RESUMO
Introducción: 25% de personas con hiperinsulinismo desarrolla diabetes 3-5 años luego del primer diagnóstico y 70% lo hará en el resto de la vida. Intervenir los niveles de glicemia desde que se detecta hiperinsulinemia evita la progresión a diabetes y restaura el metabolismo glicémico. Objetivos: Determinar la prevalencia de hiperinsulinismo patológico post-carga de glucosa (HPPG) y su relación con factores de riesgo cardiovascular en adultos 100 UI/ml a las 2 horas), sexo, hipertensión arterial, dislipidemia, malnutrición por exceso, sedentarismo, tabaquismo, ateromatosis e infarto miocárdico documentado. Con STATA 17 se calculó la prevalencia de variables en población general y según categoría de HPPG y se evaluó la significancia con prueba exacta de Fisher. Se compararon medias con ANOVA y t-test con nivel de significancia <0,05. Se usó regresión binomial para estimar Razón de Prevalencia e intervalos de confianza en variables cuantitativas y cualitativas. Resultados: la prevalencia de HPPG fue 41%. La edad promedio 37,5 años, el sexo masculino 52,9%, la hipertensión-arterial 40,5% y la dislipidemia 74,4%. Al comparar las poblaciones con y sin HPPG existieron diferencia estadísticamente significativa en las variables dislipidemia, hipertensión-arterial, malnutrición por exceso y sexo-masculino. La razón de prevalencia alcanzó a un 62%, 37%, 59% y 20% respectivamente. Conclusión: Se encontró una alta prevalencia de HPPG. Los factores de riesgo asociados a ella fueron dislipidemia, hipertensión arterial, malnutrición por exceso y sexo masculino. Esto sugiere que encontrar HPPG puede ser de utilidad para detectar precozmente a la población con un mayor riesgo de enfermedad cardiovascular.
Introduction: 25% of people with hyperinsulinism develop diabetes 3-5 years after the first diagnosis and 70% will do so in the rest of their lives. To control glycemia levels as soon as hyperinsulinemia is detected, progression to diabetes is prevented and glycemic metabolism is restored. Aim: To determine the prevalence of post-glucose load pathological hyperinsulinism (HPPG) and its relationship with cardiovascular risk factors in adults 100 uIU/ ml at 2 hours), sex, hypertension, dyslipidemia, excess malnutrition due to, sedentary lifestyle, smoking, documented atheromatosis and myocardial infarction. The prevalence of variables in the general population was calculated and, in relation to the HPPG category, significance is evaluated with Fisher's exact test. Finally means are compared with ANOVA and t-test. With significance level <0.05. Binomial regression was used to estimate the prevalence ratio and confidence intervals in quantitative and qualitative variables. Statistical analysis was performed with the STATA 17 software. Results: HPPG prevalence was 41%, mean age 37.5 years, male sex 52.9%, arterial hypertension 40.5% and dyslipidemia 74.4%. Un relation to the presence of HPPG a statistically significant difference in the variables dyslipidemia, arterial hypertension, malnutrition due to excess and male sex was found. The prevalence ratios were 62%, 37%, 59% and 20%, respectively. Conclusion: A high prevalence of HPPG was found. Risk factors associated to HPPG were dyslipidemia, arterial hypertension, malnutrition due to excess and male sex. Thus, HPPG can play a role in the early detection of a higher risk of cardiovascular disease in the general population.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fatores de Risco de Doenças Cardíacas , Hiperinsulinismo/epidemiologia , Resistência à Insulina , Prevalência , Estudos Transversais , Fatores de Risco , Análise de Variância , Intolerância à Glucose/epidemiologia , Glucose/administração & dosagemRESUMO
ANTECEDENTES: El intervalo QT representa la despolarización y repolarización ventricular y su prolongación está asociada a un mayor riesgo de arritmias graves y muerte súbita. Depende de la frecuencia cardíaca y su rápida valoración es difícil de obtener en la práctica clínica. Una forma que facilita este proceso es medir sólo el intervalo QT pero este no siempre se relaciona con un intervalo QTc prolongado. Debido a esto, se postula que una variable compuesta debería tener mejor rendimiento diagnóstico para este objetivo. OBJETIVO: Describir la correlación de 3 variables electrocardiográficas; intervalo QT (iQT), razón del intervalo QT intervalo RR (%iQTRR) y razón del intervalo RT intervalo RR (%iRTRR), en relación a la variable QT corregido (iQTc). Se efectuó una evaluación diagnóstica y validación de las variables mencionadas para establecer el diagnóstico de intervalo QT largo y las propiedades diagnósticas de las mismas para el diagnóstico de iQTc prolongado según la fórmula Bazett. METODOS Y RESULTADOS: Se efectuó un estudio transversal descriptivo-relacional, usando una muestra no probabilística formada por 220 electrocardiogramas registrados en la base de datos del centro cardiovascular. Las mediciones provenían de ECGs registrados en reposo con medición con cáliper de los intervalos QT y RR en derivadas D2 y/o V5, expresadas en milisegundos. Se excluyó la presencia de isquemia, preexcitación y repolarización precoz. Se obtuvo como resultado que la variable razón iQTRR tiene mejor correlación, concordancia, sensibilidad y valor predictivo negativo para el diagnóstico del iQTc prolongado, versus las variables iQT y razón iRTRR, principalmente en mujeres. CONCLUSIONES: La variable razón iQTRR tiene una mejor correlación, concordancia, sensibilidad y valor predictivo negativo (VPN) para el diagnóstico del iQTc prolongado, comparado con las variables iQT y razón iRTRR, principalmente, en mujeres. Utilizando ambas variables este efecto se potencia y permite concluir que si una mujer tiene un iQT observado <470 ms, y una razón QTRR< 47,5%, esto se corresponde con un intervalo QTc normal, con un VPN de 100% .
