Neck Circumference Cut-Off Points for Identifying Adiposity: Association with Chronic Metabolic Diseases in Older People.

BACKGROUND: The leading cause of death in older people is cardiovascular diseases. Several studies have found that neck circumference (NC) is a simple anthropometric marker associated with adiposity. The aim of this study is to estimate and validate NC cut-off points as adiposity markers and analyze their association with cardiovascular and chronic metabolic diseases in older people. METHODS: A cross-sectional study in 358 non-disabled, community-dwelling older people (71.7 ± 3.9 years) living in Santiago de Chile and participating in the HTSMayor study was conducted. Measurements of body composition and cardiovascular risks were evaluated. Receiver operating characteristic (ROC) curves and multiple logistic regression models were used to evaluate the association of NC with cardiovascular and chronic metabolic diseases. NC cut-off points were obtained to predict obesity, abdominal obesity, and adiposity. RESULTS: The best performance values of neck circumference relative to obesity and adiposity were obtained with respect to abdominal obesity (40.6 cm in men and 34.2 cm in women). Higher NC values were associated with a higher area under the curve (AUC) for men and women (men: AUC = 0.84; women: AUC = 0.86). NC was significantly associated with a higher risk for diabetes mellitus (OR = 1.95), hypertension (OR = 2.42), acute myocardial infarction (OR = 4.36), and comorbidities (OR = 2.01), and a lower risk for sarcopenia (OR = 0.35). CONCLUSIONS: This study shows that NC is a useful tool for detecting abdominal obesity, obesity, and adiposity in older people and that a higher NC increases the risk of chronic diseases.

Proximal and fatty acid analysis in Ostrea chilensis, Crassostrea gigas and Mytilus chilensis (Bivalvia: Mollusca) from southern Chile.

Oysters and blue mussels are important hydrobiological resources for aquaculture. In Chile, they are farming on the Chiloé island, where around 18% of the world's mussels are produced, however, their nutritional dynamics are largely unknown. For this reason, the objective of this study was to determine the proximal biochemical composition and the fatty acid profile in the Chilean oyster (Ostrea chilensis), the Pacific oyster (Crassostrea gigas) and the Chilean mussel (Mytilus chilensis), to perform an intra and interspecific comparison. Shellfish sampled in winter were characterized by a high protein content, followed by medium values for lipid content and a low carbohydrate content compared to similar species in Europe. Also, oysters and mussels were found to be rich in omega-3 long chain polyunsaturated fatty acid (n-3 LC-PUFA), so they can be considered excellent functional food option for a healthy human diet. Their high contribution of n-3 LC-PUFA ranged between 5.2-12.9 µg FA mg-1 dry weight with high n-3/n-6 ratios, which depends on both the species and the on-growing location. Both taxa can be considered a plausible option to promote a healthy diet of marine origin in future generations. Also, these results could benefit the projection and development of aquaculture of these mollusks.

Contrasting Patterns of Genetic Diversity and Divergence Between Landlocked and Migratory Populations of Fish Galaxias maculatus, Evaluated Through Mitochondrial DNA Sequencing and Nuclear DNA Microsatellites.

Galaxias species are interesting biogeographic models due to their distribution and different types of life cycles, with migratory and landlocked populations. To obtain a better understanding of the genetic consequences of the Quaternary glacial cycles in Galaxias maculatus, in this work we compared landlocked and migratory populations collected in areas that were differentially affected by ice advances and retreats. We included nine populations of G. maculatus, four collected from lakes (landlocked) and five from their associated estuaries/rivers (migratory) in three estuary-lake systems across southern Chile. Genetic analyses were performed using the mitochondrial control region and nine microsatellite loci. Genetic diversity measured with both markers was significantly higher in migratory than in landlocked populations across the study area. The levels of genetic differentiation showed higher differentiation among lakes than estuaries. Genetic diversity was higher in migratory populations located in areas that were less impacted by ice during Quaternary glacial processes. These results may be the consequence of recent recolonization of small freshwater bodies following the Last Glacial Maximum (LGM). Finally, the greatest differentiation was observed in populations that were exposed to continental ice advances and retreats during the LGM. Thus, in the present work we corroborate a pattern of differentiation between lakes and estuaries, using mtDNA sequences and microsatellite nuclear markers. This pattern may be due to a combination of biological factors, i.e., resident non-migratory behaviour or landlocking and natal homing-in, as well as geological factors, i.e., Expansion-Contraction Quaternary glacial biogeographic processes.

Feeding response and dynamic of intoxication and detoxification in two populations of the flat oyster Ostrea chilensis exposed to paralytic shellfish toxins (PST).

