Comparison of the SLE Risk Probability Index (SLERPI) scale against the European League Against Rheumatism/American College of Rheumatology (ACR/EULAR) and Systemic Lupus International Collaborating Clinics (SLICC) criteria.

INTRODUCTION: Timely diagnosis and proper recognition of Systemic Lupus Erythematosus (SLE) is essential to establish early management in inpatients and outpatients. There are different classification scales to identify SLE, which include various clinical and serological aspects. In 2021, the SLE Risk Probability Index (SLERPI) was published, which focuses predominantly on the clinical characteristics of patients with suspected SLE and uses a simple algorithm for early recognition of the disease. The aim of this study is to compare the European League Against Rheumatism/American College of Rheumatology (ACR/EULAR) classification criteria, the Systemic Lupus International Collaborating Clinics (SLICC) criteria, and the SLERPI criteria in a cohort of Colombian patients with SLE and to analyze the correlations observed between their absolute scores. METHODS: A registry of SLE patients from two referral hospitals in Bogotá, Colombia, was used. 2021 SLERPI, 2019 ACR/EULAR, and 2012 SLICC scores were calculated for each patient and the correlations found between the scales were analyzed. The sensitivities of each were compared, and frequency analyses were conducted among different clinical and laboratory variables. RESULTS: Between 2016 and 2019, 146 patients diagnosed with SLE were registered, including inpatients and outpatients. The median age was 36 years (interquartile range 26-51), and 82.2% were women. According to the SLERPI criteria, a high prevalence of antinuclear antibodies (92%), immunological disorders (71%), and arthritis (64%) were observed. The most used treatments were corticosteroids (87.6%) and chloroquine (67.8%). A Spearman evaluation analysis was performed, with a moderately strong correlation of 0.76 (p = .000) between the SLERPI and ACR/EULAR scales and very strong correlation of 0.80 (p = .000) between the SLERPI and SLICC. Patients classified with SLE according to the SLERPI scale exhibited a higher incidence of hematological compromise, along with elevated levels of serological markers such as anti-DNA antibodies. Additionally, this group more commonly received treatments involving corticosteroids and azathioprine, and displayed a higher prevalence of hypertension. CONCLUSION: The SLERPI scale could be useful in the diagnosis of SLE, especially in early stages, given its good correlation with other classification scales and its good sensitivity.

Dopamine D4 receptor subtype activation reduces the rat cardiac parasympathetic discharge.

The dopaminergic system influences the heart rhythm by inhibiting the rat cardiac sympathetic and parasympathetic neurotransmissions through activation of D2-like receptors (encompassing the D2, D3, and D4 subtypes). Whereas D2 receptor subtype activation results in cardiac sympatho-inhibition, the dopamine receptor subtypes involved in rat cardiac vago-inhibition remain unknown. Hence, this study investigated the specific functional role of the D2-like receptor subtypes (D2, D3, and/or D4) inhibiting the rat heart cholinergic drive. For this purpose, male Wistar rats were pithed and prepared for cardiac vagal stimulation. Bradycardic responses were obtained by electrical stimulation of vagal fibres (3, 6, 9 Hz; n = 100) or i.v. acetylcholine (ACh; 1, 5, 10 µg/kg; n = 15). Expression of D2, D3, and D4 receptors was studied in left and right atrium samples by PCR (n = 4). Intravenous injections of quinpirole (D2-like agonist; 1-30 µg/kg), but not of SFK-38393 (D1-like agonist; 1-30 µg/kg), dose-dependently inhibited the vagally induced bradycardia. The vago-inhibition induced by quinpirole (which failed to affect the bradycardia to i.v. ACh) was unchanged after i.v. injections of the antagonists L-741,626 (D2; 100 µg/kg) or SB-277011-A (D3; 100 µg/kg), but it was abolished by L-745,870 (D4; 100 µg/kg). mRNA levels of D2, D3, and D4 receptor subtype were detected in the left and right rat atria. Our results suggest that the quinpirole-induced vagolytic effect involves prejunctional D4 receptor subtypes, located in the left and right atria. This provides new evidence on the relevance of D4 receptor modulating the heart parasympathetic control.

Continuous endoglin (CD105) overexpression disrupts angiogenesis and facilitates tumor cell metastasis.

Endoglin (CD105) is an auxiliary receptor for members of the TFG-ß superfamily. Whereas it has been demonstrated that the deficiency of endoglin leads to minor and defective angiogenesis, little is known about the effect of its increased expression, characteristic of several types of cancer. Angiogenesis is essential for tumor growth, so high levels of proangiogenic molecules, such as endoglin, are supposed to be related to greater tumor growth leading to a poor cancer prognosis. However, we demonstrate here that endoglin overexpression do not stimulate sprouting or vascularization in several in vitro and in vivo models. Instead, steady endoglin overexpression keep endothelial cells in an active phenotype that results in an impairment of the correct stabilization of the endothelium and the recruitment of mural cells. In a context of continuous enhanced angiogenesis, such as in tumors, endoglin overexpression gives rise to altered vessels with an incomplete mural coverage that permit the extravasation of blood. Moreover, these alterations allow the intravasation of tumor cells, the subsequent development of metastases and, thus, a worse cancer prognosis.

The role of endoglin in post-ischemic revascularization.

