Exposición a temperaturas extremas y su efecto en la gestación en un departamento de Colombia / Exposure to extreme temperatures and its effect on pregnancy in a department of Colombia

Introducción: Diversas investigaciones han establecido la relación entre temperatura y duración del embarazo, la exposición a temperaturas altas durante el embarazo plantea interrogantes en especial el papel que esta juega frente a los partos prematuros y partos de bajo peso, es indispensable determinar si las temperaturas altas o bajas tienen un comportamiento protector o de riesgo sobre el feto durante la gestación en regiones tropicales. Objetivo: describir la relación entre la exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos del departamento del Guaviare-Colombia. Metodología: Estudio tipo observacional, analítico, retrospectivo de corte transversal que busco determinar la relación entre exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos, el universo estuvo conformado por 10.137 nacidos vivos, de los cuales 9.932 cumplieron los criterios de inclusión. Se determinó Odds Ratio para estimar la asociación entre las variables. Resultados: Dentro de la semana de retraso 3 el estar expuesto a temperaturas máximas percentil 90 es un factor protector para la ganancia ponderal de peso OR < 1, la exposición a temperaturas mínimas percentil 10 se asoció como factor protector para el parto prematuro en la semana de retraso 1 y 2 OR < 1.Conclusión: A pesar del beneficio de las altas y bajas temperaturas durante el embarazo en la ganancia ponderal de peso y disminución del parto prematuro, es recomendable prevenir la exposición a temperaturas extremas durante el periodo de gestación[AU]

Introduction: Various investigations have established the relationship between temperature and duration of pregnancy. Exposure to high temperatures during pregnancy raises questions, especially the role it plays in premature births and low-weight births. It is essential to determine whether high temperatures or low have a protective or risky behavior on the fetus during pregnancy in tropical regions.Objective: to describe the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns in the department of Guaviare-Colombia.Methodology:Observational, analytical, retrospective cross-sectional study that sought to determine the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns. The universe was made up of 10,137 births. alive, of which 9,932 met the inclusion criteria. Odds Ratio was determined to estimate the association between the variables.Results:Within the 3rd week of delay, being exposed to maximum temperatures at the 90th percentile is a protective factor for weight gain OR < 1, exposure to minimum temperatures at the 10th percentile was associated as a protective factor for premature birth in the week. of delay 1 and 2 OR < 1. Conclusion: Despite the benefit of high and low temperatures during pregnancy in weight gain and reduction in premature birth, it is advisable to prevent exposure to extreme temperatures during the gestation period[AU]

Introdução: Várias investigações estabeleceram a relação entre temperatura e duração da gravidez. A exposição a altas temperaturas durante a gravidez levanta questões, especialmente o papel que desempenha nos partos prematuros e nos nascimentos de baixo peso. É essencial determinar se as temperaturas altas ou baixas têm um comportamento protetor ou de risco para o feto durante a gravidez em regiões tropicais. Objetivo:descrever a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos no departamento de Guaviare-Colômbia. Metodologia: Estudo observacional, analítico, retrospectivo e transversal que buscou determinar a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos. O universo foi composto por 10.137 nascimentos. vivos, dos quais 9.932 preencheram os critérios de inclusão. O Odds Ratio foi determinado para estimar a associação entre as variáveis. Resultados:Na 3ª semana de atraso, a exposição a temperaturas máximas no percentil 90 é fator de proteção para ganho de peso OR < 1, a exposição a temperaturas mínimas no percentil 10 foi associada como fator de proteção para parto prematuro na semana. de atraso 1 e 2 OR < 1.Conclusão:Apesar do benefício das altas e baixas temperaturas durante a gravidez no ganho de peso e redução do parto prematuro, é aconselhável evitar a exposição a temperaturas extremas durante o período de gestação[AU]

Drug dosing in obese critically ill patients, a literature review. / Dosificación de fármacos en el paciente obeso crítico, una revisión bibliográfica.

INTRODUCTION: The prevalence of obesity represents a significant global public health challenge, and the available evidence concerning the appropriate dosing of pharmaceutical in patients with obesity is limited. It is uncommon for clinical trials in critically ill patients to include obese individuals, which results in a lack of specific dosing information in product data sheets. The objective of this literature review is to provide clinicians with efficacious and secure guidelines for this cohort of patients. METHODS: A multidisciplinary team comprising pharmacists specialized in hospital pharmacy and physicians with expertise in intensive care medicine was established. The therapeutic groups and, in particular, the most commonly used active ingredients within the Intensive Care Unit were identified and subjected to detailed analysis. The following terms were included in the search: "obese", "overweight", "critical illness", "drug dosification", and "therapeutic dose monitoring". All the information was then evaluated by the working group, which reached a consensus on the dosing recommendations for each drug in obese critically ill patients. RESULTS: A total of 83 drugs belonging to the following therapeutic groups were identified: antivirals, antibacterials, antifungals, immunosuppressants, antiepileptics, vasopressors, anticoagulants, neuromuscular blocking agents and sedatives. A table was produced containing the consensus dosing recommendations for each of the aforementioned drugs following a review of the available evidence. CONCLUSIONS: Drug dosing in obese patients, both in critical and noncritical settings, remains an area with significant uncertainty. This review provides comprehensive and up-to-date information on the dosing of the main therapeutic groups in obese critically ill patients, offering a valuable resource physicians in critical care units and clinical pharmacists in their practice in this setting.

Consensus document for the kangaroo mother care method.

