Beeswax Alcohol Prevents Low-Density Lipoprotein Oxidation and Demonstrates Antioxidant Activities in Zebrafish Embryos and Human Subjects: A Clinical Study.

Oxidative stress is one of the primary instigators of the onset of various human ailments, including cancers, cardiovascular diseases, and dementia. Particularly, oxidative stress severely affects low-density lipid & protein (LDL) oxidation, leading to several detrimental health effects. Therefore, in this study, the effect of beeswax alcohol (BWA) was evaluated in the prevention of LDL oxidation, enhancement of paraoxonase 1 (PON-1) activity of high-density lipid & protein (HDL), and zebrafish embryo survivability. Furthermore, the implication of BWA consumption on the oxidative plasma variables was assessed by a preliminary clinical study on middle-aged and older human subjects (n = 50). Results support BWA augmentation of PON-1 activity in a dose-dependent manner (10-30 µM), which was significantly better than the effect exerted by coenzyme Q10 (CoQ10). Moreover, BWA significantly curtails LDL/apo-B oxidation evoked by CuSO4 (final 0.5 µM) and a causes a marked reduction in lipid peroxidation in LDL. The transmission electron microscopy (TEM) analysis revealed a healing effect of BWA towards the restoration of LDL morphology and size impaired by the exposure of Cu2+ ions (final 0.5 µM). Additionally, BWA counters the toxicity induced by carboxymethyllysine (CML, 500 ng) and rescues zebrafish embryos from development deformities and apoptotic cell death. A completely randomized, double-blinded, placebo-controlled preliminary clinical study on middle- and older-aged human subjects (n = 50) showed that 12 weeks of BWA (100 mg/day) supplementation efficiently diminished serum malondialdehyde (MDA) and total hydroperoxides and enhanced total antioxidant status by 25%, 27%, and 22%, respectively, compared to the placebo-control and baseline values. Furthermore, the consumption of BWA did not exhibit any noteworthy changes in physical variables, lipid profile, glucose levels, and biomarkers pertinent to kidney and liver function, thus confirming the safety of BWA for consumption. Conclusively, in vitro, BWA prevents LDL oxidation, enhances PON-1 activity in HDL, and positively influences oxidative variables in human subjects.

Intensive Care Unit- Acquired Weakness and Hospital Functional Mobility Outcomes Following Invasive Mechanical Ventilation in Patients with COVID-19: A Single-Centre Prospective Cohort Study.

Background: Acute physical function outcomes in ICU survivors of COVID-19 pneumonia has received little attention. Critically ill patients with COVID-19 infection who require invasive mechanical ventilation may undergo greater exposure to some risk factors for ICU-acquired weakness (ICUAW). Purpose: To determine incidence and factors associated with ICUAW at ICU discharge and gait dependence at hospital discharge in mechanically ventilated patients with COVID-19 pneumonia. Methods: Single-centre, prospective cohort study conducted at a tertiary hospital in Madrid, Spain. We evaluated ICUAW with the Medical Research Council Summary Score (MRC-SS). Gait dependence was assessed with the Functional Status Score for the ICU (FSS-ICU) walking subscale. Results: During the pandemic second wave, between 27 July and 15 December, 2020, 70 patients were enrolled. ICUAW incidence was 65.7% and 31.4% at ICU discharge and hospital discharge, respectively. Gait dependence at hospital discharge was observed in 66 (54.3%) patients, including 9 (37.5%) without weakness at ICU discharge. In univariate analysis, ICUAW was associated with the use of neuromuscular blockers (crude odds ratio [OR] 9.059; p = 0.01) and duration of mechanical ventilation (OR 1.201; p = 0.001), but not with the duration of neuromuscular blockade (OR 1.145, p = 0.052). There was no difference in corticosteroid use between patients with and without weakness. Associations with gait dependence were lower MRC-SS at ICU discharge (OR 0.943; p = 0.015), older age (OR 1.126; p = 0.001), greater Charlson Comorbidity Index (OR 1.606; p = 0.011), longer duration of mechanical ventilation (OR 1.128; p = 0.001) and longer duration of neuromuscular blockade (OR 1.150; p = 0.029). Conclusions: In critically ill COVID-19 patients, the incidence of ICUAW and acute gait dependence were high. Our study identifies factors influencing both outcomes. Future studies should investigate optimal COVID-19 ARDS management and impact of dyspnea on acute functional outcomes of COVID-19 ICU survivors.

