Moderate to Severe Psoriasis in Older Adults: Recommendations on Management from the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV). / Recomendaciones del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología sobre el manejo del paciente de edad avanzada con psoriasis en placas moderada-grave.

Managing moderate to severe psoriasis in older adults is complex due to factors characteristic of the later years of life, such as associated comorbidity, polypharmacy, and immunosenescence. This consensus statement discusses 17 recommendations for managing treatment for moderate to severe psoriasis in patients older than 65 years. The recommendations were proposed by a committee of 6 dermatologists who reviewed the literature. Fifty-one members of the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) then applied the Delphi process in 2 rounds to reach consensus on which principles to adopt. The recommendations can help to improve management, outcomes, and prognosis for older adults with moderate to severe psoriasis.

Perinatal morbidity and mortality of children born to mothers with chronic kidney disease.

INTRODUCTION: Chronic kidney disease (CKD) associated with pregnancy increases the risk of maternal and fetal complications. OBJECTIVE: To determine perinatal morbidity and mortality of children born to mothers with mild and moderate CKD during pregnancy. METHODS: Retrospective study of medical records of women with mild and moderate CKD during pregnancy cared for at La Raza National Medical Center between 2010 and 2016. RESULTS: There were 142 patients, 99 (69.72%) with mild CKD and 43 (30.28%) with moderate CKD; 79 neonates (55.63%) reached full term, 28 (19.71%) had growth restriction; 44 (30.98%), low birth weight and 54 (38.02%) were admitted to the neonatal intensive care unit (NICU); and four women (4.04%) had an abortion; in four (2.81%), their children had intrauterine death, and in 10 (7.04%), neonatal death. High blood pressure (odds ratio [OR] = 6.93) and hemoglobin < 11 g/dL (OR = 2.48) were risk factors for prematurity. CONCLUSION: A relationship was found between anemia and blood pressure levels and risk for prematurity, low Apgar, and NICU admission.

INTRODUCCIÓN: La enfermedad renal (ER) crónica asociada al embarazo incrementa el riesgo de complicaciones maternas y fetales. OBJETIVO: Determinar la morbilidad y mortalidad perinatal del hijo de madre con enfermedad renal leve y moderada del embarazo. MÉTODOS: Estudio retrospectivo de expedientes de mujeres con ER leve y moderada del embarazo atendidas en el Centro Médico Nacional La Raza entre 2010 y 2016. RESULTADOS: Se trató de 142 pacientes, 99 (69.72 %) con ER leve y 43 (30.28 %) con ER moderada; 79 (55.63 %) neonatos llegaron a término, 28 (19.71 %) presentaron restricción de crecimiento; 44 (30.98 %), peso bajo al nacimiento y 54 (38.02 %) ingresaron a la unidad de cuidados intensivos neonatales; cuatro (4.04 %) mujeres presentaron aborto, en cuatro (2.81 %) sus hijos presentaron muerte intrauterina y en 10 (7.04 %), muerte neonatal. La presión arterial alta (RM = 6.93) y la hemoglobina < 11g/dL (RM = 2.48) constituyeron factores de riesgo para prematurez. CONCLUSIÓN: Se encontró relación entre la anemia y las cifras de tensión arterial como riesgo para prematurez, Apgar bajo e ingreso a unidad de cuidados intensivos neonatales.

Effect of a ready-to-use supplementary food on the recovery of preschool children with malnutrition.

INTRODUCTION: In developing countries, protein-energy malnutrition causes 60% of deaths in children < 5 years of age. OBJECTIVE: To evaluate the effect of a ready-to-use supplementary food (RUSF) on moderate acute malnutrition (MAM) in preschool children. METHOD: Clinical trial that included 155 children with MAM (weight/height Z-score > -3 and ≤ -2). Each child received RUSF in the form of biscuits, four per day (250 kcal), for 12 months. The tutor received education on nutrition, health and hygiene. Recovery (weight/height Z-score > -2) at four, six, and 12 months was assessed using intent-to-treat (ITT) and per protocol (PP) analyses. Changes in chronic malnutrition were also analyzed. RESULTS: In the first semester, adequate RUSF consumption was observed in 61% of the children, and in 42% in the second semester. In the ITT analysis, 78% were identified to have recovered, with 38% reaching normal nutritional values; in the PP analysis, > 90% recovered and > 40% reached normal values. Recovery from chronic malnutrition was also observed. CONCLUSIONS: The consumption of RUSF and an educational program reduced MAM.

INTRODUCCIÓN: En países en desarrollo, la desnutrición proteico-energética causa 60 % de las muertes en los niños menores de cinco años. OBJETIVO: Evaluar el efecto de un suplemento alimenticio listo para consumir (SALC) en la desnutrición aguda moderada (DAM) en niños preescolares. MÉTODO: Ensayo clínico que incluyó 155 niños con DAM (puntuación Z de peso/talla [pZ] mayor de −3 y menor o igual a −2). Cada niño recibió SALC en forma de galletas, cuatro por día (250 kcal), durante 12 meses. El tutor recibió educación sobre nutrición, salud e higiene. La recuperación (pZ peso/talla mayor de −2) a los cuatro, seis y 12 meses se evaluó con un análisis por intención a tratar (AIT) y por protocolo (APP). También se analizaron cambios en la desnutrición crónica. RESULTADOS: En el primer semestre se observó consumo adecuado del SALC en 61 % de los niños y en 42 % en el segundo semestre. Con el AIT se identificó que 78 % se recuperó y 38 % alcanzó valores normales de nutrición; con el APP, > 90 % se recuperó y > 40 % alcanzó valores normales. Se observó recuperación de la desnutrición crónica. CONCLUSIONES: El consumo de SALC y un programa educativo redujeron la DAM.

Moderate acute malnutrition prevention with a ready-to-use supplementary food in pre-school children from rural communities.