INTRODUCTION: Currently, kangaroo mother care (KMC) is an intervention whose implementation in clinical practice varies widely. The aim of this document is to gather the latest evidence-based recommendations in an attempt to reduce interprofessional variation and increase the quality of neonatal care. METHODS: The document was developed following the guidelines provided in the Methodological Manual for the Development of Clinical Practice Guidelines of the National Health System: formulation and prioritization of clinical questions, literature search, critical reading, development of the document and external review. The target population was preterm (PT) and/or low birth weight (LBW) newborn infants admitted to a neonatal unit. RECOMMENDATIONS: Based on the current evidence, recommendations have been issued to address 18 clinical questions regarding the impact of KMC (morbidity and mortality, physiological stability, neurodevelopment, feeding, pain, families), including infants with vascular access or respiratory support devices. It also describes the KMC procedure (transfer, positioning), the facilitators and barriers related to the implementation of KMC and how to implement KMC in extremely preterm newborns (less than 28 weeks of postmenstrual age in the first days of life). CONCLUSIONS: Kangaroo mother care is a beneficial practice for PT infants, LBW infants and their families. The implementation of these recommendations may be useful in everyday clinical practice and may improve KMC outcomes and the quality of care provided to neonatal patients.

[Pharmacological treatment of obesity. Current situation and new treatments]. / Tratamiento farmacológico de la obesidad. Situación actual y nuevos tratamientos.

The high incidence of obesity in our environment, the progressive and recurrent nature of this disease makes it necessary to know and use all the possibilities of prevention and treatment. When a person suffers from obesity we must offer a treatment plan with specific objectives that will include healthy eating, physical activity and, if necessary, treatment with medication or even surgery. At present in Spain, there are 3 medications available: New molecules will soon be marketed that will expand the treatment possibilities, which will also be reviewed in this article.

Impact on neonatal morbidity of moderate to severe early foetal growth restriction defined by doppler criteria: multicentre study.

INTRODUCTION: In recent years, there has been a change in the conceptualization of foetal growth restriction (FGR), which has gone from being defined solely based on weight criteria to being defined and staged based on Doppler criteria. The aim of our study was to evaluate neonatal risk in a cohort of neonates with moderate to severe early-onset FGR defined by Doppler criteria. POPULATION AND METHODS: We conducted a multicentre prospective cohort study in a cohort of neonates with early-onset foetal growth restriction and abnormal Doppler findings and a control cohort without Doppler abnormalities matched for sex and gestational age. RESULTS: A total of 105 patients (50 cases, 55 controls) were included. We found a higher frequency of respiratory morbidity in the FGR group, with an increased need of surfactant (30% vs. 27.3%; OR, 5.3 [95% CI, 1.1-26.7]), an increased need for supplemental oxygen (66% vs. 49.1%; OR, 5.6 [95% CI, 1.5-20.5]), and a decreased survival without bronchopulmonary dysplasia (70 vs. 87.3%; OR, 0.16 [95% CI, 0.03-0.99]). Patients with FGR required a longer length of stay and more days of parenteral nutrition and had a higher incidence of haematological abnormalities such as neutropenia and thrombopenia. The lactate level at birth was higher in the severe FGR subgroup (6.12 vs. 2.4 mg/dL; P = .02). CONCLUSION: The diagnosis of early-onset moderate to severe FGR defined by Doppler criteria carries a greater risk of respiratory, nutritional and haematological morbidity, independently of weight and gestational age. These patients, therefore, should be considered at increased risk compared to constitutionally small for gestational age preterm infants or preterm infants without FGR.

Prevalence of obesity and related factors in schoolchildren aged 3 to 4 years.

OBJECTIVE: To describe the prevalence of obesity and analyse possible differences in it according to sociodemographic characteristics, diet, physical activity, screen use and family perception of the weight and dietary habits of schoolchildren aged 3 to 4 years in Barcelona. METHODS: We conducted a cross-sectional study in a representative sample of schools selected based on the socioeconomic status (SES) of the corresponding neighbourhood and school ownership. We selected 101 schools in Barcelona and recruited pupils aged 3 to 4 years during the 2016-17 academic year (n = 2936 children). Anthropometric measurements were taken in each participant. Family members completed a questionnaire on eating habits, physical activity, sleeping hours, screen use and the family's perception of the child's weight and diet. The primary variable was the body mass index (BMI) for age and sex, subsequently categorised as normal weight, overweight or obese. RESULTS: Approximately 7.0% of girls and 7.1% of boys aged 3 to 4 years presented obesity. The prevalence of obesity (8.3%) was higher in neighbourhoods of lower SES compared to those of higher SES (5.2%; p = .004). Parents of children with obesity reported that the child had some excess weight or excess weight in 46.9% of cases, 3.9% indicated the child's weight was appropriate and 0.9% that the child was a little underweight or underweight (p < .001). DISCUSSION: The prevalence of obesity in children aged 3 to 4 years is high. There are social and geographical inequalities, and obesity was more prevalent in areas of lower SES. A large percentage of the families of children with obesity do not consider that the child's weight is excessive.

Association between overall quality of macronutrients and incidence of overweight and obesity in the SUN (Seguimiento Universidad de Navarra) cohort.

Introduction: Introduction: no previous large prospective studies have assessed the global quality of macronutrients in association with the risk of overweight/obesity. Objective: to prospectively assess the association of an overall macronutrient quality index (MQI) with weight change and the incidence of overweight/obesity in the Seguimiento Universidad de Navarra (SUN) cohort. Methods: the diet of 9,344 Spanish university graduates free of overweight/obesity (mean age: 36.5 [SD, 11.1]) was assessed through a validated 136-item food frequency questionnaire. The MQI was calculated as the sum of the Carbohydrate Quality Index, the Fat Quality Index, and the Healthy Plate Protein Quality Index. Participants were classified into groups (G) according to MQI. Incident overweight/obesity was defined if follow-up questionnaires indicated BMI was ≥ 25 kg/m2. Multiple linear regression models and Cox proportional hazard models were used to assess the average yearly weight change and the risk of overweight/obesity over follow-up time. Results: 2,465 cases of incident overweight/obesity were identified (median follow-up: 10.7 years). Increasing MQI was significantly associated with lower annual weight gain (g): ß coefficient: -99.0, (95 % CI: -173.6 to -24.5) in the G4 vs G1, p for trend = 0.007. In the fully adjusted model the incidences of overweight/obesity in G4 and G1 were 21.7 % (431 cases) and 29.3 % (954 cases), respectively. The adjusted HR was 0.87 (95 % CI, 0.77-0.98, p for trend = 0.036). When we used repeated analyses updating the MQI after 10 years of follow-up, results remained similar. Conclusions: a significant inverse association between a multidimensional MQI and the risk of overweight/obesity was found in this Mediterranean cohort of adults.