Juvenile oysters (Ostrea chilensis) from two populations (Quempillén estuary and Pullinque bay) were exposed to a toxic diet containing paralytic shellfish toxins (PST), produced by Alexandrium catenella, followed by a detoxification period. Feeding behaviour, toxin profile, dynamics of intoxication/detoxification, and survival were evaluated over the entire experimental period. Both populations reduced their feeding rates during the 30-day exposure to the toxic diet. This negative effect was reversible when the diet was switched to the non-toxic one. Oysters from the estuary accumulated PST more rapidly than the population from the bay, suggesting their increased ability to cope with more adverse conditions. Both populations showed low detoxification capacity. Survival was significantly higher in oysters from the estuary, compared to those from the bay. Due to the increasing frequency and intensity of A. catenella blooms in southern Chile, it is necessary to better understand the responses of O. chilensis in different environments. This is important not only because of the ecological and commercial relevance of the bivalve, but also in consideration of expected climate change scenarios, where the new environmental conditions could favour the frequency and intensity of harmful algal bloom events.

Non-Contact Video-Based Assessment of the Respiratory Function Using a RGB-D Camera.

A fully automatic, non-contact method for the assessment of the respiratory function is proposed using an RGB-D camera-based technology. The proposed algorithm relies on the depth channel of the camera to estimate the movements of the body's trunk during breathing. It solves in fixed-time complexity, O(1), as the acquisition relies on the mean depth value of the target regions only using the color channels to automatically locate them. This simplicity allows the extraction of real-time values of the respiration, as well as the synchronous assessment on multiple body parts. Two different experiments have been performed: a first one conducted on 10 users in a single region and with a fixed breathing frequency, and a second one conducted on 20 users considering a simultaneous acquisition in two regions. The breath rate has then been computed and compared with a reference measurement. The results show a non-statistically significant bias of 0.11 breaths/min and 96% limits of agreement of -2.21/2.34 breaths/min regarding the breath-by-breath assessment. The overall real-time assessment shows a RMSE of 0.21 breaths/min. We have shown that this method is suitable for applications where respiration needs to be monitored in non-ambulatory and static environments.

Terapia Estrogénica y Prevención Cardiovascular Primaria / Estrogen Therapy and Primary Cardiovascular Prevention

Antecedentes La terapia hormonal de la menopausia (THM) corresponde a la administración de hormonas exógenas para el tratamiento de síntomas asociados a climaterio y menopausia. Objetivo Analizar los estudios que dicen relación a THM y riesgo cardiovascular (CV) para entender el concepto de ventana de oportunidad cardiovascular, además analizar la fisiología de los estrógenos en el aparato CV es fundamental para una adecuada comprensión de su rol protector. Método revisión de la literatura disponible en PubMed durante octubre de 2018, utilizando los términos "menopausal hormone therapy'' y ''cardiovascular disease'.Además se revisó base de datos Scielo con los términos "terapia hormonal'', ''menopausia'' y ''cardiovascular''; se escogieron artículos entre 2000 y 2018 con los términos utilizados en el título o resumen. También se realizó búsqueda dirigida de estudios relevantes, guías clínicas, un metanálisis, una revisión sistemática relacionada y las últimas publicaciones de sociedades científicas dela especialidad. Resultados Desde los inicios de la THM se observó en distintos estudios observacionales un papel en la protección CV. Los últimos años se ha ido demostrando a través de diversos estudios aleatorizados, a raíz de las dudas que dejó el WHI de 2002, los beneficios de esta. Conclusión La THM mejora la calidad de vida de las mujeres en climaterio y menopausia. Los estrógenos tienen mejor beneficio sobre enfermedad CV al administrar terapia precozmente luego de la menopausia (ventana de oportunidad) y mantenerla durante un tiempo prolongado de acuerdo a estudios observacionales y aleatorizados. Dado el aumento de la esperanza de vida de la mujer y múltiples FR CV, es que el manejo clínico de la postmenopausia es un relevante problema de salud pública.

SUMMARY Background Menopausal hormone therapy (MHT) is the exogenous administration for climacteric and menopausal treatment. Objective To analyze studies in relation to THM and cardiovascular (CV) risk, to understand the ''cardiovascular window of opportunity'' concept, also, to analyze the physiology of estrogens into cardiovascular system is fundamental for a suitable comprehension of its protective role. Method Review of literature available on PubMed during October 2018, using the terms "menopausal hormone therapy" and "cardiovascular disease." In addition, Scielo database with the terms ''hormone therapy'', ''menopause'' and '' cardiovascular'' was reviewed; Articles were chosen between 2000 and 2018 with the terms used in the title or summary. A directed search of relevant studies, clinical guides, one meta-analysis, one related systematic review and the latest publications of scientific societies of the specialty was also conducted. Results Since beginning of MHT, a role in CV protection has been observed in different observational studies. Recent years have been demonstrated through various randomized studies, following the doubts left by the WHI of 2002, the benefits of MHT. Conclusion MHT improves the quality of life of women in climacteric and menopausal. Estrogen have better benefit on CV disease, by administering early therapy after menopausal and maintaining it for a long time. Given the women increase in life expectancy and multiple CV risk factors, clinical management of postmenopausal is a relevant public health problem.

