Load-Velocity Relationship in the Bulgarian Split-Squat Exercise.

ABSTRACT: Rabal-Pelay, J, Gutiérrez, H, Bascuas, P-J, Pareja-Blanco, F, and Marco-Contreras, LA. Load-velocity relationship in the Bulgarian split-squat exercise. J Strength Cond Res XX(X): 000-000, 2024-The objective of the current research was to analyze the load-velocity relationship in the Bulgarian split-squat (BSS) exercise and to compare these relationships between the dominant and nondominant legs. Twenty-one strength-trained men (age: 27.3 ± 7.3 years) performed a progressive loading test in the BSS exercise using a Smith machine for each leg. The protocol began with a load of 30 kg, incrementally adding 10 kg until the mean propulsive velocity (MPV) fell below 0.4 m·s-1. At that point, 5 kg increments were employed, with a final addition of 2.5 kg for the last estimated attempt one-repetition maximum (1RM). A total of 324 lifts were analyzed. Subjects exhibited a relative strength ratio of 1.23 ± 0.10, a 1RM of 91.3 ± 14.2 kg, and a mean range of motion of 44.7 ± 3.7 cm. Polynomial regression analysis showed a robust relationship with an R2 value of 0.945 (ρ ≤ 0.001) between the relative load (%1RM) and MPV. Despite the differences in 1RM between the dominant and nondominant legs, there were no significant differences in MPV at the %1RM between both legs. These findings suggest that training intensity can be prescribed via the MPV during the BSS exercise. Moreover, the load-velocity relationship is stable between limbs despite the potential differences in absolute strength levels.

Generalization challenges in electrocardiogram deep learning: insights from dataset characteristics and attention mechanism.

Aim: Deep learning's widespread use prompts heightened scrutiny, particularly in the biomedical fields, with a specific focus on model generalizability. This study delves into the influence of training data characteristics on the generalization performance of models, specifically in cardiac abnormality detection. Materials & methods: Leveraging diverse electrocardiogram datasets, models are trained on subsets with varying characteristics and subsequently compared for performance. Additionally, the introduction of the attention mechanism aims to improve generalizability. Results: Experiments reveal that using a balanced dataset, just 1% of a large dataset, leads to equal performance in generalization tasks, notably in detecting cardiology abnormalities. Conclusion: This balanced training data notably enhances model generalizability, while the integration of the attention mechanism further refines the model's ability to generalize effectively.

This study tackles a common problem for deep learning models: they often struggle when faced with new, unfamiliar data that they have not been trained on. This phenomenon is also known as performance drop in out-of-distribution generalization. This reduced performance on out-of-distribution generalization is a key focus of the research, aiming to improve the models' ability to handle diverse data sets beyond their training data.The study examines how the characteristics of the dataset used to train deep learning models affect their ability to detect abnormal heart activities when applied to new, unseen data. Researchers trained these models using various sets of electrocardiogram (ECG) data and then evaluated their performance in identifying abnormalities. They also introduced an attention mechanism to enhance the models' learning capabilities. The attention mechanism in deep learning is like a spotlight that helps the model focus on important information while ignoring less relevant details.The findings were particularly noteworthy. Despite being trained on a small, well-balanced subset of a larger dataset, the models excelled in detecting heart abnormalities in new, unfamiliar data. This training method significantly improved the models' generalization and performance with unseen data. Furthermore, integrating the attention mechanism substantially enhanced the models' ability to generalize effectively on new information.

Influence of Vertical-Oriented vs. Horizontal-Oriented Combined Strength Training in Young Basketball Players.

