El trabajo de fuerza muscular en la atención a adultos mayores con sarcopenia

El proceso de envejecimiento está marcado por el sedentarismo y la escasa actividad física, lo que se asocia a la disminución rápida y continua de las capacidades funcionales, la dependencia y la fragilidad. El objetivo del trabajo se orienta a valorar, mediante el test de repeticiones máximas con pesos no extremos, el efecto de la aplicación de ejercicios con pesas para la atención de la sarcopenia. Se aplicaron métodos de los niveles teóricos y empíricos como el analítico, sintético, inductivo, deductivo, revisión documental, análisis documental, observación, encuesta y entrevista. Se aplicó, como instrumento de trabajo, una batería de ejercicios físicos de resistencia a la fuerza, y aeróbicos que permitieron utilizar el método de medición en siete adultos mayores con sarcopenia, atendidos en el Centro de Actividad Física y Salud de la Universidad de las Ciencias de la Cultura Física y Deportes ¨ Manuel Fajardo. Se evaluó el trabajo de fuerza muscular mediante el test mencionado, lo que permitió identificar el peso real de la carga física con la que deben entrenar y, sobre esa base, se elaboró la batería de ejercicios con pesas. En los resultados preliminares registrados, mediante la aplicación del test, se constató que la integración del trabajo con pesas y el aeróbico influyen de manera favorable en la ganancia de fuerza en el adulto mayor.

O processo de envelhecimento é marcado por um estilo de vida sedentário e pouca atividade física, o que está associado ao declínio rápido e contínuo das capacidades funcionais, à dependência e à fragilidade. O objetivo do trabalho visa avaliar, por meio do teste de repetições máximas com pesos não extremos, o efeito da aplicação de exercícios com carga no tratamento da sarcopenia. Foram aplicados métodos dos níveis teórico e empírico como analítico, sintético, indutivo, dedutivo, revisão documental, análise documental, observação, levantamento e entrevista. Como instrumento de trabalho foi aplicada uma bateria de exercícios físicos resistidos de força e aeróbios que permitiu a utilização do método de mensuração em sete idosos com sarcopenia atendidos no Centro de Atividade Física e Saúde da Universidade de Ciências da Cultura Física e. Desporto ¨ Manuel Fajardo. O trabalho de força muscular foi avaliado por meio do referido teste, que possibilitou identificar o real peso da carga física com a qual devem treinar e, com base nisso, foi desenvolvida a bateria de exercícios com pesos. Nos resultados preliminares registrados, por meio da aplicação do teste, foi confirmado que a integração do trabalho com pesos e do trabalho aeróbio influencia favoravelmente o ganho de força em idosos.

The aging process is marked by a sedentary lifestyle and little physical activity, which is associated with the rapid and continuous decline in functional capacities, dependency and fragility. The objective of the work is aimed at assessing, through the test of maximum repetitions with non-extreme weights, the effect of the application of exercises with weights for the care of sarcopenia. Methods from the theoretical and empirical levels such as synthetic analytical, inductive-deductive, documentary review, documentary analysis, observation, survey and interview were applied. As a working instrument, a set of strength endurance and aerobic physical exercises was applied that allowed the measurement method to be used in seven older adults with sarcopenia, treated at the Center for Physical Activity and Health of the University of Sciences. of Physical Culture and Sports ¨Manuel Fajardo¨. The muscular strength work was evaluated using the aforementioned test, which made it possible to identify the real weight of the physical load with which they must train and, on that basis, the set of exercises with weights was developed. In the preliminary results recorded, through the application of the test, it was confirmed that the integration of weight work and aerobic work favorably influences strength gain in the older adults.

Effects of age, period, and cohort on the incidence of psoriasis in Spain: a 30-year review (1990-2019).

AIM: This study aimed to investigate the effects of age, period, and cohort on the incidence of psoriasis in Spain from 1990 through 2019 using the Global Burden of Disease (GBD) database and age-period-cohort (A-P-C) analysis. METHODS: We conducted an ecological trend study to analyze the incidence rates of psoriasis in Spain from 1990 through 2019. Joinpoint software and National Cancer Institute A-P-C tools were used to identify trends and assess the effects of age, period, and cohort. RESULTS: From 1990 through 2019, an estimated 2.99 million cases of psoriasis were diagnosed in Spain, with a mean annual increase of 0.49%. Significant decreases in age-standardized incidence rates (ASIR) were reported for both sexes, with women consistently maintaining a slightly higher ASIR. Joinpoint analysis revealed multiple turning points in the downward trend, indicating periods of stabilization. A-P-C analysis demonstrated significant declines in both net (overall trend) and local drift (age-specific trends), indicating a broad decrease in the incidence of psoriasis across most age groups. While the risk of psoriasis increased with age, peaking in the 50-54 age group, it declined thereafter. Furthermore, the analysis revealed a continuous decline in risk from 1990 through 2019 for both sexes, with individuals born in the early 21st century exhibiting a significantly lower risk vs those born in the early 20th century. CONCLUSION: This study observed a slight decline in the reported psoriasis ASIR in Spain, potentially due to reduced exposure to risk factors. However, limitations in data and the complexity of factors influencing the incidence of psoriasis require further research.

