The influence of body composition on the six-minute walk test in Chilean preschool and school children / Influencia de la composición corporal en el test de la caminata de seis minutos en preescolares y escolares chilenos

Background: the six minutes' walk test (6MWT) measures submaximal physical activity. Objective: this study determines the association of children´s nutritional status and body composition with the results of the 6MWT. Methods: a sample of 1419 Chilean children, 4 to 10 years of age, were assessed including anthropometry, body composition by validated equations, the 6MWT test, and in 50 % of the sample heart rate prior the test, at one minute into the test, and at one minute posttest with a Polar watch. Results: the distance walked ranged from 473.1 ± 47.8 meters in preschool children to 584.2 ± 65.7 meters in school children. In heart rate there was a significant difference between obese and eutrophic children. The distance walked in the 6MWT was positively associated with fat-free mass (p < 0.05) and BMI (R2 = 0.49). Body composition influences 6MWT quartile distribution, as well as nutritional status. Age and height explained 49 % of the variance (R2 = 0.42 and 0.47, respectively) in the 6MWT, and there are significant differences in this variable by sex, body composition, and nutritional status. Conclusions: body composition was associated with walking performance in children. Thus, it is important to evaluate height and body composition when assessing the six-minute walk test because of this important relationship (AU)

Introducción: el test de la marcha de seis minutos (TM6M) mide una actividad física submáxima. Este estudio evaluó el efecto del test de la marcha sobre la composición corporal y el estado nutricional en niños. Métodos: en una muestra de 1419 niños chilenos de 4 a 10 años de edad se evaluaron la antropometría, la composición corporal por ecuaciones validadas, el TM6M y, en el 50 % de la muesta, la frecuencia cardíaca mediante un reloj Polar. Resultados: la distancia caminada varió desde 473,1 ± 47,8 metros en los niños preescolares hasta 584,2 ± 65,7 metros en los escolares. En la frecuencia cardíaca hubo una diferencia significativa entre niños obesos y eutróficos. La distancia caminada se asoció positivamente con la masa libre de grasa (R2 = 0,37) y el IMC (R2 = 0,49). Por otra parte, la composición corporal varía en función de los cuartiles de composición corporal y el estado nutricional. La edad y la altura explicaron el 49 % de la varianza de la prueba (R2 = 0,42 and 0,47, respectivamente). Existen diferencias significativas en la distancia recorrida en el TM6M en función del sexo, la composición corporal y el estado nutricional. Conclusiones: composición corporal, talla e IMC se asociaron a la distancia recorrida en el TM6M. Por tanto, se sugiere medir estas variables cuando se evalúe el test de marcha de seis minutos (AU)

Point-of-care testing for sexually transmitted infections in low-resource settings.

BACKGROUND: Both the global incidence and the prevalence of sexually transmitted infections (STIs) continue to increase, affecting hundreds of millions of individuals, particularly in low-to middle-income countries. Although a definitive diagnosis is desirable to inform STI treatment, syndromic management is the most widely used strategy in resource-limited settings. With the development of point-of-care (POC) tests, it is important to discuss how laboratories will need to adapt to new training and supervisory roles in support of testing, which will largely be performed by peripheral clinical staff. OBJECTIVES: To discuss potential applications of STI POC tests, how they could improve existing STI control strategies and the role of clinical and reference laboratories in support of initiatives to improve STI management and control activities. SOURCES: Narrative literature review and expert opinion. CONTENT: The paper outlines the current status of the STI epidemic worldwide and discusses the problems associated with current approaches to control these infections, particularly in low-resource settings. The roles of clinical and reference laboratories will need to change to provide support for POC and near-patient STI testing as these technologies are introduced into clinical as well as laboratory settings. IMPLICATIONS: Laboratories will be expected to play a leading role in the introduction and implementation of POC and near-patient STI testing. They will be required to facilitate training and provide technical and supervisory support to clinical staff on the use of these technologies to augment existing STI management and surveillance programmes. In order to provide quality service, they will need to develop, introduce and maintain sustainable local quality control and external quality assurance systems. Evidence from implementation research for introduction and scale up of STI POC tests in different STI epidemic and laboratory infrastructure settings is required.