Introducción: Introducción: ningún estudio prospectivo previo de gran tamaño ha evaluado la asociación entre la calidad global de los macronutrientes y el riesgo de sobrepeso/obesidad. Objetivo: evaluar la asociación del índice global de calidad de macronutrientes (MQI) con el cambio de peso y la incidencia de sobrepeso/obesidad en la cohorte Seguimiento Universidad de Navarra (SUN). Métodos: la dieta se evalúo en 9344 graduados universitarios españoles mediante un cuestionario validado de frecuencia de consumo. El MQI se calculó como la suma del índice de calidad de carbohidratos, el índice de calidad de grasas y el índice de calidad de proteínas del plato saludable. Los participantes se clasificaron en cuartiles según el MQI. Se definió la incidencia de sobrepeso/obesidad durante el seguimiento si el IMC era ≥ 25 kg/m2. Se utilizaron modelos de regresión lineal múltiple y de riesgo proporcional de Cox para evaluar el cambio de peso anualizado y el riesgo de sobrepeso/obesidad durante el seguimiento. Resultados: 2465 casos incidentes de sobrepeso/obesidad (mediana de seguimiento: 10,7 años). El aumento del MQI se asoció significativamente con un menor aumento de peso anual (g): coeficiente ß: -99,0 (IC 95 %: -173,6 a -24,5) en Q4 vs. Q1 (p tendencia lineal = 0,007). En el modelo más ajustado, la incidencia de sobrepeso/obesidad en Q4 y Q1 fue del 21,7 % (431 casos) y del 29,3 % (954 casos), respectivamente. El HR ajustado fue 0,87 (IC 95 %, 0,77-0,98, p tendencia lineal = 0,036). Conclusiones: se encontró una asociación inversa significativa entre el MQI multidimensional y el riesgo de sobrepeso/obesidad en esta cohorte mediterránea de adultos.

Evidence on the benefits of probiotics for preterm infants.

Introduction: This article reviews the evidence for the use of different strains of probiotics in the prevention of prevalent pathologies in premature neonates. A systematic review was conducted of the use of probiotics in neonates with less than 37 weeks of gestational age, based on a search for systematic reviews and observational and experimental studies performed during the period from January 2014 to February 2021. For this purpose, the PubMed, MEDLINE and Cochrane Library databases were consulted. The aim of this article was to review the existing data on the relationship between the administration of probiotics (with different strains and doses) and the risk of necrotising enterocolitis, mortality, late sepsis and other disease parameters in premature infants. The literature search obtained 240 articles, of which we selected 16, representing a total sample of over 200,000 premature infants. Analysis of the data obtained reveals statistical evidence that the combined administration of probiotics (especially of Lactobacillus and Bifidobacterium strains) reduces the incidence of grade II or higher necrotising enterocolitis, all-cause mortality, late sepsis, length of hospital stay and time until complete enteral nutrition is achieved. However, no benefits were apparent with respect to alleviating bronchopulmonary dysplasia, retinopathy of prematurity or intraventricular haemorrhage. Further research is needed to determine the most appropriate strains, doses and treatment duration for preterm infants to achieve the health benefits identified.

Introducción: En este artículo se revisa la evidencia del uso de las diferentes cepas de probióticos en la prevención de diversas patologías prevalentes en recién nacidos prematuros. Se ha realizado una revisión sistemática sobre el uso de probióticos en recién nacidos de menos de 37 semanas de edad gestacional, realizando una búsqueda de revisiones sistemáticas, estudios observacionales y experimentales desde enero de 2014 hasta febrero de 2021. Para ello se han utlizado motores de búsqueda como PubMed, MEDLINE y la biblioteca Cochrane. El objetivo de este artículo fue revisar los datos existentes sobre la relación entre la administración de probióticos (con diferentes cepas y dosis) y el riesgo de enterocolitis necrotizante, mortalidad, sepsis tardía, y otros parámetros de enfermedad en prematuros. En la búsqueda se obtuvieron 240 artículos, de los que seleccionamos 16, obteniendo más de 200.000 recién nacidos prematuros como muestra. En esta revisión se muestra con evidencia estadística, que la administración combinada de probióticos (espcialmente cepas de Lactobacillus y Bifidobacterium) reducen la incidencia de NEC en grado II o mayor, mortalidad por todas las causas, sepsis tardía, días de estancia hospitalaria y tiempo en lograr nutrición enteral completa. No se han podido evidenciar beneficios en cuanto a la displasia broncopulmonar, retinopatía de la prematuridad y hemorragia intraventricular. Se precisan nuevos estudios para conocer las cepas, dosis y tiempo de tratamiento más adecuados en neonatos prematuros para lograr beneficios en salud.

Activation and disease control of patients on chronic hemodialysis: An observational study.

BACKGROUND AND OBJECTIVE: Patient activation is a concept that refers to the willingness to manage one's health and medical care. To assess it, a patient activation measure (PAM) has been developed and validated. Several studies report low activation in patients with chronic diseases. However, information on activation in hemodialysis patients is scarce. The aim of the present study is to describe the activation level of patients on chronic treatment in an HD unit and its relationship with disease control parameters. MATERIALS AND METHODS: Cross-sectional observational study in patients with advanced chronic kidney disease on chronic HD treatment. Ninety-six patients were included. Activation was measured with the PAM-13 questionnaire. Its relationship with descriptive variables (age, sex, comorbidity, studies, habitat) and disease control variables (vascular access, blood flow, potassaemia, phosphataemia, interdialytic gain) was studied. For this purpose, Spearman's correlation test, multiple linear regression model and logistic model were used as statistical methods. RESULTS: The mean (SD) PAM-13 score was 63.19 (15.21). Activation was significantly associated with vascular access (P = 0.003), blood flow (P = 0.024), and interdialytic gain of patients (P = 0.008). CONCLUSIONS: Activation in patients on chronic hemodialysis treatment is low. Higher activation is related having an arteriovenous fistula, higher blood flow and lower interdialytic gain. Future studies are needed to confirm and apply our results.

