Mujer y deporte: comportamiento de la política pública mexicana de 2000-2022 / Women and sport: behavior of Mexican public policy from 2000-2022

RESUMEN La declaración de Brighton de 1994 marcó un parteaguas para las mujeres en el deporte mundial. Auspiciada por la Asamblea de la Organización de las Naciones Unidas (ONU) y el Comité Olímpico Internacional (COI), facilitó a las mujeres que pudieran comunicar sus necesidades y construir una agenda inteligente, alcanzable, con objetivos precisos, igualitaria y equitativa. En el mismo sentido, la participación de mujeres en eventos internacionales y nacionales ha aumentado y se busca el equilibrio. El objetivo del presente trabajo fue identificar similitudes y diferencias textuales y conceptuales en los ejes, objetivos, estrategias y acciones de los 4 sexenios de gobiernos federales, desde la perspectiva comparativa cognoscitiva. Para ello, se revisaron los Planes Nacionales de Desarrollo, Planes Proigualdad/Equidad y Plan Nacional de Cultura Física y Deporte de 2000 a 2022. Con este trabajo, se puede reconocer la valía y la evolución de estos planes, para la transversalización de la perspectiva de género en el aparato gubernamental, las acciones estratégicas, la visibilización y mención en los documentos institucionales, la armonización de las leyes y normativas nacionales y estatales, así como, los llamamientos gubernamentales a la integración de las mujeres a la vida del deporte y toma de decisiones, y la vigilancia de los organismos internacionales, como la ONU y el COI. Este recorrido permite inferir que las políticas públicas desde 2000 a la fecha han fortalecido la participación deportiva de las mujeres y su llegada a puestos de toma de decisiones en el apartado institucional, pero no es concluyente en precisar, el peso de cada periodo, ni especificar la asociación del éxito con acciones ni programas. Lo verdaderamente útil, es reconocer el escalonamiento de acciones que tuvo cada periodo y como, eso visibiliza cada vez, la presencia de las mujeres deportistas en la programación pública.

ABSTRACT The 1994 Brighton declaration marked a turning point for women in world sport. Women were able to communicate their needs and develop an intelligent, achievable agenda with precise, egalitarian, and equitable objectives, held under the auspices of the United Nations Assembly (UN) and the International Olympic Committee (IOC). Likewise, women's participation in international and national events has increased and a balance is actively sought. The objective of this paper was to identify textual and conceptual similarities and differences in the axes, objectives, strategies, and actions of the 4 six-year terms of federal governments, employing a cognitive comparative perspective. For this, the National Development Plans, Pro-equality/equity Plans and the National Physical Culture and Sports Plan from 2000 to 2022 were reviewed. With this paper, the value and evolution of these plans can be recognized, for the following issues: mainstreaming of a gender perspective in the government structure, strategic actions, visibility and mention in institutional documents, harmonization of national and state laws and regulations, government calls for the integration of women into sports life and decision-making, and supervision by international organizations, such as the UN and the IOC. This path allows to infer that public policies from 2000 to date have strengthened women's sports participation and their arrival in decision-making positions in the institutional sector. However, it is not conclusive in specifying the weight of each period, nor specifying the association with actions or programs. What is useful is to recognize the gradual inclusion of actions in each period and how this generates an increasing visibilization and presence of women athletes in public programming.

Anthropometric profile and body composition of the Mexican olympic beach volleyball team / Perfil antropométrico y composición corporal de la selección olímpica mexicana de voleibol de playa

SUMMARY: The present research corresponds to a cross-sectional descriptive study in the anthropometric field, which allows coaches to develop standards to identify talent and optimize training in the discipline of beach volleyball. Its objective was to define the anthropometric profile and body composition of the Mexican Olympic beach volleyball teams in both sexes. The participants were couples one and two of Mexico in both sexes (defined by FIVB ranking), 4 women and 4 men with average age of 30.25±6.85 and 27.25±7.36 years. The technique used was Heath-Carter´s somatotype method and the anthropometric profile restricted ISAK protocol. Among the findings resulting from the research, unification can be observed in the male morphological characteristics (triceps skinfold, front thigh skinfold, calf skinfold, circumference of relaxed and contracted arm, waist, hip, femur diameter and BMI), as for the somatotype, both sexes of Mexican couples are positioned in mesomorphs-balanced. In relation to other studies consulted, balance in somatotype and muscular development is observed with high performance teams. Weight and height, as well as age, are important variables for the selection of talent and future optimal performance in world and professional volleyball.

La presente investigación corresponde a un estudio descriptivo transversal en el campo antropométrico, que permite a los entrenadores desarrollar estándares para identificar talentos y optimizar el entrenamiento en la disciplina de voleibol de playa. Su objetivo fue definir el perfil antropométrico y la composición corporal de las selecciones olímpicas mexicanas de voleibol de playa en ambos géneros. Los participantes fueron las parejas uno y dos de México en ambos géneros (definidos por ranking Fédération Internationale de Volleyball), 4 mujeres y 4 hombres con edad promedio de 30.25±6.85 y 27.25±7.36 años. La técnica utilizada fue el método del somatotipo de Heath-Carter y el protoolo ISAK del perfil antropométrico restringido. Entre los hallazgos resultantes de la investigación, se puede observar una unificación en las carácteristicas morfológicas masculinas (pliegue cuatáneotricipital, pliegue cutáneo anterior del muslo, pliegue citáneo de la pantorrila, circunferencia del brazo relajado y contraído, cintura, cadera, diámetro del fémur e IMC), en cuanto al somatotipo, ambos sexos de las parejas mexicanas se posicionan en mesomorfos-equilibrados. En relación a otros estudios consultados, se observa equilibrio en somatotipo y desarrollo muscular con equipos de alto rendimiento. El peso y la altura, así como la edad, son variables importantes para la selección del talento y en el futuro desempeño óptimo en el voleibol mundial y profesional.