ABSTRACT: Sánchez-Sabaté, J, Gutiérrez, H, Marco-Contreras, LA, Younes-Egana, O, Gonzalo-Skok, O, and Piedrafita, E. Influence of vertical-oriented vs. horizontal-oriented combined strength training in young basketball players. J Strength Cond Res 38(7): 1280-1287, 2024-This study aimed to compare the effects of 8-week combined vertical-oriented vs. horizontal-oriented training interventions in basketball athletes. Eighteen highly trained U-16 basketball players participated in this study and were randomly assigned to either a combined vertical-oriented training group (CVG, n = 9) or a combined horizontal-oriented training group (CHG, n = 9). Bilateral and unilateral vertical jump height, unilateral horizontal jump distance, 5-m, 10-m, and 20-m sprint times, change-of-direction sprint times, and a limb symmetry index were among the measured performance variables. Combined strength training was performed twice a week for 8 weeks. CVG was compounded by the squat exercise (3 sets of 6-8 R at 30-45% 1 repetition maximum [1RM]), jump squats (2 sets of 6 R, at 5-12.5% body mass [BM]), and vertical jumps (3-4 sets × 6 R). CHG included the hip thrust exercise (3 sets of 6-8 R at 30-45% 1RM), sled towing sprints (2-3 R, at 5-12.5% BM), and sprints (3-4 R of 20-m). Within-group differences showed significant ( p < 0.05 and statistical power >80%) improvements in unilateral vertical jumping with the right leg after both training interventions. By contrast, only CHG improved 5-m, 10-m, and 20-m sprint times ( p < 0.05 and statistical power >80%). Significant effects were observed for CHG compared with CVG in 5-m, 10-m, and 20-m sprint times ( p < 0.05 and statistical power >80%). This study reinforces the importance of oriented-combined training based on force-vector specificity target, mainly in horizontal-oriented actions.

Changes in Body Composition and Physical Performance after a Six-Week International Tour in Young Chilean Female Tennis Players.

Junior tennis players travel a lot to play tennis tournaments; this causes them to spend a lot of time away from their homes and disrupts their training, which could reduce their performance and increase the risk of injury. The purpose of this study was to analyze the changes in physical performance and body composition after a six-week international tour in young Chilean female tennis players. Thirty young female tennis players (15.4 ± 0.6) participated in this study. Body weight, skinfolds, and perimeters were measured. Body fat percentage (BFP) and skeletal muscle mass (SMM) were calculated. For physical performance, 5 m sprint, the 505 with stationary start test (505 test), the pro-agility test, countermovement jump (CMJ), and medicine ball throw (MBT) were evaluated. The results show a significant increase in BFP and decrease in SMM (p < 0.01; d = -0.18 and 0.19, respectively). In terms of physical performance, 5 m sprint, the 505 test (p < 0.01; d = -0.95 and -0.95, respectively), CMJ, MBT, and HJ significantly decreased post-tour (p < 0.05; d = 0.96, 0.89 and 0.47, respectively). We conclude that, after a six-week international tour, there were changes in body composition and a significant decrease in 5 m sprint, the 505 test, CMJ, and MBT.

Efficient Edge-AI Models for Robust ECG Abnormality Detection on Resource-Constrained Hardware.

This study introduces two models, ConvLSTM2D-liquid time-constant network (CLTC) and ConvLSTM2D-closed-form continuous-time neural network (CCfC), designed for abnormality identification using electrocardiogram (ECG) data. Trained on the Telehealth Network of Minas Gerais (TNMG) subset dataset, both models were evaluated for their performance, generalizability capacity, and resilience. They demonstrated comparable results in terms of F1 scores and AUROC values. The CCfC model achieved slightly higher accuracy, while the CLTC model showed better handling of empty channels. Remarkably, the models were successfully deployed on a resource-constrained microcontroller, proving their suitability for edge device applications. Generalization capabilities were confirmed through the evaluation on the China Physiological Signal Challenge 2018 (CPSC) dataset. The models' efficient resource utilization, occupying 70.6% of memory and 9.4% of flash memory, makes them promising candidates for real-world healthcare applications. Overall, this research advances abnormality identification in ECG data, contributing to the progress of AI in healthcare.

Intrauterine Transmission of Zika and Vertical Transfer of Neutralizing Antibodies Detected Immediately at Birth in Oaxaca, Mexico: An Analysis in the Context of Microcephaly.

Zika virus (ZIKV) can cause neurological issues in infants. To provide protection, neutralizing antibodies should be transferred from the mother to the infant. We conducted a study at the Hospital General de Pochutla, Oaxaca, Mexico. Samples were collected from mothers (blood and breast milk) and infants (saliva and dried blood spots) within the first 12 postnatal hours (December 2017 to February 2018) and tested for ZIKV total and neutralizing antibodies as well as ZIKV-PCR. Microcephaly was evaluated according to INTERGROWTH-21st standards. Maternal IgG seroprevalence was 28.4% with 10.4% active infection, while infant IgG seroprevalence was 5.5% with 2.4% active infection. There were two cases of virolactia, and 6.3% of the infant saliva samples tested positive for ZIKV. Additionally, 18.3% of the infants were in a cephalic perimeter percentile lower than 10 and had an association between microcephaly and serology or a PCR between 8.6 and 60.9%. The infant blood samples had neutralizing antibodies, indicating intrauterine protection. Microcephaly was correlated with serology or PCR, but in our study population, non-ZIKV factors may be involved as well. Low ZIKV infection values in breast milk mean that breastfeeding is safe in most of the mothers and infants of the endemic area studied.

