High Rate of Change of the Foot in Ecuadorian Children: The Need for Proper Shoe Design.

BACKGROUND: Physiological changes in the foot may be influenced by external factors such as shoe types or demographic parameters, leading to podiatric conditions in adulthood. The aim of this study was to assess the changes in morphological measurements of the feet of boys and girls during childhood and adolescence. METHODS: A total of 1678 Ecuadorian children aged 8 to 17 years participated in the study. The length, width, and height of the foot were analyzed using a 3D scanner to obtain the arch height ratio for the diagnosis of pediatric flat foot. RESULTS: Statistical differences were observed for lengths, widths, and perimeters of the foot in boys aged 5 to 15-16 years and girls aged 5 to 12-13 years. Differences in the height of the navicular bone were found in all age groups, with changes from 2.8 to 4.1% in boys and from 1.3 to 1.5% in girls. The greatest differences between boys and girls of the same age were found at 14 years old onwards. The highest prevalence of flat foot was found in 8-year-old girls (64.9%) and in 12-year-old boys (82.5%). CONCLUSIONS: The feet of Ecuadorian children develop progressively during childhood and adolescence. Boys presented with longer and wider feet than girls of the same age. The highest prevalence of flat foot was found in 12-year-old boys and 8-year-old girls.

Caecum OX40+CD4 T-cell subset associates with mucosal damage and key markers of disease in treated HIV-infection.

BACKGROUND: Blood OX40-expressing CD4 T-cells from antiretroviral (ART)-treated people living with HIV (PWH) were found to be enriched for clonally-expanded HIV sequences, hence contributing to the HIV reservoir. OX40-OX40L is also a checkpoint regulator of inflammation in multiple diseases. We explored gut mucosal OX40+CD4+ T-cells and their potential significance in HIV disease. METHODS: Biopsies of caecum and terminal-ileum of ART-treated PWH (n = 32) were obtained and mucosal damage and HIV reservoir were assessed. Mucosal OX40+ and Ki67+ CD4 T-cell subsets, as well as several tissue T-cell subsets modulating mucosal integrity and homeostasis (Th17, Th22, Treg, Tc17, Tc22, IL17+TCRγδ, IL22+TCRγδ) were quantified. Inflammatory-related markers, T-cell activation and thymic output were also determined in blood samples. Correlations were explored using Spearman rank test and corrected for multiple comparisons by Benjamini-Hochberg. RESULTS: Compared to healthy controls, a high frequency of mucosal, mainly caecum, CD4 T-cells were OX40+ in PWH. Such frequency strongly correlated with nadir CD4 (r = -0.836; p < 0.0001), CD4/CD8 ratio (r = -0.630; p = 0.002), caecum mucosal damage (r = 0.606; p = 0.008), caecum Th22 (r = -0.635; p = 0.002), caecum Th17 (r = 0.474; p = 0.03) and thymic output (r = -0.686; p < 0.001). It also correlated with Neutrophil-to-Lymphocyte Ratio and blood CD4 T-cell activation and tended to with mucosal HIV reservoir. CONCLUSION: High frequencies of caecum OX40+CD4 T-cells are found in people with HIV (PWH) and successful viral control. Interestingly, this cellular subset reflects key markers of disease and peripheral T-cell activation, as well as HIV-driven mucosal damage. OX40+CD4 T-cells deserve further investigation since they could expand because of T-cell homeostatic proliferation and relate to the Th22/Th17 gut mucosal ratio.

Lateral wedge insoles and their use in ankle instability.

The aim of the present study is to assess the immediate effects of applying lateral wedge insoles of different heights (0.00, 0.3, 0.4, and 0.6 cm) in patients with chronic ankle instability (CAI) in normal and supinated feet during a Star Excursion Balance Test (SEBT) and in the reflex response of Peroneus Longus (PL), Peroneus Brevis (PB), and Tibialis Anterior (TA) over a 30° inversion of the feet. The effects of the height of the wedges were assessed using a double-blind, crossover design. In total, 25 participants were allocated into two groups, depending on the foot posture (Normal = 12, Supinated = 13) and performed the tests in a random fashion. Reaction time (RT) of stabilizing muscles of the ankle was measured using superficial electromyography (EMG) and postural balance with the SEBT. Foot posture did not show any significant effects on the analyzed variables. Nonetheless, the use of a 0.3 cm external rearfoot wedge (PB p = 0.002; PL p = 0.066 and TA p = 0.006) and 0.6 cm (PB p = 0.043; PL p = 0.058 and TA p = 0.071) reduces RT in stabilizing muscles of the ankle and improves results in SEBT, except for the anterolateral direction, in subjects with CAI. Therefore, our results suggest that the use of lateral wedge insoles could reduce RT and improve dynamic balance in chronic ankle instability.

