Randomized, double-blind, placebo-controlled study to evaluate the effect of treatment with an SPMs-enriched oil on chronic pain and inflammation, functionality, and quality of life in patients with symptomatic knee osteoarthritis: GAUDI study.

BACKGROUND: Specialized pro-resolving mediators (SPMs), including 18-HEPE, 17-HDHA, and 14-HDHA are recognized as potentially therapeutic in inflammatory diseases because SPMs regulate the inflammation process, which leads to, for example; swelling and the sensation of pain. In osteoarthritis (OA), chronic pain is described as the symptom that reduces patients´ quality of life (QoL). The GAUDI study evaluated the efficacy of SPMs supplementation in reducing pain in the symptomatic knee of OA patients. METHODS: This randomized, multicenter, double-blind, and placebo-controlled parallel-group pilot study was performed in Spain and conducted on adults 18-68 years old diagnosed with symptomatic knee OA. Patients were enrolled in the study for up to 24 weeks, which included a 12-week intervention period and a follow-up visit on week 24. The primary endpoint was pain change measured through a Visual Analog Scale (VAS). Secondary endpoints included: Pain change evaluation, stiffness, and function according to the WOMAC index; assessment of constant, intermittent, and total pain according to the OMERACT-OARSI score; evaluation of changes in health-related QoL parameters; the use or not of concomitant, rescue, and anti-inflammatory medication; and safety and tolerability assessments. RESULTS: Patients were enrolled in the study from May 2018 to September 2021. VAS pain score was evaluated in the per protocol population (n = 51 patients), in which we observed a statistically significant reduction after 8 weeks (p = 0.039) and 12 weeks (p = 0.031) of treatment in patients consuming SPMs (n = 23 subjects) vs. placebo (n = 28 subjects). In line with the OMERACT-OARSI score, intermittent pain was reduced after 12 weeks with statistical significance (p = 0.019) in patients treated with SPMs (n = 23 subjects) vs. placebo (n = 28 subjects). Functional status as WOMAC score did not significantly change after SPMs or placebo consumption. Notably, patients consuming SPMs showed improvements in all five aspects of the EUROQoL-5, including a significant improvement in the usual-activities dimension. None of the patients required rescue medication, nor were any adverse events reported. CONCLUSIONS: These findings suggest that sustained SPMs consumption reduces pain in OA patients while also improving their Quality of Life. These results also support the safety profile of SPMs supplementation. Trial registration NCT05633849. Registered 1 December 1 2022. Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT05633849.

Management of anterior thigh injuries in soccer players: practical guide.

Most of the anterior thigh injuries are contusions or strains, however, some of these injuries can be career ending. Early diagnosis and correct treatment are key to successful outcome. Analyzing injury mechanism and adding both clinical and imaging findings, clinicians can make the right treatment decisions already often in the acute phase of the injury. Low grade contusions and muscle strains are treated well with planned rehabilitation, but complete tendon injuries or avulsions can require operative treatment. Also, neglected minor injuries could lead to chronic disabilities and time lost from play. Typical clinical presentation of anterior thigh injury is swelling and pain during hip flexion or knee extension. In more severe cases a clear gap can be palpated. Imaging methods used are ultrasound and magnetic resonance imaging (MRI) which are helpful for clinicians to determine more exact the extent of injury. MRI can identify possible tendon retractions which may need surgery. Clinicians should also be aware of other traumatic lesions affecting anterior thigh area such as myositis ossificans formation. Optimal treatment should be coordinated including acute phase treatment with rest, ice, and compression together with designed return-to-play protocol. The anatomical structure involved lines the treatment pathway. This narrative review describes these more common reasons for outpatient clinical visits for anterior thigh pain and injuries among soccer players.