Relación entre los niveles de actividad física y la condición física autopercibida en una muestra de estudiantes universitarios en Bogotá, Colombia / Relationship between levels of physical activity and self-perceived physical condition in a sample of university students from Bogotá, Colombia

Objetivo Determinar la relación entre los niveles actividad física (AF) y la condición física (CF) autopercibida en una muestra de estudiantes universitarios en Bogotá, Colombia. Materiales y métodos Durante los años 2017 y 2018, se desarrolló un estudio descriptivo y transversal, en 1.206 estudiantes universitarios (338 mujeres y 868 varones) pertenecientes a 2 instituciones de educación superior ubicadas en Bogotá, Colombia. Para la medición de la CF autopercibida se administró el cuestionario denominado The International Fitness Scale (IFIS) y para la valoración de la AF se aplicó el cuestionario International Physical Activity Questionnarie (IPAQ) en su versión corta. Ambos cuestionarios ya se encuentran validados para población juvenil colombiana. Se aplicó un Anova de un factor para establecer la relación entre los niveles de AF, representado en los metabolic equivalent of task (MET) consumidos semanalmente y la CF autopercibida en cada uno de sus componentes. Resultados En los varones, se presentó una relación significativa entre los MET consumidos semanalmente y la CF autopercibida en los componentes de CF general y fuerza muscular (p<0,05). En las mujeres esta relación solo se presentó con la variable de CF general. Conclusión La AF y la CF autopercibida son 2 componentes que se relacionan en estudiantes universitarios de la ciudad de Bogotá, Colombia. (AU)

Objective To determine the relationship between physical activity levels and self-perceived physical condition in a sample of university students from Bogotá, Colombia. Materials and methods During the years 2017 and 2018, a descriptive and cross-sectional study was conducted in 1206 university students (338 women and 868 men) belonging to 2 higher education institutions located in Bogotá, Colombia. For the measurement of self-perceived physical condition, the International Fitness Scale (IFIS) questionnaire was administered and for the assessment of PA the International Physical Activity Questionnaire was applied in its short version. Both questionnaires have already been validated for the Colombian youth population. A one-way ANOVA was applied to establish the relationship between levels of physical activity, represented in METs (metabolic equivalent of task) consumed weekly and self-perceived physical condition in each of its components. Results In men, there was a significant relationship between METs consumed weekly and self-perceived physical condition in the components of general physical condition and muscle strength (P<.05). In women, this relationship only occurred with the general PC variable. Conclusions Physical activity and self-perceived physical condition are two components that are related in university students from the city of Bogotá, Colombia. (AU)

Binge drinking and insomnia in students from health sciences at one university in Rio de Janeiro, Brazil.

In spite of the many studies examining alcohol consumption, recent reviews have indicated that binge drinking has not been extensively studied. Furthermore, it is becoming increasingly clear that sleep is associated with many physiological functions and to drug addictions. The present study aimed to evaluate the relationship between alcohol binge drinking and insomnia in college students of health sciences. All first-year health sciences students (n=286) were evaluated in a cross-sectional study. Envelopes containing the Insomnia Severity Index (ISI), the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and questions capturing sociodemographic data were distributed and collected in classes. It was found that most non-drinkers were female (70.6%), although there were no sex-related differences in the number of binge drinkers (more than 5 drinks on each occasion at least once a week), allowing statistical comparison. The Mann-Whitney U test indicated that the ISI scores were significantly greater in female than male binge drinkers (P=0.014). Moderate or severe insomnia was reported by 23% of the sample, with alcohol being the most frequently associated substance. A specialized intervention was suggested by ASSIST: brief for marijuana (19.2%) and tobacco (23.3%) use, and moderate (31.5%) or intensive (1.4%) for alcohol consumers. The data highlighted the need to pay attention to the habits of college students beyond obtaining scientific information. New data suggesting the influence of genetics on insomnia may be of importance when performing additional studies on the sex differences in alcohol binge drinking.

