, procedimiento quirúrgico realizado y clasificación ASA otorgada). Resultados: La población de 40 a 50 años fue la más afectada, con mayor predominancia sobre el género femenino. La Clasificación ASA II y III presentaron mayor prevalencia de infección de sitio quirúrgico, sobre todo en cirugías electivas (28 por ciento). Mientras mayor fue la estancia hospitalaria, mayor fue la probabilidad de desarrollar infección de sitio quirúrgico. Conclusiones: La prevalencia de infección en el sitio quirúrgico en pacientes operados por los distintos servicios quirúrgicos no es similar a la reportada por otros autores. La Clasificación ASA II y III presentaron infección del sitio quirúrgico con más frecuencia, mientras que la comorbilidad más llamativa de este estudio fue el índice de masa corporal como factor de riesgo que no debe pasar desapercibido(AU)

Introduction: Surgical wound infection causes high morbidity rates and impacts mortality rates. It is the first in-hospital infection among surgical patients of all nosocomial infections and the first among surgical patients. There are risk factors that influence its development, such as the ASA classification, diabetes mellitus, arterial hypertension and days of hospital stay. Objective: To determine the prevalence of surgical site infections from surgeries performed at Hospital Dr. Carlos Canseco, of Tampico, a city in the Mexican state of Tamaulipas. Methods: An observational, analytical, cross-sectional and retrospective study was carried out with 54 patients with a diagnosis of surgical site infection. The study variables were classified as dependent variables (gender, age, place of origin, days of hospital stay, weight and body mass index) and independent variables (diagnosis, surgical procedure performed, and given ASA classification). Results: The population aged 40 to 50 years was the most affected, with a greater predominance of the female gender. ASA classification II and III had a higher prevalence of surgical site infection, above all in elective surgeries (28 %). The longer the hospital stay, the higher the probability of developing surgical site infection. Conclusions: The prevalence of surgical site infection in patients operated on by the different surgical services is not similar to that reported by other authors. ASA Classification II and III presented surgical site infection more frequently, while the most remarkable comorbidity in this study was body mass index as a risk factor that should not go unnoticed(AU)

Diabetes Mellitus Y Su Manejo En Escenarios Difíciles / Diabetes mellitus and its management in difficult scenarios

Introducción: la diabetes mellitus se produce por la alteración en el metabolismo de los carbohidratos, su prevalencia viene en aumento debido al incremento en la tasa de obesidad y los cambios en los hábitos nutricionales. En Colombia, alrededor de 8,36 % de la población padece diabetes tipo 2 y menos del 1 % diabetes tipo 1. Metodología: se seleccionaron 51 artículos sobre diabetes y diferentes escenarios clínicos, publicados en su mayoría entre los años 2015-2021. Resultados: en los pacientes con enfermedad hepática crónica, se aumenta la resistencia a la insulina e intolerancia a la glucosa; por esto, deben ser tratados en primera instancia con metformina o insulinas. En los diabéticos el riesgo cardiovascular se incrementa tanto para infarto como para accidente cerebrovascular. En estos, se puede realizar tratamiento con metformina, empagliflozina, entre otros. Los pacientes con falla renal tienen mayor riesgo de hipoglicemia por el metabolismo prolongado de la insulina como consecuencia de la filtración glomerular, en estos son útiles medicamentos como liraglutide y sus similares. Conclusión: existen múltiples escenarios clínicos que se presentan en conjunto con la diabetes mellitus. Se deben tener en cuenta las múltiples comorbilidades de los pacientes al momento de instaurar un tratamiento y sus diferentes determinantes, para garantizar su efectividad.

Introduction: Diabetes mellitus is caused by alterations in carbohydrate metabolism and its prevalence is increasing due to the increase in the rate of obesity and changes in nutritional habits. In Colombia, about 8.36% of the population suffers from type 2 diabetes and less than 1% from type 1 diabetes. Methods: Fifty-one articles were selected, on diabetes and different clinical scenarios, mostly published between 2015-2021. Results: In patients with chronic liver disease, insulin resistance and glucose intolerance are increased; therefore, they should be treated in the first instance with Metformin or Insulin. In diabetics, cardiovascular risk is increased for both infarction and stroke. In these patients, treatment can be performed with Metformin, Empagliflozin, among others. Patients with renal failure have a higher risk of hypoglycemia due to prolonged insulin metabolism as a consequence of glomerular filtration; medications such as Liraglutide and similar drugs are useful in these patients. Conclusion: There are multiple clinical scenarios that occur in conjunction with diabetes mellitus. The multiple comorbidities of patients should be taken into account when instituting treatment and its different determinants to ensure the effectiveness of the treatment to be appropriate for the patients.

Rivaroxaban Monotherapy in Patients with Pulmonary Embolism: Off-Label vs. Labeled Therapy.