The role of microbiota on rheumatoid arthritis onset.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation and pain, which can lead to the loss of normal joint function. Although the exact cause of the disease is not yet fully understood, both environmental factors and genetics may play a role in its development. Moreover, research suggests microbiota contributes to the onset and progression of RA. People with RA show higher quantities of bacteria such as Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella copri, Proteus mirabilis, and Lactobacillus salivarius compared to healthy individuals. Conversely, studies propose that Lactobacillus casei, a probiotic bacterium with immunomodulatory properties, has beneficial effects for RA in murine and human models. Therefore, this work reviews the potential role of the gut microbiota in the development of RA and explores the feasibility of using probiotic bacteria as a supplementary treatment for this disease.

Modification of Superabsorbent Polymer Granules and Fibers for Antimicrobial Efficacy and Malodor Control.

Superabsorbent polymer (SAP) granules, typically used in personal care devices such as diapers, incontinence devices, hygiene pads, and wound dressings, and granular particles of zeolite and bentonite were each subjected to modification by exposure to solutions of 1-chloro-2,2,5,5-tetramethyl-4-imidazolidinone (MC) in ethanol at room temperature. The air-dried granules showed newly acquired properties attributable to the presence of active chlorine (Cl+). The treated particles effectively oxidized the malodorant 3-mercapto-3-methylbutanol (3M3MB). MC-treated granules inactivated urease, a microbial exoenzyme commonly involved in ammonia production. Modified SAP granules and superabsorbent fibers (SAFs) showed powerful antibacterial activity in an in vitro chronic wound model. The results suggest that processing of SAP granules and SAFs by this simple method at an industrial scale could add value to their widespread use in a variety of personal hygiene devices and specifically to the improvement of chronic wound care.

S4D-ECG: A Shallow State-of-the-Art Model for Cardiac Abnormality Classification.

PURPOSE: This study introduces an algorithm specifically designed for processing unprocessed 12-lead electrocardiogram (ECG) data, with the primary aim of detecting cardiac abnormalities. METHODS: The proposed model integrates Diagonal State Space Sequence (S4D) model into its architecture, leveraging its effectiveness in capturing dynamics within time-series data. The S4D model is designed with stacked S4D layers for processing raw input data and a simplified decoder using a dense layer for predicting abnormality types. Experimental optimization determines the optimal number of S4D layers, striking a balance between computational efficiency and predictive performance. This comprehensive approach ensures the model's suitability for real-time processing on hardware devices with limited capabilities, offering a streamlined yet effective solution for heart monitoring. RESULTS: Among the notable features of this algorithm is its strong resilience to noise, enabling the algorithm to achieve an average F1-score of 81.2% and an AUROC of 95.5% in generalization. The model underwent testing specifically on the lead II ECG signal, exhibiting consistent performance with an F1-score of 79.5% and an AUROC of 95.7%. CONCLUSION: It is characterized by the elimination of pre-processing features and the availability of a low-complexity architecture that makes it suitable for implementation on numerous computing devices because it is easily implementable. Consequently, this algorithm exhibits considerable potential for practical applications in analyzing real-world ECG data. This model can be placed on the cloud for diagnosis. The model was also tested on lead II of the ECG alone and has demonstrated promising results, supporting its potential for on-device application.

Mesalamine induced hepatotoxicity. Is mesalamine safe?

