Association of Stair Use With Risk of Major Chronic Diseases.

INTRODUCTION: Physical inactivity is associated with a higher risk of chronic diseases. Regular stair use can contribute to increasing physical activity in the population. This study aimed to investigate the association between flights of stairs used daily at home and all-cause mortality and cause-specific incidence and mortality. METHODS: Of the 502,628 UK Biobank participants recruited between 2007 and 2010, 442,027 (mean age, 56±8 years) had available data and were included in the analyses conducted in 2023. Participants were categorized on the basis of flights of stairs climbed daily (1-5, 6-10, 11-15, >15). The disease-specific outcomes were cardiovascular disease, respiratory disease, cancer, type 2 diabetes, and all-cause dementia. Cox proportional hazard models, adjusted for sociodemographic, lifestyle, and health-related confounding factors, were used to analyze the associations between stair use frequency and health outcomes. RESULTS: Participants were followed up for a median of 10.9 years. Climbing stairs >15 times per day was associated with a lower risk of 8 of the 9 outcomes analyzed than not using stairs. The magnitude of association ranged from 3% (95% CI=0.94, 0.99) lower risk for all-cause cancer to 51% (95% CI=0.39, 0.60) lower risk of chronic obstructive pulmonary disease. Findings were similar for mortality outcomes, with the hazard ratios ranging from 0.82 (95% CI=0.77, 0.87) for all-cause cancer to 0.46 (95% CI=0.23, 0.92) for chronic obstructive pulmonary disease mortality. CONCLUSIONS: Stair use was associated with a lower risk of all-cause mortality and cause-specific incidence and mortality independent of confounding factors, including adiposity and multimorbidity.

Reverse transcription loop­mediated isothermal amplification has a high performance in the detection of SARS­CoV­2 in saliva samples and nasal swabs from asymptomatic and symptomatic individuals.

The detection of coronavirus disease 2019 cases represents a significant challenge at the epidemiological level. Limitations exist in effectively detecting asymptomatic cases, achieving good follow-up in hospitals without the infrastructure for reverse transcription-quantitative PCR (RT-qPCR) or in difficult-to-access areas and developing methods with the need for less invasive sampling procedures. Therefore, the present study evaluated the performance of the direct reverse transcription loop-mediated isothermal amplification (RT-LAMP) test for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the saliva and nasal samples of asymptomatic individuals belonging to the university population. In addition, this test was also assessed for effectiveness in symptomatic individuals referred from a hospital with poor infrastructure in molecular biology and located outside the urban area. The RT-LAMP assay was compared with the results obtained from the RT-qPCR nasopharyngeal swab test, where the diagnosis was confirmed by lateral flow immunoassay test for rapid antigen detection. A total of 128 samples were analyzed, of which 43% were symptomatic positive individuals, 25% were asymptomatic positive individuals and 32% were SARS-CoV2-negative control individuals. Among positive individuals, no differences were found between the Cq values determined by RT-qPCR. A sensitivity of 96.5% and a specificity of 97.6% was reported for the detection of SARS-CoV-2 in symptomatic individuals by salivary and nasal RT-LAMP, as well as a sensitivity of 100% and a specificity of 97.6% for the detection of SARS-CoV-2 in asymptomatic individuals. These findings indicated that performance of the direct RT-LAMP test using saliva and nasal samples has high sensitivity and specificity, which in turn suggest that it is a viable and reliable alternative for use in epidemiological monitoring.

Aquaporins: New players in breast cancer progression and treatment response.

