Habilidades Cognitivas y Quiebres en la Conducta Sedentaria en Niños Chilenos / Cognitive Skills after Breaks in Sedentary Behavior in Chilean Children

Introducción. En Chile las tasas de sedentarismo infantil han aumentado, siete de cada 10 niños no cumple con los estándares mínimos recomendados por la Organizaciónn Mundial de la Salud. Faltan en Chile estudios que asocien el sedentarismo de tiempo libre y las horas sedentes en jornada escolar con las habilidades cognitivas. Objetivo. Determinar los cambios en las habilidades cognitivas posterior a la realización de quiebres en la conducta sedentaria. Métodos. Participaron 83 alumnos de 12 a 14 años, pertenecientes a 7° y 8° básico de la región metropolitana de Santiago de Chile. Los alumnos fueron distribuidos aleatoriamente como casos (42) y control (41). Se realizó durante 10 días, un protocolo de quiebres en la conducta sedentaria de 3 minutos cada 40 minutos, durante toda la jornada escolar. Ambos grupos tuvieron evaluaciones fisiológicas y aplicación de test de memoria y atención pre y post intervención. Resultados. Se encontraron diferencias estadísticamente significativas en la variable de atención con un valor p-value de (< 0,005) a favor del grupo intervenido. En valores de presión arterial sistólica y frecuencia cardiaca se evidencio un descenso significativo en el grupo intervenido (p<0,005) Conclusión. En este estudio se demuestra que el protocolo aplicado, mejora la habilidad cognitiva de atención en la población estudiada y además se reducen los valores de parámetros fisiológicos.

Background. In Chile, child sedentary lifestyle rates have increased; seven out of 10 children do not meet the minimum standards recommended by the World Health Organization. There is a lack of studies in Chile that associate free-time sedentary behavior and seated hours during the school day with cognitive skills. Objective. To determine the changes in cognitive abilities after the completion of sedentary behavior breaks. Methods. 83 students from 12 to 14 years old participated, belonging to 7th and 8th grade of the metropolitan region of Santiago de Chile. Students were randomly distributed as cases (42) and control (41). A protocol of sedentary behavior breaks of 3 minutes every 40 minutes was carried out during 1 week, during the whole school day. Both groups had physiological evaluations and application of memory tests and pre and post intervention care. Results. Statistically found differences were found both in the care variables with a p-value of <0.005 in favor of the intervened group, as well as in the systolic blood pressure and heart rate values evidencing a significant decrease in the intervened group (p < 0.005) Conclusion. This study shows that the applied protocol improves the cognitive ability of attention in the studied population and also reduces values of physiological parameters.

Exchanging screen for non-screen sitting time or physical activity might attenuate depression and anxiety: A cross-sectional isotemporal analysis during early pandemics in South America.

OBJECTIVES: To examine the theoretical substitutions of screen exposure, non-screen sitting time, moderate and vigorous physical activity with depressive and anxiety symptoms in South American adults during the COVID-19 pandemic. DESIGN: A cross-sectional study during the first months of the COVID-19 pandemic with data from 1981 adults from Chile, Argentina, and Brazil. METHODS: Depressive and anxiety symptoms were assessed using the Beck Depression and Anxiety Inventories. Participants also reported physical activity, sitting time, screen exposure, sociodemographic, and tobacco use data. Isotemporal substitution models were created using multivariable linear regression methods. RESULTS: Vigorous physical activity, moderate physical activity, and screen exposure were independently associated with depression and anxiety symptoms. In adjusted isotemporal substitution models, replacing 10 min/day of either screen exposure or non-screen sitting time with any intensity of physical activity was associated with lower levels of depressive symptoms. Improvements in anxiety symptoms were found when reallocating either screen exposure or non-screen sitting time to moderate physical activity. Furthermore, replacing 10 min/day of screen exposure with non-screen sitting time was beneficially associated with anxiety (B = -0.033; 95 % CI = -0.059, -0.006) and depression (B = -0.026; 95 % CI = -0.050, -0.002). CONCLUSIONS: Replacement of screen exposure with any intensity of physical activity or non-screen sitting time could improve mental health symptoms. Strategies aiming to reduce depressive and anxiety symptoms highlight physical activity promotion. However, future interventions should explore specific sedentary behaviors as some will relate positively while others negatively.

