Assessing the Fractional Curve for Proper Management of Adult Degenerative Scoliosis.

Adult degenerative scoliosis (ADS) is a coronal plane deformity often accompanied by sagittal plane malalignment. Surgical correction may involve the major and/or distally-located fractional curves (FCs). Correction of the FC has been increasingly recognized as key to ameliorating radicular pain localized to the FC levels. The present study aims to summarize the literature on the rationale for FC correction in ADS. Three databases were systematically reviewed to identify all primary studies reporting the rationale for correcting the FC in ADS. Articles were included if they were English full-text studies with primary data from ADS ( ≥ 18 years old) patients. Seventy-four articles were identified, of which 12 were included after full-text review. Findings suggest FC correction with long-segment fusion terminating at L5 increases the risk of distal junctional degeneration as compared to constructs instrumenting the sacrum. Additionally, circumferential fusion offers greater FC correction, lower reoperation risk, and shorter construct length. Minimally invasive surgery (MIS) techniques may offer effective radiographic correction and improve leg pain associated with foraminal stenosis on the FC concavity, though experiences are limited. Open surgery may be necessary to achieve adequate correction of severe, highly rigid deformities. Current data support major curve correction in ASD where the FC concavity and truncal shift are concordant, suggesting that the FC contributes to the patient's overall deformity. Circumferential fusion and the use of kickstand rods can improve correction and enhance the stability and durability of long constructs. Last, MIS techniques show promise for milder deformities but require further investigation.

Analysis of Ferritin, Hepcidin, Zinc, C-Reactive Protein and IL-6 Levels in COVID-19 in Patients Living at Different Altitudes in Peru.

BACKGROUND: Despite great scientific efforts, understanding the role of COVID-19 clinical biomarkers remains a challenge. METHODS: A cross-sectional descriptive study in two Peruvian cities at different altitudes for comparison: Lima and Huaraz. In each place, three groups were formed, made up of 25 patients with COVID-19 in the ICU, 25 hospitalized patients with COVID-19 who did not require the ICU, and 25 healthy subjects as a control group. Five biomarkers were measured: IL-6, hepcidin, ferritin, C-reactive protein, and zinc using ELISA assays. RESULTS: Ferritin, C-reactive protein, and IL-6 levels were significantly higher in the ICU and non-ICU groups at both study sites. In the case of hepcidin, the levels were significantly higher in the ICU group at both study sites compared to the non-ICU group. Among the groups within each study site, the highest altitude area presented statistically significant differences between its groups in all the markers evaluated. In the lower altitude area, differences were only observed between the groups for the zinc biomarker. CONCLUSION: COVID-19 patients residing at high altitudes tend to have higher levels of zinc and IL-6 in all groups studied compared to their lower altitude counterparts.

Leptospira spp. and Rickettsia spp. as pathogens with zoonotic potential causing acute undifferentiated febrile illness in a central-eastern region of Peru.

OBJETIVE: this study was to determine the relationship between acute febrile illness and bacterial pathogens with zoonotic potential that cause emerging and re-emerging diseases in a central-eastern region of Peru. RESULTS: Out of the 279 samples analyzed, 23 (8.2%) tested positive for infection by Rickettsia spp., while a total of 15 (5.4%) tested positive for Leptospira spp. Women had a higher frequency of infection by Rickettsia spp., with 13 cases (53.3%), while men had a higher frequency of infection by Leptospira spp., with 10 cases (66.7%). The most frequently reported general symptom was headache, with 100.0% (n = 23) of patients with Rickettsia (+) and 86.7% (n = 13) of patients with Leptospira (+) experiencing it. Arthralgia was the second most frequent symptom, reported by 95.6% (n = 22) and 60% (n = 9) of patients with Rickettsia (+) and Leptospira (+), respectively. Myalgia was reported by 91.3% (n = 21) and 66.7% (n = 10) of patients with Rickettsia (+) and Leptospira (+), respectively. Retroocular pain, low back pain, and skin rash were also present, but less frequently. Among the positives, no manifestation of bleeding was recorded, although only one positive case for Leptospira spp. presented a decrease in the number of platelets.

Closure of the Peritoneum in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP) With Cyanoacrylate Glue in a Microdroplet Device: A Single Surgeon Prospective Comparison vs. Barbed Suture.