BACKGROUND: The QT interval (QT) includes depolarization and repolarization phases of cardiac cycle. Its prolongation is associated to an increa sed risk of serious arrhythmia and sudden death. QT depends on heart rate and it is usually corrected using the Bazett formula (QTc). Prolonged QT is not usually well related to QTc. We postulate that a composite formula muy have a greater value for predicting serious arrhythmia. AIM: To correlate the predictive value of a different approach to estimate a corrected QT interval: the ratio of RT to RR intervals (QT/RR, expressed as a percentage METHODS and RESULTS: A non probabilistic sample of 220 ECGs were obtained from our data base. ECGs were recorded at rest and measurements were performed in leads Ds and/or V5 using zetcalipers, the values being expressed in ms. The presence of ischemia, pre excitation and early repolarization were excluded. The QT/RR ratio showed better correlation, concordance, sensitivity, and negative predicted value with the usual QTc interval compared to QT alone or de RT/RR ratio, especially so in women.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Síndrome do QT Longo/diagnóstico , Síndrome do QT Longo/fisiopatologia , Eletrocardiografia/métodos , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatologia , Estudos Transversais , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
This is a Document from de Chilean Society of Cardiology and Cardiovascular Surgery, along with the Chilean Society of Physical Therapy of Cardiology and Cardiovascular Surgery.
Assuntos
Humanos , Doenças Cardiovasculares/prevenção & controle , Exercício Físico , Prevenção Primária , Qualidade de Vida , Doenças Cardiovasculares/epidemiologia , Medição de Risco , Consenso , Prevenção Secundária , Comportamento Sedentário , Reabilitação Cardíaca/métodosRESUMO
El objetivo del siguiente estudio fue determinar las dimensiones del tórax y su relación con la función ventilatoria en un grupo de nadadores correspondientes a la selección de natación de la Universidad Católica del Maule. Se evaluaron 42 sujetos de sexo masculino entre 18 y 26 años, 18 seleccionados de natación y 24 estudiantes sedentarios, todos de la Universidad Católica del Maule. Se les realizó antropometría corporal básica (peso y talla corporal) y específica de tórax, diámetro antero-posterior (DAT) y transverso (DTT) de tórax y perímetro mesoesternal (PME). Posterior a esto, se evaluó la función ventilatoria a través de pletismografía corporal. Para el análisis estadístico se determinó la normalidad de los datos posteriormente se utilizó t de student o U de Mann-Whitney y Pearson o Spearman según correspondiera, para establecer significancia estadística o correlación, respectivamente. Se consideró un nivel de significancia estadística de p<0,05. Se observó un aumento significativo del índice de masa corporal (IMC), mayores dimensiones de tórax en nadadores, DAT a capacidad pulmonar total (CPT) y PME a CPT y volumen residual (VR). En función ventilatoria existió un aumento significativo de presión espiratoria máxima (PEM), presión inspiratoria máxima (PIM), capacidad inspiratoria (CI) y CPT. También se observaron correlaciones de buenas a excelentes entre diámetro y perímetro de tórax con CI y CPT en los nadadores. Por tanto, se concluye que existió una relación entre la antropometría de tórax y la función ventilatoria en nadadores de la Universidad Católica del Maule.
