Fisiología del ejercicio y pedagogía vocal: reflexiones calisténicas

Introducción: El método de calistenia gimnástica se configura como una modalidad de ejercicios específicos que involucra la adopción de posturas artificiales a través de movimientos particulares. Estos movimientos están diseñados para producir efectos higiénicos y educativos claramente definidos. Esta modalidad de ejercicio guarda notables similitudes con el modus operandi de los vocalise en la pedagogía vocal. Objetivo: El objetivo de este trabajo es investigar las relaciones potenciales entre los principios técnico-científicos que guían el sistema de calistenia gimnástica y los principios técnico-pedagógicos que rigen los ejercicios vocales realizados por cantantes durante su proceso de enseñanza-aprendizaje. Asimismo, se busca explorar las conexiones entre los objetivos y propósitos del sistema de calistenia gimnástica y los de los ejercicios vocales en dicho proceso. Método: Para abordar este objetivo, se llevó a cabo una investigación bibliográfica que implicó el análisis detallado de fuentes pertinentes. Se examinaron publicaciones académicas y literatura especializada relacionada con la calistenia gimnástica y la pedagogía vocal. Reflexión: La calistenia gimnástica y los ejercicios vocales comparten una estructura fundamental de ejercicios específicos que implican posturas artificiales y movimientos específicos. Ambos buscan un refinamiento en la higienización y educación, permitiendo a los individuos, ya sea en el ámbito físico o vocal, desarrollarse de manera adecuada y saludable. Conclusión: A partir de la investigación bibliográfica, se concluye que los ejercicios vocales en el proceso de enseñanza-aprendizaje de los cantantes pueden considerarse una suerte de calistenia vocal. Esta conclusión se fundamenta en las relaciones intrínsecas observadas entre los principios y objetivos del sistema de calistenia gimnástica y el modus operandi de los ejercicios vocales. Esta reflexión aporta perspectivas valiosas a la pedagogía vocal, con el fin de ofrecer una comprensión más específicamente fisiológica y biomecánica de los ejercicios vocales, orientando mejor la aplicación de las vocalizaciones en el proceso de educación y entrenamiento vocal.

Introduction: The gymnastic calisthenics method is configured as a specific form of exercises involving the adoption of artificial postures through specific movements. These movements are designed to produce clearly defined hygienic and educational effects. This mode of exercise bears notable similarities to the modus operandi of vocalises in vocal pedagogy. Objective: The objective of this work is to investigate the potential relationships between the technical-scientific principles that guide the gymnastic calisthenics system and the technical-pedagogical principles governing vocal exercises practiced by singers during their teaching and learning process. Additionally, it aims to explore the connections between the objectives and purposes of the gymnastic calisthenics system and those of vocal exercises in this process. Method: To address this objective, a bibliographic research was conducted, involving a detailed analysis of relevant sources. Academic publications and specialized literature related to gymnastic calisthenics and vocal pedagogy were examined. Reflection: Gymnastic calisthenics and vocal exercises share a fundamental structure of specific exercises involving artificial postures and specific movements. Both seek refinement in hygiene and education, enabling individuals, either in the physical or vocal realm, to develop appropriately and healthily. Conclusion: Based on the bibliographic research, it is concluded that vocal exercises in the teaching and learning process of singers can be considered a form of vocal calisthenics. This conclusion is based on the intrinsic relationships observed between the principles and objectives of the gymnastic calisthenics system and the modus operandi of vocal exercises. This reflection provides valuable insights into vocal pedagogy, aiming to offer a more specifically physiological and biomechanical understanding of vocal exercises. This effectively guides the application of vocalizations in the process of vocal education and training.

Anthropometric Characteristics, Training Intensity Distribution, Physiological Profile and Performance of an Elite Trail Runner: A Longitudinal Case Study / Características Antropométricas, Distribución de la Intensidad del Entrenamiento, Perfil Fisiológico y Rendimiento de un Corredor de Montaña de Élite: Un Estudio de Caso Longitudinal

SUMMARY: Trail running (TR), an extreme endurance sport, presents unique challenges due to the variety of terrain and distances, where physiological capacity and body composition have been considered better predictors of performance. This longitudinal case study examines the impact of training intensity distribution (TID) on an elite trail runner's physiological profile and performance over four years. Two TID models were implemented: polarized (POL) and pyramidal (PYR). Physiological assessments included maximal oxygen consumption (VO2max), lactate thresholds (LT1 and LT2), and anthropometric characteristics. The training was classified according to the 3-zone intensity model (zone 1: below the first lactate threshold; zone 2: between the first and second lactate threshold; zone 3: above the second lactate threshold). During the four years, the average TID distribution was 75 % zone 1, 18 % zone 2, and 7 % zone 3. Physiological capacity increased by 7.14 % (14 to 15 km/h) for velocity at LT1 (vLT1) and 8.13 % (16 to 17.3 km/h) for velocity at LT2 (vLT2). The most significant increases were observed during the second year when the percentage of training time in zone 1 was lower (65 %) and in zone 2 greater (30 %) than those reported in other years. Consequently, vLT1 and vLT2 increased by 3.5 % (from 14.1 to 14.6 km/h) and 3.6 % (from 16.5 to 17.1 km/h), respectively. In conclusion, this case study revealed that emphasizing training in zone 2 (moderate intensity) and increasing the training load significantly improved performance at lactate thresholds. Despite modifying body composition, no influence on improving endurance performance was observed. These findings underscore the importance of TID in elite trail runners and highlight the potential to optimize physiological adaptations and performance outcomes.