Predicción de la valoración del recién nacido según el estado nutricional materno: modelo basado en árboles de decisión / Prediction of newborn assessment according to maternal nutritional status: a model based on decision trees

Objetivo: Determinar si es posible predecir la valoración del recién nacido según el estado nutricional materno a través de un modelo de árbol de decisión. Métodos: Estudio analítico transversal. Se revisaron 326 historias clínicas de gestantes de un hospital público peruano, 2021. Se valoró el recién nacido mediante el puntaje APGAR, edad gestacional al nacer, peso al nacer, peso y talla para la edad gestacional. El estado nutricional materno incluyó el índice de masa corporal pregestacional y la ganancia de peso gestacional. La predicción se realizó mediante un modelo de aprendizaje automático supervisado denominado "árbol de decisión". Resultados: No fue posible predecir mediante el estado nutricional materno, el puntaje APGAR al minuto y la talla para la edad gestacional. La probabilidad de tener edad gestacional a término al nacer es de 97,2 % cuando la ganancia de peso gestacional es > 5,4 Kg (p = 0,007). Las probabilidades más altas de peso adecuado al nacer fueron con ganancia de peso gestacional entre 4,5 Kg (p < 0,001) y 17 Kg (p < 0,001) y con índice de masa corporal pregestacional ≤ 36,523 Kg/m2 (p = 0,004). Finalmente, la mayor probabilidad de peso adecuado para la edad gestacional es cuando la ganancia de peso gestacional es ≤ 11,8 Kg (p < 0,001) y con un índice de masa corporal pregestacional ≤ 36,523 Kg/m2 (p = 0,005). Conclusiones: Es posible predecir la valoración del recién nacido a partir del estado nutricional materno mediante un aprendizaje automático(AU)

Objective: To determine whether it is possible to predict the assessment of the newborn according to maternal nutritional status through a decision tree model. Methods: Cross-sectional analytical study. A total of 326 medical records of pregnant women from a Peruvian public hospital were reviewed, in 2021. The newborn was assessed using the APGAR score, gestational age at birth, birth weight, weight and height for gestational age. Maternal nutritional status included pregestational body mass index and gestational weight gain. The prediction was made using a supervised machine learning model called a "decision tree." Results: The APGAR score at one minute and height for gestational age were not possible to predict by maternal nutritional status. The probability of having full-term gestational age at birth is 97.2% when gestational weight gain is > 5.4 kg (p = 0.007). The highest probabilities of adequate birth weight were with gestational weight gain between 4.5 kg (p < 0.001) and 17 kg (p < 0.001) and with pregestational body mass index ≤ 36.523 kg/m2 (p = 0.004). Finally, the highest probability of adequate weight for gestational age is when gestational weight gain is < 11.8 Kg (p < 0.001) and with a pregestational body mass index ≤ 36.523 Kg/m2 (p = 0.005). Conclusions: It is possible to predict the assessment of the newborn based on the mother's nutritional status using machine learning(AU)

A decade of analysis describe of maternal and neonatal characteristics of live births in southern Brazil / Una década de descripción de las características maternas y neonatales de los nacidos vivos en el sur de Brasil

Introduction: Child health is conditioned by the circumstances of pregnancy, childbirth, and early life. Objective: To describe the maternal and neonatal characteristics of live births (LBs) in the Information System on Live Births of Santa Catarina (SC), Brazil. Materials and methods: A cross-sectional study describedthe maternal and neonatal characteristics of 940,059 LBs, from 2010 to 2019. Pearson's chi-square test and Fisher's exact test were conducted, with a statistical significance level of p < 0.05. Results: The mean values of maternal age, number of live children, and number of fetal deaths as well as abortions were 27.1 years, 0.9, and 0.2, respectively. The averages of the number of gestation weeks, number of prenatal consultations, the start date of the prenatal care, and birth weight were 38.5 weeks, 8.1 months, 2.5 monthsand 3,217.1 grams, respectively. Low birth weight (LBW) was prevalent among mothers without education (p < 0.001), including those without prenatal visits (p < 0.001). A higher prevalence of being underweight was observed among female neonates (p < 0.001) and with a maternal age of ≥ 40 years (10.8%; p < 0.001) compared to newborns with good vitality. Newborns with good vitality had a low prevalence of underweight (p < 0.001). The frequency of the variables studied increased, comparing the beginning and end of the period and whether the differences are statistically significant. Conclusions: The study draws attention to the need for interventions to improve the indicators that determine LBW(AU)

Introducción: La salud infantil está condicionada por las circunstancias del embarazo, parto y primeras etapas de la vida. Objetivo: Describir las características maternas y neonatales de los nacidos vivos en el Sistema de Información de Nacidos Vivos de Santa Catarina, Brasil. Materiales y métodos: Estudio transversal describiendo las características maternas y neonatales de 940.059 nacidos vivos entre 2010 y 2019. Se realizó la prueba de chi cuadrado de Pearson y exacta de Fisher y se estableció p < 0,05. Resultados: Los valores medios para la edad materna, el número de nacidos vivos y el número de mortinatos y abortos espontáneos fueron 27,1, 0,9 y 0,2, respectivamente. Las medias del número de semanas de gestación, el número de visitas prenatales, la fecha de inicio de la atención prenatal y el peso al nacer fueron 38,5 semanas (DE 2,2), 8,1 meses, 2,5 meses y 3 217,1 gramos, respectivamente. El bajo peso al nacer (BPN) fue prevalente entre las madres sin estudios (p < 0,001), incluidas las que no acudieron a una cita prenatal (p < 0,001). Hubo una mayor prevalencia de BPN en neonatos de sexo femenino (p < 0,001) con madres de edad ≥ 40 años (10,8%; p < 0,001). Los neonatos con buena vitalidad tuvieron una baja prevalencia de BPN (p < 0,001). La frecuencia de las variables estudiadas aumentó al comparar el inicio y el final del período y si las diferencias son estadísticamente significativas. Conclusiones: El estudio llama la atención sobre la necesidad de intervenciones para mejorar los indicadores que determinan el BPN(AU)

[Cardiometabolic effects of weight loss]. / Efectos cardiometabólicos de la pérdida de peso.