Terapia miofuncional en síndrome de apnea obstructiva del sueño (AOS): revisión de la literatura / Myofunctional therapy in obstructive sleep apnea syndrome (OSA): a literature review

La terapia miofuncional orofacial (TMO) ha tenido un creciente desarrollo durante la última década, presentándose como una opción terapéutica en pacientes con AOS. Sin embargo, la evidencia es limitada y en Chile no hay mucho conocimiento al respecto. Se desarrolló una revisión sistemática en PubMed, MEDLINE, Embase, Web of Science, Lilacs y Scielo, que incluyó estudios primarios publicados en los últimos 10 años en idioma inglés, español o portugués y que utilizaran la TMO en pacientes adultos con AOS. Se excluyeron estudios que combinaran otras estrategias, con alteraciones miofuncionales secundarias a patologías concomitantes y con otro tipo de trastorno del sueño. La revisión consideró 9 artículos en su análisis; los resultados mostraron beneficios significativos a favor de la TMO en relación a disminución del índice de apnea-hipopnea, mejor calidad del sueño, nivel de somnolencia de Epworth, menor intensidad y frecuencia de los ronquidos, menor circunferencia del cuello, entre otros. Se concluye que la TMO genera beneficios en los pacientes con AOS, siendo una opción no invasiva y accesible.

Orofacial myofunctional therapy (OMT) has had a growing development during the last decade, presenting itself as a therapeutic option in patients with OSA. However, the evidence is limited and in Chile there is not much knowledge about it. A systematic review was developed in PubMed, MEDLINE, Embase, Web of Science, Lilacs and Scielo, which included primary studies published in the last 10 years in English, Spanish or Portuguese that used OMT in adult patients with OSA. Studies that combined other strategies, with myofunctional alterations secondary to concomitant pathologies and with another type of sleep disorder were excluded. The review considered 9 articles in its analysis; The results showed significant benefits in favor of OMT in relation to a decrease in the apnea-hypopnea index, better sleep quality, Epworth sleepiness level, less intensity and frequency of snoring, less neck circumference, among others. It is concluded that OMT generates benefits in patients with OSA, being a non-invasive and accessible option.

Successes and challenges of latent TB screening and treatment in a high-prevalence US region.

BACKGROUND: South Texas has higher TB disease incidence than much of the United States. We evaluated a multi-site South Texas interferon-gamma release assay (IGRA)-based testing and latent TB infection (LTBI) treatment program targeting high-risk populations.METHODS: Number of IGRA tests, test results, LTBI confirmation, and treatment outcomes were collected over 2.5 years. Sixteen semi-structured patient interviews and 10 site-based focus groups were conducted with providers, nurses, and administrators. Grounded theory identified themes associated with successful outcomes.RESULTS: Of 9,050 IGRA tests, 687 (8%) were positive; 340 (49%) confirmed as LTBI; 191 initiated LTBI treatment; and 130 (68% of initiators) completed treatment. Patient barriers to treatment completion included lack of knowledge, misconceptions, and treatment toxicities. Clinic staff concurred that toxicity was a barrier to treatment and requiring new processes with limited resources were implementation barriers.CONCLUSIONS: Over 9,000 patients were screened with a high prevalence of IGRA positivity, but confirming LTBI, initiating, and completing treatment were challenging. Qualitative evaluation supports low literacy patient education on LTBI and toxicities and expanded support for process implementation and provider training. These findings highlight challenges at all levels of the LTBI care cascade and provide patient, staff, and provider perspectives on implementation of these programs.

Perfil antropométrico, somatotipo y estado nutricional del taekwondoín mexicano / Anthropometric profile, somatotype and nutritional status of Mexican taekwondoin

RESUMEN: El perfil antropométrico y el somatotipo son herramientas imprescindibles para monitorizar el rendimiento morfológico del atleta de alto rendimiento. El objetivo del presente estudio es la descripción del perfil antropométrico y el somatotipo dominante de atletas mexicanos de taekwondo (TKD) de alto rendimiento. El perfil antropométrico y el somatotipo fueron determinados en 16 atletas de TKD mexicanos [8 hombres, edad media 21,5 años (19,8-23,0, IC 95%); 8 mujeres, edad media 21,9 años (19,2-24,4, IC 95%)]. Una prueba T-Student para muestras independiente fue usada para comparar las medias entre ambos sexos (Hombres vs Mujeres). La estatura (P = 0,001), los pliegues del muslo anterior (p = 0,006) y pantorrilla (p = 0,049), la circunferencia del brazo flexionado (p = 0,047), los diámetros del húmero (p = 0,011) y fémur (p = 0,012), el área total y área muscular del brazo (p = 0,001) fueron significativamente diferentes entre hombres y mujeres. Un somatotipo ecto-mesomórfico predomino tanto en hombres (2,1-3,2-4,2) como en el grupal (2,4-3,1-3,8), pero ectomorfo-mesomórfico (2,8-3,2-3,4) para las mujeres. El somatotipo del atleta de TKD mexicano predominó por una mayor linearidad relativa seguido de una magnitud musculoesquelética y una menor adiposidad relativa. Los hallazgos de este estudio aportan evidencias morfológicas para monitorizar el rendimiento físico y nutricional del atleta de TKD.

SUMMARY: Body composition, somatotype and nutritional status are essential tools for monitoring the perfor- mance of high-performance athlete. The objective of the present study was to verify the body composition, the dominant somatotype and nutritional status of high-performance taekwondo athletes of the Mexican TKD team. The anthropometric profile, somatotype and nutritional status were determined in sixteen Mexican TKD athletes [8 men, mean age 21.5 yrs. (19.8-23.0 95% CI); 8 women, mean age 21.9 yrs. (19.2-24.4 95% CI)]. An independent-samples t-test was used to compare the means between both genders (Men vs. Women). The height (p = 0.001), the anterior thigh (p = 0.006) and calf (p = 0.049) folds, the flexed arm circumference (p = 0.047), the humerus (p = 0.011) and femur (p = 0.012) diameters, the fat free mass (p = 0.020) and arm total area (p = 0.049) and arm muscle area (p = 0.001) were significantly different between men and women. The percentage of body fat and arm fat area were not significant between both genders. A normal caloric reserve, but a slightly high percentage of body fat was observed for both genders. In addition, normal and high protein reserves were identified for men and women, respectively. An ecto-mesomorphic somatotype was highlighted in both men (2.1-3.2-4.2) and in the group (2.4-3.1-3.8), but ectomorphic- mesomorphic (2.8-3.2-3.4) to women. The somatotype of the Mexican TKD athlete predominated by a greater relative linearity followed by a musculoskeletal magnitude and a lower relative adiposity. The findings of this study provide morphological evidence to monitor the physical and nutritional performance of the high-performance TKD athlete.