Kinetic Control of the Li0.9Mn1.6Ni0.4O4 Spinel Structure with Enhanced Electrochemical Performance.

The development of more sustainable societies has become an urgent goal worldwide. Electrical batteries are currently seen as one of the most important energy storage technologies for the development of decarbonized societies. However, many lithium-ion battery manufacturers currently utilize cobalt, a toxic and hazardous mineral, in their batteries. Lithium-deficient manganese nickel oxide spinels are considered promising candidates owing to their high potential and environmental friendliness. Their electrochemical performance highly depends on their average and local structures, such as phase purities, lattice parameters, and cation sites. Thus, a synthesis protocol should be designed to control these structural parameters to improve their electrochemical performance. In this study, we controlled the average and local structures of Li0.9Mn1.6Ni0.4O4 spinels obtained by co-precipitation by optimizing their cooling rates. High-resolution techniques, including transmission electron microscopy, synchrotron X-ray diffraction, and Auger-composition analysis combined with density functional theory calculations, X-ray absorption spectroscopy, and electrochemical analysis, were used to understand the average and local structural variations and their effects on the electrochemical properties. As a result, the control of oxygen diffusion at different cooling rates can promote the rearrangement of the structure, resulting in a cation-disordered spinel with minimal variations in lattice parameters and composition. Excellent electrochemical properties were noted in the cation-disordered spinel with high crystallinity and a slightly oxygen-rich surface produced via optimized cooling rates.

Polycystin-1 mitigates damage and regulates CTGF expression through AKT activation during cardiac ischemia/reperfusion.

During ischemia/reperfusion (I/R), cardiomyocytes activate pathways that regulate cell survival and death and release factors that modulate fibroblast-to-myofibroblast differentiation. The mechanisms underlying these effects are not fully understood. Polycystin-1 (PC1) is a mechanosensor crucial for cardiac function. This work aims to assess the role of PC1 in cardiomyocyte survival, its role in profibrotic factor expression in cardiomyocytes, and its paracrine effects on I/R-induced cardiac fibroblast function. In vivo and ex vivo I/R and simulated in vitro I/R (sI/R) were induced in wild-type and PC1-knockout (PC1 KO) mice and PC1-knockdown (siPC1) neonatal rat ventricular myocytes (NRVM), respectively. Neonatal rat cardiac fibroblasts (NRCF) were stimulated with conditioned medium (CM) derived from NRVM or siPC1-NRVM supernatant after reperfusion and fibroblast-to-myofibroblast differentiation evaluated. Infarcts were larger in PC1-KO mice subjected to in vivo and ex vivo I/R, and necrosis rates were higher in siPC1-NRVM than control after sI/R. PC1 activated the pro-survival AKT protein during sI/R and induced PC1-AKT-pathway-dependent CTGF expression. Furthermore, conditioned media from sI/R-NRVM induced PC1-dependent fibroblast-to-myofibroblast differentiation in NRCF. This novel evidence shows that PC1 mitigates cardiac damage during I/R, likely through AKT activation, and regulates CTGF expression in cardiomyocytes via AKT. Moreover, PC1-NRVM regulates fibroblast-to-myofibroblast differentiation during sI/R. PC1, therefore, may emerge as a new key regulator of I/R injury-induced cardiac remodeling.

Binge drinking and insomnia in students from health sciences at one university in Rio de Janeiro, Brazil

In spite of the many studies examining alcohol consumption, recent reviews have indicated that binge drinking has not been extensively studied. Furthermore, it is becoming increasingly clear that sleep is associated with many physiological functions and to drug addictions. The present study aimed to evaluate the relationship between alcohol binge drinking and insomnia in college students of health sciences. All first-year health sciences students (n=286) were evaluated in a cross-sectional study. Envelopes containing the Insomnia Severity Index (ISI), the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and questions capturing sociodemographic data were distributed and collected in classes. It was found that most non-drinkers were female (70.6%), although there were no sex-related differences in the number of binge drinkers (more than 5 drinks on each occasion at least once a week), allowing statistical comparison. The Mann-Whitney U test indicated that the ISI scores were significantly greater in female than male binge drinkers (P=0.014). Moderate or severe insomnia was reported by 23% of the sample, with alcohol being the most frequently associated substance. A specialized intervention was suggested by ASSIST: brief for marijuana (19.2%) and tobacco (23.3%) use, and moderate (31.5%) or intensive (1.4%) for alcohol consumers. The data highlighted the need to pay attention to the habits of college students beyond obtaining scientific information. New data suggesting the influence of genetics on insomnia may be of importance when performing additional studies on the sex differences in alcohol binge drinking.

