30 años de investigación en maltrato infantil: un análisis bibliométrico (1991-2020)

Introducción: el maltrato infantil es un problema global que afecta el desarrollo de los niños y las niñas, pudiendo tener consecuencias a lo largo de su vida. A pesar de la necesidad de investigar para erradicar este fenómeno, no se ha realizado una aproximación bibliométrica de sus avances recientes. Método: este estudio examinó 16 708 artículos sobre maltrato infantil indexados en la Web of Science entre 1991 y 2020 para establecer las tendencias de investigación. Resultados: el maltrato infantil es un campo activo, influenciado principalmente por Estados Unidos, Canadá y Reino Unido, y revistas de la categoría estudios de la familia, especialmente Child Abuse & Neglect. Los artículos más relevantes abordan el tema como parte de las Experiencias Adversas en la Infancia o se centran en su evaluación. Considerando los artículos más relevantes, los temas más estudiados (sujetos, investigación, maltrato y tipos de maltrato, familia y parentalidad, y trastornos) y los principales focos (maltrato, investigación, sexo, reportes y abuso sexual), es posible que el área se esté reestructurando desde la perspectiva del ecobiodesarrollo, con énfasis en el tratamiento y la prevención. Se discuten sus implicaciones teóricas y prácticas. Conclusiones: este estudio actualiza las tendencias de investigación en el campo del maltrato infantil, proporcionando un panorama comprensivo que sugiere una evolución hacia la integración de múltiples disciplinas y enfoques. Los resultados destacan la importancia de seguir investigando este problema global, así como la necesidad de evaluar las intervenciones existentes para reducir su impacto en el desarrollo de los niños y las niñas.

Introduction: Child abuse is a global problem that affects children's development and can have consequences throughout their lives. Despite the need to research to eradicate this phenomenon, there has not been a bibliometric approach to its recent advances. Method: This study examined 16,708 articles on child abuse indexed in the Web of Science between 1991 and 2020 to establish research trends. Results: Child maltreatment is an active field, mainly influenced by the USA, Canada and the UK, and journals in the family studies category, especially Child Abuse & Neglect. The most relevant articles address the topic as part of Adverse Childhood Experiences or focus on its assessment. Considering the most relevant articles, the most studied topics (subjects, research, maltreatment and types of maltreatment, family and parenting, and disorders) and the main foci (maltreatment, research, sex, reporting, and sexual abuse), it is possible that the area is being restructured under the ecobiodevelopmental perspective, with emphasis on treatment and prevention. Its theoretical and practical implications are discussed. Conclusions: This study updates research trends in the field of child maltreatment, providing a comprehensive overview that suggests an evolution toward the integration of multiple disciplines and approaches. The results highlight the importance of further research on this global problem, as well as the need to evaluate existing interventions to reduce its impact on children's development.

Resultados de la encuesta sobre unidades asistenciales y atención a trastornos de la conducta alimentaria en España. Grupo de Trabajo sobre Trastornos de la Conducta Alimentaria de SENPE / Results of the survey on care units and caring for eating disorders in Spain. SENPE Working Group on Eating Disorders

Introducción: los trastornos de la conducta alimentaria (TCA) suponen un reto terapéutico. Objetivo: describir la asistencia a los TCA desde la perspectiva de las unidades de nutrición clínica y dietética (UNCyD) en relación con los recursos humanos y asistenciales, las actividades realizadas y la satisfacción con la atención en España; recoger demandas de los profesionales para mejorar la asistencia. Métodos: estudio transversal y observacional a partir de un cuestionario remitido online a socios de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) y al Área de Nutrición de la Sociedad Española de Endocrinología y Nutrición (SEEN). Los datos se analizaron según las camas de los hospitales encuestados (< 500/≥ 500). Resultados: 23 respuestas de 8 comunidades autónomas. En el 87 % de las UNCyD se prestaba atención a los TCA; el 65,2 % contaban con un proceso específico; el 91,3 % colaboraban con Psiquiatría; el 34,8 % tenían área propia de hospitalización; el 56,5 % disponían de hospital de día pero participaban en él el 21,7 %; el 39,1 % tenían consulta monográfica; se realizaba educación nutricional en el 87 %, sobre todo por enfermería; se prescribían frecuentemente dietas individualizadas y suplementos orales en el 39,1 y el 56,5 %, respectivamente; solo los hospitales más grandes participaban en investigación sobre TCA (62,5 %); y el 21,7 % colaboraban con asociaciones de pacientes. Los hospitales con ≥ 500 camas disponían de más recursos y estaban más satisfechos. Los profesionales demandaban recursos y procesos consensuados con psiquiatría. Conclusiones: los recursos y las prácticas asistenciales son dispares en las UNCyD encuestadas, así como la colaboración multidisciplinar. La evidencia recogida permite diseñar estrategias de mejora en este ámbito. (AU)

Introduction: eating disorders (EDs) entail a therapeutic challenge. Objective: to describe ED care from the perspective of Nutrition Units (NU) in relation to human and care resources, the activities carried out, and satisfaction with care in Spain; to collect demands from professionals to improve assistance. Methods: a cross-sectional, observational study based on a questionnaire sent online to members of the Spanish Society of Clinical Nutrition and Metabolism (SENPE) and to the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN). The data were analyzed according to number of beds of the hospitals surveyed (< 500/≥ 500). Results: 23 responses from 8 autonomous communities. In 87 % of NUs care was given to eating disorders; 65.2 % had a specific process; 91.3 % collaborated with Psychiatry; 34.8 % had their own hospitalization area; 56.5 % had a day hospital, but 21.7 % participated in it; 39.1 % had a monographic consultation office; nutritional education was carried out in 87 %, especially by nursing; individualized diets and oral supplements were frequently prescribed in 39.1 % and 56.5 %, respectively; only the largest hospitals participated in research on EDs (62.5 %), and 21.7 % collaborated with patient associations. Hospitals with ≥ 500 beds had more resources and were more satisfied. Professionals demanded resources and processes agreed with Psychiatry. Conclusions: resources and care practices are uneven in the NUs surveyed, as well as multidisciplinary collaboration. The collected evidence allows us to design improvement strategies in this area. (AU)

[Results of the survey on care units and caring for eating disorders in Spain. SENPE Working Group on Eating Disorders]. / Resultados de la encuesta sobre unidades asistenciales y atención a trastornos de la conducta alimentaria en España. Grupo de Trabajo sobre Trastornos de la Conducta Alimentaria de SENPE.