Following arterial occlusion, blood vessels respond by forming a new network of functional capillaries (angiogenesis), by reorganizing preexisting capillaries through the recruitment of smooth muscle cells to generate new arteries (arteriogenesis) and by growing and remodeling preexisting collateral arterioles into physiologically relevant arteries (collateral development). All these processes result in the recovery of organ perfusion. The importance of endoglin in post-occlusion reperfusion is sustained by several observations: (1) endoglin expression is increased in vessels showing active angiogenesis/remodeling; (2) genetic endoglin haploinsufficiency in humans causes deficient angiogenesis; and (3) the reduction of endoglin expression by gene disruption or the administration of endoglin-neutralizing antibodies reduces angiogenesis and revascularization. However, the precise role of endoglin in the several processes associated with revascularization has not been completely elucidated and, in some cases, the function ascribed to endoglin by different authors is controversial. The purpose of this review is to organize in a critical way the information available for the role of endoglin in several phenomena (angiogenesis, arteriogenesis and collateral development) associated with post-ischemic revascularization.

EGFR amplification and EGFRvIII predict and participate in TAT-Cx43266-283 antitumor response in preclinical glioblastoma models.

BACKGROUND: Glioblastoma (GBM) commonly displays epidermal growth factor receptor (EGFR) alterations (mainly amplification and EGFRvIII) and TAT-Cx43266-283 is a Src-inhibitory peptide with antitumor properties in preclinical GBM models. Given the link between EGFR and Src, the aim of this study was to explore the role of EGFR in the antitumor effects of TAT-Cx43266-283. METHODS: The effect of TAT-Cx43266-283, temozolomide (TMZ), and erlotinib (EGFR inhibitor) was studied in patient-derived GBM stem cells (GSCs) and murine neural stem cells (NSCs) with and without EGFR alterations, in vitro and in vivo. EGFR alterations were analyzed by western blot and fluorescence in situ hybridization in these cells, and compared with Src activity and survival in GBM samples from The Cancer Genome Atlas. RESULTS: The effect of TAT-Cx43266-283 correlated with EGFR alterations in a set of patient-derived GSCs and was stronger than that exerted by TMZ and erlotinib. In fact, TAT-Cx43266-283 only affected NSCs with EGFR alterations, but not healthy NSCs. EGFR alterations correlated with Src activity and poor survival in GBM patients. Finally, tumors generated from NSCs with EGFR alterations showed a decrease in growth, invasiveness, and vascularization after treatment with TAT-Cx43266-283, which enhanced the survival of immunocompetent mice. CONCLUSIONS: Clinically relevant EGFR alterations are predictors of TAT-Cx43266-283 response and part of its mechanism of action, even in TMZ- and erlotinib-resistant GSCs. TAT-Cx43266-283 targets NSCs with GBM-driver mutations, including EGFR alterations, in an immunocompetent GBM model in vivo, suggesting a promising effect on GBM recurrence. Together, this study represents an important step toward the clinical application of TAT-Cx43266-283.

Functional Alterations Involved in Increased Bleeding in Hereditary Hemorrhagic Telangiectasia Mouse Models.

Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal-dominant genetic disorder involving defects in two predominant genes known as endoglin (ENG; HHT-1) and activin receptor-like kinase 1 (ACVRL1/ALK1; HHT-2). It is characterized by mucocutaneous telangiectases that, due to their fragility, frequently break causing recurrent epistaxis and gastrointestinal bleeding. Because of the severity of hemorrhages, the study of the hemostasis involved in these vascular ruptures is critical to find therapies for this disease. Our results demonstrate that HHT patients with high bleeding, as determined by a high Epistaxis Severity Score (ESS), do not have prolonged clotting times or alterations in clotting factors. Considering that coagulation is only one of the processes involved in hemostasis, the main objective of this study was to investigate the overall mechanisms of hemostasis in HHT-1 (Eng +/-) and HHT-2 (Alk1 +/-) mouse models, which do not show HHT vascular phenotypes in the meaning of spontaneous bleeding. In Eng +/- mice, the results of in vivo and in vitro assays suggest deficient platelet-endothelium interactions that impair a robust and stable thrombus formation. Consequently, the thrombus could be torn off and dragged by the mechanical force exerted by the bloodstream, leading to the reappearance of hemorrhages. In Alk1 +/- mice, an overactivation of the fibrinolysis system was observed. These results support the idea that endoglin and Alk1 haploinsufficiency leads to a common phenotype of impaired hemostasis, but through different mechanisms. This contribution opens new therapeutic approaches to HHT patients' epistaxis.

Use of Antiangiogenic Therapies in Pediatric Solid Tumors.

Cancer is an important cause of death in childhood. In recent years, scientists have made an important effort to achieve greater precision and more personalized treatments against cancer. But since only a few pediatric patients have identifiable therapeutic targets, other ways to stop the neoplastic cell proliferation and dissemination are needed. Therefore, the inhibition of general processes involved in the growth and behavior of tumors can be a relevant strategy for the development of new cancer therapies. In the case of solid tumors, one of these processes is angiogenesis, essential for tumor growth and generation of metastases. This review summarizes the results obtained with the use of antiangiogenic drugs in the main pediatric malignant solid tumors and also an overview of clinical trials currently underway. It should be noted that due to the rarity and heterogeneity of the different types of pediatric cancer, most studies on antiangiogenic drugs include only a small number of patients or isolated clinical cases, so they are not conclusive and further studies are needed.

Hot and Cold Tumors: Is Endoglin (CD105) a Potential Target for Vessel Normalization?

Tumors are complex masses formed by malignant but also by normal cells. The interaction between these cells via cytokines, chemokines, growth factors, and enzymes that remodel the extracellular matrix (ECM) constitutes the tumor microenvironment (TME). This TME can be determinant in the prognosis and the response to some treatments such as immunotherapy. Depending on their TME, two types of tumors can be defined: hot tumors, characterized by an immunosupportive TME and a good response to immunotherapy; and cold tumors, which respond poorly to this therapy and are characterized by an immunosuppressive TME. A therapeutic strategy that has been shown to be useful for the conversion of cold tumors into hot tumors is vascular normalization. In this review we propose that endoglin (CD105) may be a useful target of this strategy since it is involved in the three main processes involved in the generation of the TME: angiogenesis, inflammation, and cancer-associated fibroblast (CAF) accumulation. Moreover, the analysis of endoglin expression in tumors, which is already used in the clinic to study the microvascular density and that is associated with worse prognosis, could be used to predict a patient's response to immunotherapy.