Aquaporins (AQPs) are a family of small transmembrane proteins that selectively transport water and other small molecules and ions following an osmotic gradient across cell plasma membranes. This enables them to regulate numerous functions including water homeostasis, fat metabolism, proliferation, migration, and adhesion. Previous structural and functional studies highlight a strong biological relationship between AQP protein expression, localization, and key biological functions in normal and cancer tissues, where aberrant AQP expression correlates with tumorigenesis and metastasis. In this review, we discuss the roles of AQP1, AQP3, AQP4, AQP5, and AQP7 in breast cancer progression and metastasis, including the role of AQPs in the tumor microenvironment, to highlight potential contributions of stromal-derived to epithelial-derived AQPs to breast cancer. Emerging evidence identifies AQPs as predictors of response to cancer therapy and as targets for increasing their sensitivity to treatment. However, these studies have not evaluated the requirements for protein structure on AQP function within the context of breast cancer. We also examine how AQPs contribute to a patient's response to cancer treatment, existing AQP inhibitors and how AQPs could serve as novel predictive biomarkers of therapy response in breast cancer. Future studies also should evaluate AQP redundancy and compensation as mechanisms used to overcome aberrant AQP function. This review highlights the need for additional research into how AQPs contribute molecularly to therapeutic resistance and by altering the tumor microenvironment.

[Patterns of physical activity in Chilean adults across the lifespan]. / Caracterización de los patrones de actividad física en distintos grupos etarios chilenos.

INTRODUCTION: Background: international physical activity (PA) guidelines recommend 150 minutes of moderate to vigorous PA or 75 minutes of vigorous PA weekly; however, the proportion of the Chilean population who meet this recommendation across the lifespan remains unknown. Objective: to characterize PA patterns by age categories and sex in the Chilean population. Methods: participants from the Chilean Health Survey 2009-2010 (5,293 individuals) were included in this study. PA types (transport, moderate and vigorous) and sedentary behavior were measured using the global physical activity questionnaire (GPAQ). Time spent on different intensities of physical activity by age and sex was investigated using regression analyses. Results: compared to participants aged < 20 years (reference group), commuting-related PA decreased for both men and women from the age of 60 years onwards. Moderate intensity PA increases for both sexes reaching the highest level between the ages of 40-49 years, and then it shows a decline with increasing age. Vigorous PA reaches the highest levels between ages 30-39 and 40-49 years for women and men, respectively. Time spent sitting increased markedly on participants aged 60 years and above, reaching the highest levels at the age of 80 years. Conclusion: in the Chilean population, there are clear patterns of change in PA levels and sitting time across age groups. These findings may help informing stakeholders on tailoring interventions to increase PA levels, especially at ages when the population is more likely to reach their lowest levels of activity.

INTRODUCCIÓN: Antecedentes: las recomendaciones internacionales fomentan la realización de al menos 150 minutos de actividad física (AF) moderada/vigorosa o 75 minutos de AF vigorosa semanalmente; sin embargo, se desconoce cuál es el porcentaje de cumplimiento de estas recomendaciones en los distintos grupos etarios chilenos. Objetivo: caracterizar los patrones de AF según grupos etarios y sexo en población chilena. Métodos: fueron incluidos 5.293 participantes de la Encuesta Nacional de Salud (ENS) 2009-2010. Se determinaron los niveles de AF (de transporte, moderada y vigorosa) y el tiempo sedentario a través del cuestionario GPAQ V2. El tiempo total destinado a los diferentes tipos de AF y el tiempo sedentario entre las diferentes categorías de edad fueron analizados según sexo mediante regresión lineal. Resultados: en comparación con el grupo < 20 años, la AF de transporte muestra una disminución a partir de los 60 años en ambos sexos. En ambos sexos, la AF de intensidad moderada alcanzó su nivel más alto entre los 40-49 años, pero posterior a esta edad se observó una pronunciada disminución. La AF vigorosa alcanzó su nivel más alto entre los 30-39 años para mujeres y 40-49 años para hombres. Finalmente, el tiempo sedente se incrementó a partir de los 60 años, alcanzando su nivel más alto en ≥ 80 años en ambos sexos. Conclusión: los patrones de AF en población chilena se modifican con la edad y su intensidad varía por sexo. Estos resultados podrían orientar el desarrollo de políticas y programas que promuevan la realización de AF, especialmente en edades donde se observan los niveles más bajos.