Importancia de la nutrición en el trastorno por déficit de atención e hiperactividad (TDAH) / Importance of nutrition in attention deficit hiperactivity disorder (ADHD)

Introducción: La alimentación puede influir sobre las macro y microestructuras cerebrales y la función de neurotransmisores; todo esto, en su conjunto, va a tener impacto sobre el desarrollo cognitivo. El sistema nervioso central es más vulnerable a la influencia nutricional en aquellos periodos en los que el crecimiento, desarrollo y plasticidad son más intensos. El trastorno por déficit de atención e hiperactividad (TDAH) es el desorden del neurodesarrollo más frecuente en la edad pediátrica, afecta entre un 2 y un 12 por ciento de los niños y adolescentes. Se estima que la prevalencia en la Argentina es similar al del resto del mundo, esto es, alrededor de un 5% en menores de 18 años. La alimentación juega un papel fundamental en la salud de quienes padecen este trastorno, ya que puede contribuir de forma considerable a mejorar tanto su salud, como su calidad de vida. Por lo expuesto, el objetivo de este trabajo es realizar una actualización bibliográfica, sobre el efecto que la alimentación en general y algunos nutrientes en particular (azúcares simples, ácidos omega3, dieta mediterránea, minerales, microbiota intestinal) tienen sobre esta patología psiquiátrica. Métodos: Se tomó como base las publicaciones en Pub Med y LILACS en el periodo 2015-2021, trabajos completos, en español e inglés. Resultados y conclusiones: De esta revisión bibliográfica emergen muchas dudas por falta de evidencias concretas y se vislumbra la necesidad de seguir estudiando y analizando los efectos de la alimentación en los individuos, de los diferentes rangos de edad, que padecen TADH. Pero también surgen algunos consejos nutricionales que, junto con el tratamiento farmacológico correspondiente, serán de utilidad para mejorar la calidad de vida de estos niños/jóvenes/adultos

Introduction: Diet can influence brain macro and microstructures and neurotransmitter function; all this together will have an impact on cognitive development. The central nervous system is more vulnerable to nutritional influence in those periods when growth, development and plasticity are more intense. Attention deficit disorder and hyperactivity (ADHD) is the most frequent neurodevelopmental disorder in pediatric age, affects between 2 and 12 percent of children and adolescents. It is estimated that the prevalence in Argentina is similar to that of the rest of the world, that is, around 5% in those under 18 years of age. Diet plays a fundamental role in the health of those who suffer from this disorder, since it can contribute considerably to improving both their health and their quality of life. Therefore, the objective of this work is to carry out a bibliographic update on the effect that food in general and some nutrients in particular (simple sugars, omega3 acids, Mediterranean diet, minerals, intestinal macrobiotic), have on this psychiatric pathology. Methods: The publications in Pub Med and LILACS in the period 2015-2021, complete works, in Spanish and English, were taken as a basis. Results and conclusions: many doubts arise, from this bibliographic review, due to the lack of concrete evidence and the need to continue studying and analyzing the effects of diet on individuals, of different ranges of age, who suffer from ADHD. But there are also some nutritional tips that, together with the corresponding pharmacological treatment, will be useful to improve the quality of life of these children/young people/adults

Sudden cessation of fluoxetine before alcohol drinking reinstatement alters microglial morphology and TLR4/inflammatory neuroadaptation in the rat brain.

Preclinical studies on the effects of abrupt cessation of selective serotonin reuptake inhibitors (SSRIs), a medication often prescribed in alcohol use disorder (AUD) patients with depression, results in alcohol consumption escalation after resuming drinking. However, a potential neuroinflammatory component on this escalation remains unexplored despite the immunomodulatory role of serotonin. Here, we utilized a rat model of 14-daily administration of the SSRI fluoxetine (10 mg/kg/day) along alcohol self-administration deprivation to study the effects of fluoxetine cessation on neuroinflammation after resuming alcohol drinking. Microglial morphology and inflammatory gene expression were analyzed in prelimbic cortex, striatum, basolateral amygdala and dorsal hippocampus. Results indicated that alcohol drinking reinstatement increased microglial IBA1 immunoreactivity and altered morphometric features of activated microglia (fractal dimension, lacunarity, density, roughness, and cell area, perimeter and circularity). Despite alcohol reinstatement, fluoxetine cessation modified microglial morphology in a brain region-specific manner, resulting in hyper-ramified (spatial complexity of branching), reactive (lower heterogeneity and circularity)-like microglia. We also found that microglial cell area correlated with changes in mRNA expression of chemokines (Cx3cl1/fractalkine, Cxcl12/SDF1α, Ccl2/MCP1), cytokines (IL1ß, IL6, IL10) and the innate immune toll-like receptor 4 (TLR4) in dorsal hippocampus. Specifically, TLR4 correlated with microglial spatial complexity assessed by fractal dimension in striatum, suggesting a role in process branching. These findings suggest that alcohol drinking reinstatement after fluoxetine treatment cessation disturbs microglial morphology and reactive phenotype associated with a TLR4/inflammatory response to alcohol in a brain region-specific manner, facts that might contribute to alcohol-induced damage through the promotion of escalation of alcohol drinking behavior.

Immunological features beyond CD4/CD8 ratio values in older individuals.