Core Synergies Measured with Ultrasound in Subjects with Chronic Non-Specific Low Back Pain and Healthy Subjects: A Systematic Review.

Low back pain represents the leading cause of disability since 1990. In 90% of cases, it is classified as non-specific low back pain, being chronic in 10% of subjects. Ultrasound has proven to be an effective measurement tool to observe changes in the activity and morphology of the abdominal muscles. This article reviews which core synergies are studied with ultrasound in healthy subjects and with chronic non-specific low back pain. A systematic review was conducted on studies analyzing synergies between two or more core muscles. Publications from 2005 until July 2021 were identified by performing structured searched in Pubmed/MEDLINE, PEDro and WOS. Fifteen studies were eligible for the final systematic review. A total of 56% of the studies established synergies between the core muscles and 44% between the homo and contralateral sides of the core muscles. The most studied core synergies were transversus abdominis, internal oblique and external oblique followed by the rectus abdominis and the lumbar multifidus. No studies establishing synergies with diaphragm and pelvic floor were found. Eight studies were conducted in healthy subjects, five studies in subjects with chronic non-specific low back pain compared to healthy subjects and two studies in subjects with chronic non-specific low back pain.

Ultrasound Evaluation of Onset Core Muscle Activity in Subjects with Non-Specific Lower Back Pain and Without Lower Back Pain: An Observational Case-Control Study.

Lower back pain (LBP) has been the leading cause of disability since 1990. Objectives: The main objective of this observational case-control study was to evaluate, using ultrasound, whether there were differences in the onset and ratio of core muscle contraction between subjects with non-specific chronic lower back pain and healthy subjects. Methods: A total of 60 participants (52% women), split between those with non-specific chronic lower back pain (n = 26) and healthy (n = 34) subjects, were recruited. Initial muscle contraction of the lateral abdominal wall, pelvic floor, lumbar multifidus, and respiratory diaphragm was measured using ultrasound. The abdominal drawing-in maneuver, contralateral arm elevation, the Valsalva maneuver, and voluntary contraction of the pelvic floor in seated and standing positions were performed. The muscle thickness of the lateral abdominal wall and lumbar multifidus and excursion of the pelvic floor and diaphragm at rest and during testing were also analyzed. Results: No differences were found between the groups in the initial contraction. Statistically significant differences were found in the following variables: diaphragm excursion (p = 0.032, r = 0.277) and lumbar multifidus ratio (p = 0.010, r = 0.333) in the standing-abdominal retraction maneuver; pelvic floor excursion (p = 0.012, r = 0.325) in the standing-contralateral arm raise; and transverse abdominis ratio (p = 0.033, r = 0.275) in the sitting-contralateral arm raise. A statistically significant interaction between the groups and body mass index was observed in resting diaphragm excursion (p = 0.018, partial eta squared = 0.096) during sitting-voluntary pelvic floor contraction. Conclusions: It cannot be concluded that there is a specific pattern of core activation in any of the groups. However, statistically significant differences were found in the contraction indexes of the lumbopelvic musculature.

Improving hand hygiene compliance in the emergency department: getting to the point.