Purpose: To describe and compare a peritoneal closure technique using cyanoacrylate glue (Glubran 2®, GEM, Cardiolink SL) with a microdroplet device (Glutack®, GEM, Cardiolink SL) in laparoscopic transabdominal preperitoneal repair (TAPP) of inguinal hernia with the routinely used barbed suture peritoneal closure (V-Lock 3.0, Covidien France). Materials and methods: From January to August 2022, 60 patients undergoing TAPP repair for uni- or bilateral inguinal hernia were randomized into one of two groups. One using as mesh fixation and peritoneal closure the Glutack® device with Glubran 2® cyanoacrylate glue (Glu-close group) and the other using mesh fixation with cyanoacrylate and peritoneal closure with V-lock 3.0 (Sut-close group), with a follow-up of 12 months. Demographic variables, operative time, peritoneal closure time, main surgical findings and main intra- and postoperative complications were analyzed prospectively. Results: 63 patients were included with no losses to follow-up. The mean operative time was 34 min (range 58.25) for the glu-close group and 40 (range 64.25) for the sut-close group, with no conversion (0%) for either group. The mean flap closure time was 1.18 min (SD 24 0.19) for the glu-close group and 3.24 min (SD 0.78) for the sut-close group, with statistically significant differences (p < 0.001). The intraoperative complication rate was 0 for the glu-close group and 0 for the sut-close group, with no significant difference. The median hospital stay was 0.8 days (range, 0-1) for both groups. The median duration of follow-up was 12 months and none had hernia recurrence. The postoperative VAS score at the first and second check-up at 1 month and 3 months was 2.83 (SD 1.341) and 0.60 (SD 0.621) in the sut-close group and 1.03 (0.984) and 0.24 (SD 0.435) in the glue-close group, with significant differences (p < 0.001 and p < 0.012). Conclusion: The data demonstrated by the study are that the glue can be used safely to close the peritoneum and that the method provides a small, statistically significant but not clinically relevant reduction in the time to close the peritoneal flap, as well as in postoperative pain after surgery in short and medium term.

[Incidence of intrahospitalary major cardiac events with the use of mechanic thromboaspiration versus only use of IIB/IIIA glucoprotein inhibitors on patients with acute ST elevation myocardial infarction]. / Incidencia de eventos cardiovasculares mayores intrahospitalarios en pacientes sometidos a tromboaspiración mecánica más IIb/IIIa contra solo inhibidores de la glucoproteína IIb/IIIa en infarto agudo al miocardio con elevación del segmento ST.

Objective: To identify the incidence of in-hospital major adverse cardiac events (MACE) with the use of mechanic thromboaspiration plus IIb/IIIa glycoprotein inhibitors versus only use of IIb/IIIa glycoprotein inhibitors on patients with acute ST elevation myocardial infarction. Method: Retrospective, observational, cohort analytic study, on patients with acute ST elevation myocardial infarction that had angiography thrombus TIMI 5 grade, treated between October 2021 and December 2022. Results: A total of 237 patients were included. In 113 patients thromboaspiration were used, 124 patients didn't used. 81.6% were men. In-hospital MACE occurred on 31.9% of patients with thromboaspiration use vs. 30.6% on patients with no use (RR: 1.05; IC95%: 0.61-1.93; p = 0.840). Incidence of malignant arrhythmias were of 8% with thromboaspiration use vs. 1.6% on patients with no use (RR: 5.27; IC95%: 1.11-24.97; p = 0.020). Conclusions: The use of thromboaspiration on concomitant treatment with IIb/IIIa glycoprotein inhibitors was similar with only IIb/IIIa glycoprotein inhibitors in reducing incidence of in-hospital MACE on patients with ST elevation acute myocardial infarction and high thrombus burden. The study has several limitations, so results should be taken with caution.