Factors Associated With Cysticidal Treatment Response in Extraparenchymal Neurocysticercosis.

Extraparenchymal neurocysticercosis is the most severe form of cysticercosis, and response to treatment is suboptimal. We sought to determine how demographic and clinical characteristics and albendazole sulfoxide concentrations were related to cysticidal treatment response. We conducted a longitudinal study of 31 participants with extraparenchymal vesicular parasites who received the same treatment, albendazole 30 mg/kg/day for 10 days with dexamethasone 0.4 mg/kg/day for 13 days, followed by a prednisone taper. Response to treatment was determined by parasite volumes before and 6 months after treatment. Eight participants (25.8%) had a complete treatment response, 16 (51.6%) had a treatment response > 50% but < 100%, and 7 (22.6%) had a treatment response < 50%. Complete treatment response was significantly associated with higher concentrations of albendazole sulfoxide (P = .032), younger age (P = .032), fewer cysts (P = .049) and lower pretreatment parasite volume (P = .037). Higher number of previous cysticidal treatment courses was associated with a noncomplete treatment response (P = .023). Although the large proportion of participants with less than a complete response emphasizes the need to develop more efficacious pharmacologic regimens, the association of albendazole sulfoxide concentrations with treatment response highlights the importance of optimizing existing therapeutic regimens. In addition, the association of treatment response with parasite volume emphasizes the importance of early diagnosis.

[Speech by Carlos Matus in the presentation of Adiós, Señor Presidente]. / Discurso de Carlos Matus en la presentación de Adiós, Señor Presidente.

The text of this article was written by Carlos Matus and read aloud by him at the first presentation of his book Adiós, Señor Presidente [Goodbye, Mr. President] in Venezuela in 1987. Matus describes the problems of the governments of Latin America of that day, in order to address the growing gap between the capacity of governments to govern and the complexity of social systems. For Matus, bridging this gap requires theories, techniques, systems and methods so as to develop government projects in which the governability of the system is not less than the magnitude of its problems. This document was recovered from the Mario Testa fund, in the Center for Documentation and Research Pensar en Salud (CEDOPS) of the Institute of Collective Health in the Universidad Nacional de Lanús.

Discurso de Carlos Matus en la presentación de Adiós, Señor Presidente / Speech by Carlos Matus in the presentation of Adiós, Señor Presidente

El texto que reproducimos en este artículo fue escrito y leído por Carlos Matus en la primera presentación del libro Adiós, Señor Presidente realizada en 1987, en Venezuela. Matus describe los problemas de los gobiernos de América Latina de aquellos años para abordar la brecha creciente entre la capacidad de gobierno y la complejidad de los sistemas sociales, que exige teorías, técnicas, sistemas y métodos para desarrollar proyectos de gobierno en los que la gobernabilidad del sistema no sea más baja que la magnitud de los problemas. Este documento fue recuperado del fondo Mario Testa, perteneciente al Centro de Documentación e Investigación Pensar en Salud (CEDOPS) del Instituto de Salud Colectiva de la Universidad Nacional de Lanús.

The text of this article was written by Carlos Matus and read aloud by him at the first presentation of his book Adiós, Señor Presidente [Goodbye, Mr. President] in Venezuela in 1987. Matus describes the problems of the governments of Latin America of that day, in order to address the growing gap between the capacity of governments to govern and the complexity of social systems. For Matus, bridging this gap requires theories, techniques, systems and methods so as to develop government projects in which the governability of the system is not less than the magnitude of its problems. This document was recovered from the Mario Testa fund, in the Center for Documentation and Research Pensar en Salud (CEDOPS) of the Institute of Collective Health in the Universidad Nacional de Lanús.

Errors in managing postsurgical pediatric pain in Mexico.