The prevalence of overweight and obesity, and, consequently, associated comorbidities, is increasing significantly worldwide. The guidelines recommend a percentage of weight loss> 5% to achieve beneficial effects on metabolic comorbidities associated with obesity. Furthermore, greater weight losses (> 10%) produce more significant improvements, and may even produce remission of some of these comorbidities. In this chapter, we review the evidence of the effect of weight loss through different strategies (lifestyle intervention, pharmacological treatment, or bariatric surgery) on the main cardiometabolic pathologies associated with excess adipose tissue (type 2 diabetes, high blood pressure, dyslipidemia, metabolic dysfunction-associated steatotic liver disease, inflammation, cardiovascular diseases, and mortality).

Changes on food intake, body weight and salivary amylase synthesis in the submandibular gland of wistar rats treated with bevacizumab and cytostatics / Cambios en la ingesta de alimentos, peso corporal y síntesis de amilasa salival en la glándula submandibular de ratas wistar tratadas con bevacizumab y citostáticos

Background: Bevacizumab together with 5-fluorouracil and oxaliplatin inhibit microvascular growth of tumor blood vessels and tumor proliferation. Few reports state the effect of these therapeutic schemes on salivary glands. Materials and Methods: Food consumption, body weight and salivary amylase activity were assessed in the submandibular gland of rats. Adult male Wistar rats, of three months old with 350/400 grams body weight, under 12-hour light/dark cycles respectively, were divided into the following experimental groups: G1) Control group, G2) 5-Fluorouracil and leucovorin calcium treated group, G3) Bevacizumab treated group, G4) Oxaliplatin treated group, G5) Bevacizumab, oxaliplatin, 5-fluorouracil and leucovorin calcium treated group and G6) Drug-free paired feeding treated group. Assessment of treatment effect was performed by one-way ANOVA. A value of p<0.05 was set for statistical significance. Results: Salivary amylase activity in gland homogenate was G1: 137.9 ± 4.64, G2: 60.95±4.64, G3: 120.93 ± 4.96, G4: 26.17 ±4.64, G5: 10.77 ±4.64 and G6: 82.87 ±4.64 U/mg protein (mean ± S.D.) Amylase activity in the G1 group was higher relative to the other experimental groups p<0.0001. Conclusions: The drugs 5-fluorouracil and oxaliplatin altered salivary amylase activity by serous granules of the submandibular gland interpreted as a mechanism of impaired acinar function. Bevacizumab administered in isolation did not alter salivary amylase activity compared to the control group. While the lower intake of the matched feeding group affected salivary amylase activity compared to the control group, the effect was significantly greater in animals treated with the oncology drugs used in the present animal model.

Antecedentes: Bevacizumab, junto con 5-fluorouracilo y oxaliplatino, inhiben el crecimiento microvascular de los vasos sanguíneos tumorales y la proliferación tumoral. Pocos reportes establecen el efecto de estos esquemas terapéuticos sobre las glándulas salivales. Materiales y Métodos: Se evaluaron el consumo de alimentos, el peso corporal y la actividad de amilasa salival en la glándula submandibular de ratas Wistar macho adultas, de tres meses de edad con 350/400 gramos de peso corporal, bajo ciclos de luz/oscuridad de 12 horas respectivamente, se dividieron en los siguientes grupos experimentales: G1) Grupo control, G2) Grupo tratado con 5-Fluorouracilo y Leucovorina cálcica. , G3) Grupo tratado con bevacizumab, G4) Grupo tratado con oxaliplatino, G5) Grupo tratado con bevacizumab, oxaliplatino, 5-fluorouracilo y leucovorina cálcica y G6) Grupo tratado con alimentación emparejada sin fármacos. La evaluación del efecto del tratamiento se realizó mediante ANOVA unidireccional. Se estableció un valor de p<0,05 para significación estadística. Resultado: La actividad de amilasa salival en homogeneizado de glándula fue G1: 137,9 ± 4,64, G2: 60,95 ± 4,64, G3: 120,93 ± 4,96, G4: 26,17 ± 4,64, G5: 10,77 ± 4,64 y G6: 82,87 ± 4,64 U/mg de proteína (media ± S.E.). La actividad de amilasa en el grupo G1 fue mayor en relación con los otros grupos experimentales p<0,0001. Conclusión: Los fármacos 5-fluorouracilo y oxaliplatino alteraron la actividad de la amilasa salival mediante gránulos serosos de la glándula submandibular interpretados como un mecanismo de deterioro de la función acinar. Bevacizumab administrado de forma aislada no alteró la actividad de la amilasa salival en comparación con el grupo de control. Mientras que la menor ingesta del grupo de alimentación combinada afectó la actividad de la amilasa salival en comparación con el grupo de control, el efecto fue significativamente mayor en los animales tratados con los medicamentos oncológicos utilizados en el grupo. modelo animal actual.

Social inequalities, advanced maternal age, and birth weight. Evidence from a population-based study in Spain.