Introduction: Introduction: eating disorders (EDs) entail a therapeutic challenge. Objective: to describe ED care from the perspective of Nutrition Units (NU) in relation to human and care resources, the activities carried out, and satisfaction with care in Spain; to collect demands from professionals to improve assistance. Methods: a cross-sectional, observational study based on a questionnaire sent online to members of the Spanish Society of Clinical Nutrition and Metabolism (SENPE) and to the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN). The data were analyzed according to number of beds of the hospitals surveyed (< 500/≥ 500). Results: 23 responses from 8 autonomous communities. In 87 % of NUs care was given to eating disorders; 65.2 % had a specific process; 91.3 % collaborated with Psychiatry; 34.8 % had their own hospitalization area; 56.5 % had a day hospital, but 21.7 % participated in it; 39.1 % had a monographic consultation office; nutritional education was carried out in 87 %, especially by nursing; individualized diets and oral supplements were frequently prescribed in 39.1 % and 56.5 %, respectively; only the largest hospitals participated in research on EDs (62.5 %), and 21.7 % collaborated with patient associations. Hospitals with ≥ 500 beds had more resources and were more satisfied. Professionals demanded resources and processes agreed with Psychiatry. Conclusions: resources and care practices are uneven in the NUs surveyed, as well as multidisciplinary collaboration. The collected evidence allows us to design improvement strategies in this area.

Introducción: Introducción: los trastornos de la conducta alimentaria (TCA) suponen un reto terapéutico. Objetivo: describir la asistencia a los TCA desde la perspectiva de las unidades de nutrición clínica y dietética (UNCyD) en relación con los recursos humanos y asistenciales, las actividades realizadas y la satisfacción con la atención en España; recoger demandas de los profesionales para mejorar la asistencia. Métodos: estudio transversal y observacional a partir de un cuestionario remitido online a socios de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) y al Área de Nutrición de la Sociedad Española de Endocrinología y Nutrición (SEEN). Los datos se analizaron según las camas de los hospitales encuestados (< 500/≥ 500). Resultados: 23 respuestas de 8 comunidades autónomas. En el 87 % de las UNCyD se prestaba atención a los TCA; el 65,2 % contaban con un proceso específico; el 91,3 % colaboraban con Psiquiatría; el 34,8 % tenían área propia de hospitalización; el 56,5 % disponían de hospital de día pero participaban en él el 21,7 %; el 39,1 % tenían consulta monográfica; se realizaba educación nutricional en el 87 %, sobre todo por enfermería; se prescribían frecuentemente dietas individualizadas y suplementos orales en el 39,1 y el 56,5 %, respectivamente; solo los hospitales más grandes participaban en investigación sobre TCA (62,5 %); y el 21,7 % colaboraban con asociaciones de pacientes. Los hospitales con ≥ 500 camas disponían de más recursos y estaban más satisfechos. Los profesionales demandaban recursos y procesos consensuados con psiquiatría. Conclusiones: los recursos y las prácticas asistenciales son dispares en las UNCyD encuestadas, así como la colaboración multidisciplinar. La evidencia recogida permite diseñar estrategias de mejora en este ámbito.

Procesamiento sensorial en menores de seis años con trastorno específico del lenguaje / Sensory processing in children under six years of age with specific language disorder

Introducción: El procesamiento sensorial determina e influencia el nivel de desarrollo que presentan los individuos en la infancia y cuando se afecta alguno de los sistemas que lo integran, se alteran dominios del desarrollo que impiden a los niños desenvolverse de manera adecuada en su entorno. Objetivos: Describir y comparar el procesamiento sensorial de los niños con trastorno específico del lenguaje y con desarrollo típico del lenguaje. Métodos: La muestra estuvo conformada por 60 niños con edades de 4 a 5 años de la escuela especial de lenguaje San Clemente, asignados a dos grupos de acuerdo con la presencia o ausencia de trastorno específico del lenguaje. El procesamiento sensorial se evaluó mediante la escala de procesamiento sensorial. Se evaluó el tipo de distribución de las variables de la escala para su posterior análisis. Resultados: Los niños con trastorno específico del lenguaje obtuvieron 275 puntos y se ubicaron por debajo del puntaje de corte, en cambio los menores con desarrollo típico obtuvieron 309 puntos y se situaron por sobre el puntaje de corte. Es decir, los niños con trastorno específico del lenguaje presentaron un procesamiento sensorial más bajo en comparación con los niños que poseen desarrollo típico del lenguaje con diferencias significativas en el sistema auditivo y propioceptivo. Conclusiones: Los niños con trastorno específico del lenguaje exhiben un desempeño más bajo en tareas de procesamiento sensorial, es por ello, que este último debe ser considerado en la evaluación y diagnóstico de niños con este trastorno para generar un abordaje más integral(AU)

Introduction: Sensory processing determines and influences the level of development presented by individuals in childhood and when any of the systems that integrate it are affected. Developmental domains are altered and they prevent children from developing adequately in their environment. Objectives: To describe and compare sensory processing in children with specific language impairment and typical language development. Methods: The sample consisted of 60 children aged 4 to 5 years from the San Clemente Special Language School, whom were assigned to two groups according to the presence or absence of specific language disorder. Sensory processing was assessed using the sensory processing scale. The type of distribution of the scale variables was evaluated for further analysis. Results: Children with specific language disorder obtained 275 points and were below the cut-off score, while children with typical development obtained 309 points and were above the cut-off score. That is, children with specific language disorder have lower sensory processing compared to children with typical language development with significant differences in the auditory and proprioceptive system. Conclusions: Children with specific language disorder show lower performance in sensory processing tasks, which is why the latter should be considered in the evaluation and diagnosis of children with this disorder to generate a more comprehensive approach(AU)

[Associated epidemiologic factors with recurring infection of the lower urinary tract in pregnant women]. / Factores epidemiológicos asociados a recurrencia de infecciones de vías urinarias bajas en mujeres gestantes.