Comparison of the sensitivity of the EULAR / ACR 2019 and SLICC 2012 classification criteria in a Colombian population with systemic lupus erythematosus.

BACKGROUND: /Objective: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with a wide range of clinical manifestations. The latest classification criteria, EULAR/ACR 2019, have not been validated in a Latin American population of Amerindian ancestry. The objective of this study is to compare the sensitivity of the EULAR/ACR 2019 and SLICC 2012 classification criteria in a group of SLE patients with the above ancestry. METHODS: A cross-sectional study was done. Data were obtained from the review of medical records of patients who met the inclusion criteria. The overall sensitivity of the criteria was calculated and compared to each other using the McNemar test. RESULTS: 146 medical records of patients from two referral centers were included. There were no differences in the sensitivity of the EULAR/ACR and SLICC 2012 criteria (84.9% versus 85.6% p = 0.79) nor were differences found when the groups based on disease duration were compared: less than 5 years (91.0% versus 92.5% p = 0.70), between 5 and 10 years (82.8% versus 82.8% p = 1), and 10 years or more (76.7% versus 76.7% p = 1). However, SLICC 2012 criteria was found to better classify patients with a less than 5-year disease duration compared to those with 10-year duration or more (92.5% versus 76.4% p = 0.024). CONCLUSIONS: There are no statistically significant differences between the EULAR/ACR and SLICC 2012 criteria in the population studied. Nor were differences found when evaluating them by age at diagnosis and duration of the disease except when the group with less than 5 years of duration was compared to those with 10 years or more using the SLICC 2012 criteria.

Impairment of Autophagic Flux Participates in the Antitumor Effects of TAT-Cx43266-283 in Glioblastoma Stem Cells.

Autophagy is a physiological process by which various damaged or non-essential cytosolic components are recycled, contributing to cell survival under stress conditions. In cancer, autophagy can have antitumor or protumor effects depending on the developmental stage. Here, we use Western blotting, immunochemistry, and transmission electron microscopy to demonstrate that the antitumor peptide TAT-Cx43266-283, a c-Src inhibitor, blocks autophagic flux in glioblastoma stem cells (GSCs) under basal and nutrient-deprived conditions. Upon nutrient deprivation, GSCs acquired a dormant-like phenotype that was disrupted by inhibition of autophagy with TAT-Cx43266-283 or chloroquine (a classic autophagy inhibitor), leading to GSC death. Remarkably, dasatinib, a clinically available c-Src inhibitor, could not replicate TAT-Cx43266-283 effect on dormant GSCs, revealing for the first time the possible involvement of pathways other than c-Src in TAT-Cx43266-283 effect. TAT-Cx43266-283 exerts an antitumor effect both in nutrient-complete and nutrient-deprived environments, which constitutes an advantage over chloroquine and dasatinib, whose effects depend on nutrient environment. Finally, our analysis of the levels of autophagy-related proteins in healthy and glioma donors suggests that autophagy is upregulated in glioblastoma, further supporting the interest in inhibiting this process in the most aggressive brain tumor and the potential use of TAT-Cx43266-283 as a therapy for this type of cancer.

Validez y confiabilidad de un instrumento para identificar factores que influyen en la adherencia al tratamiento en personas con factores de riesgo cardiovascular

Introducción: Es necesario contar con instrumentos válidos y confiables para identificar los factores que influyen en la adherencia al tratamiento en personas con factores de riesgo cardiovascular. En Colombia, Bonilla y Gutiérrez diseñaron un instrumento que cuenta con validez facial y de contenido. Sin embargo, no se ha demostrado la validez de constructo. Objetivo: Determinar la validez de constructo y confiabilidad del instrumento, factores que influyen en la adherencia al tratamiento farmacológico y no farmacológico en personas con factores de riesgo cardiovascular. Metodología: Investigación metodológica. Participaron 694 personas con factores de riesgo de enfermedad cardiovascular residentes en tres ciudades de Colombia (Neiva, Espinal y Tunja). Se realizó un análisis factorial exploratorio (extracción de componentes principales y rotación Varimax), análisis factorial confirmatorio (estimación de máxima verosimilitud) y una prueba de confiabilidad global y por dimensiones (alfa de Cronbach y Test-retest). Resultados: El análisis factorial exploratorio reportó un instrumento de 30 ítems con estructura de 4 factores (varianza total acumulada de 42,6 %). Los índices de ajuste del modelo propuesto indicaron ajuste absoluto excelente y ajuste incremental aceptable. El alfa de Cronbach global fue 0,86, lo que indica alta confiabilidad. Discusión: El estudio proporciona evidencia de un instrumento más robusto que otras versiones. Los instrumentos estandarizados para medir factores que influyen en la adherencia pueden ser muy útiles para la investigación y la práctica si cumplen con pruebas psicométricas de fiabilidad y validez. Conclusión: Se pone a disposición de los investigadores y del personal de salud un instrumento válido y confiable. Se recomienda su uso en poblaciones similares a la de este estudio.