Sustentabilidad hospitalaria, calidad y seguridad del paciente en el Hospital Clínico Universidad de Chile / Hospital sustainability, quality and patient safety in Hospital Clínico Universidad de Chile

The sustainability of the Universidad de Chile Clinical Hospital must be understood comprehensively; providing higher quality and safety for our patients, ensuring highest standards of medical care. The quality of care must be understood not only in complying with the minimum standards to accredit and grant GES benefits, establish agreements with health insurers and be financially competitive; It must be incorporated into its management the dimensions of quality - effectiveness, efficiency, accessibility, safety, equity and patient-centered care- minimizing the costs of non-quality work. Our Clinical Hospital, as our country's main training center in healthcare professions, must include training at the undergraduate students' curriculum in quality and patient safety issues. (AU)

Perfil antropométrico y composición corporal de la selección mexicana varonil mayor de voleibol / Anthropometric profile and body composition of the Mexican men´s volleyball team

RESUMEN: Determinar el perfil antropométrico y de composición corporal de los atletas ha sido -hasta hace poco- una herramienta fundamental para predecir el rendimiento deportivo y comportamiento biomecánico. Para este estudio, se evaluaron a 15 jugadores de la Selección Mexicana de Voleibol Varonil, con edad de 26,4 ± 4,73, previo a la XIV Copa Panamericana de Voleibol 2019. Se utilizó el protocolo ISAK para la toma antropométrica así como las ecuaciones de Carter & Heath para determinar el perfil antropométrico y somatotipo, el porcentajey kg de grasa, se calculó a partir de la ecuación de Durnin & Womersley, la masa muscular con el método De Rose y Gimares, y tejido óseo con la ecuación de Rocha. Resultados: el peso promedio fue de 85,45 kg (± 8,39), estatura 192,71 cm (± 7,15); somatotipo: endomorfo (2,3 ± 0,8), mesomorfo (4,0±1,4) y ectomorfo (3,6 ± 1,5). El % GC promedio fue de (3,6 ± 1,5), kg GC (11,2 ± 4,0), de % MM (43,8 ± 2,3), kg MM (37,3 ± 2,7), % TO (19,3 ± 1,8), KgTO (16,4 ± 1,2). Se concluye que la Selección Mexicana Varonil Mayor de Voleibol se encuentra dentro de los rangos competitivos de una Selección mayor; así como también muestra valores de referencia internacional. Presenta dos perfiles somatotípicos, endo-mesomórfico para jugadores defensivos y ecto-mesomórficos en jugadores ofensivos, beneficiando técnicamente su desempeño.

SUMMARY: Until recently, determining the anthropometric and body composition profile of athletes has been a fundamental tool for predicting sports performance and biomechanical behavior. For this study, 15 players form the Mexican Men`s Volleyball Team, aged 26.4±4.73, were evaluated prior to the beginning of the XIV 2019 Pan- American Volleyball Cup, using the ISAK protocol. As well as the Carter & Heath equation to determine the anthropometric profile and somatotype, the percentage and Kg of fat, with the Durnin & Womersley equation, the De Rose and Gimares muscle mass, and bone tissue with the Rocha equation. The average weight was 85.45 kg (± 8.39), height 192.71 cm (±7.15); somatotype: endomorphic (2.3 ± 0.8), mesomorphic (4.0 ± 1.4), and ectomorphic (3.6 ± 1.5). The overage % GC was (3.6 ± 1.5). kg GC (11.2 ± 4.0), de % MM (43.8 ± 2.3) kg MM (37.3 ± 2.7), % TO (19.3 ± 1.8), kg TO (16.4 ± 1.2). It is concluded that the Mexican Men`s Volleyball Team is within the competitive ranges of a larger international teams, in addition, and as international reference values, the Selection presents two somatotypes profile, endo-mesomorphic for defensive players and ecto-mesomorphic for offensive players, technically benefiting their performance.

Dimorfismo sexual de la leptina, resistencia a la insulina y composición corporal en prepúberes normopeso / Leptin sexual dimorphism, insulin resistance, and body composition in normal weight prepubescent

INTRODUCCIÓN: La etapa prepuberal es un periodo crítico del desarrollo de la grasa corporal, en el cual la leptina y la resistencia a la insulina han sido asociados, sin embargo, hay pocos estudios en prepúberes normo- peso. OBJETIVO: Evaluar la relación de leptina con composición corporal y resistencia a la insulina en un grupo de prepúberes normopeso. PACIENTES Y MÉTODO: Estudio transversal analítico en 128 pre púberes saludables, normopeso, entre 6 y 10 años. Se midieron, talla, peso, índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), perímetro abdominal (PA) y perímetro de cadera (PC). Se determinó leptina (ng/ml) e Insulina (μU/L) en plasma por inmunoensayo y glicemia (mmol/L) por método enzimático. Se calculó HOMA-IR. Se hizo análisis de comparación y de correlación por sexo. RESULTADOS: Se confirmó en niñas un mayor nivel de leptina (6,8 ± 5 vs 3,3 ± 3,7; p = 0,000), insulina (7,1 ± 4,5 vs 5,2 ± 2,5; p = 0,016), PGC (22,4 ± 4,3 vs 18,6 ± 3,9; p = 0,000) y PC (67 ± 5,7 vs 65,0 ± 4,5; p = 0,019), y un menor índice cintura/cadera (0,84 ± 0,04 vs 0,88 ± 0,04; p = 0,000) comparado con varones. Las correlaciones de leptina con variables antropométricas fueron signifi cantes en ambos sexos, con mayor asociación en sexo femenino. La asociación del HOMA-IR con la leptina fue similar en ambos sexos. CONCLUSIONES: En prepúberes normopeso de 6 a 10 años, hay diferencias por sexo en adiposidad y en niveles de leptina, no asociadas con diferencias en el IMC ni en la resistencia a la insulina. La mayor asociación de leptina con adiposidad en las niñas podría estar relacionada con una elevada tasa de adipogénesis inducida por esta hormona.