Trail running (TR), un deporte de resistencia extrema, presenta desafíos únicos debido a la variedad de terrenos y distancias, donde la capacidad fisiológica y la composición corporal se han considerado mejores predictores del rendimiento. Este estudio de caso longitudinal examina el impacto de la distribución de la intensidad del entrenamiento (TID) en el perfil fisiológico y el rendimiento de un corredor de montaña de élite durante cuatro años. Se implementaron dos modelos TID: polarizado (POL) y piramidal (PYR). Las evaluaciones fisiológicas incluyeron el consumo máximo de oxígeno (VO2max), los umbrales de lactato (LT1 y LT2) y las características antropométricas. El entrenamiento se clasificó según el modelo de intensidad de 3 zonas (zona 1: por debajo del primer umbral de lactato; zona 2: entre el primer y segundo umbral de lactato; zona 3: por encima del segundo umbral de lactato). Durante los cuatro años, la distribución TID promedio fue 75 % zona 1, 18 % zona 2 y 7 % zona 3. La capacidad fisiológica aumentó un 7,14 % (14 a 15 km/h) para la velocidad en LT1 (vLT1) y un 8,13 % (16 a 17,3 km/h) para velocidad en LT2 (vLT2). Los incrementos más significativos se observaron durante el segundo año cuando el porcentaje de tiempo de entrenamiento en la zona 1 fue menor (65 %) y en la zona 2 mayor (30 %) que los reportados en otros años. En consecuencia, vLT1 y vLT2 aumentaron un 3,5 % (de 14,1 a 14,6 km/h) y un 3,6 % (de 16,5 a 17,1 km/h), respectivamente. En conclusión, este estudio reveló que enfatizar el entrenamiento en la zona 2 (intensidad moderada) y aumentar la carga de entrenamiento mejoró significativamente el rendimiento en los umbrales de lactato. A pesar de modificar la composición corporal, no se observó influencia en la mejora del rendimiento de resistencia. Estos hallazgos subrayan la importancia del TID en los corredores de trail de élite y resaltan el potencial para optimizar las adaptaciones fisiológicas y los resultados de rendimiento.

Series en Disnea. Parte 4. Una experiencia sensorial y afectiva de la disnea / Dyspnea Series. Part 4. A Sensory and Affective Experience of Dyspnea

RESUMEN No todos sentimos lo mismo ante un estímulo físico, cada uno expresa una sensación con diferentes palabras, no todos describimos de igual forma las sensaciones respi ratorias y, por qué no decirlo, no todos los profesionales entienden lo que el paciente les relata. La psicofísica de la disnea (las relaciones cuantitativas entre un estímulo respiratorio y una sensación), los descriptores para referirse a la falta de aire (el lenguaje de la disnea) pueden ayudar a romper las barreras comunicacionales entre pacientes, familia y personal de salud. Los datos generales apoyan una red cortical-límbica para la percepción de la disnea. Hay acuerdo en que la corteza insular es un elemento central esencial para el circuito neuronal, mientras que la corteza cingulada anterior y la corteza prefrontal dorsolateral se cree que modulan la magnitud de la percepción de disnea y su alivio. La disnea como un fenómeno del sistema nervioso central y con dimensiones tanto sensoriales como afectivas, esto ha sido confirmado en estudios de neuroimágenes. Se ha establecido firmemente que la disnea es una experiencia com pleja de la mente y el cuerpo, que comprende diferentes sensaciones que solo pueden ser percibidas por el individuo. Los componentes afectivos impulsan los sentimientos acompañantes de angustia, miedo y ansiedad, y es el cerebro, no los pulmones, el que genera estos fenómenos.

ABSTRACT When confronted with a physical stimulus, not everyone feels the same way; each one expresses a sensation with different words; not all of us describe respiratory sensations in the same way; and, why not say it, not all professionals understand what the patient tells them. The psychophysics of dyspnea (the quantitative relationships between a re spiratory stimulus and a sensation) and descriptors for shortness of breath (the dyspnea language) can aid in breaking down communication barriers between patients, families, and health care personnel. The insular cortex is widely agreed to be an important cen tral component of neural circuitry, while the anterior cingulate cortex and dorsolateral prefrontal cortex are thought to modulate the magnitude of dyspnea perception and its relief. Dyspnea is a central nervous system phenomenon, and neuroimaging studies have confirmed this with both sensory and affective dimensions. Dyspnea is a complex mind-body experience that consists of different sensations that can only be perceived by the individual. The accompanying feelings of distress, fear, and anxiety are driven by affective components, which are generated by the brain rather than the lungs.

The value of POSSUM score system in predicting postoperative complications in elderly patients and its correlation with Clavien-Dindo classification / 重庆医学

Objective To explore the value of the Physiology and Surgical Severity Score(POSSUM)scoring system in predicting postoperative complications in elderly patients with thoracic surgery,and to ana-lyze its correlation with Clavien-Dindo classification.Methods The data of 182 elderly patients who under-went thoracic surgery in this hospital from October 2019 to March 2023 were retrospectively analyzed.They were divided into the complication group and the non-complication group according to whether there were complications after surgery.The baseline data and POSSUM score of the two groups were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of POSSUM for post-operative complications in elderly patients.POSSUM of patients with different Clavien-Dindo classification was compared,and the correlation between POSSUM and Clavien-Dindo classification analyzed.Results The incidence of pulmonary infection was the highest in the complication group,followed by hypoproteinemia.POSSUM in the complication group was higher than that in non-complication group before operation,and the difference was statistically significant(P＜0.05).The ROC curve showed that the area under curve(AUC)value of POSSUM was 0.829;In the complication group,according to Clavien-Dindo classification,there were 5 cases of grade Ⅰ,47 cases of grade Ⅱ,8 cases of grade Ⅱ Ⅲ,7 cases of grade Ⅳ and 8 cases of grade V,the difference was statistically significant(P＜0.05).The correlation analysis showed that POSSUM score was positively correlated with Clavien-Dindo classification(r＞0.513,P＜0.05).Conclusion The POSSUM scoring system has a high value in predicting postoperative complications in elderly patients with thoracic surgery.

