ABSTRACT
The aim of the study was to compare the impact of 12-week resistance training with blood flow restriction (GRTBFR) versus, traditional resistance training (GTRT) and non-training on the muscle strength and body composition HIV/AIDS participants. Muscle strength was tested at baseline, and on the 6th, 21st and 36th training sessions, using maximal repetition test. Pre- and post-intervention body composition changes were measured by dual-energy X-ray absorptiometry. Resistance training was undertaken three times a week comprising bilateral elbow extension and flexion exercises, unilateral flexion and bilateral knee extension. Changes in strength and body composition (pre- and post-intervention) between groups were evaluated by mixed models of repeated measures, and by paired and unpaired comparisons, considering the Effect Size. All groups were similar at baseline for muscle strength and body composition. Post-intervention, the training groups showed similar, statistically significant increases in muscle strength (GRTBFR=25.7-57.4%; GTRT=24.5-52.3%) and skeletal muscle tissue (GRTBFR=8.4%; GTRT=8.3%). There was also a significant change in body fat (p=0.023-0.043), with significant effect sizes for strength and skeletal muscle tissue (0.41-2.27), respectively. These results suggest that both resistance training interventions promoted muscle hypertrophy, body fat reduction and positive impact on muscle strength in people living with HIV/AIDS. Resistance training with blood flow restriction proved to be an effective alternative to include patients with marked physical weakness, unable to engage in regular strength training programme.ClinicalTrials.gov identifier: NCT02783417.
Subject(s)
Body Composition/physiology , HIV Infections/physiopathology , Muscle Strength/physiology , Resistance Training/methods , Absorptiometry, Photon , Adipose Tissue/anatomy & histology , Adult , Female , Humans , Male , Middle Aged , Muscle, Skeletal/anatomy & histology , Regional Blood Flow/physiology , Tibial Arteries/physiology , Time FactorsABSTRACT
Objetivo: Comparar los riesgos de morbilidad neonatal entre los prematuros tardíos (PT) y neonatos de término. Método: Estudio de caso control. Se revisan fichas clínicas de partos durante el año 2007. Se excluyen neonatos con malformaciones congénitas mayores, alteración neuromuscular, embarazos múltiples y aneuploidias. Los casos corresponden a todo PT nacido durante el periodo estudiado y los controles a nacidos de término en el mismo periodo. Los resultados neonatales fueron obtenidos y los riesgos calculados usando pruebas de Chi cuadrado y exacto de Fisher. Resultados: Se identifican 1536 partos, con una tasa de PT de 7,1 por ciento (109 casos), 62 cumplieron con criterios de inclusión. El grupo control consistió en 124 partos de término. PT presentaron 2 veces más riesgo de cesárea (p=0,0094) que los de término. El riesgo de ser admitido en UCIN fue de 88 (p=0,000). Los riesgos de morbilidad neonatal fueron: SDR (OR 23; p=0,000), hipoglicemia (OR 6; p=0,014), hipocalcemia (OR 6; p=0,014), hiperbilirrubinemia (OR 28; p=0,000) y necesidad de fototerapia (OR 23; p=0,000). No hubo diferencias en la presentación de enterocolitis necrotizante (p=0,478) ni sepsis neonatal (p=0,615). La mortalidad neonatal fue significativamente superior en los PT (p=0,044). Conclusión: Los PT deben ser considerados de alto riesgo en el período neonatal. Nuestros resultados son importantes para tomar decisiones clinicas respecto al mejor momento de finalizar un embarazo con riesgo inminente de prematurez.