Partnerships for the Productive Development of the Health Economic-Industrial Complex: the health question / Parcerias para o Desenvolvimento Produtivo do Complexo Econômico-Industrial da Saúde: a questão da saúde

This paper discusses some of the main criteria used to define priorities for technological and industrial development by the Brazilian Ministry of Health regarding the Partnerships for Productive Development (PDP) Program. In order to focus on the question of how to define priorities for technological development, the methodologies developed by the WHO and the EMA for that purpose are presented. WHO's and Brazilian findings on main causes of burden of disease are briefly compared. WHO's selected findings on major therapeutical gaps and technological development priorities are also compared to priorities selected and supported by the PDP program since its inception. A divorce between medicines prioritized and supported by the PDP program and the main causes of the Brazilian burden of disease was observed. Also, the incremental cost-effectiveness ratios of several medications supported by the program were preliminarily estimated. The resulting ratios were about thirty times higher than the opportunity cost estimated for Brazil. Findings of the above comparisons and cost-effectiveness exercise indicate that inadequate choices were made by the PDP program in the way to a progressive and equanimous universal health access in Brazil, anticipating a low impact on the Brazilian total burden of disease as well as a low effectiveness, efficiency and equity of the program regarding the health of the Brazilian population as a whole.

Estudos brasileiros que analisaram as Parcerias para o Desenvolvimento Produtivo (PDP) apontam limitações do desenho e da implementação das PDPs de medicamentos vis à vis os objetivos de saúde do SUS. Este artigo discute a definição de prioridades para o desenvolvimento tecnológico e industrial do complexo da saúde (CEIS), com foco na universalidade e na equidade em saúde, tendo por objeto o programa de Parcerias para o Desenvolvimento Produtivo (PDP) do Ministério da Saúde, programa de gastos anuais multibilionários, iniciado em 2009. Para aprofundar a questão do processo utilizado para definir prioridades de desenvolvimento tecnológico, o presente trabalho revê as metodologias utilizadas pela OMSepela European Medicines Agency (EMA) para esse propósito. As prioridades de saúde definidas pela OMS, partindo principalmente do critério carga de doença, e as correspondentes lacunas terapêuticas selecionadas para desenvolvimento tecnológico, com base sobretudo em evidências de monitoramento do horizonte e de avaliação tecnológica, são resumidamente apresentadas. A seguir, foram comparados os achados do relatório da OMS_ as prioridades de saúde selecionadas e as prioridades tecnológicas resultantes_ com os achados sobre carga de doença no Brasil e as prioridades selecionadas e apoiadas pelas PDPs. Observou-se um divórcio entre as prioridades medicamentosas apoiadas pelas PDPs e as principais causas de carga de doença no país. Abordamos ainda, nesse artigo, o papel da análise de custo-efetividade e do custo de oportunidade na discussão das escolhas do programa PDP. O exemplo trabalhado indica que o custo de oportunidade de várias tecnologias apoiadas pelas PDPs vigentes é dezenas de vezes superior ao limiar de custo-efetividade estimado para o Brasil. O divórcio entre as prioridades apoiadas pelas PDPs e as principais causas de carga de doença no país e o limiar de custo-efetividade assumido pelo programa PDP indicam escolhas insatisfatórias na busca para alcançar, de forma progressiva e equânime, o acesso universal à atenção de saúde em nosso país, no SUS. Essas escolhas devem resultar em uma baixa efetividade, baixa eficiência e baixa equidade do programa do ponto de vista da saúde da população brasileira como um todo.

Burden of COVID-19 variant omicron in immunocompromised patients in Spain: systematic review. / Carga de la COVID-19 variante ómicron en pacientes inmunocomprometidos en España: revisión sistemática.

After the COVID-19 pandemic, the omicron variant of the SARS-CoV-2 virus became the dominant lineage in Spain in 2022. Although it possesses a milder pathogenicity than previous variants, it still poses a high risk of causing severe COVID-19 for immunocompromised populations. A systematic review was conducted to assess the burden of COVID-19 in Spain among immunocompromised patients during the omicron predominance (1/04/2022-1/04/2023), using PubMed, Cochrane Library, and EPICOVIDEHA between May and July 2023. The search retrieved 217 articles, of which a total of 5 were included. Upon analysis, it was observed that immunocompromised patients during the omicron lineage predominance continue to exhibit higher rates of hospitalizations, ICU admissions, and mortality compared to the general population affected by COVID-19. Although the pandemic has ended, the risk persists for immunocompromised individuals.

[Translated article] Pharmaceutical recommendations for therapeutic appropriateness in patients with multiple sclerosis.

OBJECTIVE: To determine the prevalence of PIMDINAC criteria and to implement pharmacological interventions in a population with multiple sclerosis over 55 years of age. METHODS: Retrospective, observational, open-label study, including patients with multiple sclerosis aged 55 years and older during December 2022 and February 2023. The main variable determined was the percentage of compliance with the PIMDINAC criteria. RESULTS: Ninety-five patients were included, with the presence of PIMDINAC criteria detected in 67.4%. The most frequently detected criterion was non-adherence to concomitant treatment (84.4%), followed by drug-drug interactions (56.2%) and potentially inappropriate medication (25%). A total of 20 pharmaceutical interventions were performed in 17 patients (17.9%). Potentially inappropriate medication was responsible for 11 interventions, non-adherence for 7, and drug-drug interactions for 2. The 81.8% of interventions were accepted, resulting in the discontinuation of 15 inappropriately prescribed drugs. The prevalence of PIMDINAC criteria in this group of patients is high. The study revealed that PIMDINAC criteria were prevalent in 67.4% of the study population, with polypharmacy playing an important role, suggesting the potential for a multidisciplinary approach, through pharmaceutical interventions to address unnecessary or duplicate treatments.