Dear Editor: Mesalamine is a medication used widely in the treatment of patients with inflammatory bowel disease. Although mesalamine is considered safe, hepatotoxicity has been reported with an incidence of 0-4%. We present the clinical picture of a patient with hepatotoxicity due to mesalamine. A 79-year-old woman in the context of chronic diarrhea, a left-sided ulcerative colitis diagnosis was made, and treatment was initiated with oral mesalamine 4 g per day, and mesalamine suppositories. Before starting treatment, she had normal liver test results. After three months, she presented with headache, fatigue, and intermittent low fever. Her laboratory tests showed a liver profile with a cholestatic pattern, and elevation of inflammatory parameters. Mesalamine was suspended, and an extensive study was performed. Cholangioresonance reported intra and extrahepatic bile duct dilation without obstruction, and thickening of the intrahepatic bile duct. She progressed with worsening of the liver profile without signs of liver failure. A liver biopsy was performed, which showed chronic non-suppurative cholangitis with granulomas and focal concentric fibrosis related to medium-caliber bile ducts, and IgG4 stain was negative.

The Evaluation and Treatment of Merkel Cell Carcinoma and Brain Metastasis: A Case Report and Review of the Literature.

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor associated with high mortality if metastases are identified. Currently, there is no standardized nor curative treatment for neurometastatic MCC. In this study, we have reviewed the more recent cases and the use of immunotherapy in a population. In this case report and review, we present a case of MCC with brain metastasis currently undergoing treatment with immunotherapy (pembrolizumab) resulting in an initial complete response with a progression-free survival time of five months. We also review the past reported literature and the 11 newly presented cases on their clinical presentation of neurometastatic MCC, immunohistochemical markers, and treatment outcomes. In summary, immunotherapy initially showed a promising response with the complete elimination of MCC brain metastasis. The early aggressive treatment of pembrolizumab with stereotactic radiosurgery should be considered as this treatment plan has shown improved therapeutic effects compared to the standard chemoradiation therapy. Further investigations are needed to determine the efficacy and response of immunotherapy use for neurometastatic MCC.

Proctitis y enfermedad perianal de causa infecciosa: una mirada más allá de la enfermedad inflamatoria intestinal / Infectious proctitis and perianal disease: a gaze beyond inflammatory bowel disease

Resumen La proctitis infecciosa secundaria a una enfermedad de transmisión sexual ha aumentado en incidencia y deben ser consideradas especial-mente en varones homosexuales o bisexuales con síntomas rectales. Presentamos un paciente con una proctitis y enfermedad perianal por Chlamydia trachomatis que podría haber sido diagnosticado con otra enfermedad ano-rectal como es la enfermedad inflamatoria intestinal, si la historia clínica no hubiese sido considerada. Un alto nivel de sospecha es necesario para evitar un diagnóstico incorrecto, retrasar el tratamiento antimicrobiano y el desarrollo de complicaciones.

Abstract Infectious proctitis by sexually transmitted diseases are increasing in incidence and should be considered in homosexual patients with rectal symptoms. In this case, we show a patient with proctitis and perianal disease caused by Chlamydia trachomatis that could be diagnosed as another anorectal disease such as inflammatory bowel disease if the clinical history is not taken into account. A high level of suspicion is crucial, in order to avoid an incorrect diagnosis, delayed antibiotic therapy and the development of complications.

Apendicectomía profiláctica en la dotación Antártica: experiencia del Hospital de la Fuerza Aérea de Chile / Prophylactic appendectomy in the Antarctic endowment: experience of the Chilean Air Force Hospital

Resumen Objetivo: Reportar y caracterizar las complicaciones quirúrgicas de las apendicectomías laparoscópicas electivas profilácticas, realizadas a pacientes destinados a dotación antártica, realizadas en Hospital clínico de la Fuerza Aérea de Chile (FACh). Materiales y Método: Análisis retrospectivo descriptivo de fichas clínicas de todos los pacientes sometidos a apendicectomía laparoscópica profiláctica entre los años 2013 y 2017 en Hospital FACh. Se registraron variables demográficas y quirúrgicas de los pacientes. Las complicaciones fueron registradas y clasificadas de acuerdo a Clavien-Dindo. Resultados: Se incluyeron 200 pacientes, 96% hombres y solo 4% mujeres. Se registraron 6 pacientes (3%) con complicaciones quirúrgicas, clasificadas como grado I según Clavien-Dindo. Discusión: No existen reportes de complicaciones en apendicectomías profilácticas. En nuestra serie éstas alcanzan el 3%. Conclusiones: La apendicectomía profiláctica es una cirugía segura, con escasas complicaciones, pero existen y se desarrollan en un paciente que estaba previamente sano.

