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Captive housed non-human primates, specifically great apes such as chimpanzees (Pan troglodytes) are frequently reported to have died from or are diagnosed with potentially fatal heart conditions that require the monitoring of physiological signals such as electrocardiogram (ECG) or respiratory rate. ECG screening must be conducted after applying full anaesthesia, causing potential physical and emotional stress as well as risk for the animal. Here, we present an electronic system that simultaneously measures the ECG and the electrical bioimpedance for the early detection of abnormal cardiovascular activity. Modified gloves whose fingers are equipped with electrodes enable the caregiver to obtain three cardiovascular signals (ECG, pulse rate and respiratory rate) by placing the fingertips on specific parts of the non-human primate without needing any prior physical preparations. Validation (ECG and bioimpedance) was performed both on humans and on captive housed chimpanzees, where all the signals of interest were correctly acquired.
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Anestesia , Pan troglodytes , Animais , Humanos , Primatas , Eletrocardiografia/veterinária , CoraçãoRESUMO
A low-power long-term ambulatory ECG monitor was developed for the acquisition, storage and processing of three simultaneous leads DI, aVF and V2 with a beat-to-beat heart rate measurement in real time. It provides long-term continuous ECG recordings until 84 h. The monitor uses a QRS complex detection algorithm based on the continuous wavelet transform with splines, which automatically selects the scale for the analysis of ECG records with different sampling frequencies. It includes a lead-off detection to continuously monitor the electrode connections and a real-time system of visual and acoustic alarms to alert users of abnormal conditions in its operation. The monitor presented is based in an ADS1294 analogue front end with four channels, 24-bit analog-to-digital converters and programmable gain amplifiers, a low-power dual-core ESP32 microcontroller, a microSD memory for data storage in a range of 4 GB to 32 GB and a 1.4 in thin-film transistor liquid crystal display (LCD) variant with a resolution of 128 × 128 pixels. It has programmable sampling rates of 250, 500 and 1000 Hz; a bandwidth of 0 Hz to 50% of the selected sampling rate; a CMRR of -105 dB; an input margin of ±2.4 V; a resolution of 286 nV; and a current consumption of 50 mA for an average battery life of 84 h. The ambulatory ECG monitor was evaluated with the commercial data-acquisition system BIOPAC MP36 and its module for ECG LABEL SS2LB, simultaneously comparing the morphologies of two ECG records and obtaining a correlation of 91.78%. For the QRS detection in real time, the implemented algorithm had an error less than 5%. The developed ambulatory ECG monitor can be used for the analysis of the dynamics of the heart rate variability in long-term ECG records and for the development of one's own databases of ECG recordings of normal subjects and patients with cardiovascular and noncardiovascular diseases.
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Eletrocardiografia Ambulatorial , Processamento de Sinais Assistido por Computador , Humanos , Frequência Cardíaca/fisiologia , Coração/fisiologia , Eletrocardiografia , Arritmias Cardíacas/diagnóstico , AlgoritmosRESUMO
Commuters are often exposed to higher concentrations of air pollutants due to its proximity to mobile sources. Despite recent trends in urban transport toward zero- and low-tailpipe emission alternatives, the assessments of the impact of these transformations on commuter exposure are limited by the low frequency of such studies. In this work, we use a unique data set of personal exposure concentration measurements collected over the span of 5 years to analyze changes due to the introduction of a new fleet for Bogotá's Bus Rapid Transit System. In that system, over a thousand Euro-II and -III diesel-powered buses were replaced with Euro-VI compressed natural gas and filter-equipped Euro-V diesel buses. We measured personal exposure concentrations of equivalent black carbon (eBC), fine particulate (PM2.5), and ultra fine particles (UFP) during and after the retirement of old buses and the introduction of new ones. Observations collected prior to the fleet renewal were used as baseline and later compared to data collected over two follow-up campaigns in 2019 and 2020. Significant reductions in the concentration of PM2.5 and eBC were observed during the 2019 campaign, with a 48% decrease for mean in-bus eBC (89.9 to 46.4 µg m-3) and PM2.5 (180.7 to 95.4 µg m-3) concentrations. Further reductions were observed during the 2020 follow-up, when the fleet renovation was completed, with mean in-bus eBC decreasing to 17.7 µg m-3 and PM2.5 to 42.3 µg m-3. These observations imply nearly a 5-fold reduction in eBC exposure and a 4-fold decrease in PM2.5. There was a much smaller reduction of in-bus UFP concentration between 2019 and 2020, indicating a persistent presence of high particle number concentrations in the near-road environment despite the fleet renovation process. In-bus UFP concentrations ranged between 65â¯000 and 104â¯500 cm-3 during the follow-up campaigns. The results in this work illustrate the immediate benefits of reducing personal exposure through the adoption of vehicles with more stringent emission standards.