Background: The use of rivaroxaban in clinical practice often deviates from manufacturer prescribing information. No studies have demonstrated an association between this practice and improved outcomes. Methods: We used the RIETE registry to assess the clinical characteristics of patients with pulmonary embolism (PE) who received off-label rivaroxaban, and to compare their 3-month outcomes with those receiving the labeled therapy. The patients were classified into four subgroups: (1) labeled therapy; (2) delayed start; (3) low doses and (4) both conditions. Results: From May 2013 to May 2022, 2490 patients with PE received rivaroxaban: labeled therapy­1485 (58.6%); delayed start­808 (32.5%); low doses­143 (5.7%); both conditions­54 (2.2%). Patients with a delayed start were more likely to present with syncope, hypotension, raised troponin levels and more severe abnormalities on the echocardiogram than those on labeled therapy. Patients receiving low doses were most likely to have cancer, recent bleeding, anemia, thrombocytopenia or renal insufficiency. During the first 3 months, 3 patients developed PE recurrence, 4 had deep-vein thrombosis, 11 had major bleeding and 16 died. The rates of major bleeding (11 vs. 0; p < 0.001) or death (15 vs. 1; OR: 22.5; 95% CI: 2.97−170.5) were higher in patients receiving off-label rivaroxaban than in those on labeled therapy, with no differences in VTE recurrence (OR: 1.11; 95% CI: 0.25−6.57). Conclusions: In patients with severe PE, the start of rivaroxaban administration was often delayed. In those at increased risk for bleeding, it was often prescribed at low doses. Both subgroups had a worse outcome than those on labeled rivaroxaban.

Prototipo móvil para fomentar el uso de condón en jóvenes mexicanos: un estudio de caso / Mobile Prototype for the Promotion of Condom Use in Mexican Youth: a Case Study

Se han utilizado aplicaciones móviles para promover el uso del condón que carecen de fundamento teórico y no consideran la opinión de los usuarios en su desarrollo por lo que han sido evaluadas negativamente. El objetivo fue desarrollar y evaluar una aplicación móvil para promover el uso correcto y consistente del condón en jóvenes mexicanos con riesgo de VIH, basado en enfoque de pensamiento de diseño centrado en el usuario. Utilizando metodología cualitativa se realizaron tres fases. En la primera fase, inspiración, se identificaron las necesidades de 9 jóvenes con respecto al uso del prototipo. En la segunda fase, ideación, se transformaron estas necesidades en soluciones y se validaron en 15 jóvenes. En la tercera fase, implementación, se realizó una prueba de usabilidad en otros 15 jóvenes. En conclusión, este enfoque ofreció una solución práctica para el desarrollo de un prototipo móvil para fomentar el uso de condón en jóvenes(AU)

Mobile applications have been used to promote the use of condoms, but those have no theoretical basis and do not consider the opinion of users in their development, which is why they have been evaluated negatively. The objective was to develop and evaluate a mobile application to promote the correct and consistent use of the condom in youth at risk of HIV, based on a user-centered design thinking approach. Using qualitative methodology, three phases were carried out. In the first phase, inspiration, the needs of 9 young people were identified with respect to the use of the prototype. In the second phase, ideation, these needs were transformed into solutions and validated in 15 youths. In the third phase, implementation, a usability test was conducted on other 15 youths. In conclusion, this approach offered a practical solution for the development of a mobile prototype to encourage the use of condoms in young people(AU)

Comparación de la percepción de calidad de vida relacionado con la salud en hombres y mujeres adultos mayores / Comparison of the perception of health-related quality of life between older men and women

Introducción: La calidad de vida relacionada con la salud se entiende como el efecto funcional y anímico que una enfermedad produce en una persona, incluyendo el tratamiento y cómo este proceso es percibido por la persona, el cual puede estar influido por el género.Objetivo: Determinar la percepción de la calidad de vida relacionada con la salud entre hombre y mujeres adultos mayores en la Comarca Lagunera de Coahuila.Método: Estudio cuantitativo y descriptivo de corte transversal. La muestra estuvo conformada por 100 adultos mayores seleccionados a conveniencia en la escuela de Lic. en Enfermería, U.T. de la Universidad Autónoma de Coahuila y un hospital público de la localidad. Los datos se analizaron en el programa SPSS v22 para Mac, se utilizó estadística descriptiva y la prueba U de Mann-Withney.Resultados: El análisis entre el género y la percepción de calidad de vida relacionada con la salud no observó diferencia significativa (U= 922.00, p=.178); sin embargo, al analizar la calidad de vida por dimensiones, existe diferencia significativa en tres componentes que son movilidad física (U= 812.00, p>.05), dolor (U= 816.00, p>.05) y energía (U= 807.50, p>.05).Conclusiones: En la presente investigación, se puede observar que los hombres y mujeres adultos mayores perciben la calidad de vida relacionada a la salud de una forma muy parecida, sin embargo, se encontró diferencia en algunos componentes que desde el punto de vista de los autores están muy ligados al rol social que cumple una mujer o un hombre adulto mayor

Introduction: The quality of life related to health is understood as the functional and emotional effect that a disease produces in a person, including treatment and how this process is perceived by the person, which may be influenced by gender.Objective: To determine the perception of quality of life related to health among men and older women in the Comarca Lagunera of Coahuila.Method: Quantitative and descriptive cross-sectional study. The sample was 100 old adults selected at convenience in the Nursing School, U.T. from the Autonomous University of Coahuila and a public hospital in the town. Data were analyzed in the SPSS v22 program for Mac, descriptive statistics and the Mann-Whitney U test were used.Results: The analysis between gender and health-related quality of life perception did not observe a significant difference (U=922.00, p=.178); However, when analyzing the quality of life by dimensions, there is a significant difference in three components that are physical mobility (U= 812.00, p< .05), pain (U= 816.00, p< .05) and energy (U= 807.50, p< .05).Conclusions: In the present investigation, it can be observed that older men and women perceive the quality of life related to health in a very similar way, however, a difference was found in some components that from the point of view of the authors, they are closely linked to the social role played by a woman or an older adult man

Allostatic load and canine companionship: a comparative study using biomarkers in older adults.