INTRODUCTION: Child malnutrition in Mexico reaches a prevalence as high as 27.5 % in rural areas. OBJECTIVE: To assess the effectiveness of a ready-to-use supplementary food (RUSF) to correct mild acute malnutrition and prevent moderate acute malnutrition in preschool children from rural communities. METHOD: Randomized clinical trial, with assignment to two groups: group with RUSF (RUSF-g) or group without it (non-RUSF-g); children aged from two to five years, with weight-for-height Z-scores (WHZ) between -2 and -1 and low socioeconomic status were included. All received education on nutrition, health and hygiene twice monthly; the RUSF-g children had to consume one portion of the supplement every day. WHZ was assessed at baseline and at four, six, and 12 months. The comparison between groups was carried out with Cox proportional hazards model. RESULTS: With regard to mild acute malnutrition correction in the RUSF-g, 68.7 versus 52.1 % in the control group was observed in the intent-to-treat analysis, with a hazard ratio (HR) = 1.25; in the per-protocol analysis of first semester, a HR = 1.48 was observed, and in the second semester, HR = 1.56. One patient progressed to moderate acute malnutrition. CONCLUSIONS: The RUSF-g showed a significantly higher resolution of mild acute malnutrition. INTRODUCCIÓN: La desnutrición infantil en México alcanza prevalencias de 27.5 % en zonas rurales. OBJETIVO: Evaluar la efectividad de un suplemento alimenticio listo para consumir (SALC) para corregir desnutrición aguda leve y prevenir desnutrición aguda moderada en preescolares de comunidades rurales. MÉTODO: Ensayo clínico aleatorizado por grupos: con y sin SALC (g-SALC y g-S/SALC); se incluyeron niños de dos a cinco años, con puntuaciones-Z de peso para la talla (pZ-P/T) mayor de −2 y menor de −1 y nivel socioeconómico bajo. Todos recibieron educación sobre nutrición, salud e higiene dos veces al mes; los niños del g-SALC debieron consumir diariamente una porción del suplemento. Se evaluó pZ-P/T al inicio y a los cuatro, seis y 12 meses. La comparación entre grupos se realizó con el modelo de riesgos proporcionales de Cox. RESULTADOS: Respecto a la recuperación de desnutrición aguda leve, en g-SALC se observó 68.7 versus 52.1 % en el grupo control en el análisis de intención para tratar, con una razón de riesgo (HR) = 1.25; en el análisis por protocolo del primer semestre se observó una HR = 1.48 y en el segundo semestre, HR = 1.56. Un paciente progresó a desnutrición aguda moderada. CONCLUSIONES: El g-SALC mostró resolución significativamente mayor de desnutrición aguda leve.

The complex relationship between personal sense of connection to animals and self-reported proenvironmental behaviors by zoo visitors.

The global biodiversity crisis requires an engaged citizenry that provides collective support for public policies and recognizes the consequences of personal consumption decisions. Understanding the factors that affect personal engagement in proenvironmental behaviors is essential for the development of actionable conservation solutions. Zoos and aquariums may be some of the only places where many people can explore their relations with wild animals and proenvironmental behaviors. Using a moderated-mediation analysis of a survey of U.S. zoo and aquarium visitors (n = 3588), we explored the relationship between the sense of connection to animals and self-reported engagement in proenvironmental behaviors related to climate change and how this relationship is affected by certainty that climate change is happening, level of concern about climate change, and perceptions of effectiveness in personally addressing climate change. We found a significant, directional relationship between sense of connection to animals and self-reported proenvironmental behaviors. Political inclination within the conservative to liberal spectrum did not affect the relationship. We conclude that a personal sense of connection to animals may provide a foundation for educational and communication strategies to enhance involvement in proenvironmental actions.

[Effects of a recreational general physical activity program with short term and moderate intensity of blood pressure and other cardiovascular risk factors in hypertensive patients over 50 years old]. / Efecto de un programa lúdico de actividad física general de corta duración y moderada intensidad sobre las cifras de presión arterial y otros factores de riesgo cardiovascular en hipertensos mayores de 50 años.

OBJECTIVES: To evaluate the effects of a recreational general physical activity program with moderate intensity and short duration on blood pressure and other cardiovascular risk factors (BMI, cholesterol, Rest Heart Rate, HDL, LDL, Triglycerides) in hypertensive patients older than 50years. DESIGN: Non-randomised pre-post design, quasi-experimental study. LOCATION: Íllora, Granada, Spain. PARTICIPANTS: A total of 60 subjects aged 50-75years taking part in the Health Hypertensive Program in the Medical Centre were selected. INTERVENTION: A recreational general physical activity program, mainly aerobic capacity, of 4weeks duration, 3days/week, and an intensity of 45-55% HR Reserve. MAIN MEASUREMENTS: SBP, DBP, HR, BMI, total cholesterol, HDL, LDL, TG, and Glucose. RESULTS AND CONCLUSIONS: Statistically significant decreases (P<.05) were observed in BMI (-0.51%; 95%CI: 30.26 to 31.93units), HR (-5.57beats/min; 95%CI: 68.76 to 71.73beats/min), SBP (-14.82mmHg; 95%CI: 131.57 to 137.52mmHg), DBP (-5.33mmHg; 95%CI: 78.94 to 83.68mmHg), Glucose (-7.63mg/dL; 95%CI: 125.06 to 153.73mg/dL) and REGICOR risk (-20.46%; 95%CI: 5.45 to 6.90%). Statistically significant increases were observed in HDL (+2.82mg/dl; 95%CI: 46.78 to 52.11mmHg), and TG (+8.27mg/dl; 95%CI: 133.89 to 152.60mg/dL). Men had a wider variation in HR and DBP, and women in SBP (P<.05). Subjects with baseline SBP≥160mmHg experienced greater declines in HR, SBP, DBP, Glucose and TG (-10.67beats/min, -31mmHg, -8.27mmHg, -10.86mg/dL, and 34.66mg/dL, respectively) than those with an initial SBP<160mmHg, where there was an increase in HDL and a decrease in LDL. After this program, improvements in BP and other cardiovascular risk factors were obtained in hypertensive subjects over 50years.

