Atención médica de body packers en un territorio colombiano / Medical care for body packers in a Colombian territory

Introducción. El número de capturas a los body packers, que son aquellas personas que ingieren paquetes con estupefacientes para tráfico ilegal, ha aumentado paulatinamente. El objetivo de este estudio fue presentar los casos de body packers atendidos en dos instituciones de salud de Florencia, un territorio al sur de Colombia, entre 2003 y 2017. Métodos. Este es un estudio retrospectivo descriptivo. Se hizo un análisis univariado en RStudio y Microsoft Excel® de variables sociodemográficas y clínicas. Se emplearon medidas de tendencia central y dispersión para las variables continuas, frecuencias y proporciones para las variables categóricas. Resultados. Se incluyeron 72 pacientes. La mayoría de los casos fueron reportados entre 2007 y 2012 (77,5 %). La relación entre hombres y mujeres fue de 4,9:1. La edad media fue de 29,1 años. El principal motivo de admisión fue para chequeo médico tras captura por parte de los organismos de seguridad nacional (76,4 %). En 9 de cada 10 admitidos se realizaron estudios de imagen (94,4 %); la principal ayuda diagnóstica fue la radiografía de abdomen simple (84,7 %), con una sensibilidad del 91,6 %. Se realizó manejo expectante en tres de cada cuatro pacientes (74,6 %). El 6,9 % presentaron complicaciones, con una mortalidad (1,4 %). Conclusiones. La radiografía de abdomen simple es una ayuda diagnóstica adecuada para el tamizaje de los body packers. El manejo conservador es aceptable, teniendo en cuenta el porcentaje bajo de complicaciones.

Introduction. The number of arrests of body packers, who are those people who ingest packages with narcotics for illegal trafficking, has gradually increased. The objective of this study was to present the cases of body packers treated in two health institutions in Florencia, a territory in southern Colombia, between 2003 and 2017. Methods. This is a descriptive retrospective study. A univariate analysis was performed in RStudio and Microsoft Excel® of sociodemographic and clinical variables. Measures of central tendency and dispersion were used for continuous variables, frequencies and proportions for categorical variables. Results. 72 patients were included. Most cases were reported between 2007 and 2012 (77.5%). The ratio between men and women was 4.9:1. The mean age was 29.1 years. The main reason for admission was for medical check-up after capture by national security agencies (76.4%). In nine out of ten admitted patients, imaging studies were performed (94.4%); the main diagnostic imaging was simple abdominal X-ray (84.7%), with a sensitivity of 91.6%. Expectant management was performed in three out of four patients (74.6%). 6.9% presented complications, with one mortality (1.4%). Conclusions. Simple abdominal x-ray is an adequate diagnostic tool for screening body packers. Conservative management is acceptable, taking into account the low percentage of complications.

Performance of the phonatory deviation diagram in monitoring voice quality before and after voice exercise in individuals with Parkinson's Disease. / Desempenho do diagrama de desvio fonatório no monitoramento da qualidade vocal pré e pós exercício vocal em indivíduos com Doença de Parkinson.

PURPOSE: To assess the performance of the phonatory deviation diagram and its measurements in monitoring voice quality before and after voice exercise in individuals with Parkinson's Disease. METHODS: Retrospective and documentary study. A sample of 30 subjects was used, 50% male, with a mean age of 62.13 ± 9.05 years. The results of the phonatory deviation diagram were analyzed, in the moments before and after vocal exercise with the pushing technique associated with plosive sounds, considering the area, density, shape and location of the diagram in the quadrants. For comparison purposes, the acoustic parameters of jitter, shimmer, glottal to noise excitation ratio and results of the auditory-perceptual analysis, carried out in previous research, were also considered, in the pre- and post-technical moments. RESULTS: Despite the fact that there was no difference in the distribution of samples in the diagram, after performing the vocal technique, a change in the displacement of the diagram towards the area of normality was identified in the visual qualitative analysis, and there was an association between the general degree of vocal deviation in the analysis auditory perception and the area of the diagram. There was an improvement in the shimmer values after the vocal technique. CONCLUSION: The displacement of the phonatory deviation diagram towards the area of normality corroborated the results in relation to the general degree of dysphonia, evaluated by the auditory-perceptual analysis and the shimmer results, after the vocal technique. Thus, the diagram shows good performance in monitoring voice quality of individuals with Parkinson's.

OBJETIVO: Verificar o desempenho do diagrama de desvio fonatório e de suas medidas no monitoramento da qualidade da voz, pré e pós exercício vocal, em indivíduos com Doença de Parkinson. MÉTODO: Estudo retrospectivo e documental. Utilizou-se uma amostra de 30 sujeitos, sendo 50% do sexo masculino, com média de idade de 62,13 ± 9,05 anos. Foram analisados os resultados do diagrama de desvio fonatório, nos momentos pré e pós exercício vocal com a técnica de empuxo associada aos sons plosivos, considerando-se a área, densidade, forma e localização do diagrama nos quadrantes. Para fins de comparação, os parâmetros acústicos de jitter, shimmer, glottal to noise excitation ratio e resultados da análise perceptivo-auditiva, realizada em pesquisa anterior, também foram considerados, nos momentos pré e pós-técnica. RESULTADOS: A despeito de não ocorrer diferença na distribuição das amostras no diagrama, após realização da técnica vocal, foi identificada, na análise qualitativa visual, mudança no deslocamento do diagrama em direção à área de normalidade e houve associação entre o grau geral do desvio vocal da análise perceptivoauditiva e a área do diagrama. Houve melhora nos valores de shimmer, após a técnica vocal. CONCLUSÃO: O deslocamento do diagrama de desvio fonatório em direção à área de normalidade corroborou os resultados em relação ao grau geral de disfonia avaliado pela análise perceptivoauditiva e os resultados de shimmer, após a técnica vocal empregada. Desse modo, o diagrama de desvio fonatório apresentou bom desempenho no monitoramento da qualidade vocal de indivíduos com Parkinson.