OBJECTIVE: To examine whether advanced maternal age (≥40 years) is linked to an increased likelihood of low or high birth weight among native and foreign-born mothers giving birth in Spain. METHOD: A cross-sectional study was conducted using a novel database provided by the Spanish National Statistics Office which links the 2011 Census with information on individual births (2011-2015) from the Vital Statistics (Natural Movement of the Population). First, multinomial logistic regression models were used to estimate the potential association between maternal age and the likelihood of having a baby with low or high birth weight. Second, average adjusted predictions of giving birth to children with low, high, and adequate weight for the origin and the maternal age at birth were also calculated. RESULTS: Findings indicate that women with advanced maternal age showed an increased probability of giving birth to low birth weight infants. Conversely, mothers aged below <30 years had an elevated risk for high birth weight infants. When considering maternal migratory status, the findings were mixed. On one hand, foreign-born mothers showed a higher likelihood of delivering infants with high birth weight; on the other, they displayed a lower risk of low birth weight among newborns in comparison to Spanish natives. CONCLUSIONS: The study addresses two key aspects. First, it highlights the increased risk of low birth weight in mothers delivering at an advanced age. Second, it emphasizes the importance of accounting for maternal migratory status when investigating the association between age at birth and birth weight outcomes among immigrant mothers.

Interevaluator reliability of a tool for measuring body height in adult intensive care patients.

BACKGROUND: The calculation of body height in the intensive care unit is essential for obtaining the ideal body weight, which is used to program the tidal volume and establish objective and effective pulmonary ventilation. The objective of the study was to determine the interrater reliability of a tool for measuring body height in adult patients in an intensive care unit (ICU) in southwestern Colombia. METHODS: This cross-sectional observational study was conducted between January and May 2021, following the recommendations of the COSMIN protocol. Two physiotherapists in the roles of observer/evaluator measured the heights of 106 patients upon admission to the ICU with a previously designed. The sample size was calculated based on Pearson's correlation coefficient. For interrater reliability, the intraclass correlation coefficient (ICC) was used, and Bland-Altman analysis was used to assess concordance. The 95% confidence interval was established, and a P value <0.05 indicated statistical significance. RESULTS: A total of 106 individuals with a mean age of 59.3 years were included; the mean body height was 158.5 cm for women. The interrater reliability of the measurement of height was excellent (global ICC of 0.99, P = 0.000), and an almost perfect positive correlation was obtained between the raters for both women and men (R = 0.99). CONCLUSIONS: Excellent interrater/interobserver reliability was obtained for the measurement of body height in the ICU. This research highlights the importance of protocolizing the measurement of height in critical patients with valid and reliable instruments.

Resultados cardiometabólicos de largo plazo tras cirugía bariátrica: control de comorbilidades, pérdida y reganancia de peso a los 5 años de seguimiento / Long-term cardiometabolic results after bariatric surgery: Control of comorbidities, weight loss and regain at 5 years of follow-up

Introducción. La cirugía bariátrica y metabólica (CBM) es efectiva en lograr pérdida de peso a corto plazo. Sin embargo, existe evidencia limitada en desenlaces clínicos y metabólicos a largo plazo. Métodos. Estudio longitudinal retrospectivo con pacientes llevados a baipás gástrico en Y de Roux (BGYR) o gastrectomía en manga (MG) por laparoscopia en Bogotá, D.C., Colombia, entre 2013 y 2021. El cambio de peso, control de comorbilidades y resultados metabólicos se recopilaron al inicio del estudio, 3, 6 y 12 meses después de cirugía, y anualmente hasta el quinto año. Las tasas de control de comorbilidades se evaluaron mediante la prueba Kaplan-Meier. Se utilizó un modelo de riesgos proporcionales de Cox para evaluar el efecto de covariables en la reganancia de peso. Resultados. De 1092 pacientes con CBM (71,4 % MG y 28,6 % BGYR), 67 % eran mujeres, con mediana de edad 48 años e índice de masa corporal de 35,5 Kg/m2. Después de cinco años de seguimiento, la tasa de control en diabetes mellitus fue 65,5 %, en hipertensión 56,6 % y en dislipidemia 43,6 %. La tasa de reganancia de peso fue 28 %, sin diferencias entre MG vs BGYR (p=0,482). El tiempo promedio hasta peso nadir fue 14 meses. La edad al momento de CBM fue el mejor predictor independiente de reganancia (HR=1,02, IC95% 1,01-1,04), pero con efecto clínico modesto. Conclusión. La CBM es segura y muestra beneficios a largo plazo en la pérdida de peso y control de comorbilidades en población colombiana.

Introduction. Bariatric and metabolic surgery (BMS) has shown its efficacy in achieving short-term weight loss. However, there is limited evidence regarding long-term clinical and metabolic outcomes. Methods. Retrospective longitudinal study with patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) interventions in Bogotá, Colombia, between 2013 and 2021. Weight change, comorbidity control, and metabolic outcomes were collected at the onset, 3-, 6-, and 12-month post-surgery, and annually up to the fifth year. Comorbidity control rates were assessed using the Kaplan-Meier test. A Cox proportional hazards model was used to evaluate the effect of covariates on weight regain. Results. Of 1092 patients with BMS (71.4% SG and 28.6% RYGB), 67% were women, with a median age of 48 years, BMI 35.5 kg/m2. After five years of follow-up, the control rate in diabetes mellitus was 65.5%, in hypertension 56.6%, and dyslipidemia 43.6%. The weight regain rate was 28% with no differences between SG vs RYGB (p=0.482). The mean time to nadir weight was 14 months. Age at the time of BMS was the best independent predictor of weight regain (HR=1.02, 95%CI: 1.01-1.04), but with a modest clinical effect. Conclusion. BMS is safe and shows long-term benefits in weight loss and control of comorbidities in Colombian population.

