Reference ventricular dimensions and function parameters by cardiovascular magnetic resonance in highly trained Caucasian athletes.

BACKGROUND: Data regarding cardiovascular magnetic resonance (CMR) reference values in athletes have not been well determined yet. Using CMR normal reference values derived from the general population may be misleading in athletes and may have clinical implications. AIMS: To determine reference ventricular dimensions and function parameters and ratios by CMR in high performance athletes. METHODS: Elite athletes and age- and gender-matched sedentary healthy controls were included. Anatomical and functional variables, including biventricular volumes, mass, systolic function, wall thickness, sphericity index and longitudinal function were determined by CMR. RESULTS: A total of 148 athletes (29.2 ± 9.1 years; 64.8% men) and 124 controls (32.1 ± 10.5 years; 67.7% men) were included. Left ventricular (LV) mass excluding papillary muscles was 67 ± 13 g/m2 in the control group and increased from 65 ± 14 g/m2 in the low intensity sport category to 83 ± 16 g/m2 in the high cardiovascular demand sport category; P < 0.001. Regarding right ventricular (RV) mass, the data were 20 ± 5, 31 ± 6, and 38 ± 8 g/m2, respectively; P < 0.001. LV and RV volumes, and wall thickness were higher in athletes than in the control group, and also increased with sport category. However, LV and RV ejection fractions were similar in both groups. LV and RV dimensions, wall thickness and LV/RV ratios reference parameters for athletes are provided. CONCLUSIONS: LV and RV masses, volumes, and wall thicknesses are higher in athletes than in sedentary subjects. Specific CMR reference ranges for athletes are provided and can be used as reference levels, rather than the standard upper limits used for the general population to exclude cardiomyopathy.

Diet and Lifestyle Changes During the COVID-19 Pandemic in Ibero-American Countries: Argentina, Brazil, Mexico, Peru, and Spain.

This study aimed to evaluate changes in dietary and lifestyle habits during the period of confinement due to the first wave of the COVID-19 pandemic in Ibero-American countries. A cross-sectional investigation was conducted with 6,325 participants of both genders (68% women), over 18 years of age and from five countries: Brazil (N = 2,171), Argentina (N = 1,111), Peru (N = 1,174), Mexico (N = 686), and Spain (N = 1,183). Data were collected during the year 2020, between April 01 and June 30 in Spain and between July 13 and September 26, in the other countries studied using a self-administered online survey designed for the assessment of sociodemographic, employment, physical activity, health status, and dietary habits changes. Most participants (61.6%), mainly those from Spain, remained constant, without improving or worsening their pattern of food consumption. Among those who changed, a pattern of better eating choices prevailed (22.7%) in comparison with those who changed toward less healthy choices (15.7%). Argentina and Brazil showed the highest proportion of changes toward a healthier pattern of food consumption. Peruvians and Mexicans were less likely to make healthy changes in food consumption (OR: 0.51; 95% CI: 0.4-0.6 and OR: 0.69; 95% CI: 0.4-0.8, respectively), when compared to Argentinians. Most respondents did not change their pattern of meal consumption, but those who did reduced their consumption of main meals and increased intake of small meals and snacks. Although most participants affirmed to be doing physical activity at home, about one-half reported perception of weight gain. Individuals with alterations in sleep pattern (either by increasing or decreasing sleep time) were more likely to change their diets to a healthier pattern. In contrast, individuals with confirmed diagnosis of COVID-19 and those who reported feeling anxious were more likely to perform changes to a less healthy eating pattern (OR: 1.72; 95% CI: 1.2-2.3 and OR: 1.21; 95% CI: 1.1-1.4, respectively). In conclusion, although most participants remained constant in their eating habits, lifestyle changes and anxiety feelings were reported. Among those who changed patterns of food consumption, healthier choices prevailed, with differences between countries. However, there were alterations in the distribution of meals, with higher consumption of snacks and small meals. These results can be used to guide policies to prevent deleterious consequences that may affect the incidence of chronic diseases.

Arterial Stiffness and Blood Pressure in a Multicultural Child Sample (Angola, Brazil, and Spain).