Introduction: It is necessary to have valid and reliable instruments to identify the factors that influence adherence to treatment in people with cardiovascular risk factors. In Colombia, Bonilla y Gutierrez designed an instrument that has face and content validity. However, construct validity has not been demonstrated. Objective: To determine the construct validity and reliability of the instrument, factors that influence adherence to pharmacological and non-pharmacological treatment in people with cardiovascular risk factors. Methodology: Methodological research. A total of 694 people with risk factors for cardiovascular disease residing in three Colombian cities (Neiva, Espinal and Tunja) participated. Exploratory factor analysis (extraction of principal components and Varimax rotation), confirmatory factor analysis (maximum likelihood estimation) and global and dimensional reliability test (Cronbach's alpha and Test-retest) were performed. Results: The exploratory factor analysis reported a 30-item instrument with a 4-factor structure (total cumulative variance of 42.6%). The fit indices of the proposed model indicated excellent absolute fit and acceptable incremental fit. The overall Cronbach's alpha was 0.86, indicating high reliability. Discussion: The study provides evidence of a more robust instrument than other versions. Standardized instruments to measure factors that influence adherence can be very useful for research and practice if they meet psychometric tests of reliability and validity. Conclusion: A valid and reliable instrument is made available to researchers and health personnel. Its use is recommended in populations similar to that of this study.

Endoglin-based biological therapy in the treatment of angiogenesis-dependent pathologies.

INTRODUCTION: Alterations in the process of angiogenesis, either by excess or by defect, are present in different common pathologies. For this reason, great efforts are being made toward the development of pro- and anti-angiogenic therapies. Since endoglin levels are enhanced in tissues undergoing angiogenesis, and changes in its expression lead to alterations in vessel formation, endoglin has become an ideal target for these types of therapies. Areas covered: In this review, the role of endoglin in angiogenesis is summarized. In addition, the authors review pro- and anti-angiogenic therapies that are currently being used and new approaches that target endoglin. The article includes therapies that are both in preclinical and clinical development. Expert opinion: Endoglin is a very good target for anti-angiogenic therapy, as demonstrated by the positive results obtained with anti-endoglin antibodies. However, although endoglin in pro-angiogenic therapies has been successful in vitro, its use has not yet reached clinical settings. Moreover, the authors believe that establishing the exact role of endoglin in angiogenesis is essential and that this should be the next step in this field in the coming years.

[Household risk factors for consumption of psychoactive substances in students of a technical education institution in Colombia]. / Factores familiares de riesgo de consumo de sustancias psicoactivas en estudiantes de una institución de educación media técnica de Colombia.

OBJECTIVE: To determine household risk factors that have an impact on the use of psychoactive substances (SPA, by its acronym in Spanish) by students of the technical educational institution San Luis Gonzaga in Chicoral, Tolima (Colombia). METHODOLOGY: This is a quantitative, descriptive and cross-sectional study. Data were collected by applying the International survey for middle school students - standardized questionnaire, 2009, Argentinian version. The processing of the information was done through the statistical data base package SPSS version 19. RESULTS: The most common psychoactive substances consumed by students are alcohol, cigarettes, marijuana, stimulants, energizing pills or drinks, tranquilizers and others. The list of legal substances is led by alcohol, followed by cigarettes, while the most used illegal substance is marijuana. The age of initiation ranges between 8 and 13, with the highest prevalence between 15 and 17. There are no significant differences between males and females. The family, friends and school environments are the most common places for SPA consumption. CONCLUSIONS: The family plays an important role in the teenager's life and in the prevention against the use of SPA, by playing an active role in the knowledge of children's activities, the places they frequent and their friends, in order to establish control mechanism to build a strong relationship.

OBJETIVO: El presente estudio busca determinar los factores de riesgo familiar que inciden en el consumo de sustancias psicoactivas (SPA), en estudiantes de la Institución Educativa Técnica San Luís Gonzaga del corregimiento de Chicoral. METODOLOGÍA: Esta investigación es de tipo cuantitativo, descriptivo y transversal. La recolección de la información se realizó aplicando la "Encuesta Internacional para estudiantes de enseñanza media; cuestionario estandarizado-Versión 2009 de Argentina. El procesamiento de la información se llevó a cabo en la base de datos, del paquete estadístico SPSS versión 19. RESULTADOS: Las sustancias psicoactivas consumidas por los estudiantes son: alcohol, cigarrillo, marihuana, estimulantes, energizantes, tranquilizantes y otras; ocupando el alcohol el primer lugar, seguido del cigarrillo, dentro de las sustancias lícitas; la marihuana ocupa el primer lugar. La edad de inicio para el consumo de Sustancias Psicoactivas se da entre los 8 y los 13 años y las edades de mayor consumo son entre los 15 y los 17 años. No hay una diferencia significativa entre hombres y mujeres. La casa propia, la de los amigos, el colegio y sus alrededores son los ambientes que se identifican como aquellos donde se ofrecen el mayor número de SPA. CONCLUSIONES: La familia juega un papel primordial en los adolescentes y en la prevención frente al consumo de Sustancias psicoactiva; modificando acciones que lleven al conocimiento de los hijos, actividades que realizan, lugares que frecuentan y amigos con los cuales se relacionan, se pueden establecer mecanismos de control que permitan estar más cerca de ellos.

Circulating soluble endoglin modifies the inflammatory response in mice.

Inflammation is associated with every health condition, and is an important component of many pathologies such as cardiovascular diseases. Circulating levels of soluble endoglin have been shown to be higher in the serum of patients with cardiovascular diseases with a significant inflammatory component. The aim of this study was to evaluate the implication of circulating soluble endoglin in the inflammatory response. For this purpose, a transgenic mouse expressing human soluble endoglin (sEng+) was employed, and three different inflammatory approaches were used to mimic inflammatory conditions in different tissues. This study shows that control sEng+ mice have a normal inflammatory state. The lung and kidney injury induced by the inflammatory agents was reduced in sEng+ mice, especially the intra-alveolar and kidney infiltrates, suggesting a possible reduction in inflammation induced by soluble endoglin. To deepen into this possible effect, the leukocyte number in the bronchoalveolar lavage and air pouch lavage was evaluated and a significant reduction of neutrophil infiltration in LPS-treated lungs and ischemic kidneys from sEng+ with respect to WT mice was observed. Additionally, the mechanisms through which soluble endoglin prevents inflammation were studied. We found that in sEng+ animals the increment of proinflammatory cytokines, TNFα, IL1ß and IL6, induced by the inflammatory stimulus was reduced. Soluble endoglin also prevents the augmented adhesion molecules, ICAM, VCAM and E-selectin induced by the inflammatory stimulus. In addition, vascular permeability increased by inflammatory agents was also reduced by soluble endoglin. These results suggest that soluble endoglin modulates inflammatory-related diseases and open new perspectives leading to the development of novel and targeted approaches for the prevention and treatment of cardiovascular diseases.