Background: The urinary tract infections in pregnant women are the second most frequent medical pathology in pregnancy, presenting an incidence of 5-10%. In Mexico, according to the Mexican Clinical Practice Guide, the incidence is 2%, and establishes a recurrence of 23% of them. Objective: To determine the associated epidemiologic factors with recurring infections in lower urinary tract in pregnant women during the period of May 2019 through May 2020. Material and methods: Analytical observational cross-sectional and retrospective research study, where prenatal control sheets of clinical records were reviewed from the institutional program to identify frequency of recurrence and epidemiologic factors associated with lower urinary tract infections in 90 pregnant women; the variables were analyzed through descriptive statistics and analytical statistics. Results: Of a total of 90 electronic records of pregnant women, a recurrence of lower urinary tract infections was found in 41 patients (45.6%). Conclusions: The prevalence of recurring lower urinary tract infections during pregnancy in our population is alarming in whom no association was found with the presence of the epidemiologic factors studied in the present investigation; however, a tendency of recurrence urinary tract infections was identified in women that are not working, superior level of education, 2 pregnancies or less, patients under 20 years of age and in those who were treated with nitrofurantoin for a period of time less than 7 days.

Introducción: la infección de vías urinarias en las mujeres embarazadas es la segunda patología médica más frecuente en el embarazo, presentando una incidencia del 5-10%. En México, según la Guía de Práctica Clínica Mexicana la incidencia es del 2%, y establece una recurrencia del 23% en ellas. Objetivo: determinar los factores epidemiológicos asociados a la recurrencia de infecciones de vías urinarias bajas en mujeres gestantes adscritas a la Unidad de Medicina Familiar No. 1 en el periodo de mayo del 2019 a mayo del 2020. Material y métodos: estudio de investigación observacional analítico, transversal y retrospectivo donde se revisaron hojas de control prenatal de expedientes clínicos a partir del programa institucional para identificar la frecuencia de recurrencia y los factores epidemiológicos asociados a las infecciones de vías urinarias bajas en una muestra de 90 mujeres embarazadas; las variables estudiadas se analizaron a través de estadística descriptiva y estadística analítica. Resultados: de un total de 90 expedientes electrónicos de mujeres gestantes, se encontró una recurrencia de infecciones de vías urinarias bajas a lo largo de su embarazo en 41 pacientes. Conclusiones: la prevalencia de recurrencia de infecciones de vías urinarias bajas en el embarazo en nuestra población es alarmante y no se encontró ningún factor epidemiológico asociado a esta situación; sin embargo, si se identificó una tendencia a recurrir infecciones de vías urinarias cuando no son trabajadoras, tienen escolaridad de nivel superior, dos gestas o menos, pacientes jóvenes menores de 20 años de edad y en aquellas que fueron tratadas con nitrofuranos por un periodo de tiempo inferior a 7 días.

Differential regulation of transposable elements (TEs) during the murine submandibular gland development.

The submandibular gland (SG) is a relatively simple organ formed by three cell types: acinar, myoepithelial, and an intricate network of duct-forming epithelial cells, that together fulfills several physiological functions from assisting food digestion to acting as an immune barrier against pathogens. Successful SG organogenesis is the product of highly controlled and orchestrated genetic and transcriptional programs. Mounting evidence links Transposable Elements (TEs), originally thought to be selfish genetic elements, to different aspects of gene regulation in mammalian development and disease. To our knowledge, the role of TEs during murine SG organogenesis has not been studied. Using novel bioinformatic tools and publicly available RNA-Seq datasets, our results indicate that a significant number of genic and intergenic TEs are differentially expressed during the SG development. Furthermore, changes in expression of specific TEs correlated with that of genes involved in cellular division and differentiation, critical aspects for SG maturation. Altogether, we propose that TEs modulate gene networks that operate during SG development.

Ambient temperature and prevalence of diabetes and insulin resistance in the Spanish population: Di@bet.es study.

Objective The activity of brown adipose tissue is sensitive to changes in ambient temperature. A lower exposure to cold could result in an increased risk of developing diabetes at population level, although this factor has not yet been sufficiently studied. Design We studied 5072 subjects, participants in a national, cross-sectional population-based study representative of the Spanish adult population (Di@bet.es study). All subjects underwent a clinical, demographic and lifestyle survey, a physical examination and blood sampling (75 g oral glucose tolerance test). Insulin resistance was estimated with the homeostasis model assessment (HOMA-IR). The mean annual temperature (°C) in each individual municipality was collected from the Spanish National Meteorology Agency. Results Linear regression analysis showed a significant positive association between mean annual temperature and fasting plasma glucose (ß: 0.087, P < 0.001), 2 h plasma glucose (ß: 0.049, P = 0.008) and HOMA-IR (ß: 0.046, P = 0.008) in multivariate adjusted models. Logistic regression analyses controlled by multiple socio-demographic variables, lifestyle, adiposity (BMI) and geographical elevation showed increasing odds ratios for prediabetes (WHO 1999), ORs 1, 1.26 (0.95-1.66), 1.08 (0.81-1.44) and 1.37 (1.01-1.85) P for trend = 0.086, diabetes (WHO 1999) ORs 1, 1.05 (0.79-1.39), 1.20 (0.91-1.59) and 1.39 (1.02-1.90) P = 0.037, and insulin resistance (HOMA-IR ≥75th percentile of the non-diabetic population): ORs 1, 1.03 (0.82-1.30), 1.22 (0.96-1.55), 1.26 (0.98-1.63) (P for trend = 0.046) as the mean annual temperature (into quartiles) rose. Conclusions Our study reports an association between ambient temperature and the prevalence of dysglycemia and insulin resistance in Spanish adults, consistent with the hypothesis that a lower exposure to cold could be associated with a higher risk of metabolic derangements.