Objetivo: Identificar la incidencia de eventos cardiovasculares adversos mayores (ECAM) intrahospitalarios con el uso de tromboaspiración mecánica más inhibidores de la glucoproteína IIb/IIIa contra solo inhibidores de la glucoproteína IIb/IIIa en pacientes con infarto agudo al miocardio con elevación del segmento ST (IAMCEST). Método: Estudio retrospectivo, observacional, analítico, de cohorte, en pacientes con IAMCEST con trombo angiográfico de grado TIMI 5, tratados entre octubre de 2021 y diciembre de 2022. Resultados: Cumplieron los criterios de inclusión 237 pacientes. En 113 se usó tromboaspirador más inhibidores IIb/IIIa y en 124 solo inhibidores IIb/IIIa. El 81.6% fueron hombres. La incidencia de ECAM intrahospitalarios fue del 31.9% en los pacientes con tromboaspiración y del 30.6% en los pacientes con solo inhibidores IIb/IIIa (RR: 1.05; IC95%: 0.61-1.93; p = 0.840). La incidencia de arritmias graves fue del 8% en los pacientes con tromboaspiración y del 1.6% en los pacientes con solo inhibidores IIb/IIIa (RR: 5.27; IC95%: 1.11-24.97; p = 0.020). Conclusiones: La frecuencia de ECAM asociados al uso de tromboaspiración mecánica como coadyuvante a los inhibidores de la glucoproteína IIb/IIIa en pacientes con IAMCEST y trombo angiográfico de grado TIMI 5 no es diferente de la de aquellos pacientes en las que solo se utilizan inhibidores de la glucoproteína IIb/IIa. El estudio tiene varias limitaciones, por lo que los resultados deben tomarse con cautela.

Nonlocality activation in a photonic quantum network.

Bell nonlocality refers to correlations between two distant, entangled particles that challenge classical notions of local causality. Beyond its foundational significance, nonlocality is crucial for device-independent technologies like quantum key distribution and randomness generation. Nonlocality quickly deteriorates in the presence of noise, and restoring nonlocal correlations requires additional resources. These often come in the form of many instances of the input state and joint measurements, incurring a significant resource overhead. Here, we experimentally demonstrate that single copies of Bell-local states, incapable of violating any standard Bell inequality, can give rise to nonlocality after being embedded into a quantum network of multiple parties. We subject the initial entangled state to a quantum channel that broadcasts part of the state to two independent receivers and certify the nonlocality in the resulting network by violating a tailored Bell-like inequality. We obtain these results without making any assumptions about the prepared states, the quantum channel, or the validity of quantum theory. Our findings have fundamental implications for nonlocality and enable the practical use of nonlocal correlations in real-world applications, even in scenarios dominated by noise.

Identification and Clinical Characteristics of Community-Acquired Acinetobacter baumannii in Patients Hospitalized for Moderate or Severe COVID-19 in Peru.

Acinetobacter baumannii has been described as a cause of serious community-acquired infections in tropical countries. Currently, its implications when simultaneously identified with other pathogens are not yet adequately understood. A descriptive study was conducted on hospitalized patients with a diagnosis of moderate/severe SARS-CoV-2-induced pneumonia confirmed via real-time RT-PCR. Patients aged > 18 years who were admitted to a specialized COVID-19 treatment center in Peru were selected for enrollment. A. baumannii was detected via the PCR amplification of the blaOXA-51 gene obtained from nasopharyngeal swabs within 48 h of hospitalization. A total of 295 patients with COVID-19 who met the study inclusion criteria were enrolled. A. baumannii was simultaneously identified in 40/295 (13.5%) of COVID-19-hospitalized patients. Demographic data and comorbidities were comparable in both Acinetobacter-positive and -negative subgroups. However, patients identified as being infected with Acinetobacter were more likely to have received outpatient antibiotics prior to hospitalization, had a higher requirement for high-flow nasal cannula and a higher subjective incidence of fatigue, and were more likely to develop Acinetobacter-induced pneumonia during hospitalization. Conclusions: The group in which SARS-CoV-2 and A. baumannii were simultaneously identified had a higher proportion of fatigue, a higher frequency of requiring a high-flow cannula, and a higher proportion of superinfection with the same microorganism during hospitalization.

Parasitosis by Fasciola hepatica and Variations in Gut Microbiota in School-Aged Children from Peru.