Análisis de la carga laboral en tiempo médico en función del grado de complejidad de las muestras y propuesta de algoritmo para la distribución equitativa del trabajo asistencial en un servicio de anatomía patológica / Analysis of the workload in medical time according to the degree of complexity of the samples and proposal of an algorithm for the equitable distribution of the workload in an anatomic pathology department

Introducción: En un servicio de anatomía patológica se analiza la carga laboral en tiempo médico en función de la complejidad de las muestras recibidas, y se valora su distribución entre los patólogos, presentado un nuevo algoritmo informático que favorece una distribución equitativa. Métodos: Siguiendo las directrices para la «Estimación de la carga de trabajo en citopatología e histopatología (tiempo médico) atendiendo al catálogo de muestras y procedimientos de la SEAP-IAP (2.ª edición)» se determinan las unidades de carga laboral (UCL) por patólogo y UCL global del servicio, la carga media laboral que soporta el servicio (factor MU), el tiempo de dedicación de cada patólogo a la actividad asistencial y el número de patólogos óptimo según la carga laboral del servicio. Resultados: Determinamos 12.197 UCL totales anuales para el patólogo jefe de servicio, así como 14.702 y 13.842 para los patólogos adjuntos, con una UCL global del servicio de 40.742. El factor MU calculado es 4,97. El jefe ha dedicado el 72,25% de su jornada a la asistencia y los adjuntos el 87,09 y 82,01%. El número de patólogos óptimo para el servicio es de 3,55. Conclusiones: Todos los resultados obtenidos demuestran la sobrecarga laboral médica, y la distribución de las UCL entre los patólogos no resulta equitativa. Se propone un algoritmo informático capaz de distribuir la carga laboral de manera equitativa, asociado al sistema de información del laboratorio, y que tenga en cuenta el tipo de muestra, su complejidad y la dedicación asistencial de cada patólogo.(AU)

Introduction: In a pathological anatomy service, the workload in medical time is analyzed based on the complexity of the samples received and its distribution among pathologists is assessed, presenting a new computer algorithm that favors an equitable distribution. Methods: Following the second edition of the Spanish guidelines for the estimation of workload in cytopathology and histopathology (medical time) according to the Spanish Pathology Society-International Academy of Pathology (SEAP-IAP) catalog of samples and procedures, we determined the workload units (UCL) per pathologist and the overall UCL of the service, the average workload of the service (MU factor), the time dedicated by each pathologist to healthcare activity and the optimal number of pathologists according to the workload of the service. Results: We determined 12 197 total annual UCL for the chief pathologist, as well as 14 702 and 13 842 UCL for associate pathologists, with an overall of 40 742 UCL for the whole service. The calculated MU factor is 4.97. The chief pathologist devoted 72.25% of his working day to healthcare activity while associate pathologists dedicated 87.09% and 82.01% of their working hours. The optimal number of pathologists for the service is found to be 3.55. Conclusions: The results demonstrate medical work overload and a non-equitable distribution of UCLs among pathologists. We propose a computer algorithm capable of distributing the workload in an equitable manner. It would be associated with the laboratory information system and take into account the type of specimen, its complexity and the dedication of each pathologist to healthcare activity.(AU)

Real-World Clinical, Psychosocial and Financial Burden of Atopic Dermatitis: Results from the Spanish Cohort of the MEASURE-AD Trial. / Carga clínica, psicosocial y económica de la dermatitis atópica en vida real: resultados de la cohorte española del estudio MEASURE-AD.

BACKGROUND: Atopic dermatitis (AD) is one of the most prevalent skin diseases, but there are numerous knowledge gaps surrounding the impact this disease has on quality of life (QoL), mental health, and out-of-pocket expenses involved in the management of AD. The available scientific evidence on the multidimensional burden of AD is usually based on studies with measures reported by patients themselves. METHODS: In this context, the MEASURE-AD trial was developed as a cross-sectional, multicenter, multinational trial using patient- and physician-reported measures to characterize the multidimensional burden of AD in adults with moderate-to-severe AD. RESULTS: This paper presents the results of the Spanish cohort. We found that Spanish adults with moderate-to-severe AD and high EASI score (21.1-72) had a significantly increased disease burden, high severity of symptoms such as itch and sleep disturbances, impaired mental health and QoL, higher use of health care resources, and more out-of-pocket expenses than patients with low EASI scores (0-7 or 7.1-21). CONCLUSIONS: This study provides information to better understand disease burden, and identify aspects to be improved in the management of AD.

Survival analysis of the surgical treatment of hepatocellular carcinoma at a tertiary care center.