Moderate Psoriasis: A Proposed Definition. / Psoriasis moderada. Propuesta de definición.

INTRODUCTION: The Psoriasis Area Severity Index (PASI) is the most widely used scale for assessing the severity of psoriasis and for therapeutic decision making. On the basis of the PASI score, patients have been stratified into 2 groups: mild disease and moderate-to-severe disease. OBJECTIVE: To draft a proposal for the definition and characterization of moderate psoriasis based on PASI and Dermatology Life Quality Index (DLQI) scores. MATERIAL AND METHODS: A group of 6 dermatologists with experience in the treatment of psoriasis undertook a critical review of the literature and a discussion of cases to draft a proposal. RESULTS: In order of priority, PASI, DLQI, and body surface area (BSA) are the parameters to be used in daily practice to classify psoriasis as mild, moderate, or severe. Severity should be assessed on the basis of a combined evaluation and interpretation of the PASI and DLQI. And 3, PASI and DLQI should carry equal weight in the determination of disease severity. On this basis, psoriasis severity was defined using the following criteria: mild, PASI<7 and DLQI<7; moderate, PASI=7-15 and DLQI=5-15 (classified as severe when difficult-to-treat sites are affected or when there is a significant psychosocial impact); severe, PASI >15, independently of the DLQI score. CONCLUSIONS: A more precise classification of psoriasis according to disease severity will improve the risk-benefit assessment essential to therapeutic decision making in these patients.

Estimation of the prevalence of latent tuberculosis infection in patients with moderate to severe plaque psoriasis in Spain: The Latent study.

BACKGROUND AND OBJECTIVE: Anti-tumor necrosis factor therapy for moderate to severe psoriasis can increase the risk of active tuberculosis in patients who have latent tuberculosis infection (LTBI). The main objective of this study was to estimate the prevalence of LTBI in patients with moderate to severe plaque psoriasis being treated in dermatology clinics in Spain. MATERIAL AND METHOD: Non-interventional, cross-sectional, national epidemiological study conducted in Spain in 2011-2012. Patients with moderate to severe plaque psoriasis were included if they had undergone at least one tuberculin skin test (TST) and/or been evaluated with an interferon-γ release assay (IGRA) based on enzyme-linked immunosorbent assay (QuantiFERON(®) TB Gold In-Tube) in the 2 years preceding the study. RESULTS: Data for 440 patients were valid for analysis. In total, 97.7% of the patients had undergone a TST, with a positive result in 23%. Of the 238 patients in whom the initial result was negative, 5% converted to positive on re-testing for a booster effect. IGRA results were available for 16.8%, 20.5% of them positive. Two of the patients with positive IGRA results had a negative TST. The prevalence of LTBI in the whole sample was 26.6%. The degree of concordance between the TST and the IGRA was moderate (κ=0.516; P<.001). CONCLUSIONS: The prevalence of LTBI in this study was similar to previous estimates for Spain.

[Survival and neurological outcome in out-of-hospital cardiac arrests due to shockable rhythms treated with mild therapeutic hypothermia]. / Supervivencia y pronóstico neurológico en paradas cardiorrespiratorias extrahospitalarias por ritmos desfibrilables tratadas con hipotermia terapéutica moderada.

OBJECTIVE: To analyze survival and neurological outcome at short and medium term in patients treated with mild therapeutic hypothermia (HTM) in our hospital after suffering an out-of-hospital cardiac arrest (CA) secondary to a shockable rhythm. DESIGN: Prospective, observational study from September 1, 2010 to December 31, 2012, with a follow up of 6 months. SETTING: Tertiary hospital. PATIENTS: All patients who suffer an out-of-hospital CA due to shockable rhythms. EXCLUSION CRITERIA: non-shockable rhythms, resuscitation >45 minutes without pulse recovery, septic shock, previous coagulopathy, terminal illness or order for withholding treatment. INTERVENTION: Mild hypothermia (33°C) and postresuscitation care on the basis of standardized protocols. MAIN VARIABLES: Demographic and epidemiological data, CA data and survival and neurological outcome at hospital discharge and after 6 months. To assess the patients' neurological status, Cerebral Performance Categories (CPC) scale was used. RESULTS: A total of 54 patients were analyzed. 37 patients were discharged to hospital, representing a survival at discharge of 68.5%, which remains 6 months later because no discharged patient died during the follow up period. Regarding neurological outcome, 44.4% of patients were alive and with CPC 1-2 at discharge and up to 54.71% at 6 months. CONCLUSIONS: The results of survival and neurological functional status obtained in our center after implementation of HTM are comparable to those published in the literature.

Transposition of the inferior oblique muscle belly without disinsertion for overshoot in adduction treatment.

PURPOSE: To evaluate the efficacy and safety of inferior oblique muscle transposition and myopexy in patients with mild/moderate inferior oblique muscle overaction, with or without diplopia. METHOD: We retrospectively analysed data for the 12 patients who underwent the technique. Data were collected from October 2018 to September 2021. Surgery was performed by suturing the inferior oblique belly to the sclera at 5 mm posterior to the temporal end of the inferior rectus. All 12 patients had mild hypertropia (≤6 prism diopters [pd]) in primary position and mild/moderate inferior oblique overaction. Mean preoperative hypertropia was 4.42 pd ±â€¯1.62. Diplopia was recorded in 10 cases. The diagnoses were fourth nerve paresis (9), unilateral primary inferior oblique overaction (2) and dissociated vertical deviation (1). Torticollis was observed in 7 cases, 2 had subjective torsion and 2 objective torsion. RESULTS: Mean age was 46.86 ±â€¯25.1 years (50%: men). Diplopia resolved in 9 of the 10 cases. The mean final vertical deviation was 1.5 ±â€¯2.93 (p = 0.001) pd in straight gaze. Of 7 mild overshoot in adduction, it disappeared in 3 and 4 remained the same. Of 5 moderate overshoot in adduction, 2 improved to mild and 3 disappeared. Torticollis was eliminated in 5 patients and improved in another 2. Mean time from surgery was 14.08 ±â€¯8.05 months. There were no overcorrections. CONCLUSIONS: Inferior oblique muscle transposition with myopexy is a safe and effective procedure in patients with mild-to-moderate inferior oblique muscle overaction and small-angle hypertropia, with or without diplopia.