The predictive value of serum sTWEAK,Netrin-1 combined with APACHE Ⅱ score for poor prognosis in patients with severe craniocerebral injury after surgery / 国际检验医学杂志

Objective To investigate the predictive value of serum soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)and Netrin-1 combined with acute physiology and chronic health evaluationⅡ(APACHE Ⅱ)score for poor prognosis in patients with severe craniocerebral injury after surgery.Methods Totally 120 patients with severe craniocerebral injury admitted to a hospital from June 2020 to June 2022 were divided into good prognosis group and poor prognosis group according to the prognosis 30 days af-ter surgery.The serum levels of sTWEAK,Netrin-1 and APACHE Ⅱ score were compared between the two groups.Univariate and multivariate Logistic regression were used to analyze the influencing factors of poor prognosis in patients with severe craniocerebral injury,and the prediction model of serum sTWEAK,Netrin-1 and APACHE Ⅱ score combined was constructed.The predictive value of serum sTWEAK,Netrin-1 level and APACHE Ⅱ score in patients with severe craniocerebral injury after surgery was analyzed by receiver operat-ing characteristic(ROC)curve.Results The duration of intensive care unit stay in the poor prognosis group was longer than that in the good prognosis group,and the albumin level,Glasgow Coma scale and serum Ne-trin-1 level at admission were lower than those in the good prognosis group.The proportion of multiple brain contusion and laceration,the proportion of mechanical ventilation,APACHE Ⅱ score at admission and the lev-els of serum sTWEAK,blood creatinine and blood urea nitrogen were higher than those in the group with good prognosis,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that multiple brain contusion and laceration,decreased Netrin-1 level,increased APACHE Ⅱscore and increased sTWEAK level at admission were risk factors for poor prognosis in patients with severe craniocerebral injury(P＜0.05).ROC curve analysis showed that the area under the curve and 95％CI of ser-um sTWEAK,Netrin-1 and APACHE Ⅱ scores were 0.742(0.552-0.925),0.731(0.488-0.963),0.714(0.502-0.911)and 0.882(0.795-0.947)respectively when the three indexes were used alone and in com-bination.Conclusion Serum sTWEAK and Netrin-1 combined with APACHE Ⅱ score have good predictive value for the poor prognosis of patients with severe craniocerebral injury after surgery,and can provide refer-ence for the formulation of clinical treatment.

The mechanism and application of heart rate variability biofeedback regulation of the autonomic nervous system / 中国组织工程研究

BACKGROUND:Heart rate variability biofeedback is a respiratory training method that uses slow and deep breathing at the resonant frequency to induce rhythmic,high-amplitude oscillations in the cardiovascular system,thereby stimulating and exercising the autonomic and baroreflex.However,current studies have not systematically reviewed how heart rate variability biofeedback modulates the autonomic function and produces effects.There is a lack of public understanding of the mechanism of heart rate variability biofeedback,and its application progress and scheme are not fully understood. OBJECTIVE:To review the existing experimental studies on the effects of heart rate variability biofeedback on symptoms in different populations at home and abroad and to introduce the mechanisms and advances in the application of heart rate variability biofeedback to modulate the autonomic nervous system. METHODS:"Heart rate variability biofeedback,resonance breathing,heart rate variability,autonomic nerve,breathing training,chronic diseases,mental illness,biofeedback"were used as Chinese or English keywords to search in CNKI,WanFang Database,PubMed,and Web of Science.A total of 72 core related papers were included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:The body's oscillation system and resonance system are essential for the effectiveness of heart rate variability biofeedback.Oscillations reflect the response to external stimuli and self-regulating reflex systems,while resonances involve synchronous oscillations that result in higher amplitude operations.The balance between sympathetic and parasympathetic nerves is crucial for maintaining a stable internal environment.Autonomic nervous system disorders are associated with reduced heart rate variability and are closely linked to the progression of related diseases.Heart rate variability biofeedback utilizes the resonance characteristics of the cardiovascular system,inducing rhythmic high-amplitude oscillations by employing deep slow breathing at the resonance frequency.This method improves the regulatory function of the sympathetic and parasympathetic system reflexes and enhances the balance regulation between the two systems.Two major mechanisms of cardiovascular system resonance are the baroreflex closed-loop pathway and respiratory sinus arrhythmia.These mechanisms,along with the unique delay of baroreflex,result in a 0° phase angle oscillation between heart rate and respiration and a 180° phase angle oscillation between blood pressure and respiration during breathing at the resonant frequency rhythm.Periodically stimulating the human cardiovascular oscillation system through this method is an easy-to-operate and effective training approach.Currently,heart rate variability biofeedback is mainly applied in the fields of mental illness,chronic disease,and sports.However,the intervention mechanism and efficacy are unclear,the intervention content,frequency and duration are varied,and there are limited review studies on the intervention methods tailored to different types of individuals.As a non-drug and non-invasive intervention,heart rate variability biofeedback can significantly increase heart rate variability,regulate the balance between sympathetic and parasympathetic nerves,and improve the stability and adaptability of the autonomic nervous system.In the future,it is suggested to investigate the mechanisms and potential applications of the pathways of the heart rate variability biofeedback that induce cardiovascular resonance.It is also recommended to incorporate long-term follow-ups to assess the sustained value of heart rate variability biofeedback in various fields.This would provide new directions and strategies for the comprehensive treatment of complex diseases.

Physiological characteristics of the choroid and its association with myopia in children and adolescents / 中国学校卫生

Abstract@#The choroid is a multifunctional dynamic structure located between the sclera and the Bruch membrane, which may be involved in the regulation of eye growth and the development of myopia. Choroidal thickness may serve as an important biomarker for predicting the development of myopia and the effectiveness of myopia control treatments in children and adolescents. The study reviews and summarizes the physiological structure and measuring methods of the choroid, and discusses its influencing factors including age, physiological changes, refractive status, axial length, drug effects, optical environment and so on. The review points out the potential applications of choroidal thickness in myopia research among children and adolescents.