The main point of this study is to determine the dimensions of the thorax and its relation to the ventilatory function of a group of swimmers members of the swimming team at Universidad Católica del Maule. 42 male subjects, whose age vary between 18 and 26 years old, were evaluated. 18 subjects were on the swimming team and 24 were sedentary students, all of them study in Universidad Católica del Maule. They were performed a basic bodily anthropometry assessment (weight and body size) and they were also performed a specific anthropometric assessment of the thorax, as well as one of the anteroposterior diameter (ATD) and the transverse diameter (TDT), thorax and the mesosternal perimeter (MP). Finally, they were performed an evaluation of the ventilatory function trough body plethysmography. For the statistical analysis the normality of the data was determined, then came the use of t of student or U of Mann-Whitney and Pearson or Spearman, depending of the case, whether it was to determine the statistical significance or correlation, respectably. A level of statistical significance of p> 0,05 was considered. A significant increase of the body mass index (BMI) was observed, bigger thorax dimensions, PDA to full pulmonary capacity (FPC) and PME to FPC and residual volume. In the ventilatory function there was a significant increase of maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), inspiratory capacity (IC) and FPC. There were also correlations that vary from good to excellent between the diameter and perimeter of the thorax and IC and FMP, among the swimmers. Thus, it is concluded that relations exist between the anthropometrical of the thorax and the ventilatory function in swimmers of the Universidad Católica del Maule, Talca, Chile.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Adulto Jovem , Antropometria , Pulmão/fisiologia , Natação , Tórax/anatomia & histologia , Capacidade VitalRESUMO
Introducción: La disfunción eréctil (DE) afecta a millones de personas en el mundo. Se caracteriza por daño endotelial vascular y actualmente es considerado un marcador de riesgo de enfermedad cardiovascular. Sin embargo, no es evaluada normalmente por el personal médico y los pacientes se rehúsan a discutirlo. El objetivo de este trabajo es determinar la prevalencia de DE y sus factores asociados en pacientes con indicación de rehabilitación cardíaca. Material y Método: Estudio descriptivo, transversal, incluyó 225 pacientes con indicación de rehabilitación cardíaca de 6 países de Latinoamérica: Chile (CH), Brasil (BR), Perú (PE), Colombia (CO), Argentina (AR) y Paraguay (PY) en el período de marzo-agosto 2014. Se obtuvo datos demográficos y se utilizó el cuestiona-rio Índice Internacional de Función Eréctil (CIIFE) auto administrado. Las variables fueron procedencia, edad, peso, talla, IMC, obesidad, hipertensión arterial (HTA), diabetes mellitus (DM), infarto agudo del miocardio (IAM), tabaquismo y uso de fármacos. Resultados: Se evaluó a 225 hombres. De acuerdo al CIIFE, 80,1% tuvo algun tipo de DE; 8,9% severa; 10,7% moderada; 26,2% media a moderada y 35,6% media. Los factores asociados significativamente fueron el país de procedencia, la DM, la edad y el tabaquismo. Conclusión: La prevalencia de Disfunción Eréctil en pacientes con indicación de rehabilitación cardíaca de Chile, Brasil, Perú, Colombia, Argentina y Paraguay fue 80,1% y sus factores asociados son edad, obesidad, IAM, DM, HTA y tabaquismo.
Background: Erectile dysfunction (ED) affects millions of males around the world. It is characterized by endothelial dysfunction and is currently considered to be a marker of cardiovascular disease. However, it is seldom evaluated by medical personnel and patients frequently refuse to discuss the subject. The aim of this investigation was to determine incidence and prevalence of ED and associated factors in patients referred for cardiac rehabilitation. Method: A descriptive, cross sectional study was performed in 225 patients referred for cardiac rehabilitation in 6 Latin American countries: Chile (CH), Brazil (BR), Perú (PE), Colombia (CO), Argentina (AR) and Paraguay (PY), from March to August 2014. Demographic data were collected and the self-administered International ED questionnaire was applied to evaluate ED. Variables included age, weight, height, BMI, obesity, hypertension (HT), diabetes mellitus (DM), acute myocardial infarction, smoking habit and use of different medications Results: 80.1% of subjects had some type of ED: it was severe in 8.9%, moderate in 10.7%. moderate to intermediate in 26.2% and intermediate in 35.6%. Factors associated to the presence of ED were country of origin, DM, age, and smoking habit Conclusion: ED was present in a mean of 80.1% of patients referred for cardiac rehabilitation in Chile, Brazil, Perú, Colombia, Argentina, and Paraguay. ED was associated to age, obesity, myocardial infarction, DM, HT, and smoking habit.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Reabilitação Cardíaca , Disfunção Erétil/epidemiologia , Comorbidade , Estudos Transversais , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , América Latina/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Tabagismo/epidemiologiaRESUMO
Background: Cardiac rehabilitation (CR) programs play an important role in the control and prevention of new cardiac events. Aim: A survey was performed to evaluate the current situation of CR programs in Chile. Material and Methods: A questionnaire evaluating the structure of rehabilitation centers, characteristics of the rehabilitation programs and patients, management of risk factors, reimbursement methods, human resources and potential barriers for an efficient rehabilitation, was mailed to centers dedicated to CR in Chile. Results: Eight centers were contacted and seven responded. Coronary heart disease is the most common underlying disease of attended patients and CR is carried out mainly during phases II and III. All CR centers perform an initial assessment, stratify patients, plan and provide tips on physical activity and nutrition. Only three centers provide help to quit smoking. Lipid profile and blood sugar are assessed in 62% of centers. Most practitioners involved are cardiologists, nurses, physiotherapists and nutritionists, all trained in cardiopulmonary resuscitation. The main barrier for their development is the lack of patient referral from practitioners. Conclusions: Despite the recognized value of CR in the care of patients after a cardiac event, this study reveals the need for further development of such programs and improvement of patient referrals.