[Image-guided brachyablation for hepatocarcinoma. Report of one case]. / Image-Guided BrachyAblation (IGBA) en hepatocarcinoma. Descripción de la técnica y reporte del primer caso en Chile.

Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.

Image-Guided BrachyAblation (IGBA) en hepatocarcinoma: descripción de la técnica y reporte del primer caso en Chile / Image-guided brachyablation for hepatocarcinoma: report of one case

Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.

Nivel de indicadores de responsabilidad social empresarial (RSE) en la ese hospital local de Montelíbano, 2015 / Level of indicators of corporate social responsibility (CSR) in the ESE hospital local de Montelibano, 2015

Objetivo. Determinar el nivel de los indicadores de (RSE) con el fin de recomendar acciones de mejoramiento en la ESE Hospital Local de Montelibano. Materiales y métodos. Estudio descriptivo transversal cuantitativo, se tomó la población total de los funcionarios directivos, administrativos y operativos. Se utilizó la técnica de la encuesta con aplicación del cuestionario como instrumento para establecer el nivel de responsabilidad social de la empresa desde la percepción de los diferentes grupos de interés como son: Directivos, empleados, proveedores y usuarios determinados en la muestra. Una vez recolectada la información se procedió al registro, procesamiento, análisis y discusión de acuerdo con los objetivos planteados y los resultados de otros estudios usando para ello la elaboración de cuadros estadísticos y técnicas gráficas que ilustraron en forma resumida y organizada la información. La tabulación y graficación se realizó con ayuda de la hoja electrónica de cálculo Excel, la cual permitió hacer operaciones matemáticas sencillas, uso de funciones estadísticas, hasta tablas dinámicas y gráficos. Resultados. el 56% de la población de los grupos de interés, funcionarios y usuarios, era de sexo femenino, 100% de las edades de los usuarios osciló entre 18 a 33 años, y la de los funcionarios en el intervalo de los 24 a 59 años. En el nivel socioeconómico encontramos que el 89.5% de los usuarios perteneció al estrato I, mientras que el 8.9% vivían en estrato II y solo el 1.6% del total encuestados pertenecieron al estrato III, en los funcionarios se evidenció que la mayoría se clasificaron en un 65% en los estratos I y II. A nivel general y teniendo en cuenta la valoración de la percepción en cada grupo de indicadores, el nivel de Responsabilidad Social de la institución es de 3,0, la cual la clasificó en un nivel poco satisfactorio. Conclusiones. Aunque la Empresa muestra fortalezas en aspectos relacionados con la buena percepción que tienen los grupos de interés frente a factores como el fomento del trabajo en equipo, la no discriminación, la empleabilidad femenina, respeto al derecho de liquidación y despidos, capacitaciones continuas, mecanismos de conocimiento de las expectativas de las comunidades, minimización de desperdicios a través de la realización de programas de auditoría verde; presenta un alto nivel de insatisfacción en aspectos relacionados con el desarrollo de sus empleados y la calidad de vida de las familias y prestaciones superiores a la ley, poco ascenso en empleos femeninos a posiciones ejecutivas, falta de esquemas de trabajos flexibles y de programas para estimular la generación de ideas. Igualmente con la falta de aplicación de normas de certificación ambiental e información detallada del destino de sus productos y o servicios, no perciben metas formales ni declaración de principios medio ambientales para prevenir la contaminación, como tampoco la generación de incentivos previos y reconocimientos para los empleados que sugieran alternativas a los procesos de contaminación. A nivel general y teniendo en cuenta la valoración de la percepción en cada grupo de indicadores, el nivel de Responsabilidad Social de la institución es de 3.0, la cual la clasificó en un nivel poco satisfactorio.