Efectos de la quiebra de la conducta sedentaria sobre parámetros fisiológicos y cognitivos en pediatría / Effects of Sedentary Behavioral Breakdown on Physiological and Cognitive Parameters in Pediatrics

Introducción: La actividad física resulta relevante para la salud física y mental. La conducta sedentaria diaria afecta la salud, y realizar actividad física contribuye al mantenimiento de la salud mental. Objetivo: Analizar, en población pediátrica, la evidencia científica actualizada relacionada con los efectos de las quiebras de la conducta sedentaria sobre marcadores cardiometabólicos y la función cognitiva. Métodos: Revisión sistemática de estudios publicados en bases de datos científicas: PubMed, Cochrane, Science Direct, Medline. Los límites de la búsqueda se ubicaron en estudios publicados entre 2016 y 2022, realizados en niños y niñas entre 4 y 13 años. Análisis y síntesis de la información: Se identificaron 127 artículos con 2522 pacientes. Se incluyeron en el análisis final 10 artículos y se consideraron dos subgrupos; a) pacientes con quiebres de la conducta sedentaria y su efecto sobre marcadores cardiometabólicos y b) pacientes con quiebras de la conducta sedentaria y su efecto sobre funciones cognitivas. Conclusiones: Los resultados obtenidos indicaron que las intervenciones con protocolos de quiebra de la conducta sedentaria constituyen un método eficaz para mejorar indicadores de salud cardiometabólica e indicadores de funciones cognitivas en la población pediátrica(AU)

Introduction: Physical activity is relevant to physical and mental health. Daily sedentary behavior affects health, and physical activity contributes to the maintenance of mental health. Objective: To analyze, in a pediatric population, the updated scientific evidence related to the effects of sedentary behavioral breaks on cardiometabolic markers and cognitive function. Methods: Systematic review of studies published in scientific databases like: PubMed, Cochrane, Science Direct, Medline. The search limits were placed on studies published between 2016 and 2022, and conducted in boys and girls aged 4 to 13 years. Analysis and synthesis of information: 127 articles with 2522 patients were identified. Ten articles were included in the final analysis and two subgroups were considered: a) patients with breaks in sedentary behavior and their effect on cardiometabolic markers and b) patients with breaks in sedentary behavior and their effect on cognitive functions. Conclusions: The results obtained indicated that interventions with sedentary behavior breakdown protocols constitute an effective method to improve cardiometabolic health markers and cognitive function markers in the pediatric population(AU)

Test cardiopulmonar: una herramienta de utilidad diagnóstica y pronóstica / Cardiopulmonary exercise test for diagnostic and prognostic purposes

The functional assessment of patients with dyspnea usually uses static or submaximal exercise tests, which provide limited information because they do not expose patients to the real situation that causes exercise intolerance. The cardiopulmonary exercise test (CPET) is an increasingly used tool that can be used in these circumstances. It determines peak oxygen consumption, anaerobic threshold and cardiac and respiratory reserves, measuring oxygen uptake and carbon dioxide production during standardized exercise conditions. It is useful for risk assessment in cardiothoracic surgery and can provide valuable information such as the timing for transplant in patients with severe chronic disease. The test is non-invasive, has a short duration, and exhibits an adequate safety profile in specialized centers. It is mainly indicated for the dynamic evaluation of athletes or patients with heart, respiratory, and neuromuscular diseases, it is essential part of the study of dyspnea of unknown origin, and in the prognostic assessment of patients who face highly complex interventions. This review provides a comprehensive review of CPET with emphasis on its main indications in healthy people, athletes and, in particular, in functional evaluation of patients with exercise limitations in the context of their chronic diseases.

[Effect of life style interventions over quality of life in colorectal cancer survivors]. / Efectos sobre la calidad de vida a través de intervenciones de estilo de vida en sobrevivientes de cáncer colorrectal.