BACKGROUND: The emergency department (ED) represents an environment with a high density of invasive, and thus, infection-prone procedures. The two primary goals of this study were (1) to define the number of hand-rubs needed for an individual patient care at the ED and (2) to optimize hand hygiene (HH) compliance without increasing workload. METHODS: Prospective tri-phase (6-week observation phases interrupted by two 6-week interventions) before after study to determine opportunities for and compliance with HH (WHO definition). Standard operating procedures (SOPs) were optimized for invasive procedures during two predefined intervention periods (phases I and II) to improve workflow practices and thus compliance with HH. RESULTS: 378 patient cases were evaluated with 5674 opportunities for hand rubs (HR) and 1664 HR performed. Compliance significantly increased from 21% (545/2603) to 29% (467/1607), and finally 45% (652/1464; all p<0.001) in phases 1, 2, and 3, respectively. The number of HR needed for one patient care significantly decreased from 22 to 13 for the non-surgical and from 13 to 7 for the surgical patients (both p<0.001) due to improved workflow practices after implementing SOPs. In parallel, the number of HR performed increased from 3 to 5 for non-surgical (p<0.001) and from 2 to 3 for surgical patients (p=0.317). Avoidable opportunities as well as glove usage instead of HR significantly decreased by 70% and 73%, respectively. CONCLUSIONS: Our study provides the first detailed data on HH in an ED setting. Importantly, HH compliance improved significantly without increasing workload.

Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6†months after intensive care unit discharge.

Background: Knowledge regarding the long-term impact of invasive mechanical ventilation on the inspiratory muscles and functional outcomes in COVID-19 survivors is limited. Methods: In this single-centre prospective cohort study, we evaluated invasively ventilated patients with COVID-19 pneumonia 3 and 6 months post-intensive care unit (ICU) discharge. Outcomes included: maximal inspiratory pressure (MIP), ultrasound parameters for diaphragm function, 6-min walk distance (6MWD), dyspnoea and quality of life. We evaluated associations between MIP and duration of mechanical ventilation with follow-up outcomes. Results: 50 COVID-19 survivors discharged from ICU between 15 October 2020 and 1 April 2021 were enrolled. Overall, survivors showed a recovery trajectory over time. However, impaired MIP remained in 24 (48%) and 12 (24%) at 3 and 6 months, respectively. Diaphragm dysfunction was not observed. At 3 months, 23 (46%) had impaired functional capacity versus 10 (20%) at 6 months. Dyspnoea persisted in 44 (88%) patients at 3 months and 38 (76%) at 6 months. Quality of life was slightly decreased at 3 months with further improvements at 6 months. MIP was correlated to 6MWD, 6MWD % predicted, dyspnoea across follow-up, and quality of life at 3 months. The duration of invasive ventilation was correlated with 6MWD and 6MWD % predicted. Conclusion: In invasively ventilated COVID-19 survivors, inspiratory muscle strength impairments persisted 6 months after ICU discharge, while maintaining normal diaphragm function. Decreased functional capacity, dyspnoea and slightly reduced health status were observed. Early screening of survivors is of utmost importance to identify those with impairments and at risk of delayed or incomplete recovery.

Real-time ultrasound evaluation of CORE muscle activity in a simultaneous contraction in subjects with non-specific low back pain and without low-back pain. Protocol of an observational case-control study.

Non-specific low back pain represents 90-95% of all cases of low back pain and it has a prevalence of 18% in the adult population, assuming a great socioeconomic impact. The main objective of this observational case-control study study is to evaluate if there are differences in the simultaneous contraction of the core muscles between nonspecific low back pain and healthy subjects. This study will be carried out in the Physiotherapy department of the University of Alcalá. Eighty-two participants <18 years old, will be recruited, paired with NSLBP (n = 41) and healthy (n = 41). The main outcome will be the onset muscle contraction of lateral abdominal wall (internal oblique, external oblique and transversus abdominis), pelvic floor, lumbar multifidus and respiratory diafragm. The maneuvers that the subjects will perform will be abdominal drawing in maneouver, contralateral arm lift, valsalva, and voluntary pelvic floor contraction in sitting and standing. As a secondary objective, to analyze the amount of contraction of each muscle group and the capacity of the diaphragms to be excreted in both groups of subjects. Finally, to relate pain and disability.

l-Isoleucine-Schiff Base Copper(II) Coordination Polymers: Crystal Structure, Spectroscopic, Hirshfeld Surface, and DFT Analyses.