The CD4/CD8 T-cell ratio is emerging as a relevant marker of evolution for many pathologies and therapies. We aimed to explore immunological features beyond CD4/CD8 ratio values in older subjects (>65 years old) who were classified as having lower (<1.4), intermediate (1.4-2), or higher (>2) ratio values. The lower group showed a lower thymic output (sj/ß-TREC ratio) and frequency of naïve T-cells, concomitant with increased mature T-cells. In these subjects, the CD4 T-cell subset was enriched in CD95+ but depleted of CD98+ cells. The regulatory T-cell (Treg) compartment was enriched in CTLA-4+ cells. The CD8 T-cell pool exhibited increased frequencies of CD95+ cells but decreased frequencies of integrin-ß7+ cells. Interestingly, in the intermediate group, the CD4 pool showed greater differences than the CD8 pool, mostly for cellular senescence. Regarding inflammation, only hsCRP was elevated in the lower group; however, negative correlations between the CD4/CD8 ratio and ß2-microglobulin and sCD163 were detected. These subjects displayed trends of more comorbidities and less independence in daily activities. Altogether, our data reveal different thymic output and immune profiles for T-cells across CD4/CD8 ratio values that can define immune capabilities, affecting health status in older individuals. Thus, the CD4/CD8 ratio may be used as an integrative marker of biological age.

Efecto de la suplementación con ácidos grasos n-3 sobre el perfil de lípidos séricos de ratas

RESUMEN La grasa alimentaria influye en la modulación de las funciones inmunitarias y los procesos inflamatorios; la mayor parte del impacto se atribuye a los ácidos grasos poliinsaturados de cadena larga (AGPI). Los ácidos grasos esenciales (AGE), como el Ácido Linoleico (AL; 18:2n-6) y el Ácido α-Linolénico (AAL; 18:3n-3), que deben ser incorporados con la dieta, son precursores de otros ácidos grasos de gran importancia para el organismo. El AAL, perteneciente a la familia n-3, da origen a los ácidos Eicosapentaenoico (EPA; 20:5n-3) y Docosahexaenoico (DHA; 22:6n-3). Ellos confieren flexibilidad, fluidez y permeabilidad a las membranas, que favorece la salud cardiovascular, reduce el riesgo de deficiencias en la visión y el desarrollo neural de bebés y niños y de demencia en adultos mayores; algunos son precursores en la síntesis de prostaglandinas. También se han observado efectos en la prevención y tratamiento de enfermedades coronarias, hipertensión, diabetes, artritis, inflamaciones, desórdenes autoinmunes y cáncer. Estos efectos pueden explicarse a través de las acciones específicas de cada uno de ellos. El objetivo del estudio fue analizar el efecto de una dieta a base de manteca, con y sin la suplementación de AGPI n-3 sobre los lípidos y perfil de AG séricos, de ratas en período de crecimiento activo. Ratas Wistar al destete, recibieron durante 10 días una dieta normocalórica a base de manteca (M). Los otros grupos recibieron la misma dieta suplementada con 24 mg/día de aceite de pescado (MP) -aportador de EPA y DHA- o aceite de chía (MCh)- que proporciona ácido α-linolénico (AAL). El control recibió dieta según AIN´93. Se determinó colesterol total y triglicéridos por métodos enzimáticos y el perfil de ácidos grasos sérico, por cromatografía gaseosa. Resultados: Los grupos M, MP y MCh mostraron niveles más bajos de linoleico y más altos de oleico serie n-9, comparados con C. Sólo M y MP presentan valores bajos de AAL. Los grupos MP y MCh presentaron altos niveles de EPA y DHA. La suplementación con aceite de chía, es más beneficiosa que con aceite de pescado, incrementando el EPA y DHA sérico junto con el AAL. Conclusión: No sólo es importante el porcentaje de lípidos dietarios que se consumen sino también el perfil de ácidos grasos que componen los alimentos.

ABSTRACT Dietary fat influences the modulation of immune functions and inflammatory processes; most of the impact is attributed to long-chain polyunsaturated fatty acids. Essential fatty acids, such as Linoleic Acid (AL) and α-Linolenic Acid (ALA), which must be incorporated in the diet, are precursors of other fatty acids of great importance for the body. ALA, belonging to n-3 family, gives rise to Eicosapentaenoic (EPA) and Docosahexaenoic (DHA) acids. They confer flexibility, fluidity and selective permeability to the membranes, which favor cardiovascular health, reduce the risk of deficiencies in vision and neural development in infants and children, and dementia in older adults; some are precursors in the synthesis of prostaglandins. Effects have also been observed in the prevention and treatment of coronary heart disease, hypertension, diabetes, arthritis, inflammation, autoimmune disorders, and cancer. These effects can be explained through the specific actions of each of them. The objective was to analyze the effect of a butter-based diet, with and without n-3 fatty acid supplementation, on the lipids and serum fatty acid profile of rats in a period of active growth. Wistar rats at weaning received a normo-caloric butter-based diet for 10 days (M). The other groups received the same diet supplemented with 24 mg / day of fish oil (MP) -providing EPA and DHA- or chia oil (MCh)- containing linolenic acid (ALA). The control (C) received a diet according to AIN'93. Total cholesterol and triglycerides were determined by enzymatic methods and the serum fatty acid profile, by gas chromatography. Results: M, MP and MCh groups showed lower levels of linoleic and higher levels of oleic-n-9, compared to C. Only M and MP have low values of ALA. The MP and MCh groups presented high levels of EPA and DHA. Chia oil supplementation is more beneficial than fish oil, increasing serum EPA and DHA along with ALA. Conclusion: Not only the dietary lipids percentage is important but also the fatty acid profile of the source too.