INTRODUCTION: The prepubertal stage is a critical period of body fat development, in which leptin and insulin re sistance has been associated, however, there are few studies in normal-weight prepubescents. OBJECTIVE: To assess the relationship between leptin and body composition and insulin resistance in a group of normal-weight prepubescents. PATIENTS AND METHOD: Analytical cross-sectional study with 128 healthy prepubescents of normal weight, aged between 6 and 10 years. Height, weight, body mass index (BMI), body fat percentage (BFP), waist circumference (WC), and hip circumference (HC) were measured. Plasma leptin (ng/mL) and insulin (mU/L) were evaluated by immunoassay and glycemia (mmol/L) by enzymatic method. HOMA-IR was calculated. A comparison study and correlation analysis by sex were performed. RESULTS: Females presented higher values than males of leptin (6.8 ± 5 vs 3.3 ± 3.7; p = 0.000), insulin (7.1 ± 4.5 vs 5.2 ± 2.5; p = 0.016), BFP (22.4 ± 4.3 vs 18.6 ± 3.9; p = 0.000), and HC (67 ± 5.7 vs 65.0 ± 4.5; p = 0.019), and a lower waist/hip ratio (0.84 ± 0.04 vs 0.88 ± 0.04; p = 0.000). Leptin correlations with anthropometric variables were significant in both sexes, with greater association in females. The association of HOMA-IR with leptin was similar in both sexes. CONCLUSIONS: in normal-weight prepubescents aged between 6-10 years, there are sex differences in adiposity and leptin levels not associated with differences in BMI or insulin resistance. The greater association of leptin with adiposity in girls could be related to a high rate of adipogenesis induced by this hormone.

Estudio etnográfico de jóvenes skater: prácticas corporales y urbanas / Ethnographic study of young skaters: body and urban practices

El presente trabajo corresponde a un estudio etnográfico clásico, que tiene como objetivo explorar el espacio de construcción de los nuevos estilos de vida y prácticas corporales en los jóvenes skaters urbanos de Colima. El estudio se realizó en un parque emblemático: La Piedra Lisa, localizado en la capital del estado de Colima, México. La unidad de observación la integraron 50 jóvenes, entre 12 y 20 años, que practican el skate durante la semana. El método utilizado fue el etnográfico, las técnicas de investigación fueron la observación participante ­durante un mes y medio­ y la entrevista informal; y como instrumento de registro se empleó el diario de campo. En la sistematización de la información y clasificación se usó la Guía de Murdock. El estudio describe aspectos identitarios de los jóvenes skaters, información acerca del desarrollo de habilidades físicas coordinativas, condicionales y de experticia skate, lugares de encuentro y apropiación de espacios públicos, clasificación de los skaters por grupos, el equipamiento utilizado, y la percepción social que se tiene de sí mismos, de la sociedad, la familia y de los amigos.

The present work corresponds to a classic ethnographic study, which aims to explore the construction space of new lifestyles and bodily practices in young urban skaters in Colima. The study was conducted in an emblematic park: La Piedra Lisa, located in the capital of the state of Colima, Mexico. The observation unit was made up of 50 young people between 12 and 20 years old, who skate during the week. The method used was ethnographic, the research techniques were participant observations ­for a month and a half­ and the informal interview, and the field newspaper was used as recording instrument. For the systematization of information and classification, the Murdock Guide was used. The study describes identity aspects of young skaters, information about the development of coordinative, conditional and skateboarding physical skills, meeting places and appropriation of public spaces, classification of skaters by groups, the equipment used, and the social perception that it has of itself, society, family and friends.

Aspects of inflammatory bowel disease during the COVID-19 pandemic and general considerations. / Aspectos y consideraciones generales en la enfermedad inflamatoria intestinal durante la pandemia por COVID-19.

So far, available evidence suggests that patients with inflammatory bowel disease (IBD) are not at greater risk for developing COVID-19 infection. In regard to patients with IBD remission: 5-aminosalycylates (5-ASAs) do not increase the risk for infection and should be continued. There is no need to suspend them or lower the dose. Immunomodulating drugs, such as thiopurines and methotrexate, should be continued, without modifying doses (even in patients with positive SARS-CoV-2 infection). No type of biologic therapy should be suspended, unless there are signs of COVID-19. Regarding patients with IBD activity: the oral and/or topical 5-ASA dose should be optimized in cases of disease relapse. Budesonide MMX should be considered in cases of mild-to-moderate activity, to avoid systemic steroid use. Systemic steroids should be avoided whenever possible because doses above 20mg per day have an immunosuppressive effect, which could increase susceptibility to any type of infection, including COVID-19. The combined use of thiopurines with steroids and/or tumor necrosis factor (TNF) monoclonal antibodies should also be avoided because those combinations can increase the risk for infections, including COVID-19. Finally, biologic treatment with anti-TNF-alpha agents or any other mechanism of action, such as anti-integrins or anti-interleukins, should be suspended if patients become infected with SARS-CoV-2. The drugs can be restarted once the infectious process is resolved.

Correlation between imagenological and histological diagnosis of bone tumors. A retrospective study / Correlación entre el diagnóstico imagenológico e histológico de tumores óseos. Un estudio retrospectivo

Abstract: Introduction: The objective of this study was to retrospectively compare imaging techniques with histopathological findings from bone biopsy. Material and methods: Imaging techniques such as X-Ray, CT scan and MRI where compared with the histopathological findings from bone biopsy, in a population of 64 patients with bone tumors, with 64.1% of males and an age range of 5 to 79 years. Results: Histologically, 39.1% were malignant bone tumors, while 60.9% were benign. The X-ray showed 90% of diagnostic accuracy, with sensitivity of 92.9%, specificity of 87.5%, positive predictive value of 86.7% and negative predictive value of 93.3%. CT scan presented 75.9% of diagnostic accuracy, with 84.6, 68.8, and 84.6% of sensitivity, specificity, positive predictive value and negative predictive value, respectively. The MRI documented a diagnostic accuracy of 95.1%, with 94.4% os sensitivity, 95.7% of specificity, 94.4% of positive predictive value and 95.7% for negative predictive value. This showed a great agreement between the histology findings and those within the X-Ray and MRI (K = 0.8 and 0.9, respectively), but doesn't depreciate the value of bone biopsy in diagnosis of bone tumors. Conclusion: This data showed good correlation between imagenological and histopatologic techniques.