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Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Monitoramento Ambiental/métodos , Material Particulado/análise , Fuligem , Emissões de Veículos/análiseRESUMO
A fully automatic, non-contact method for the assessment of the respiratory function is proposed using an RGB-D camera-based technology. The proposed algorithm relies on the depth channel of the camera to estimate the movements of the body's trunk during breathing. It solves in fixed-time complexity, O(1), as the acquisition relies on the mean depth value of the target regions only using the color channels to automatically locate them. This simplicity allows the extraction of real-time values of the respiration, as well as the synchronous assessment on multiple body parts. Two different experiments have been performed: a first one conducted on 10 users in a single region and with a fixed breathing frequency, and a second one conducted on 20 users considering a simultaneous acquisition in two regions. The breath rate has then been computed and compared with a reference measurement. The results show a non-statistically significant bias of 0.11 breaths/min and 96% limits of agreement of -2.21/2.34 breaths/min regarding the breath-by-breath assessment. The overall real-time assessment shows a RMSE of 0.21 breaths/min. We have shown that this method is suitable for applications where respiration needs to be monitored in non-ambulatory and static environments.
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Respiração , Taxa Respiratória , Algoritmos , Monitorização Fisiológica , Sistema RespiratórioRESUMO
INTRODUCTION: Despite the strong evidence of the clinical utility of QTc prolongation as a surrogate marker of cardiac risk, QTc measurement is not part of clinical routine either in hospital or in physician offices. We evaluated a novel device ("the QT scale") to measure heart rate (HR) and QTc interval. METHOD: The QT scale is a weight scale embedding an ECG acquisition system with four limb sensors (feet and hands: lead I, II, and III). We evaluated the reliability of QT scale in healthy subjects (cohort 1) and cardiac patients (cohorts 2 and 3) considering a learning (cohort 2) and two validation cohorts. The QT scale and the standard 12-lead recorder were compared using intraclass correlation coefficient (ICC) in cohorts 2 and 3. Absolute value of heart rate and QTc intervals between manual and automatic measurements using ECGs from the QT scale and a clinical device were compared in cohort 1. RESULTS: We enrolled 16 subjects in cohort 1 (8 w, 8 m; 32 ± 8 vs 34 ± 10 years, P = 0.7), 51 patients in cohort 2 (13 w, 38 m; 61 ± 16 vs 58 ± 18 years, P = 0.6), and 13 AF patients in cohort 3 (4 w, 9 m; 63 ± 10 vs 64 ± 10 years, P = 0.9). Similar automatic heart rate and QTc were delivered by the scale and the clinical device in cohort 1: paired difference in RR and QTc were -7 ± 34 milliseconds (P = 0.37) and 3.4 ± 28.6 milliseconds (P = 0.64), respectively. The measurement of stability was slightly lower in ECG from the QT scale than from the clinical device (ICC: 91% vs 80%) in cohort 3. CONCLUSION: The "QT scale device" delivers valid heart rate and QTc interval measurements.