(1) Background: Human fascioliasis is considered an endemic and hyper-endemic disease in the Peruvian Andean valleys. Our objective was to determine variations in the composition of the gut microbiota among children with Fasciola hepatica and children who do not have this parasitosis. (2) Method: A secondary analysis was performed using fecal samples stored in our biobank. The samples were collected as part of an epidemiological Fasciola hepatica cross-sectional study in children from 4 through 14 years old from a community in Cajamarca, Peru. (3) Results: In a comparison of the bacterial genera that make up the intestinal microbiota between the F. hepatica positive and negative groups, it was found that there are significant differences in the determination of Lactobacillus (p = 0.010, CI: 8.5-61.4), Bacteroides (p = 0.020, CI: 18.5-61.4), Clostridium (p < 0.001, CI: 3.5-36.0), and Bifidobacterium (p = 0.018, CI: 1.1-28.3), with each of these genera being less frequent in children parasitized with F. hepatica. (4) Conclusions: These results show that F. hepatica may be associated with direct or indirect changes in the bacterial population of the intestinal microbiota, particularly affecting three bacterial genera.

Pressure alopecias: A review.

Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to circumscribed areas of hair loss. Initially described after prolonged surgeries or immobilization, type 1 PA occurs after sustained external pressure to the skin, mainly the scalp prominences. Alopecia induced by cosmetic procedures, referred in this review as type 2 PA, is reported with increased frequency in literature and predominantly emerges from pressure exerted by the volume of injectables. It is important to differentiate type 2 PA from vascular occlusion-induced alopecia because they represent distinct entities. Clinically, PA may present with erythema, swelling, and tenderness; however, alopecia might be the sole manifestation. Crusts and ulceration are associated with a worse outcome and a higher risk of scarring alopecia. Prompt diagnosis is paramount to prevent complications. Trichoscopy, although considered nonspecific, may provide relevant clues for an accurate diagnosis. Hair regrows in most cases, but prognosis depends on ischemia severity and timely treatment with reperfusion therapies or mobilization. Treatment of hair loss is usually not necessary because the disease in most cases is self-limited and reversible. The role of topical minoxidil and corticosteroids remains unknown.

Laparoscopic vs. Open Approach in Emergent Inguinal Hernia: Our Experience and Review of Literature.

There is currently no consensus or homogeneous recommendation about the role of the laparoscopic approach in emergent inguinal hernia surgery. The aim of this manuscript is showing our experience and results of laparoscopic approach for emergent groin hernia repair comparing with open approach. A retrospective review of a prospectively maintained database between January 2011 and December 2021 of acute incarcerated groin hernia that were operated at Virgen del Rocio University Hospital. In this period, they were identified 463 patients with groin hernia that required an emergency repair. 454 patients underwent open surgery (group 1) and 36 patients underwent laparoscopic approach (TAPP procedure) (group 2). Median length stay was 1 day in lap group and 2 days in open approach. Reintervention was necessary in 20 cases (4.40%) from group 1 and one (2.27%) from group 2. In laparoscopic approach, no mortality was described but in open approach, 10 patients (2.20%) died. Globally, 58 cases (12.77%) from group 1 and six patients (16.66%) from group 2 presented any complication. Wound infection was higher in group of open repairs (5.94% vs. 2.77%). Non-surgical complications were higher in open approach (19 vs. 0). There is no statistical significance in any of these items. Laparoscopic approach is a safe, feasible and effective therapeutic option for the treatment of incarcerated groin hernia that require emergency surgery, but prospective and randomized comparative studies are needed to establish the best approach.

Enfermedad de Paget pigmentada de la mama simuladora de melanoma cutáneo / Pigmented mammary Paget's disease mimicking cutaneous melanoma