Treatment of mild-to-moderate hypertriglyceridemia. / Tratamiento de la hipertrigliceridemia leve-moderada.

The atherogenic role of triglycerides (TG) as an independent cardiovascular risk factor has been discussed for many years, largely because hypertriglyceridaemia (HTG) is a complex metabolic entity of multiple aetiology involving processes of diverse nature. In this chapter, a discussion will be presented on the current recommendations for the management of mild-moderate hypertriglyceridaemia (150-880mg/dL). The aim of the interventions used is to decrease the LDL-cholesterol (c-LDL) and control the HTG. This entails reducing apoprotein B (ApoB) levels, the number of remaining TG-rich lipoproteins (LRP), non-HDL-cholesterol (c-non-HDL), and increasing HDL-cholesterol (c-HDL). The management strategy includes healthy lifestyle recommendations, and subsequent use of lipid-lowering drugs, including statins, fibrates, n-3 fatty acids and PCSK9 inhibitors.

[Effects of moderate to vigorous intensity interval exercise program on fitness and fatness in 11-and 12-years-old schoolchildren]. / Efectos de un programa de ejercicio interválico de intensidad moderada-vigorosa sobre la condición física y la composición corporal en escolares de 11 y 12 años.

INTRODUCTION: Introduction: there is growing evidence of concern for values in terms of physical condition and body composition alarming that place school child at risk parameters in physical health. Numerous investigations relate physical activity with improvement in physical condition and body composition. Objective: to analyze the effects of a sub-maximal intensity interval exercise program on physical condition (upper body isometric strength in both hands, lower body explosive strength, velocity-agility and cardiorespiratory fitness) and body composition (body mass index, % of body fat, waist circumference and waist/height index), all of them related to health, in schoolchildren of 11 and 12 years. Methods: an intervention was developed in which an experimental group participated and another control group with 28 schoolchildren each. Happened over 8 weeks, with sessions of total 30 minutes before the start of the academic activity 3 days per week. Different intervallic games were made with motor, cognitive and coordination challenges; with a moderate-vigorous intensity (70 %-80 % of maximum heart rate). The registration in physical condition and body composition was made through the ALPHA Battery. Results: significant improvements in isometric strength with both hands and a reduction in waist circumference and waist/height index. Conclusions: the results show significant improvements in indicators of fitness and fatness, however, it requires a long-term intervention to know if the other improvements achieved in the analyzed indicators are significant over time.

INTRODUCCIÓN: Introducción: se evidencia un aumento cada vez mayor de la preocupación debido a condiciones físicas y composición corporal alarmantes, que sitúan a los escolares en unos parámetros de riesgo en lo relativo a la salud física. Numerosas investigaciones relacionan la actividad física con la mejora en la condición física y la composición corporal. Objetivo: analizar los efectos de un programa de ejercicio interválico de intensidad moderada-vigorosa sobre indicadores de condición física (fuerza isométrica manual en ambas manos, fuerza explosiva del tren inferior, velocidad-agilidad y capacidad aeróbica) y de composición corporal (índice de masa corporal, % de grasa corporal, perímetro de cintura e índice cintura/altura), referentes todos ellos para la salud en escolares de 11 y 12 años. Métodos: se desarrolla una intervención en la que participó un grupo experimental y otro control con 28 escolares cada uno de ellos. Transcurrió a lo largo de 7 semanas, con sesiones de 30 minutos totales antes del inicio de la actividad académica, 3 días por semana. Se realizaron diferentes juegos interválicos, con una intensidad moderada-vigorosa (70-80 % de la frecuencia cardíaca máxima). El registro en condición física y composición corporal se realizó a través de la batería ALPHA. Resultados: mejoras significativas en fuerza isométrica con ambas manos y una reducción significativa del perímetro de cintura e índice cintura/altura. Conclusión: los resultados muestran mejoras significativas en indicadores de condición física y composición corporal; sin embargo, se precisa de una intervención de mayor duración para conocer si las otras mejoras logradas en los indicadores analizados consiguen ser significativas con el transcurso del tiempo.

Restorative effect of jogging on lower limb muscles / Efeito reparador da corrida moderada sobre a musculatura dos membros inferiores / Efecto restaurador del trote moderado sobre los músculos de los miembros inferiores