Factores asociados al estilo de vida en pacientes diagnosticados con cáncer colorrectal en un Hospital de Chile / Lifestyle Factors Associated with Colorectal Cancer in Patients of a Hospital in Chile

Resumen Antecedentes: el cáncer es la segunda causa de muerte a nivel mundial, siendo uno de los más prevalentes el cáncer colorrectal. Diversos autores concluyen que un estilo de vida saludable previene en un 30 a 40 % el desarrollo de cualquier tipo de cáncer. Objetivo: evaluar retrospectivamente la ingesta de vitaminas C, E, fibra dietética, frutas, verduras, grasas saturadas, nivel de actividad física, sedentarismo, consumo de tabaco y alcohol en sujetos diagnosticados con cáncer colorrectal. Materiales y métodos: estudio descriptivo retrospectivo en 22 pacientes. Se aplicaron como instrumentos la encuesta de tendencia de consumo cuantificada, el cuestionario mundial sobre actividad física y la encuesta estructurada de caracterización. Resultados: el consumo de vitamina C fue de 131,8 mg/día; y de vitamina E, de 34,8 mg/día sobrepasando la recomendación diaria admisible (p<0,05). La ingesta de fibra dietética (8,6 g/día) fue menor a la recomendación (p<0,001). La actividad física moderada e intensa fue de 418 y 475 min/sem respectivamente, ambas mayores a la recomendación (p=0,029, p=0,015). Conclusión: una ingesta deficiente de fibra y verduras podría estar relacionada con la oncogénesis colorrectal.

Abstract Background: Cancer is the second cause of death globally and nationally in Chile. Various authors conclude that a healthy lifestyle prevents decreases the chances of developing any cancer by 30 to 40%. Objective: Retrospectively evaluate the intake of vitamin C, vitamin E, dietary fiber, fruits, vegetables, and saturated fats, and well as levels of physical activity, alcohol consumption and smoking in patients diagnosed with colorectal cancer. Materials and Methods: A descriptive retrospective study was conducted in 22 participants to establish the lifestyle factors associated with colorectal cancer. Food frequency questionnaires, a global physical activity questionnaire, and structured characterization survey were applied. Results: Vitamin C intake was 131.8 mg/day and vitamin E 34.8 mg/day, exceeding the recommended dietary allowances (p<0.05). The dietary fiber intake (8.6 g/day) was lower than the recommendation (p <0.001). Moderate and intense physical activity levels were 418 and 475 min/week respectively, both higher than the recommendation (p=0.029, p=0.015). Conclusions: Low intake of fiber and vegetables may be related to colorectal cancer.

Prevalencia de factores de riesgo cardiometabólico en estudiantes universitarios de la región centro-occidente, en la Universidad Michoacana de San Nicolás de Hidalgo, México / Prevalence of cardiometabolics factors of risk in university students of the region the center west of Mexico, in Universidad Michoacana de San Nicolas de Hidalgo México

Introducción: Las enfermedades cardiometabólicas son causa de 30% de las muertes en el mundo, siete de cada 10 mexicanos tienen sobrepeso u obesidad, condicionantes de diabetes mellitus, hipertensión arterial y enfermedades cardiovasculares. Objetivo: Estudiar la prevalencia de factores de riesgo cardiometabólico en estudiantes de la Facultad de Ciencias Médicas y Biológicas ''Dr. Ignacio Chávez'' de la Universidad Michoacana de San Nicolás de Hidalgo en Morelia, Michoacán. Material y métodos: se realizó un estudio epidemiológico, transversal, descriptivo, aleatorio y voluntario. Se evaluaron factores de riesgo cardiovascular como edad, sexo, antecedentes heredofamiliares, hipertensión arterial, diabetes mellitus, tabaquismo, obesidad, cardiopatía isquémica prematura y actividad física. Resultados: De 141 estudiantes, 67 (47.5%) fueron hombres y 74 (52.5%) mujeres, el promedio de edad (homogéneo 22.66 ± 0.18 varones y 22.23 ± 0.10 mujeres). Fumadores mujeres 9 (6.38%) y hombres 15 (10.63%); el perímetro abdominal en 5 hombres (3.5 %) fue > 102 cm, y en 13 mujeres (9.20%) > 88 cm. El valor de colesterol total normal en mujeres fue de 73 (51.80%) y en hombres de 64 (45.40%). Conclusiones: Un porcentaje elevado de universitarios presentaron sobrepeso, obesidad, tabaquismo, hipertensión arterial y alteración del perfil lipídico. Algunos factores de riesgo son modificables con cambios de estilo de vida. Es necesario que autoridades en salud y educación tomen medidas para establecer estilos de vida saludables.