Resumen ANTECEDENTES: La enfermedad de Paget pigmentada de la mama es una variante poco frecuente de este padecimiento cutáneo, una dermatosis que afecta al complejo areola-pezón de manera típicamente unilateral. La importancia del reconocimiento de esta dermatosis pigmentada inespecífica es que forma parte del diagnóstico diferencial del melanoma cutáneo, por manifestarse como una mácula pigmentada irregular, cuyo estudio histopatológico muestra una proliferación de melanocitos en los estratos suprabasales de la epidermis, fagocitosis de melanina y melanófagos en dermis, hallazgos muy similares al melanoma cutáneo, además de la coexistencia de células claras malignas, características de la enfermedad de Paget. La inmunohistoquímica es una técnica auxiliar en la dermatopatología, que forma parte del proceso diagnóstico de los pacientes para lograr el diagnóstico certero que, al correlacionar la clínica y el estudio histopatológico, le permite al dermatólogo tratar a los pacientes con enfermedad de Paget pigmentada de la mama junto con un equipo multidisciplinario para la búsqueda, diagnóstico y, en su caso, tratamiento quirúrgico de las neoplasias subyacentes que suelen relacionarse con esta variante pigmentada. CASO CLÍNICO: Paciente de 35 años con una lesión pigmentada que afectaba el complejo areola-pezón derecho. Con la correlación histopatológica e inmunohistoquímica se estableció el diagnóstico de enfermedad de Paget pigmentada de la mama y posterior al procedimiento ginecológico, se asoció esta dermatosis con un adenocarcinoma microinvasor triple negativo. CONCLUSIONES: La enfermedad de Paget pigmentada de la mama es un diagnóstico complejo que requiere correlación clínico-patológica y estudios de extensión para valorar su asociación con neoplasias subyacentes.

Abstract BACKGROUND: Pigmented Mammary Paget's Disease is a rare variant of this skin condition, an unilateral dermatosis that typically affects the areola-nipple complex. The importance of recognizing this nonspecific pigmented dermatosis resides in its differential diagnosis of cutaneous melanoma, as it presents as an irregular pigmented macula. The histopathological study shows proliferation of melanocytes in the suprabasal layers of epidermis, phagocytosis of melanin and melanophages in dermis. These findings are very similar to cutaneous melanoma, in addition to the presence of malignant clear epitelial cells that are characteristic of Paget's disease. Immunohistochemistry is part of the approach of patients with lesions that shows proliferating melanocytes to rule out other neoplasms. Making an accurate diagnosis by correlating the clinical, histopathological study and immunohistochemistry allows the dermatologist to approach patients with mammary pigmented mammary Paget's disease with a multidisciplinary team for the diagnosis and surgical treatment of the underlying neoplasms that are usually related to this pigmented variant. CASE REPORT: We report the case of a 35 years old woman with a pigmented lesion that affected the right areola-nipple complex. With the histopathological and immunohistochemical correlation, the diagnosis of pigmented mammary Paget's disease was made and after the gynecological approach, this dermatosis was associated with a triple negative microinvasive adenocarcinoma. CONCLUSION: Pigmented mammary Paget's disease is a complicated diagnosis that requires clinicopathological correlation and extension studies to assess its association to underlying neoplasms.

Rendimiento diagnóstico de la prueba rápida para la detección del antígeno NS1 y anticuerpos IgM e IgG contra el virus del dengue / Diagnostic performance of the rapid test for the detection of NS1 antigen and IgM and IgG anti-antibodies against dengue virus

Objetivos. Determinar el rendimiento diagnóstico de la prueba rápida SD dengue DUO (Inyecta) para la detección de NS1, IgM e IgG en comparación con la prueba de ELISA. Materiales y métodos. Es una evaluación de prueba diagnóstica que incluyó 286 muestras de suero de pacientes con sintomatología atribuible a dengue de zonas endémicas del Perú. Las muestras se analizaron por ELISA y la prueba rápida SD dengue DUO (Inyecta) para IgM, NS1 e IgG en el Instituto de Investigación Nutricional en Lima. Resultados. La sensibilidad de la prueba rápida fue de 68% para NS1 e IgM, y 86% para IgG, mejorando este parámetro a 75% y 81% para NS1 e IgM, respectivamente, en los tres primeros días. La especificidad para los tres analitos fue mayor a 87%. La concordancia de los resultados obtenidos medidos por el coeficiente Kappa para los tres analitos fue buena y no se encontró reacción cruzada con otros arbovirus. Conclusiones. La prueba rápida SD Dengue DUO permite detectar con una adecuada sensibilidad y especificidad NS1, IgM e IgG. La sensibilidad para IgM y NS1 aumenta cuando se detecta en los tres primeros días de síntomas, por lo que se recomienda su implementación en los centros de primer nivel de atención para un diagnóstico temprano y oportuno.

