[Prevalence of metabolic syndrome in Mapuche individuals living in urban and rural environment in Chile]. / Prevalencia de síndrome metabólico en individuos de etnia Mapuche residentes en zonas rurales y urbanas de Chile.

BACKGROUND: Metabolic Syndrome (MS) increases the risk of diabetes and mortality associated with cardiovascular disease. However, the prevalence of MS could differ by ethnicity and lifestyle factors. AIM: To determine the prevalence of MS in Mapuche individuals living in urban and rural environments in Chile and to investigate whether the prevalence and risk of MS in urban and rural environments differs by sex, age and nutritional status. MATERIAL AND METHODS: A total of 1077 Mapuche participants were recruited from urban (MU = 288) and rural (MR = 789) settings. Body mass index, waist circumference and blood pressure were measured. A fasting blood sample was obtained to measure serum glucose, HDL cholesterol and triacylglycerol. The prevalence of MS was determined using the unified IDF and ATP-III criteria. RESULTS: An environment and sex interaction was found for the prevalence of MS (p = 0.042). The prevalence was significantly lower in male MR (13%) compared to other groups (22, 23 and 25% among female MR, female MU and male MU respectively). Also, the prevalence of central obesity and low HDL-cholesterol were significantly lower in male MR. MU are at an increased risk of developing MS compared to MR, with an odds ratio of 1.59 (95% confidence intervals 1.1 to 2.2). This risk increases along with age or body mass index of the population. CONCLUSIONS: The adoption of an urbanized lifestyle increases the risk of developing MS in Mapuche individuals. This risk is enhanced by age and nutritional status.

Antimicrobial resistance in commensal Escherichia coli and Enterococcus spp. isolated from pigs subjected to different antimicrobial administration protocols.

The antimicrobial resistance (AMR) in human and animal pathogens is a global concern, and antimicrobial use (AMU) is considered the most important driver for its increase. The aim of this study was to assess AMR in Escherichia coli and Enterococcus spp. in faecal samples of pigs subjected to four different AMU protocols from birth to finishing: G1, no in-feed antimicrobials; G2: a total average dose 6018 mg antimicrobials/pig; G3: a total average dose 8127 mg antimicrobials/pig; and G4: a total average dose 15,678 mg antimicrobials/pig. Faecal samples were collected at six time points and AMR was assessed in both bacteria. The microbiota composition was assessed by 16S rRNA sequencing. Minor differences on the microbiota profile was observed among groups, but a lower Firmicutes:Bacteroidetes ratio was noted in G4. Escherichia coli and Enterococcus spp. strains isolated from all groups showed a high level of multi-drug resistance (MDR). The amount of antimicrobials used was significantly positively associated with the probability of MDR in both bacteria. Approximately 43% of the variation in MIC90 for colistin could be explained by AMU, and a one-day increase in administration of colistin increased MIC90 by 0.05 µg mL-1. In conclusion, the results suggest that the higher the use of antimicrobials in farms, the higher the MDR frequency and resistance to the highest priority critically important antimicrobials for humans in commensal gut bacteria of pigs.

Lack of relationship between masticatory performance and nutritional status in adults with natural dentition.

OBJECTIVE: This study assessed the relation among several aspects of the masticatory function and the nutritional status in adults with natural dentition. DESIGN: One hundred adults with natural dentition participated in this cross-sectional study. They performed one free-style masticatory test consisting of five trials of 20 silicon-chewing cycles. The preferred chewing side was determined by calculating the asymmetry index. Masticatory performance was determined by sieving the silicon particles, and the cycle duration was also recorded. Weight, body water percentage, body fat mass, muscle mass and osseous mass were measured using a portable digital weighing machine. Body mass index (BMI), waist-hip ratio, skinfold thickness and the upper-arm composition were determined. The relation between masticatory function and a nutritional variable were tested using Pearson or Spearman rank correlation coefficients or using analysis of variance or the Kruskal-Wallis H-test and the Mann-Whitney U test, as appropriate. RESULTS: Whereas body fat percentages for women were significantly higher than for men, the body mass index was higher in men than in women. Participants who were underweight chewed more asymmetrically and more slowly than normal weight or obese participants. A negative correlation was observed between body fat percentage and masticatory laterality. No relation between masticatory performance and any nutritional status indicator was detected. CONCLUSION: Being underweight and having a low body fat percentage seem to be related to a masticatory lateral asymmetry and to a large cycle duration in young adults with natural dentition. Masticatory performance does not seem to be related to nutritional status.