BACKGROUND: To analyze the relationship between early-life indicators, blood pressure (BP), and arterial stiffness in childhood, in three samples with different bio-cultural characteristics. METHODS: The total sample included 520 schoolchildren 9-10 years of age from Madrid (Spain), Vitória (Brazil), and Luanda (Angola). Height and weight, BP, and carotid-femoral pulse wave velocity (cf-PWV) were measured, all by one observer in each site, and body mass index (BMI) was calculated. Birth weight, gestational age, type of feeding, and age at weaning were extracted from official health cards. Data were analyzed by multiple linear regression models. RESULTS: No significant differences were observed in systolic blood pressure (SBP) and diastolic blood pressure (DBP) among the samples (P = 0.107 and P = 0.808). Luanda showed the higher cf-PWV (5.7 m/s), followed by Vitória (5.3 m/s) and Madrid (4.9 m/s; P < 0.001). Explanatory factors for the observed variability in SBP, DBP, and cf-PWV, obtained by means of multiple linear regression models, were different in three samples. BMI showed a positive and significant association with SBP, DBP, and cf-PWV in three samples. In the Angolan sample, in addition to BMI, birth weight was maintained in the explanatory models of SBP and cf-PWV adjusted for BP, with a negative and significant coefficient (-0.019 and -0.019). CONCLUSIONS: Higher values of BMI in childhood are related with higher values of cf-PWV, SBP, and DBP in the three samples. Children from Angola showed the highest mean value of cf-PWV, especially those who had lower birth weight, suggesting that worse conditions in fetal life may contribute to increased aortic stiffness in childhood.

Eosinophilic Esophagitis: Review and Update.

Background: Eosinophilic esophagitis (EoE) was first described in the 1990s, showing an increasing incidence and prevalence since then, being the leading cause of food impaction and the major cause of dysphagia. Probably, in a few years, EoE may no longer be considered a rare disease. Methods: This article discusses new aspects of the pathogenesis, symptoms, diagnosis, and treatment of EoE according to the last published guidelines. Results: The epidemiological studies indicate a multifactorial origin for EoE, where environmental and genetic factors take part. EoE affects both children and adults and it is frequently associated with atopic disease and IgE-mediated food allergies. In patients undergoing oral immunotherapy for desensitization from IgE-mediated food allergy the risk of developing EoE is 2.72%. Barrier dysfunction and T-helper 2 inflammation is considered to be pathogenetically important factors. There are different patterns of clinical presentation varying with age and can be masked by adaptation habits. Besides, symptoms do not usually correlate with histologic disease activity. The diagnostic criteria for EoE has evolved but mainly requires symptoms of esophageal dysfunction with histologic evidence of a peak value of at least 15 eosinophils per high-power field. Endoscopies have to be repeated in order to diagnose, monitor, and treat EoE. Treatment of EoE can be started either by drugs (PPIs and topical corticosteroids) or elimination diets. The multistage step-up elimination diet management approach of EoE is promising. Endoscopic dilation is used for patients with severe dysphagia/food impaction with inadequate response to anti-inflammatory treatment. Conclusions: Research in recent years has contributed to a better understanding of EoE's pathogenesis, genetic background, natural history, allergy workup, standardization in assessment of disease activity, evaluation of minimally invasive diagnostic tools, and new therapeutic approaches. However, several unmet needs are to be solved urgently, as finding a non-invasive disease-monitoring methods and biomarkers for routine practice, the development or new therapies, novel food allergy testing to detect triggering foods, drug, and doses required for initial therapy and safety issues with long-term maintenance therapy, amongst others. Besides, multidisciplinary management units of EoE, involving gastroenterologists, pediatricians, allergists, pathologists, dietitians, and ENT specialists are needed.

New records of ectoparasitic Acari (Arachnida) and Streblidae (Diptera) from bats in Jalisco, Mexico.

Ectoparasites of bats in the Neotropics are diverse and play numerous ecological roles as vectors of microbial pathogens and endoparasites and as food sources for other cave fauna living both on their hosts and in bat roosts. The ectoparasites of bats in Jalisco State of western Mexico have not been as well described as those of other states with recent checklists that have focused primarily on the Yucatan Peninsula. We captured bats from 2011-2015 on the south coast and Sierra de Amula, Jalisco using mist nets, and we removed ectoparasites by hand. We identified 24 species of streblid bat flies and six ectoparasitic mites from bats caught in mist nets. There were an additional eight possibly undescribed species of Streblidae. Our collections extend the known range of species into Jalisco.