Aim: To present and characterize surgical complications of elective prophylactic appendectomies, performed in patients for the Antarctic endowment at the Hospital Clínico de la Fuerza Aérea de Chile. Materials and Method: Retrospective descriptive analysis of all patients operated of prophylactic laparoscopic appendectomy between 2013 and 2017. Demographic and surgical variables of the patients were recorded and analysed. Complications were classified according Clavien-Dindo. Results: 200 patients were included, 96% mens. Six patients (3%) had a surgical complication, all classified as Grade I. Discussion: There are no previous reports of surgical complications on prophylactics appendectomies. The complications rate is 3%. Conclusions: The prophylactic appendectomy is a safe surgery with a low rate of complications, although its exists and develops in a previously healthy patient.

Orientaciones Deporte y COVID-19: Recomendaciones sobre el retorno a la actividad física y deportes de niños niñas y adolescentes / Sport COVID-19 Orientations: Recommendations for return to physical activity and sports in children and adolescents

Resumen: La pandemia por COVID-19, originada en diciembre de 2019 en Wuhan, China, obligó a los países, incluido Chile, a un confinamiento masivo para evitar la propagación de SARS-CoV2. Desde marzo de 2020 en Chile, también se afectó la realización de actividad física y deporte en los niños, niñas y adolescentes (NNA). En un esfuerzo por reunir la escasa evidencia disponible sobre el retorno a la práctica de ejercicio en NNA post pandemia COVID-19 y la opinión de expertos de 4 sociedades científicas y académicas (Sociedad Chilena de Medicina del Deporte, Sociedad Chilena de Pediatría, Sociedad Chilena de Kinesiología Deportiva y la Consejo Académico Nacional de Educación Física) se han generado recomendaciones para un retorno seguro a la actividad para el ramo Educación Física y Salud, deporte escolar y federado tanto para disminuir los riesgos asociados a los efectos del confinamiento como para evitar la propagación de COVID-19. Adicionalmente, se incluyen una guía de recomendación para padres y profesores y otra para médicos sobre la vigilancia y evaluación de los pacientes NNA que sostendrán enfermedad COVID-19 y deseen volver al deporte y ejercicio.

Abstract: The COVID-19 pandemic, originated in December 2019 in Wuhan, China, forced a massive quaran tine in most countries including Chile to avoid the propagation of SARS-CoV2. Since March 2020 in Chile, it affected the participation of children and youth athletes as well in education, physical activity and sports. In an effort to assess the scarce available evidence about return to sport and exercise in children and adolescents post COVID-19 pandemic and gather the opinion of experts of 4 Chilean scientific and academic societies (Sociedad Chilena de Medicina del Deporte, Sociedad Chilena de Pediatría, Sociedad Chilena de Kinesiología Deportiva and Consejo Académico Nacional de Edu cación Física) we have produced recommendations for a safe return to activities in Physical Activity and Health class, School Sports and Federation Sports to reduce the risks associated with the effects of confinement and to avoid the propagation of COVID-19 and. Additionally, a recommendation for parents and teachers and a another for physicians for surveillance and evaluation of children and adolescents who were or will become COVID-19 patients and wish to return to sports end exercise.

Symptoms of anxiety and depression and self-care behaviors during the COVID-19 pandemic in the general population / Síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en la población general

Abstract Introduction: The COVID-19 pandemic can have important psychosocial consequences in the population. Objective: To determine the levels anxiety and depression symptoms and self-care behaviors during the COVID-19 pandemic in the general population. Method: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and a self-care behaviors visual analogue scale were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Results: Out of 1508 included participants, 20.8 % had symptoms of severe anxiety, while 27.5 % showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were associated with the presence of higher levels of anxiety and depression symptoms; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. Conclusion: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public mental health problem, and implementation of programs for their care is therefore recommended.

Resumen Introducción: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la población. Objetivo: Determinar los niveles de síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en población general. Método: Encuesta en línea distribuida durante tres semanas mediante muestreo no probabilístico. Se empleó el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala análoga visual de conductas de autocuidado. Se realizaron análisis descriptivos y de comparación entre los grupos con ansiedad y depresión. Resultados: Se incluyeron 1508 participantes, 20.8 % presentó síntomas de ansiedad grave y 27.5 %, síntomas de depresión grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad médica y antecedentes de atención a la salud mental estuvieron relacionados con la presencia de mayores niveles de síntomas de ansiedad y depresión; 66 a 80 % de la población cumplía con las recomendaciones de autocuidado. Se identificó la necesidad de recibir atención de salud mental. Conclusión: Se observó mayor número de individuos con síntomas de ansiedad y depresión moderadas a graves que en otras pandemias. Los efectos psicológicos de la pandemia de COVID-19 se consideran un problema de salud mental pública emergente, por lo que se recomienda la implementación de programas para su atención.