A new copper(II) coordination polymer was synthesized from the l-isoleucine-Schiff base and characterized by elemental analysis, Fourier transform infrared (FT-IR) spectroscopy, ultraviolet-visible (UV-vis) spectroscopy, single-crystal X-ray diffraction (XRD) analysis, electronic paramagnetic resonance, and thermogravimetric analysis. XRD analysis confirmed the square planar coordination geometry of metallic centers and a zipper-like polymer structure. Vibrational, electronic, and paramagnetic spectroscopies and thermal analysis were consistent with the crystal structure. A Hirshfeld surface (HS) and density functional theory (DFT) analyses were employed to gain additional insight into interactions responsible for complex packing. The quantitative examination of two-dimensional (2D) fingerprint plots revealed, among other van der Waals forces, the dominating participation of H···H and H···Cl interactions in the molecular packing. The use of computational methods provided great help in detailing the supramolecular interactions occurring in the crystal, which were mainly van der Waals attractions. The electronic transition analysis helped corroborate the electronic transitions observed experimentally in the absorption spectrum. The frequency and vibrational mode analysis gave a deeper insight into the characterization of the CuLCL complex.

Effects of Dry Needling on Neuromuscular Control of Ankle Stabilizer Muscles and Center of Pressure Displacement in Basketball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial.

This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.

Acute caffeine supplementation in combat sports: a systematic review.

Caffeine used as a supplement has been shown to improve physical and cognitive performance in several sport modalities due to its effects on the central nervous system. This review assesses the direct effects of caffeine supplementation on performance in combat sports. Using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, relevant studies were identified through the Medline, Scopus and SPORTDiscus databases. Of 1053 search results, only 9 articles fulfilled the inclusion criteria. Of these, three studies detected no ergogenic effect of caffeine supplementation, while six studies did observe a significant positive effect. Supplementation with 3-6 mg/kg of caffeine was found to increase the glycolytic contribution to energy metabolism during the execution of real or simulated combats, as indicated by elevated blood lactate concentrations. Caffeine intake was also noted to improve levels of strength, power and upper arm muscular endurance. These effects were not paralleled by an increase in the exertion perceived by the athlete.

Development and validation of the Relaxation-Mindfulness Scale for Adolescents (EREMIND-A).

BACKGROUND: The aim of this investigation was to validate the Relaxation-Mindfulness Scale for Adolescents (EREMIND-A), consisting of 18 items and three factors (Attention-Concentration in the present moment; Relaxation (abilities and attitudes); and Sensory awareness/Contemplation/Interiority). METHOD: The validation was done with a sample of Secondary Education and Baccalaureate students from four different centres in Spain (n = 1.120). EFA and CFA of the EREMIND-A were performed and construct and incremental validities calculated. RESULTS: Initial results confirm the validity and reliability of the scale. CONCLUSIONS: There is a need for a broader conceptualization of mindfulness, as well as the inclusion and analysis of other related and cross-cutting concepts. The research in this sense will propitiate the adaptation of the Mindfulness-Based Interventions to the reality of the adolescents in the educational centers, where relaxation and the interiority are aspects to be taken into consideration.

Study of the Technical Feasibility of Increasing the Amount of Recycled Concrete Waste Used in Ready-Mix Concrete Production.

The construction industry generates a considerable amount of waste. Faced with this undesirable situation, the ready-mix concrete sector, in particular, has invested energy and resources into reusing its own waste in its production process as it works towards the goal of more sustainable construction. This study examines the feasibility of incorporating two types of concrete waste, which currently end up in landfill, into the production process of ready-mix concrete: the waste generated during the initial production stage (ready-mix concrete waste), and waste created when demolition waste is treated to obtain artificial aggregate. The first phase of the study's methodology corroborates the suitability of the recycled aggregate through characterization tests. After this phase, the impact of incorporating different percentages of recycled coarse aggregate is evaluated by examining the performance of the produced concrete. The replacement rate varied between 15% and 50%. The results indicate that recycled aggregates are, indeed, suitable to be incorporated into ready-mix concrete production. The impact on the final product's performance is different for the two cases examined herein. Incorporating aggregates from generic concrete blocks led to a 20% decrease in the produced concrete's strength performance. On the other hand, using recycled aggregates made from the demolition waste led to a smaller decrease in the concrete's performance: about 8%. The results indicate that with adequate management and prior treatment, the waste from these plants can be re-incorporated into their production processes. If concrete waste is re-used, concrete production, in general, becomes more sustainable for two reasons: less waste ends up as landfill and the consumption of natural aggregates is also reduced.