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Fibrilação Atrial/fisiopatologia , Frequência Cardíaca/fisiologia , Síndrome do QT Longo/fisiopatologia , Adulto , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Eletrocardiografia , Feminino , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fenetilaminas/uso terapêutico , Sulfonamidas/uso terapêuticoRESUMO
This work presents an algorithm for the detection and classification of QRS complexes based on the continuous wavelet transform (CWT) with splines. This approach can evaluate the CWT at any integer scale and the analysis is not restricted to powers of two. The QRS detector comprises four stages: implementation of CWT with splines, detection of QRS complexes, searching for undetected QRS complexes, and correction of the R wave peak location in detected QRS complexes. After, the onsets and ends of the QRS complexes are detected. The algorithm was evaluated with synthetic ECG and with the manually annotated databases: MIT-BIH Arrhythmia, European ST-T, QT and PTB Diagnostic ECG. Evaluation results of the QRS detector were: MIT-BIH arrhythmia database (109,447 beats analyzed), sensitivity Se = 99.72% and positive predictivity P+ = 99.87%; European ST-T database (790522 beats analyzed), Se = 99.92% and P+ = 99.55% and QT database (86498 beats analyzed), Se = 99.97% and P+ = 99.99%. To evaluate the delineation algorithm of the QRS onset (Qi) and QRS end (J) with the QT and PTB Diagnostic ECG databases, the mean and standard deviations of the differences between the automatic and manual annotated location of these points were calculated. The standard deviations were close to the accepted tolerances for deviations determined by the CSE experts. The proposed algorithm is robust to noise, artifacts and baseline drifts, classifies QRS complexes, automatically selects the CWT scale according to the sampling frequency of the ECG record used, and adapts to changes in the heart rate, amplitude and morphology of QRS complexes.
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Eletrocardiografia , Análise de Ondaletas , Humanos , Eletrocardiografia/métodos , Algoritmos , Arritmias Cardíacas/diagnóstico , Bases de Dados FactuaisRESUMO
Vehicle non-exhaust emissions are a major component of particle matter, including the direct wear of tires, brakes, road, and the resuspension of deposited particles. It is suggested that resuspended PM (RPM) emissions can be at the same magnitude or even larger than combustion emissions in urban centers. Factors affecting RPM can be included in four categories: road characteristics, traffic condition, land use, and meteorology. In order to study and evaluate these influencing factors, road dust less than 10 micrometers (RD10) was collected in 41 sites across Bogotá. The sampling points had diverse characteristics. RD10 levels varied between 1.0 and 45.8 mg/m2 with an average of 8.9 ± 8.4 mg/m2. Lower RD10 values were observed when vegetation density was high, pavement condition good, driving speeds fast and construction activities absent. On the contrary, RD10 increased under heavy-duty traffic influence and dry conditions. Among dust mitigation measures, management of land-use variables could be as important as traffic control and road maintenance. Implications: This study documented for the first time in Latin America dust loadings less than 10 micrometers, information that can be used to estimate resuspended particle matter emissions in the region. The influence of meteorology, traffic characteristics, road condition, and land-use variables was analyzed and quantified. The management of land-use variables could be as important as traffic control and road maintenance for road dust mitigation. Further research interests are discussed.
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Poluentes Atmosféricos , Poeira , Poluentes Atmosféricos/análise , Poeira/análise , Monitoramento Ambiental , América Latina , Tamanho da Partícula , Emissões de Veículos/análiseRESUMO
This work presents a Green's function approach, originally implemented in graphene with well-defined edges, to the surface of a strong 3D topological insulator with a sequence of proximitized superconducting (S) and ferromagnetic (F) surfaces. This consists of the derivation of the Green's functions for each region by the asymptotic solutions method and their coupling by a tight-binding Hamiltonian with the Dyson equation to obtain the full Green's functions of the system. These functions allow the direct calculation of the momentum-resolved spectral density of states, the identification of subgap interface states and the derivation of the differential conductance for a wide variety of configurations of the junctions. We illustrate the application of this method for some simple systems with two and three regions, finding the characteristic chiral state of the quantum anomalous Hall effect at the NF interfaces, and chiral Majorana modes at the NS interfaces. Finally, we discuss some geometrical effects present in three-region junctions such as weak Fabry-Pérot resonances and Andreev bound states.
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In this paper, a novel technique for heart rate measurement on a standing subject is proposed that relies on electrical impedance variations detected by a plantar interface with booth feet, such as those in some bathroom weighting scales for body composition analysis. Heart-related impedance variations in the legs come from arterial blood circulation and are below 500 mOmega. To detect them, we have implemented a system with a gain in excess of 600, and whose fully differential AC input amplifier has a gain of 4.5 and a common-mode rejection ratio (CMRR) higher than 90 dB at 10 kHz. Differential coherent demodulation based on synchronous sampling yields a signal-to-noise ratio (SNR) of about 54 dB . The system sensitivity is 610 mV/Omega. The technique has been demonstrated on 18 volunteers, whose bioimpedance signal and ECG were simultaneously recorded. A Bland-Altman plot shows a mean bias of -0.2 ms between the RR time intervals obtained from these two signals, which is negligible. The technique is simple and user friendly and does not require any additional sensors or electrodes attached to the body, hence no conductive gel or skin preparation.