[Analysis of the epidemiological profile of the indigenous community of Hueyapan, Morelos]. / Análisis del perfil epidemiológico de la comunidad indígena de Hueyapan, Morelos.

BACKGROUND: The epidemiological transition is a phenomenon that has had a different impact between urban and rural settings. The WHO points out that the population with the lowest socioeconomic status is the most adversely affected for the unequal distribution of resources, indigenous people are a part of this population. OBJECTIVE: To analyze the epidemiological profile of the indigenous people of Hueyapan, Morelos during the months of March to June 2017. METHODS: A cross-sectional epidemiological study was carried out in the indigenous community of Hueyapan, belonging to the municipality of Morelos, in 2017. A sample of 338 households was calculated; as inclusion criteria, those dwellings where the age of residence in Hueyapan was equal to or greater than four years were taken; a systematic sampling was carried out every three households, in addition, Mexico's INEGI and Health Department databases were analyzed from 2011 to 2015. RESULTS: In relation to morbidity, an upward trend was found in the crude rate, from 119.7 per 1,000 in 2011 to 270.7 per 1000 in 2015, among the most prevalent diseases in those years, infectious diseases were identified as major and the appearance of noncommunicable diseases began to be observed. In relation to mortality, a linear trend was observed in the crude rate of 5.7 per 1000 in 2011 to 6.6 per 1000 in 2015. CONCLUSIONS: The epidemiological profile of Hueyapan coincides with a process of epidemiological transition where there is a double burden of disease. This suggests a challenge for the public health area that should be addressed from the creation of health strategies, programs and policies aimed at this population from an intercultural approach.

INTRODUCCIÓN: la transición epidemiológica es un fenómeno que se ha presentado de forma distinta entre sectores urbanizados y rurales. OBJETIVO: analizar el perfil epidemiológico de la comunidad indígena de Hueyapan, Morelos, durante el periodo de marzo a junio de 2017. MÉTODOS: se realizó un estudio epidemiológico transversal en la comunidad indígena de Hueyapan, perteneciente al municipio de Morelos, en 2017. Se calculó un tamaño de muestra de 338 viviendas; como criterios de inclusión se tomaron aquellas viviendas dónde la edad de residencia en Hueyapan fuera igual o mayor a cuatro años; se realizó un muestreo sistemático cada tres viviendas, además se analizaron bases de datos de INEGI y Secretaría de Salud de 2011 a 2015. RESULTADOS: en relación con la morbilidad, se encontró una tendencia ascendente en la tasa bruta. Dentro de las enfermedades más prevalentes se identificaron las enfermedades infecciosas como principales y se empezó a observar la aparición de enfermedades no transmisibles. En relación con la mortalidad, se observó una tendencia lineal en su tasa bruta. CONCLUSIONES: el perfil epidemiológico de Hueyapan coincide con un proceso de transición epidemiológica, donde existe una doble carga de enfermedad. Esto sugiere un reto para el área de la salud pública que debiera enfrentarse desde la creación de estrategias, programas y políticas de salud dirigidas a esta población desde un enfoque intercultural.

Prevalencia del síndrome metabólico en población de 15 a 74 años del municipio Guantánamo / Prevalence of metabolic syndrome in the population aged 15-74 in Guantanamo municipality

Introducción: la carga y amenaza mundial de las enfermedades no transmisibles socavan el desarrollo social y económico en todo el mundo. Objetivo: determinar la prevalencia de síndrome metabólico en la población de 15 a 74 años del municipio Guantánamo en 2010. Método: se realizó una investigación observacional transversal que incluyó 1 629 personas, seleccionadas mediante muestreo complejo, por conglomerados y polietápico. Para la definición de síndrome metabólico se utilizaron los criterios NCEP-ATP III modificados. Para recoger la información se utilizó la Versión Panamericana de la Encuesta Nacional de Vigilancia de Factores de Riesgo. Se determinó la prevalencia por edades y sexos mediante estimaciones con 95 por ciento de confiabilidad, expresadas en por ciento, utilizando el programa SPSS, versión 11.5. Resultados: el síndrome metabólico fue más frecuente en las mujeres y en el grupo de edades de 55-64 años. La prevalencia obtenida no difiere de los estimados realizados por la OMS y es un indicador que puede utilizarse como línea base para estudios posteriores que evalúen impacto de modificaciones en los factores de riesgo. Conclusiones: la alta prevalencia de SM en guantanameros de 15 a 74 años indica la necesidad de implementar acciones preventivas diseñadas para controlar la HTA, reducir la obesidad central, la dislipidemia y la hiperglicemia y mejorar la vigilancia de las enfermedades cardio-metabólicas y con ello evitar las consecuencias futuras del SM para la salud de la población(AU)

Introduction: the global burden and threat of noncommunicable diseases undermine social and economic development throughout the world. Objective: to determine the prevalence of metabolic syndrome in the population aged 15 to 74 years of the Guantánamo municipality in 2010. Method: a cross-sectional observational research was carried out that included 1 629 people, selected by complex sampling, by conglomerates and multistage. For the definition of metabolic syndrome the modified NCEP-ATP III criteria were used. To collect the information, the Pan American Version of the National Surveillance of Risk Factors Survey was used. The prevalence by age and sex was determined by means of estimations with 95 percent reliability, expressed in percent, using the SPSS program, version 11.5. Results: Metabolic syndrome was more frequent in women and in the 55-64 age group. The prevalence obtained does not differ from the estimates made by WHO and is an indicator that can be used as a baseline for subsequent studies that assess the impact of changes in risk factors. Conclusions: the high prevalence of MS in guantanameros from 15 to 74 years indicates the need to implement preventive actions designed to control hypertension, reduce central obesity, dyslipidemia and hyperglycemia and improve the surveillance of cardio-metabolic diseases and thereby avoid the future consequences of MS for the health of the population(AU)