Introduction: The cardiometabolics diseases cause 30% of deaths in the world, seven of ten Mexicans have overweight or obesity, conditioners of diabetes mellitus, arterial hypertension and cardiovascular diseases. Objective: To study prevalence of cardiometabolics factors of risk in students of the Faculty of Medical Sciences and Biological ''Dr. Ignacio Chávez'', in Morelia, Michoacán. Material and Methods: Study cross-sectional, descriptive, random and voluntary epidemiologist, familiars here to factors of cardiometabolics risk like the age, sex, antecedents, arterial hypertension, diabetes mellitus, tobacco addiction, obesity, premature ischemic cardiopathy and physical activity were evaluated. Results: Of 141 students 67 (47.5%) men and 74 (52.5%) women, homogenous average of age men 22.66 ± 0.10 women, 22.23 ± 0.18 women 9 (6.38%) and men 15 (10.63%) are smokers. The abdominal risk in man 5 (3.50) of ( > 102 cm), and women 13 (9.20%) ( > 88 cm). The value of normal total cholesterol was in women 73 (51.80%) and in men 64 (45.40%). Conclusions: A lifted percentage of college students presented/displayed overweight, obesity, tobacco addiction, arterial hypertension and alteration of the lipoid profile. Some factors of risk are modifiable with changes of life style, is necessary that authorities in health and education take measures to establish healthful styles of life.

Prevalencia de factores de riesgo cardiovascular en poblaciones: Rural, suburbana y urbana de los estados de Guanajuato y Michoacán / Prevalence of cardiovascular risk factors in rural, suburban and urban areas of the states of Guanajuato and Michoacan, Mexico

Introducción: Desconocemos la prevalencia de la enfermedad cardiovascular y factores de riesgo cardiovasculares en poblaciones: rurales, suburbanas y urbanas de los estados de Guanajuato y Michoacán, tienen en común al medio rural exportador de mano de obra a los Estados Unidos de Norte América y a las ciudades urbanas, hábitos como: actividad física inadecuada, consumo de grasas saturadas, inestabilidad laboral; pueden generar tensión emocional, y posible hipertensión arterial sistémica, dislipidemias, sobrepeso, obesidad, estados disglucémicos e incluso tabaquismo, factores de riesgo que varían de acuerdo a costumbres, cultura, y educación en salud de cada población. Objetivo: Determinar prevalencia de factores de riesgo cardiometabólico y su asociación con los diferentes tipos de dislipidemias, entre poblaciones: rural, suburbana y urbana de Guanajuato y Michoacán. Material y métodos: Estudio epidemiológico, transversal, descriptivo, observacional aplicado a 721 individuos de poblaciones rurales, suburbanas y urbanas de Guanajuato y Michoacán. Se registró: edad, género, antecedentes de enfermedad cardiovascular prematura, tensión arterial sistémica, tabaquismo, mediciones antropométricas, porcentaje de grasa corporal, glucemia y perfil de lípidos. Se obtuvo prevalencia de factores de riesgo y su asociación con diferentes tipos de dislipidemias determinando el riesgo relativo. Resultados: Las prevalencias de factores de riesgo fueron: para el medio rural de Michoacán, la circunferencia abdominal y porcentaje de grasa corporal. Medio urbano únicamente porcentaje de grasa corporal; para Guanajuato medio suburbano índice de masa corporal, porcentaje de grasa corporal y talla. El medio urbano de Michoacán resulto desfavorable contra el rural y suburbano de Guanajuato y Michoacán en porcentaje de grasa corporal. El colesterol HDL resultó inferior en la población suburbana, desfavorable clínicamente para Michoacán, aunque estadísticamente homogéneo. Los triglicéridos clínicamente resultaron elevados y estadísticamente homogéneos para el medio rural, suburbano y urbano en los dos estados. 1.- La dislipidemia aterogénica en el medio urbano se asoció con obesidad, hipertensión arterial y síndrome metabólico; en el medio suburbano con sobrepeso, hipertensión arterial y síndrome metabólico y en el medio rural con sobrepeso y síndrome metabólico. 2.- La dislipidemia mixta con prehipertensión y diabetes mellitus en el medio rural; con tabaquismo en el medio suburbano. 3.- La hipertrigliceridemia aislada con sobrepeso en el medio suburbano y urbano, con obesidad y síndrome metabólico en el suburbano y se asoció con tabaquismo en el medio suburbano. Conclusiones: Con los resultados obtenidos se puede sugerir: 1.- En las poblaciones rurales se retome la alimentación tradicional propia de cada región con alimentos naturales, en su mayoría sin la presencia de grasas saturadas y con carbohidratos simples, así como la implementación de planes de actividad física que permitan disminuir la incidencia de factores de riesgo cardiovascular para disminuir la circunferencia abdominal, y tensión arterial sistólica en Michoacán. 2.- La población suburbana se encuentra expuesta a estilos de vida diferentes a las poblaciones urbanas y rurales, así como a factores sociales como carencia de recursos económicos para hacer frente a sus necesidades básicas, presencia de estrés laboral o falta de trabajo, alimentación inadecuada con un elevado consumo de carbohidratos simples y grasas saturadas, falta de actividad física, presencia de tabaquismo, falta de acceso o carencia de servicios médicos preventivos y asistenciales, públicos o privados por lo que se requiere favorecer las propuestas educativas en: salud, alimentación, compensación económica y oferta de trabajo para llegar a cambios sustentables en el estilo de vida para aumentar la talla y disminuir el índice de masa corporal en Guanajuato. 3.- La población urbana tiene algunas necesidades satisfechas y de esta manera apreciamos que con menos factores de riesgo, tienen consecuencias más avanzadas como obesidad, hipertensión arterial sistémica, y síndrome metabólico.