OBJECTIVE: to compare the biomarkers and the allostatic load levels in a sample of older persons with and without canine companionship. METHOD: descriptive and comparative study. Data were collected using a sociodemographic questionnaire and a fasting blood sample. The allostatic load comprised 11 biomarkers that are primary and secondary stress mediators, which arise from the following systems: neuroendocrine, immune, metabolic, cardiovascular and anthropometric. RESULTS: a significant difference was found in two biomarkers: cortisol (t= -3.091, df=104, p=0.003) and total cholesterol (t= -2.566, df=104, p=0.012), in the allostatic load levels between older adults with and without a canine companionship (U= 1714.00, Z= 2.01, p=0.044). By associating the allostatic load level with the canine companionship, there was a higher frequency of older adults with low allostatic load among those who have canine companion, compared with those who do not have canine companionship. (χ2= 3.69, df=1, p= 0.043). CONCLUSION: canine companionship influences health in a positive way, as the allostatic load is lower in older adults who have a dog as companion, in addition to presenting lower levels of cortisol and total cholesterol.

Asociación de obesidad general y abdominal con hipertensión, dislipemia y presencia de prediabetes en el estudio PREDAPS / Association of general and abdominal obesity with hypertension, dyslipidemia and prediabetes in the PREDAPS study

Introducción y objetivos: Algunas medidas antropométricas muestran mayor capacidad que otras para discriminar la presencia de factores de riesgo cardiovascular. Este trabajo estima la magnitud de la asociación de diversos indicadores antropométricos de obesidad con hipertensión, dislipemia y prediabetes (glucemia basal o glucohemoglobina alteradas). Métodos: Análisis transversal de la información recogida en 2.022 sujetos del estudio PREDAPS (etapa basal). Se definió obesidad general como índice de masa corporal ≥ 30 kg/m2 y obesidad abdominal con 2 criterios: a) perímetro de cintura (PC) ≥ 102 cm en varones/PC ≥ 88 cm en mujeres, y b) índice cintura/estatura (ICE) ≥ 0,55. La magnitud de la asociación se estimó mediante regresión logística. Resultados: La hipertensión arterial mostró la asociación más alta con la obesidad general en mujeres (OR = 3,01; IC95%, 2,24-4,04) y con la obesidad abdominal según el criterio del ICE en varones (OR = 3,65; IC95%, 2,66-5,01). La hipertrigliceridemia y los valores bajos de colesterol unido a lipoproteínas de alta densidad mostraron la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,49; IC95%, 1,68-3,67 y OR = 2,70; IC95%, 1,89-3,86) y la obesidad general en varones (OR = 2,06; IC95%, 1,56-2,73 y OR = 1,68; IC95%, 1,21-2,33). La prediabetes mostró la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,48; IC95%, 1,85-3,33) y con obesidad abdominal según el criterio del PC en varones (OR = 2,33; IC95%, 1,75-3,08). Conclusiones: Los indicadores de obesidad abdominal mostraron la mayor asociación con la presencia de prediabetes. La relación de los indicadores antropométricos con hipertensión y con dislipemia mostró resultados heterogéneos (AU)

Introduction and objectives: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). Methods: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30 kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102 cm in men/WC ≥ 88 cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. Results: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). Conclusions: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results (AU)

Allostatic load and canine companionship: a comparative study using biomarkers in older adults / Carga alostática e companhia canina: um estudo comparativo utilizando biomarcadores em idosos / Carga alostática y compañía canina: un estudio comparativo mediante biomarcadores en adultos mayores

ABSTRACT Objective: to compare the biomarkers and the allostatic load levels in a sample of older persons with and without canine companionship. Method: descriptive and comparative study. Data were collected using a sociodemographic questionnaire and a fasting blood sample. The allostatic load comprised 11 biomarkers that are primary and secondary stress mediators, which arise from the following systems: neuroendocrine, immune, metabolic, cardiovascular and anthropometric. Results: a significant difference was found in two biomarkers: cortisol (t= -3.091, df=104, p=0.003) and total cholesterol (t= -2.566, df=104, p=0.012), in the allostatic load levels between older adults with and without a canine companionship (U= 1714.00, Z= 2.01, p=0.044). By associating the allostatic load level with the canine companionship, there was a higher frequency of older adults with low allostatic load among those who have canine companion, compared with those who do not have canine companionship. (χ2= 3.69, df=1, p= 0.043). Conclusion: canine companionship influences health in a positive way, as the allostatic load is lower in older adults who have a dog as companion, in addition to presenting lower levels of cortisol and total cholesterol.