Effect of a Mindfulness Training Program on the Impulsivity and Aggression Levels of Adolescents with Behavioral Problems in the Classroom.

Objective: The aim of the present study was to analyze the effects of a mindfulness training psycho-educative program on impulsivity and aggression levels in a sample of high school students. Methods: A randomized controlled trial with pre-test-post-test measurements was applied to an experimental group and a control group (waiting list). The Barratt Impulsivity Scale (BIS-11) Patton et al. (1995) and the Aggression Questionnaire (Buss and Perry, 1992) were used. Results: Statistical analyses showed a significant decrease in the levels of impulsivity and aggressiveness in the experimental group compared with the control group. These results have important implications for improving the level of academic engagement and self-efficacy of students and for reducing school failure. Conclusion: This is one of the first studies showing the effectiveness of mindfulness training at reducing impulsive and aggressive behaviors in the classroom. The efficacy of mindfulness-based programs is emphasized.

Development and validation of the relaxation-mindfulness scale for adolescents (eremind-A) / Desarrollo y validación de la Escala de Relajación-Mindfulness para Adolescentes (EREMIND-A)

BACKGROUND: The aim of this investigation was to validate the Relaxation-Mindfulness Scale for Adolescents (EREMIND-A), consisting of 18 items and three factors (Attention-Concentration in the present moment; Relaxation (abilities and attitudes); and Sensory awareness/Contemplation/Interiority). METHOD: The validation was done with a sample of Secondary Education and Baccalaureate students from four different centres in Spain (n = 1.120). EFA and CFA of the EREMIND-A were performed and construct and incremental validities calculated. RESULTS: Initial results confirm the validity and reliability of the scale. CONCLUSIONS: There is a need for a broader conceptualization of mindfulness, as well as the inclusion and analysis of other related and cross-cutting concepts. The research in this sense will propitiate the adaptation of the Mindfulness-Based Interventions to the reality of the adolescents in the educational centers, where relaxation and the interiority are aspects to be taken into consideration

ANTECEDENTES: el objetivo de esta investigación fue validar la Escala de relajación-Mindfulness para Adolescentes (EREMIND-A), que contiene 18 ítems y tres factores (Atención-Concentración en el momento presente; Relajación (habilidades y actitudes); Consciencia Sensorial/Contemplación/Interioridad. MÉTODO: la validación se realizó con una muestra de estudiantes de Educación Secundaria y Bachillerato de cuatro centros diferentes en España (n = 1.120). Se realizaron análisis factoriales exploratorios y confirmatorios de la escala y se calcularon la validez de constructo e incremental. RESULTADOS: los resultados iniciales confirman la fiabilidad y validez de la escala. CONCLUSIONES: es necesaria una conceptualización más amplia de la atención plena, así como la inclusión y análisis de otros conceptos relacionados y transversales. La investigación en este sentido propiciará la adaptación de las intervenciones basadas en mindfulness a la realidad de los adolescentes en los centros educativos, donde la relajación y la interioridad son aspectos a tener en consideración

Hand hygiene in medical students: performance, education and knowledge.

BACKGROUND: Despite several guidelines on hand hygiene (HH), compliance especially in physicians is reported to be low which has huge implications for healthcare-associated infections. To evaluate performance of HH, influence of teaching and influence of monitoring the results in medical students, we conducted an observational study. METHODS: Performance of hand disinfection was evaluated in first (N=28), third (N=193) and fifth (N=45) year medical students using fluorescent hand disinfectant. The influence of teaching and information about result control was assessed. The students perception of the impact of HH was also evaluated by a questionnaire. RESULTS: Presence of disinfectant gaps was observed significantly more often in first year medical students compared to third year ones (82% vs, 60%; p=0.02). In additional, > 3 gaps were seen significantly more often in first year medical students compared to fifth year students (36% vs. 9%; p=0.007). Both information about teaching and monitoring the results improved outcome significantly. For example, gaps were present in 92% without information and without teaching, in 70% (RR: 1.3 (1.0-1.6); p=0.003) with information about result control only, and in only 18% (5.1 (3.0-8.5); p=0.0001) after teaching. Notably, the medical students ascribed HH to be of a great importance regardless of their level of education. CONCLUSIONS: Performance of HH could be improved by practical training as evidenced by best HH performance being documented immediately after teaching and a training effect during the course of medical studies was also observed. Thus, we suggest implementing regular education and practical training on HH from early on in the medical studies curricula to improve overall quality of patient care. regular education and practical training on HH from early on in the medical studies curricula to improve overall quality of patient care.