INTRODUCTION AND AIMS: Hepatocellular carcinoma (HCC) is a primary malignant tumor of liver epithelial cells and is the most frequent primary liver cancer. The broadening of transplantation and resectability criteria has made therapeutic decisions more complex. Our aim was to describe the clinical and survival characteristics of patients with HCC treated through resection or liver transplantation at our hospital and identify the presence of factors that enable outcome prediction and facilitate therapeutic decision-making. MATERIALS AND METHODS: Patients with HCC that underwent surgery with curative intent at the Hospital Universitario Marqués de Valdecilla, within the time frame of 2007 and 2017, were retrospectively identified. Survival, mortality, disease-free interval, and different outcome-related variables were analyzed. RESULTS: Ninety-six patients with a mean follow-up after surgery of 44 months were included. Overall mortality and recurrence were higher in the resection group. Mean survival was 51.4 months in the liver transplantation group and 37.5 months in the resection group, and the disease-free interval was 49.4 ±â€¯37.2 and 27.4 ±â€¯28.7 months, respectively (p = 0.002). The tumor burden score was statistically significant regarding risk for recurrence and specific mortality. CONCLUSIONS: There appears to be no patient subgroup in whom the results of surgical resection were superior or comparable to those of transplantation. Tumor burden determination could be a useful tool for patient subclassification and help guide therapeutic decision-making.

Recommendations on the treatment of metastatic hormone-sensitive prostate cancer: Patient selection.

The standard treatment for metastatic hormone-sensitive prostate cancer (mHSPC) is now a combination of androgen deprivation therapy plus an androgen receptor-targeted therapy (abiraterone, apalutamide, enzalutamide or darolutamide), with or without chemotherapy (docetaxel). The selection of suitable patients for each therapeutic approach has become a determining factor to ensure efficacy and minimize side effects. This article combines recent clinical evidence with the accumulated experience of experts in medical oncology, radiation oncology and urology, to provide a comprehensive view and therapeutic recommendations for mHSPC.

Coronary atherosclerotic burden in veteran athletes: The relationship between cardiovascular risk and volume of exercise.

INTRODUCTION AND OBJECTIVES: The association between exercise and coronary atherosclerosis still remains unclarified. We aimed to analyze the prevalence of high coronary atherosclerotic burden in veteran athletes, considering cardiovascular (CV) risk and volume of exercise. METHODS: A total of 105 asymptomatic male veteran athletes (48±5.6 years old) were studied. A high coronary atherosclerotic burden was defined as one of the following characteristics in coronary computed tomography angiography: calcium score >100, >75th percentile, obstructive plaques, involving left main, three-vessels or two-vessels including proximal anterior descending artery, segment involvement score >5 or CT-adapted Leaman score ≥5. CV risk was stratified by SCORE2 and volume of exercise by metabolic equivalent task score. RESULTS: Most athletes (n=88) were engaged in endurance sports for 17.1±9.8 years, with a median exercise volume of 66 [IQR 44-103] metabolic equivalent of tasks/hour/week. The mean Systematic Coronary Risk Evaluation 2 was 2.8±1.5%; 76.9% of athletes had a low-moderate risk and none a very high risk. High coronary atherosclerotic burden was present in 25.7% athletes. Athletes with high cardiovascular risk and high exercise volume (above the median) showed significantly high coronary atherosclerotic burden compared to those with low-moderate risk and high volume (50.0% vs. 15.6%; p=0.017). Among athletes with low to moderate risk, a high volume of exercise tended to be protective, while in those with low volume, there was similar rate of high coronary atherosclerotic burden, regardless of CV risk. CONCLUSIONS: A combination of higher volume of exercise and high cardiovascular risk revealed the worst association with coronary atherosclerosis in veteran athletes. The relationship between these variables is controversial, but integrating exercise characteristics and risk assessment into preparticipation evaluation is essential.

Impact of a mobile application-based home care nursing program on patients' quality of life and family burden.

OBJECTIVE: This study aims to identify the effectiveness of a mobile application-based home care nursing service in improving patient quality of life and healthy lifestyle and reducing the family burden. METHODS: This study was a clinical trial with a pre- and post-test control group design. The accessible population in this study was post-discharge patients from general hospitals in West Kalimantan and East Kalimantan, Indonesia, who required home care nursing. We allocated a selected sample of 40 people to the intervention group and 40 people to the control group using a randomized block design. We gave mobile application-based home care nursing to the intervention group and community health nursing care to the control group. This study was conducted in 10 months (January-October 2022). We measure the patient quality of life, healthy lifestyle, and family burden before and 3 months after the intervention. RESULTS: There was no significant difference in the post-test quality of life between the two groups (p = 0.187), but there was a significant difference in the psychological (p = 0.014) and environmental health (p = 0.021) domain of quality of life. There was no significant difference in the post-test of a healthy lifestyle between the two groups (p = 0.083). There was a significant difference in the post-test family burden between the two groups (p = 0.015). CONCLUSION: Mobile Application-Based Home Care Nursing is effective in improving patient quality of life in the psychological and environmental health domains and reducing the family burden for post-discharge patients.