ABSTRACT Introduction: Jogging can be a great way to improve physical condition, boosting mind and body. Its method of movement is simple, and there are no sporting limitations as to age, gender, or training place. Jogging is believed to help repair muscle and joint injuries in the lower limbs. Objective: To explore the effects of running on recovering lower limb muscles. Methods: We surveyed 60 undergraduate students who took a 400-meter test at the same site. According to the test results, they were divided into low, medium, and high fitness levels. A questionnaire survey was also used with 20 undergraduate students from the Physical Education Department. Four groups of volunteers did some jogging exercises. Physiological, biochemical, and muscle strength measurements were performed after jogging. The data were statistically treated. Results: The magnitude of change in the sagittal angle of the knee and ankle joint did not increase significantly with increasing jogging rate. The changes in the sagittal angles of the hip, knee, and ankle joints were the same for the volunteers with different jogging rates. After 60 minutes of exercise, the low-fitness group showed faster breathing, an elevated heart rate, and a higher rate of lactate and creatinine in the blood. After 120 minutes of exercise training, all sedentary volunteers showed an increase in lactate, creatinine, respiratory rate, and heart rate (P<0.05). The test performance started to decrease at 400 meters. Conclusion: The maximal activation of different parts of the locomotor system changed under different rates of movement. Brief, controlled jogging may be beneficial to lower limb muscles. Still, long-term jogging may cause even more damage to the body and deleterious changes to rehabilitation in blood and biochemical parameters. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A corrida moderada pode ser uma ótima maneira de melhorar a condição física, impulsionando mente e corpo. Seu método de movimento é simples e não há limitações esportivas quanto a idade, sexo ou local de treino. Acredita-se que a corrida moderada possa auxiliar no reparo de lesões musculares e articulares nos membros inferiores. Objetivo: Explorar os efeitos da corrida sobre a musculatura nos membros inferiores em recuperação. Métodos: Foram pesquisados 60 estudantes de graduação que fizeram um teste de 400 metros no mesmo local. De acordo com os resultados do teste, eles foram divididos em baixo, médio e alto nível de aptidão física. Também se utilizou uma pesquisa por questionário com 20 estudantes universitários do Departamento de Educação Física. Quatro grupos de voluntários fizeram alguns exercícios de corrida moderada. As medidas fisiológicas, bioquímicas e de força muscular foram realizadas após a corrida moderada. Os dados foram tratados estatisticamente. Resultados: A magnitude da mudança no ângulo sagital da articulação do joelho e tornozelo não aumentou significativamente com o aumento da taxa de corrida moderada. As mudanças nos ângulos sagitais das articulações do quadril, joelho e tornozelo foram as mesmas para os voluntários com diferentes taxas de corrida moderada. Após 60 minutos de exercício, o grupo de baixa condição física apresentou uma respiração mais rápida, um ritmo cardíaco elevado e uma taxa maior de lactato e creatinina no sangue. Após 120 minutos de treinamento físico, todos os voluntários sedentários apresentaram um aumento de lactato, creatinina, frequência respiratória e cardíaca (P<0,05). O desempenho do teste começou a diminuir aos 400 metros. Conclusão: A ativação máxima de diferentes partes do sistema locomotor alterou-se sob diferentes taxas de movimento. A corrida moderada breve e controlada pode ser benéfica a musculatura dos membros inferiores, porém a corrida moderada de longo prazo pode causar ainda mais danos ao corpo e mudanças deletérias à reabilitação nos parâmetros sanguíneos e bioquímicos. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El trote moderado puede ser una gran manera de mejorar la condición física, impulsando la mente y el cuerpo. Su método de movimiento es sencillo y no existen limitaciones deportivas en cuanto a edad, sexo o lugar de entrenamiento. Se cree que trotar puede ayudar a reparar las lesiones musculares y articulares de las extremidades inferiores. Objetivo: Explorar los efectos de la carrera en la recuperación de los músculos de las extremidades inferiores. Métodos: Se encuestó a 60 estudiantes universitarios que realizaron una prueba de 400 metros en el mismo lugar. Según los resultados de la prueba, se dividieron en nivel de aptitud bajo, medio y alto. También se utilizó una encuesta con 20 estudiantes de grado del Departamento de Educación Física. Cuatro grupos de voluntarios realizaron ejercicios de trote. Se realizaron mediciones fisiológicas, bioquímicas y de fuerza muscular después del trote moderado. Los datos fueron tratados estadísticamente. Resultados: La magnitud del cambio en el ángulo sagital de la articulación de la rodilla y el tobillo no aumentó significativamente con el aumento de la velocidad del trote. Los cambios en los ángulos sagitales de las articulaciones de la cadera, la rodilla y el tobillo fueron los mismos para los voluntarios con diferentes ritmos de trote. Después de 60 minutos de ejercicio, el grupo de baja forma física mostró una respiración más rápida, una frecuencia cardíaca elevada y un mayor índice de lactato y creatinina en la sangre. Tras 120 minutos de entrenamiento físico, todos los voluntarios sedentarios mostraron un aumento del lactato, la creatinina, la frecuencia respiratoria y la frecuencia cardíaca (P<0,05). El rendimiento de la prueba comenzó a disminuir a partir de los 400 metros. Conclusión: La activación máxima de diferentes partes del aparato locomotor cambió bajo diferentes ritmos de movimiento. El trote moderado y de forma controlada puede ser beneficioso para los músculos de las extremidades inferiores, pero trotar a largo plazo puede causar aún más daño al cuerpo y cambios nocivos para la rehabilitación en los parámetros sanguíneos y bioquímicos. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Analysis of jogging on muscle fatigue and body balance / Análise da corrida moderada sobre a fadiga muscular e o equilíbrio corporal / Análisis del trote sobre la fatiga muscular y el equilibrio corporal