O contributo da educação física para a a formação de indivíduos fisicamente cultos: uma perspetiva portuguesa / The contribution of physical education to the training of physically educated individuals: a portuguese perspective / Las aportaciones de la educación física para la formación de individuos físicamente cultos: una perspectiva portuguesa

Resumo: Este trabalho, realizado com 150 indivíduos no final da escolaridade obrigatória e candidatos a uma licenciatura em Ciências do Desporto, pretende perceber se a Educação Física está a contribuir para a formação de indivíduos fisicamente cultos. Seguimos uma metodologia quantitativa e optámos por um questionário com três partes: a primeira de questões fechadas e de caracterização sociodemográfica da amostra; a segunda, também de questões fechadas, sobre o entendimento acerca das Finalidades da Educação Física; e a terceira composta por 25 afirmações de escolha dicotómica (verdadeiro/falso), sobre conteúdos fundamentais para uma prática autónoma de atividade física, constantes nos Programas Nacionais de Educação Física (Currículos Nacionais) para o ensino secundário. Os resultados revelam fragilidades nos conhecimentos dos indivíduos relativamente ao desenvolvimento das capacidades motoras, aos efeitos da prática de exercício físico, a procedimentos de segurança e à composição e funcionamento corporal, afastando-se do preconizado por aqueles Programas Nacionais.

Abstract: This study was carried out with 150 male students at the end of their mandatory education and with candidates to a degree in Sports Science and Physical Education. It aims to understand if Physical Education contributed to the education of physically educated individuals. We followed a quantitative methodology and administered a three-part questionnaire: close-ended questions for the sociodemographic characterization of the sample; close-ended questions on participants' understanding of the purposes of Physical Education; true-or-false questions on fundamental contents for an autonomous practice of physical activity, which are included in the National Curricula of Physical Education for secondary school. The results reveal individuals' weak knowledge of motor skills development, effects of physical exercise, safety procedures, and body composition and functioning, which is not in accordance with National Curricula.

Resumen: Este trabajo, realizado con 150 estudiantes al final de su escolaridad obligatoria y aspirantes a cursar la licenciatura en Ciencias del Deporte, pretende averiguar si la Educación Física está contribuyendo con la formación de individuos físicamente cultos. Seguimos una metodología cuantitativa y optamos por un cuestionario con tres partes: la primera con cuestiones cerradas y de caracterización sociodemográfica de los participantes; la segunda, también con cuestiones cerradas y sobre su entendimiento acerca de las finalidades de la Educación Física; y la tercera, compuesta por 25 afirmaciones de selección dicotómica (verdadero y falso), sobre contenidos fundamentales para una práctica autónoma de la actividad física y que constan en los Programas Nacionales de Educación Física (Currículos Nacionales) para el bachillerato. Los resultados revelan fragilidades en los conocimientos de los participantes en lo referente al desarrollo de las capacidades motoras, los efectos de la práctica de ejercicio físico, los procedimientos de seguridad y la composición y funcionamiento corporal, alejándose de lo preconizado en aquellos Programas Nacionales.

Terapia continua intra-arterial selectiva con nimodipino para el tratamiento del vasoespasmo refractario en hemorragia subaracnoidea aneurismática: caso clínico / Continuous intra arterial nimodipine for vasospasm secondary to subarachnoid hemorrhage: report of one case