Síndrome pilórico en un body packer / Pyloric syndrome in a body packer

Introducción. El embalaje y transporte de estupefacientes dentro del organismo, o body packing, es una práctica frecuente en Centroamérica y el Caribe. Además del riesgo de muerte por la exposición a las sustancias tóxicas, existe el riesgo de complicaciones mecánicas con indicación de manejo quirúrgico. El Hospital de Engativá, por su cercanía al aeropuerto de Bogotá, D.C., Colombia, es el centro de referencia para el tratamiento de estos pacientes. Caso clínico. Un hombre de 65 años traído al hospital por un episodio emético con expulsión de cuatro cápsulas para el transporte de estupefacientes. Al examen físico se encontraron masas palpables en el hemiabdomen superior, sin abdomen agudo. La tomografía de abdomen informó un síndrome pilórico secundario a retención gástrica de cuerpos extraños. Fue llevado a laparotomía y gastrotomía logrando la extracción de 97 objetos cilíndricos de látex que contenían sustancias ilícitas. Discusión. En los body packer asintomáticos, la administración de soluciones laxantes es una estrategia terapéutica segura. Los casos reportados de obstrucción gastrointestinal son infrecuentes y se relacionan con la ingesta de un gran número de cápsulas, por lo que es necesario el tratamiento quirúrgico. Conclusión. El síndrome pilórico es una presentación infrecuente en un body packer. Se debe tener un alto índice de sospecha para garantizar un manejo oportuno

Introduction. Packaging and transportation of narcotic drugs inside a human body, or body packing, is a frequent practice in Central America and the Caribbean. In addition to the risk of death due to exposure to toxic substances, there is a risk of mechanical complications with an indication for surgical management. The Engativá Hospital, due to its proximity to the airport in Bogotá, D.C., Colombia, is the reference center for the treatment of these patients. Clinical case. A 65-year-old man brought to the hospital for an emetic episode with expulsion of four narcotic transport capsules. Physical examination revealed palpable masses in the upper abdomen, without an acute abdomen. Abdominal tomography revealed pyloric syndrome secondary to gastric retention of foreign bodies. He was taken to laparotomy and gastrotomy, achieving the extraction of 97 cylindrical latex objects that contained illicit substances. Discussion. In asymptomatic body packers, the administration of laxative solutions is a safe therapeutic strategy. Reported cases of gastrointestinal obstruction are infrequent and are related to the ingestion of a large number of capsules, for which surgical treatment is necessary. Conclusion. Pyloric syndrome is an uncommon presentation in body packers. A high index of suspicion is required to ensure timely management

Description and evaluation of cocaine body-packers management in French Guiana (2016-2019).

INTRODUCTION: French Guiana is a hub for drugs trafficking between South America and Europe. In Corpore transport, or Body-packing, is one of the options favored. In 2018, 577 people were arrested for smuggling cocaine from French Guiana to mainland France. The objective of this study was to update the epidemiological data and to evaluate the overall management of body-packers. METHODS: A monocentric retrospective and observational study included patients admitted to the emergency department of the Cayenne General Hospital from January 1st, 2016 to December 31st, 2019 after ingestion of cocaine pellets. RESULTS: During the period, 668 people were referred to Cayenne hospital's emergency department by for suspected body-packing. Two hundred nineteen were excluded due to the absence of cocaine pellets in the initial X-ray or because they were carrying cannabis pellets. The mean age was 25.2 years with a sex ratio of 2.21 males per female. Among them, 13.7% of cases were complicated without endangering the vital prognosis. The mean number of pellets was similar between the population with and without complications (respectively 54.1 [50.9-57.4] and 57.8 [48.9-66.6], p = 0.22). The presence of cocaine in the urine was not significantly associated with the risk of complications (OR = 0.5, [95%CI = 0.1-1.8], p = 0.23). Compared to the CT-scanner which has the highest diagnostic accuracy (Se 100%, Sp 94%), the sensitivity of the Abdominal X-ray was 44%. CONCLUSION: This study showed that complications were rare, most of which were digestive stagnation requiring endoscopy. Given the low rate of complications and their low severity the average duration of hospitalization was relatively short. The type 3, micro-industrial quality packaging, almost exclusively used in body-packing in French Guiana, seems to be the main factor in this reduction of complications. This observation suggests possible adaptations of the current protocol for body-packers monitoring.

Body Packer y Body Stuffer: Serie de Casos. Revisión / Body Packer y Body Stuffer: serie de casos. Revision

"Body packing", "Body pushing" y "Body stuffing" son distintas formas de transportar sustancias ilegales dentro del cuerpo humano. Frente al ingreso en la unidad de emergencias de un "Body Packer", conocido como "tragador de paquetes" con fines de contrabando o un "Body Stuffer" llamados "tragadores rápidos", quienes ingieren en forma compulsiva paquetes manufacturados para la venta de sustancias ante la posibilidad de ser sorprendidos por agentes de la ley; se plantean una serie de desafíos en cuanto al tratamiento que al día de hoy permanecen en debate. Generalmente se prefiere mantener una conducta conservadora facilitando la expulsión de los paquetes. En aquellos casos en los que los pacientes presenten paquetes atascados o rotos o no mejoren con el tratamiento conservador, se recomienda el tratamiento quirúrgico.El presente trabajo tiene por objetivo reportar una serie de casos internados por ingesta de paquetes potencialmente peligrosos que se sometieron a una evacuación farmacológica y/o quirúrgica en 8 pacientes y una revisión bibliográfica sobre el tema.

"Body packing", "Body pushing", and "Body stuffing" are different ways to use the interior of the human body to transport illegal substances. In the face of a "Body Packer" or a "Body Stuffer" known as "fast swallowers", which are those cases in which they compulsively swallow manufactured packages for the sale of substances before the possibility of being surprised by law enforcement officers, a series of challenges present themselves regarding the treatment, which is currently up for debate. Generally, a conservative conduct is preferred, facilitating the expulsion of the packages. In those cases, in which patients have stuck or broken packages or do not improve with conservative treatment, surgical treatment is recommended.The present paper aims to report a series of cases in which the patients were admitted due to an intake of potentially dangerous packages and put through a pharmacological evacuation and/or surgical evacuation of 8 patients, and a bibliographical revision on the subject.

Impact of warmer constant and fluctuating temperatures in the male Jamaican field cricket, Gryllus assimilis (Fabricius, 1775) (Orthoptera: Gryllidae).