Introdução: a carga global e a ameaça de doenças não transmissíveis prejudicam o desenvolvimento social e econõmico em todo o mundo. Objetivo: determinar a prevalência da síndrome metabólica na população de 15 a 74 anos do município de Guantánamo em 2010. Método: foi realizada uma pesquisa observacional transversal que incluiu 1.629 pessoas, selecionadas por amostragem complexa, por conglomerados e multiestágios. Para a definição de síndrome metabólica foram utilizados os critérios modificados do NCEP-ATP III. Para coletar as informações, foi utilizada a versão pan-americana da Pesquisa Nacional de Vigilãncia de Fatores de Risco. A prevalência por idade e sexo foi determinada por meio de estimativas com 95% de confiabilidade, expressas em porcentagem, utilizando o programa SPSS, versão 11.5. Resultados: A síndrome metabólica foi mais frequente em mulheres e na faixa etária de 55 a 64 anos. A prevalência obtida não difere das estimativas feitas pela OMS e é um indicador que pode ser usado como base para estudos posteriores que avaliam o impacto de mudanças nos fatores de risco. Conclusões: A alta prevalência de MS em Guantánamo a partir de 15 a 74 anos, indica a necessidade de executar acções preventivas destinadas a controlar a hipertensão, reduzir central de obesidade, dislipidemia e hiperglicemia e melhorar o controlo de doenças cardio-metabólicas e assim evitar as consequências futuras dos EM para a saúde da população(AU)

Normative reference values for hand grip dynamometry in Spain. Association with lean mass.

BACKGROUND AND OBJECTIVES: The objective of this study was to establish reference values for hand grip strength, compare the results obtained with Collin and Jamar type dynamometers and determine their association with anthropometric and lean mass measurements. MATERIAL AND METHODS: This cross-sectional population-based study was undertaken in Pizarra (Málaga, Spain). The grip strength of the dominant hand was measured using Collin and Jamar dynamometers. Skinfolds (triceps, abdominal, biceps of dominant arm and subscapular) were measured, and body composition was estimated. Eight hundred seventeen adults randomly selected from the census were recruited. Dynamometry reference values are presented for the dominant hand, by gender and age groups. RESULTS: No determinations could be made with the Collin dynamometer in 69 women due to the difficulty in grasping the dynamometer. We found significant positive correlations between the measurements with Jamar and Collin dynamometers (r = 0.782; p < 0.001) and between grip strength and lean mass index (LMI), determined by both dynamometers (r = 0.538, p < 0.001 and r = 0.462, p < 0.001, respectively). Malnourished patients according to LMI had significantly lower grip strength than normally nourished patients (p < 0.001 for Jamar; p < 0.02 for Collin). CONCLUSIONS: Dynamometry reference values in the Spanish population are presented. We recommend the use of the Jamar type dynamometer versus the Collin type dynamometer. Hand grip dynamometry is associated with lean mass, which confirms its usefulness in nutritional assessment.

Normative reference values for hand grip dynamometry in Spain. Association with lean mass / Valores de normalidad de dinamometría de mano en España. Relación con la masa magra

Background and objectives: The objective of this study was to establish reference values for hand grip strength, compare the results obtained with Collin and Jamar type dynamometers and determine their association with anthropometric and lean mass measurements. Material and methods: This cross-sectional population-based study was undertaken in Pizarra (Málaga, Spain). The grip strength of the dominant hand was measured using Collin and Jamar dynamometers. Skinfolds (triceps, abdominal, biceps of dominant arm and subscapular) were measured, and body composition was estimated. Eight hundred seventeen adults randomly selected from the census were recruited. Dynamometry reference values are presented for the dominant hand, by gender and age groups. Results: No determinations could be made with the Collin dynamometer in 69 women due to the difficulty in grasping the dynamometer. We found significant positive correlations between the measurements with Jamar and Collin dynamometers (r = 0.782; p < 0.001) and between grip strength and lean mass index (LMI), determined by both dynamometers (r = 0.538, p < 0.001 and r = 0.462, p < 0.001, respectively). Malnourished patients according to LMI had significantly lower grip strength than normally nourished patients (p < 0.001 for Jamar; p < 0.02 for Collin). Conclusions: Dynamometry reference values in the Spanish population are presented. We recommend the use of the Jamar type dynamometer versus the Collin type dynamometer. Hand grip dynamometry is associated with lean mass, which confirms its usefulness in nutritional assessment (AU)

Antecedentes y objetivos: no existen valores de normalidad en España con el dinamómetro Jamar. El objetivo fue determinar valores de normalidad de fuerza muscular, comparar los resultados obtenidos con los dinamómetros tipo Collin y tipo Jamar entre sí, y determinar su asociación con medidas antropométricas y de masa magra. Material y métodos: estudio transversal de base poblacional en Pizarra (Málaga). Se determinó la fuerza de prensión de la mano dominante mediante dinamómetros Collin y Jamar. Se midieron los pliegues cutáneos (tricipital, abdominal, bicipital del brazo dominante y subescapular) y se estimó la composición corporal. Se reclutaron 817 adultos seleccionados aleatoriamente del censo. Se presentan valores de referencia de dinamometría para la mano dominante, por género y grupos de edad. Resultados: no se pudieron realizar determinaciones con el dinamómetro Collin en 69 mujeres debido a la dificultad para agarrar el dinamómetro. Encontramos correlaciones positivas significativas entre las medidas de los dinamómetros Jamar y Collin (r = 0,782; p < 0,001) y entre la fuerza muscular determinada mediante ambos dinamómetros y el índice de masa magra (IMM) (r = 0,538, p < 0,001 y r = 0,462, p <0,001, respectivamente). Los pacientes desnutridos según IMM presentaron una fuerza muscular significativamente menor a la de los pacientes normonutridos (p < 0,001 para Jamar y p < 0,02 para Collin). Conclusiones: se presentan valores de referencia de dinamometría en población española. Recomendamos el uso del dinamómetro tipo Jamar frente al dinamómetro tipo Collin. La dinamometría de mano se asocia con la masa magra, lo que avala su utilidad en la valoración nutricional (AU)