INTRODUCTION: One third of cancer deaths are related to poor diet, physical inactivity and obesity. The high healthcare costs of cancer treatment and its repercussions on the quality of life have led the scientific community to investigate a variety of other interventions. METHODS: Review of experimental and observational studies of the last 5 years, including adult subjects surviving colorectal cancer, subjected to lifestyle interventions of a minimum duration of 12 weeks. The review was guided by the PRISMA statement (data extraction from PubMed, Science Direct and EBSCO: Medline Complete). The selection of the studies was completed using the Covidence platform. RESULTS: There are positive associations between physical activity level and quality of life; on the other hand, in survivors of colorectal cancer, inverse relationships between time of sedentary attitude and quality of life are evidenced. CONCLUSION: Lifestyle interventions generate an increase in quality of life indicators in survivors of colorectal cancer.

Efectos sobre la calidad de vida a través de intervenciones de estilo de vida en sobrevivientes de cáncer colorrectal / Effect of life style interventions over quality of life in colorectal cancer survivors

Introducción: Un tercio de las muertes por cáncer se relacionan con la mala alimentación, inactividad física y obesidad. Los elevados costos sanitarios del tratamiento de cáncer y sus repercusiones en la calidad de vida han llevado a la comunidad científica a investigar otra variedad de intervenciones. Métodos: Revisión de estudios experimentales y observacionales de los últimos 5 años, que incluyan sujetos adultos sobrevivientes de cáncer colorrectal, sometidos a intervenciones de estilo de vida de una duración mínima de 12 semanas. La revisión se guió por la declaración PRISMA (extracción de datos desde PubMed, Science Direct y EBSCO: Medline Complete). La selección de los estudios fue completada utilizando la plataforma Covidence. Resultados: Existen asociaciones positivas entre nivel de actividad física y calidad de vida; por contraparte, en sobrevivientes de cáncer colorrectal, se evidencian relaciones inversas entre tiempo de actitud sedentaria y calidad de vida. Conclusión: Las intervenciones en el estilo de vida generan aumento en los indicadores de calidad de vida, en los sobrevivientes de cáncer colorrectal.

Introduction: One third of cancer deaths are related to poor diet, physical inactivity and obesity. The high healthcare costs of cancer treatment and its repercussions on the quality of life have led the scientific community to investigate a variety of other interventions. Methods: Review of experimental and observational studies of the last 5 years, including adult subjects surviving colorectal cancer, subjected to lifestyle interventions of a minimum duration of 12 weeks. The review was guided by the PRISMA statement (data extraction from PubMed, Science Direct and EBSCO: Medline Complete). The selection of the studies was completed using the Covidence platform. Results: There are positive associations between physical activity level and quality of life; on the other hand, in survivors of colorectal cancer, inverse relationships between time of sedentary attitude and quality of life are evidenced. Conclusion: Lifestyle interventions generate an increase in quality of life indicators in survivors of colorectal cancer.

[Characterization of the physical capacity in children of the Chilean National Program of Cystic Fibrosis]. / Caracterización de la capacidad física en niños del Programa Nacional de Fibrosis Quística de Chile.