Aspectos epidemiologicos, clínicos y terapeuticos de la fibrilacion auricular aguda / Epidemiologic, clinical and therapeutical aspects of acute atrial fibrillation

Se realizó estudio descriptivo transversal con 42 pacientes con Fibrilación Auricular Aguda sintomática, atendidos en la terapia intensiva municipal del Policlínico Docente Noelio Capote del municipio Jaruco, provincia La Habana, en el periodo comprendido desde el 1 de enero de 2006 hasta el 31 de diciembre de 2008, con el objetivo de conocer algunos aspectos epidemiológicos, clínicos y terapéuticos en estos pacientes. Todos fueron estudiados según las variables: edad, sexo, hábitos tóxicos, antecedentes patológicos personales, tiempo de evolución, presencia de recurrencias y conducta terapéutica. Predominó el sexo femenino y los mayores de 70 años. El café y el hábito de fumar resultaron ser los hábitos tóxicos que más estaban presentes; mientras que la Hipertensión Arterial y la Cardiopatía Isquémica fueron los antecedentes patológicos más frecuentes. Predominaron los pacientes con menos de 72 horas de iniciado el evento de FA y más de la mitad de los pacientes eran recurrentes. La conducta terapéutica más utilizada fue frenar la frecuencia cardiaca más la cardioversión farmacológica (AU)

A descriptive-transversal study was conducted with 42 patients with symptomatic acute atrial fibrillation assisted in the municipal intensive care unit of Noelio Capote Teaching Polyclinic in Jaruco, Havana Province, in the period from January 1st, 2006 to December 31st , 2008, in order to know some epidemiological, clinical and therapeutical aspects in these patients. All patients were studied according to the variables: age, sex, toxic habits, personal pathological antecedents, time of evolution, presence of recurrences and therapeutical behavior. The female sex predominated and patients over 70 years. Coffee and smoking habit were found to be the most frequent toxic habits, while the arterial hypertension and Ischemic cardiopathy were the most common personal pathological antecedents. There was prevalence of patients with less than 72 hours into the event of AF and more than half of the patients were recurrent. The most used therapeutic conduct was to reduce the heart rate plus pharmacological cardioversion (AU)

Características de la asistencia médica del infarto agudo del miocardio en la atención primaria / Characteristics of health care of acute myocardial infarction in primary care

Se realizó estudio descriptivo transversal con 38 pacientes con Infarto Agudo del Miocardio con elevación del segmento s-t en el electrocardiograma, atendidos en la terapia intensiva municipal del Policlínico Docente Noelio Capote del municipio Jaruco, provincia La Habana, desde el 1 de enero de 2006 hasta 31 de diciembre de 2008, con el objetivo de conocer las características de la asistencia primaria de salud en estos pacientes. Todos fueron estudiados según las variables: edad, sexo, complicaciones, uso de tratamiento trombolítico, tipo de transporte utilizado hacia y desde la terapia intensiva y la mortalidad. Predominó el sexo masculino y los mayores de 70 años. No fue frecuente la trombolisis, siendo la taquicardia y la bradicardia sinusal las complicaciones que más se presentaron. Predominó el trasladado de pacientes en el apoyo vital básico hacia el policlínico y en el apoyo vital avanzado desde la terapia intensiva municipal hacia otras unidades de cuidados intensivos. La mortalidad fue del 13,16 por ciento (AU)