The effects of auditory stimulation on heart rate variability in healthy individuals with normal hearing and with hearing loss: a systematic review and meta-analysis

ABSTRACT Purpose To analyze the effects of auditory stimulation on heart rate variability (HRV) indices in healthy individuals with normal hearing and with hearing loss, regardless of type and/or grade, by means of a systematic review. Research strategies This is a systematic review with a meta-analysis that addresses the following question: in healthy individuals with normal hearing and/or with hearing loss, what are the effects of auditory stimulation on HRV indices in comparison to silence? We consulted the Cochrane Library, Embase, LILACS, PubMed, Web of Science, and Scopus databases and the gray literature (Google Scholar, OpenGrey, and ProQuest). Selection criteria There were no restrictions as to period or language of publication. Data analysis We identified 451 records, an additional 261 in the gray literature, and five studies in a search through the references, resulting in a total of 717 records, with 171 duplicate records. After screening the titles and abstracts of 546 studies, we excluded 490 and considered 56 studies in full to assess their eligibility. Results Nine of these studies were included in the systematic review, eight of which were suitable for the meta-analysis. Conclusion It is suggested that auditory stimulation may influence the RMSSD, pNN50, SDNN, RRTri and SD2 indices of HRV in healthy adults with normal hearing.

Estudio fisiológico invasivo para evaluar lesiones coronarias

Introducción: La revascularización mediante intervención coronaria percutánea con colocación de stent, o cirugía de derivación coronaria, alivia la isquemia miocárdica. Sin embargo, las pruebas de estrés no invasivas y la angiografía coronaria no siempre proporcionan la información adecuada sobre la importancia funcional de las estenosis en las arterias coronarias. Objetivo: Describir las recomendaciones actuales de la literatura médica con respecto a la fisiología coronaria en la cardiopatía isquémica. Desarrollo: El índice de reserva fraccional de flujo se considera el estándar de oro para detectar la isquemia miocárdica. Su naturaleza invasiva se equilibra con la resolución espacial inigualable y su relación lineal con el flujo sanguíneo máximo. Los resultados clínicos de pacientes cuya estrategia de revascularización se basa en mediciones de reserva fraccional de flujo son decisivos en varios subconjuntos de diferentes lesiones. En la última década se ha propuesto la evaluación de la gravedad de la estenosis coronaria mediante índices no hiperémicos. Sin embargo, la precisión de estos índices para distinguir correctamente la isquemia miocárdica es solo del 80 %. Conclusiones: Actualmente, la hiperemia máxima se recomienda para una óptima toma de decisiones sobre la revascularización.

Introduction: Revascularization by percutaneous coronary intervention with stenting, or coronary bypass surgery, alleviates myocardial ischemia. However, noninvasive stress testing and angiography do not always provide adequate information on the functional significance of coronary artery stenoses. Objective: To describe the recommendations of the medical literature regarding coronary physiology in ischemic heart disease. Development: The fractional flow reserve index is considered the gold standard for detecting myocardial ischemia. Its invasive nature is balanced by unmatched spatial resolution and its linear relationship to peak blood flow. The clinical outcomes of patients whose revascularization strategy is based on fractional flow reserve measurements are decisive in several subsets of other lesions. In the last decade, assessment of coronary stenosis severity by non-hyperemic indices has been proposed; however, the accuracy of these indices to correctly distinguish myocardial ischemia does not exceed 80%. Conclusions: Currently, maximal hyperemia is recommended for optimal revascularization decision making.

Series en disnea. Parte 2. Análisis de sus mecanismos según pasan los años / Series on dyspnea. Part 2. Analysis of its mechanisms as the years go by

Este artículo está dedicado al análisis detallado de los mecanismos de disnea. Se tratarán el control químico de la respiración, los reflejos neurales, la mecánica respiratoria, el costo de oxígeno para respirar y la inadecuación entre tensión y longitud de la fibra muscular. En general, las diferentes explicaciones estuvieron asociadas al desarrollo de aparatos y metodologías de estudio de los laboratorios pulmonares. Todas las teorías tuvieron defensores y detractores e, interesantemente, con el desarrollo de sofisticadas técnicas neurofisiológicas y de imágenes funcionales ha sido posible jerarquizar cada uno de los mecanismos. Todas han sobrevivido al paso del tiempo y ninguna puede explicar de manera unicista la disnea en todas las situaciones clínicas, lo cual habla de la naturaleza compleja y multifactorial del fenómeno.

This article is devoted to a detailed analysis of the mechanisms of dyspnea. Chemical control of respiration, neural reflexes, respiratory mechanics, the cost of oxygen to breathe, and the mismatch between tension and muscle fiber length will be discussed. In general, the different explanations were associated with the development of apparatus and study methodologies in pulmonary laboratories. All the theories had defenders and detractors and, interestingly, with the development of sophisticated neurophysiological techniques and functional imaging it has been possible to prioritize each of the mecha nisms. All have survived the passage of time and none can explain dyspnea in all clinical situations, which speaks of the complex and multifactorial nature of the phenomenon.

Effect of rapid maxillary expansion on masticatory and swallowing functions in children with posterior crossbite

Abstract Objective: Investigate the influence of posterior crossbite on masticatory and swallowing functions by videofluoroscopy examination and to analyze the effects of Rapid Maxillary Expansion (RME) on the same functions. Methods: A prospective longitudinal study was conducted on 32 children, 21 of them with posterior crossbite (10 girls and 11 boys, mean age 9.2 years, study group) and 11 children with no occlusal changes (6 girls and 5 boys, mean age 9.3 years, control group). The children were evaluated by an orthodontist for diagnosis, group characterization and occlusal treatment, by the otorhinolaryngology team for the assessment of respiratory symptoms, and by a speech therapist for videofluoroscopic evaluation of masticatory and swallowing parameters. The children with posterior crossbite were treated orthodontic ally using the Haas disjunctor for approximately six months and re-evaluated 5-months after removal of the appliance. Data were analyzed statistically by the Studentt-test for independent samples for comparison of the crossbite and control groups before and after treatment. Results: There was no significant difference in oral preparatory and oral transit times, nor in cycles and masticatory frequency, between the pre and post orthodontic treatment groups and the control group. Conclusion: Rapid maxillary expansion did not influence the masticatory and swallowing variables studied by videofluoroscopy. However, the data require caution in interpretation.