Importancia de los ácidos grasos Omega 3 en la salud / Importance of Omega 3 fatty acids in health

La grasa alimentaria influye en la modulación de las funciones inmunitarias y los procesos inflamatorios; la mayor parte del impacto se atribuye a los ácidos grasos poliinsaturados de cadena larga (long-chain polyunsaturated fatty acids, LCPUFA, sus siglas en inglés). Los ácidos grasos esenciales (AGE), como el ácido linoleico (AL) y el ácido α-linolénico (AAL), que deben incorporarse por la dieta, son precursores de otros AG de gran importancia para el organismo. El AAL, perteneciente a la familia ω3, da origen a los ácidos eicosapentaenoico (EPA) y docosahexaenoico (DHA). Ellos confieren flexibilidad, fluidez y permeabilidad selectiva a las membranas lo que favorece la salud cardiovascular, reduce el riesgo de deficiencias en la visión y el desarrollo neural de bebés y niños, y de demencia en adultos mayores; algunos son precursores en la síntesis de prostaglandinas. También se observan efectos en la prevención y tratamiento de enfermedades coronarias, hipertensión, diabetes, artritis, inflamaciones, desórdenes autoinmunes y cáncer. Estos efectos pueden explicarse a través de las acciones específicas de cada uno de ellos1-3. El EPA ejerce: efecto hipotrigliceridémico a nivel de LDL y VLDL, efecto hipocolesterolémico por aumento de eflujo biliar y del transporte reverso de colesterol, y efecto antitrombótico por formación de eicosanoides de la serie 3. El DHA aumenta la fluidez de las membranas neuronales, gliales, y de conos y bastoncitos, disminuye la apoptosis neuronal, facilita el reciclaje de neurotransmisores, regula la expresión de enzimas involucradas en el metabolismo de lípidos como ligando de PPARs (peroxisome proliferator activated receptors) e inhibe la resistencia a la insulina a los tejidos musculares y adiposo3-7. Las recomendaciones de ingesta son: ácidos grasos poliinsaturados ω6: 2,5-9% de ingesta energética/diaria, y ácidos grasos poliinsaturados ω3: 0,6-2,0% de ingesta energética/diaria8

Omega 3 fatty acids are polyunsaturated fatty acids, essential since the human body does not produce them and they are obtained mainly from the diet. They confer flexibility, fluidity and selective permeability to the membranes, which favors cardiovascular health, reduces the risk of deficiencies in vision and neural development in infants and children, and dementia in older adults; some of them are precursors in the synthesis of prostaglandins. Some effects have also been seen in the prevention and treatment of coronary heart disease, hypertension, diabetes, arthritis, inflammation, autoimmune disorders, and cancer. These effects can be explained through the specific actions of each of them. Dietary fat influences the modulation of immune functions and inflammatory processes; most of the impact is attributed to long-chain polyunsaturated fatty acids (LCPUFA). The EPA exerts: hypotriglyceridemic effect at LDL and VLDL level; hypocholesterolemic effect due to increase in bile efflux and reverse cholesterol transport; antithrombotic effect due to the formation of Series 3 eicosanoids. DHA: increases the fluidity of neuronal, glial, and cone and rod membranes; decreases neuronal apoptosis; facilitates the recycling of neurotransmitters; regulates the expression of enzymes involved in lipid metabolism as a ligand for PPARs; inhibits insulin resistance to muscle and fat tissues. The intake recommendations are: 6 polyunsaturated fatty acids: 2.5-9% of energy intake/daily, and ω3 polyunsaturated fatty acids: 0.6-2.0% of energy intake/daily

Spectrophotometric Color Measurement to Assess Temperature of Exposure in Cortical and Medullar Heated Human Bones: A Preliminary Study.

Heated-bone color changes may provide information about temperature of exposure, with interest for anthropologists and forensic experts. The aim of this study was to assess heat-induced color changes by spectrophotometry in cortical and medullar human bones heated at different temperatures and times. CIELAB (International Commission on Illumination-LAB) color parameters (L*, a*, and b*) and whiteness (WI) and yellowness (YI) indexes were obtained by spectrophotometry in the cortical and medullar zones of 36 bone sections exposed at 200, 400, 600, and 800 °C for 30 and 60 min. The accuracy of color-based temperature estimations was evaluated by Receiver Operating Characteristics (ROC) analysis. Chromaticity a* showed the best significant discrimination power with the area under the ROC curve (AUC) values ranged from 0.9 to 1.0 in cortical zones and 0.7 to 1.0 in medullar zones for all temperatures of exposures and both time of exposures. Chromaticity b*, and WI and YI indexes showed an AUC of 1.0 at 400, 600, and 800 °C for 30 and 60 min in the cortical and medullar zones. The spectrophotometric color parameters provided a highly accurate estimation of the temperature of exposure to discriminate between temperatures and exposure times in the cortical and medullar zones. Spectrophotometric bone color measurement in cortical and medullar zones can be an objective and reproducible method to estimate the temperature of exposition, and it can be considered useful for forensic and anthropological purposes.