We report a 39-year-old male with an aneurysmal subarachnoid hemorrhage without hydrocephalus, in whom a right choroidal aneurysm was early excluded by endovascular coil insertion. Intracranial pressure (PIC) and cerebral oxygenation (PtiO2) sensors for neuromonitoring were installed due to a persistent comatose state. From the 3rd day, neuromonitoring became altered. CT angiography and cerebral angiography showed severe proximal and distal vasospasm (VE) of the middle (ACM) and anterior (ACA) right cerebral arteries. VE was treated with angioplasty and intravenous nimodipine. Forty eight hours later, despite hemodynamic maximization, neuromonitoring became altered again, mainly explained by a decrease in PtiO2 below 15 mmHg. A severe VE in ACM and right ACA was confirmed by angiography. Given the presence of an early and recurrent VE, which was associated with a decrease in cerebral oxygenation, internal carotid micro-catheters for continuous nimodipine infusion were installed. This therapy maintained a normal neuromonitoring for 15 days. During this period, attempts were done to decrease or discontinue the infusion, but the patient presented parallel falls of cerebral oxygenation or decreased cerebral perfusion observed with perfusion CT, interpreted as persistent VE. Finally, the infusion was stopped at day 15 without significant complication. We conclude that intra-arterial nimodipine continuous infusion in refractory VE can be useful and safe in selected patients. Multimodal neuromonitoring is essential.

Aneurisma gigante de la arteria coronaria derecha, reporte de un caso y revisión de la literatura / Giant aneurysm of the right coronary artery, report of a case and review of the literature

Resumen Los aneurismas de las arterias coronarias se definen como una dilatación localizada que excede el diámetro normal en 1.5 veces. Esta es una condición poco frecuente, su incidencia varía del 0.3 hasta el 5.3% de las angiografías coronarias. Los aneurismas que exceden cuatro veces el diámetro del vaso normal se consideran gigantes. Estos son aún más raros y se presentan en el 0.02 a 0.2% de todos los casos. Existe controversia en cuanto a su fisiopatología, sin embargo, hasta el 50% de los casos se relacionan con la aterosclerosis. Se diagnostican más frecuentemente entre la sexta y séptima décadas de vida. Las principales manifestaciones clínicas están relacionadas con la cardiopatía isquémica. Respecto a su tratamiento, no existe un consenso del manejo en los pacientes adultos, las opciones son: médico, quirúrgico o intervencionismo. Reportamos la presencia de un aneurisma gigante de la coronaria derecha y ectasia gigante del sistema izquierdo con trombosis activa en un hombre con antecedentes de un aneurisma en la aorta abdominal, tratado por vía endovascular, e infarto agudo al miocardio sin elevación del segmento ST no reperfundido. Requirió de estudio de angiotomografía coronaria, el cual permitió la identificación de las características anatómicas de esta enfermedad.

Abstract Coronary artery aneurysms are described as a localized dilatation that exceeds the normal diameter by 1.5 times. This is a rare condition; its incidence varies from 0.3% up to 5.3% of all coronary angiographies. Those aneurysms that exceed 4 times the diameter of a normal artery are considered giant aneurysms, which are even more uncommon, presenting between 0.02% and 0.2% of all cases. There is controversy regarding its pathophysiology, however, up to 50% of the cases are related to atherosclerosis. They are diagnosed more frequently between the sixth and seventh decade of life. The main clinical manifestations are related to ischemic heart disease. Regarding their treatment, there is no general consensus towards its management in adult patients. The options are medical, surgical or percutaneous treatment. We report the presence of a giant aneurysm of the right coronary artery and giant ectasia of the left coronary system with active thrombosis in a man with history of an abdominal aortic aneurysm, with endovascular treatment and a non-ST segment elevation myocardial infarction with no reperfusion strategy, who required a coronary computed tomography, identifying the anatomical characteristics of this disease.

Intervención en crisis: estrategia de enfermería para el afrontamiento de la vivencia dolorosa / Intervention in crisis: nursing strategy for coping with painful life