Salud mental asociada a la pandemia de COVID-19 en estudiantes de fisioterapia de la Universidad Nacional Autónoma de México / Mental health associated with the COVID-19 pandemic in physiotherapy students at the National Autonomous University of Mexico

Antecedentes y objetivo: A nivel mundial la pandemia por el COVID-19 ha interrumpido el aprendizaje de más de mil millones de estudiantes, quienes reportan alteraciones en la salud mental, niveles altos de estrés académico y carga de trabajo. En la Licenciatura en Fisioterapia de la Universidad Nacional Autónoma de México, 331 estudiantes dejaron de asistir a clases presenciales indispensables para su formación académica y, tras un año de confinamiento, se desconoce el impacto psicológico y académico en esta población. El objetivo fue evaluar la salud mental, carga de trabajo y estrés académico de los estudiantes e identificar la asociación entre variables. Materiales y métodos: Se aplicó el Cuestionario de Salud Emocional por la Pandemia de COVID-19 - Fisioterapia, la escala de carga de trabajo UNIPSICO Battery y el Cuestionario de estrés estudiantil COVID-19. Se incluyeron los alumnos inscritos entre el primer y cuarto año de la Licenciatura en Fisioterapia de la Universidad Nacional Autónoma de México mayores de 18 años que contestaron la encuesta vía online y otorgaron su consentimiento informado. Resultados: El 62,7% de los estudiantes reportaron ansiedad, el 61,8% reportaron depresión, el 51,0% indicaron una percepción moderada del estrés académico y el 42,2% percibieron una carga de trabajo alta. La ansiedad y depresión tuvieron una asociación estadísticamente significativa con el estrés académico y carga de trabajo (p<0,05). Conclusiones: El estudio evidencia los efectos psicológicos y académicos derivados de la pandemia del COVID-19 en estudiantes de fisioterapia, que amerita medidas de intervención fisioterapéuticas y académicas que mitiguen los efectos del confinamiento.(AU)

Background and objective: Worldwide, the COVID-19 pandemic has disrupted the learning of over a billion students, who report mental health disorders, high levels of academic stress, and workload. In the bachelor's degree in physical therapy at the National Autonomous University of Mexico, 331 students stopped attending essential face-to-face classes for their academic training, and after a year of confinement, the psychological and academic impact on this population is unknown. The objective was to evaluate the mental health, workload, and academic stress of students in the bachelor's degree and identify the association between variables. Materials and methods: The Emotional Health Questionnaire for the COVID-19 pandemic – physical therapy was applied, including the UNIPSICO battery workload scale and the COVID-19 student stress questionnaire. Students enrolled between the first and fourth year of the Bachelor's degree in Physical Therapy at the National Autonomous University of Mexico over 18 years old who completed the survey online and provided informed consent were included. Results: 62.7% of students reported anxiety, 61.8% reported depression, 51.0% indicated a moderate perception of academic stress, and 42.2% perceived a high workload. Anxiety and depression had a statistically significant association with academic stress and workload (P<.05). Conclusions: The study demonstrates the psychological and academic effects of the COVID-19 pandemic on physical therapy students, which warrants physiotherapeutic and academic intervention measures to mitigate the effects of confinement.(AU)

[Analysis of the workload in medical time according to the degree of complexity of the samples and proposal of an algorithm for the equitable distribution of the workload in an anatomic pathology department]. / Análisis de la carga laboral en tiempo médico en función del grado de complejidad de las muestras y propuesta de algoritmo para la distribución equitativa del trabajo asistencial en un servicio de anatomía patológica.

INTRODUCTION: In a pathological anatomy service, the workload in medical time is analyzed based on the complexity of the samples received and its distribution among pathologists is assessed, presenting a new computer algorithm that favors an equitable distribution. METHODS: Following the second edition of the Spanish guidelines for the estimation of workload in cytopathology and histopathology (medical time) according to the Spanish Pathology Society-International Academy of Pathology (SEAP-IAP) catalog of samples and procedures, we determined the workload units (UCL) per pathologist and the overall UCL of the service, the average workload of the service (MU factor), the time dedicated by each pathologist to healthcare activity and the optimal number of pathologists according to the workload of the service. RESULTS: We determined 12 197 total annual UCL for the chief pathologist, as well as 14 702 and 13 842 UCL for associate pathologists, with an overall of 40 742 UCL for the whole service. The calculated MU factor is 4.97. The chief pathologist devoted 72.25% of his working day to healthcare activity while associate pathologists dedicated 87.09% and 82.01% of their working hours. The optimal number of pathologists for the service is found to be 3.55. CONCLUSIONS: The results demonstrate medical work overload and a non-equitable distribution of UCLs among pathologists. We propose a computer algorithm capable of distributing the workload in an equitable manner. It would be associated with the laboratory information system and take into account the type of specimen, its complexity and the dedication of each pathologist to healthcare activity.

La mujer cubana en el levantamiento de pesas: una perspectiva metodológica

Uno de los deportes que más versatilidad representa es el levantamiento de pesas, pues su práctica no solo se reduce al deporte competitivo, sino es una actividad física que desarrolla la capacidad de fuerza, en el resto de los deportes. Esto constituye una realidad que se concreta en el rendimiento deportivo, sin embargo, las féminas que lo practican no cuentan con un tratamiento ajustado a su género, por lo que el objetivo de este trabajo consistió en determinar qué nivel de conocimientos poseen los entrenadores de levantamiento de pesas en Santiago de Cuba, para distribuir las cargas en el equipo femenino de este deporte. Para lograr este propósito, se implementaron métodos del nivel empírico como la observación científica aplicada a las +sesiones de entrenamiento y la encuesta a los entrenadores que atienden a estas atletas. Como resultado del diagnóstico, se declaró que existe un significativo desconocimiento sobre cómo distribuir las cargas en estas pesistas y se carece de una metodología para incrementar este conocimiento y mejorar los resultados competitivos del género femenino, en esta categoría.