Condición física saludable y su relación con habilidades básicas para la independencia del adulto mayor / Healthy physical condition and its relationship with basic skills for the independence of the senior citizen / Condição física saúdavel e sua relação com habilidades básicas para a independência do idoso

Introducción: se estudia la relación entre la condición física saludable y algunas habilidades básicas para la independencia de las personas mayores del municipio de La Plata, Argentina, desde el año 2015 al 2018. Hipótesis: Las personas adultas mayores que tienen mejor condición física tienen mayor independencia para las actividades de la vida diaria básicas. Métodos: se aplicó el test de Barthel para medir las habilidades para la vida diaria en adultos mayores. Se midió la fuerza máxima de prensión con dinamómetro, y se tomaron las pruebas "velocidad de la marcha" y "time up and go", para evaluar condición física. Se calculó correlación, coeficiente de determinación. Resultados: 91 adultos mayores, 25 hombres, 64 mujeres. Edad: 74,81±9,38, peso: 69,99±19,09, talla: 155±13,06. A medida que aumentó la edad, la fuerza máxima disminuyó significativamente (r-0,40 R2 0,16, p<0,05). La fuerza muscular es significativamente mayor en personas que son independientes que en aquellas que tienen algún grado de dependencia (dependientes Fmax 17,47 kg ± 6,58 P<0,05 con IC 95% 14,1-20, 85 vs independientes Fmax 23,76 kg ± 6,3 P<0,05 con IC 95% 22,27-25,25). Conclusiones: la fuerza máxima de prensión de la mano está relacionada con la independencia para las actividades de la vida diaria. El componente de fuerza muscular puede ser relevante en programas de salud y calidad de vida en esta población.

Introduction: The relationship between healthy physical condition and some basic skills for the independence of the senior citizen in the Municipality of La Plata, Argentina, from 2015 to 2018 is studied. Hypothesis: senior citizens who are in better physical condition have greater independence for basic activities of daily living. Methods: the Barthel test was applied to measure daily living skills on senior citizens. The maximum grip strength was measured with dynamometer, and the "walking speed" and "time up and go" tests were applied to assess physical condition. Correlation, coefficient of determination was calculated. Results: A total of 91 senior citizens, 25 men, 64 women with an average age of 74.81 ± 9.38, average weight 69.99 ± 19.09, and average height 155 ± 13.06 were evaluated. As age increased, the maximum strength decreased significantly (r-0.40, R2 0.16, p <0.05). Maximum strength is significantly greater in people who are independent than in those who have some degree of dependence (dependent Fmax 17,47kg ± 6,58 with IC 95% 14,1-20,85 vs independent 23,76 kg ± 6,3 P <0.05 with IC 95% 22.27-25.25). Conclusions: the maximum grip strength of the hand is related to the independence for activities of daily living. The component of muscular strength may be relevant in health and quality of life programs in this population.

A escola é um espaço privilegiado de promoção da saúde, em Colômbia se desenvolve a estratégia escola saudável como uma ferramenta integradora de políticas em saúde no âmbito escolar. Objetivo: o estudo busca avaliar a execução da estratégia escola saudável no contexto rural do município de Ibagué. Materiais e métodos: a avaliação da execução se realizou mediante a construção de um modelo lógico e a definição de critérios avaliativos em relação com os ambientes saudáveis, as políticas públicas e planos para a escola saudável, a participação social, o empoeiramento e a educação para a saúde. Avaliaram se um total de 93 escolas rurais, a informação foi levantada mediante questionários aos responsáveis das escolas e a través de entrevistas aos gestores de saúde. Resultados: se identificaram problemáticas sanitárias e ambientais nas escolas associadas às carências da ruralidade, falta de articulação do setor saúde e educação, baixa participação social, a educação enfocada à prevenção da doença. Conclusão: promover os entornos escolares saudáveis na ruralidade requer de um marco legal nacional e local que garante à atuação estadual, a intersetorial, a participação efetiva do setor educativo, a renovação da saúde e que promova interesses e vontades político, sociais e administrativas.