RESUMO Objetivo: comparar os biomarcadores e o nível de carga alostática em uma amostra de idosos com e sem companhia canina. Método: estudo descritivo e comparativo. Os dados foram coletados por meio de uma ficha sociodemográfica e uma amostra de sangue em jejum. A carga alostática incluiu 11 biomarcadores que são mediadores primários e secundários de estresse, os quais são resultantes dos sistemas: neuroendócrino, imune, metabólico, cardiovascular e antropométrico. Resultados: houve diferença significativa em dois biomarcadores: cortisol (t= -3,091; gl=104; p=0,003) e colesterol total (t= -2,566; gl=104; p=0,012), no nível de carga alostática entre os idosos com e sem companhia canina (U= 1714,00; Z= 2,01; p= 0,044). Ao associar o nível de carga alostática com a companhia canina, houve uma maior frequência de idosos com baixa carga alostática naqueles que têm companhia canina, em comparação com aqueles que não têm a companhia canina (χ2= 3,69; gl=1; p=0,043). Conclusão: a companhia canina interfere na saúde de maneira positiva, pois a carga alostática dos idosos que têm um cão como companhia é menor, além de apresentarem uma concentração menor de cortisol e de colesterol total.

RESUMEN Objetivo: comparar los biomarcadores y el nivel de carga alostática en una muestra de adultos mayores con y sin acompañamiento canino. Método: estudio descriptivo, comparativo. Los datos se colectaron mediante una ficha sociodemográfica y una muestra de sangre en ayuno. La carga alostática incluyó 11 biomarcadores que son mediadores primarios y secundarios del estrés, los cuales provienen de los sistemas: neuroendocrino, inmune, metabólico, cardiovascular y antropométrico. Resultados: hubo diferencia significativa en dos biomarcadores: cortisol (t=-3.091, gl=104, p=0.003) y colesterol total (t=-2.566, gl=104, p=0.012), en el nivel de carga alostática entre los adultos mayores con y sin compañía canina (U=1714.00, Z=2.01, p=0.044). Al asociar el nivel de carga alostática con la compañía canina, existió mayor frecuencia de adultos mayores con carga alostática baja en quienes son acompañados por un canino, comparado con aquellos que no tienen acompañamiento canino (χ2=3.69, gl=1, p=0.043). Conclusión: el acompañamiento canino interviene en la salud de forma positiva, ya que es menor la carga alostática de los adultos mayores que tienen un perro como compañía, asimismo, presentan menor concentración de cortisol y colesterol total.

Effects of yoga (pranayama) on lung function and lactate kinetics in sedentary adults at intermediate altitude / Efectos de la práctica de yoga (pranayamas) sobre la función pulmonar y cinética del lactato en adultos sedentarios de altitud intermedia

Abstract Introduction: Clinical evidence-based medicine has found increasing benefits of yoga. Objective: To describe the effects on lung function assessed by rest spirometry -vital forced capacity (VFC), forced expiratory volume in one second (FEV1), and FEV1/VFC ratio- in a group of apparently healthy adults, as well as to explore the effects of pranayama techniques in lactate kinetics. Materials and methods: Quasi-experimental study performed in sedentary adults with no prior experience in yoga practice, who received a stimulus during 12 weeks with a minimum frequency of two sessions per week. They were divided into a yoga group (YG) and a control group (CG). Body composition, blood pressure, heart rate, double product (DP), peripheral oxygen saturation (SpO2), blood lactate (Lacts), hematocrit (Htc) by micromethod, and spirometry were determined before and after a training plan with Pranayama. The variables analyzed were forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1/ FVC ratio. Results: Significant differences were found in FVC, FEV1 and lactate among YG and CG (p<0.05), and before and after the stimulus in the YG (p<0.05). The double product improved in both groups. Conclusions: Targeted practice ofpranayama for 12 weeks improved FVC, FEV1, double product (p <0.05) and lactate production capacity (anaerobic capacity).

Resumen Introducción. La medicina basada en evidencia clínica encuentra cada vez más beneficios del yoga en sus practicantes. Objetivo. Describir los efectos en la función pulmonar y la cinética del lactato ocasionados por la práctica de pranayamas en adultos con apariencia saludable. Materiales y métodos. Se realizó un estudio cuasiexperimental en adultos sedentarios sin experiencia en la práctica de yoga, quienes realizaron un estímulo durante 12 semanas con un frecuencia mínima de dos sesiones por semana. Se dividieron en un grupo de yoga (GY) y un grupo de control (GC). Se determinó composición corporal, presión arterial, frecuencia cardíaca, doble producto (DP), saturación periférica de oxígeno (SpO2), lactato en sangre (Lacts), hematocrito (Htc) por micrométodo, y espirometría previa y posterior a un plan de entrenamiento con pranayamas. Las variables analizadas fueron: capacidad vital forzada (CVF), volumen espiratorio forzado del primer segundo (VEF1) y relación VEF1/CVF. Resultados. Los resultados de la CVF, VEF1 y lactato presentaron diferencias significativas entre el GY y el GC (p<0.05), antes y después del estímulo en el GY (p<0.05). El doble producto mejoró en ambos grupos. Conclusiones. La práctica dirigida de pranayamas durante 12 semanas mejoró la CVF, el VEF1, el doble producto (p<0.05) y la capacidad de producción de lactato (capacidad anaeróbica).