Ectotherms, such as insects, are susceptible to climate changes because their body temperature is not physiologically regulated. Forecasts indicate a worldwide temperature rise of 1.4-6 °C by 2100, and an increase in heatwave frequency is expected. This study investigated the effects of constant temperatures (CT; 27, 34, 39, 40 and 41 °C) and fluctuating temperature (FT; 27/34 °C: 12/12 h) on the survival, metabolic rate, locomotor activity, gas exchange pattern, heat loss and water content of the male Jamaican field cricket, Gryllus assimilis (Fabricius, 1775) (Orthoptera: Gryllidae). It was found that 39 °C was the estimated lethal temperature for 50% of the population and that 41 °C was considered the thermal limit, causing 100% mortality in 96 h. Furthermore, FT caused slightly higher mortality (8.9 ± 3.8%) than CT27 (0%) and CT34 (1.43 ± 1.43%). FT caused a greater increase in the metabolic rate and locomotor activity than CT27. It was found that G. assimilis males had a continuous gas exchange as a standard at CT27; however, CT34 changed the gas exchange pattern from continuous to cyclic in 27% of crickets. FT decreased heat loss in crickets more than CT34; however, no significant differences were found in locomotor activity and metabolic rate. In addition, no significant differences between CT27, CT34 and FT were observed in terms of water content, thus suggesting no difference in water loss. Thus, it is suggested that FT, despite involving a modest warming, increased the climate sensitivity of G. assimilis males and led to a change in their optimum temperature, pushing it beyond its usual thermal limits. However, higher mortality in FT compared to CT27 (control) and CT34 must be interpreted with caution. In addition, the risk of higher mortality of G. assimilis males is predicted, especially in South America, where this cricket is widely distributed.

O corpo da criança como receptáculo da violência física: análise dos dados epidemiológicos do Viva/SINAN / The childs body as a receptacle of physical violence: analysis of epidemiological data from Viva/SINAN

Introdução A violência física doméstica contra crianças e adolescentes é grave problema de saúde pública, que traz inúmeros agravos às vítimas. A alta incidência da violência física contra a criança e o adolescente no Brasil aponta a necessidade urgente de elaboração de políticas públicas para enfrentar e prevenir o problema. Objetivo Estudar o perfil das notificações (SINAN) de violência física doméstica contra a criança e o adolescente no Brasil e Regiões, no período de 2009 a 2019. Metodologia O presente estudo caracteriza-se como estudo descritivo, epidemiológico, baseado em dados secundários, obtidos no Sistema de Informação de Agravos de Notificação (SINAN-NET) e sistema TABWIN. Os dados foram analisados por meio da estatística descritiva com elaboração de medidas de frequência absoluta e relativa. Resultados A maior taxa de violência física doméstica se refere a meninas de 10 a 14 anos (248 por 100 mil habitantes). Em relação às crianças e adolescentes do sexo masculino a faixa etária com maior taxa de violência física é de 0 a 4 a anos (232 por 100 mil habitantes). No que se refere às regiões do Brasil, se considerarmos o sexo masculino, em todas as regiões a faixa etária mais acometida por situações de violência foi de 0 a 4 anos. As meninas de 0 a 4 anos sofrem mais violência nas regiões Nordeste, Sul e Centro-Oeste. Nas regiões Norte e Sudeste, a faixa etária de 10 a 14 anos apresenta a maior taxa de ocorrência (204 e 320 por 100 mil habitantes respectivamente). A população indígena possui as maiores taxas de violência em todas as Regiões. Pai e mãe são os agressores mais frequentes (41,13% e 39,84%, respectivamente). Em todas as Regiões do Brasil, a faixa etária que apresenta maiores taxas de óbito por violência física doméstica é de 0 a 4 anos, para meninas e meninos. Meninos sofrem com maior frequência violência fatal (63,31%). A raça com maior taxa de óbito por violência física doméstica é a indígena para meninos e meninas (41 e 16 por 1 milhão de pessoas, respectivamente). Os autores mais frequentes de violência fatal contra meninas são mãe e pai (45,11% e 38,32%, respectivamente). Conclusões O presente estudo identificou que meninos são mais suscetíveis à violência física doméstica na infância e meninas na adolescência. Os meninos morrem com maior frequência em decorrência de violência física. A faixa etária que é mais acometida por violência física doméstica é de 0 a 4 anos. É nessa mesma faixa etária que ocorrem, com maior frequência, os óbitos em decorrência de violência. As raças mais acometidas pela violência são a indígena e a parda. A população indígena apresenta uma altíssima taxa de óbito em decorrência da violência. Pai e mãe são os agressores mais frequentes e os que mais cometem violência fatal. O padrasto e a madrasta são quem mais reincidem na violência física. O meio de agressão mais frequente foi força corporal/espancamento e, na maior parte das vezes, a violência aconteceu dentro de casa.

Introduction Domestic physical violence against children and adolescents is a serious public health problem, which causes countless harm to the victims. The high incidence of physical violence against children and adolescents in Brazil points to the urgent need to develop public policies to address and prevent the problem. Objective To study the profile of notifications (SINAN) of domestic physical violence against children and adolescents, in Brazil and its Regions, in the period from 2009 to 2019. Methodology The present study is characterized as a descriptive epidemiological study of time-series, based on secondary data obtained from the Notifiable Diseases Information System (SINAN-NET, in Portuguese) and TABWIN system. The data were analyzed using descriptive statistics with elaboration of absolute and relative frequency measures. Results The highest rate of domestic physical violence refers to girls aged 10 to 14 years (248 per 100 thousand inhabitants). In relation to male children and adolescents, the age group with the highest rate of physical violence is from 0 to 4 years (232 per 100 thousands inhabitants). Regarding the regions of Brazil, if considered the male sex, in all the regions the age group most affected by situations of violence was 0 to 4 years old. Girls from 0 to 4 years of age suffer more violence in the Northeast, South and Center-West regions. In the Northern and Southeastern regions, the age group between 10 and 14 years old presents the highest rate of occurrence (204 and 320 per 100,000 inhabitants, respectively), The indigenous population has the highest rates of violence in all regions. Father and mother are the most frequent aggressors (41.13% and 39.84%, respectively). In all regions of Brazil, the age group with the highest death rates caused by physical domestic violence is from 0 to 4 years old, for girls and boys, Boys suffer fatal violence more frequently (63.31%). The race with the highest death rate caused by physical domestic violence is the indigenous for both boys and girls (41 and 16 per 1 million people, respectively). The most frequent perpetrators of fatal violence against girls are mother and father (45.11% and 38.32%, respectively). Conclusions The present study identified that boys are more susceptible to physical domestic violence in childhood and girls in adolescence. Boys die more frequently as a result of physical violence. The age group that is most affected by physical domestic violence is 0 to 4 years old. This is also the age group in which deaths caused by violence occur most frequently. The races that are most affected by violence are indigenous and grayish-brown. The indigenous population presents a very high death rate due to violence. Fathers and mothers are the most frequent aggressors and the ones who commit the most fatal violence. Stepfathers and stepmothers are the most repeat offenders of physical violence. The most frequent means of aggression was bodily force/pushing and, most of the time, the violence happened at home.