INTRODUCTION: Cystic fibrosis (CF) is an inherited, progressive, multisystem disease. Better physical capacity may slow disease progression, thus improving prognosis and survival. The objective of this research was to evaluate the physical capacity of children admitted to the National CF Pro gram of the Metropolitan Region, Chile. PATIENTS AND METHOD: A multicenter, cross-sectional stu dy design was used. The inclusion criteria were children aged 6 to 12 years enrolled in the National CF Program; Tanner sexual maturity stage I, no respiratory exacerbations in the last 30 days, and no musculoskeletal pathologies. The maximum aerobic capacity was assessed through the peak oxygen uptake (VO2peak) and determined with an incremental protocol in a magnetic cycle ergometer connected to an ergo-spirometer with which, at the same time, respiratory gases, oxygen consumption and carbon dioxide production values every 30 seconds, anaerobic threshold, and maximum workload were analyzed. The values of forced vital capacity (FVC), forced expiratory volume in 1 second (FEVJ, FEVj/FVC ratio, and forced expiratory flows between 25% and 75% of vital capacity were assessed through ergo-spirometry. At the beginning of the ergo-spirometry, arterial oxygen saturation, respiratory rate, heart rate, blood pressure, tidal volume and the per ception of lower extremity fatigue and dyspnea were recorded using the modified Borg scale. The test lasted approximately 10 minutes. RESULTS: The clinical records of 43 children collected from six health centers were reviewed. Out of these, 29 children met inclusion criteria, and 23 were re cruited. Two children were unable to participate, reducing the final subject group to 21 (13 males, 8 females). The mean age was 8.8 ± 2 years; weight 30.5 ± 10.9 kg; height 1.32 ± 0.11 m; and body mass index 17.1 ± 3.5 (z-score 0.01 ± 1.34). More than half of the children (61%) had normal weight. The obtained VO2peak was 43.7 ± 6.5 ml/min/kg (106.7 ± 19.8% of the predictive values). Only 10% of the children had values lower than those predicted by sex and age. No correlations were found between VO2peak and anthropometric and pulmonary function variables. Conclu sion: Most of the evaluated children (90%) had physical capacity similar to healthy subjects by sex and age.

Caracterización de la capacidad física en niños del Programa Nacional de Fibrosis Quística de Chile / Characterization of the physical capacity in children of the Chilean National Program of Cystic Fibrosis

Resumen: Introducción: La fibrosis quística (FQ) es una enfermedad multisistémica hereditaria y progresiva. Una mejor capacidad física puede retardar la progresión de la enfermedad, mejorando así el pronós tico y la supervivencia. El objetivo de esta investigación fue evaluar la capacidad física de los niños admitidos en el programa nacional de FQ de la Región Metropolitana, Chile. Pacientes y Método: Se utilizó un diseño de estudio transversal multicéntrico. Los criterios de inclusión fueron: niños de 6 a 12 años de edad, incluidos en el Programa Nacional de FQ, madurez sexual Tanner I, ausencia de exacerbaciones respiratorias en los últimos 30 días y ausencia de enfermedades musculoesqueléticas. La capacidad aeróbica máxima fue evaluada a través del consumo pico de oxígeno (VO2pico) y se determinó con un protocolo incremental en un cicloergómetro magnético conectado a un ergoespirómetro en el que paralelamente se analizaron los gases respiratorios: valores de consumo de oxí geno y producción de dióxido de carbono cada 30 segundos, umbral anaeróbico y carga máxima de trabajo. Además, se evaluaron los valores de capacidad vital forzada (CVF), volumen espiratorio al primer segundo (VEFj), relación VEFj/CVF y los flujos espiratorios forzados entre el 25 y 75% de la capacidad vital. Durante la prueba se registró: saturación arterial de oxígeno, frecuencia respiratoria, frecuencia cardíaca, presión arterial, volumen corriente y se consultó la percepción de fatiga de extre midades inferiores y disnea a través de la escala de Borg modificada. La duración aproximada del test fue alrededor de 10 minutos. Resultados: Se revisaron los registros clínicos de 43 niños, recogidos en seis centros de salud. Veintinueve niños cumplieron los criterios de inclusión siendo 23 reclutados. Dos niños no pudieron participar, reduciendo el grupo final de sujetos a 21 (13:8 varones:mujeres). La edad media fue de 8,8 ± 2 años; el peso fue de 30,5 ± 10,9 kg; la talla fue de 1,32 ± 0,11 m y el índice de masa corporal fue de 17,1 ± 3,5 (z-score 0,01 ± 1,34). Más de la mitad (61%) de los niños estaba eutrófico. El VO2pico obtenido fue de 43,7 ± 6,5 ml/min/kg (106,7 ± 19,8% de los valores teóricos de referencia). Sólo el 10% de los niños tenían valores inferiores a los valores teóricos esperados para población normal, ajustados por sexo y edad. No se encontraron correlaciones entre el VO2pico y las variables antropométricas y de función pulmonar. Conclusión: La mayoría de los niños evaluados (90%) tenían capacidad física similar a los valores teóricos de referencia para niños sanos ajustados por sexo y edad.