Clinical Outcomes After 1 Year of Augmented Insulin Pump Therapy in Patients with Diabetes in a Specialized Diabetes Center in Medellín, Colombia.

BACKGROUND: Type 1 diabetes can be difficult to control. Augmented pump therapy (CSII-rtCGM) has become an important tool for controlling blood glucose and decreasing hypoglycemia. METHODS: Describe the results 1 year after starting CSII-rtCGM in patients with diabetes in Medellín, Colombia. This is an observational, retrospective study. Patients with type 1 and type 2 diabetes started on CSII-rtCGM between January 2008 and June 2015 were included. Qualitative variables were analyzed as absolute or relative frequencies. Quantitative variables were obtained through central tendency and dispersion according to the normal distribution of the analyzed variable using Kolmogorov-Smirnov. SPSS 19 from IBM was used. RESULTS: Two hundred forty-seven patients were identified, of those 183 were included. The starting HbA1C was 8.7% ± 1.7% and 7.4% ± 0.8% (P < 0.05) 1 year later. 16.5% of patients had been admitted to the hospital before starting CSII-rtCGM, after 1 year the admission rate was 6.0% (P < 0.05). The incidence of severe hypoglycemia at the beginning was 32%, 1 year later it was 7.1%. CONCLUSION: CSII-rtCGM therapy improves glucose control and decreases severe hypoglycemic events and hospital admission rate.

[Nursing Workforce Characteristics and Control of Diabetes Mellitus in Primary Care: a Multilevel Analysis]. / Control de la diabetes mellitus en población adulta según las características del personal de enfermería de atención primaria de la comunidad de Madrid: análisis multinivel.

OBJECTIVE: Nurse activity is determined by the characteristics of nursing staff. The objective was to determine the impact of Primary Health Care (PHC) nursing workforce characteristics on the control of Diabetes Mellitus (DM) in adults. METHODS: Cross-sectional analytical study. Administrative and clinical registries and questionnaire PES-Nursing Work Index from PHC nurses. Participants 44.214 diabetic patients in two health zones within the Community of Madrid, North-West Zone (NWZ) with higher socioeconomic situation and South-West Zone (SWZ) with lower socioeconomic situation, and their 507 reference nurses. Analyses were performed to multivariate multilevel logistic regression models. PRIMARY OUTCOME MEASURE: Poor DM control (figures equal or higher than 7% HbA1c). RESULTS: The prevalence of poor DM control was 40.1% [CI95%: 38.2-42.1]. There was a risk of 25% more of poor control if the patient changed centre and of 27% if changed of doctor-nurse pair. In the multilevel multivariate regression models: in SWZ increasing the ratio of patients over 65 years per nurse increased the poor control (OR=1.00008 [CI95%:1.00006-1.001]); and higher proportion of patients whose Hb1Ac was not measured at the centre contributed to poor DM control (OR=5.1 [CI95%:1.6-15.6]). In two models for health zone, the economic immigration condition increased poor control, in SWZ (OR=1.3 [CI95%:1.03-1.7]); and in NWZ (OR=1.29 [CI95%:1.03-1.6]). CONCLUSIONS: Higher 65 years old patients ratio per nurse, economic immigration condition and a higher proportion of patients whose Hb1Ac was not measured contribute to worse DM control.

OBJETIVO: La actividad de enfermería está condicionada por las características de la plantilla. El objetivo fue determinar cómo afectan las características de la plantilla de enfermería de atención primaria (AP) al control de la diabetes mellitus (DM) en personas adultas. METODOS: Estudio analítico transversal. Instrumentos para la recogida de datos: sistemas de información de AP y cuestionario PES-Nursing Work Index. Participantes: 44.214 pacientes diabéticos en dos zonas de salud de la Comunidad de Madrid: Zona Noroeste (ZNO) con mejor situación socioeconómica y Zona Suroeste (ZSO) con peor situación socioeconómica y los 507 profesionales de enfermería de referencia. Se realizaron análisis multivariantes multinivel de regresión logística. La variable dependiente fue la DM estaba mal controlada (cuando los valores de Hb1Ac eran igual o mayor que 7%). RESULTADOS: La prevalencia DM mal controlada fue de 40,1% (IC95%:38,2-42,1). Existía un riesgo de un 25% más de peor control si el paciente cambiaba de centro de salud y de un 27% si cambiaba de pareja médico de cabaecera y enfermera. En los modelos de regresión logística multivariante multinivel: para la ZSO a mayor ratio de pacientes mayores de 65 años aumentaba el riesgo de mal control (OR=1,00008 [IC95%:1,00006-1,001]); a mayor proporción de pacientes sin seguimiento por centro de salud peor control (OR=5,1 [IC95%:1,6-15,6]). En los dos modelos por zona de salud, la condición de ser inmigrante económico aumentó el riesgo de mal control, ZSO (OR=1,3 [IC95%:1,03-1,7]); y ZNO (OR=1,29 [IC95%:1,03-1,6]). CONCLUSIONES: Son factores de riesgo de tener mal controlada la diabetes mellitus la mayor proporción de pacientes mayores de 65 años por enfermera, ser inmigrante y la proporción de pacientes sin seguimiento.