[Management of severe ulcerative colitis: An up-to-date]. / Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada.

Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy. In patients without response, cytomegalovirus infection must be quickly ruled out to escalate to second line therapy with biological drugs or cyclosporine. Total colectomy must not be delayed if there is no response to second line therapy, if there is a contraindication for second line therapies or there are complications such as: megacolon, perforation or massive bleeding. An active management with quick escalation on therapy allows to decrease the prolonged exposure to corticoids, reduce colectomy rates and its perioperative complications.

Diagnóstico y manejo de colitis ulcerosa grave: una mirada actualizada / Management of severe ulcerative colitis: an up-to-date

Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy. In patients without response, cytomegalovirus infection must be quickly ruled out to escalate to second line therapy with biological drugs or cyclosporine. Total colectomy must not be delayed if there is no response to second line therapy, if there is a contraindication for second line therapies or there are complications such as: megacolon, perforation or massive bleeding. An active management with quick escalation on therapy allows to decrease the prolonged exposure to corticoids, reduce colectomy rates and its perioperative complications.

Escucha tras las rejas: desafíos y posibilidades de una terapia de grupo psicoanalítica en cárcel de mujeres / Listen behind bars: challenges and opportunities of a psychoanalitical group therapy in women’s prison

En este artículo se describe y analiza una intervención con psicoterapia de grupo de orientación psicoanalítica en la cárcel de mujeres de Santiago de Chile. Se revisan los aspectos metodológicos y éticos del desarrollo de los grupos, reflexionando sobre limitaciones, contribuciones y exigencias que imponen las condiciones de la institución penal al desarrollo un dispositivo grupal. Se analizan como las principales características de los procesos clínicos las dificultades: en el manejo de la confidencialidad; la paulatina asunción de una posición como pacientes –y no de presidiarias- en las participantes; y la disociación presente tanto en el discurso individual como en la dinámica grupal. Finalmente, se discute sobre la relevancia de la posición de escucha del terapeuta, quien debe sortear la demanda institucional de juzgar o re-educar, para permitir los procesos de elaboración de las propias pacientes.

Escucha tras las rejas: desafíos y posibilidades de una terapia de grupo psicoanalítica en cárcel de mujeres / Listen behind bars: challenges and opportunities of a psychoanalitical group therapy in womenÆs prison

En este artículo se describe y analiza una intervención con psicoterapia de grupo de orientación psicoanalítica en la cárcel de mujeres de Santiago de Chile. Se revisan los aspectos metodológicos y éticos del desarrollo de los grupos, reflexionando sobre limitaciones, contribuciones y exigencias que imponen las condiciones de la institución penal al desarrollo un dispositivo grupal. Se analizan como las principales características de los procesos clínicos las dificultades: en el manejo de la confidencialidad; la paulatina asunción de una posición como pacientes ûy no de presidiarias- en las participantes; y la disociación presente tanto en el discurso individual como en la dinámica grupal. Finalmente, se discute sobre la relevancia de la posición de escucha del terapeuta, quien debe sortear la demanda institucional de juzgar o re-educar, para permitir los procesos de elaboración de las propias pacientes.(AU)

[Prevalence of metabolic syndrome among Chilean adults]. / Prevalencia de sindrome metabólico en población adulta chilena: Datos de la Encuesta Nacional de Salud 2003.

BACKGROUND: There are several diagnostic criteria for Metabolic Syndrome (MS) definition. AIM: To study their application in the Chilean general adult population. MATERIAL AND METHODS: We analyzed data from a random sub sample of 1.833 adults aged 17 years and older surveyed during the First Chilean National Health Survey conducted in 2003. The prevalence of MS was estimated using the update Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF 2005) criteria. The distribution of MS was analyzed according to age, gender, educational level, geographic area, obesity and sedentary lifestyle. RESULTS: The overall prevalence of MS was 31.6% (95% CI 28.5-34.9) and 36.8% (95% CI 33.5-40.3), according to update ATPIII-NCEP and IDF criteria respectively. Both criteria had a 90% concordance. Demographic and socioeconomic distribution was similar for both criteria. The prevalence of high blood pressure, high fasting glucose, and low HDL cholesterol (MS components) were: 46, 22 and 53% respectively. The prevalence of abnormal waist circumference was 30 and 59% according to update ATPIII-NCEP and IDF criteria, respectively. Using update ATPIII-NCEP criteria, the gender, age and educational level adjusted odds ratio (OR) for having MS was 9.59 (95% IC 6.8-13.6) for obese subjects compared with normal weight subjects and 2.14 (95% IC 1.3-3.7) for sedentary subjects compared with non sedentary. CONCLUSIONS: There was a 90% agreement between update ATPIII-NCEP and IDF criteria for the diagnosis of MS. The overall prevalence of MS in this population was 32% usuing update ATPIII-NCEP criteria, with higher prevalence among obese and sedentary subjects.