[Knowledge among physicians of the main cause of death in women]. / Percepción en médicos del impacto de la enfermedad cardiovascular en la mortalidad femenina.

BACKGROUND: There is a misconception that the main cause of death among women is breast cancer, even among physicians, who may neglect cardiovascular preventive measures in this gender Aim: To assess the knowledge among physicians about the main cause of death among women. MATERIAL AND METHODS: A survey was answered by 231 physicians attending a Cardiology and a Gynecology Meeting. RESULTS: Sixty eight percent of respondents indicated that cardiovascular diseases are the main cause of death among women. A higher proportion of specialists than trainees, answered correctly the question (72 and 56% respectively). No gender differences in the answers were recorded. CONCLUSIONS: The knowledge about cardiovascular risk in women should be reinforced among physicians.

Clinical Relevance of Physical Function Outcomes in Cancer Cachexia.

Managing clinical manifestations of cancer/treatment burden on functional status and quality of life remains paramount across the cancer trajectory, particularly for patients with cachexia who display reduced functional capacity. However, clinically relevant criteria for classifying functional impairment at a single point in time or for classifying meaningful functional changes subsequent to disease and/or treatment progression are lacking. This unmet clinical need remains a major obstacle to the development of therapies for cancer cachexia. This review aims to describe current literature-based evidence for clinically meaningful criteria for (1) functional impairment at a single timepoint between cancer patients with or without cachexia and (2) changes in physical function over time across interventional studies conducted in patients with cancer cachexia. The most common functional assessment in cross-sectional and interventional studies was hand grip strength (HGS). We observed suggestive evidence that an HGS deficit between 3 and 6 kg in cancer cachexia may display clinical relevance. In interventional studies, we observed that long-duration multimodal therapies with a focus on skeletal muscle may benefit HGS in patients with considerable weight loss. Future studies should derive cohort-specific clinically relevant criteria to confirm these observations in addition to other functional outcomes and investigate appropriate patient-reported anchors.

Impact of Gestational Diabetes Mellitus on Sexual Function: A Case-Control Study.

Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide, and this condition may be compromising female sexual function. However, there are controversial findings regarding the impact of GDM diagnosis and proposed treatments on sexual function during pregnancy. Therefore, this study seeks to elucidate the impact of GDM on sexual function in pregnant women by making a comparison between GDM and non-GDM groups using pregnancy sexual response inventory (PSRI). Materials and Methods: A case-control study involved 303 [168 women without GDM (control group) and 108 women diagnosed with GDM (case group)] Brazilian pregnant women at the Perinatal Diabetes Research Centre-Universidade Estadual Paulista, Brazil. PSRI was used to collect the data. The sexual function was scored in 10 domains as composite and specific scores by domains, categorized into quartiles (0 < 25 "very low," 25 < 50 "low," 50 < 75 "high," and 75-100 "very high"), for "before pregnancy" and "during pregnancy." The obtained data were subjected to statistical analysis using Student's t-, F-, and chi-square tests. Results: GDM women (PSRI composite score <50) are at risk of decreased sexual function during pregnancy, while non-GDM women are not at risk (PSRI composite score >50). There were no significant differences in the sexual functions between the two groups before pregnancy (p > 0.0001). After GDM diagnosis and proposed treatment, the differences were significant (p < 0.0001), notably in the frequency, arousal, orgasm, satisfaction, and dyspareunia score. Conclusions: This study showed that GDM diagnosis and proposed treatment resulted in decreased sexual functions during pregnancy.