Control de las diabetes mellitus en población adulta según las características del personal de enfermería de atención primaria de la Comunidad de Madrid: análisis multinivel / Nursing workforce characteristics and control of diabetes mellitus in primary care: a multilevel analysis. Spain

Fundamentos: La actividad de enfermería está condicionada por las características de la plantilla. El objetivo fue determinar cómo afectan las características de la plantilla de enfermería de atención primaria (AP) al control de la diabetes mellitus (DM) en personas adultas. Método: Estudio analítico transversal. Instrumentos para la recogida de datos: sistemas de información de AP y cuestionario PES-Nursing Work Index. Participantes: 44.214 pacientes diabéticos en dos zonas de salud de la Comunidad de Madrid: Zona Noroeste (ZNO) con mejor situación socioeconómica y Zona Suroeste (ZSO) con peor situación socioeconómica y los 507 profesionales de enfermería de referencia. Se realizaron análisis multivariantes multinivel de regresión logística. La variable dependiente fue la DM estaba mal controlada (cuando los valores de Hb1Ac eran ≥ a 7%) Resultados: La prevalencia DM mal controlada fue de 40,1% (IC95%:38,2-42,1). Existía un riesgo de un 25% más de peor control si el paciente cambiaba de centro de salud y de un 27% si cambiaba de pareja médico de cabaecera y enfermera. En los modelos de regresión logística multivariante multinivel: para la ZSO a mayor ratio de pacientes mayores de 65 años aumentaba el riesgo de mal control (OR=1,00008 [IC95%:1,00006-1,001]); a mayor proporción de pacientes sin seguimiento por centro de salud peor control (OR=5,1 [IC95%:1,6-15,6]). En los dos modelos por zona de salud, la condición de ser inmigrante económico aumentó el riesgo de mal control, ZSO (OR=1,3 [IC95%:1,03-1,7]); y ZNO (OR=1,29 [IC95%:1,03-1,6]). Conclusiones: Son factores de riesgo de tener mal controlada la diabetes mellitus la mayor proporción de pacientes mayores de 65 años por enfermera, ser inmigrante y la proporción de pacientes sin seguimiento (AU)

Background: Nurse activity is determined by the characteristics of nursing staff. The objective was to determine the impact of Primary Health Care (PHC) nursing workforce characteristics on the control of Diabetes Mellitus (DM) in adults. Method: Cross-sectional analytical study. Administrative and clinical registries and questionnaire PES-Nursing Work Index from PHC nurses. Participants 44.214 diabetic patients in two health zones within the Community of Madrid, North-West Zone (NWZ) with higher socioeconomic situation and South-West Zone (SWZ) with lower socioeconomic situation, and their 507 reference nurses. Analyses were performed to multivariate multilevel logistic regression models. Primary outcome measure: Poor DM control (figures ≥ 7% HbA1c) Results: The prevalence of poor DM control was 40.1% [CI95%: 38.2-42.1]. There was a risk of 25% more of poor control if the patient changed centre and of 27% if changed of doctor-nurse pair. In the multilevel multivariate regression models: in SWZ increasing the ratio of patients over 65 years per nurse increased the poor control (OR=1.00008 [CI95%:1.00006-1.001]); and higher proportion of patients whose Hb1Ac was not measured at the centre contributed to poor DM control (OR=5.1 [CI95%:1.6-15.6]). In two models for health zone, the economic immigration condition increased poor control, in SWZ (OR=1.3 [CI95%:1.03-1.7]); and in NWZ (OR=1.29 [CI95%:1.03-1.6]). Conclusions: Higher 65 years old patients ratio per nurse, economic immigration condition and a higher proportion of patients whose Hb1Ac was not measured contribute to worse DM control (AU)

Epidemiological characterization of diabetic patients on therapy with continuous subcutaneous insulin infusion and continuous glucose monitoring in real time.

OBJECTIVE: To describe baseline characteristics of diabetic patients who were started on insulin pump and real time continuous glucose monitor (CSII-rtCGM) in a specialized center in Medellin, Colombia. MATERIALS AND METHODS: All patients with diabetes with complete data who were started on CSII-rtCGM between February 2010 and May 2014 were included. This is a descriptive analysis of the sociodemographic and clinical characteristics. RESULTS: 141 of 174 patients attending the clinic were included. 90,1% had type 1diabetes (T1D). The average age of T1D patients at the beginning of therapy was 31,4 years (SD 14,1). 75.8% of patients had normal weight (BMI<25), 21.0% were overweight (BMI 25-30) and 2,3% were obese (BMI>30). The median duration of T1D was 13 years (P25-P75=10.7-22.0). 14,2% of the patients were admitted at least once in the year preceding the start of CSII-rtCGM because of diabetes related complications. Mean A1c was 8.6%±1.46%. The main reasons for starting CSII-rtCGM were: poor glycemic control (50.2%); frequent hypoglycemia, nocturnal hypoglycemia, hypoglycemia related to exercise, asymptomatic hypoglycemia (30.2%); severe hypoglycemia (16.44%) and dawn phenomena (3.1%). CONCLUSION: Baseline characteristics of patients included in this study who were started on CSII-rtCGM are similar to those reported in the literature. The Clinic starts CSII-rtCGM mainly in T1D patients with poor glycemic control, frequent or severe hypoglycemia despite being on basal/bolus therapy.