Medical ethics teaching in the new undergraduate physiology competency-based curriculum in medical institutions in Delhi: A pilot, feasibility study

Background: Medical ethics teaching has received little attention in India's undergraduate medical curriculum, so the National Medical Commission’s formal inclusion of medical ethics in the new competency-based curriculum (CBME) is creditable. However, the policymakers have left out the most crucial stakeholders — the teachers. This study was conducted to find out how physiology educators in Delhi felt about the implementation of ethics teaching in physiology in the CBME. Methods: This was a pilot, cross-sectional, observational, feasibility study conducted using a questionnaire, involving faculty and senior residents (post-MD) in the departments of Physiology at nine medical colleges in Delhi, conducted over the period from February to October 2020. Results: The response rate was 76% (60/79), of which 40% (24/60) were senior residents and 60 (36/60) were faculty. Around 55% (n=33) felt bioethics and clinical ethics are not synonymous; 53% (n=32) believed ethics education can be accomplished in a large group setting; 75% (n=45) believed it should be the responsibility of the physiology faculty, rather than the clinical faculty, and 61.7% (n=37) wanted it to be included in the formative assessment. The respondents shared ethical concerns that should be included in the physiology curriculum and the best candidates to teach them to achieve integration. Despite the challenges, the majority 65% (n=39) felt ethics in the physiology CBME should be an inseparable part of teaching in all instructional modalities. Conclusion: Early clinical exposure was considered preferable to the Attitude, Ethics, and Communication (AETCOM) programme. Using the five W’s and one H method, we talk about how our findings can be used as a road map to help physiologists teach ethics to medical students in the new CBME.

Effect of applications of 1-MCP and ethylene on the ripening and degreening process of banana fruits cv. Barranquillo

The banana cv. Barranquillo (Musa acuminata, AAA, 'Gros Michel') is a highly desired fruit because of its productive potential and organoleptic quality but various aspects of the ripening process are unknown. The objective of this research was to evaluate the effect of applications of 1-MCP and ethylene on the ripening and degreening process. Two experiments were carried out at room temperature with fruits harvested at commercial maturity. The first four treatments evaluated maturation: control, ethylene, 1-MCP, and 1-MCP + ethylene. In the second experiment, different concentrations of ethylene based on ethephon (0, 100, 500 and 1000 µL L-1) were evaluated. The fruits treated with 1-MCP decreased the ripening process, and 1-MCP was a good alternative for conserving the fruits; the ethylene had opposite results. The color index of the skin, weight loss, firmness, total soluble solids, and maturity ratio had changes associated with the presence of ethylene. In the second experiment, the ethylene applications between 100 and 500 µL L-1 sufficiently stimulated degreening but accelerated the ripening process.

El banano cv. Barranquillo (Musa acuminata, AAA, 'Gros Michel') es un fruto muy apetecido por su potencial productivo y calidad organoléptica, pero se desconocen varios aspectos del proceso de maduración. El objetivo de esta investigación fue evaluar el efecto de la aplicación de 1-MCP y etileno en la maduración y en el proceso de desverdizado. Se realizaron dos experimentos a temperatura ambiente y con frutos cosechados en madurez comercial; en el primero, se evaluaron cuatro tratamientos, para entender la regulación de la maduración, estos fueron: testigo, etileno, 1-MCP y 1-MCP+etileno. En el segundo experimento, se evaluaron diferentes concentraciones de etileno, a base de etefon (0, 100, 500 y 1000 µL L-1). Los frutos tratados con 1- MCP presentaron una disminución en el proceso de maduración, por tanto, el 1-MCP, se convierte en una buena alternativa de conservación, mientras que con etileno, el proceso fue opuesto. Se evidenció que el índice de color de la epidermis, la pérdida de peso, la firmeza, los sólidos solubles totales y la relación de madurez se consideran cambios asociados a la presencia de etileno. En el segundo experimento se encontró que, aplicaciones de etileno entre 100 y 500µL L-1, se consideran suficientes para estimular el desverdizado, pero aceleran el proceso de maduración.

Full study of characteristics of morphological adaptations in response to chronic exercise across musculoskeletal tissues: a systematic review / Estudio completo de adaptaciones morfológicas en respuesta al ejercicio crónico en los tejidos osteomusculares: una revisión sistemática

León, F., Mestre. A., Priego, L., & Vera, J.C. (2023). Full study of Morphological adaptations in response to chronic exercise across musculoskeletal tissues: a systematic review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-21. To date, there is no systematic review that summarizes the morphological adaptations of the musculoskeletal system in response to chronic exercise. This systematic review selected original articles published in English between 2000 and 2020, with a clear exercise intervention and presenting a morphological change in the tissue under study, and covering human participants irrespective of age, gender or health condition. In total, 2819 records were identified. After removal of duplicates, title and abstract screening and full-text review, 67 records were included in the final analysis (6 for inter-vertebral disc, 6 for cartilage, 36 for bone, 2 for ligament, 9 for tendon and 7 for muscle). The most used interventions were aerobic, resistance, and plyometric exercise. Population ranged from children and healthy active people to individuals with a health condition. In conclusion, as a response to chronic exercise there are morphological adaptations in the tissues of the musculoskeletal system which vary from increased stiffness to an increase in cross-sectional area. Although tissues can adapt, several questions still linger, such as optimal dose and type of exercise, whether adaptations can occur in an injured tissue, and functional implications of these adaptations. Future research should address these questions.