ABSTRACT Introduction: The changes in muscle condition during jogging are studied according to their characteristics to formulate a correct fitness plan. With a medium effort intensity, studies on jogging have shown positive effects on mental de-stress and motor coordination. Objective: Study the effect of running training on muscle fatigue and body balance. Methods: A total of 60 sedentary freshmen from a university were selected, including 30 male and 30 female students. The volunteers were randomly divided into experimental and control groups. While the control performed routine sports activities according to the teaching plan during physical education class, the students in the experimental group performed a jogging training protocol. Data were collected before and after the intervention for comparison and statistical analysis. Results: The vestibular step test changed from 20.56 to 13.87, evidencing that jogging training significantly improved body balance ability in addition to providing body flexibility. Conclusion: Combined with curriculum standards and the level of physical training required, jogging can be integrated into physical education classes to promote student health. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: As alterações da condição muscular na corrida moderada são estudadas segundo suas características próprias no intuito de formular um plano de aptidão física correta. Com uma intensidade de esforço média, estudos sobre a corrida vem demonstrando efeitos positivos sobre o desestresse mental e a coordenação motora. Objetivo: Estudar o efeito do treino de corrida moderada sobre a fadiga muscular e o equilíbrio corporal. Métodos: Um total de 60 calouros sedentários de uma universidade foram selecionados, incluindo 30 estudantes do sexo masculino e 30 do sexo feminino. Os voluntários foram divididos aleatoriamente em grupo experimental e grupo de controle. Enquanto o controle realizou atividades esportivas rotineiras, de acordo com o plano de ensino durante a aula de educação física, os alunos do grupo experimental realizaram um protocolo de treinamento de corrida. Os dados foram coletados antes e após a intervenção para comparação e análise estatística. Resultados: O teste de passo vestibular alterou-se de 20,56 para 13,87, evidenciando que o treinamento em corrida melhorou significativamente a capacidade de equilíbrio corporal além de propiciar a flexibilidade corporal. Conclusão: Combinado às normas curriculares e ao nível de aptidão física exigida dos estudantes, o treinamento em corrida moderada pode ser integrado às aulas de educação física para fomentar a saúde dos estudantes. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Los cambios en el estado muscular durante el trote se estudian en función de sus características propias con el fin de formular un correcto plan de acondicionamiento físico. Con una intensidad de esfuerzo media, los estudios sobre el trote han demostrado efectos positivos sobre el desestresamiento mental y la coordinación motora. Objetivo: Estudiar el efecto del entrenamiento de carrera sobre la fatiga muscular y el equilibrio corporal. Métodos: Se seleccionó a un total de 60 estudiantes sedentarios de primer año de una universidad, de los cuales 30 eran hombres y 30 mujeres. Los voluntarios se dividieron aleatoriamente en grupo experimental y grupo de control. Mientras que el grupo de control realizó actividades deportivas rutinarias según el plan de enseñanza durante la clase de educación física, los estudiantes del grupo experimental llevaron a cabo un protocolo de entrenamiento de trote. Se recogieron datos antes y después de la intervención para su comparación y análisis estadístico. Resultados: La prueba de paso vestibular cambió de 20,56 a 13,87, lo que evidencia que el entrenamiento de trote mejoró significativamente la capacidad de equilibrio corporal además de proporcionar flexibilidad corporal. Conclusión: Combinado con las normas curriculares y el nivel de condición física exigido a los alumnos, el entrenamiento de trote puede integrarse en las clases de educación física para promover la salud de los estudiantes. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effects of running combined with muscular training of the abdominal core / Efeitos da corrida aliada ao treinamento muscular do centro abdominal / Efectos de la carrera combinada con el entrenamiento muscular del núcleo abdominal

ABSTRACT Introduction: Running has specific effects on different areas of the human body, and the sagittal angular variation of the hip, knee, and ankle joints is widely explored. In addition to accelerating body metabolism, it can also improve body shape. Recent studies have revealed that running can also improve athletes' muscular strength of the abdominal core. Objective: Explore the effects of running combined with muscle training on the abdominal center strength of athletes. Methods: It investigated the effects of 3 different running intensities on athletes' abdominal core muscle strength. Computerized kinematic motion capture technology was used to measure the impacts of running on 18 young volunteers. The sagittal planes of the hip, knee, and ankle joints were evaluated. Abdominal center muscle strength was assessed during running. Results: Running particularly affected the combined contraction rate of the tibial, gluteal, and soleus muscles. The correlation between speed, muscle activation, and joint angle was also analyzed. Conclusion: Athletes tend to adjust the angle and frequency of joint movements to reduce fatigue. It was noted can have the ability to control muscle strength in different regions of the abdominal core. The research results establish a theoretical basis for the effectiveness of abdominal core muscle strength performance in athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A corrida tem efeitos específicos em distintas áreas do corpo humano e a variação angular sagital das articulações do quadril, joelho e tornozelo são amplamente exploradas. Além de acelerar o metabolismo corporal, também pode melhorar a forma corporal e alguns estudos recentes revelaram que a corrida também pode melhorar a força muscular do centro abdominal dos atletas. Objetivo: Explorar os efeitos da corrida aliada ao treinamento muscular sobre a força do centro abdominal dos atletas. Métodos: Investigou-se os efeitos de 3 diferentes intensidades de corrida sobre a força muscular do centro abdominal dos atletas. Foi utilizada a tecnologia de captura de movimento cinemática computadorizada para medir os impactos da corrida sobre 18 jovens voluntários. Os planos sagitais das articulações do quadril, joelho e tornozelo foram avaliados. A força muscular do centro abdominal foi avaliada durante a corrida. Resultados: A corrida afetou particularmente o índice combinado de contração dos músculos tibial, glúteo e sóleo. A correlação entre velocidade, ativação muscular e ângulo articular também foi analisada. Conclusão: Os atletas tendem a ajustar o ângulo e a frequência de movimentos articulares para reduzir a fadiga. Notou-se que os atletas também tem a capacidade de controlar a força muscular em diferentes regiões do centro abdominal. Os resultados da pesquisa estabelecem uma base teórica para a eficácia do desempenho de força muscular do centro abdominal nos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Correr tiene efectos específicos en diferentes áreas del cuerpo humano y la variación angular sagital de las articulaciones de la cadera, la rodilla y el tobillo son ampliamente exploradas. Además de acelerar el metabolismo, también puede mejorar la forma del cuerpo y algunos estudios recientes revelaron que correr también puede mejorar la fuerza muscular del núcleo abdominal en los atletas. Objetivo: Explorar los efectos de la carrera combinada con el entrenamiento muscular en la fuerza del núcleo abdominal de los atletas. Métodos: Investigamos los efectos de 3 intensidades de carrera diferentes en la fuerza muscular del centro abdominal de los atletas. Se utilizó la tecnología de captura del movimiento cinemático por ordenador para medir los impactos de la carrera en 18 jóvenes voluntarios. Se evaluaron los planos sagitales de las articulaciones de la cadera, la rodilla y el tobillo. Se evaluó la fuerza muscular del núcleo abdominal durante la carrera. Resultados: Correr afectó especialmente a la tasa de contracción combinada de los músculos tibiales, glúteos y sóleo. También se analizó la correlación entre la velocidad, la activación muscular y el ángulo articular. Conclusión: Los deportistas tienden a ajustar el ángulo y la frecuencia de los movimientos articulares para reducir la fatiga. Se observó que los atletas también tienen la capacidad de controlar la fuerza muscular en diferentes regiones del núcleo abdominal. Los resultados de la investigación establecen una base teórica para la eficacia del rendimiento de la fuerza muscular del núcleo abdominal en los atletas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Does physical activity improve adaptive behaviour, fitness, and quality of life of adults with intellectual disability? / A atividade física promove o comportamento adaptativo, aptidão física e qualidade de vida de adultos com dificuldade intelectual e desenvolvimental? / ¿La actividad física promueve el comportamiento adaptativo, la aptitud física y los qualidad de vida de los adultos con dificultades intelectuales y de desarrollo?