Prevalencia del síndrome metabólico en población de 15 a 74 años del municipio Guantánamo / Prevalência da síndrome metabólica na população de 15 a 74 anos do município de Guantánamo / Prevalence of metabolic syndrome in the population aged 15-74 in Guantanamo municipality

Introducción: la carga y amenaza mundial de las enfermedades no transmisibles socavan el desarrollo social y económico en todo el mundo. Objetivo: determinar la prevalencia de síndrome metabólico en la población de 15 a 74 años del municipio Guantánamo en 2010. Método: se realizó una investigación observacional transversal que incluyó 1 629 personas, seleccionadas mediante muestreo complejo, por conglomerados y polietápico. Para la definición de síndrome metabólico se utilizaron los criterios NCEP-ATP III modificados. Para recoger la información se utilizó la Versión Panamericana de la Encuesta Nacional de Vigilancia de Factores de Riesgo. Se determinó la prevalencia por edades y sexos mediante estimaciones con 95 por ciento de confiabilidad, expresadas en por ciento, utilizando el programa SPSS, versión 11.5. Resultados: el síndrome metabólico fue más frecuente en las mujeres y en el grupo de edades de 55-64 años. La prevalencia obtenida no difiere de los estimados realizados por la OMS y es un indicador que puede utilizarse como línea base para estudios posteriores que evalúen impacto de modificaciones en los factores de riesgo. Conclusiones: la alta prevalencia de SM en guantanameros de 15 a 74 años indica la necesidad de implementar acciones preventivas diseñadas para controlar la HTA, reducir la obesidad central, la dislipidemia y la hiperglicemia y mejorar la vigilancia de las enfermedades cardio-metabólicas y con ello evitar las consecuencias futuras del SM para la salud de la población(AU)

Introduction: the global burden and threat of noncommunicable diseases undermine social and economic development throughout the world. Objective: to determine the prevalence of metabolic syndrome in the population aged 15 to 74 years of the Guantánamo municipality in 2010. Method: a cross-sectional observational research was carried out that included 1 629 people, selected by complex sampling, by conglomerates and multistage. For the definition of metabolic syndrome the modified NCEP-ATP III criteria were used. To collect the information, the Pan American Version of the National Surveillance of Risk Factors Survey was used. The prevalence by age and sex was determined by means of estimations with 95percent reliability, expressed in percent, using the SPSS program, version 11.5. Results: Metabolic syndrome was more frequent in women and in the 55-64 age group. The prevalence obtained does not differ from the estimates made by WHO and is an indicator that can be used as a baseline for subsequent studies that assess the impact of changes in risk factors. Conclusions: the high prevalence of MS in guantanameros from 15 to 74 years indicates the need to implement preventive actions designed to control hypertension, reduce central obesity, dyslipidemia and hyperglycemia and improve the surveillance of cardio-metabolic diseases and thereby avoid the future consequences of MS for the health of the population(AU)

Introdução: a carga global e a ameaça de doenças não transmissíveis prejudicam o desenvolvimento social e econõmico em todo o mundo. Objetivo: determinar a prevalência da síndrome metabólica na população de 15 a 74 anos do município de Guantánamo em 2010. Método: foi realizada uma pesquisa observacional transversal que incluiu 1.629 pessoas, selecionadas por amostragem complexa, por conglomerados e multiestágios. Para a definição de síndrome metabólica foram utilizados os critérios modificados do NCEP-ATP III. Para coletar as informações, foi utilizada a versão pan-americana da Pesquisa Nacional de Vigilãncia de Fatores de Risco. A prevalência por idade e sexo foi determinada por meio de estimativas com 95 por cento de confiabilidade, expressas em porcentagem, utilizando o programa SPSS, versão 11.5. Resultados: A síndrome metabólica foi mais frequente em mulheres e na faixa etária de 55 a 64 anos. A prevalência obtida não difere das estimativas feitas pela OMS e é um indicador que pode ser usado como base para estudos posteriores que avaliam o impacto de mudanças nos fatores de risco. Conclusões: A alta prevalência de MS em Guantánamo a partir de 15 a 74 anos, indica a necessidade de executar acções preventivas destinadas a controlar a hipertensão, reduzir central de obesidade, dislipidemia e hiperglicemia e melhorar o controlo de doenças cardio-metabólicas e assim evitar as consequências futuras dos EM para a saúde da população(AU)

Attitudes towards drug policies in Latin America: Results from a Latin-American Survey.

BACKGROUND: In recent years Latin American countries have increasingly rejected the traditional prohibitionist paradigm of drug policy, reflecting its failure to reduce either consumption or trafficking. The extent to which these policy trends currently command pubic support is unclear, however. This article goes some way to filling this gap, providing a snapshot of public attitudes towards drug policies in nine Latin American countries. METHODS: The 2014 Annual Survey of the Observatory of Drug Policies and Public Opinion, which has representative population samples, was used to measure public opinion. Country comparisons are made using descriptive and inferential statistics. RESULTS: Countries fall into three groups: Peru, Bolivia and El Salvador are the most conservative countries on drug policy and perceptions of risks of cannabis use; they also score lowest on Human Development Index. On the other hand, the public in Chile and Uruguay are more likely to support drug policy reform. The remaining four countries (Argentina, Colombia, Mexico and Peru) tend to occupy the middle ground between these extremes. In addition, cannabis legalization is explained by its recreational use, being this the main meaning attached to cannabis policy among Latin American citizens. CONCLUSION: There is a significant heterogeneity in attitudes towards drug policies in Latin American countries, which suggests that people are questioning the policies that set the norm in Latin America without achieving any consensus regarding future measures for each country.