Postoperative pain is a subjective symptom that has been extensively studied in adults, but only minimally in children. In children, use of low analgesic doses and failure to document the pain and its management are common concerns. In newborns and infants pain is difficult to interpret. This was a double-blind, prospective, multicenter observational study conducted in four public Mexican hospitals to identify analgesic use. One hundred subjects were enrolled at each institution and monitored for 24 to 48 hours following surgery. Data were collected on 152 girls and 248 boys ranging in age from newborns to 14 years. Nearly 300 (290) underwent major procedures; 110 had short stay surgery. The most common analgesics used were paracetamol and dipyrone at low doses. Less frequently ibuprofen or another anti-inflammatory was used. Many children received no analgesic, including 30 newborns, and others received only one or two analgesic doses. Fifteen burn patients received ketorolac. The occurrence and characteristics of the pain were poorly documented in all four hospitals. Postoperative pain causes suffering and can prolong hospital stays. Graphic pain intensity scales exist to evaluate pain, but use of them was not documented in medial records. Nurses and doctors in training did not have the skills needed to evaluate pain. The study revealed errors in pain management and fear among staff in using high doses of common analgesics. The study results document patterns of care in most Mexican hospitals today and indicate a need for pain management training for Mexican doctors and nurses.

El líder sin estado mayor: la oficina del gobernante / The leader without staff: the office of the ruler

Contenido: Líder y liderazgo. La capacidad de gobierno. El gobierno. La oficina del Presidente. Sistema de dirección en Estados Unidos de América y algunos países europeos

Teoría del juego social / Social game theory

Contenido: ¿Hay ciencias para gobernar?. Ciencias verticales y horizontales. Determinismo e indeterminismo. Cálculo interactivo y orden abierto. El actor en situación. El juego de las ciencias. Teoría de la producción social. Los nueve juegos del poder. Cooperación, conflicto y estrategia. Macrogobierno y gestión pública. En memoria de Carlos Matus. Escuela Latinoamericana de Gobierno: Documento ESCOLAG

Reparación de hernias inguinales por técnica sin tensión / Reparation of inguinal hernia by technique

Demostrar las ventajas de la técnica sin tensión para la reparación de hernias inguinales en comparación a la técnica de Bassini. Estudio comparativo y prospectivo entre los años 1996 y 1998, que incluyó 73 pacientes con diagnóstico de hernia inguinal ingresados para cirugía electiva que calificaron dentro de los criterios de inclusión del estudio, divididos en dos grupos, uno operado con la técnica sin tensión y otro con la técnica de Bassini; ambos fueron comparados en cuanto a dolor postoperatorio, complicaciones postoperatorias, estancia postoperatoria y reintegro a actividades habituales. Servicio de Cirugía II, Hospital Dr. Miguel Pérez Carreño, Caracas. La técnica sin tensión produjo en los pacientes un nivel menor de dolor postoperatorio, una menor estancia postoperatoria y el reintegro más rápido del paciente a sus actividades habituales, todos, estadísticamente significativos. La técnica sin tensión es un procedimiento sencillo, que puede ser utilizado en la reparación de cualquier tipo de hernia inguinofemoral, proporcionando al paciente, un mayor confort, rápida rehabilitación, y en la mayoría de los casos, un retorno inmediato al trabajo, ofreciendo en contraste con la técnica de Bassini, menor dolor, menor estancia postoperatoria y rápido reintegro a las actividades habituales del paciente

Buprenorfina sublingual en cirugía pediátrica / Sublingual buprenorphine im pediatric surgery