Caracterización de estado nutricional y riesgo cardiovascular y su relación con dieta mediterránea en adultos mayores de la región metropolitana de Chile / Characterization of nutritional status and cardiovascular risk and its relationship with the Mediterranean diet in older adults from the metropolitan region of Chile

Introducción: La dieta mediterránea es una de las más completas y adecuadas para mantener un correcto estado nutricional. En adultos mayores, producto de los cambios fisiológicos propios de la senectud, se evidencia una modificación en su alimentación, aumentando del riesgo cardiovascular y alterando su estado nutricional. Objetivo: Analizar la adherencia a la dieta mediterránea y la asociación con el estado nutricional y riesgo cardiovascular en adultos mayores no institucionalizados. Materiales y Métodos: Estudio descriptivo de corte transversal, en adultos mayores no institucionalizados de Chile. Se determinó el estado nutricional por medio de IMC, el riesgo cardiovascular se determinó según la circunferencia de cintura. Para determinar la adherencia a la dieta mediterránea (IDM) se utilizó la prueba ID-Chile, el cual contiene 22 preguntas, evaluando la frecuencia del consumo de 14 grupos de alimentos. Para el análisis estadístico se calculó el valor de p mediante chi2 de Pearson. El nivel de significancia se estableció al 5% (p<0,05). Resultados: El 61% de los participantes fueron mujeres, de edad predominio de 72,13 años, con mayor representación de obesidad y sobrepeso (31,15%). El 39% de los participantes fueron hombres, con edad promedio de 72,33 años y mayoritariamente con peso normal o sobrepeso (35,89%). Se observó diferencias significativas entre varones y mujeres considerando el peso (p<0,052). No se observó relación significativa con variables como edad, IMC, adherencia a dieta mediterránea y riesgo cardiovascular. Se observó una relación significativa al comparar adherencia a la dieta mediterránea con el estado nutricional (p<0,027) y el riesgo cardiovascular (p<0,032). Conclusión: La adherencia a la dieta mediterránea es un factor asociado con mejor estado nutricional y la reducción del riesgo cardiovascular en la población de adultos mayores. Es importante masificar el consumo de alimentos de este estilo de vida para así mejorar..(AU)

Introduction: The Mediterranean diet is one of the mostcomplete and adequate to maintain a correct nutritional status.In older adults, because of the physiological changes typical ofold age, there is evidence of a change in their diet, increasingcardiovascular risk and altering their nutritional status.Objective: To analyze adherence to the Mediterraneandiet and its association with nutritional status and cardiovas-cular risk in non-institutionalized older adults. Materials and Methods: Descriptive cross-sectionalstudy in non-institutionalized older adults in Chile.Nutritional status was determined by BMI, cardiovascularrisk was determined by waist circumference/height ratio. Todetermine adherence to the Mediterranean diet (MDI), theID-Chile test was used, which contains 22 questions, evalu-ating the frequency of consumption of 14 food groups. Forstatistical analysis, the p value was calculated usingPearson’s chi square. The level of significance was estab-lished at 5% (p<0.05).Results: 61% of the participants were women, an averageage of 72.13 years, with a greater representation of obesityand overweight (31.15%). 39% of the participants were men,with an average age of 72.33 years and mostly with normalweight or overweight (35.89%). Significant differences wereobserved between men and women considering weight(p<0.052). No significant relationship was observed with vari-ables such as age, BMI, adherence to the Mediterranean dietand cardiovascular risk. A significant relationship was ob-served when comparing adherence to the Mediterranean dietwith nutritional status (p<0.027) and cardiovascular risk(p<0.032).Conclusion: Adherence to the Mediterranean diet is a fac-tor associated with better nutritional status and reduced car-diovascular risk in the elderly population. It is important tomassify the food consumption of this lifestyle to improve thequality of life of older adults.(AU)

Evaluación de la percepción de riesgo cardiovascular en mujeres posterior a un programa de rehabilitación cardíaca / Perception of cardiovascular risk in women after a rehabilitation program