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Amplificadores Eletrônicos , Diagnóstico por Computador/instrumentação , Eletrocardiografia/instrumentação , Pé/fisiologia , Frequência Cardíaca/fisiologia , Pletismografia de Impedância/instrumentação , Adulto , Diagnóstico por Computador/métodos , Impedância Elétrica , Desenho de Equipamento , Análise de Falha de Equipamento , Feminino , Humanos , Masculino , Pletismografia de Impedância/métodos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Los captadores de niebla son usados para interceptar agua contenida en la niebla y abastecer de agua a comunidades que habitan en lugares donde este recurso escasea. Se evaluó el uso de captadores de niebla para la captación de agua en un área ubicada en el páramo Pan de Azúcar, Duitama-Boyacá. Se instalaron 60 captadores de niebla, 24 de ellos, con dispositivos para medir los volúmenes de agua interceptados. Los volúmenes de agua captados, se midieron en periodos de 24 horas, por 26 días, durante un año y se usó el modelo geométrico para diferenciar el agua proveniente de la niebla. La precipitación registrada fue mayor a la reportada en la literatura. La precipitación mensual osciló entre 51 y 1198 mm y la temperatura media mensual entre los 6 y 8 °C. Los volúmenes de agua promedio colectados por los 24 captadores de niebla estuvieron entre los 0,02 Lm-2dia-1 hasta los 4,4Lm-2dia-1. Los aportes de agua provenientes de la niebla oscilaron entre los 0,02 y 1,77 mmdía-1. La dirección del viento no afectó la captación de agua y aún se presenta incertidumbre al separar el aporte real de agua proveniente de la niebla a partir de la lluvia orográfica, lo cual, sigue siendo un desafío en los ecosistemas de páramo, por lo que se debe ampliar la investigación, para mejorar los diseños y las eficiencias de los captadores de niebla.
Fog collectors are used to intercept water contained in fog and supply water to communities that live in places where this resource is scarce. We evaluated the use of mist collectors to collect water in an area located in the Pan de Azúcar paramo, Duitama-Boyacá. We installed 60 mist collectors, 24 of them with devices to measure the volumes of water intercepted. The volumes of water captured were measured in periods of 24 hours for 26 days during one year and we used the geometric model to differentiate the water from the fog. The recorded precipitation was higher than that reported in the literature. Monthly rainfall ranged between 51 and 1198mm and mean monthly temperature ranged between 6 and 8°C. The average volumes of water collected by the fog collectors were below 0.5Lm-2day-1 with a maximum of 4.4Lm-2day-1. The contributions of water from the mist ranged between 0.02 and 1.77 mmday-1. The direction of the wind did not affect the capture of water and there is still uncertainty when separating the real contribution of water from the fog from the orographic rain, which continues to be a challenge in the paramo ecosystems, for which it is necessary to expand research, to improve the designs and efficiencies of fog collectors.
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The effect of roscovitine, a purine analogue and cyclin dependent kinase inhibitor, on DNA synthesis rate in tissue mini-units obtained from human cervical cancers was investigated. Roscovitine (100 microM) gave a DNA synthesis rate inhibition by 61% (P<0.0001; range 23-93%) within 30 min of incubation. This inhibitory effect was concentration-dependent. The results suggest that the inhibition of tumor DNA synthesis rate is due to a direct effect on the DNA synthesis machinery via presently unknown mechanisms. In addition, the potential application of CDKs inhibitors as preventive agents is discussed.