León, F., Mestre. A., Priego, L. y Vera, J.C. (2023). Estudio complete de Adaptaciones morfológicas en respuesta al ejercicio crónico en los tejidos osteomusculares: una revisión sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-21. Hasta la fecha, no existe una revisión sistemática que resuma las adaptaciones morfológicas del sistema osteomuscular en respuesta al ejercicio crónico. Esta revisión sistemática seleccionó artículos originales, con fecha de publicación de 2000 a 2020, idioma de publicación en inglés, con una clara intervención de ejercicio y que presentaron un cambio morfológico en el tejido estudiado. Participantes humanos independientemente de la edad, el género o condición de salud. Se identificaron 2819 registros. Después de eliminar los duplicados, la selección de títulos y resúmenes y la revisión de texto completo, se incluyeron 67 registros en el análisis final (6 para disco intervertebral, 6 para cartílago, 36 para hueso, 2 para ligamento, 9 para tendón y 7 para músculo). Los resultados destacan que las intervenciones más utilizadas fueron ejercicio aeróbico, contra resistencia y pliométrico. La población abarcó desde niños y personas sanas activas hasta personas con alguna condición de salud. Se concluye que como respuesta al ejercicio crónico existen adaptaciones morfológicas en los tejidos del sistema musculoesquelético, que pueden variar desde un aumento de rigidez hasta un aumento de área. Aunque los tejidos pueden adaptarse, aún quedan varias preguntas, como la dosis y tipo de ejercicio óptimo, si pueden ocurrir adaptaciones en un tejido lesionado y las implicaciones funcionales de estas adaptaciones. La investigación futura debe abordar estas preguntas.

León, F., Mestre. A., Priego, L. e Vera, J.C. (2023). Estudo completo de Adaptações morfológicas em resposta ao exercício crônico nos tecidos osteomusculares: uma revisão sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-21. Até o momento, não há uma revisão sistemática que resuma as adaptações morfológicas do sistema osteomuscular em resposta ao exercício crônico. Esta revisão sistemática selecionou artigos originais, com data de publicação de 2000 a 2020, idioma de publicação em inglês, com clara intervenção de exercícios e que apresentaram alteração morfológica no tecido estudado. Participantes humanos, independentemente da idade, sexo ou condição de saúde. Foram identificados 2.819 registros. Após eliminar os artigos duplicados, triagem de título e resumo e revisão do texto completo, 67 registros foram incluídos na análise final (6 para disco intervertebral, 6 para cartilagem, 36 para osso, 2 para ligamento, 9 para tendão e 7 para músculo). Os resultados destacam que as intervenções mais utilizadas foram exercícios aeróbicos, resistidos e pliométricos. A população variou de crianças e pessoas saudáveis ativas a pessoas com alguma condição de saúde. Conclui-se que, em resposta ao exercício crônico, ocorrem adaptações morfológicas nos tecidos do sistema musculoesquelético, que podem variar desde um aumento de rigidez até um aumento de área. Embora os tecidos possam se adaptar, várias questões permanecem, como a dose ideal e o tipo de exercício, se adaptações podem ocorrer no tecido lesado e as implicações funcionais dessas adaptações. Pesquisas futuras devem abordar essas questões.

Morphological adaptations in response to chronic exercise across musculoskeletal tissues: a systematic review / Adaptaciones morfológicas en respuesta al ejercicio crónico en los tejidos osteomusculares: una revisión sistemática

León, F., Mestre. A., Priego, L., & Vera, J.C. (2023). Morphological adaptations in response to chronic exercise across musculoskeletal tissues: a systematic review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-28. To date, there is no systematic review that summarizes the morphological adaptations of the musculoskeletal system in response to chronic exercise. This systematic review selected original articles published in English between 2000 and 2020, with a clear exercise intervention and presenting a morphological change in the tissue under study, and covering human participants irrespective of age, gender or health condition. In total, 2819 records were identified. After removal of duplicates, title and abstract screening and full-text review, 67 records were included in the final analysis (6 for inter-vertebral disc, 6 for cartilage, 36 for bone, 2 for ligament, 9 for tendon and 7 for muscle). The most used interventions were aerobic, resistance, and plyometric exercise. Population ranged from children and healthy active people to individuals with a health condition. In conclusion, as a response to chronic exercise there are morphological adaptations in the tissues of the musculoskeletal system which vary from increased stiffness to an increase in cross-sectional area. Although tissues can adapt, several questions still linger, such as optimal dose and type of exercise, whether adaptations can occur in an injured tissue, and functional implications of these adaptations. Future research should address these questions.

León, F., Mestre. A., Priego, L. y Vera, J.C. (2023). Adaptaciones morfológicas en respuesta al ejercicio crónico en los tejidos osteomusculares: una revisión sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-28. Hasta la fecha, no existe una revisión sistemática que resuma las adaptaciones morfológicas del sistema osteomuscular en respuesta al ejercicio crónico. Esta revisión sistemática seleccionó artículos originales, con fecha de publicación de 2000 a 2020, idioma de publicación en inglés, con una clara intervención de ejercicio y que presentaron un cambio morfológico en el tejido estudiado. Participantes humanos independientemente de la edad, el género o condición de salud. Se identificaron 2819 registros. Después de eliminar los duplicados, la selección de títulos y resúmenes y la revisión de texto completo, se incluyeron 67 registros en el análisis final (6 para disco intervertebral, 6 para cartílago, 36 para hueso, 2 para ligamento, 9 para tendón y 7 para músculo). Los resultados destacan que las intervenciones más utilizadas fueron ejercicio aeróbico, contra resistencia y pliométrico. La población abarcó desde niños y personas sanas activas hasta personas con alguna condición de salud. Se concluye que como respuesta al ejercicio crónico existen adaptaciones morfológicas en los tejidos del sistema musculoesquelético, que pueden variar desde un aumento de rigidez hasta un aumento de área. Aunque los tejidos pueden adaptarse, aún quedan varias preguntas, como la dosis y tipo de ejercicio óptimo, si pueden ocurrir adaptaciones en un tejido lesionado y las implicaciones funcionales de estas adaptaciones. La investigación futura debe abordar estas preguntas.

