Asociación entre la dependencia funcional, capacidad funcional y dolor, en personas mayores con artrosis severa de cadera / Association between functional dependence, functional capacity, and pain in older people with severe osteoarthritis of the hip

Antecedentes y objetivo: Determinar si existe asociación entre dependencia funcional, capacidad funcional e intensidad del dolor en personas mayores con artrosis de cadera. Materiales y métodos: Estudio transversal-analítico con reclutamiento consecutivo de 85 individuos. Se evaluó dependencia funcional (índice de Barthel), capacidad funcional (WOMAC) y dolor (escala numérica del dolor). Se determinaron diferencias en capacidad funcional y dolor, según la condición de dependencia funcional. Además, se analizó la correlación entre estas variables. Todos los análisis consideraron un nivel de significación de p<0,05. Resultados: Ochenta y cinco participantes (72,26±5,69 años de edad; 54,12% mujeres) fueron incluidos en el estudio. Los promedios para el índice de Barthel, WOMAC e intensidad del dolor fueron 94,00±9,35; 44,49±17,08 y 6,09±3,12 respectivamente. Del total de participantes 46 fueron clasificados como independientes. El análisis demostró que los participantes clasificados como dependientes presentaron un mayor puntaje en WOMAC-total (p=0,001), WOMAC-dolor (p=0,037), WOMAC-función (p<0,001) y dolor (p=0,010), con tamaños de efecto entre medio y grande. No se encontró diferencias en WOMAC-rigidez (p=0,184). Se encontró una correlación inversa, moderada y significativa entre los puntajes de WOMAC-total (p<0,001), WOMAC-dolor (p=0,007), WOMAC-función (p<0,001) e intensidad del dolor (p=0,002) con el puntaje de dependencia funcional de Barthel, pero no con WOMAC-rigidez (p=0,141). Conclusiones: Los individuos con artrosis de cadera avanzada dependientes funcionalmente tienen una capacidad funcional menor y una intensidad del dolor mayor que los clasificados como independientes. Esta información provee un insumo valioso para clínicos y para la planificación de estrategias de salud.

Background and aim: To determine the association between functional dependence, functional capacity, and pain intensity in older adults with hip osteoarthritis. Methods: Cross-sectional study with a consecutive sampling of 85 participants. Functional dependence (Barthel Index), functional capacity (WOMAC questionnaire), and pain (Numerical Rating Scale) were measured. Differences between functional capacity and pain, depending on functional dependence status were determined. Moreover, correlation analyses were performed between these outcomes. All analyses considered a significance level of p<.05. Results: 85 participants (72.26±5.69 years old; 54.12% women) were included. Mean values for Barthel Index, WOMAC, and pain intensity were 94.00±9.35; 44.49±17.08 and 6.09±3.12, respectively. Of the total participants, 46 were classified as independent. The analysis showed that participants classified as dependent exhibited a higher score in WOMAC-total (p=.001), WOMAC-pain (p=.037), WOMAC-function (p<.001), and pain intensity (p=.01), with medium to high effect sizes. No differences were seen in WOMAC-stiffness (p=.184). An inversed, moderate correlation between the Barthel Index and WOMAC-total (p<.001), WOMAC-pain (p=.007), WOMAC-function (p<.001) and pain intensity (p=.002) were seen, but not in WOMAC-stiffness (p = .141). Conclusion: Functionally dependent older adults with advanced hip osteoarthritis have lower functional capacity and higher pain intensity than those classified as functionally independent. This information provides a valuable insight for clinicians to plan future health strategies.

Frecuencia cardíaca postejercicio aeróbico y anaeróbico en niños con y sin riesgo cardiovascular / Heart rate recovery after aerobic and anaerobic exercise in children with and without cardiovascular risk

Introducción: La obesidad y el sobrepeso constituyen un problema de salud creciente tanto a nivel mundial como nacional. Estas alteraciones se presentan a edades cada vez más tempranas, determinando un importante factor de riesgo cardiovascular (RCV). Dentro de las alteraciones inmediatas, se encuentran anomalías del sistema cardiovascular controladas por el sistema nervioso autónomo. No obstante, la evidencia encontrada es limitada y en su mayoría no considera el ejercicio como método para evaluar la respuesta autonómica, la cual puede ser valorada mediante la recuperación de la frecuencia cardíaca (FCR) postejercicio. Objetivo: Analizar la capacidad de recuperación de la frecuencia cardíaca postejercicio aeróbico y anaeróbico de carácter submáximo en niños con y sin RCV. Metodología: Este es un estudio observacional, descriptivo, de corte transversal. Se incluyó a 49 niños de ambos sexos, entre 10 y 12 a˜nos, de colegios públicos. Se aplicó la prueba pararsesentarse en 30 s (anaeróbica) y la prueba Navetta (aeróbica), previa medición de diversas variables antropométricas por cada grupo. Resultados: No hubo diferencias significativas en la FCR al minuto 1, 2 y 3 postejercicio aeróbico y anaeróbico, entre sujetos con y sin RCV. Los niños sin RCV presentaron mejor rendimiento en la prueba aeróbica que los niños con RCV. Conclusiones: La recuperación de la frecuencia cardíaca no presenta diferencias entre niños con y sin RCV posterior a un ejercicio aeróbico y anaeróbico; sin embargo, los niños sin RCV presentan mayor rendimiento aeróbico que niños con RCV (AU)