Objectives . To assess the diagnostic performance of the SD dengue DUO rapid test (Inyecta) for the detection of NS1, IgM and IgG in comparison to the ELISA test. Materials and methods . This is a diagnostic test evaluation that included 286 serum samples from patients with symptomatology attributable to dengue from endemic areas of Peru. The samples were analyzed by ELISA and the SD dengue DUO rapid test (Inyecta) for IgM, NS1 and IgG at the Instituto de Investigación Nutricional in Lima. Results . The sensitivity of the rapid test was 68.0% for NS1 and IgM, and 86.0% for IgG, improving to 75.0% and 81.0% for NS1 and IgM, respectively, during the first three days. The specificity for all three analytes was greater than 87.0%. The concordance of the results, measured by the Kappa coefficient for the three analytes, was good and no cross-reaction with other arboviruses was found. Conclusions . The SD dengue DUO rapid test allows detection of NS1, IgM and IgG with adequate sensitivity and specificity. Sensitivity for IgM and NS1 increases when detected during the first three days of symptoms. Therefore, we recommend its implementation in primary care centers for early and timely diagnosis.

Percepción del esfuerzo y niveles objetivos de intensidad en clases de Educación Física de escolares de primaria según sexo y estado nutricional: Estudio piloto / Perception of Effort and Objective Levels of Intensity in Physical Education Classes of Primary Schoolchildren According to Gender and Nutritional Status: A Pilot Study

Resumen El presente estudio aborda el análisis del esfuerzo percibido y tiempo en actividades de intensidad moderada y vigorosa en clases de Educación Física, considerando las diferencias según sexo y el estado nutricional de la persona estudiante. Participaron 95 estudiantes de 5° y 6° año de primaria de escuelas de la ciudad de Coyhaique, Chile. Se utilizó la escala EPInfant para la evaluación del esfuerzo percibido y acelerómetros Actigraph GT3X+ para determinar el tiempo en intensidad moderada y vigorosa. En el esfuerzo percibido no se encontraron diferencias significativas según sexo (p=0,144), pero sí según estado nutricional, siendo los estudiantes con obesidad quienes indican una percepción de esfuerzo mayor que el estudiantado de peso normal (p=0,022). En actividades moderadas y vigorosas dentro de la clase de Educación Física, los niños presentan significativamente más minutos en comparación a las niñas (p=0,017); mientras que los escolares normopeso presentarían levemente mayor tiempo en este nivel de intensidad, sin que esta diferencia sea estadísticamente significativa (p=0,622). El esfuerzo realizado en las clases de Educación Física ha sido percibido como más exigente por los escolares con obesidad, y para esto se deben comprender las dificultades físicas y motrices que este grupo presenta. Asimismo, las niñas han participado un menor tiempo en intensidades moderadas y vigorosas, por lo que es pertinente buscar estrategias que permitan aumentar el tiempo de su participación.

Abstract This study focuses on the analysis of perceived effort and time of moderate and vigorous activities in physical education classes, considering differences based on gender and the nutritional status of schoolchildren. A total of 95 children in 5th and 6th grade of primary school in the city of Coyhaique, Chile, participated in the study. The EPInfant scale was used to assess the perceived effort, and Actigraph GT3X+ accelerometers were used to determine the time of moderate and vigorous activity. No significant differences were found in the perceived effort by gender (p=0.144); instead, by nutritional status, obese students indicated a higher perceived effort than students with a normal weight (p=0.220). Regarding moderate and vigorous activities in Physical Education class, the boys were significantly more active than the girls (p=0.017). In contrast, normal-weight children were slightly more active at this intensity level, but this difference was not statistically significant (p=0.622). The effort in Physical Education classes has been perceived as more demanding by the obese students; for this reason, it is important to understand the physical and motor difficulties that this group presents. Likewise, girls have participated for a shorter time in moderate and vigorous intensities, being pertinent to look for didactic strategies to increase the time of their participation.