ABSTRACT The effects of a physical activity program on adaptive behaviour, motor proficiency, fitness, and quality of life of 16 adults with intellectual disability (ID) were analysed. Portuguese versions of Adaptive Behavior Scale, Personal Outcomes Scale, Bruininsky-Oseretsky Motor Proficiency Test, and Fullerton scale were applied twice before, after, and one month after the program. Mann-Whitney and Wilcoxon tests were used and Bonferroni manual correction was performed to establish a new p-value. The control group stabilized performance over time, the experimental group improved in most domains, such as socialization (p <0.005), responsibility (p <0.005), and arm curl (p <0.01). Our findings call for tailor-made interventions to improve PA levels among adults with ID.

RESUMO Os efeitos de um programa de atividade física no comportamento adaptativo, proficiência motora, aptidão física e qualidade de vida de 16 adultos com dificuldade intelectual foram analisados. As versões Portuguesas das Escalas de Comportamento Adaptativo, Pessoal de Resultados, Teste de Proficiência Motora Bruininsky-Oseretsky e Fullerton foram aplicada antes, após e um mês após o programa. Os testes de Mann-Whitney e Wilcoxon foram aplicados, com correção manual de Bonferroni. O grupo de controlo estabilizou o desempenho, o grupo experimental melhorou na maioria dos domínios, como a socialização (p<0.005), a responsabilidade (p<0.005) e a flexão do antebraço (p<0.01). Resultados pedem intervenções personalizadas para melhorar os níveis de AF dos adultos com DI.

RESUMEN Se analizaron los efectos de un programa de actividad física sobre la conducta adaptativa, competencia motora, aptitud física y calidad de vida en 16 adultos con discapacidad intelectual (DI). Se aplicaron versiones portuguesas de las Escalas de conducta adaptativa, Resultados Personales, Prueba de Competencia Motora Bruininsky-Oseretsky y Fullerton antes, después y un mes después del programa. Se utilizó la prueba de Mann-Whitney y Wilcoxon, com corrección Bonferroni. El grupo de control estabilizó el desempeño con el tiempo, el grupo experimental mejoró en la mayoría de los dominios como socialización (p<0.005), responsabilidad (p <0.005) y flexión del antebrazo (p <0.01). Los resultados exigen intervenciones personalizadas para mejorar los niveles de AF en adultos con DI.

Interobserver Agreement of the Static Methods of Evaluating the Types of Footprint in Runners / Concordância interobservadores dos métodos estáticos de avaliação dos tipos de pisada em praticantes de corrida

Abstract Objective To evaluate the accuracy of interobserver diagnostic methods of the type of footprint among running athletes using three evaluation methods: physical examination, podoscopy, and baropodometry compared with radiographic measurement of Meary angles and calcaneal pitch. Methods This is a cross-sectional study of athletes who practice running. The inclusion criteria were: individuals with minimum age of 18 years and maximum age of 65, male or female, healthy and without comorbidities that interfere with running performance; regular practitioners who run at least twice a week; body mass index between 18.5 and 29.99 Kg/m2; acceptance of the written informed consent form (WICF). The non-inclusion criteria included: presence of previous or active injuries that compromise sports activity; previous foot surgeries; obesity. Forty patients were selected, 29 (72.5%) male and 11 (27.5%) female, whose mean age was 39 years (minimum 19 years and maximum 61 years). The body mass index (BMI) of the 40 patients ranged from 21.00 to 29.99 kg/m2 (mean 25.48 kg/m2 with standard deviation of 2.39 kg/m2 and a median of 25.50 kg/m2). We excluded those with values above 29.99. Running frequency ranged from 2 to 5 times per week (average 3.13 times per week, with standard deviation of 0.79 times per week and median of 3 times per week). Physical examination, podoscopy, and baropodometry were performed, and their evaluation was made by 4 examiners. Additionally, the results were compared with the radiographic classification of the footprint type obtained by measuring the Meary angles and the calcaneal pitch. Results The interobserver agreement of these parameters was verified by the weighted Kappa agreement index, in which we obtained a significant agreement between the participants considering physical examination, podoscopy, and baropodometry, and according to the Kappa index. The agreement was marginal when comparing the results of the three methods with the radiographic angular classification. Conclusion We obtained excellent agreement among observers when considering physical examination, podoscopy, and baropodometry for the diagnosis of the footprint type among runners. However, when comparing the results obtained with the radiographic measurements, the agreement for the diagnosis of footprint type was low.