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DNA/biossíntese , Purinas/farmacologia , Neoplasias do Colo do Útero/metabolismo , Adulto , Idoso , Antineoplásicos/farmacologia , Quinases Ciclina-Dependentes/antagonistas & inibidores , Relação Dose-Resposta a Droga , Inibidores Enzimáticos/farmacologia , Feminino , Humanos , Pessoa de Meia-Idade , Roscovitina , Fatores de TempoRESUMO
Electrical properties of myocardial tissue are anisotropic due to the complex structure of the myocardial fiber orientation and the distribution of gap junctions. For this reason, measured myocardial impedance may differ depending on the current distribution and direction with respect to myocardial fiber orientation and, consequently, according to the measurement method. The objective of this study is to compare the specific impedance spectra of the myocardium measured using two different methods. One method consisted of transmural measurements using an intracavitary catheter and the other method consisted of nontransmural measurements using a four-needle probe inserted into the epicardium. Using both methods, we provide the in situ specific impedance spectrum (magnitude and phase angle) of normal, ischemic, and infarcted pig myocardium tissue from 1 kHz to 1 MHz. Magnitude spectra showed no significant differences between the measurement techniques. However, the phase angle spectra showed significant differences for normal and ischemic tissues according to the measurement technique. The main difference is encountered after 60 min of acute ischeimia in the phase angle spectrum. Healed myocardial tissue showed a small and flat phase angle spectrum in both methods due tothe low content of cells in the transmural infarct scar. In conclusion, both transmural and nontransmural measurements of phase angle spectrum allow the differentiation among normal, ischemic, and infarcted tissue.
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Condutividade Elétrica , Eletrodos , Coração/fisiopatologia , Miocárdio Atordoado/diagnóstico , Miocárdio Atordoado/fisiopatologia , Animais , Anisotropia , Cateterismo Cardíaco/métodos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/fisiopatologia , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/fisiopatologia , Recuperação de Função Fisiológica , SuínosRESUMO
We describe a fully automatable quantification process for the assessment of unilateral pulmonary function (UPF) by means of EIT and propose a measurement protocol for its clinical implementation. Measurements were performed at the fourth and sixth intercostal levels on a first group of ten healthy subjects (5M, 5F, ages 26-48 years) to define the proper protocol by evaluating the most common postures and ventilation modes. Several off-line processing tools were also evaluated, including the use of digital filters to extract the respiratory components from EIT time series. Comparative measures were then carried out on a second group consisting of five preoperatory patients with lung cancer (4M, IF, ages 25-77 years) scheduled for radionuclide scanning. Results show that measurements were best performed with the subject sitting down, holding his arms up and breathing spontaneously. As regards data processing, it is best to extract Fourier respiratory components. The mean of the healthy subject group leads to a left-right division of lung ventilation consistent with literature values (47% left lung, 53% right lung). The comparative study indicates a good correlation (r = 0.96) between the two techniques, with a mean difference of (-0.4+/-5.4)%, suggesting that the elimination of cardiac components from the thoracic transimpedance signal leads to a better estimation of UPF.
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Impedância Elétrica , Pulmão/fisiologia , Testes de Função Respiratória/métodos , Tomografia/métodos , Adulto , Idoso , Algoritmos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Cintilografia , Compostos Radiofarmacêuticos , Pertecnetato Tc 99m de Sódio , SoftwareRESUMO
Monitoring of the moisture and temperature of composting process is a key factor to obtain a quality product beyond the quality of raw materials. Current methodologies for monitoring these two parameters are time consuming for workers, sometimes not sufficiently reliable to help decision-making and thus are ignored in some cases. This article describes an advance on monitoring of composting process through a Wireless Sensor Network (WSN) that allows measurement of temperature and moisture in real time in multiple points of the composting material, the Compo-ball system. To implement such measurement capabilities on-line, a WSN composed of multiple sensor nodes was designed and implemented to provide the staff with an efficient monitoring composting management tool. After framing the problem, the objectives and characteristics of the WSN are briefly discussed and a short description of the hardware and software of the network's components are presented. Presentation and discussion of practical issues and results obtained with the WSN during a demonstration stage that took place in several composting sites concludes the paper.