Effects of a high-intensity interval training program on body composition and physical fitness in female field hockey players / Efectos de un programa de entrenamiento intervalado de alta intensidad sobre la composición corporal y condición física en jugadoras de hockey césped

SUMMARY: High-intensity interval training (HIIT) is zed by achieving similar effects to conventional physical and physiological training in a shorter time, allowing its dissemination in the sports field. The present study was aimed to analyze the effects of a HIIT program on body composition and general and specific physical fitness in Chilean female field hockey players. Experimental, repeated measures, simple blind, parallel groups, and a quantitative approach were used. The participants were randomized, and distributed into a control group (CG; n= 10) that maintained regular field hockey training and an experimental group (EG; n= 10) that also received complementary training with HIIT. Body composition (muscle mass and adipose mass), general physical fitness (jump performance with countermovement jump [CMJ] and maximum oxygen consumption [VO2max] were evaluated with the test Course-Navette), and specific physical fitness (pushing speed, dribbling speed, and shooting accuracy) were assessed with established protocols. Pre- and post-intervention comparisons were made with Student's t and Wilcoxon tests, considering p<0.05. The main results indicate that the EG presented a significant increase in muscle mass (p = 0.024; d = 0.62), CMJ (p = 0.005; d = 1.10), VO2max (p = 0.001; d = 1.58) and a significant reduction in adipose mass (p = 0.023; d = 0.36) and time in pushing speed (p = 0.028; d = 0.79). The CG did not present significant changes in any of the variables analyzed, and no significant differences were reported between the groups. In conclusion, eight weeks of HIIT significantly increases muscle mass, jump performance, and VO2max and significantly reduces adipose mass and time in pushing speed in Chilean female field hockey players.

RESUMEN: El entrenamiento intervalado de alta intensidad (EIAI) se caracteriza por conseguir en un menor tiempo efec- tos similares al entrenamiento convencional a nivel físico y fisiológico, lo que ha permitido su difusión en el ámbito deportivo. El objetivo del presente estudio fue analizar los efectos de un programa de EIAI sobre la composición corporal, condición física general y específica en mujeres chilenas que practican hockey césped. Estudio experimental, de medidas repetidas, simple ciego, grupos paralelos y enfoque cuantitativo. Las participantes fueron aleatorizadas y distribuidas en grupo control (GC; n=10) que mantuvo los entrenamientos regulares de hockey césped y grupo experimental (GE; n=10) que además recibió de complemento EIAI. Se evaluó la composición corporal (masa muscular y masa adiposa), condición física general (capacidad de salto con el salto contra movimiento [CMJ] y consumo máximo de oxígeno [VO2máx] con la prueba Course de Navette) y condición física específica (velocidad de empuje, velocidad de dribling y precisión de tiro) con protocolos establecidos. Se realizaron comparaciones pre y post intervención con las pruebas t de Student y Wilcoxon, considerando un p<0,05. Los principales resultados indican que el GE presentó un aumento significativo de la masa muscular (p=0,024; d=0,62), CMJ (p=0,005; d=1,10), VO2máx (p=0,001; d=1,58) y, una reducción significativa, de la masa adiposa (p=0,023; d=0,36) y del tiempo en la velocidad de empuje (p=0,028; d=0,79). El GC no presentó cambios significativos en ninguna de las variables analizadas, mientras que no se reportaron diferencias significativas entre los grupos. En conclusión, ocho semanas de EIAI aumentan significativamente la masa muscular, capacidad de salto y VO2máx, además de reducir significativamente la masa adiposa y el tiempo en la velocidad de empuje en mujeres chilenas que practican hockey césped.

Anestesia para emergencias en obstetricia / Obstetric patient and anesthesia

Pregnancy induces changes in almost every body system, pushing their reserves to the limit. There is a decrease in systemic vascular resistance, a progressive increase in blood volume, heart rate and myocardial size, resulting in an increased cardiac output. It reduces the functional residual capacity and increases the tidal volume. Oxygen consumption increases, leading to a decrease in oxygen reserves and increased risk of hypoxemia under hypoventilation or apnea (more frequent due to difficult airway management as a result of edema). Important changes are also observed at the hematological, renal and intestinal levels. Uterineplacental blood flow increases progressively during pregnancy, elevating the risk of massive hemorrhage. When intrauterine resuscitation does not resolve acute fetal distress, urgent cesarean section should be performed. Neuraxial over general anesthesia is recommended. In emergency situations, general anesthesia or "Rapid Sequence Spinal Anesthesia" is suggested as an alternative. The requirements of both, hypnotics and inhalation agents, decrease during pregnancy. Obstetric hemorrhage may be the result of bleeding from placenta or a consequence of trauma to the genital tract during delivery. The most severe cases present hypovolemic shock. Along with controlling the source of bleeding, the treatment goals are: treat hypovolemia and acute trauma coagulopathy, preserve oxygen transport capacity, repair the endothelium and prevent dilutional coagulopathy. Management of placenta accreta must be multidisciplinary. Preoperative diagnosis is essential for adequate preparation. Combined spinal-epidural technique is recommended. When hysterectomy becomes necessary, conversion to general anesthesia should be considered. Amniotic fluid embolism in its early stage produces right ventricular dysfunction due to acute pulmonary hypertension and, in its late stage, left ventricular dysfunction. In 40% of cases, multifactorial coagulopathy is observed. The diagnostic criteria are: 1) hypotension or cardiac arrest, hypoxia and coagulopathy; 2) during labor, caesarean section, uterine curettage or in the first 30 minutes postpartum; 3) in the absence of another diagnosis that explains the symptoms. Treatment is supportive, besides termination of pregnancy. Resuscitation during pregnancy must be led by a professional who understands the complexities of the situation. Maternal well-being is the best predictor of fetal well-being. A perimortem cesarean may become necessary.