Um dos esportes mais versáteis é o levantamento de peso, pois sua prática não se limita apenas ao esporte competitivo, mas é uma atividade física que desenvolve a capacidade de força em outros esportes. Essa é uma realidade que se reflete no desempenho esportivo, no entanto, as mulheres que o praticam não têm um tratamento ajustado ao seu gênero, por isso o objetivo deste estudo foi determinar qual o nível de conhecimento que os treinadores de halterofilismo em Santiago de Cuba têm para distribuir as cargas na equipe feminina desse esporte. Para atingir esse objetivo, foram utilizados métodos empíricos, como a observação científica aplicada às sessões de treinamento e uma pesquisa com os técnicos que treinam essas atletas. Como resultado do diagnóstico, constatou-se que há uma significativa falta de conhecimento sobre como distribuir as cargas nessas levantadoras de peso e que falta uma metodologia para aumentar esse conhecimento e melhorar os resultados competitivos do gênero feminino nessa categoria.

One of the sports that represents the most versatility is weightlifting, since its practice is not only reduced to competitive sports, but is a physical activity that develops strength capacity in the rest of the sports. This constitutes a reality that is reflected in sports performance, however, the women who practice it do not have treatment adjusted to their gender, so the objective of this work was to determine what level of knowledge lifting coaches have of weights in Santiago de Cuba, to distribute the loads in the women's team of this sport. To achieve this purpose, empirical level methods were implemented such as scientific observation applied to training sessions and surveys of coaches who care for these athletes. As a result of the diagnosis, it was declared that there is a significant lack of knowledge about how to distribute the loads in these weightlifters and there is a lack of a methodology to increase this knowledge and improve the competitive results of the female gender, in this category.

Identificación del alelo HLA B*57: 01 en una población militar, de Lima-Perú / Identification of the allele HLA B*57: 01 in a military population, from Lima-Peru

El alelo HLA B*57:01 es un marcador genético asociado con la hipersensibilidad al fármaco anti-retroviral abacavir (ABC) y su frecuencia en la población peruana todavía es desconocida. El objetivo fue identificar el alelo HLA B*57:01 en una población militar de Lima, Perú. Se reclutaron 43 personas viviendo con VIH (PVV) quienes aceptaron participar a través de un consentimiento informado. La detección del alelo HLA B*57:01 se realizó mediante RPC en tiempo real (RT-PCR). Asimismo, se determinó la carga viral (CV), el recuento de linfocitos CD4 y la genotipificación del VIH. Se identificaron dos casos positivos al alelo HLA B*57:01 (4,7%). Además, uno de ellos presentó múltiples mutaciones de resistencia a los anti-retrovirales (ARV), incluyendo ABC. Se demostró por primera vez en el Perú la presencia del alelo HLA B*57:01.

The HLA B*57:01 allele is a genetic marker associated with hypersensitivity to the antiretroviral Abacavir (ABC) and its frequency in the Peruvian population is still unknown. The objective was to identify the HLA B*57:01 allele in a military population from Lima, Peru. Forty three people living with HIV (PLWH) were recruited, who agreed to participate through informed consent. Detection of the HLA B*57:01 allele was performed by real-time PCR (RT-PCR). Likewise, viral load (VL), CD4 lymphocyte count and HIV genotyping were determined. Two cases positive for the HLA B*57:01 allele (4.7%) were identified. In addition, one of them had multiple resistance mutations to antiretrovirals (ARVs), including ABC. The presence of the HLA B*57:01 allele was demonstrated for the first time in Peru.

Dental implants in patients with ectodermal dysplasia: a computer guided quad zygomatic case report and literature review / Implantes dentales en pacientes con displasia ectodérmica: Reporte de caso y revisión de literatura

Abstract Ectodermal dysplasia (ED) is a genetic disorder affecting anatomical structures with an ectodermal origin. The consequent alveolar bone anomalies and lack of teeth require a multidisciplinary approach to rehabilitate patients function and esthetics. To avoid bone grafting procedures the application of zygomatic implants was suggested for the upper jaw treatment. The advancements in three-dimensional (3D) radiology and the introduction of digital implant planning software could enhance the approach to zygomatic implants in ED patients. The present case report describes the quad zygomatic implant treatment of the edentulous maxilla of an ED patient by means of computer guided implant surgery. The patient reported previous failure of bone grafting procedures in the upper jaw. The implants were immediately loaded with a screw-retained complete-arch resin prosthesis. The patient was followed up for 1 year with no biological nor mechanical complications reported, but a slight bone resorption in the anterior zone was observed. Zygomatic implants could be a potential alternative treatment to bone grafting in upper jaw and the digital implant planning could enhance the surgical procedure.