[Use of complementary and alternative therapies in children with cancer]. / Utilización de terapias complementarias y alternativas en niños con cáncer.

Objective To determine the frequency, characteristics and related factors for the use of complementary and alternative therapies in pediatric patients with cancer in a Colombian pediatric oncology department. METHODS: Cross-sectional study consisting of a survey of 398 caregivers of pediatrics patients with cancer evaluated in the Instituto Nacional de Cancerología in Bogotá, Colombia. The survey collected sociodemographic and clinical information and evaluated the type of complementary and alternative therapies, mechanisms of action, and patterns of use of these treatments. Logistic regression was conducted to identify predictors of complementary and alternative therapies use. Results In this study complementary therapies were used not as a substitute but in addition to conventional treatments to cure or to control the disease or to treat symptoms. A total of 326 patients (81.9 %, CI95 %: 77.8 % to 85.6 %) had received some type of complementary therapy and 81 different types of therapies were used. The most common type of complementary therapy corresponded to the group of biologically based therapies (mainly berry juices). Female family caregivers with higher educational status were more likely to use complementary therapies. Time from diagnosis and having received surgical treatment were also associated with the use of therapies. Reinforcement of the immune system appears to be the most likely mechanism of action. Conclusion A high prevalence of use of complementary therapies was found in this sample. Pediatricians need to ask their patients about complementary and alternative therapy practices considering the potential for interactions with pharmacological treatments or adverse effects.

Características de las intervenciones realizadas con adolescentes en condición de sobrepeso y obesidad: una revisión integrativa / Characteristics of interventions with overweight and obese adolescents: an integrative review / Características das intervenções realizadas com adolescentes em condição de sobrepeso e obesidade: uma revisão integrada

Resumen Introducción Dado que el sobrepeso y la obesidad en la población adolescente van en aumento, es necesario identificar las intervenciones para la prevención y manejo de estas condiciones en el grupo de jóvenes. Objetivo Presentar la evidencia encontrada, en relación con las características de las intervenciones publicadas en revistas científicas indexadas, sobre la prevención y manejo del sobrepeso y de la obesidad, respecto de la nutrición y la actividad física, para ser utilizada en la toma de decisiones, en cuanto a políticas y programas de promoción y prevención de esta condición de salud. Materiales y Métodos Se realizó la revisión sistemática de estudios cualitativos y cuantitativos (desde descriptivos hasta experimentales, que incluyeran tanto revisiones sistemáticas como meta-análisis), publicados en el período comprendido entre 2005 y 2017, a través de las bases de datos PubMed y ScienceDirect, las bibliotecas virtuales Ovid y SciELO, y el compendio de revisiones Cochrane. Resultados Existe gran variedad en diseño e implementación de las intervenciones, en cuanto a componentes, teorías, escenarios, evaluación de los efectos, dosis, tiempo y seguimiento, que tienen efecto en los hábitos nutricionales, en la actividad física, en la autoeficacia y en el índice de masa corporal (IMC) de la población estudiada. Discusión La efectividad de las intervenciones varía, dependiendo de los componentes y de la fidelidad en la aplicación de la misma, lo cual debe revisarse a la luz de los mejores efectos encontrados. Conclusiones 47 estudios cumplieron los requisitos de inclusión. Las intervenciones se robustecen con el uso de una teoría que direccione y fundamente los hallazgos que permitan dar mayores y mejores resultados. Los componentes de las intervenciones incluyen: duración, dosis, intensidad de la intervención, respuesta y seguimiento. Los adolescentes prefieren metodologías participativas e interactivas; sin embargo, aún no existe una intervención concreta y claramente definida que pueda ser estandarizada para enfrentar este problema de salud.

Abstract Introduction Overweight and obesity in the adolescent population are on the rise, it is thus necessary to identify interventions to prevent and manage these conditions in the youth group. Objective To show the evidence found about the characteristics of the interventions published in indexed scientific journals on prevention and management of overweight and obesity, nutrition and physical activity, so that they are used in decision-making of policies and programs for the promotion and prevention of this health condition. Materials and Methods A systematic review of qualitative and quantitative studies (ranging from experimental to descriptive, including both systematic reviews and meta-analyzes) published in 2005-2017 was performed by means of the PubMed and ScienceDirect databases, the Ovid and SciELO virtual libraries, and the Cochrane library reviews. Results There is great variety in the design and implementation of interventions concerning components, theories, scenarios, evaluation of the effects, dosage, timing and monitoring that impact nutritional habits, physical activity, self-efficacy and the body mass index (BMI) of the studied population. Discussion The effectiveness of interventions varies depending on the components and accuracy of implementation; consequently, this must be reviewed in the light of the best effects that have been found. Conclusions 47 studies met the inclusion criteria. Interventions will be strengthened with the use of a theory that guides and supports the findings to provide greater and better results. The components of interventions include: duration, dosage, intensity of intervention, response and monitoring. Adolescents prefer participatory and interactive methodologies; however, there is still no specific and clearly defined intervention that could be standardized to address this health issue.