Resumen: Introducción: El objetivo de este estudio fue comparar retrospectivamente las técnicas de imagen con los hallazgos histopatológicos de la biopsia ósea. Material y métodos: Las técnicas de diagnóstico por imágenes como rayos X, tomografía computarizada y resonancia magnética fueron comparadas con los hallazgos histopatológicos de la biopsia ósea, en una población de 64 pacientes con tumores óseos, con 64.1% de los varones y un rango de edad de cinco a 79 años. Resultados: Histológicamente, 39.1% eran tumores óseos malignos, mientras que 60.9% eran benignos. Los rayos X mostraron un 90% de precisión diagnóstica, con una sensibilidad de 92.9%, especificidad de 87.5%, valor predictivo positivo de 86.7% y un valor predictivo negativo de 93.3%. La tomografía computarizada presentó 75.9% de la precisión diagnóstica, con 84.6, 68.8, y 84.6% de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo, respectivamente. La resonancia magnética documentó una precisión diagnóstica de 95.1%, con 94.4% de sensibilidad, 95.7% de especificidad, 94.4% de valor predictivo positivo y 95.7% para valor predictivo negativo. Esto mostró un gran acuerdo entre los hallazgos de histología y los que están dentro de la radiografía y la RMN (K=0.8 y 0.9, respectivamente), pero no deprecia el valor de la biopsia ósea en el diagnóstico de tumores óseos. Conclusiones: Estos datos mostraron una buena correlación entre técnicas imagenológicas e histopatológicas.

Tratamiento del síndrome de apneas e hipopneas obstructivas del sueño con terapia miofuncional orofaríngea: experiencia en hospital público de Chile / Treatment of obstructive sleep apnea syndrome with myofunctional oropharyngeal therapy: experience in public hospital of Chile

RESUMEN Introductión El síndrome de apneas e hipopneas obstructivas del sueño (SAHOS) afecta al 2%-4% de las personas adultas. El CPAP es la principal terapia en casos moderados y severos, pero sólo es tolerado en el 50%-70% de los pacientes. La terapia miofuncional orofaríngea (TMO) ayuda a reducir el colapso de la via aérea superior mediante ejercicios de fortalecimiento de la musculatura orofaríngea. En la última década ha demostrado una buena eficacia en grupos variados de pacientes con SAHOS. Objetivo Estudiar efectividad de la TMO en pacientes con SAHOS. Material y método Revisamos retrospectivamente 12 pacientes con SAHOS leve y moderado tratados con TMO. Los datos demográficos y polisomnográficos se analizaron antes y después de la terapia. Resultados Edad media: 65 ±9,0 años, el 58,3% eran mujeres, el 33,3% eran obesos. Observamos una disminución significativa del IAH (13,64 ±1,99 vs 10,13 ±2,09, p =0,008); una mejoría en la eficiencia del sueño, los porcentajes de etapas N3-REM y del índice de microdespertares. También observamos una reducción clínicamente significativa en las puntuaciones de la escala de somnolencia de Epworth, del Mallampatti y el perímetro cervical. Conclusión La TMO fue eficaz en la mayoría de los pacientes con SAHOS leve y moderado. Cada unidad de sueño en centros de salud públicos en Chile debe considerar este tratamiento.

ABSTRACT Introduction The obstructive sleep apnea syndrome (OSA) affects about 2%-4% of adults. CPAP is the first indication to treat moderate and severe cases, however the treatment is tolerated in only 50%-70% of patients. Therapy with myofunctional oropharyngeal (TMO) exercises helps to reduce upper airway collapsibility by strengthening the oropharyngeal musculature, and in the last decades had demonstrated good efficacy in variated groups of OSA patients. Aim: To study TMO effectivity in OSA patients. Material and method: We reviewed retrospectively the clinical records of 12 (7 female) mild and moderate unselected OSA patients. Clinical and polysomnographic data were analyzed before and after TMO. Results: The mean age of patients was 65.0 ±9.0 years and median BMI was 26.7 kg/m2. TMO was associated to a significant reduction in median of Epworth somnolence scale (11.0 vs. 7.0), median apnea hypopnea index (13.4 vs 9.0 events/h), and decrease in cervical circumference. There was a tendency to improve quality of NREM sleep with increases in N3 stage and decrease in arousal index. Conclusion: In a real clinical context, TMO reduced the severity of OSA in 41.6% in the studied patients. Because of its safety and low cost, TMO should be introduced as a therapeutic option in public sleep units in Chile.

Correlation between imagenological and histological diagnosis of bone tumors. A retrospective study.

INTRODUCTION: The objective of this study was to retrospectively compare imaging techniques with histopathological findings from bone biopsy. MATERIAL AND METHODS: Imaging techniques such as X-Ray, CT scan and MRI where compared with the histopathological findings from bone biopsy, in a population of 64 patients with bone tumors, with 64.1% of males and an age range of 5 to 79 years. RESULTS: Histologically, 39.1% were malignant bone tumors, while 60.9% were benign. The X-ray showed 90% of diagnostic accuracy, with sensitivity of 92.9%, specificity of 87.5%, positive predictive value of 86.7% and negative predictive value of 93.3%. CT scan presented 75.9% of diagnostic accuracy, with 84.6, 68.8, and 84.6% of sensitivity, specificity, positive predictive value and negative predictive value, respectively. The MRI documented a diagnostic accuracy of 95.1%, with 94.4% os sensitivity, 95.7% of specificity, 94.4% of positive predictive value and 95.7% for negative predictive value. This showed a great agreement between the histology findings and those within the X-Ray and MRI (K = 0.8 and 0.9, respectively), but doesnt depreciate the value of bone biopsy in diagnosis of bone tumors. CONCLUSION: This data showed good correlation between imagenological and histopatologic techniques.