Condición física saludable y su relación con habilidades básicas para la independencia del adulto mayor / Healthy physical condition and its relationship with basic skills for the independence of the senior citizen / Condição física saúdavel e sua relação com habilidades básicas para a independência do idoso

Resumen Introducción: se estudia la relación entre la condición física saludable y algunas habilidades básicas para la independencia de las personas mayores del municipio de La Plata, Argentina, desde el año 2015 al 2018. Hipótesis: Las personas adultas mayores que tienen mejor condición física tienen mayor independencia para las actividades de la vida diaria básicas. Métodos: se aplicó el test de Barthel para medir las habilidades para la vida diaria en adultos mayores. Se midió la fuerza máxima de prensión con dinamómetro, y se tomaron las pruebas "velocidad de la marcha" y "time up and go", para evaluar condición física. Se calculó correlación, coeficiente de determinación. Resultados: 91 adultos mayores, 25 hombres, 64 mujeres. Edad: 74,81±9,38, peso: 69,99±19,09, talla: 155±13,06. A medida que aumentó la edad, la fuerza máxima disminuyó significativamente (r-0,40 R2 0,16, p<0,05). La fuerza muscular es significativamente mayor en personas que son independientes que en aquellas que tienen algún grado de dependencia (dependientes Fmax 17,47 kg ± 6,58 P<0,05 con IC 95% 14,1-20, 85 vs independientes Fmax 23,76 kg ± 6,3 P<0,05 con IC 95% 22,27-25,25). Conclusiones: la fuerza máxima de prensión de la mano está relacionada con la independencia para las actividades de la vida diaria. El componente de fuerza muscular puede ser relevante en programas de salud y calidad de vida en esta población.

Abstract Introduction: The relationship between healthy physical condition and some basic skills for the independence of the senior citizen in the Municipality of La Plata, Argentina, from 2015 to 2018 is studied. Hypothesis: senior citizens who are in better physical condition have greater independence for basic activities of daily living. Methods: the Barthel test was applied to measure daily living skills on senior citizens. The maximum grip strength was measured with dynamometer, and the "walking speed" and "time up and go" tests were applied to assess physical condition. Correlation, coefficient of determination was calculated. Results: A total of 91 senior citizens, 25 men, 64 women with an average age of 74.81 ± 9.38, average weight 69.99 ± 19.09, and average height 155 ± 13.06 were evaluated. As age increased, the maximum strength decreased significantly (r-0.40, R2 0.16, p <0.05). Maximum strength is significantly greater in people who are independent than in those who have some degree of dependence (dependent Fmax 17,47kg ± 6,58 with IC 95% 14,1-20,85 vs independent 23,76 kg ± 6,3 P <0.05 with IC 95% 22.27-25.25). Conclusions: the maximum grip strength of the hand is related to the independence for activities of daily living. The component of muscular strength may be relevant in health and quality of life programs in this population.

Resumo Introdução: A escola é um espaço privilegiado de promoção da saúde, em Colômbia se desenvolve a estratégia escola saudável como uma ferramenta integradora de políticas em saúde no âmbito escolar. Objetivo: o estudo busca avaliar a execução da estratégia escola saudável no contexto rural do município de Ibagué. Materiais e métodos: a avaliação da execução se realizou mediante a construção de um modelo lógico e a definição de critérios avaliativos em relação com os ambientes saudáveis, as políticas públicas e planos para a escola saudável, a participação social, o empoeiramento e a educação para a saúde. Avaliaram se um total de 93 escolas rurais, a informação foi levantada mediante questionários aos responsáveis das escolas e a través de entrevistas aos gestores de saúde. Resultados: se identificaram problemáticas sanitárias e ambientais nas escolas associadas às carências da ruralidade, falta de articulação do setor saúde e educação, baixa participação social, a educação enfocada à prevenção da doença. Conclusão: promover os entornos escolares saudáveis na ruralidade requer de um marco legal nacional e local que garante à atuação estadual, a intersetorial, a participação efetiva do setor educativo, a renovação da saúde e que promova interesses e vontades político, sociais e administrativas.

[High prevalence of asymptomatic COVID-19 in haemodialysis: learning day by day in the first month of the COVID-19 pandemic]. / Alta prevalencia de COVID-19 asintomático en hemodiálisis. Aprendiendo día a día el primer mes de pandemia de COVID-19.

Dialysis patients are a risk group for SARS-CoV-2 infection and possibly further complications, but we have little information. The aim of this paper is to describe the experience of the first month of the SARS-CoV-2 pandemic in a hospital haemodialysis (HD) unit serving the district of Madrid with the second highest incidence of COVID-19 (almost 1,000 patients in 100,000h). In the form of a diary, we present the actions undertaken, the incidence of COVID-19 in patients and health staff, some clinical characteristics and the results of screening all the patients in the unit. We started with 90 patients on HD: 37 (41.1%) had COVID-19, of whom 17 (45.9%) were diagnosed through symptoms detected in triage or during the session, and 15 (40.5%) through subsequent screening of those who, until that time, had not undergone SARS-CoV-2 PCR testing. Fever was the most frequent symptom, 50% had lymphopenia and 18.4% <95% O2 saturation. Sixteen (43.2%) patients required hospital admission and 6 (16.2%) died. We found a cluster of infection per shift and also among those using public transport. In terms of staff, of the 44 people involved, 15 (34%) had compatible symptoms, 4 (9%) were confirmed as SARS-CoV-2 PCR cases by occupational health, 9 (20%) required some period of sick leave, temporary disability to work (ILT), and 5 were considered likely cases. CONCLUSIONS: We detected a high prevalence of COVID-19 with a high percentage detected by screening; hence the need for proactive diagnosis to stop the pandemic. Most cases are managed as outpatients, however severe symptoms are also appearing and mortality to date is 16.2%. In terms of staff, 20% have required sick leave in relation to COVID-19.