La mujer cubana en el levantamiento de pesas: una perspectiva metodológica

Uno de los deportes que más versatilidad representa es el levantamiento de pesas, pues su práctica no solo se reduce al deporte competitivo, sino es una actividad física que desarrolla la capacidad de fuerza, en el resto de los deportes. Esto constituye una realidad que se concreta en el rendimiento deportivo, sin embargo, las féminas que lo practican no cuentan con un tratamiento ajustado a su género, por lo que el objetivo de este trabajo consistió en determinar qué nivel de conocimientos poseen los entrenadores de levantamiento de pesas en Santiago de Cuba, para distribuir las cargas en el equipo femenino de este deporte. Para lograr este propósito, se implementaron métodos del nivel empírico como la observación científica aplicada a las +sesiones de entrenamiento y la encuesta a los entrenadores que atienden a estas atletas. Como resultado del diagnóstico, se declaró que existe un significativo desconocimiento sobre cómo distribuir las cargas en estas pesistas y se carece de una metodología para incrementar este conocimiento y mejorar los resultados competitivos del género femenino, en esta categoría.

Um dos esportes mais versáteis é o levantamento de peso, pois sua prática não se limita apenas ao esporte competitivo, mas é uma atividade física que desenvolve a capacidade de força em outros esportes. Essa é uma realidade que se reflete no desempenho esportivo, no entanto, as mulheres que o praticam não têm um tratamento ajustado ao seu gênero, por isso o objetivo deste estudo foi determinar qual o nível de conhecimento que os treinadores de halterofilismo em Santiago de Cuba têm para distribuir as cargas na equipe feminina desse esporte. Para atingir esse objetivo, foram utilizados métodos empíricos, como a observação científica aplicada às sessões de treinamento e uma pesquisa com os técnicos que treinam essas atletas. Como resultado do diagnóstico, constatou-se que há uma significativa falta de conhecimento sobre como distribuir as cargas nessas levantadoras de peso e que falta uma metodologia para aumentar esse conhecimento e melhorar os resultados competitivos do gênero feminino nessa categoria.

One of the sports that represents the most versatility is weightlifting, since its practice is not only reduced to competitive sports, but is a physical activity that develops strength capacity in the rest of the sports. This constitutes a reality that is reflected in sports performance, however, the women who practice it do not have treatment adjusted to their gender, so the objective of this work was to determine what level of knowledge lifting coaches have of weights in Santiago de Cuba, to distribute the loads in the women's team of this sport. To achieve this purpose, empirical level methods were implemented such as scientific observation applied to training sessions and surveys of coaches who care for these athletes. As a result of the diagnosis, it was declared that there is a significant lack of knowledge about how to distribute the loads in these weightlifters and there is a lack of a methodology to increase this knowledge and improve the competitive results of the female gender, in this category.

Peso al nacer en el noroeste argentino. Comparación con una referencia nacional y un estándar internacional / Birth weight in the Northwest region of Argentina. Comparison with a national reference and an international standard

Introducción. El tamaño al nacer se encuentra sujeto a influencias genéticas y ambientales; la altura geográfica es muy influyente. El peso al nacer (PN) es el indicador más utilizado para evaluarlo; existen diferentes estándares y referencias. Debido a la variabilidad de la distribución del PN en relación con la altura en la provincia de Jujuy (Argentina), este trabajo analiza la distribución percentilar del PN para tierras altas (TA) y tierras bajas (TB) jujeñas según edad gestacional (EG) y sexo, y su comparación con una referencia nacional y el estándar internacional INTERGROWTH-21st (IG-21). Población y métodos. Se analizaron los registros de 78 524 nacidos vivos en Jujuy en el período 20092014. Utilizando el método LMS, se estimaron los percentiles 3, 10, 50, 90 y 97 de PN/EG por sexo, para TA (≥2000 msnm), TB (<2000 msnm) y el total provincial, y se compararon gráficamente con la referencia poblacional argentina de Urquía y el estándar IG-21. La significación estadística se determinó mediante la prueba de Wilcoxon. Resultados. El PN en Jujuy presentó distribución heterogénea, con diferencias estadísticamente significativas (p <0,05) entre TB y TA. Al comparar con la referencia nacional y el estándar IG-21, se observaron diferencias por altitud, principalmente en los percentiles 90 y 97 para ambas regiones, y en los percentiles 3 y 10 en TA comparados con el estándar. Conclusiones. Se observó variabilidad de la distribución del PN asociada a la altura geográfica, por lo que, para evaluar el crecimiento intrauterino, resulta fundamental incluir la EG y el contexto donde transcurre la gestación.

Introduction. Size at birth is subject to genetic and environmental influences; altitude is highly influential. Birth weight (BW) is the most widely used indicator to assess size at birth; different standards and references are available. Due to the variability in BW distribution in relation to altitude in the province of Jujuy (Argentina), the purpose of this study is to analyze the percentile distribution of BW in the highlands (HL) and the lowlands (LL) of Jujuy based on gestational age (GA) and sex and compare it with a national reference and the INTERGROWTH-21 st (IG-21) international standard. Population and methods. The records of 78 524 live births in Jujuy in the 2009­2014 period were analyzed. Using the LMS method, the 3 rd, 10 th, 50 th, 90 th, and 97 th percentiles of BW/GA by sex were estimated for the HL (≥ 2000 MASL), the LL (< 2000 MASL), and the total for Jujuy, and compared with the Argentine population reference by Urquía and the IG-21 standard using growth charts. The statistical significance was established using the Wilcoxon test. Results. BW in Jujuy showed a heterogeneous distribution, with statistically significant differences (p < 0.05) between the LL and the HL. When compared with the national reference and the IG-21 standard, differences in terms of altitude were observed, mainly in the 90 th and 97 th percentiles for both regions and the 3 rd and 10 th percentiles in the HL compared with the international standard. Conclusions. BW distribution varied in association with altitude; therefore, to assess intrauterine growth, it is critical to include GA and the environment in which the pregnancy takes place.