Prevalencia puntual de arbovirosis en salas del Hospital General Docente Dr Agostinho Neto, Guantánamo / Prevalence of arboviruses in rooms of the General Teaching Hospital Dr AgostinhoNeto, Guantánamo

Se realizó un estudio descriptivo transversal en pacientes hospitalizados con el diagnóstico de arbovirosis en el Hospital General Docente Agostinho Neto de Guantánamo. El universo estuvo conformado por los pacientes ingresados día 10 de noviembre del 2016 en las tres salas de aislamiento habilitadas al efecto, que fueron 68 casos. Se estudiaron variables clínicas, epidemiológicas y se revisaron las historias clínicas de los pacientes Se emplearon como medidas de resumen para variables cualitativas número absoluto y el porcentaje y para variables cuantitativas el promedio. La prevalencia puntual de arbovirosis fue de 100 por ciento. El 50 por ciento de los pacientes tenía 38.5 años y el sexo femenino predominó sobre el masculino. La arbovirosis más representada fue la sospecha de zika. Existen dificultades en la detección e ingreso temprano de los casos(AU)

A cross-sectional descriptive study was performed in hospitalized patients with the diagnosis of arbovirosis in Guantanamo's General Teaching Hospital AgostinhoNeto. The universe consisted of patients admitted on November 10, 2016 in the three isolation rooms authorized for that purpose, which were 68 cases. Clinical and epidemiological variables were studied and reviewed in the patients' clinical histories. The absolute number and percentage were used as summary measures for qualitative variables and for quantitative variables in the average. The point prevalence of arbovirosis was 100 percent. 50 percent of the patients were 38.5 years old and the female sex predominated over the male. The most represented arbovirosis was the suspicion of zika. There were difficulties in the detection and early entry of cases

Utilidad de la fisioterapia respiratoria en pacientes con enfermedad pulmonar obstructiva crónica / Usefulness of respiratory physiotherapy in patients with chronic obstructive pulmonary disease

Se realizó un estudio de intervención terapéutica en el departamento de neumología del policlínico universitario Omar Ranedo del municipio Guantánamo en el período marzo 2010 - diciembre 2011, con seguimiento en 2014 para evaluar la utilidad de la fisioterapia respiratoria en 60 pacientes de 45 y más años, de ambos sexos, con enfermedad pulmonar obstructiva crónica (EPOC), leve y moderada. Se compararon las manifestaciones clínicas, estadios de la EPOC, valores espirométricos del volumen espiratorio forzado en el 1er segundo (VEF 1er segundo) y evolución clínica antes y después de aplicado el tratamiento basado en tareas programadas. Se utilizó el número absoluto y el porcentaje como medida de resumen y el porcentaje de variación para comparar los resultados antes y después. Se concluyó que la fisioterapia respiratoria mejoró la evolución clínica y espirométrica de los enfermos, por lo que se recomendó aplicar las tareas programadas de la fisioterapia respiratoria en el tratamiento alternativo en enfermos con EPOC leve y moderada(AU)

A study of therapeutic intervention was carried out in the department of pneumology of the polyclinic Omar Ranedo of Guantánamo from March 2010 to December 2011, with follow - up in 2014 to evaluate the usefulness of respiratory physiotherapy in 60 patients aged 45 and over, Of both sexes, with mild and moderate chronic obstructive pulmonary disease (COPD). It was compared the clinical manifestations, stages of COPD, spirometric values of forced expiratory volume in the 1st second (FEV 1er second) and clinical evolution before and after the treatment based on scheduled tasks. Absolute number and percentage were used as a summary measure and percentage variation to compare before and after results. It was concluded that respiratory physiotherapy improved the clinical and spirometric evolution of the patients, so it was recommended to apply the scheduled tasks of respiratory physiotherapy in the alternative treatment in patients with mild and moderate COPD(AU)

Randomized clinical trial of the efficacy and safety of insulin glargine vs. NPH insulin as basal insulin for the treatment of glucocorticoid induced hyperglycemia using continuous glucose monitoring in hospitalized patients with type 2 diabetes and respiratory disease.

AIMS: To investigate the clinical efficacy and safety of insulin glargine compared with NPH insulin as basal insulin for the management of corticosteroid-induced hyperglycemia in hospitalized people with type 2 diabetes (T2DM) and respiratory disease. MATERIALS AND METHODS: Randomized, two-arm parallel group, clinical trial undertaken from February 2011 to November 2012 on the pneumology ward of the Hospital Regional Universitario de Málaga (Spain), involving 53 participants with T2DM treated with medium/high doses of intermediate-acting corticosteroids. Participants were randomly assigned to receive one single dose of insulin glargine or NPH insulin in three equally divided doses before each meal as basal insulin within a basal-bolus insulin protocol. The intervention lasted six days or until discharge if earlier. RESULTS: No significant differences were seen between groups during the study in mean blood glucose (11.43±3.44 mmol/l in glargine vs. 11.88±2.94 mmol/l in NPH, p=0.624), and measures of glucose variability (standard deviation 3.27±1.16 mmol/l vs. 3.61±0.99 mmol/l, p=0.273; coefficient of variation 1.55±0.33 mmol/l vs. 1.72±0.39 mmol/l, p=0.200). Results from CGM were concordant with those obtained with capillary blood glucose reading. The length of hospital stay was also similar between groups (8.2±2.8 days vs. 9.8±3.4 days, p=0.166) There was a non significant trend for lower episodes of mild (4 vs. 8, p=0.351) and severe hypoglycemia (0 vs. 3, p=0.13) in the glargine group. CONCLUSIONS: The results of this study showed that insulin glargine and NPH insulin are equally effective in a basal-bolus insulin protocol to treat glucocorticoid-induced hyperglycemia in people with T2DM on a pneumology ward.