Objective: To compare neonatal morbidity risks between late preterm (LP) and term deliveries. Methods: Case control study. Medical records in 2007 were reviewed. Major congenital malformations, neuromuscular handicap, twin pregnancies and aneuploidies were excluded. The Study group corresponds to all LP births during that period and the control group to term deliveries in the same period. Neonatal outcomes were collected and different risks were calculated using Chi square test and Fisher exact tests. Results: 1536 deliveries with a LP rate of 7.1 percent (109 cases) were observed, 62 cases met inclusion criteria. The control group consisted in 124 single term deliveries. LP had 2 times more risk of cesarean section (p=0.0094) than term deliveries. The risk of NICU admission was 88 (p=0.000). Neonatal morbidity risks were: RDS (OR 23, p=0.000), hypoglycemia (OR 6, p=0.014), hypocalcaemia (OR 6, p=0.014), hyperbillirrubinemia (OR 28, p=0.000) and phototherapy (OR 23, p=0.000). There were no differences in necrotizing enterocolitis (p=0.478) and risk of neonatal sepsis (p=0.615). Neonatal mortality was significantly higher in LP babies (p=0.044). Conclusion: LP newborn must be considered as high risk in the neonatal period. These results are important in making clinical decisions about the better time to end pregnancy.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant, Premature, Diseases/epidemiology , Infant, Premature , Gestational Age , Enterocolitis, Necrotizing/epidemiology , Case-Control Studies , Hyperbilirubinemia, Neonatal/epidemiology , Hypocalcemia/epidemiology , Hypoglycemia/epidemiology , Risk Assessment , Premature Birth/mortality , Pregnancy Outcome , Sepsis/epidemiology , Respiratory Distress Syndrome, Newborn/epidemiologyABSTRACT
ANTECEDENTES: En embarazadas seropositivas sin profilaxis antirretroviral la transmisión vertical (TV) del VIH es de 30%, cifra que disminuye bajo al 2% con un manejo integral de prevención. OBJETIVO: Conocer el comportamiento epidemiológico de la TV en Chile desde la creación del programa nacional de prevención. MÉTODO: Datos aportados por el Departamento de Epidemiología del MINSAL y CONASIDA (1984-2006). Estudió de situación VIH/SIDA por año, regiones, grupo etario y sexo, con especial énfasis en TV. RESULTADOS: Se notificaron 9.317 casos de VIH y 7.886 casos de SIDA (1984-2006), prevalencia en aumento hasta el 2003 con tendencia descendente posteriormente. La razón actual de VIH entre hombres y mujeres es de 4:1, con clara tendencia al aumento de notificación en mujeres. La principal vía de exposición sigue siendo la vía sexual (93,4%). El grupo más afectado está entre los 20-39 años (73,1% para VIH y 63,1% para SIDA), cabe destacar que entre 0-9 años se encuentra el 1,1% de los afectados por VIH y el 1,4% por SIDA, todos infectados por TV. CONCLUSIONES: La transmisión vertical de VIH en Chile es responsable de un bajo porcentaje de las personas notificadas de VIH/SIDA, pero es la causa de la totalidad de los niños afectados por la infección en nuestro país. Se observa una importante reducción de la TV, llegando a niveles muy cercanos a los objetivos ministeriales.
BACKGROUND: The risk of transmitting HIV from mother to unborn child, without any antiretroviral prophylaxis, reaches 30%. It can be reduced to less than 2% by implementing integral preventive strategies. OBJECTIVE: To assess the epidemiological profile of HIV vertical transmission in Chile since the implementation of the national AIDS transmission prevention program. METHOD: Data from the Epidemiology Department of the Health Ministry and the National Commission for AIDS grouped by year, location, ageandgender. Withspecial emphasis on vertical transmission. RESULTS: 9317 cases of HIV infection and 7886 cases of AIDS have been reported in Chile (1984-2006), with a decreasing tendency since 2003. Sexual exposure continues to be the primary route with 93.4% of the cases. The male/female ratio for case notif¡cation is 4:1, with a rising tendency among women. The most affected is between 20-39 years old (73% HIV notification and 63.1% for AIDS). Among children between 0-9 years of age is 1.1% of the HIV and 1.4% of AIDS notifications, all of them for vertical transmission. CONCLUSIONS: HIV vertical transmission in Chile is responsible for a small percentage of HIV/AIDS notifications, but it accounts for all of the infected children. There's been an important reduction in this transmission route, reaching prevalence close to the aimed rates, which can explained by the expanding prevention programs of the health policies implemented by the Health Ministry.