RESUMEN: Introducción: La rehabilitación cardíaca después de padecer un evento cardiovascular (CV) grave es un proceso en el cual el paciente establece una relación cercana con el equipo médico, brindando la oportunidad de conocer factores psicosociales que influyeron en el desenlace cardíaco y los eventuales aprendizajes de la experiencia. El objetivo de este estudio fue conocer la percepción sobre su propia salud de mujeres que participaron de un programa de rehabilitación cardíaca. Método: Se invitó a participar a 35 mujeres de 35 a 75 años con diverso nivel educativo, ingreso familiar y situación laboral. Los datos se recolectaron por medio de entrevistas presenciales semiestructuradas. Resultados: A pesar de haber pasado por un proceso de rehabilitación posterior a un evento CV las mujeres mencionaron en forma mayoritaria al cáncer de mama como la principal eventual causa de muerte. En relación con los factores de riesgo de CV, el más nombrado fue el estrés (57%), aunque solo el 29% de las entrevistadas realizó con posterioridad actividades orientadas a su manejo y control. En cuanto a las motivaciones más frecuentes para realizar cambios de hábitos, destacaron el cuidado de la familia (29%), el vivir más (26%) y el deseo de sentirse mejor (23%). Conclusión: Estos resultados sugieren la necesidad de una educación más integral en la mujer durante la rehabilitación, promoviendo no solo hábitos más saludables desde el punto de vista físico, sino también psicológico. Se sugiere integrar el manejo del estrés en los programas de prevención y rehabilitación CV.

ABSTRACT: Introduction: After suffering a serious cardiovascular event (CV), cardiac rehabilitation is a process in which the patient establishes a close relationship with the medical team, providing an opportunity to learn about psychosocial factors that influence cardiac outcome and eventual learnings from the experience. The objective of this study was to learn about women´s perception of their own health after participating in a cardiac rehabilitation program. Method: 35 women from 35 to 75 years of age with varying educational level, household income and employment status were invited to participate. Data was collected through semi-structured face-to-face interviews. Results: Women mentioned breast cancer as the leading cause of death (60%) despite having gone through a post-CV rehabilitation process. Stress was mentioned as the main CV risk factor (57%). Only 29% of responders subsequently carried out activities aimed at their management and control. The most common motivations for making changes in habits, were family care (29%), living longer (26%) and a desire to feel better (23%). Conclusion: These results suggest the need for a more comprehensive education in women during rehabilitation, promoting not only healthier habits from a physical but also from a psychological points of view. The introduction of stress management into CV prevention and rehabilitation programs is suggested.

Percepción en médicos del impacto de la enfermedad cardiovascular en la mortalidad femenina / Knowledge among physicians of the main cause of death in women

Background: There is a misconception that the main cause of death among women is breast cancer, even among physicians, who may neglect cardiovascular preventive measures in this gender Aim: To assess the knowledge among physicians about the main cause of death among women. Material and methods: A survey was answered by 231 physicians attending a Cardiology and a Gynecology Meeting. Results: Sixty eight percent of respondents indicated that cardiovascular diseases are the main cause of death among women. A higher proportion of specialists than trainees, answered correctly the question (72 and 56% respectively). No gender differences in the answers were recorded. Conclusions: The knowledge about cardiovascular risk in women should be reinforced among physicians.

Caso Clínico: Tetralogía de Fallot Extrema / Case Report: Extreme Tetralogy of Fallot

INTRODUCCIÓN: La tetralogía de Fallot representa la cardiopatía congénita cianógena más frecuente después del primer año de vida, ocurre aproximadamente en 1 de cada 3 500 nacimientos y representa el 7 al 10% de todas las Enfermedades Cardiacas Congénitas. Su variante extrema que se acompaña de atresia pulmonar representa el 1 a 2% de las cardiopatías congénitas. Presentamos una Tetralogía de Fallot Extrema Ductus Dependiente de manejo complejo. CASO CLÍNICO: Se trata de un neonato a término de 12 días de vida, adecuado para la edad gestacional, sin factores de riesgo prenatales, ni antecedentes patológicos familiares, el cual es diagnosticado de Tetralogía de Fallot Extrema por ecocardiograma. EVOLUCIÓN: Paciente inicialmente tratado con infusión de prostaglandina E1. Posteriormente mediante fístula Blalock-Taussig izquierda. CONCLUSIONES: Para mejorar el pronóstico y sobrevida de un paciente con Tetralogía de Fallot Extrema el diagnóstico prenatal oportuno y el tratamiento apropiado es de vital importancia, sin embargo el tratamiento definitivo con derivaciones pulmonares sistémicas representan complicaciones con riesgo de mortalidad. El presente caso tuvo un desenlace desfavorable.