León, F., Mestre. A., Priego, L. e Vera, J.C. (2023). Adaptações morfológicas em resposta ao exercício crônico nos tecidos osteomusculares: uma revisão sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-28. Até o momento, não há uma revisão sistemática que resuma as adaptações morfológicas do sistema osteomuscular em resposta ao exercício crônico. Esta revisão sistemática selecionou artigos originais, com data de publicação de 2000 a 2020, idioma de publicação em inglês, com clara intervenção de exercícios e que apresentaram alteração morfológica no tecido estudado. Participantes humanos, independentemente da idade, sexo ou condição de saúde. Foram identificados 2.819 registros. Após eliminar os artigos duplicados, triagem de título e resumo e revisão do texto completo, 67 registros foram incluídos na análise final (6 para disco intervertebral, 6 para cartilagem, 36 para osso, 2 para ligamento, 9 para tendão e 7 para músculo). Os resultados destacam que as intervenções mais utilizadas foram exercícios aeróbicos, resistidos e pliométricos. A população variou de crianças e pessoas saudáveis ativas a pessoas com alguma condição de saúde. Conclui-se que, em resposta ao exercício crônico, ocorrem adaptações morfológicas nos tecidos do sistema musculoesquelético, que podem variar desde um aumento de rigidez até um aumento de área. Embora os tecidos possam se adaptar, várias questões permanecem, como a dose ideal e o tipo de exercício, se adaptações podem ocorrer no tecido lesado e as implicações funcionais dessas adaptações. Pesquisas futuras devem abordar essas questões.

Deep infiltrating endometriosis: cine magnetic resonance imaging in the evaluation of uterine contractility / Endometriose infiltrativa profunda: cine ressonância magnética na avaliação da contratilidade uterina

Abstract Objective: To evaluate uterine function by using cine magnetic resonance imaging to visualize the contractile movements of the uterus in patients with and without deep infiltrating endometriosis (with or without associated adenomyosis). Materials and Methods: This was a prospective case-control study. The study sample comprised 43 women: 18 in the case group and 25 in the control group. We performed cine magnetic resonance imaging in a 3.0 T scanner, focusing on the presence, direction, and frequency of uterine peristalsis. Results: The frequency of uterine peristalsis was higher in the case group than in the control group, in the periovulatory phase (3.83 vs. 2.44 peristaltic waves in two minutes) and luteal phase (1.20 vs. 0.91 peristaltic waves in two minutes). However, those differences were not statistically significant. There was a significant difference between the patients with adenomyosis and those without in terms of the frequency of peristalsis during the late follicular/periovulatory phase (0.8 vs. 3.18 peristaltic waves in two minutes; p < 0.05). Conclusion: The frequency of uterine peristalsis appears to be higher during the periovulatory and luteal phases in patients with deep infiltrating endometriosis, whereas it appears to be significantly lower during the late follicular/periovulatory phase in patients with adenomyosis. Both of those effects could have a negative impact on sperm transport and on the early stages of fertilization.

Resumo Objetivo: Avaliar a função uterina mediante visualização dos movimentos contráteis do útero por meio de cine-ressonância magnética em pacientes com e sem endometriose infiltrativa profunda (com ou sem adenomiose associada). Materiais e Métodos: Estudo caso-controle prospectivo. A amostra foi composta por 43 mulheres, sendo 18 mulheres no grupo caso e 25 mulheres no grupo controle. A cine-ressonância magnética foi realizada com magneto 3.0 T, com foco na presença, direção e frequência do peristaltismo uterino. Resultados: O peristaltismo uterino foi mais frequente nas pacientes do grupo endometriose do que no grupo controle na fase periovulatória (3,83 × 2,44 peristalses em dois minutos) e lútea (1,20 × 0,91 peristalse em dois minutos). No entanto, esses resultados não foram estatisticamente significantes. Nas pacientes com adenomiose, observou-se redução significativa na frequência de peristaltismo durante a primeira fase do ciclo menstrual (3,18 × 0,8 peristalses; p < 0,05). Conclusão: A frequência de peristaltismo uterino parece estar aumentada durante a fase periovulatória e lútea em pacientes com endometriose infiltrativa profunda e significativamente reduzida em pacientes com adenomiose durante a primeira fase do ciclo menstrual. Ambos os efeitos têm potencial de interferir negativamente no transporte de espermatozoides e nos primeiros estágios de fecundação.

Manejo de la disfagia en pacientes con antecedente de infección severa por COVID-19 / Manejo de la disfagia en pacientes con antecedente de infección severa por COVID-19

de la deglución, los cuales representan todas las alteraciones del proceso fisiológico encargado de llevar el alimento desde la boca al esófago y después al estómago, salvaguardando siempre la protección de las vías respiratorias. OBJETIVO. Definir el manejo óptimo, de la disfagia en pacientes con antecedente de infección severa por COVID-19. METODOLOGÍA. Se realizó una revisión de la literatura científica en las bases de datos PubMed y Elsevier que relacionan el manejo de la disfagia y pacientes con antecedente de infección severa por SARS-CoV-2. Se obtuvo un universo de 134 artículos que cumplieron los criterios de búsqueda. Se seleccionaron 24 documentos, para ser considerados en este estudio. RESULTADOS. La incidencia de disfagia posterior a infección severa por SARS-CoV-2 fue del 23,14%, siendo la disfagia leve la más frecuente 48,0%. Los tratamientos clínicos más empleados en el manejo de la disfagia fueron rehabilitación oral y cambio de textura en la dieta en el 77,23% de los casos, mientras que el único tratamiento quirúrgico empleado fue la traqueotomía 37,31%. Un 12,68% de pacientes recuperó su función deglutoria sin un tratamiento específico. La eficacia de los tratamientos clínicos y quirúrgicos en los pacientes sobrevivientes de la infección severa por SARS-CoV-2 fue del 80,68%, con una media en el tiempo de resolución de 58 días. CONCLUSIÓN. La anamnesis es clave para el diagnóstico de disfagia post COVID-19. El tratamiento puede variar, desde un manejo conservador como cambios en la textura de la dieta hasta tratamientos más invasivos como traqueotomía para mejorar la función deglutoria.