Introduction: Unknown prevalence of cardiovascular disease in cardio metabolic risk factors in rural, suburban and urban areas of the states of Guanajuato and Michoacán, which are common to rural work exporter to the United States of America and urbanized cities, habits such as inadequate physical activity, consumption of saturated fats, job instability, which can lead to emotional stress, consequently hypertension, dyslipidemia, overweight, obesity, smoking and even disglycemics states, risk factors that vary according to customs, culture, health and education in each population. Objective: Determine prevalence of cardio metabolic risk factors and their association with different types of dyslipidemia, among populations: rural, suburban and urban areas of Guanajuato and Michoacán. Material and methods: Epidemiologic, cross-sectional, descriptive and observational study applied to 721 individuals of rural, suburban and urban populations of Guanajuato and Michoacán, what was registered: age, short, antecedents of premature cardiovascular disease, systemic blood pressure, smoking, anthropometric measurements, percentage of corporal fat, glucose and lipid profile. Results obtained the prevalence of risk factors and his association with different types of dyslipidemia determining the relative risk. Results: The prevalence of risk factors were: for rural population in Michoacán, the abdominal circumference and percentage of corporal fat. Urban population solely percentage of corporal fat; for Guanajuato suburban population the index of corporal mass, percentage of corporal fat and Stature. The results in the urban population of Michoacán are unfavorable against the rural and suburban population of Guanajuato and Michoacán in percentage of corporal fat. Cholesterol HDL was inferior in the suburban, clinically unfavorable for Michoacán, although statistically homogenous. The triglycerides were clinically high and statistically homogenous for rural, suburban and urban population in both states. 1.- Atherogenic dislipidemia in urban population are associated with obesity, arterial hypertension and metabolic syndrome; in suburban population with overweight, arterial hypertension and metabolic syndrome and in rural population with overweight and metabolic syndrome. 2.- Dislipidemia mixed with prehypertension and diabetes in rural population; and with smoking addiction in suburban population. 3.- Hypercholesterolemia are associated with smoking addiction in suburban population. Conclusions: With these results the suggestion is that rural populations return to traditional foods of each region with natural foods, mostly without the presence of saturated fats and simple carbohydrates, as well as the implementation of physical activity plans that would reduce the incidence of cardiovascular risk factors to reduce abdominal circumference, and systolic blood pressure in Michoacán. The suburban population is exposed to different lifestyles to urban and rural populations, as well as determining risk factors such as lack of financial resources to satisfy their basic needs, presence of work stress or lack of work, inadequate food with a high intake of simple carbohydrates and saturated fats, lack of physical activity, smoking status, lack of access or lack of preventive health services and welfare, public or private, requiring new proposals to promote education of health, food, economic compensation and labor opportunities to reach sustainable changes in lifestyles to increase the height and to lower body mass index in Guanajuato. Finally the urban population has more needs satisfied, with fewer risk factors but advanced consequences as obesity, hypertension, and metabolic syndrome.