Objective. To determine the level of corporate social responsibility indicators in order to design a strategic plan for improvement in the Local Hospital ESE Montelibano. Materials and Methods. Quantitative Cross-sectional study, the total population of managers, administrative and operational staff took the survey technique was used with application of the questionnaire as a tool to establish the level of social responsibility of the company from the perception of different interest groups such as: Managers, employees, suppliers and users identified in the sample. Once we collected the information we proceeded to the recording, processing, analysis and discussion in accordance with the objectives and results of other studies using for this purpose the preparation of statistical tables and graphs that illustrated techniques summarized and organized information. Tabulation and graphing was performed using electronic Excel spreadsheet, which allowed to make from simple math, using statistical functions, dynamic tables and graphs. Results. 56% of the population of interest groups officials and users were female, 100%, ages users ranged from 18 to 33 years, and that of officials in the range of 24 to 59 years . In the socioeconomic level found that 89.5% of users belonged to the stratum I, while 8.9% lived in stratum II and only 1.6% of the total respondents belonged to the stratum III, officials it became clear that most were classified in 65% in strata I and II. At a general level and taking into account the assessment of perception indicators in each group, the level of social responsibility of the institution is 3.0, which classified it in an unsatisfactory level. Conclusion. Although the Company shows strengths in areas related to good perception of stakeholders against factors such as promoting teamwork, non- discrimination, women's employability, respect for the right of settlement and layoffs, ongoing training, mechanisms of knowledge of the expectations of communities, waste minimization through the realization of green audit programs; It has a high level of dissatisfaction with aspects related to the development of its employees and the quality of life of families and above the law benefits, little rise in women to executive positions jobs, lack of schemes of flexible work and programs to stimulate the generation of ideas. Also with the lack of enforcement of environmental certification standards, and detailed information about the destination of its products or services, they do not receive formal statement or goals of environmental principles to prevent pollution, any generation previous incentives and recognition for employees They are suggesting alternatives to contamination processes. At a general level and taking into account the assessment of perception indicators in each group, the level of social responsibility of the institution is 3.0, which classified it in an unsatisfactory level.

Factores fisiopatológicos y metas terapéuticas perioperatorias que influyen en procedimientos quirúrgicos reconstructivos mediante colgajos en pacientes con Diabetes Mellitus / Pathophysiologic factors and perioperative therapeutic goals that affect reconstructive surgical procedures with flaps in patients with Diabetes Mellitus

RESUMEN Introducción: la diabetes mellitus es considerada un factor de riesgo para complicaciones locales y fracaso quirúrgico en cirugías reconstructivas mediante el uso de colgajos debido a las alteraciones en el proceso de cicatrización propias de esta patología. Objetivo: hacer una revisión de la literatura disponible sobre los factores fisiopatológicos que influyen en los resultados posquirúrgicos a corto, mediano y largo plazo en la población diabética, así como de las metas terapéuticas perioperatorias asociadas a mayores tasas de éxito. Metodología de Búsqueda: se realizó búsqueda en las bases de datos PUBMED, MEDLINE Y SCIELO, mediante el gestor de búsqueda utilizando los términos: "Period perioperative", "Reconstructive surgical procedures", "Surgical flaps", "Diabetes mellitus", obteniendo un total de 160 artículos de revistas en línea, de los cuales se seleccionaron 50. Resultados: la realización de colgajos en pacientes con diabetes mellitus se asocia a mayor riesgo de fracaso y complicaciones, las cuales disminuyen considerablemente si se realiza un estricto manejo perioperatorio enfocado en metas. Conclusiones: la diabetes mellitus causa alteraciones en la respuesta inflamatoria, disfunción microvascular y mayor estrés oxidativo, lo cual se ve reflejado en un proceso de cicatrizacion anormal, generando mayores tasas de infeccion y perdidas de colgajos; un estricto manejo peri operatorio guiado por metas logra disminuir las complicaciones y aumentar el exito quirurgico. MÉD.UIS. 2017;30(1):35-43.