Abstract: Introduction: Cystic fibrosis (CF) is an inherited, progressive, multisystem disease. Better physical capacity may slow disease progression, thus improving prognosis and survival. The objective of this research was to evaluate the physical capacity of children admitted to the National CF Pro gram of the Metropolitan Region, Chile. Patients and Method: A multicenter, cross-sectional stu dy design was used. The inclusion criteria were children aged 6 to 12 years enrolled in the National CF Program; Tanner sexual maturity stage I, no respiratory exacerbations in the last 30 days, and no musculoskeletal pathologies. The maximum aerobic capacity was assessed through the peak oxygen uptake (VO2peak) and determined with an incremental protocol in a magnetic cycle ergometer connected to an ergo-spirometer with which, at the same time, respiratory gases, oxygen consumption and carbon dioxide production values every 30 seconds, anaerobic threshold, and maximum workload were analyzed. The values of forced vital capacity (FVC), forced expiratory volume in 1 second (FEVj), FEVj/FVC ratio, and forced expiratory flows between 25% and 75% of vital capacity were assessed through ergo-spirometry. At the beginning of the ergo-spirometry, arterial oxygen saturation, respiratory rate, heart rate, blood pressure, tidal volume and the per ception of lower extremity fatigue and dyspnea were recorded using the modified Borg scale. The test lasted approximately 10 minutes. Results: The clinical records of 43 children collected from six health centers were reviewed. Out of these, 29 children met inclusion criteria, and 23 were re cruited. Two children were unable to participate, reducing the final subject group to 21 (13 males, 8 females). The mean age was 8.8 ± 2 years; weight 30.5 ± 10.9 kg; height 1.32 ± 0.11 m; and body mass index 17.1 ± 3.5 (z-score 0.01 ± 1.34). More than half of the children (61%) had normal weight. The obtained VO2peak was 43.7 ± 6.5 ml/min/kg (106.7 ± 19.8% of the predictive values). Only 10% of the children had values lower than those predicted by sex and age. No correlations were found between VO2peak and anthropometric and pulmonary function variables. Conclu sion: Most of the evaluated children (90%) had physical capacity similar to healthy subjects by sex and age.

Hipertensión arterial pulmonar: el entrenamiento físico como complemento de la terapia farmacológica / Cardiopulmonary rehabilitation in pulmonary arterial hypertension

Cardiopulmonary rehabilitation is a promising therapy for Pulmonary arterial hypertension (PAH) whose survival does not exceed 65% at five years. We performed a literature search about rehabilitation on PAH in MEDLINE, LILACS and COCHRANE databases, considering articles from 2005 to 2017. Fifteen articles were incorporated in the final analysis. We obtained information about safety parameters, type of exercises applied, duration and frequency of sessions. The interventions included aerobic, resistance and respiratory muscle training exercises. The results showed improvements in peak oxygen uptake, six minutes walking test, quality of life and inspiratory muscle strength, among others. We conclude that the evidence supports the recommendation of physical rehabilitation in selected patients with stable PAH as a complementary strategy to the available pharmacological therapy.

Conflictos éticos en las autorías de trabajos científicos / Ethical conflicts in the authorship of scientific papers

The frequency of conflicts about authorship of publications has increased along with the increase in the number of people involved in scientific work. Some of the factors that strongly influence the generation of conflicts and malpractices in authorship definition of scientific publications are the pressure of academia, economic incentives from the pharmaceutical industry in the field of biomedicine and authors’ wishes and expectations of recognition, among other factors. The article analyzes this problem, increasingly common in the field of medicine and related areas. Special attention is devoted to the prevailing laws in our country and international guidelines related to intellectual property and authorship of scientific publications, respectively. However, the ethical commitment, intellectual honesty and truthfulness of each of the authors about what is reported seems to be the decisive factor for the solution to these authorship conflicts.