Gender, health, and initiation of breastfeeding.

The aim of this study was to explore the associations of health, gender, and motherhood with the decisions about breastfeeding. The sample consisted of 265 pregnant women (mean age: 32.34, SD: 4.01 years) who were recruited in healthcare centers and hospitals in southeast Spain between 2010 and 2011. Mental health was measured by the 12-Item General Health Questionnaire and gender by the Conformity to Feminine Norms Inventory. Women in our sample showed a higher conformity to gender norms than women surveyed in the adaptation of the inventory to the Spanish population (t = 11.25, p < 0.001, effect estimate (Cohen's d) = 0.59). After adjustment for covariates, women who exclusively breastfed did not differ significantly in their conformity to gender norms from those who used partial breastfeeding or bottle feeding. Although good, our expectant mothers had worse mental health than the women aged 15-44 years in the Spanish National Health Survey (t = 2.96, p < 0.001, d = 0.26). Those who partially breastfed had significantly better mental health values. Gender norms were modulators in a model of factors related to initiation of breastfeeding. This study provides information about health and social construction of gender norms.

The GHQ-12 for the assessment of psychological distress of family caregivers.

This study examined the utility of the 12-item General Health Questionnaire (GHQ-12) to assess the psychological distress of family caregivers. To accomplish this goal, a sample of 172 caregivers, 25 men and 147 women, aged 56.6 (SD = 13.7) completed self-report questionnaires and provided data on demographic factors. Univariate and bivariate models adjust adequately, although the two-factor model (anxiety/depression and social dysfunction) presented a better fit. Relative caregivers scored higher in psychological distress (anxiety and depression levels) on the GHQ-12 than did the normal population. In conclusion, the GHQ-12 is a sensitive instrument to detect the presence of anxiety and depression in relative caregivers, and the external validity of the instrument is generally adequate. The GHQ-12 seems particularly appropriate for research and clinical and health intervention in caregivers. Implications and limitations of these results are discussed, along with suggestions for future research.

[Systematic review about the usefulness and prognostic value of the p53 oncoprotein and proliferation marker Ki-67 for upper urinary tract transitional cell carcinoma]. / Revisión sistemática sobre la utilidad y el valor pronóstico de la oncoproteína p53 y el marcador de proliferación Ki-67 en el car- cinoma de células transicionales del tracto urinario superior.

OBJECTIVES: To perform a systematic review on the expression and prognostic value of the p 53 oncoprotein and Ki 67 proliferation marker in transitional cell carcinoma of the upper urinary tract. METHODS: A systematic review of cohort, prospective and retrospective studies from 1/1/1990 to 11/24/2003 has been undertaken, performing a bibliographic search both manual and electronic in the main databases. 632 works were found using the keywords "ureter, renal and pelvis tumor", and 14 with "ureter, renal and pelvis tumor, and immunohistochemical". RESULTS: 509 patients were studied; they were selected from 7 retrospective studies about the usefulness of p53 and Ki 67 in transitional cell carcinoma of the upper urinary tract published between 1995 and 2002 (three Spanish studies, three Japanese and one North American). Each one analyzes between 37 and 121 cases, with a mean age of 66.8 years (range 63.0-74.7) and a predominance of male sex in 100% of the studies. The pyelocalyceal site was the most frequent in these series. Treatment is another issue taken into consideration in this papers, being nephroureterectomy the most frequently found. The p53 and Ki 67 percentage expression in various studies has been related to clinical and histological factors. Only 5 studies performed a multivariate analysis using Cox regression models. Three of them deal with Ki 67 and two with p53, although one of the p53 studies associates cyclin E determinations. Only two out of three studies about Ki 67 were considered evaluable, because multivariate analysis was not performed in the other one. CONCLUSIONS: 1) There are a few studies and they are very heterogeneous in terms of design, selection criteria, follow-up, and use of prognostic variables. 2) The analyzed studies establish that oncoprotein p53 and proliferation marker Ki 67 are prognostic factors for transitional cell carcinoma of the upper urinary tract, and 3) To perform a meta-analysis was deemed not indicated because of the heterogeneicity of the studies found in our search.