Resumo Introdução Uma vez que o sobrepeso e a obesidade na população adolescente estão aumentando, é aconselhável identificar intervenções necessárias para a prevenção e o controle dessas condições no grupo de jovens. Objetivo Apresentar as evidências encontradas em relação às características das intervenções publicadas em periódicos científicos indexados sobre prevenção e controle do sobrepeso e da obesidade, e sobre a nutrição e a atividade física, a serem utilizadas na tomada de decisão no que diz respeito a políticas e programas para promover e prevenir esta condição de saúde. Materiais e Métodos A revisão sistemática de estudos qualitativos e quantitativos (de descritivos a experimentais, incluindo tanto revisões sistemáticas, quanto metanálises), publicados no período entre 2005 y 2017, foi realizada por meio do PubMed e do ScienceDirect, das bibliotecas virtuais Ovid e SciELO e do compêndio de revisão da Cochrane. Resultados Existe uma grande variedade na concepção e na aplicação de intervenções, em termos de componentes, teorias, cenários, avaliação dos efeitos, da dose, do tempo e do acompanhamento, que têm um efeito sobre os hábitos nutricionais, na atividade física, na auto eficácia e no índice de massa corporal (IMC) da população estudada. Discussão A efetividade das intervenções varia, dependendo dos componentes e da fidelização em sua aplicação, portanto deve ser revista à luz dos melhores efeitos encontrados. Conclusões 47 estudos atenderam aos requisitos de inclusão. As intervenções são fortalecidas com o uso de uma teoria que direcione e fundamente os achados que permitam maiores e melhores resultados. Os componentes das intervenções incluem: duração, dose, intensidade da intervenção, resposta e acompanhamento. Os adolescentes preferem metodologias participativas e interativas, no entanto, ainda não existe uma intervenção concreta e claramente definida que possa ser padronizada para fazer frente a esse problema de saúde.

Conocimiento, actitudes y prácticas del consumo de sustancias psicoactivas en estudiantes universitarios / Knowledge, attitudes and practices of the consumption of psychoactive substances in university students

El consumo de sustancias psicoactivas en los universitarios es un problema que va en aumento, por tal motivo es un tema necesario pensar y analizar entre los diversos actores, docentes, empleados, estudiantes y de una manera más profunda por aquellos que somos los llamados a acompañar a los estudiantes en la vivencia académica de los claustros universitarios. Objetivo Caracterizar los conocimientos, actitudes y prácticas del consumo de sustancias psicoactivas en los estudiantes de los programas de medicina y enfermería de la Facultad de Ciencias de la Salud, con el propósito de implementar estrategias de prevención y manejo de forma integral, del problema, año 2015. Método Estudio descriptivo, transversal, realizado entre Marzo y Diciembre del 2015, utilizando el instrumento "Factores de riesgo y de protección para el consumo de drogas en Jóvenes. Resultados Los jóvenes inician el consumo de sustancias psicoactivas a los 17 años, el alcohol es la primera sustancia consumida por los estudiantes de medicina con un 92, 85%, enfermería un 91,12% y el tabaco es la segunda con un 24,80% por enfermería y un 37,03% por medicina; la marihuana es la tercera sustancia consumida con mayor frecuencia con 26,31 por enfermeria y 19, 51 en Medicina. Conclusión El presente estudio evidencia que el consumo de sustancias psicoactivas en los estudiantes de la universidad del Tolima, va en ascenso, si comparamos cifras con estudios anteriores, lo cual amerita la adopción de una política clara y precisa en consumo de las sustancias psicoactivas dentro del campus universitario.

The use of psychoactive substances in college is a problem that is increasing, for that reason is a necessary topic, thinking and analyzing among the different actors, teachers, staff, students and a deeper way by those who are called to be closer to the students in the academic experience of university faculties Purpose To describe the knowledge, attitudes and practices of psychoactive substances among students in medical and nursing programs of the Health Sciences Faculty, with the purpose of implement prevention strategies and comprehensive manner of the problem, year 2015 Method A descriptive, cross-sectional study conducted between March and December 2015, using the "risk factors and protective drug in youth". Results The young initiate the use of psychoactive substances at 17 age, Alcohol is the first substance consumed by medical students with 92, 85%, 91.12% nursing, and the snuff is the second with 24.80% for nursing and 37.03% for medicine; Marihuana is the third most commonly consumed substance with 26.31 per nursing and 19, 51 in Medicine. Conclusion This study shows that the use of psychoactive substances among students of Tolima University, is on the rise, if we compare figures with previous studies, which in fact deserves the adoption of a clear and precise policy on consumption of psychoactive substances within the university campus.

Factores de riesgo cardiovascular modificables en adolescentes escolarizados de Ibagué, 2013 / Modifiable Cardiovascular Risk Factors in Adolescent Students of Ibague, 2013 / Fatores de risco cardiovascular modificáveis em adolescentes estudantes de Ibagué 2013

Resumen Objetivo: escribir los factores de riesgo cardiovascular modificables en adolescentes escolarizados de la comuna uno de la ciudad de Ibagué durante el segundo semestre del 2013. Metodología: Se realizó un estudio transversal, con 149 estudiantes; utilizando 4 módulos de la encuesta mundial de salud a escolares (GSHS), medidas antropométricas y presión arterial, pruebas no paramétricas para el análisis de los factores de riesgo según características sociodemográficas y clínicas; análisis bivariado para determinar las diferencias de los factores de riesgo cardiovascular modificables por edad, sexo y tipo de establecimiento educativo. Resultados: La prevalencia de sedentarismo fue del 97%; riesgo de alcoholismo 59%; alimentación no saludable 53%; sobrepeso y obesidad 13%; fumador actual adolescente 9%, y por último, la hipercolesterolemia con el 7%. Discusión:: los factores de riesgo en los adolescentes presentan una alta prevalencia aun cuando no indican enfermedad establecida, sin embargo la continuidad de estas conductas puede llevar a problemas a nivel cardiovascular, personal y social. Conclusiones: Este estudio aporta una línea de base determinante en la implementación de estrategias de promoción y prevención en adolescentes para la disminución de la morbi-mortalidad por enfermedad cardio-vascular de la población Tolimense, se deben incluir la creación de espacios de recreación y deporte, control de consumo de alcohol y tabaco y educación nutricional para madres y propietarios de establecimientos que permitan aumentar la ingesta diaria y la oferta de alimentos saludables entre otros.