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , HIV Infections/transmission , HIV Infections/epidemiology , HIV Infections/mortality , HIV Infections/prevention & control , Chile/epidemiology , Acquired Immunodeficiency Syndrome/transmission , Acquired Immunodeficiency Syndrome/epidemiology , Age and Sex Distribution , National Health ProgramsABSTRACT
Neurofeedback (NFB) is an operant conditioning procedure, by which the subject learns to control his/her EEG activity. On one hand, Learning Disabled (LD) children have higher values of theta EEG absolute and relative power than normal children, and on the other hand, it has been shown that minimum alpha absolute power is necessary for adequate performance. Ten LD children were selected with higher than normal ratios of theta to alpha absolute power (theta/alpha). The Test Of Variables of Attention (TOVA) was applied. Children were divided into two groups in order to maintain similar IQ values, TOVA values, socioeconomical status, and gender for each group. In the experimental group, NFB was applied in the region with highest ratio, triggering a sound each time the ratio fell below a threshold value. Noncontingent reinforcement was given to the other group. Twenty half-hour sessions were applied, at a rate of 2 per week. At the end of the 20 sessions, TOVA, WISC and EEG were obtained. There was significant improvement in WISC performance in the experimental group that was not observed in the control group. EEG absolute power decreased in delta, theta, alpha and beta bands in the experimental group. Control children only showed a decrease in relative power in the delta band. All changes observed in the experimental group and not observed in the control group indicate better cognitive performance and the presence of greater EEG maturation in the experimental group, which suggests that changes were due not only to development but also to NFB treatment.
Subject(s)
Biofeedback, Psychology/methods , Electroencephalography/methods , Learning Disabilities/diagnosis , Learning Disabilities/therapy , Behavior , Behavior Therapy/methods , Child , Female , Humans , Male , Placebo Effect , Treatment OutcomeABSTRACT
We describe a case of unintentional poisoning from a cardioactive steroid and the subsequent analytic investigation. A 36-year-old woman with no past medical history and taking no conventional medications ingested an herbal preparation marketed for "internal cleansing." Its ingredients were neither known to the patient nor listed on the accompanying literature. The next morning, nausea, vomiting, and weakness developed. In the emergency department, her blood pressure was 110/60 mm Hg, and her pulse rate was 30 beats/min. Her ECG revealed a junctional rhythm at a rate of 30 beats/min and a digitalis effect on the ST segments. After empiric therapy with 10 vials of digoxin-specific Fab (Digibind), her symptoms resolved, and she reverted to a sinus rhythm at a rate of 68 beats/min. Her serum digoxin concentration measured by means of the fluorescence polarization immunoassay (Abbott TDx) was 1.7 ng/mL. Further serum analysis with the Tina Quant digoxin assay, a more digoxin-specific immunoassay, found a concentration of 0.34 ng/mL, and an enzyme immunoassay for digitoxin revealed a concentration of 20 ng/mL (therapeutic range 10 to 30 ng/mL). Serum analysis by means of high-performance liquid chromatography revealed the presence of active digitoxin metabolites; the parent compound was not present. When the diagnosis of cardioactive steroid poisoning is suspected clinically, laboratory analysis can confirm the presence of cardioactive steroids by using immunoassays of varying specificity. An empiric dose of 10 vials of digoxin-specific Fab might be beneficial in patients poisoned with an unknown cardioactive steroid.