Resumo Objetivo Avaliar a acurácia dos métodos de diagnóstico interobservadores do tipo de pisada em atletas corredores utilizando três métodos de avaliação: exame físico, podoscopia e baropodometria comparando com a medida radiográfica dos ângulos de Meary e pitch do calcâneo. Métodos Trata-se de estudo transversal de atletas que praticam corrida. Os critérios de inclusão foram: indivídulos com idade mínima de 18 anos e máxima de 65 anos de ambos os sexos; indivídulos hígidos, sem comorbidades que interfiram no desempenho da corrida; praticantes regulares que realizam corrida ao menos duas vezes na semana; índice de massa corpórea entre 18,5 e 29,99 Kg/m2; aceitação dos termos de consentimento livre e esclarecido (TCLE). Os critérios de não inclusão compreenderam: presença de lesões prévias ou ativas que comprometam a atividade esportiva; cirurgias prévias dos pés; obesidade. Foram selecionados 40 pacientes, sendo 29 (72,5%) do sexo masculino e 11 (27,5%) do sexo feminino cuja média das idades foi de 39 anos (mínimo de 19 anos e máximo de 61 anos). O índice de massa corpórea (IMC) dos 40 pacientes variou de 21,00 a 29,99 Kg/m2 (média de 25,48 Kg/m2 com desvio-padrão de 2,39 Kg/m2 e mediana de 25,50 Kg/m2). Excluímos os que apresentaram valor superior a 29,99 Kg/m2. A frequência de corrida variou de 2 a 5 vezes por semana (média de 3,13 vezes por semana com desvio-padrão de 0,79 vezes por semana e mediana de 3 vezes por semana). Foram realizados exame físico, podoscopia e baropodometria, e sua avaliação foi feita por quatro examinadores; além disso, os resultados foram comparados com a classificação radiográfica do tipo de pisada obtida através da mensuração dos ângulos de Meary e pitch do calcâneo. Resultados A concordância interobservadores destes parâmetros foi verificada pelo índice de concordância de Kappa ponderado, segundo o qual obtivemos uma concordância significante entre os participantes, levando-se em consideração o exame físico, podoscopia e baropodometria e de acordo com o índice Kappa. A concordância foi marginal quando comparados os resultados dos três métodos com a classificação angular radiográfica. Conclusão Obtivemos uma concordância excelente entre os observadores ao considerarmos o exame físico, a podoscopia e a baropodometria para o diagnóstico do tipo pisada em corredores. Porém, quando comparados os resultados obtidos com as medidas radiográficas, a concordância para o diagnóstico do tipo da pisada foi baixa.

Prevención de desnutrición aguda moderada con un suplemento alimenticio listo para consumir en niños preescolares de comunidades rurales / Moderate acute malnutrition prevention with a ready-to-use therapeutic food in pre-school children from rural communities

Resumen Introducción: La desnutrición infantil en México alcanza prevalencias de 27.5 % en zonas rurales. Objetivo: Evaluar la efectividad de un suplemento alimenticio listo para consumir (SALC) para corregir desnutrición aguda leve y prevenir desnutrición aguda moderada en preescolares de comunidades rurales. Método: Ensayo clínico aleatorizado por grupos: con y sin SALC (g-SALC y g-S/SALC); se incluyeron niños de dos a cinco años, con puntuaciones-Z de peso para la talla (pZ-P/T) mayor de −2 y menor de −1 y nivel socioeconómico bajo. Todos recibieron educación sobre nutrición, salud e higiene dos veces al mes; los niños del g-SALC debieron consumir diariamente una porción del suplemento. Se evaluó pZ-P/T al inicio y a los cuatro, seis y 12 meses. La comparación entre grupos se realizó con el modelo de riesgos proporcionales de Cox. Resultados: Respecto a la recuperación de desnutrición aguda leve, en g-SALC se observó 68.7 versus 52.1% en el grupo control en el análisis de intención para tratar, con una razón de riesgo (HR) = 1.25; en el análisis por protocolo del primer semestre se observó una HR = 1.48 y en el segundo semestre, HR = 1.56. Un paciente progresó a desnutrición aguda moderada. Conclusiones: El g-SALC mostró resolución significativamente mayor de desnutrición aguda leve.

Abstract Introduction: Child malnutrition in Mexico reaches a prevalence as high as 27.5 % in rural areas. Objective: To assess the effectiveness of a ready-to-use supplementary food (RUSF) to correct mild acute malnutrition and prevent moderate acute malnutrition in preschool children from rural communities. Method: Randomized clinical trial, with assignment to two groups: group with RUSF (RUSF-g) or group without it (non-RUSF-g); children aged from two to five years, with weight-for-height Z-scores (WHZ) between -2 and -1 and low socioeconomic status were included. All received education on nutrition, health and hygiene twice monthly; the RUSF-g children had to consume four biscuits of the supplement every day. WHZ was assessed at baseline and at four, six, and 12 months. The comparison between groups was carried out with Cox proportional hazards model. Results: With regard to mild acute malnutrition correction in the RUSF-g, 68.7 versus 52.1 % in the control group was observed in the intent-to-treat analysis, with a hazard ratio (HR) = 1.25; in the per-protocol analysis of first semester, a HR = 1.48 was observed, and in the second semester, HR = 1.56. One patient progressed to moderate acute malnutrition. Conclusions: The RUSF-g showed a significantly higher resolution of mild acute malnutrition.

Exercício: quanto mais, melhor? / Exercise: The more the merrier?

O entusiasmo com a melhora progressiva da potência aeróbica faz com que as pessoas se animem a se envolver cada vez mais com corridas de longa duração. Mas será que quanto mais, melhor? As evidências têm se acumulado mostrando que realmente a redução do risco de morte por todas as causas e mortalidade cardiovascular ocorre de forma marcante em volumes modestos ou intermediários. No entanto, é surpreendente verificar que a maior parte desses benefícios se reduzem à medida que o envolvimento com esses exercícios passa a ser muito intenso ou extremamente intenso. A somatória das evidências permite concluir que temos uma relação do tipo curva L ou mesmo U entre nível de intensidade do exercício e a mortalidade. Uma interessante hipótese para explicar o alto índice de mortes cardiovasculares entre esses grandes corredores recebeu a denominação de síndrome de Fidípides, em que esses excessos levariam a microisquemias miocárdicas, que evoluíram para áreas de microfibrose disparando o aparecimento de arritmias que poderiam evoluir para fibrilação ventricular.