Caracterización epidemiológica de pacientes diabéticos en terapia con infusión subcutánea continua de insulina y monitorización continua de glucosa en tiempo real / Epidemiological characterization of diabetic patients on therapy with continuous subcutaneous insulin infusion and continuous glucose monitoring in real time

OBJETIVO: Caracterizar los pacientes con diabetes que iniciaron terapia con bomba de insulina y monitorización continua de glucosa en tiempo real (CSII-rtCGM) en un centro especializado de Medellín, Colombia. MATERIALES Y MÉTODOS: Se evaluaron los pacientes con diabetes que recibieron entrenamiento e instalación del dispositivo en el centro entre febrero de 2010 y mayo de 2014. Se realizó un análisis descriptivo de las variables sociodemográficas y clínicas. RESULTADOS: Se incluyeron 141 pacientes de los 174 pertenecientes al programa. El 90,1% tenía diabetes tipo 1 (DT1), siendo la edad promedio al inicio de la terapia de 31,4 años (SD: 14,1). El 75,8% de los pacientes tenía peso normal (IMC < 25), el 21,0% sobrepeso (IMC = 25-30) y el 2,3% era obeso (IMC ≥ 30). La mediana de duración de la enfermedad fue de 13 años (P25-P75 = 10,7-22,0). El 14,2% de los pacientes fueron hospitalizados al menos una vez en el año previo al inicio de la terapia con CSII-rtCGM por causas relacionadas con la diabetes. El promedio de hemoglobina glucosilada era de 8,6% ± 1,46%. Las principales indicaciones para la formulación de CSII-rtCGM fueron: mal control glucémico (50,2%); hipoglucemias frecuentes, nocturnas o asociadas al ejercicio y sin síntomas de alarma (30,2%); hipoglucemias severas (16,44%) y fenómeno del alba (3,1%). CONCLUSIÓN: Las características de los pacientes que inician terapia con CSII-rtCGM son similares a las reportadas en la literatura. Los resultados muestran que el centro especializado inicia esta terapia principalmente en pacientes con DT1 con mal control glucémico a pesar de la terapia intensiva, hipoglucemias leves persistentes o hipoglucemias severas

OBJECTIVE: To describe baseline characteristics of diabetic patients who were started on insulin pump and real time continuous glucose monitor (CSII-rtCGM) in a specialized center in Medellin, Colombia. MATERIALS AND METHODS: All patients with diabetes with complete data who were started on CSII-rtCGM between February 2010 and May 2014 were included. This is a descriptive analysis of the sociodemographic and clinical characteristics. RESULTS: 141 of 174 patients attending the clinic were included. 90,1% had type 1 diabetes (T1D). The average age of T1D patients at the beginning of therapy was 31,4 years (SD 14,1). 75.8% of patients had normal weight (BMI < 25), 21.0% were overweight (BMI 25-30) and 2,3% were obese (BMI > 30). The median duration of T1D was 13 years (P25-P75 = 10.7-22.0). 14,2% of the patients were admitted at least once in the year preceding the start of CSII-rtCGM because of diabetes related complications. Mean A1c was 8.6% ± 1.46%. The main reasons for starting CSII-rtCGM were: poor glycemic control (50.2%); frequent hypoglycemia, nocturnal hypoglycemia, hypoglycemia related to exercise, asymptomatic hypoglycemia (30.2%); severe hypoglycemia (16.44%) and dawn phenomena (3.1%). CONCLUSION: Baseline characteristics of patients included in this study who were started on CSII-rtCGM are similar to those reported in the literature. The Clinic starts CSII-rtCGM mainly in T1D patients with poor glycemic control, frequent or severe hypoglycemia despite being on basal/bolus therapy

Absence of a significant pharmacokinetic interaction between atorvastatin and fenofibrate: a randomized, crossover, study of a fixed-dose formulation in healthy Mexican subjects.

Several clinical trials have substantiated the efficacy of the co-administration of statins like atorvastatin (ATO) and fibrates. Without information currently available about the interaction between the two drugs, a pharmacokinetic study was conducted to investigate the effect when both drugs were co-administered. The purpose of this study was to investigate the pharmacokinetic profile of tablets containing ATO 20 mg, or the combination of ATO 20 mg with fenofibrate (FNO) 160 mg administered to healthy Mexican volunteers. This was a randomized, two-period, two-sequence, crossover study; 36 eligible subjects aged between 20-50 years were included. Blood samples were collected up to 96 h after dosing, and pharmacokinetic parameters were obtained by non-compartmental analysis. Adverse events were evaluated based on subject interviews and physical examinations. Area under the concentration-time curve (AUC) and maximum plasma drug concentration (Cmax) were measured for ATO as the reference and ATO and FNO as the test product for bioequivalence design. The estimation computed (90% confidence intervals) for ATO and FNO combination versus ATO for Cmax, AUC0-t and AUC0-∞, were 102,09, 125,95, and 120,97%, respectively. These results suggest that ATO and FNO have no relevant clinical-pharmacokinetic drug interaction.