Subject(s)
Bradycardia/chemically induced , Cardiac Glycosides/poisoning , Dietary Supplements/poisoning , Hypokalemia/chemically induced , Plant Preparations/poisoning , Adult , Digoxin/poisoning , Electrocardiography/drug effects , Female , Humans , Immunoglobulin Fab Fragments/therapeutic use , Muscle Weakness/chemically induced , Nausea/chemically induced , Treatment Outcome , Vomiting/chemically inducedABSTRACT
Se realizó un estudio prospectivo en un grupo de 75 niños asmáticos graves, incorporados al área terapéutica de natación, ubicada en la piscina "Martires de Barbados", en el período comprendido entre septiembre de 1997 y junio de 1999, con el objetivo de determinar el estado evolutivo de los mismos. A estos pacientes se les realizó una terapéutica natural, dirigida por un equipo multidisciplinario y basadas fundamentalmente en las medidas educativas scerca de la enfermedad, la prácticas de ejercicios respiratorios y la natación. El 80 por ciento de los pacientes se encontraban en edades comprendidas entre seis y nueve años. Al inicio del tratamiento el 100 por ciento de los pacientes presentaban 10 o0 más crisis al año. Y a los dos años en el área, ascendió a un 96 por ciento el número de pacientes que presentó una evolución satisfactoria con marcada reducción del número de ingreso. También al cabo de los años de tratamiento logran disminuir las dosis de fármacos el 57,3 por ciento de los pacientes, mientras que el 38,7 por ciento del total permanecían con terapéuticas farmacológicas. Consideramos que un tratamiento donde se combinen las medidas preventivas, los ejercicios respiratorios y la práctica de natación es fundamental en el manejo integral del niño asmático severo
Subject(s)
Asthma/therapy , Swimming , Breathing ExercisesABSTRACT
alpha-Amyrin palmitate, present in a Ghanaian antiarthritic herbal preparation of Alstonia boonei, Elaies guineensis and Rauvolfia vomitoria, was synthesised and tested on complete Freund's adjuvant-induced arthritic rats. Administered orally at 56 mg/kg body weight (BW) daily for 8 days from days 11 to 18 post adjuvant (acute) or at 66 mg/kg BW every 48 h for 5 days from days 32 to 40 (chronic), the drug returned the increases in serum hyaluronate and blood granulocytes towards non-arthritic levels and corrected the moderate anaemia of adjuvant arthritis. Histological examinations of the proximal interphalangeal foot joints showed reduced synovial proliferation and invasion of joints and reduced leucocyte infiltration of bone marrow and periarticular tissue in treated rats. The results suggest that alpha-amyrin palmitate contributes to the previously shown antiarthritic effect of the herbal preparation.
Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Experimental/drug therapy , Plant Extracts/therapeutic use , Triterpenes/therapeutic use , Acute Disease , Administration, Oral , Anemia/drug therapy , Animals , Antirheumatic Agents/administration & dosage , Antirheumatic Agents/pharmacology , Arthritis, Experimental/chemically induced , Biomarkers/blood , Bone Marrow/drug effects , Bone Marrow Cells , Cartilage, Articular/drug effects , Cartilage, Articular/pathology , Cell Division/drug effects , Chronic Disease , Disease Models, Animal , Ghana , Granulocytes/drug effects , Hyaluronic Acid/classification , Leukocytes/drug effects , Leukocytes/pathology , Oleanolic Acid/analogs & derivatives , Plant Extracts/administration & dosage , Plant Extracts/pharmacology , Plants, Medicinal , Rats , Rats, Wistar , Synovial Fluid/cytology , Synovial Membrane/drug effects , Synovial Membrane/pathology , Tarsal Joints/drug effects , Tarsal Joints/pathology , Triterpenes/administration & dosage , Triterpenes/pharmacologyABSTRACT
We evaluated four commercial kits for measuring serum ferritin, based on three techniques: immunoradiometric assay, radioimmunoassay, and enzyme immunoassay. The kits evaluated were those manufactured by Abbott Laboratories, Clinical Assays, Corning Medical, and Ramco. Two of the immunoradiometric kits showed satisfactory results with respect to sensitivity and precision; they should be useful in diagnosing individuals with uncomplicated iron-deficiency anemia. One of the immunoradiometric assay kits, however, showed a high-dose "hook effect," beginning at 10 mg of ferritin per liter. We modified this kit to eliminate this effect, at least to ferritin concentrations of 33 mg/L. (We observed a ferritin value as high as 47 mg/L in one patient.) Results with all these kits did not inter-compare well for ferritin concentrations greater than 300 micrograms/L, a finding that casts further doubt on the controversial use of serum ferritin measurement in cases of iron overload.