Effect of Diets with Different Lipid's Sources On Serum and Brain Fatty Acids Profile: Experimental Model.

BACKGROUND: The importance of diet in health is widely accepted and recognized. Diet lipid profile is important to prevent chronic diseases and improve the quality of an individual's life. OBJECTIVE: The objective of this report is to analyze the effect of different sources of dietary lipids with standard and high concentration on growing rats. METHODS: Experimental diets contained 15 or 42% kcal of fat, provided by butter (B), olive oil (O), high oleic sunflower oil (HO), and sunflower oil (S). Control diet (C) was normocaloric with 15% kcal of fat provided by soy oil. All diets were complete in the other nutrients according to AIN 1993 and were administered for 40 days. RESULTS: Daily intake was similar in all groups. The administration of these diets provoked changes in serum fatty acid profile in response to the different sources of dietary lipids used; no changes were observed in the brain´s fatty acids. CONCLUSION: These results would suggest that the organism tries first to supply the brain´s fatty acid needs at the expense of its modification in serum.

Improved CD4 T cell profile in HIV-infected subjects on maraviroc-containing therapy is associated with better responsiveness to HBV vaccination.

BACKGROUND: Maraviroc-containing combined antiretroviral therapy (MVC-cART) improved the response to the hepatitis B virus (HBV) vaccine in HIV-infected subjects younger than 50 years old. We aimed here to explore the effect of this antiretroviral therapy on different immunological parameters that could account for this effect. METHODS: We analysed baseline samples of vaccinated subjects under 50 years old (n = 41). We characterized the maturational subsets and the expression of activation, senescence and prone-to-apoptosis markers on CD4 T-cells; we also quantified T-regulatory cells (Treg) and dendritic cell (DC) subsets. We used binary logistic regression to evaluate the immunological impact of MVC-cART, correlation with MVC exposure and linear regression for association with the magnitude of the HBV vaccine response. RESULTS: HIV-infected subjects on MVC-cART prior to vaccination showed increased recent thymic emigrants levels and reduced myeloid-DC levels. A longer exposure to MVC-cART was associated with lower frequencies of Tregs and activated and proliferating CD4 T-cells. Furthermore, the frequencies of activated and proliferating CD4 T-cells were inversely associated with the magnitude of the HBV vaccine response. CONCLUSION: The beneficial effect of MVC-cART in the HBV vaccine response in subjects below 50 years old could be partially mediated by its reducing effect on the frequencies of activated and proliferating CD4 T-cells prior to vaccination.

HIV-Infected Subjects With Poor CD4 T-Cell Recovery Despite Effective Therapy Express High Levels of OX40 and α4ß7 on CD4 T-Cells Prior Therapy Initiation.

BACKGROUND: HIV-infected subjects with suboptimal CD4 restoration despite suppressive combined antiretroviral treatment (cART) (immunodiscordant subjects) have been classically characterized after a variable period of time under cART. Recently, we have reported that an increased frequency of proliferating CD4 T-cells in these subjects is already present before the cART onset. The potential contribution of peripheral compensatory homeostatic proliferation (HP) is yet unknown. We aimed to analyze the expression of HP-related cellular markers on CD4 T-cells of immunodiscordant subjects before cART. METHODS: We analyzed the expression of OX40 and α4ß7 on peripheral CD4 T-cells from immunodiscordant and control subjects (n = 21 each group) before cART initiation, and also on available follow-up samples (after 24 month of suppressive cART). Additionally, we tested the expression of these markers in an in vitro system for the study of human HP processes. RESULTS: Immunodiscordant subjects showed increased levels of OX40 and α4ß7 on CD4 T-cells before cART initiation. While the cART tended to reduce these levels, immunodiscordant subjects still maintained comparatively higher levels of OX40 and α4ß7 after 24 months under suppressive cART. These HP-related markers were upregulated in vitro during the human HP, especially during the fast HP. CONCLUSION: Our results are compatible with exacerbated HP processes in immunodiscordant subjects, already before the cART onset.

An in vitro system of autologous lymphocytes culture that allows the study of homeostatic proliferation mechanisms in human naive CD4 T-cells.

The size of peripheral T-cell pool is kept constant throughout life. However, a decline in lymphocyte numbers is a feature of several human disorders, in which fast and slow homeostatic proliferation play a crucial role. Several in vitro and in vivo models have been developed to study such processes. Nevertheless, self- and commensal- antigens, well-known triggers of homeostatic proliferation, have not been examined in these models. We have designed an in vitro culture of human T-cells exposed to rIL7 and autologous antigen-presenting cells (aAPC) that allows the simultaneous characterization of the different types of homeostatic proliferation. Using our model, we first confirmed that both rIL7 and aAPC are survival signals ultimately leading to homeostatic proliferation. In addition, we explored the modulation of different anti-apoptotic, proliferative, activation and homing markers during fast and slow homeostatic proliferation. Finally, different subsets of Treg were generated during homeostatic proliferation in our model. In summary, our in vitro system is able to simultaneously reproduce both types of homeostatic proliferation of human naive CD4 T-cells, and allows the characterization of these processes. Our in vitro system is a useful tool to explore specific features of human homeostatic proliferation in different human lymphopenia-related disorders and could be used as a cell therapy approach.