ABSTRACT Introduction: diabetes mellitus is considered a risk factor for local complications and surgical failure in reconstructive surgeries, mainly in flaps due to the fact that it causes alterations in the cicatrization process. Objective: to review the available literature on the pathophysiological factors that influence the short-, medium- and long-term results in the diabetic population, the perioperative therapeutic goals associated with higher success rates, and to establish a baseline protocol for the perioperative management of these patients. Searching methodology: we searched the PUBMED, MEDLINE and SCIELO databases using the search terms "Period perioperative", "Reconstructive surgical procedures", "Surgical flaps", "Diabetes mellitus", obtaining a total of 160 online journal articles, of which 50 were selected. Results: the performance of flaps in patients with diabetes mellitus is associated with an increased risk of failure and complications, which decrease considerably when a strict goal-directed perioperative management is performed. Conclusions: diabetes mellitus causes alterations in the inflammatory response, microvascular dysfunction and increases oxidative stress, which is reflected in an abnormal healing process, generating higher infection rates and graft loss, but if glycemic management goals are achieved in the perioperative period it is possible to reduce the complications and to increase the surgical success. MÉD.UIS. 2017;30(1):35-43.

Miocardiopatía de Tako-Tsubo: una manifestación inusual de feocromocitoma / Takotsubo cardiomyopathy: rare manifestation of pheochromocytoma

Takotsubo cardiomyopathy (MTT) is an acute ventricular dysfunction and reversible in absence of coronary disease. It is a rare presentation of pheochromocytoma and paraganglioma (FPGL). It was described for the first time in 1990 by Sato et al, the physiopathology is not clear yet. It is associated with high levels of catecholamines, vasospasm in the micro vascularization, rupture of atheromatous plaque and myiocarditis. The clinical presentation is similar to an acute myocardial infarction because of that the FPGL must be considered in patients without obstructive coronary lesions. We present a case of a 50 years old women with history of Arterial Hypertension, active smoking and Neurofibromatosis, who is admitted to emergency room with an acute myocardial pain.

Anthropometric indicators as predictors of total body fat and cardiometabolic risk factors in Chilean children at 4, 7 and 10 years of age.

BACKGROUND/OBJECTIVE: To compare the association between anthropometric indicators of global and central obesity as predictors of total body fat (TBF) and cardiometabolic risk factors in children. SUBJECTS/METHODS: A total of 1044 children were evaluated at 4 years (n=320), 7 years (n=1044) and 10 years (n=483). The following anthropometric indices were determined: body mass index (BMI) for age (BAZ, WHO), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). To estimate TBF we used validated predictive equations. We measured blood sample concentrations of glucose, insulin, triglycerides, total cholesterol, Low-density lipoprotein (LDL) and High-density lipoprotein (HDL), adiponectin, C-reactive protein (CRP) and Insulin-like growth factor-1 (IGF-1). RESULTS: Adiposity and cardiometabolic markers, particularly those related to glucose metabolism increased from 4 years to 10 years. BAZ and WC were highly correlated to body fat at all ages (all r>0.8) but at 10 years WC was more strongly correlated than BAZ (r=0.94 WC vs r=0.88 BAZ, P<0.05); conversely, WHtR was significantly associated with body fat from 7 years (r=0.85) and 10 years (r=0.88). WHR was unrelated all over the period studied at all ages. Anthropometrical adiposity indicators became associated to cardiometabolic markers only from 7 years on with associations being slightly higher at 10 years, particularly for adiponectin and lipid markers. At all ages, BAZ, WC and WHtR performed similarly as cardiometabolic markers (P<0.05) while WHR was a slightly weaker marker. CONCLUSIONS: Relationship between anthropometrical indicators of adiposity and cardiometabolic markers becomes stronger from 7 years onwards; BAZ, WC and WHtR perform similarly as markers of cardiometabolic risk at least until 10 years of age.

A mathematical model and quantitative comparison of the small RNA circuit in the Vibrio harveyi and Vibrio cholerae quorum sensing systems.