Resumo O presente estudo aborda a análise do esforço e do tempo percebido em atividades de intensidade moderada e vigorosa nas aulas de educação física, considerando as diferenças de acordo com o sexo e o estado nutricional de cada estudante. Participaram do estudo noventa e cinco alunos do 5º e 6º ano do ensino fundamental de escolas da cidade de Coyhaique, no Chile. A escala EPInfant foi utilizada para avaliar o esforço percebido e os acelerômetros Actigraph GT3X+ para determinar o tempo em intensidade moderada e vigorosa. Não foram encontradas diferenças significativas na percepção de esforço segundo o sexo (p=0,144), mas foram encontradas diferenças significativas segundo o estado nutricional, com estudantes obesos indicando uma percepção de maior esforço do que estudantes de peso normal (p=0,022). Nas atividades moderadas e vigorosas nas aulas de Educação Física, os meninos apresentam significativamente mais minutos que as meninas (p=0,017), enquanto os estudantes de peso normal apresentaram um pouco mais de tempo nesse nível de intensidade, embora essa diferença não tenha sido estatisticamente significativa (p=0,622). O esforço feito nas aulas de educação física foi percebido como mais exigente por estudantes obesos, e para isso é necessário compreender as dificuldades físicas e motoras que este grupo apresenta. Da mesma forma, as meninas têm participado por um tempo mais curto em intensidades moderadas e vigorosas, por isso é pertinente procurar estratégias para aumentar o tempo da sua participação.

Evaluación tomográfica de las cisternas basales

Introducción: Las características radiológicas de las cisternas de la base son de interés en el diagnóstico, evolución y pronóstico de los pacientes con lesiones traumáticas. En la actualidad el estado de las mismas es un factor predictivo importante en pacientes con trauma craneoencefálico severo. En la mayor parte se refieren solo a cisternas normales, comprimidas o ausentes. Objetivo: Determinar las dimensiones normales de las principales cisternas basales en la tomografía y su relación con la edad y el sexo. Métodos: Se realizó un estudio analítico, de corte transversal en un periodo de dos meses: marzo y abril de 2021, en labor conjunta de los servicios de Neurocirugía e Imagenología del Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey. El universo quedó formado por 101 pacientes mayores de 18 años con tomografías de cráneo sin alteraciones. El estudio incluyó la evaluación de las imágenes de TAC simples de cráneo de pacientes con sospecha de enfermedad cerebrovascular, estudio de epilepsia de debut tardío, síndrome confucional o de síndrome cefalálgico. Se evaluaron la cisterna crural, interpeduncular, ambiens y cuadrigeminal. Las mensuraciones fueron realizadas siempre por especialistas en Imagenología y Neurocirugía con años de experiencia. El criterio básico de selección fue que la tomografía fuera informada sin alteraciones, independiente de la edad y el sexo. Resultados: De los 101 pacientes, 53 fueron del sexo masculino y 48 correspondieron al sexo femenino. El promedio del diámetro de la cisterna interpeduncular fue de 5,5 mm, la cisterna crural promedió 2,3 mm, mientras que la cisterna ambiens y la cuadrigeminal promediaron 3,1 mm y 5 mm respectivamente. Los mayores de 60 años tuvieron las cisternas basales con mayor diámetro. Conclusiones: El diámetro de las cisternas basales varía con la edad, no así con el sexo. Esto está determinado por el envejecimiento fisiológico del cerebro.

Introduction: The radiological characteristics of the cisterns of the base are of interest in the diagnosis, evolution and prognosis of patients with traumatic injuries. Currently, their condition is an important predictive factor in patients with severe head trauma. For the most part they refer only to normal, compressed or absent cisterns. Objective: To determinate the normal measurements of the principal basal cisterns in a tomagraphy and their relation with age and sex. Methods: An analytical, cross-sectional study was carried out in a period of two months: March and April 2021, in joint work of the Neurosurgery and Imaging services of the Manuel Ascunce Domenech University Hospital in Camagüey province. The universe was made up of 101 patients over 18 years of age with skull tomographies without alterations. The study included the evaluation of simple CT images of the skull of patients with suspected cerebrovascular disease, study of late-onset epilepsy, confusional syndrome or cephalalgic syndrome. The crural, interpeduncular, ambiens and quadrigeminal cistern were evaluated. The measurements were always performed by specialists in Imaging and Neurosurgery with years of experience. The basic selection criterion was that the tomography was reported without alterations, regardless of age and sex. Results: The sample was 101 patients, 53 males and 48 females. The average width of the interpeduncular cistern was 5.5 mm, besides crural cistern averages 2.3 mm and the ambiens and cuadrigeminal cisterns average 3.1 mm and 5 mm respectively. The patients older than 60 years had major dimensions of the cranial cisterns. Conclusions: The width of basal cisterns could be change with age but not with sex. This is associated with brain physiological aging.