Introduction: Obesity and overweight constitute a growing national and worldwide health problem. This problem is progressively developing at younger ages, and has become an important cardiovascular risk factor (CVR). Immediate alterations include deregulations in the cardiovascular system controlled by the autonomic nervous system. Nevertheless, evidence is limited and most studies do not use exercise as a method to assess the autonomic response, which can be measured by heart rate recovery (HRR) after exercise. Objective: To analyze HRR after submaximal aerobic and anaerobic exercise in children with and without CVR. Methodology: This observational, descriptive, cross-sectional study included 49 boys and girls from public schools between the ages of 10 and 12 years. Diverse anthropometric variables were measured in each group. Two tests were applied, the 30-second Sit-to-Stand test (anaerobic) and the Course Navette test (aerobic). Results: No statistical significances at the first, second or third minute after aerobic or anaerobic exercise were found in HRR among participants with and without CVR. Children and teenagers without CVR performed better in the aerobic test. Conclusions: No differences in HRR were found among children and teenagers with or without CVR after aerobic or anaerobic exercise; however, the children without CVR performed better in the aerobic test than children with CVR (AU)

[Impact of domestic violence on reproductive and neonatal health]. / Impacto de la violencia doméstica sobre la salud reproductiva y neonatal.

BACKGROUND: Domestic violence can have an important influence on mother and child health. AIM: To assess the consequences of remote and actual, emotional or physical, domestic violence on the reproductive and newborn health in pregnant women. MATERIAL AND METHODS: A longitudinal epidemiological observation from an Urban Primary Health Care Center from Valdivia, Chile, in 1998. Two cohorts were studied: Pregnant women that experienced domestic violence (index group) and pregnant women not exposed to domestic violence (control group). Women were followed during pregnancy and at labor. The newborn was also assessed. RESULTS: The index group had a higher relative risk (RR) for impending abortion (RR 1.44, 95% confidence interval (CI): 1.07-1.93), hypertensive syndrome of pregnancy (RR 1.5, 95% CI: 1.18-1.96), intrahepatic cholestasis (RR 1.5, 95% CI: 1.1-1.94). Women that experienced violence during pregnancy had a higher risk of urinary tract infection (RR 2.88, 95% CI: 1.28-6.43), intrauterine growth retardation (RR 3.7, 95% CI: 1.77-7.93) and intrahepatic cholestasis. Newborns from the index group had lower weight, size and gestational age. CONCLUSIONS: Domestic violence is associated with hypertension during pregnancy and intrauterine growth retardation. The incorporation of bio-psychological evaluation and monitoring systems could attenuate the consequences of domestic violence.

[Domestic violence and sexuality]. / Violencia doméstica y sexualidad.

BACKGROUND: Women's reproductive health is closely related to the conditions in which intercourse is carried out with the sexual partner. Physical and emotional abuse is expressed as loss of bonds, reduction in self esteem and deterioration in interpersonal relationships. AIM: To assess the effects of domestic violence on pregnant women attitudes towards sexual relations with their partners, and to critically analyze the dependence of these variables on biosociodemographic factors, socioeconomic status and family functioning. MATERIAL AND METHODS: Sixty three pregnant women with a domestic violence background (index group) and 43 women without such background (control group) were subjected to a structured survey including questions about biosociodemographic variables, socioeconomic status, family relations, couple interactions and questions about attitudes towards sexual relations. RESULTS: Domestic violence was caused by the woman's partner or ex partner in 73% of cases. A greater family dysfunction and disturbance in the couple's relation was observed in the index group (p < 0.05). Association tests and multiple correspondence analysis did not show a clear correspondence between variables related to a woman's attitude towards sex relations and the risk of domestic violence. CONCLUSIONS: This quantitative methodology was unable to identify the reasons, interpretations and meanings that women with a background of violence, give to features associated with their sexuality.