INTRODUCCIÓN: El objetivo de este estudio fue comparar retrospectivamente las técnicas de imagen con los hallazgos histopatológicos de la biopsia ósea. MATERIAL Y MÉTODOS: Las técnicas de diagnóstico por imágenes como rayos X, tomografía computarizada y resonancia magnética fueron comparadas con los hallazgos histopatológicos de la biopsia ósea, en una población de 64 pacientes con tumores óseos, con 64.1% de los varones y un rango de edad de cinco a 79 años. RESULTADOS: Histológicamente, 39.1% eran tumores óseos malignos, mientras que 60.9% eran benignos. Los rayos X mostraron un 90% de precisión diagnóstica, con una sensibilidad de 92.9%, especificidad de 87.5%, valor predictivo positivo de 86.7% y un valor predictivo negativo de 93.3%. La tomografía computarizada presentó 75.9% de la precisión diagnóstica, con 84.6, 68.8, y 84.6% de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo, respectivamente. La resonancia magnética documentó una precisión diagnóstica de 95.1%, con 94.4% de sensibilidad, 95.7% de especificidad, 94.4% de valor predictivo positivo y 95.7% para valor predictivo negativo. Esto mostró un gran acuerdo entre los hallazgos de histología y los que están dentro de la radiografía y la RMN (K=0.8 y 0.9, respectivamente), pero no deprecia el valor de la biopsia ósea en el diagnóstico de tumores óseos. CONCLUSIONES: Estos datos mostraron una buena correlación entre técnicas imagenológicas e histopatológicas.

Autonomic dysfunction in hereditary spastic paraplegia type 4.

BACKGROUND AND PURPOSE: SPAST mutations are the most common cause of hereditary spastic paraplegia (SPG4-HSP), which is characterized by progressive lower limb weakness, spasticity and hyperreflexia. There are few studies about non-motor manifestations in this disease and none about autonomic involvement. Therefore, the aim was to determine the frequency and pattern of autonomic complaints in patients with SPG4-HSP, as well as to determine the clinical relevance and the possible factors associated with these manifestations. METHODS: Thirty-four molecularly confirmed SPG4 patients were recruited in a multicenter cross-sectional study, of whom 26 underwent detailed neurophysiological testing (heart rate variability, sympathetic skin response and the Quantitative Sudomotor Axonal Reflex Test). The Scales for Outcomes in Parkinson's Disease - Autonomic Questionnaire (SCOPA-AUT) was applied to quantify the severity of autonomic symptoms. Results were compared with 44 age- and gender-matched healthy controls using non-parametric tests. P values <0.05 were considered significant. RESULTS: In the SPG4-HSP group, there were 18 men with a mean age of 47.7 ± 12.6 years. SCOPA-AUT scores were similar between patients and controls (P = 0.238). Only the urinary domain subscore was significantly higher amongst patients (4 vs. 2.5, P = 0.05). Absent sympathetic skin response in the hands and feet was more frequent amongst patients (20% vs. 0%, P < 0.001, and 64% vs. 0%, P = 0.006, respectively). Quantitative Sudomotor Axonal Reflex Test responses were also smaller throughout all recording regions in the SPG4-HSP group. CONCLUSION: Our results indicate that SPG4-HSP patients have sudomotor dysfunction caused by damaged small post-ganglionic cholinergic fibers. Damage in SPG4-HSP extends to the peripheral nervous system.

INFLUENCE OF TEMPERATURE ON THE AVERAGE VELOCITY OF MUSCLE FATIGUE IN Rhinella marina SARTORIUS / Influencia de la temperatura en la velocidad promedio de la fatiga muscular en el sartorio de rhinella marina

Abstract Objective: To analyze and compare the effect of temperature on the average velocity of the linear phase and the exponential phase stages produced by periodic stimulation with simple twitching or with tetanus in the toad sartorius. Methods: an in vitro experimental study with a sample of 46 toad sartorius muscles randomly selected. At the temperatures studied, peak tension produced with two stimulus patterns (twitching and tetanus) were measured until reaching the corresponding muscle fatigue in each case. The tension velocity drop in the linear phase and the exponential phase for each type of fatigue were calculated, and the regression slopes obtained with the Arrhenius equation were compared. Results: The temperatures used (1 to 12°C) significantly affected the velocity of fatigue in the stages of linear and exponential phases of both types of fatigue (p <0.05). The function of which the fatigue curves were adjusted to the temperatures used was similar to the function used with the curves at room temperature. When comparing the slopes of Arrhenius regression in the exponential phase and the different stages of the linear phase of each fatigue and between both fatigues, no significant differences were found (p>0.05). Conclusions: The temperature significantly affected average development velocity of fatigue in the different phases of the two types of fatigue, but when comparing slopes of most regressions corresponding to Arrhenius there were no significant differences, suggesting that the mechanisms underlying the different stages of fatigue have equal sensitivity to temperature.

Resumen Objetivos: Analizar y comparar el efecto de la temperatura en la velocidad promedio de las etapas de la fase lineal y de la fase exponencial de la fatiga producida por estimulación periódica con sacudida simple o con tétanos en el sartorio de sapo. Métodos: Estudio experimental, in vitro; muestra: 46 músculos de sartorio de sapo seleccionados aleatoriamente. A las temperaturas estudiadas, se midió la tensión pico producida con dos patrones de estímulo (sacudida simple o tétanos) hasta llegar en cada caso a un tipo de fatiga muscular, se calculó la velocidad de caída de la tensión en las etapas de la fase lineal y en la fase exponencial de cada tipo de fatiga y se compararon las pendientes de las regresiones obtenidas con la ecuación de Arrhenius. Resultados: Las temperaturas utilizadas (1 a 12°C) afectaron significativamente (p<0,05) la velocidad de la fatiga en las etapas de las fases lineal y exponencial de ambos tipos de fatiga. La función con que se ajustaron las curvas de fatiga a las temperaturas usadas fue similar a la usada con las curvas a temperatura ambiente. Al comparar entre las pendientes de las regresiones de Arrhenius de la fase exponencial y las diferentes etapas de la fase lineal de cada una de las fatigas y entre ambas fatigas, no hubo diferencias significativas (p>0,05). Conclusiones: La temperatura afectó significativamente la velocidad promedio de desarrollo de la fatiga en las diferentes fases de los dos tipos de fatiga, pero al comparar las pendientes de la mayoría de las regresiones correspondientes de Arrhenius, no se encontraron diferencias significativas, lo cual sugiere que, los mecanismos que subyacen a las diferentes etapas de la fatiga tienen igual sensibilidad a la temperatura.