El embarazo induce cambios en casi todos los sistemas corporales, llevando al límite las reservas a cada uno de ellos. Hay disminución de la resistencia vascular sistémica, aumento progresivo de la volemia, frecuencia cardiaca y tamaño miocárdico, lo que produce un aumento del débito cardiaco. Se reduce de la capacidad residual funcional y aumenta del volumen corriente. Aumenta el consumo de oxígeno, lo que conlleva disminución de la reserva de oxígeno y aumenta el riesgo de hipoxemia frente a hipoventilación o apnea (más frecuente dificultad en el manejo de vía aérea por edema). También se observan importantes cambios a nivel hematológico, renal e intestinal. El aumento progresivo de flujo úteroplacentario propicia el desarrollo de hemorragias masivas. Cuando la reanimación intrauterina no resuelve el sufrimiento fetal agudo se debe proceder a la cesárea de urgencia. En dicho caso, se privilegia la anestesia neuroaxial por sobre la general. En la cesárea de emergencia se recomienda anestesia general o "anestesia espinal en secuencia rápida" como alternativa. Los requerimientos tanto de hipnóticos como de agentes inhalatorios disminuyen en el embarazo. La hemorragia obstétrica resulta del sangrado del lecho placentario o como consecuencia del traumatismo al tracto genital durante el parto. La forma de presentación de los casos graves generalmente es con hipovolémico. Junto con controlar la fuente del sangrado los objetivos son: tratar la hipovolemia, tratar la coagulopatía aguda del trauma, preservar la capacidad de transporte de oxígeno, reparar el endotelio y prevenir la coagulopatía dilucional. El manejo de la placenta acreta es multidisciplinario. El diagnóstico preoperatorio es imprescindible para la adecuada preparación. Es recomendable una técnica combinada espinal-epidural y conversión a anestesia general en caso de histerectomía. La embolia de líquido amniótico en su etapa temprana produce disfunción ventricular derecha, por hipertensión pulmonar aguda y en su etapa tardía, disfunción ventricular izquierda. En el 40% de los casos, se observa coagulopatía multifactorial. Los criterios diagnósticos son: 1) hipotensión o paro cardíaco, hipoxia y coagulopatía; 2) durante el trabajo de parto, cesárea, legrado uterino o en los primeros 30 min posparto; 3) en ausencia de otro cuadro que explique los síntomas. El tratamiento es de soporte y la interrupción del embarazo. La reanimación durante el embarazo debe ser liderada por un profesional que conozca las particularidades del manejo. El bienestar materno es el mejor predictor de bienestar fetal. Una cesárea puede ser necesaria.

Assédio sexual em mulheres praticantes de musculação: impactos no seu cotidiano / Sexual harassment of women who practice strength training: impacts on their everyday life / El acoso sexual de mujeres practicantes de culturismo: impactos en su cotidiano

Objetivou-se caracterizar o impacto das experiências de assédio sexual com relação ao cotidiano e à prática regular de atividades físicas das mulheres praticantes de musculação. O estudo foi realizado em quatro academias de ginástica de Iguatu, Ceará, Brasil, tendo a colaboração de 25 mulheres praticantes de musculação, que responderam a um questionário sociodemográfico e participaram de uma entrevista semiestruturada. A análise das entrevistas foi por meio da análise de conteúdo. As experiências de assédio sexual vivenciadas pelas mulheres na academia de ginástica ocorreram por olhares invasivos, perseguidores, constrangedores, direcionados às partes íntimas dos corpos durante a execução dos movimentos e conversas insistentes abordando assuntos considerados inapropriados, comprometendo o cotidiano das praticantes de musculação, afastando-as da prática regular de exercícios físicos e levando-as a evitar vínculos com o público masculino como forma de se proteger. (AU)

This study aimed to characterize the impact of the sexual harassment of women who practice strength training on their everyday life and the practice of regular physical activity. The study was conducted with 25 women who practiced strength training in four gyms in Iguatu in the State of Ceará, Brazil using a sociodemographic questionnaires and semi-structured interviews. The content of the interviews was analyzed using content analysis. The respondents' experiences of sexual harassment in the gyms included embarrassing and uncomfortable leering and staring at intimate body parts during exercise and insistent conversations and inappropriate comments, negatively affecting their everyday life and pushing them away from the practice of regular physical exercise, seeking to avoid contact with men as a way of protecting themselves. (AU)

El objetivo fue caracterizar el impacto de las experiencias de acoso sexual con relación al cotidiano y a la práctica regular de actividades físicas de las mujeres practicantes de culturismo. El estudio se realizó en cuatro gimnasios de Iguatu, Ceará, Brasil, con la colaboración de veinticinco mujeres practicantes de culturismo que respondieron un cuestionario sociodemográfico y participaron en una entrevista semiestructurada. El análisis de las entrevistas fue por medio del análisis de contenido. Las experiencias de acoso sexual vividas por las mujeres en el gimnasio tuvieron lugar por medio de miradas invasivas, perseguidoras, intimidadoras, dirigidas a las partes íntimas de los cuerpos durante la realización de los movimientos y de conversaciones insistentes abordando asuntos considerados inadecuados, perjudicando el cotidiano de las practicantes de culturismo, apartándolas de la práctica regular de ejercicios físicos y buscando evitar vínculos con el público masculino como forma de protegerse. (AU)

Evisceración vaginal post histerectomía abdominal: presentación de un caso / Vaginal evisceration after abdominal hysterectomy. Filing a case