INTRODUCCIÓN: la enfermera, debido a su quehacer como profesional del cuidado, mantiene una cercanía mayor que el resto de los profesionales de salud con los usuarios que son sujetos de sus cuidados, muchos de los que experimentarán dolor en distintas intensidades. esta cercanía emplaza a las enfermeras en una ubicación estratégica para detectar el dolor precozmente e intervenir de manera oportuna, desde una mirada holística. el dolor como concepto se trata de un constructo universalmente conocido por todos los seres humanos, pero a la vez vivenciado por cada uno de nosotros de manera única e individual. sobre la vivencia dolorosa participan factores multidimensionales, más allá del biológico, destacando el componente emocional, del cual se ha investigado sobre su relación bidireccional con la sensación dolorosa. desde esta relación bidireccional, es que la vivencia dolorosa puede convertirse en una crisis situacional con consecuencias graves para la salud mental del individuo, la contención emocional que pueda realizar un profesional de enfermería a través de la intervención en crisis favorecerá el afrontamiento emocional más efectivo posible de la vivencia dolorosa. OBJETIVOS: realizar una revisión bibliográfica respecto a la aplicación de la intervención en crisis, como estrategia para la entrega de cuidados de enfermería dirigidos a usuarios portadores de dolor, considerando la estrecha relación existente entre el dolor y calidad de vida. MATERIAL Y MÉTODO: revisión bibliográfica de estudios sobre la participación de enfermería en pacientes que sufren dolor físico, de tipo agudo y/o crónico, a través de intervención en crisis, disponible y publicado en revistas chilenas e internacionales en idioma español o inglés. búsqueda bibliográfica de información publicada en bases de datos electrónicas nacionales e internacionales, que publican información científica nacional e internacional: Scopus, Enferteca y Google Académico. los descriptores en inglés y en español que se utilizaron en la búsqueda fueron: pain (dolor), nursing (enfermería), crisis intervention (intervención en crisis). para la búsqueda en español se utilizaron los siguientes descriptores: dolor, enfermería, intervención en crisis. RESULTADOS: una vez realizada la revisión bibliográfica, se confirma escasez de publicaciones vinculadas a la intervención en crisis con participación específica de profesionales de enfermería en personas que presentan dolor físico. se acepta que la preparación emocional previa, así como el acompañamiento emocional de quien sufre dolor, tienen impacto sobre la intensidad del dolor, sin embargo no es posible cuantificar. DISCUSIÓN: la intervención en crisis de enfermería tiene impacto sobre los factores psicológicos, emocionales y sociales asociados a la vivencia dolorosa. adquiere protagonismo la realización de una valoración de enfermería integral y multidimensional en el momento que la persona reporta dolor, con la finalidad de planificar cuidados integrales que aborden los factores determinantes de dolor identificados de una manera integral, tanto en la etapa de preparación, afrontamiento y posterior a la vivencia dolorosa. es necesario capacitar al profesional de enfermería en salud mental a través de técnicas de intervención, considerando que se constituye como el primero en la cadena de atención de la persona que sufre dolor.

INTRODUCTION: nurses, as professional caretakers, have a proportionally closer relation than other health professionals with the users who are subjected to their care, many of whom will experience pain of varying intensity. this closeness places nurses in a strategic position to detect pain precociously and intervene in a timely manner from a holistic viewpoint. as a concept, pain is a construct universally known by all human beings, but at the same time it is experienced by each of us in a unique and individual way. multidimensional factors participate in the pain experience, beyond the purely biological, with the emotional component standing out, with research being done on its bidirectional relation with the painful feeling. from this bidirectional relation the painful experience can turn into a situational crisis with serious consequences to the individual's mental health, so the emotional containment that a nursing professional can be realized through the crisis intervention will favor the most effective emotional handling of this painful experience. OBJECTIVES: to make a literature review on the application of crisis intervention as a strategy to deliver nursing care aimed at pain bearers, considering the close relation existing between the pain and the quality of life. MATERIAL AND METHODS: a literature review of studies published on nursing interventions by performing crisis interventions to take care of patients suffering acute and/or chronic physical pain, published in chilean and international journals in spanish or english language, available in national and international electronic data bases that publish national and international scientific information, like Scopus, Enferteca, and Academic Google. the descriptors that were used for the search were pain, nursing, and crisis intervention in english, and dolor, enfermería, and intervención en crisis in spanish. results: tthe literature review confirmed the scarcity of publications on crisis intervention with specific participation of nursing professionals in people presenting physical pain. it is accepted that the previous emotional training, as well as the emotional support of those suffering pain, have an impact on the intensity of pain, yet it cannot be quantified. DISCUSSION: nursing crisis intervention has an impact on the psychological, emotional, and social factors associated with a painful experience. making an integral and multidimensional nursing valuation at the time the person reports pain takes on a greater role, with the purpose of planning integral care that will deal with the factors determining the pain identified in an integral manner, in preparing, coping with, and following the painful experience. It is necessary to train the nurse in mental health through intervention techniques, considering that this professional becomes the first one in the attention chain of the person who suffers pain.