Myosin XI is associated with fitness and adaptation to aridity in wild pearl millet.

Phenotypic changes in plants can be observed along many environmental gradients and are determined by both environmental and genetic factors. The identification of alleles associated with phenotypic variations is a rapidly developing area of research. We studied the genetic basis of phenotypic variations in 11 populations of wild pearl millet (Pennisetum glaucum) on two North-South aridity gradients, one in Niger and one in Mali. Most of the 11 phenotypic traits assessed in a common garden experiment varied between the populations studied. Moreover, the size of the inflorescence, the number of flowers and aboveground dry mass co-varied positively with a decrease in rainfall. To decipher the genetic basis of these phenotypes, we used an association mapping strategy with a mixed model. We found two SNPs on the same myosin XI contig significantly associated with variations in the average number of flowers. Both the allele frequency of the two SNPs and the average number of flowers co-varied with the rainfall gradient on the two gradients. Interestingly, this gene was also a target of selection during domestication. The Myosin XI gene is thus a good candidate for fitness-related adaptation in wild populations.

[Atipic osteosarcoma in the femoral shaft case report and review of the literature]. / Osteosarcoma con presentación atípica en tercio medio de diáfisis de fémur. Reporte de un caso clínico y revisión de la literatura.

Osteosarcoma is the most frequent primary malignant bone tumor. It is characterized by osteoid production by tumor cells. Its most frequent location is in the metaphyses of long bones, but a purely diaphyseal presentation is reported in 10% of cases. We report the case of a female 25 year-old patient whose symptoms of pain and swelling of the right mid thigh started four months before, without an apparent cause. Femur X-rays showed a tumor in the femoral shaft. The MRI showed extension to soft tissues with no compromise of the neurovascular bundle. The histopathologic report of the incisional biopsy was osteoblastic and chondroblastic osteosarcoma, classified as Enneking IIB, AJCC IIB. Treatment consisted of three cycles of neoadjuvant chemotherapy. Then intercalary femur resection plus reconstruction with centromedullary nailing and a diaphyseal spacer were performed. The histopathologic report was 95% necrosis (Huvos grade III). Three cycles of adjuvant chemotherapy were given and now, 18 months after completing the latter, the patient has no signs of local or distant tumor activity, and she can walk unassisted. Despite the fact that osteosarcoma does not occur usually in the mid shaft of long bones, we should always bear it in mind as part of the differential diagnosis for other conditions that occur more frequently in that region. Such location allows for a broad gamut of surgical approaches that spare the adjacent joints.

El osteosarcoma es el tumor maligno primario más frecuente del hueso. Se caracteriza por la formación de osteoide por las células tumorales. Su localización más frecuente es en las metáfisis de los huesos largos; sin embargo, la presentación puramente diafisaria se reporta en 10% de los casos. Se expone el caso de paciente del género femenino de 25 años que inició padecimiento cuatro meses previos a nuestra valoración al presentar dolor y aumento de volumen en tercio medio de muslo derecho, sin causa aparente. Las radiografías del fémur revelaron un tumor en la diáfisis del mismo. La resonancia magnética mostró extensión a partes blandas, sin compromiso del paquete neurovascular. Se tomó biopsia incisional con reporte histopatológico de osteosarcoma osteoblástico y condroblástico. Se clasificó como Enneking IIB, AJCC IIB. Inició tratamiento con tres ciclos de quimioterapia neoadyuvante y posteriormente se le realizó resección intercalar de fémur más reconstrucción con clavo centromedular y espaciador diafisario. El reporte histopatológico evidenció necrosis de 95% (Huvos grado III). Se continuó con tres ciclos de quimioterapia adyuvante. A 18 meses de concluida la quimioterapia adyuvante la paciente se encuentra sin datos de actividad tumoral local o a distancia, tolerando la deambulación sin auxiliares de la marcha. A pesar de que el osteosarcoma no se presenta de forma habitual en el tercio medio de la diáfisis de los huesos largos, debe siempre tomarse en cuenta como un diagnóstico diferencial con otras patologías de localización más frecuente en dicha región. Esta localización nos permite una amplia gama de alternativas quirúrgicas con la preservación de las articulaciones adyacentes.

[Functional evaluation of the supraspinatus tendon repair comparing mini-open and open techniques]. / Evaluación funcional de la reparación del tendón del supraespinoso comparando técnica mínimamente invasiva contra técnica abierta.

OBJECTIVE: To compare two surgical techniques to address the painful shoulder syndrome with partial or total supraspinous tendon tear. METHODS: Patients with a diagnosis of complete supraspinous tendon tear who required surgical repair and subacromial decompression. One group was treated with acromioplasty and tendon plasty using an open approach (G1), and the second one underwent arthroscopy with tendon plasty using a minimally-invasive approach (G2). The surgical approach was not decided at random, but was based on the surgeons preference. The major outcome was functional assessment at postoperative month 12 using the UCLA scale. The variables compared were the operative time, anesthesia time, intraoperative bleeding, and immediate complications. Means and standard deviations were analyzed for the quantitative variables, and percentages for the qualitative variables. The U Mann-Whitney test was used to compare the ranges of non-related groups. RESULTS: Thirty-two patients were included in G1, and 13 in G2. No differences were found in age, gender, comorbid conditions, and the time elapsed before surgical treatment. G2 patients were found to have better function according to the UCLA scale (p = 0.032). No differences were reported in the operative time (60 versus 80 minutes, p = 0.12), anesthesia time (120 versus 97 minutes, p = 0.12), total bleeding (50 ml in both groups, p = 0.09), or length of stay (2 versus 1, p = 0.81). No immediate complications were reported. CONCLUSIONS: Arthroscopic repair plus a minimally-invasive approach to treat subacromial impingement and supraspinous tendon tear seems to provide better clinical outcomes based on function recovery and patient satisfaction.