Resumen La displasia ectodérmica (DE) es una enfermedad genética que afecta las estructuras anatómicas de origen ectodérmico. Las consiguientes anomalías del hueso alveolar y la anodoncia requieren un planteamiento multidisciplinario para rehabilitar la función y la estética de los pacientes. Para evitar procedimientos de injerto óseo se sugirió la aplicación de implantes cigomáticos para el tratamiento del maxilar superior. Los avances en radiología tridimensional (3D) y la introducción de software de planificación de implantes digitales podrían mejorar el enfoque de los implantes cigomáticos en los pacientes con displasia ectodérmica. El presente reporte de caso describe el tratamiento con implantes cigomáticos en el maxilar superior edéntulo de un paciente con displasia ectodérmica mediante cirugía de implantes guiada por ordenador. El paciente refirió fracaso de procedimientos de injerto óseo en el maxilar superior. Los implantes se cargaron inmediatamente con una prótesis de resina de arcada completa. El paciente ha sido incluido en un programa de control postoperatorio por 1 año, sin reportarse complicaciones ni biológicas ni mecánicas, siendo el único problema encontrado una ligera reabsorción ósea en la zona anterior. Los implantes cigomáticos podrían ser un posible tratamiento alternativo al injerto óseo en el maxilar superior y la planificación de implantes digitales podría mejorar el procedimiento quirúrgico.

Smoking contribution to the global burden of metabolic disorder: A cluster analysis.

INTRODUCTION AND OBJECTIVES: Smoking is associated with various health risks, including cancer, cardiovascular disease, and chronic obstructive pulmonary disease. In this retrospective cohort study, we aimed to determine whether smoking is harmful to the whole metabolic system. METHODS: We collected data from 340 randomly selected participants who were divided into three groups: smokers (n=137), non-smokers (n=134), and ex-smokers (n=69). We obtained information on participants' body mass index, waist circumference, indicators of glucose metabolism, lipid metabolism, bone metabolism, and uric acid from health screen data during the past three years. A cluster analysis was used to synthesize each participant's overall metabolic characteristics. RESULTS: According to the cluster analysis, the 340 participants were divided into three groups: excellent metabolizers (137, 40.3%), adverse metabolizers (32, 9.4%), and intermediate metabolizers (171, 50.3%). The Chi-squared test analysis shows that people with different smoking statuses have different metabolic patterns. Non-smokers had the highest proportion of excellent metabolizers (56%), and current smokers had the highest proportion of adverse metabolizers (15.3%). The proportion of adverse metabolizers (5.8%) in the ex-smoker group was clinically relevantly lower than that of current smokers. CONCLUSION: The statistically significant differences in the distribution of smokers into different metabolic clusters indicate that smoking has adverse effects on the whole metabolic system of the human body, which further increases the existing global burden of metabolic disorders.

Estudio tecnofarmacéutico de los Anticuerpos Conjugados a Fármacos comercializados en España / Technopharmaceutical study of antibodies drug conjugated marketed in Spain

Introducción: el tratamiento del cáncer supone uno de los grandes desafíos a los que se enfrenta la sociedad cien-tífica actual. En esta lucha sanitaria, se desarrollan los anticuerpos conjugados a fármacos, capaces de lograr la muerte celular mediante el transporte y liberación de compuestos citotóxicos selectivamente sobre células tumorales. Se componen de un anticuerpo monoclonal (de naturaleza proteica) unido a un fármaco citotóxico (de carácter lipófilo) mediante un enlazador. Las formulaciones se han de diseñar para mantener dicha unión durante su almacenamiento y administración. Objetivo: identificar los medicamentos comercializados en España cuyo principio activo es un anticuerpo conjugado a fármaco, estudiando diferentes aspectos tecnofarmacéuticos, en especial los componentes de sus formulaciones. Método: dado que este tipo de medicamento pertenece al grupo ATC L01F, han sido identificados a través del bus-cador de la Agencia Española de Medicamentos y Productos Sanitarios. La consulta de sus fichas técnicas, artículos de revisión e investigación relacionados con el tema así como el Handbook of Pharmaceuticals Excipients, ha permitido realizar el estudio tecnofarmacéutico. Resultados: se han analizado distintos aspectos tecnofarmacéuticos: forma farmacéutica, vía de administración, conservación y, en especial, sus formulaciones. Se ha estudiado en profundidad la naturaleza del principio activo y los requisitos de las formulaciones en base a sus características. Conclusiones: los ocho anticuerpos conjugados a fármacos aprobados en España se presentan en forma de polvo liofilizado en vial que se deben almacenar entre 2-8 ºC. Para su administración, se reconstituyen obteniéndose inicialmente un concentrado, que posteriormente se diluye y administra en forma de perfusión intravenosa o goteo. Su formulación tipo incluye un lioprotector, un antiagregante, un regulador del pH y eventualmente antioxidantes o reductores de la viscosidad. (AU)

Introduction: cancer treatment is one of the great challenges facing today’s scientific society. In this health fight, drug-conjugated antibodies (ADCs) are being developed, drugs capable of causing cell death by transporting and releasing cytotoxic compounds into tumor cells. They are composed of a monoclonal antibody (of protein nature) linked to a cytotoxic drug (of lipophilic character) through a linker. Formulations must be designed to maintain this binding during storage and administration.Objective: identify the medicines marketed in Spain whose active ingredient is an antibody-drug conjugate, studying techno pharmaceutical aspects, especially the components of their formulations. Method: since this type of drugs belongs to the ATC group L01F, they have been identified through the search engine of the Spanish Agency of Medicines and Health Products. The search for their technical sheets, along with articles of review and research related to the topic, as well as the Handbook of Pharmaceuticals Excipients, has enabled the execution of the techno pharmaceutical study.the formulation of the tested conjugates to drugs marketed in Spain belonging to the ATC L01F group corresponding to “monoclonal antibodies and tested conjugated to drugs” identified through the search engine of the Spanish Agency of Medicines and Health Products has been studied. Results: different aspects of this group of drugs have been analyzed, such as the pharmaceutical form, the route of administration, conservation and especially the techno pharmaceutical formulation. The nature of the active ingredient and the requirements of the formulations based on their characteristics have been studied in depth. Conclusions: the eight antibody-drug conjugates approved in Spain are presented in the form of lyophilized powder in a vial and should be stored between 2-8 ºC... (AU)

Pharmaceutical recommendations for therapeutic appropriateness in multiple sclerosis patients. / Recomendaciones farmacéuticas de adecuación terapéutica en pacientes con esclerosis múltiple.