Effects of school-based interventions on blood pressure in obese children: metanalysis / Efeitos de intervenções de base escolar na pressão arterial de crianças com obesidade: metanálise

Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA), a systematic review with metanalysis was conducted to identify and summarize the effects of school-based physical activity interventions that sought to control and / or reduce blood pressure (systolic and diastolic) in children and / or adolescents with overweight and / or obesity. In September 2022, potential studies were searched in five electronic databases (Pubmed, Scielo, Scopus, Sportdiscus, and Web of Science) and in reference lists. Randomized controlled trials conducted in schools with interventions involving physical activity and assessment of systolic and diastolic blood pressure in children and adolescents aged 6 to 19 years with overweight and / or obesity were con-sidered for synthesis. The risk of bias was assessed using an adapted version of the Effective Public Health Practice Project tool (EPHPP). Metanalysis was developed from the random model. Four studies were included. For systolic blood pressure, a summary effect of -0.10 (95% CI: -0.39; 0.19; I2 = 0%) was observed. For diastolic pressure, the metanalysis indicated -0.33 (95% CI: -0.62; -0.04; I2 = 11%). Considering the promising effects on diastolic blood pressure, we suggest the develop-ment of more school-based interventions based on physical activity practice for overweight and / or obese populations, which may also add environmental elements, longer duration, multicomponent approaches, and parent / guardian involvement to their strategies.

Com base na declaração Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), foi realizada uma revisão sistemática com metanálise para identificar e sumarizar os efeitos de intervenções escolar baseadas na atividade física que buscaram o controle e / ou redução da pressão arterial (sistólica e diastólica) em crianças e / ou adolescentes com excesso de peso e / ou obesidade. Em setembro de 2022, estudos potenciais foram pesquisados em cinco bases de dados eletrônicas (Pubmed, Scielo, Scopus, Sportdiscus, e Web of Science) e em listas de referências. Foram considerados para a síntese ensaios controlados randomizados realizados em escolas, com intervenções que envolviam a atividade física e avaliação da pressão arterial sistólica e diastólica em crianças e adolescentes dos 6 aos 19 anos com excesso de peso e/ ou obesidade. O risco de viés foi avaliado utilizando uma versão adaptada do instrumento Effective Public Health Practice Project (EPHPP). A metanálise foi elaborada a partir do modelo randômico. Foram incluídos quatro estudos. Para a pressão arterial sistólica, observou-se um efeito sumarizado de -0,10 (IC 95%: -0,39; 0,19; I2 = 0%). Para a pressão diastólica, a metanálise indicou -0,33 (IC 95%: -0,62; -0,04; I2 = 11%). Considerando os efeitos promissores na pressão arterial diastólica, sugerimos o desenvolvimento de mais intervenções escola-res fundamentadas na prática de atividade física às populações com sobrepeso e / ou obesidade, que possam agregar também, em suas estratégias, elementos ambientais, maior duração, abordagens multicomponentes e envolvimento dos pais / responsáveis.

Hemorragia intraventricular y factores asociados en recién nacidos pretérmino: Cohorte retrospectiva / Intraventricular hemorrhage and factors associated in preterm newborns

RESUMEN Objetivo: Estimar la frecuencia de la hemorragia intraventricular y los factores asociados en neonatos pretérmino hospitalizados en una unidad de cuidado intensivo neonatal de alta complejidad. Metodología: Estudio de cohorte, en el que se incluyeron neonatos menores de 37 semanas de gestación, atendidos en una institución de alta complejidad, entre enero de 2015 hasta diciembre de 2018; se valoró el desarrollo de hemorragia intraventricular diagnosticada por métodos de imagen. Los datos se obtuvieron a partir de la revisión de las historias clínicas electrónicas y se analizaron variables sociodemográficas y clínicas. Resultados: Se incluyeron 296 pacientes, 128 (43,2%) eran mujeres; 23 pacientes (7,8%) desarrollaron hemorragia intraventricular, la cual predominó en el sexo femenino (11,7%). La mediana de edad gestacional fue de 34 semanas. Los factores asociados al desarrollo de hemorragia intraventricular fueron el peso al nacer por debajo de 1500 gr, las infecciones (p<0,0001), los cuadros de apneas (<0,0001), la hiperglicemia (p = 0,025) y la necesidad de surfactante (p= 0,019); por su parte, los esteroides prenatales se comportaron como un factor protector (p=0,002). Los pacientes con hemorragia intraventricular tuvieron mayor necesidad de ventilación mecánica, mayor uso de inotrópicos o vasopresores, más transfusiones y mayor estancia hospitalaria. Conclusiones: A pesar de que la hemorragia intraventricular resultó ser una patología poco frecuente en la población de neonatos analizada, existen factores de riesgo que se relacionan con su desarrollo, como la edad gestacional, el bajo peso al nacer, las infecciones, las apneas y la hiperglicemia.

ABSTRACT Objective: Estimate the frequency of intraventricular hemorrhage and associated factors in hospitalized preterm infants in a highly complex neonatal intensive care unit. Methodology: Cohort study, which included neonates younger than 37 weeks gestation, attended in a highly complex institution, between January 2015 and December 2018; The development of intraventricular hemorrhage diagnosed by imaging methods was assessed. The data was obtained from the review of the electronic medical records and sociodemographic and clinical variables were analyzed. Results: 296 patients were included, 128 (43.2%) were women; 23 patients (7.8%) developed intraventricular hemorrhage, which predominated in the female sex (11.7%). The median gestational age was 34 weeks. The factors associated with the development of intraventricular hemorrhage were birth weight below 1500 gr, infections (p <0.0001), apnea symptoms (<0.0001), hyperglycemia (p = 0.025) and surfactant requirement (p = 0.019); meanwhile, prenatal steroids behaved as a protective factor (p = 0.002). Patients with intra-ventricular hemorrhage had a greater need for mechanical ventilation, use of inotropics or vasopressors, more transfusions, and a longer hospital stay. Conclusions: Despite the fact that intraventricular hemorrhage turned out to be a rare pathology in the analyzed neonatal population, there are risk factors related to its development, such as gestational age, low birth weight, infections, apneas, and hyperglycemia.