[Dengue-related knowledge, attitudes, and practices in primary schools in Tapachula, Chiapas, Mexico]. / Conocimientos, actitudes y prácticas sobre el dengue en las escuelas primarias de Tapachula, Chiapas, México.

OBJECTIVE: To identify dengue-related knowledge, attitudes, and practices among primary school students in Tapachula, Chiapas, Mexico, before and after an educational intervention. METHODS: The study was carried out at 19 randomly selected public primary schools. Surveys of knowledge, attitudes, and practices were conducted before and after educational sessions with fifthand sixth-grade elementary school students. The educational strategy "Escuelas sin mosquitos" ("Schools without Mosquitoes") emphasized the importance of students' participation in taking care of their schools and homes in order to prevent dengue through vector control. RESULTS: Before and after the educational sessions, a total of 3 124 surveys were conducted on the knowledge, attitudes, and practices of 1 562 fifth and sixth-grade students (772 and 790 students, respectively) between 10 and 12 years of age. The students' level of knowledge was significantly higher after the implementation of the educational strategy. In comparison with the fifth-graders, the sixth-grade students both already had and also acquired significantly more knowledge of several aspects of the disease and the vector. In all the schools, there were containers with water identified as potential breeding sites, and in 68% of the schools, these containers tested positive for Aedes aegypti larvae. CONCLUSIONS: It was demonstrated that by implementing an educational strategy, children's knowledge, attitudes, and practices were improved in terms of taking care of their schools and promoting a change of attitude to this disease at home.

Conocimientos, actitudes y prácticas sobre el dengue en las escuelas primarias de Tapachula, Chiapas, México / Dengue-related knowledge, attitudes, and practices in primary schools in Tapachula, Chiapas, Mexico

OBJETIVO: Identificar los conocimientos, actitudes y prácticas sobre el dengue en alumnos de escuelas primarias de Tapachula, Chiapas, México, antes y después de una intervención educativa. MÉTODOS: El estudio se desarrolló en 19 escuelas primarias públicas seleccionadas al azar. Se aplicaron encuestas de conocimientos, actitudes y prácticas antes y después de una estrategia educativa a alumnos de 5º y 6º grado de nivel primario. La estrategia educativa se denominó "Escuelas sin mosquitos" e hizo énfasis en la importancia de la participación de los alumnos en el autocuidado de sus escuelas y hogares para la prevención del dengue mediante el control del vector. RESULTADOS: Se aplicaron 3 124 encuestas de conocimientos, actitudes y prácticas antes y después de la estrategia educativa, a 1 562 alumnos de 5º y 6º grado (772 y 790 alumnos, respectivamente) con edades que oscilaron entre los 10 y los 12 años. El nivel de conocimiento aumentó de manera significativa en comparación con el que los alumnos tenían antes de la estrategia educativa. Los alumnos de 6º grado tenían y adquirieron significativamente más conocimiento sobre varios aspectos de la enfermedad y el vector en comparación a los de 5º grado. En todas las escuelas se hallaron recipientes con agua y 68% de las escuelas tuvieron recipientes positivos para larvas de Aedes aegypti. CONCLUSIONES: Se demostró que mediante la implementación de una estrategia educativa, aumentan el conocimiento, actitudes y prácticas de los niños sobre el autocuidado de sus escuelas y que pueden actuar como promotores del cambio de actitud sobre esta enfermedad en sus hogares.

OBJECTIVE: To identify dengue-related knowledge, attitudes, and practices among primary school students in Tapachula, Chiapas, Mexico, before and after an educational intervention. METHODS: The study was carried out at 19 randomly selected public primary schools. Surveys of knowledge, attitudes, and practices were conducted before and after educational sessions with fifthand sixth-grade elementary school students. The educational strategy "Escuelas sin mosquitos" ("Schools without Mosquitoes") emphasized the importance of students' participation in taking care of their schools and homes in order to prevent dengue through vector control. RESULTS: Before and after the educational sessions, a total of 3 124 surveys were conducted on the knowledge, attitudes, and practices of 1 562 fifthand sixth-grade students (772 and 790 students, respectively) between 10 and 12 years of age. The students' level of knowledge was significantly higher after the implementation of the educational strategy. In comparison with the fifth-graders, the sixth-grade students both already had and also acquired significantly more knowledge of several aspects of the disease and the vector. In all the schools, there were containers with water identified as potential breeding sites, and in 68% of the schools, these containers tested positive for Aedes aegypti larvae. CONCLUSIONS: It was demonstrated that by implementing an educational strategy, children's knowledge, attitudes, and practices were improved in terms of taking care of their schools and promoting a change of attitude to this disease at home.