INTRODUCTION. The difficulty to swallow or dysphagia is included within the problems of swallowing, which represent all the alterations of the physiological process in charge of carrying the food from the mouth to the esophagus, and then to the stomach, always taking into account the protection of the airways. OBJECTIVE. To define the optimal management, both clinical and surgical, for the adequate treatment of dysphagia produced as a consequence of severe SARS-CoV-2 infection. METHODOLOGY. A review of the scientific literature was carried out using both PubMed and Elsevier databases, which relate the management of dysphagia and patients with a history of severe SARS-CoV-2 infection. RESULTS. The incidence of dysphagia following severe SARS-CoV-2 infection was of 23,14%, with mild dysphagia being the most frequent 48,00%. The most frequently used clinical treatments for dysphagia management were oral rehabilitation and change in dietary texture in 77,23% of cases, while tracheotomy was the only surgical treatment used 37,31%. A total of 12,68% of patients recovered their swallowing function without specific treatment. The efficacy of clinical and surgical treatments in survivors of severe SARS-CoV-2 infection was 80,68%, with a mean resolution time of 58 days. CONCLUSION. An adequate medical history is key to the diagnosis of post-COVID-19 dysphagia. Treatment can range from conservative management such as changes in diet texture to more invasive treatments such as tracheotomy to improve swallowing function.

Inicio de la enseñanza de la Fisiología en Chile / Beginning of the teaching of Physiology in Chile

Este trabajo pretende dar a conocer el inicio y desarrollo temprano de los estudios fisiológicos en Chile. La fisiología, como disciplina científica, se comenzó a enseñar desde el momento mismo de la fundación de la Escuela de Medicina en 1833 asociada estrechamente a la anatomía e higiene. Las tres disciplinas eran enseñadas por el mismo catedrático. Su primer profesor fue el destacado anatomista chileno Pedro Morán, a quien continuaron los profesores Dr. Julio Francisco Lafargue y Dr. Vicente Padín del Valle. En un segundo período (1868-1901), la enseñanza de la fisiología se debilitó fuertemente, pues fue enseñada por varios médicos clínicos que no conocían en profundidad esta disciplina. Luego de este período inicial (1833-1900), que podríamos denominar etapa teórica, nació la denominada fisiología experimental con Teodoro Muhm, la cual, mediante clases con demostraciones experimentales y luego trabajos prácticos, intentaba acercar al alumno a la realidad del fenómeno fisiológico.

This work intends to present the beginning and early development of physiological studies in Chile. Physiology, as a scientific discipline, began to be taught from the moment the School of Medicine was founded in 1833, closely associated with anatomy and hygiene. The three disciplines were taught by the same professor. His first professor was the outstanding Chilean anatomist Pedro Morán, who was continued by the outstanding professors Dr. Julio Francisco Lafargue and Dr. Vicente Padín del Valle. In a second period (1868-1901), the teaching of physiology was severely weakened, as it was taught by various clinicians who did not know this discipline in depth. After this initial period (1833-1900), which we could call the theoretical stage, the so-called experimental physiology was born, which, through classes with experimental demonstrations and then practical work, tried to bring the student closer to the reality of the physiological phenomenon.

Series en disnea. Parte 1. Definiciones, mecanismos y perspectiva histórica / Series on Dyspnea. Part 1. Definitions, Mechanisms and Historical Perspective

Este artículo es el primero de una serie dedicada a ese extraño fenómeno de la vida atrapado a medio camino entre lo consciente y lo inconsciente: la disnea. El artículo proporciona información sobre las definiciones a lo largo del tiempo y presenta la evolución de las ideas que hicieron a la comprensión de sus mecanismos. La relevancia de cada uno de ellos debe evaluarse en el contexto de cada situación clínica y fisiopatológica específica. La experiencia de la disnea comienza a ser vista como un fenómeno multidimensional que debe estar centrado en lo que percibe el paciente. Considerando la complejidad de la experiencia y su multidimensión, es posible que se desarrollen nuevas opciones terapéuticas en tiempos venideros(AU)

This article is the first in a series dedicated to that strange phenomenon of life caught halfway between the conscious and the unconscious: dyspnea. The article provides information on the definitions over time and presents the evolution of the ideas that led to understanding its mechanisms. The relevance of each of these mechanisms must be evaluated in the context of each specific clinical and pathophysiological situation. The experience of dyspnea begins to be seen as a multidimensional phenomenon that must be centred on what the patient perceives. Considering the complexity of the experience and its multidimensionality, it is possible that new therapeutic options will be developed in the future times(AU)

Dependence of radioactive iodine-131 capture by the lacrimal ducts on the tear production level

Purpose: Secondary acquired lacrimal duct obstruction (SALDO) is one of the complications of radioiodine therapy. SALDO is formed a few months after therapy if there is a sufficient uptake of radioactive iodine by the nasolacrimal duct. To date, risk factors leading to SALDO are unclear. The objective was to determine the correlation between the tear production level and radioactive iodine?131 uptake in the lacrimal ducts.Methods: Basal and reflex tear production was studied in 64 eyes prior to the therapy with radioactive iodine?131 after drug?induced hypothyroidism. The condition of the ocular surface was assessed using the Ocular Surface Disease Index (OSDI) questionnaire. Seventy?two hours after the radioactive iodine therapy, scintigraphy was performed, which determined the presence or absence of iodine?131 in the lacrimal ducts. T?statistics and the Mann–Whitney criterion were used to identify the differences between the groups. The differences were considered significant at P ? 0.05. The current tear production level in patients receiving radioiodine therapy was determined using a mathematical model. Results: A statistically significant difference between the basal (p = 0.044) and reflex (p = 0.015) tear production levels was found in cases with and without iodine?131 uptake by the lacrimal ducts. The probable current tear production level corresponds to the sum of basal and 10–20% of reflex tear production. The uptake of iodine?131 was found regardless of the OSDI results.Conclusion: The probability of iodine?131 uptake by the lacrimal ducts rises as the tear production level increases.