Abstract Objective: to describe the modifiable cardiovascular risk factors among adolescent students in the district one of the city of Ibague in the second half of 2013 Methodology: A cross-sectional study with 149 students; using 4 modules of global school health survey (GSHS), anthropometric measurements and blood pressure, non-parametric tests for the analysis of risk factors as sociodemographic and clinical characteristics; bivariate analysis to determine differences of modifiable cardiovascular risk factors by age, sex and type of educational establishment. Results: The prevalence of sedentary lifestyle was 97%; 59% risk of alcoholism; unhealthy eating 53%; 13% overweight and obesity; current smoker teenager 9%, and finally, hypercholesterolemia 7%. Discussion: the risk factors in adolescents had a high prevalence even without established disease indicate, however the continuity of these behaviors can lead to cardiovascular problems and social level staff. Conclusions: This study provides a critical line based on the implementation of promotion and prevention strategies in adolescents for reducing morbidity and mortality from cardio-vascular disease of the Tolima population, should include the creation of opportunities for recreation and sport control of alcohol and snuff and nutrition for mothers and owners of establishments that increase the daily intake and the supply of healthy foods including education.

Resumo Objetivo: descrever os fatores de risco cardiovascular modificáveis em adolescentes escolarizados da comuna de Ibagué durante o segundo semestre de 2013. Metodologia: Se realizó um estudo transversal, com 149 estudantes; Utilizando 4 módulos da pesquisa mundial de saúde em escolares (gshs), medidas antropométricas e pressão arterial, testes não paramétricos para análise de fatores de risco por características sociodemográficas e clínicas; Análise bivariado para determinar as diferenças de fatores de risco cardiovascular modificáveis por idade, sexo e tipo de desenvolvimento educativo. Resultados: a prevalencia de sedentarismo fue del 97%; Risco de alcoolismo 59%; Alimentación no saludable 53%; Sobrepeso y obesidad 13%; Fumador real adolescente 9%, y por último, la hipercolesterolemia con el 7%. Discusión: os fatores de risco e os adolescentes apresentam uma alta prevalência, embora não haja uma doença estável, sem embargo, a continuidade dessas condutas pode levar a problemas cardiovasculares, pessoais e sociais. Conclusões: o estudo aporta uma linha de base determinante na execução de estratégias de promoção e de prevenção em adolescentes para a diminuição da morbi-mortalidade por doença cardio-vascular da população Tolimense, Controle de consumo de álcool e tabaco e educação nutricional para madres e proprietários de estabelecimentos que permitam aumentar a ingesta diária ea oferta de alimentos saudáveis entre outros.

Factores familiares de riesgo de consumo de sustancias psicoactivas en estudiantes de una institución de educación media técnica de Colombia / Household risk factors for consumption of psychoactive substances in students of a technical education institution in Colombia

RESUMEN Objetivo El presente estudio busca determinar los factores de riesgo familiar que inciden en el consumo de sustancias psicoactivas (SPA), en estudiantes de la Institución Educativa Técnica San Luís Gonzaga del corregimiento de Chicoral. Metodología Esta investigación es de tipo cuantitativo, descriptivo y transversal. La recolección de la información se realizó aplicando la "Encuesta Internacional para estudiantes de enseñanza media; cuestionario estandarizado-Versión 2009 de Argentina. El procesamiento de la información se llevó a cabo en la base de datos, del paquete estadístico SPSS versión 19. Resultados Las sustancias psicoactivas consumidas por los estudiantes son: alcohol, cigarrillo, marihuana, estimulantes, energizantes, tranquilizantes y otras; ocupando el alcohol el primer lugar, seguido del cigarrillo, dentro de las sustancias lícitas; la marihuana ocupa el primer lugar. La edad de inicio para el consumo de Sustancias Psicoactivas se da entre los 8 y los 13 años y las edades de mayor consumo son entre los 15 y los 17 años. No hay una diferencia significativa entre hombres y mujeres. La casa propia, la de los amigos, el colegio y sus alrededores son los ambientes que se identifican como aquellos donde se ofrecen el mayor número de SPA. Conclusiones La familia juega un papel primordial en los adolescentes y en la prevención frente al consumo de Sustancias psicoactiva; modificando acciones que lleven al conocimiento de los hijos, actividades que realizan, lugares que frecuentan y amigos con los cuales se relacionan, se pueden establecer mecanismos de control que permitan estar más cerca de ellos.(AU)

ABSTRACT Objective To determine household risk factors that have an impact on the use of psychoactive substances (SPA, by its acronym in Spanish) by students of the technical educational institution San Luis Gonzaga in Chicoral, Tolima (Colombia). Methodology This is a quantitative, descriptive and cross-sectional study. Data were collected by applying the International survey for middle school students - standardized questionnaire, 2009, Argentinian version. The processing of the information was done through the statistical data base package SPSS version 19. Results The most common psychoactive substances consumed by students are alcohol, cigarettes, marijuana, stimulants, energizing pills or drinks, tranquilizers and others. The list of legal substances is led by alcohol, followed by cigarettes, while the most used illegal substance is marijuana. The age of initiation ranges between 8 and 13, with the highest prevalence between 15 and 17. There are no significant differences between males and females. The family, friends and school environments are the most common places for SPA consumption. Conclusions The family plays an important role in the teenager's life and in the prevention against the use of SPA, by playing an active role in the knowledge of children's activities, the places they frequent and their friends, in order to establish control mechanism to build a strong relationship.(AU)