Introducción: la evisceración vaginal después de una cirugía pélvica es una emergencia quirúrgica extremadamente rara. La dehiscencia laparotómica consiste en la desunión y separación precoz de los bordes de una herida quirúrgica suturada, con exteriorización o sin ella del contenido de la cavidad abdominal. Presentación de caso: el caso que aquí se reporta es el de una mujer de 36 años con antecedentes de hipertensión arterial. Intervenida hacia 3 meses de histerectomía abdominal por fibromiomas, sin prolapso uterino. Acude al cuerpo de guardia del hospital por dolor abdominal, sensación de ocupación vaginal y estreñimiento. Niega distensión abdominal y síntomas respiratorios. Ya en el cuerpo de guardia refiere deseos de defecar y al pujar ocurre una protrusión de intestino delgado de más o menos 3 cm, irreductible a través de orificio vaginal. Se realizó laparatomía, revisión por vía vaginal, reducción de las asas intestino delgado y ampliación del orificio por donde se produjo la evisceración. Discusión: se localizaron los bordes del peritoneo parietal, se sutura la cúpula vaginal con puntos continuos y se colocó una malla en el fondo de la pelvis recubierta por peritoneo. Se utilizaron los datos provenientes de la historia clínica hospitalaria. Exámenes complementarios, la entrevista y el examen físico de la paciente, a pesar las probables complicaciones no hubo perdida de tiempo y la operación fue un éxito. Conclusiones: la evolución fue satisfactoria, gracias a la labor del personal médico que estuvo a cargo del caso(AU)

Introduction: vaginal evisceration after pelvic surgery is an extremely rare surgical emergency. Laparotomic dehiscence consists of disunity and early separation of the edges of a sutured surgical wound, with or without externalization of the contents of the abdominal cavity. Case presentation: the case reported here is that of a 36-year-old woman with a history of high blood pressure. She underwent 3 months of abdominal hysterectomy for fibromyomas, without uterine prolapse. She comes to the hospital guard corps for abdominal pain, a feeling of vaginal occupation and constipation. He denies abdominal bloating and respiratory symptoms. Already in the body of guard it refers desires to defecate and when pushing a protrusion of small intestine of more or less 3 cm occurs, irreducible through the vaginal opening. Laparatomy, vaginal revision, reduction of the small intestine loops and enlargement of the hole through which evisceration occurred were performed. Discussion: the edges of the parietal peritoneum were located, the vaginal dome was sutured with continuous stitches, and a mesh was placed at the bottom of the pelvis covered by peritoneum. The data from the hospital medical history were used. Complementary examinations, the interview and the physical examination of the patient, despite the probable complications, there was no loss of time and the operation was successful. Conclusions: the evolution was satisfactory, thanks to the work of the medical personnel who were in charge of the case(EU)

Evisceración vaginal post histerectomía abdominal. Presentación de un caso / Vaginal eviscerationafter abdominal hysterectomy. Filing a case / Evisceração vaginal após histerectomia abdominal. Arquivar um caso

RESUMEN Introducción: la evisceración vaginal después de una cirugía pélvica es una emergencia quirúrgica extremadamente rara. La dehiscencia laparotómica consiste en la desunión y separación precoz de los bordes de una herida quirúrgica suturada, con exteriorización o sin ella del contenido de la cavidad abdominal. Presentación de caso: el caso que aquí se reporta es el de unamujer de 36 años con antecedentes de hipertensión arterial. Intervenida hacia 3 meses de histerectomía abdominal por fibromiomas, sin prolapso uterino. Acude al cuerpo de guardia del hospital por dolor abdominal, sensación de ocupación vaginal y estreñimiento. Niega distensión abdominal y síntomas respiratorios. Ya en el cuerpo de guardia refiere deseos de defecar y al pujar ocurre una protrusión de intestino delgado de más o menos 3 cm, irreductible a través de orificio vaginal. Se realizó laparatomía, revisión por vía vaginal, reducción de las asas intestino delgado y ampliación del orificio por donde se produjo la evisceración. Discusión: se localizaron los bordes del peritoneo parietal, se sutura la cúpula vaginal con puntos continuos y se colocó una malla en el fondo de la pelvis recubierta por peritoneo. Se utilizaron los datos provenientes de la historia clínica hospitalaria. Exámenes complementarios, la entrevista y el examen físico de la paciente, a pesar las probables complicaciones no hubo pérdida de tiempo y la operación fue un éxito. Conclusiones: la evolución fue satisfactoria, gracias a la labor del personal médico que estuvo a cargo del caso.

ABSTRACT Introduction: vaginal evisceration after pelvic surgery is an extremely rare surgical emergency. Laparotomic dehiscence consists of disunity and early separation of the edges of a sutured surgical wound, with or without externalization of the contents of the abdominal cavity. Case presentation: the case reported here is that of a 36-year-old woman with a history of high blood pressure. She underwent 3 months of abdominal hysterectomy for fibromyomas, without uterine prolapse. She comes to the hospital guard corps for abdominal pain, a feeling of vaginal occupation and constipation. He denies abdominal bloating and respiratory symptoms. Already in the body of guard it refers desires to defecate and when pushing a protrusion of small intestine of more or less 3 cm occurs, irreducible through the vaginal opening. Laparatomy, vaginal revision, reduction of the small intestine loops and enlargement of the hole through which evisceration occurred were performed. Discussion: the edges of the parietal peritoneum were located, the vaginal dome was sutured with continuous stitches, and a mesh was placed at the bottom of the pelvis covered by peritoneum. The data from the hospital medical history were used. Complementary examinations, the interview and the physical examination of the patient, despite the probable complications, there was no loss of time and the operation was successful. Conclusions: the evolution was satisfactory, thanks to the work of the medical personnel who were in charge of the case.

RESUMO Introdução: a evisceração vaginal após cirurgia pélvica é uma emergência cirúrgica extremamente rara. A deiscência laparotômica consiste em desunião e separação precoce das bordas de uma ferida cirúrgica suturada, com ou sem externalização do conteúdo da cavidade abdominal. Apresentação do caso: o caso relatado aqui é o de uma mulher de 36 anos com histórico de pressão alta. Ela foi submetida a 3 meses de histerectomia abdominal por fibromiomas, sem prolapso uterino. Ele veio à guarita do hospital devido a dor abdominal, sensação de ocupação vaginal e constipação. Ele nega inchaço abdominal e sintomas respiratórios. Já no corpo de guarda refere desejos de defecar e ao empurrar uma protrusão do intestino delgado de mais ou menos 3 cm, ocorre irredutível através da abertura vaginal. Foram realizadas laparometria, revisão vaginal, redução das alças do intestino delgado e aumento do orifício através do qual a evisceração ocorreu. Discussão: as margens do peritônio parietal foram localizadas, a cúpula vaginal foi suturada com pontos contínuos e uma malha foi colocada na parte inferior da pelve coberta por peritônio. Foram utilizados os dados do histórico médico do hospital. Exames complementares, entrevista e exame físico do paciente, apesar das prováveis ​​complicações, não houve perda de tempo e a operação foi bem-sucedida. Conclusões: a evolução foi satisfatória, graças ao trabalho da equipe médica responsável pelo caso.

Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial.

BACKGROUND: A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. METHODS/DESIGN: Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11-17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75-85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55-75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. DISCUSSION: The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02753231 . Registered on 21 April 2016.

Tratamiento médico del "body packer" entre los años 2014 y 2016 en un hospital universitario del caribe colombiano / Medical management of the "body packer" at a university hospital in the colombian caribbean in the period 2014-2016

Introducción. El término "body packer" hace referencia a sujetos portadores de objetos intraabdominales extraños, que contienen drogas ilícitas con fines de contrabando. La mayoría son pacientes asintomáticos, en quienes se instaura conducta expectante, observación clínica estrecha y administración de medicamentos para la evacuación de los paquetes, con miras a prevenir posibles complicaciones, como obstrucción intestinal o intoxicación, asociadas a su transporte intraabdominal. Materiales y método. Se llevó a cabo un estudio transversal de linealidad retrospectiva en pacientes admitidos en la E.S.E Hospital Universitario del Caribe entre los años 2014 y 2016,bajo la sospecha diagnóstica de "body packer". Luego de una revisión de las bases de datos institucionales se analizaron variables demográficas y clínicas de los sujetos incluidos en el estudio. Resultados. Se incluyeron 4 pacientes de género masculino, entre los 22 y 66 años de edad. La cantidad de cápsulas transportadas en promedio fue de 43, para una máxima de 74. La cocaína fue la sustancia que más se identificó. Para la evacuación de los paquetes se empleó irrigación intestinal con polietilenglicol. El tiempo de evacuación máximo fue de 48 horas y no hubo complicaciones asociadas al manejo proporcionado. Discusión. Estudios respecto al tema, como este, confirman la seguridad del manejo conservador del paciente asintomático y apoyan el uso de polietilenglicol dada su efectividad para lograruna limpieza intestinal completa y por su bajo riesgo de complicaciones asociado a su uso en comparación con otros métodos, así como la menor necesidad de intervenciones quirúrgicas. Se requieren estudios prospectivos aleatorizados controlados a partir de los cuales se determinen, con base en mayor evidencia, las mejores prácticas a seguir

Introduction. The term "body packer" refers to subjects carrying intraabdominal foreign objects that contain illicit drugs for contraband purposes. The majority of patients are asymptomatic, in whom expectant management is established, with close clinical observation and administration of medications for evacuation of the packages, with prevention of possible complications such as intestinal obstruction or intoxication associated with intraabdominal transport. Materials and method. A retrospective linearity cross sectional study was carried out in patients admitted to the Hospital Universitario del Caribe, Cartagena, Colombia, under the diagnostic suspicion of "body packer" in the period 2014 and 2016. After a review of the institutional databases, demographic and clinical variables of the study subjects were analyzed. Results. Four patients were included, male, ages 22 to 66 years. The average number of capsules transported was 43, with maximum of 74. Cocaine was the substance mainly identified. Intestinal irrigation with polyethylene glycol was used for intestinal evacuation. The maximum evacuation time was 48 hours and there were no complication associated with the given management. Discussion. The existing studies on the subject, as well as this one, confirm the safety of the conservative management in the asymptomatic patient and support the effectiveness of polyethyleneglycol in achieving complete intestinal cleansing and the low risk of complications associated with its use with respect to other methods, together with diminished need for surgical intervention. Controlled randomized prospective studies are required to provide greater evidence in order to determine the best practice to be followed

Analysis of elbow muscle strength parameters in Brazilian jiu-jitsu practitioners.

Upper-body dynamic and isometric maximum strength are essential components for success in Brazilian jiu-jitsu (BJJ). This study was aimed at analysing strength parameters in the elbow flexor and extensor muscles of BJJ practitioners. Participants (n = 28) performed maximum isometric contractions of elbow flexors and extensors to determine peak torque (PT), rate of force development (RFD), and the torque-angle (T-A) relationship at elbow angles of 45°, 60°, 75°, 90°, 105°, and 120°. Additionally, concentric and eccentric PTs were measured at 1.04 rad·s-1. Student t-test and ANOVA were performed using α = 0.05. Elbow flexors were stronger isometrically (P < 0.001, ES = 1.23) but weaker concentrically (P < 0.05, ES = 0.54) than extensor muscles, possibly because of the extensive grip disputes and pushing of opponents in BJJ. The T-A relationship had an inverted "U"-shape. Torque differences across elbow angles were moderate (ES = 0.62) for the extensor and large (ES = 0.92) for the flexor muscles. Isometric torque was greatest for elbow angles of 105° and 75° and smallest for 45° and 120° for extensor and flexor muscles, respectively. Elbow flexors had a greater RFD than extensors, regardless of elbow angle. The present study provides comprehensive results for elbow muscle strength in BJJ practitioners.

Factores de riesgo relevantes vinculados a molestias musculoesqueléticas en trabajadores industriales / Relevant risk factors linked to musculoskeletal discomfort in industrial workers

Los trastornos musculoesqueléticos (TME) de origen laboral representan una de las enfermedades profesionales más comunes que afectan a gran cantidad de trabajadores industriales. El objetivo de la investigación fue identificar los factores de riesgo relevantes asociados a la existencia de molestias o dolores musculoesqueléticos, según la parte del cuerpo afectada. Para ello se llevó a cabo un estudio transversal de campo, sobre una muestra de 174 trabajadores pertenecientes al área productiva de tres empresas venezolanas del sector cárnico. Para la identificación de TME se utilizó el cuestionario nórdico estandarizado y para la selección de los factores relevantes se emplearon los métodos de minería de datos CfsSubsetEvaly ConsistencySubsetEval, disponibles en Weka. Se encontró una prevalencia general de TME de 77%, destacando los hombros (49,4%) y la espalda (47,1%) como las partes del cuerpo que aquejan a mayor cantidad de trabajadores. Luego de relacionar esta prevalencia con diferentes factores de riesgo biomecánicos, psicosociales e individuales se determinó que los factores que mayor correspondencia presentan con las molestias de los hombros son: la sobrecarga postural, la repetitividad, las exigencias psicológicas y la antigüedad en el puesto de trabajo; mientras que en el caso de las molestias de espalda resaltan: la sobrecarga postural, el levantamiento de cargas, el empuje o arrastre de cargas, el bajo apoyo social y los antecedentes médicos vinculados a TME. Se confirma de esta forma la etiología multifactorial de los TME(AU)