Risk Factors for Low Back Pain in Childhood and Adolescence: A Systematic Review.

OBJECTIVES: To identify factors associated with low back pain (LBP) in children and adolescents. MATERIALS AND METHODS: A systematic review was conducted (Prospero CRD42016038186). Observational studies analyzing LBP risk factors among participants aged between 9 and 16 were searched for in 13 electronic databases and 8 specialized journals until March 31, 2016, with no language restrictions. In addition, references in the identified studies were manually tracked. All identified studies that included ≥50 participants aged 9 to 16, were reviewed. Their methodological quality was assessed by 2 reviewers separately, using validated tools, which scored, from worst to best, 0 to 100 for cross-sectional and 0 to 12 for cohort studies. A sensitivity analysis only included studies that had adjusted for confounders, had ≥500 participants, and had a methodological score of ≥50%. RESULTS: A total of 5142 citations were screened and 61 studies, including 137,877 participants from 5 continents, were reviewed. Their mean (range) methodological scores were 74.56 (50 to 100) for cross-sectional studies and 7.36 (5 to 9) for cohort studies. The studies had assessed 35 demographic, clinical, biological, family, psychological, ergonomic, and lifestyle risk factors. The mean (range) prevalence of LBP ranged between 15.25% (3.20 to 57.00) for point prevalence and 38.98% (11.60 to 85.56) for lifetime prevalence. Results on the association between LBP and risk factors were inconsistent. In the sensitivity analysis, "older age" and "participation in competitive sports" showed a consistent association with LBP. DISCUSSION: Future studies should focus on muscle characteristics, the relationship between body and backpack weights, duration of carrying the backpack, characteristics of sport practice, and which are the factors associated with specifically chronic pain.

The uterocervical angle and its relationship with preterm birth.

OBJECTIVES: The objective of this study is to determine whether the uterocervical angle (UCA) correlates with the risk of spontaneous preterm birth (sPTB) < 34 weeks and assess its interobserver variability. STUDY DESIGN: Case-control study of 275 women including 34 who started labor spontaneously and gave birth before 34 weeks of gestation (preterm group) and 241 who gave birth at term (control group). Images used to report cervical length were re-measured for UCA. RESULTS: Mean UCA in the second trimester was wider in the preterm group (105.16°) compared with the control group (94.53°), p = .015. The intraclass correlation coefficient was 0.821 (95% CI: 0.74-0.97) for masked interobserver variability, which implies correct agreement among UCA measurements. Mean UCA increased from the first to the second trimester (84.2° versus 94.5°; p = .019). CONCLUSIONS: Wider UCA in the second trimester is related to sPTB. UCA measurement is a reproducible technique. UCA appears to increase from the first to the second trimester. Prospective studies, with ultrasound examinations aimed at measuring UCA in vivo, are needed to accurately assess the characteristics of this marker and its potential as a predictor of sPTB in clinical practice.

Increased frequencies of Th17 cells and IL17a-producing regulatory T-cells preceding the immunodiscordant response to antiretroviral treatment.

BACKGROUND: Despite the fact that antiretroviral therapy (cART) suppresses HIV-viremia, an adequate CD4 T-cell recovery is not always achieved (immunodiscordant response to cART). IL17a-producing CD4 T-cells (Th17) constitutes an important subset involved in the preservation of mucosal surfaces integrity, which depletion has been associated with disease progression in HIV-infection. However, whether Th17 frequency at cART initiation is associated with a poor CD4 T-cell recovery has not been yet explored. Our aim was to explore whether the Th17 cells and other IL17a-producing T-cell subsets at cART initiation were associated with a subsequent immunodiscordant response to cART. METHODS: We selected pre-cART samples of antiretroviral-naïve subjects with and without a low CD4 recovery after cART (LR-subjects and HR-subjects, respectively). Peripheral blood mononuclear cells (PBMCs) were stimulated with PMA/ionomycine, and the production of several cytokines including IL17a was analyzed by flow cytometry. RESULTS: A trend to higher Th17 (p = 0.05) and increased frequencies of IL17a-producing Treg (p = 0.011) was found in LR-subjects before cART onset. Despite increased frequencies of both Treg and Th17 in LR-subject at cART initiation, no alteration of Treg/Th17 ratio was observed. While polifunctional profile of CD4 T-cells was not different, frequencies of CD4 T-cells producing cytokine-combinations including IL17a were increased in LR-subjects. CONCLUSION: Increased frequencies of Th17, IL17a-producing Treg and CD4 T-cells producing specific IL17a-containing combinations of cytokines, precede the immunodiscordant response to cART, suggesting a potential contribution of these subsets in such anomalous response to cART.