A descriptive and transversal study was conducted in 38 patients with acute myocardial infarction AMI with ST segment elevation on the electrocardiogram, treated in the Municipal Intensive Care Unit MICU of Noelio Capote Teaching Polyclinic of Jaruco municipality, in Havana province, since January 1st, 2006 to December 31st, 2008, in order to ascertain the characteristics of the primary health care in these patients. All patients were studied according to the variables: age, sex, complications, use of thrombolytic therapy, type of transport used to and from the MICU and mortality. Masculine sex predominated and those over 70 years. Thrombolysis was infrequent, being tachycardia and sinus bradycardia the most frequent complications. There was predominance of patients' transferal on Basic Life Support to the polyclinic and in the advanced life support from MICU to other intensive care units. The mortality rate was 13,16 per cent (AU)

Evaluación en resultados de salud del proceso diabetes tipo 2 / Assessment of health outcomes in the type 2 diabetes process

Objetivo: Analizar la asociación entre el desarrollo del proceso diabetes tipo 2 (DM2) y lacalidad de vida relacionada con la salud (CVRS).Diseño: Estudio descriptivo transversal.Emplazamiento: Unidad de Gestión Clínica (Ayamonte, Huelva).Participantes: Selección por muestreo aleatorio simple entre los pacientes registrados en elproceso DM2: n=143.El proceso DM2 es una herramienta que utiliza indicadores de buena práctica clínica para elseguimiento de los pacientes.Recogida de datos desde registros y entrevista personal para el cuestionario de CVRS SF-36.Resultados: Se analizaron 101 pacientes. 51,5% mujeres. Edad media: 66,8 años (DE 11,3).Realizan actividad física: 52,5%. Tiempo de evolución de la diabetes: 9,6 años (DE 7,7). Índicede calidad del proceso (ISCD): 64,5%.Peor puntuación en componente físico de CVRS, media de 41,9 (DE 9,6).Mayor puntuación en hombres. Practicar ejercicio físico regular mejora la puntuación (diferenciade medias de 19,5 IC95% 10,2—28,8). Asociación negativa entre: edad y función física(r=−0,354 p<0,005), tiempo de evolución de diabetes y componente sumario físico (r=−0,278p<0,005).Retinopatía (t=2,03 p<0,04) y cardiopatía (t=2,6 p<0,008) se relacionan con menor puntuaciónen componente físico.La asociación de CVRS con control metabólico, automedida de glucemia y educación diabetológicaes no significativa.Predictores de la CVRS son: actividad física y enfermedades comórbidas.Conclusiones: La CVRS es mala en los diabéticos tipo 2 a pesar de tener buenos indicadores enel proceso.Debería incluirse la CVRS como estándar del proceso DM2(AU)

Objective: To analyse association between the development of type 2 diabetes and the healthrelatedquality of life (HRQL).Design: Descriptive cross-sectional study.Setting: Primary care centre in Ayamonte (Huelva). Participants: Selection by simple randomsampling between the patients registered with type 2 diabetes: n=143.The type 2 diabetes process is a tool that uses indicators of good clinical practice for thefollow-up of the patients.Collection of data from records and personal interview for the questionnaire HRQL SF-36.Results: A total of 101 patients were analysed, of which 51.5% were women. the average agewas 66.8 years (SD 11.3). Performing physical activity 52.5%. Time of evolution of diabetes: 9.6years (SD 7.7). Quality Index of the process: 64.5%. Worst score in physical component HRQL,mean of 41.9 (SD 9.6). Men had a better score, and it improves if there is regular physical exercise(mean difference 19.5% IC95%CI: 10.2—28.8). Age was inversely associated with physicalfunction (r −0.354 P<0,005); and the time of evolution of diabetes with physical component (r−0.278 P<0.005). Retinopathy (t=2.03 P<0.04) and heart disease (t=2.6 P<0.008) were associatedwith lowest score in physical component. The association of HRQL with metabolic control,self control of glucose and diabetes education was not significant. Physical activity and comorbiddiseases predict HRQL.Conclusions: The HRQL is poor in type 2 diabetics despite having good indicators in the process.The HRQL should be included as standard in the type 2 diabetes process(AU)