Work-related musculoskeletal Disorders (MSDs) are one of the most common occupational diseases, affecting large numbers of industrial workers. The aim of this study was to identify relevant risk factors associated with the presence of musculoskeletal discomfort or pain, according to the affected body part. A cross-sectional field study was conducted in a sample of 174 workers at three Venezuelan meat processing plants. The standardized Nordic questionnaire was used for the identification of MSDs and the CfsSubsetEvaly ConsistencySubsetEvaldata mining methods, available in Weka,were used to select the relevant factors. MSDs prevalence was 77%; shoulders (49.4%) and back (47.1%) were the most commonly involved body parts. After relating this prevalence to different biomechanical, psychosocial and individual risk factors, those most commonly associated with shoulder discomfort were postural overload, repetitive motion, psychosocial demands and tenure at work. For back discomfort, postural overload, lifting of loads, pushing or pulling loads, low social support and past medical history were the most frequent associations. This study confirms the multifactorial etiology of MSDs(AU)

The use of pelvic fins for benthic locomotion during foraging behavior in Potamotrygon motoro (Chondrichthyes: Potamotrygonidae)

Synchronized bipedal movements of the pelvic fins provide propulsion (punting) during displacement on the substrate in batoids with benthic locomotion. In skates (Rajidae) this mechanism is mainly generated by the crural cartilages. Although lacking these anatomical structures, some stingray species show modifications of their pelvic fins to aid in benthic locomotion. This study describes the use of the pelvic fins for locomotory performance and body re-orientation in the freshwater stingray Potamotrygon motoro (Müller & Henle, 1841) during foraging. Pelvic fin movements of juvenile individuals of P. motoro were recorded in ventral view by a high-speed camera at 250-500 fields/s-1. Potamotrygon motoro presented synchronous, alternating and unilateral movements of the pelvic fins, similar to those reported in skates. Synchronous movements were employed during straightforward motion for pushing the body off the substrate as well as for strike feeding, whereas unilateral movements were used to maneuver the body to the right or left during both locomotion and prey capture. Alternating movements of the pelvic fins are similar to bipedal movements in terrestrial and semi-aquatic tetrapods. The pelvic fins showed coordinated movements during feeding even when stationary, indicating that they have an important function in maintaining body posture (station holding) during prey capture and manipulation. The use of pelvic fins during prey stalking may be advantageous because it results in less substrate disturbance when compared to movements generated by pectoral fin undulation. The range of pelvic fin movements indicates more complex control and coordination of the pelvic radial muscles.

The use of pelvic fins for benthic locomotion during foraging behavior in Potamotrygon motoro (Chondrichthyes: Potamotrygonidae)

Synchronized bipedal movements of the pelvic fins provide propulsion (punting) during displacement on the substrate in batoids with benthic locomotion. In skates (Rajidae) this mechanism is mainly generated by the crural cartilages. Although lacking these anatomical structures, some stingray species show modifications of their pelvic fins to aid in benthic locomotion. This study describes the use of the pelvic fins for locomotory performance and body re-orientation in the freshwater stingray Potamotrygon motoro (Müller & Henle, 1841) during foraging. Pelvic fin movements of juvenile individuals of P. motoro were recorded in ventral view by a high-speed camera at 250-500 fields/s-1. Potamotrygon motoro presented synchronous, alternating and unilateral movements of the pelvic fins, similar to those reported in skates. Synchronous movements were employed during straightforward motion for pushing the body off the substrate as well as for strike feeding, whereas unilateral movements were used to maneuver the body to the right or left during both locomotion and prey capture. Alternating movements of the pelvic fins are similar to bipedal movements in terrestrial and semi-aquatic tetrapods. The pelvic fins showed coordinated movements during feeding even when stationary, indicating that they have an important function in maintaining body posture (station holding) during prey capture and manipulation. The use of pelvic fins during prey stalking may be advantageous because it results in less substrate disturbance when compared to movements generated by pectoral fin undulation. The range of pelvic fin movements indicates more complex control and coordination of the pelvic radial muscles.(AU)

Periodontal disease as a risk indicator for poor physical fitness: a cross-sectional observational study.

BACKGROUND: Physical inactivity has been associated with poor oral health. The aim of this study is to assess whether periodontal disease is a risk indicator for poor physical fitness. METHODS: This cross-sectional study included 111 males who performed a physical fitness test (PFT) composed of four exercises: 1) push-ups conducted by pushing the body up and lowering it down using the arms; 2) pull-ups with the body suspended by the arms gripped on a bar; 3) sit-ups in which the upper and lower vertebrae are lifted from the floor; and 4) running for 12 minutes. A PFT score (range of 1 to 300) was determined for each participant, with higher scores indicating better physical fitness. One periodontist assessed attachment loss (AL) and probing depth (PD). Physical fitness was dichotomized according to whether the highest PFT score was "achieved" or "not achieved." Multivariable logistic models were fitted adjusting for age, overweight (body mass index of 25 to 29.9 kg/m(2)), and frequency of daily exercise. RESULTS: The mean age of the sample was 34.8 ± 10.3 years. Overweight individuals demonstrated significantly lower PFT scores (276.9 ± 24.1 points) than normal-weight individuals (289.3 ± 16.8 points). Individuals presenting at least one tooth with AL ≥ 4 mm had significantly lower PFT scores (277.8 ± 23.6 points) compared with those without this status (285.9 ± 20.2 points). A 1-mm increment in PD or AL significantly decreased the chance of reaching the highest PFT score by 69% or 75%, respectively. CONCLUSION: Periodontal disease may be considered a risk indicator for poor physical fitness in males.