OBJECTIVE: To determine the prevalence of PIMDINAC criteria and to implement pharmacological interventions in a population with multiple sclerosis over 55 years of age. METHODS: Retrospective observational open-label study including patients with multiple sclerosis aged 55 years and older between December 2022 and February 2023. The main variable determined was the percentage of compliance with the PIMDINAC criteria. RESULTS: Ninety-five patients were included, with the presence of PIMDINAC criteria detected in 67.4%. The most frequently detected criterion was non-adherence to concomitant treatment (84,4%), followed by drug-drug interactions (56.2%) and potentially inappropriate medication (25%). A total of 20 pharmaceutical interventions were performed in 17 patients (17.9%). Potentially inappropriate medication was responsible for 11 interventions, non-adherence for 7 and drug-drug interactions for 2. The 81.8% of interventions were accepted, resulting in the discontinuation of 15 inappropriately prescribed drugs. The prevalence of PIMDINAC criteria in this group of patients is high. The study revealed that PIMDINAC criteria were prevalent in 67.4% of the study population, with polypharmacy playing an important role, suggesting the potential for a multidisciplinary approach, through pharmaceutical interventions to address unnecessary or duplicate treatments.

Ejecución neuropsicológica y carga de enfermedad en sujetos en riesgo de desarrollar enfermedad de Huntington / Neuropsychological performance and disease burden in individuals at risk of developing Huntington disease

Introducción La enfermedad de Huntington (EH) es un trastorno neurodegenerativo y hereditario. Gracias al diagnóstico predictivo se han descrito características clínicas incipientes en la fase prodrómica. Objetivo Comparar la ejecución en tareas cognitivas de portadores (PEH) del gen de la huntingtina y no portadores (NPEH) y observar la variabilidad en la ejecución, dependiendo de la carga de la enfermedad y cercanía a la etapa manifiesta (edad de inicio de los síntomas). Método Los 146 participantes de un Programa de Diagnóstico Predictivo de EH (PDP-EH) fueron divididos en PEH (41,1%) y NPEH (58,9%). Mediante fórmulas matemáticas se obtuvo la carga de enfermedad y cercanía a la etapa manifiesta en el grupo PEH y se correlacionó con la ejecución neuropsicológica. Resultados Se observaron diferencias significativas entre los grupos con las pruebas Mini-Mental State Examination (MMSE), Stroop-B, SDMT y fluidez fonológica. En el grupo PEH se observaron correlaciones entre la carga de enfermedad con la MMSE, Stroop-B y SDMT. El grupo «Cerca» de la etapa manifiesta es el que obtuvo la puntuación más baja en las pruebas MMSE, Stroop-B, Stroop-C, SDMT y fluidez verbal semántica. De acuerdo al MANCOVA, el efecto MMSE evidencia diferencias estadísticamente significativas entre carga de la enfermedad y la cercanía de inicio de los síntomas. Conclusiones Se observa un nivel menor de desempeño en el grupo PEH con probabilidad de inicio cercano de la fase manifiesta en pruebas que evalúan la velocidad de procesamiento y atención. La disfunción cognitiva prefrontal se altera de manera precoz varios años antes del diagnóstico motor de la EH. (AU)

Introduction Huntington disease (HD) is a hereditary neurodegenerative disorder. Thanks to predictive diagnosis, incipient clinical characteristics have been described in the prodromal phase. Objective To compare performance in cognitive tasks of carriers (HDC) and non-carriers (non-HDC) of the huntingtin gene and to analyse the variability in performance as a function of disease burden and proximity to the manifest stage (age of symptom onset). Method A sample of 146 participants in a predictive diagnosis of HD programme were divided into the HDC (41.1%) and non-HDC groups (58.9%). Mathematical formulae were used to calculate disease burden and proximity to the manifest stage in the HDC group; these parameters were correlated with neuropsychological performance. Results Significant differences were observed between groups in performance on the Mini-Mental State Examination (MMSE), Stroop-B, Symbol-Digit Modalities Test (SDMT), and phonological fluency. In the HDC group, correlations were observed between disease burden and performance on the MMSE, Stroop-B, and SDMT. The group of patients close to the manifest stage scored lowest on the MMSE, Stroop-B, Stroop-C, SDMT, and semantic verbal fluency. According to the multivariate analysis of covariance, the MMSE effect shows statistically significant differences in disease burden and proximity to onset of symptoms. Conclusions Members of the HDC group close to the manifest phase performed more poorly on tests assessing information processing speed and attention. Prefrontal cognitive dysfunction appears early, several years before the motor diagnosis of HD. (AU)