Assuntos
Humanos , Doenças Cardiovasculares/reabilitação , Pessoal de Saúde/estatística & dados numéricos , Centros de Reabilitação/normas , Doenças Cardiovasculares/prevenção & controle , Chile , Doença das Coronárias/reabilitação , Equipe de Assistência ao Paciente , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Encaminhamento e Consulta , Centros de Reabilitação/organização & administração , Centros de Reabilitação/estatística & dados numéricos , Fatores de Risco , Prevenção SecundáriaRESUMO
Acute myocardial infarction (AMI) is the first cause of death in Chile. Aim To assess the magnitude of risk of individuals and population associated with AMI risk factors. Material and methods: Case control study with incident cases and 2 controls paired by age and gender. History of diabetes, hypertension, smoking, stress, depression, diet, weight, height, hip and waist circumference, apolipoprotein (Apo) Al and B were determined. Odds ratio (OR) and population attributable risk (PAR) were calculated with 95 percent confidence interval. Results: Three hundred thirty two cases and 672 controls were included. Mean age was 61.6±12 years and 22 percent were women. The higher individual risk was associated with smoking: OR 3.1 (2.3-4.2), hypertension: 2.9 (2.1-3.9), permanent stress: 2.2 (1,3-2,8), increased apoB/ApoAl ratio: 2.1 (1.4-3.0) and diabetes: 2.0 (1.4-2.9). A protective effect of daily consumption of vegetables and/or fruits with and OR of 0.54 (0.4-0.8), was observed. The highest PAR was due to smoking: 42 percent (33.2-51.4), increased ApoB/ApoAl ratio: 35.2 (19.0-55.8) and hypertension: 32 percent (24.5-40.8). These three factors explained 71.3 percent of the AMI risk in Chile. A moderate effect on PAR was observed for abdominal obesity: 16.6 percent (2.4-61.2), permanent stress: 12.0 percent (2.3-44.1) and diabetes: 10.8 percent (6.1-18.3). Conclusions: Known risk factors ¡ike dyslipidemia, smoking and hypertension explain most of the AMI cases in Chile. The control of these risk factors should have a major effect on morbidity and mortality due to coronary artery disease in our country.
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Estudos de Casos e Controles , Chile/epidemiologia , Dislipidemias/complicações , Dislipidemias/epidemiologia , Hipertensão/complicações , Hipertensão/epidemiologia , Infarto do Miocárdio/epidemiologia , Razão de Chances , Prevalência , Fatores de Risco , Distribuição por Sexo , Fumar/efeitos adversos , Fumar/epidemiologiaRESUMO
Se realizó un estudio taxonómico y enzimático cualitativo de hongos aislados desde sedimentos del lago Riñihue, seis tributarios (laboratorio, Quilahuentru, Riñihue, La Peña, Remehue y Triu-triu) y un efluente del río San Pedro. En estos lugares se tomaron muestras a profundidades de 1 a 205 m, dependiendo de la estación de muestreo. Los sedimentos se procesaron por el método de las diluciones seriadas y se sembraron en AEM al 2 porciento. Las cepas aisladas se identificaron taxonómicamente y se determinó la actividad de enzimas de interés lignocelulolítico. Se aislaron 82 cepas, correspondientes a 30 géneros, 37 especies y 2 micelios estériles; todas correspondieron a hongos de origen terrestre. Se aislaron por primera vez en Chile, las especies aspergillus brunneo-uniseriatus, chaunopycnis alba, eupenicillium euglaucum, eupenicillium javanicum, pseudeurotium zonatum. Del total de cepas aisladas 73 presentaron potenciales enzimáticos para celulosa, 55 para enzimas del complejo lignina, 26 para proteasa y 34 para amilasa. Entre las enzimas del complejo lignina, citocromo oxidasa se presentó la mayor cantidad de cepas positivas (40) y tirosinasa la menor (4 cepas). Fusarium oxysporum presentó el mayor potencial lignolítico, pues fue positivo para todas las enzimas del complejo lignina