Dolor plantar calcáneo. Experiencias y opciones de tratamiento / Calcaneal plantar pain. Experiences and treatment options

La talalgia se define como la percepción de dolor localizado en el talón que anatómicamente corresponde al hueso calcáneo y a las partes blandas colaterales, constituye la causa más frecuente de consulta a los especialistas en pie y tobillo, identificando dos zonas de aparición del dolor, el dolor plantar y el dolor posterior, los que están directamente relacionados con la inervación de esa zona del pie, realizamos un análisis general para evaluar las opciones iniciales de tratamiento y las indicaciones fisioterapéuticas exponiendo nuestra opinión y experiencias(AU)

Talalgia is defined as the perception of localized pain in the heel that anatomically corresponds to the calcaneus bone and collateral soft tissue, is the most frequent cause of consultation with foot and ankle specialists, identifying two areas of pain appearance, pain plantar and subsequent pain, which are directly related to the innervation of that area of the foot, we perform a general analysis to evaluate the initial treatment options and physiotherapeutic indications exposing our opinion and experiences(AU)

Prevalencia de síndrome metabólico en individuos de etnia Mapuche residentes en zonas rurales y urbanas de Chile / Prevalence of metabolic syndrome in Mapuche individuals living in urban and rural environment in Chile

Background: Metabolic Syndrome (MS) increases the risk of diabetes and mortality associated with cardiovascular disease. However, the prevalence of MS could differ by ethnicity and lifestyle factors. Aim: To determine the prevalence of MS in Mapuche individuals living in urban and rural environments in Chile and to investigate whether the prevalence and risk of MS in urban and rural environments differs by sex, age and nutritional status. Material and Methods: A total of 1077 Mapuche participants were recruited from urban (MU = 288) and rural (MR = 789) settings. Body mass index, waist circumference and blood pressure were measured. A fasting blood sample was obtained to measure serum glucose, HDL cholesterol and triacylglycerol. The prevalence of MS was determined using the unified IDF and ATP-III criteria. Results: An environment and sex interaction was found for the prevalence of MS (p = 0.042). The prevalence was significantly lower in male MR (13%) compared to other groups (22, 23 and 25% among female MR, female MU and male MU respectively). Also, the prevalence of central obesity and low HDL-cholesterol were significantly lower in male MR. MU are at an increased risk of developing MS compared to MR, with an odds ratio of 1.59 (95% confidence intervals 1.1 to 2.2). This risk increases along with age or body mass index of the population. Conclusions: The adoption of an urbanized lifestyle increases the risk of developing MS in Mapuche individuals. This risk is enhanced by age and nutritional status.

Consideraciones sobre intubación endotraqueal y traqueostomía / Consideration about endotracheal intubation and tracheostomy

Se realizó una revisión bibliográfica de intubación endotraqueal y traqueostomía. Fueron analizados la histopatología del daño producido en la vía aérea, los factores que determinan este daño y las complicaciones secundarias a estos procedimientos. Se propone una conducta terapéutica en relación al momento de realizar la conversión de intubación a traqueostomía

Subgalato de bismuto y la hemostasia en adenoamigdalectomía / Bismuth subgalate and hemostasis in adenotonsillectomy

En el presente trabajo se intenta demostrar la utilidad del subgalato de bismuto, sal de metal pesado con propiedades hemostáticas, para realizar la hemostasia en las amigdalectomías. Se incluyeron 213 pacientes, los cuales tenían indicación de amigdalectomía y a los que se le extirparon ambas amígdalas con la misma técnica. Se eligió un lado al azar, intentando la hemostasia sólo con subgalato de bismuto, lo que se logró en 97,2 por ciento y se comparó con los resultados obtenidos en la hemostasia del lado contralateral en que se realizó la técnica clásica de ligadura o de punto montado con catgut. De los 213 pacientes, 4 presentaron hemorragia postoperatoria, 3 precoces y una tardía. Los que sangraron sólo lo hicieron en el lado en que se usó la técnica de ligadura o punto montado con catgut. La técnica de hemostasia con subgalato de bismuto fue muy segura, ya que ningún paciente presentó hemorragia en el lado en que se utilizó; su uso no provocó complicaciones ni efectos colaterales

Fibroangioma de rinofaringe: experiencia de 20 años / Nasopharyngeal angiofibroma: an experience of 20 years

Se presentan 34 pacientes con diagnóstico de angiofibroma de rinofaringe tratados en 1975 y 1995. Todos tenían confirmación histológica preoperatoria. Hubo variación en la modalidad de diagnóstico utilizado, dependiendo de la disponibilidad del examen y el año en que fue hecho el diagnóstico. Angiografía se efectuó en 24 pacientes, 21 de éstos fueron embolizados (un caso murió y otro presentó accidente vascular encefálico). Los pacientes se etapificaron según la clasificación de Chandler basada en datos clínicos y radiológicos. Treinta y tres pacientes fueron tratados. Veintiocho casos recibieron una modalidad terapéutica única: cirugía (23), escleroterapia (4) o radioterapia (1). El abordaje quirúrgico varió dependiendo de la localizacion específica del tumor, extensión y año en el período de estudio. Tratamiento combinado se efectuó en 5 pacientes. Las complicaciones presentadas en todo el grupo tratado fueron: hemorragia postoperatoria (1), necrosis palatal (1), problema estético-funcional (4) y radionecrosis (1). El rango de seguimiento varió entre 1 a 8 años. Todos los pacientes tratados están vivos al finalizar este estudio