En cirugía pediátrica, aparte del impacto psicosocial, el dolor postoperatorio es el síntoma más temido por el niño y la familia. Para controlar el dolor postoperatorio, se utilizan diversos analgésicos, pero poco se usan derivados opiáceos ante el temor de efectos secundarios. Desde hace tiempo existe la buprenorfina, analgésico potente agonista-antagonista de receptores específicos, que porporciona una analgesia importante de rápida acción y larga duración, más potente que la morfina y con menos efectos secundarios. Con el objeto de evaluar el efecto analgésico, se estudiaron 50 pacientes pediátricos sometidos a cirugías diversas, administrando de acuerdo a edad y peso, una dosis de buprenorfina sublingual 30 min antes de la anestesia, evaluando el efecto analgésico postoperatorio, los efectos adversos en el transoperatorio y efectos secundarios en el postoperatorio (Grupo I). El dolor se valoró por escala visual análoga EVA de 1 a 10 y los resultado se compararon con otro grupo similar tratado con analgésicos convencionales (Grupo II). Resultados: en el grupo I se observó un efecto analgésico rápido y duraderó, que en la mayoría de los casos no requirió de nueva dosis, con media de EVA de 2.69, favoreciendo la rápida recuperación postoperatoria y sólo en seis pacientes se presento somnolencia leve. En el grupo control II, la media del EVA fue de 5.34, requiriendo de varias dosis de nalagésico (p<0.05). En este estudio se demostró la efectividad analgésica y seguridad en el manejo de la buprenorfina con mínimos efectos secundarios en este tipo de pacientes.

Participación del pediatra en la salud dental infantil / Pediatric participation in child dental health

Con objeto de conocer la incidencia de patología dental en la consulta medicopediátrica, se estudió un grupo de 1500 niños de 2 a 14 años de edad, encontrándose 390 niños sanos y 1110 con alguna patología bucal que requerían tratamiento odontológico. La caries, el sindrome de biberón y la maloclusión fueron las patologías más frecuentes. Se analizaron hábitos dietéticos, uso de biberón o chupón, atención pediátrica y odontológica previas. Se recomienda la colaboración entre el pediatra y el odontólogo para mejorar la salud dental del niño

Esofagólisis por toracoscopía en cáncer del tercio medio del esófago: comunicación preliminar / Esophagolysis for thoracoscopy in mid-third esophageal cancer: preliminar report

Se presenta la experiencia con abordaje videotoracoscópico para realizar la esofagólisis del segmento torácico, en el cáncer del esófago medio. Se fundamenta su conveniencia en la eventual ventaja de eludir la toracotomía posterolateral convencional y sus complicaciones postoperatorias. Se describe la técnica y se presenta la serie inicial de 3 casos realizados entre mayo y agosto de 1992. El tiempo operatorio promedio fue de 90 minutos y la estadía postoperatoria, de 20 días. No se observó complicaciones atribuibles a la técnica

Abordaje transumbilical para la separación de las hernias umbilicales / Transumbilical appeoach to repair umbilical hernias

Las hernias umbilicales ocupan un lugar importante dentro de la patología herniaria, con una alta incidencia tanto en niños como en adultos, afectando entre un 18 y 26// de la población general. La alta incidencia de complicaciones de las hernias umbilicales en el adulto, obliga la reparación de todas ellas. Tomando en consideración el efecto negativo que una cicatriz visible ocasiona en la población actual, consciente de su aspecto corporal, se describe una alternativa quirúrgica para el abordaje y reparación de las hernias umbilicales a través de una incisión transumbilical

Actinomicosis abdómino-pélvica: a propósito de un caso / Abdominopelvic actinomycosis: apropos of a case

Se presenta un caso de actinomicosis abdómino-pélvica asociado a dispositivos intrauterino en una paciente de 26 años de edad con historia de síntomas abdominales y masa en fosa ilíaca derecha de dos semanas de evolución. Los exámenes de ingreso sugirieron el diagnóstico de plastrón apendicular involucrado vejiga anexo derecho. El drenaje quirúrgico seguido de tratamiento con penicilina G dio buen resultado

Política, planejamento & governo / Politics, planning and government

Analisa a questäo do planejamento público. Trata do planejamento estratégico situacional (PES). Apresenta seus fundamentos e faz uma análise do processo. (NMPM)