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Solo/química , Gerenciamento de Resíduos , Tecnologia sem Fio , Temperatura , Água/análiseRESUMO
Electronic bathroom scales are an easy-to-use, affordable mean to measure physiological parameters in addition to body weight. They have been proposed to obtain the ballistocardiogram (BCG) and derive from it the heart rate, cardiac output and systolic blood pressure. Therefore, weighing scales may suit intermittent monitoring in e-health and patient screening. Scales intended for bioelectrical impedance analysis (BIA) have also been proposed to estimate the heart rate by amplifying the pulsatile impedance component superimposed on the basal impedance. However, electronic weighing scales cannot easily obtain the BCG from people that have a single leg neither are bioimpedance measurements between both feet recommended for people wearing a pacemaker or other electronic implants, neither for pregnant women. We propose a method to detect the heart rate (HR) from bioimpedance measured in a single foot while standing on an bathroom weighting scale intended for BIA. The electrodes built in the weighing scale are used to apply a 50 kHz voltage between the outer electrode pair and to measure the drop in voltage across the inner electrode pair. The agreement with the HR simultaneously obtained from the ECG is excellent. We have also compared the drop in voltage across the waist and the thorax with that obtained when measuring bioimpedance between both feet to compare the possible risk of the proposed method to that of existing BIA scales.
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Impedância Elétrica , Eletrocardiografia/métodos , Frequência Cardíaca/fisiologia , Pesos e Medidas , Balistocardiografia , HumanosRESUMO
Transients are present in sensor and instrumentation systems. They are caused by energy transference and are typically modeled as first-order systems. If too long, transients may suppose a critical factor for these systems unless they are analyzed (e.g., in terms of consumption). This work presents a new method for estimating the final value of a first-order system transient. Since this problem may be harmful, mainly to autonomous systems, the method equations are composed of simple operations that can be implemented on microcontrollers or similar interfaces with low computational capacity. The experimental results validate the theoretical models of the method and prove that, when the system coexists with disturbances, it is possible to estimate the final value in around 60% of the time we would have to wait until reaching it, in the worst case scenario.
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En México, desde la década de los ochenta se emitieron diferentes documentos en los cuales está especificada la atención de la salud de la población como lo es la obesidad, documentos que se han enriquecido con documentos emitidos en fechas recientes. Sin embargo como problema de salud, el sobrepeso y la obesidad, se han convertido en los retos más importantes, ubicando al país en primer lugar en las estadísticas de salud a nivel mundial. Esta situación se identifica en las diferentes entidades federativas del país, como lo es el Estado de México. El objetivo de este trabajo fue conocer la relación entre emisión de programas de salud, su contenido y la actuación de los participantes. El trabajo que se realizó es de tipo documental, retrospectivo, analítico y reflexivo. Se analizaron en una primera etapa, diferentes documentos emitidos en el ámbito nacional y regional que se caracterizan por formar el marco normativo de la atención de la obesidad. Posteriormente, se retomaron los hallazgos de cuatro investigaciones, las cuales realizan una vinculación entre los programas y la implementación de los mismos. Se observó que en México, la atención de la salud y prevención de la obesidad están clasificadas como una garantía individual expresada en la Constitución Política. Como parte de las políticas nacionales de salud, diferentes documentos establecen la prevención de la obesidad, sin embargo, al contrastar lo establecido en ellos con los resultados obtenidos en los cuatro estudios, se identifica una falta de coherencia para su implementación. Es importante dar seguimiento estrecho en el proceso de implementación de los programas preventivos para lograr los objetivos planteados en las políticas nacionales de salud.
In Mexico, from the eighties decade, various documents were made, and in which is specified the health care of the population, including obesity, documents which have been enriched by documents recently issued yet. However, as a health problem, overweight and obesity have become major challenges, placing the country at first place in health statistics on worldwide. This situation is identified in the different zones of the country, such as in the case of the State of Mexico. The objective of this work was to understand the relationship between emission of health programs, its contents, and the performance of the participants. The present paper was documentary, retrospective, analytical, and reflective kind. In a first step, different documents issued at national and regional level, characterized by including the regulatory framework for the care of obesity, were analyzed. Subsequently, the findings of four researches were considered, which made a link between the programs and their implementation. It can be stated that in Mexico, the health care and prevention of obesity are classified as an individual guarantee, expressed in the Political Constitution. As part of the national health policies, various documents establish the prevention of obesity; however by contrasting them with the results of the four studies, an inconsistency in implementation is identified. A closely monitoring of the process of implementation of preventive programs is required, to achieve the objectives posed in national health policies.
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Thoracic and lumbar spine conditions cause primarily mechanical back pain, although the clinician has to ensure that the symptoms are not from another etiology. We present the case of a patient with thoracic and lumbar non mechanical pain, resistant to treatment, diagnosed with a herniation of the intervertebral disc through the vertebral end-plate. We also performed a literature review.