Comportamientos de autocuidado y adherencia terapéutica en personas con enfermedad coronaria que reciben atención en una institución hospitalaria de Ibagué, Colombi / Self-care Behaviors and Therapeutic Adherence in People with Coronary Disease who Receive Care at a Hospital in Ibague, Colombia / Comportamentos de autocuidado e adesão terapêutica em personas com doenças coronárias que recebem atendimento em uma instituição hospitalar de Ibagué, Colômbia

Objetivo: Valorar comportamientos de autocuidado y de adherencia terapéutica en tratamientos de un grupo de personas con enfermedad coronaria que recibieron atención en Ibagué, Colombia, en el 2013. Método: Estudio descriptivo-transversal en una muestra de 55 pacientes con enfermedad coronaria, atendidos en el servicio de consulta externa de una institución prestadora de servicios de salud de cuarto nivel de atención en la ciudad de Ibagué, entre septiembre y noviembre del 2013. La información se recogió utilizando la Escala Europea de Autocuidado (ajustada) y el Instrumento de Adherencia, tercera versión, de Bonilla y De-Reales, y el análisis estadístico se realizó con el programa SPSS v. 19. Resultados: El promedio de autocuidado resultado de la muestra fue de regular autocuidado con 32 puntos (DE: 7,04); distribuidos en 7,27% para bajo autocuidado, 61,81% para regular autocuidado y 30,3% para buen autocuidado. Al analizar la adherencia se obtuvo un promedio de 53,96 puntos (DE: 5,01) de riesgo de no adherencia a los tratamientos; es decir, el 3,63% de las personas no tiene adherencia, el 65,45% está en riesgo de no adherencia y el 30,9% está en ventaja de adherencia. Conclusiones: Los comportamientos de autocuidado que se relacionan con una regular agencia de autocuidado afectan especialmente la realización de actividades diarias, como pesarse todos los días, disminuir la ingesta de líquidos y hacer ejercicio regularmente. Así, más de la mitad de la población encuestada se encuentra en riesgo de no adherencia, manifestada en la dificultad de realizar acciones para seguir recomendaciones de tipo farmacológico y no farmacológico. Y la medición de los fenómenos de autocuidado y de adherencia en grupos específicos de pacientes sirve como elemento orientador del cuidado de enfermería, por lo cual es necesario realizar estudios similares en poblaciones mayores.

Objective: To assess self-care behaviors and adherence to treatment of a group of people with coronary heart disease who received care in Ibague, Colombia, in 2013.Method: descriptive cross-sectional study in a sample of 55 patients with coronary artery disease treated at the outpatient service at a fourth-level health providing institution in the city of Ibague, between September and November 2013. The information was collected using the The European Heart Failure Self-care Behavior scale(adjusted) and the Instrument of Adhesion, third version by Bonilla and De-Royal, and the statistical analysis was performed using SPSS program v 19. Results: The average selfcare generated from the sample was: ordinary self-care with 32 points (SD 7.04); Distributed in 7.27% to low self- care, ordinary self-care 61.81% and 30.3% for good self-care. By analyzing adherence an average of 53.96 points (SD: 5.01) of risk to nonadherence to treatment was obtained; ie 3.63% of people have no compliance, 65.45% are at risk of non-adherence and 30.9% are in advantage of adhesion. Conclusions: self-care behaviors that relate to an ordinary self-care performance especially affect the development of daily activities such as weighing every day, reducing fluid intake and exercising regularly. Thus, more than half of the surveyed population is at risk of non-adherence, manifested in the difficulty of taking action to follow pharmacologic and non-pharmacologic recommendations. And measuring the phenomena of selfcare and adherence to specific patient groups serves as a guiding element of nursing care, and therefore it is important to carry out similar studies in larger populations.

Objetivo: Valorar comportamentos de autocuidado e adesão terapêutica em tratamentos do pessoal com doenca coronária que receberam atendimento em Ibagué, Colômbia, em 2013. Método: Estudo descritivo-transversal com amostra de 55 pacientes com doença coronária, atendidos no serviço de consulta externa em uma instituição prestadora de serviços de saúde de quarto nível de atendimento na cidade de Ibagué, entre setembro e novembro de 2013. A informação foi coletada utilizando a Escala Europeia de Autocuidado (ajustada) e o Instrumento de Adesão, terceira versão, de Bonilla e De-Reales, e a análise estatística foi realizada com o programa SPSS v. 19. Resultados: O autocuidado médio resultante da amostra foi de regular autocuidado com 32 pontos (DE: 7,04); distribuídos em 7,27% para baixo autocuidado, 61,81% para regular autocuidado e 30,3% para bom autocuidado. Na análise da adesão foi obtida uma média de 53,96 pontos (DE: 5,01) de risco de não adesão aos tratamentos; ou seja, 3,63% do pessoal não tem adesão, 65,45% está em risco de não adesão e 30,9% está em vantagem de adesão. Conclusões: Comportamentos de autocuidado relacionados com uma agência regular de autocuidado afetam especialmente a realização de atividades diárias, como pesar-se todo dia, diminuir a ingesta de líquidos e fazer exercício regularmente. Assim, mais da metade da população pesquisada encontra-se em risco de não adesão, manifesta na dificuldade de realizar ações para seguir recomendações de tipo farmacológico e não-farmacológico. E a aferição de fenômenos de autocuidado e adesão em grupos específicos de pacientes serve como elemento norteador do cuidado de enfermagem, por tanto é preciso realizar estudos semelhantes em populações maiores.