Comparar dos técnicas quirúrgicas para la resolución del síndrome de hombro doloroso con lesión parcial o total del tendón del supraespinoso (SPS/RTS).

CFTR genotype-related body water and electrolyte balance during a marathon.

The aim of this investigation was to determine the influence of CFTR genotype on body water and electrolyte balance during a marathon. Fifty-one experienced runners completed a marathon race. Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected using sweat patches, and fluid and electrolyte intake were obtained using self-reported questionnaires. Thirty-eight participants (74.5% of the total) were 7T/7T homozygotes, 11 (21.6%) were 7T/9T heterozygotes, and one participant presented the rare genotype 5T/7T. Another participant with 9T/9T presented the mutation p.L206W. Participants with 7T/7T showed higher sweat sodium concentrations (42.2 ± 21.6 mmol/L) than 7T/9T (29.0 ± 24.7 mmol/L; P = 0.04). The runner with the 5T/7T genotype (10.2 mmol/L) and the participant with the p.L206W mutation (20.5 mmol/L) exhibited low-range sweat sodium concentrations. However, post-race serum sodium concentration was similar in 7T/7T and 7T/9T (142.1 ± 1.3 and 142.4 ± 1.6 mmol/L, respectively; P = 0.27) and did not show abnormalities in participants with the 5T/7T genotype (140.0 mmol/L) and the p.L206W mutation (143.0 mmol/L). Runners with the CFTR-7T/7T genotype exhibited increased sweat sodium concentrations during a marathon. However, this phenotype was not related with increased likelihood of suffering body water and electrolyte imbalances during real competitions.

Efecto del ejercicio y reposo postintervención sobre variables de riesgo cardiovascular en grupo de escolares / Effect of exercise and a post-intervention rest in cardiovacular risk variables in schoolars / Efeitos de exercicios e do repouso pos-operatorio sobre variaveis de risco cardiovascular em grupo de escolares

Objetivo: determinar el efecto de un programa de ejercicio seguido de un periodo de reposo post-intervención en marcadores de riesgo cardiovascular de un grupo de escolares de un Colegio de Cali-Colombia. Materiales y métodos: estudio experimental en el que se incluyeron 26 escolares con edades entre 10 y 13 años. Estos se sometieron a un período (4 meses) de intervención con ejercicio seguido de un periodo de reposo. Cambios en: glucosa y perfil lipídico; variables antropométricas; y parámetros de capacidad física, fueron evaluados. Resultados: los niños mostraron mayores valores de porcentaje (%) grasa corporal, cHDL, VO2max, carga y lactato al finalizar la intervención con ejercicio, e incremento significante en el valor de glicemia, IMC y % grasa corporal respecto al final del periodo de reposo post-intervención. En las niñas solo se observó incremento en la mediana de la carga luego de intervención con ejercicio. En el periodo de reposo post-intervención el IMC, porcentaje de grasa corporal y glicemia fueron más altos, y el valor de carga menor en comparación con el final de la intervención con ejercicio. Conclusiones: los niños presentaron mejor respuesta al ejercicio en variables relacionadas con riesgo cardiovascular, y este hallazgo podría estar influenciado por actividad física espontanea en los varones. En la mayoría de variables se observaron cambios negativos tras el periodo de reposo post-intervención. Para el conocimiento de los autores, este ensayo representa una primera exploración del efecto de un periodo sedentario tras un programa de ejercicio en el perfil cardiovascular de un grupo de escolares.

Objective: to determine the effect of an exercise program followed by a rest period post-intervention on cardiovascular risk markers in a group of children of Cali-Colombia school. Materials: experimental study which included 26 children aged 10-13 years old. These were subjected to a exercise intervention period (4 months) followed by a rest period. Changes in: glucose and lipid profile, anthropometric variables, and parameters of physical capacity, were evaluated. Results:boys showed higher values of body fat percentage, cHDL, VO2max, load and lactate at the end of the exercise intervention, and significant increase in the value of blood glucose, BMI and body fat percentage at the end of the post-intervention rest period. In girls only was observed an increase in load median after exercise intervention. In the post-intervention rest period BMI, body fat percentage and blood glucose were higher and the load value was lower compared to the end of the exercise intervention. Conclusions: boys had a better response to exercise in variables related to cardiovascular risk, and this finding could be influenced by spontaneous physical activity in men. In most of the variables, negative changes were observed after the post-intervention rest period. To the author’s knowledge, this paper represents a first exploration of the effect of a sedentary period after an exercise program on the cardiovascular profile of a schoolchildren group.

Objetivo: determinar o efeito de um programa de exercícios seguidos por um período de pós-intervenção nos marcadores de risco cardiovascular em um grupo de resto escolares de Cali Colombia.Materiais: estudo experimental em que 26 alunos foram incluídos com idades entre 10 e 13 anos. Estes foram submetidos a um período (4 meses ), seguido intervenção de exercício com um período de descanso. Mudanças: glicose e do perfil lipídico; variáveis antropométricas ; e foram avaliados parâmetros de capacidade física Resultado: as crianças apresentaram maior percentagem (%) de gordura corporal, o cHDL, VO2max, de carga e de lactato no final da intervenção de exercício, e aumento significativo na quantidade de glicose, imce % de gordura corporal em comparação com o fim de período de descanso pós-intervenção. Em raparigas foi observado aumento apenas no meio de carga, após a intervenção do exercício. No período de descanso pós-intervenção imc, percentual de gordura e de glicose no sangue foram maiores e menor valor de carga em relação ao final da intervenção de exercícios.Conclusões: as crianças apresentaram melhor resposta ao exercício em variáveis relacionadas ao risco cardiovascular, e este achado poderia ser influenciada pela atividade física espontânea em homens. Na maioria das variáveis foram observadas variações negativas depois do período de descanso pós-intervenção. Para o conhecimento dos autores , este estudo representa a primeira análise do efeito de um período sedentário após um programa de exercício no perfil cardiovascular de um grupo de crianças em idade escolar