Aprendizaje servicio, una estrategia de aprendizaje significativo en la formación de estudiantes de Terapia Ocupacional de la Universidad Central de Chile / Service learning, as a meaningful strategy training students in occupational therapy at the Central University of Chile

Los constantes cambios sociales, políticos y culturales, han generado problemáticas comunitarias que exigen de soluciones integrales e intersectoriales, efectivas y contextualizadas, dirigidas por profesionales competentes y comprometidos con el desarrollo social del país. Este artículo pretende dar a conocer una estrategia curricular necesarias para afrontar estos nuevos escenarios, los cuales han sido asumidos por la Educación superior a través del Proyecto Educativo y Planeación Estratégica de la Universidad Central de Chile y que permiten efectuar procesos de gestión a partir del conocimiento del contexto social y diagnóstico de las necesidades de la sociedad sobre la que se trabaja, construir proyectos educativos en los cuales se incorporen valores, principios de participación y compromiso social, además de utilizar metodologías pertinentes y acompañamiento académico adecuado y sostenible. La escuela de Terapia Ocupacional de dicha Institución, asume el compromiso de llevar a cabo el desafío de incorporar la metodología de aprendizaje-servicio dentro de la formación de pregrado, reconociendo el impacto de la metodología en los procesos de aprendizajes significativos y su aporte al proyecto educativo desde el enfoque por competencias, experiencia que genera resultados significativos no sólo en términos de rendimiento, sino que además en los procesos de integración de conocimiento, movilización de recursos cognitivos y la interacción de estos frente a una problemática real, que dieron como resultado la elaboración de soluciones contextualizadas. El análisis y sistematización de dichas experiencias pretenden evidenciar el impacto en los procesos de aprendizaje y compromiso que adoptan los estudiantes de pregrado, frente a vinculación, guiada y reflexiva, durante el desarrollo de una asignatura electiva, en la cual se ofrece un servicio comunitario, local y contextualizado bajo la Modalidad de Aprendizaje Servicio.

The constant social, political and cultural changes, have produced community problems that demand a comprehensive, intersectoral, effective and contextualized solutions directed by competent and committed professionals to social development. This paper describes a necessary curriculum strategy to face these new situations, which have been assumed by the Higher Education through the Educational Project and Strategic Planning of the Central University of Chile, This allows for management processes from knowledge of the social context and diagnosis of local needs of society, also create educational projects in which values, principles of participation and social commitment are incorporated and use relevant methodologies and appropriate and sustainable academic support. School of Occupational Therapy is committed to the challenge of incorporating service-learning methodology in undergraduate education, the impact of the methodology are recognizing significant learning processes and its contribution to the educational project from the skills approach, this experience has significant consequences not only in terms of academic performance, but also in the processes of integration of knowledge, cognitive mobilization of resources and the interaction of these facing a real problem, which resulted in the development of contextualized solutions. The analysis and systematization of these experiences demonstrate the impact of learning processes and commitment to adopt undergraduates in the relationship, guided and reflective, during the development of an elective course, offering a community, specific service and contextualized from the Methodology Learning Service.

Becoming an adult: A proposed typology of adult status based on a study of Spanish youths.

Emerging adulthood is a transitional period which has been examined in relatively few studies in Southern European countries. This study has two aims: (1) to determine the features of emerging adulthood in Spain based on criteria for adulthood and experiential dimensions; and (2) to explore whether variations in these criteria are related to gender and adult status (self-classification as an adult and adult role adoption). Participants included 347 young Spanish people, aged 18-30, who completed a questionnaire about their conceptions of adulthood. They used similar criteria for adulthood to other Western countries, placing an extremely strong emphasis on psychological maturity criteria in comparison with role transition indicators. Important variations were observed in both the importance and achievement of criteria for adulthood according to gender and adult status. The results likewise suggest there may be different psychosocial profiles associated with each adult status group. The relevance of this classification to future research in the field of emerging adulthood is discussed.

Intervención educativa al personal médico y paramédico sobre Inermicapsifer madagascariensis / Educational intervention to medical and paramedical personnel on Inermicapsifer madagascariensis

Se realiza una intervención educativa en el personal de salud de la provincia Guantánamo durante el mes de septiembre de 2013, con el objetivo de capacitar sobre aspectos esenciales del diagnóstico, tratamiento y prevención de la helmintiasis por Inermicapsifer madagascariensis. El universo de estudio estuvo formado por 10 tecnólogos de laboratorio, seis técnicos, ocho MGI y un decidor a los que se les aplicó una encuesta para determinar el nivel de conocimiento sobre Inermicapsifer madagascariensis. Se obtuvo que existía desconocimiento sobre el diagnóstico clínico-epidemiológico y de laboratorio. Se diseña e imparte un curso de posgrado y un plegable para elevar el nivel de conocimiento de esta parasitosis(AU)

An educational intervention is done in health personnel of this province during the month of September 2013, with the objective of training on key aspects of diagnosis, treatment and prevention of helminth Inermicapsifer madagascariensis. The study group consisted of 10 laboratory technologists, 6 technicians, 8 MGI and decidor those who were given a survey to determine the level of knowledge about Inermicapsifer madagascariensis. It was found that there was lack of knowledge about the clinical-epidemiological and laboratory diagnosis. It is designed and is received a graduate course and a folding to raise awareness of this parasitosis(AU)

Ambient temperature and prevalence of obesity in the Spanish population: The Di@bet.es study.

OBJECTIVE: The aim of this study was to examine possible associations between ambient temperature and obesity in the Spanish population using an ecological focus. METHODS: The Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifestyle. SAMPLE: 5,061 subjects in 100 clusters. VARIABLES: Clinical, demographic and lifestyle survey, physical examination, and blood sampling. The mean annual temperature (°C) for each study site was collected from the Spanish National Meteorology Agency (1971-2000). RESULTS: The prevalence rates of obesity in the different geographical areas divided according to mean annual temperature quartiles were 26.9% in quartile 1 (10.4-14.5°C), 30.5% in quartile 2 (14.5-15.5°C), 32% in quartile 3 (15.5-17.8°C), and 33.6% in quartile 4 (17.8-21.3°C) (P = 0.003). Logistic regression analyses including multiple socio-demographic (age, gender, educational level, marital status) and lifestyle (physical activity, Mediterranean diet score, smoking) variables showed that, as compared with quartile 1, the odd ratios for obesity were 1.20 (1.01-1.42), 1.35 (1.12-1.61), and 1.38 (1.14-1.67) in quartiles 2, 3, and 4, respectively (P = 0.001 for difference, P < 0.001 for trend). CONCLUSIONS: Our study reports an association between ambient temperature and obesity in the Spanish population controlled for known confounders.