BACKGROUND: The Tetralogy of Fallot represents the most common cyanogenic heart disease after the first year of life. It occurs in 1 of 3 500 live births and accounts as 7 to 10% of all Congenital Heart Diseases. Its extreme variant is accompanied by pulmonary atresia and accounts 1 to 2% of the Congenital Heart Diseases. We present an Extreme Tetralogy of Fallot­ Ductus Dependent of complex management. CLINICAL CASE: A full term 12 day neonate, adequate for gestational age, without prenatal risk factors or pathologic family antecedents, is diagnosed with Extreme Tetralogy of Fallot by echocardiogram. EVOLUTION: The patient was treated initially with an infusion of prostaglandin E1. Then, a left Blalock-Taussig shunt was performed. CONCLUSIONS: To improve the prognosis and survival rates of patients with Extreme Tetralogy of Fallot , a timely diagnosis and treatment are of vital importance. Definitive treatment with systemic pulmonary shunts carries high risk complications. The present case had an unfavorable evolution.

Sexismo, pensamientos distorsionados y violencia en las relaciones de pareja en estudiantes universitarios de Ecuador de áreas relacionadas con el bienestar y la salud / Sexism, Distorted Thoughts and Violence in Couple Relationships in Ecuadorian Universities with Students Related to Welfare and Health

Resumen Este estudio tiene como objetivo analizar las relaciones entre las actitudes sexistas, los pensamientos distorsionados sobre la mujer y el uso de la violencia y los comportamientos de violencia con la pareja, en universitarios ecuatorianos de ramas relacionas con el bienestar y la salud. La muestra está conformada por 646 alumnos de tres universidades (424 alumnas y 222 alumnos). Se aplicaron los siguientes instrumentos: Versión modificada de la Escala de Tácticas para los Conflictos, Inventario de Sexismo Ambivalente, Inventario de Pensamientos Distorsionados y Escala de Deseabilidad Social. Para la detección de diferencias estadísticamente significativas, se aplicó el test de Mann Whitney y el test de Kruskal Wallis. Para estimar el efecto de la deseabilidad social en las respuestas, se realizaron diferentes regresiones lineales. Los resultados identifican un alto nivel de sexismo y de violencia ejercida y sufrida en la muestra de universitarios, aunque estos parecen estar influidos por la deseabilidad social. Este hecho cobra especial relevancia debido al papel que juegan estos profesionales en la detección y tratamiento de violencia en la pareja. Los resultados obtenidos indican la oportunidad de trabajar en intervenciones educativas en población universitaria para minimizar los pensamientos sexistas que pueden ser fundamento de la violencia de género.

Abstract This study aims to analyze the relationships between sexist attitudes, distorted thoughts about women, the use of violence and violent behaviors in couples. The study was carried out in Ecuadorian universities with students related to Welfare and Health studies. There were 646 students from three universities (424 men and 222 women). The following tests were applied: Modified version of the Scale Conflict Tactics, Ambivalent Sexism Inventory, Inventory of Distorted Thoughts and Social Desirability Scale. The Mann-Whitney and Kruskal Wallis tests were applied to detect statistically significant differences. In order to estimate the effect of social desirability on responses it was performed different linear regressions. The results identify high levels of sexism and perpetrated and suffered violence, although these results seemed to be influenced by social desirability. This becomes especially important due to the role played by these professionals in the detection and treatment of intimate partner violence. The results show the importance to work on educational interventions in universities to minimize sexist thoughts that cause violence against women.