Quorum sensing is the process by which bacteria regulate their gene expression based on the local cell-population density. The quorum sensing systems of Vibrio harveyi and Vibrio cholerae are comprised of a phosphorelay cascade coupled to a small RNA (sRNA) circuit. The sRNA circuit contains multiple quorum regulated small RNA (Qrr) that regulate expression of the homologous master transcriptional regulators LuxR (in V. harveyi) and HapR (in V. cholerae). Their quorum sensing systems are topologically similar and homologous thereby making it difficult to understand why repression of HapR is more robust than LuxR to changes in Qrr. In this work we formulate and parameterize a novel mathematical model of the V. harveyi and V. cholerae sRNA circuit. We parameterize the model by fitting it to a variety of empirical data from both species. We show that we can distinguish all of the parameters and that the parameterizations (one for each species) are robust to errors in the data. We then use our model to propose some experiments to identify and explain kinetic differences between the species. We find that V. cholerae Qrr are more abundant and more sensitive to changes in LuxO than V. harveyi Qrr and argue that this is why expression of HapR is more robust than LuxR to changes in Qrr.

[Methods of body composition and four compartiments model in obese school children]. / Métodos de composición corporal y modelo de cuatro compartimentos en escolares obesos chilenos.

INTRODUCTION: In Chile, the prevalence of obesity in schoolchildren is 21.3%. The study and individual intervention of this malnutrition, it is necessary to have not only global indicators of nutritional status, but also indicators that give information on body composition. OBJECTIVE: To compare estimates of body fat isotopic dilution, plethysmography and radiographic absorptiometry 4C model in overweight schoolchildren. METHODS: We worked with 61 obese (BMI ≥ p 95) of both sexes, between 8 and 13 years, enrolled in a school in a district of the city of Santiago. The multicompartmental body composition determination, considered isotopic dilution, plethysmography and radiographic absorptiometry. Using as a reference standard four compartment model of Fuller. RESULTS: In both sexes, the method showed better agreement with the reference of 4 compartments was isotope dilution (r = 0.98, p < 0.01). In children, the isotopic dilution underestimates body fat in -0.40 kg. By contrast, DEXA and plethysmography overestimate body fat by 0.81 kg and 1.89 kg respectively. In women, all methods overestimate body fat, with less emphasis isotopic dilution value 0.46 kg, 0.52 kg after DEXA and plethysmography 1.31 kg. CONCLUSIONS: The deuterium isotopic dilution would be the most sensitive method for estimating body fat in research studies because it shows the best agreement with the gold standard multicompartmental model.

Métodos de composición corporal y modelo de cuatro compartimentos en escolares obesos chilenos / Methods of body composition and four compartiments model in obese school children

Introducción: En Chile, la prevalencia de obesidad en los escolares es de 21,3%. El estudio y la intervención individual de esta malnutrición, hacen necesario contar no sólo con indicadores globales de estado nutricional, sino también, indicadores que entreguen información de la composición corporal. Objetivo: Comparar las estimaciones de la grasa corporal de dilución isotópica, pletismografía y absorciometría radiográfica con el modelo de 4C en escolares obesos. Métodos: Se trabajó con 61 niños obesos (IMC > p 95) de ambos sexos, entre 8 y 13 años, reclutados en un colegio de una comuna de la ciudad de Santiago. La determinación de composición corporal multicompartimental, consideró dilución isotópica, pletismografía y absorciometría radiográfica; utilizando como patrón de referencia el modelo de cuatro compartimentos de Fuller. Resultados: En ambos sexos, el método que mejor concordancia mostró con el referente de 4 compartimentos fue la dilución isotópica (r = 0,98; p < 0,01). En niños, la dilución isotópica subestima la grasa corporal en -0,40 kg. Al contrario, la absorciometría radiográfica y la pletismografía sobreestiman la grasa corporal en 0,81 kg y 1,89 kg respectivamente. En mujeres, todos los métodos sobreestiman la grasa corporal, destacando con un menor valor la dilución isotópica (0,46 kg), luego la absorciometría radiográfica (0,52 kg) y la pletismografía (1,31 kg). Conclusiones: La dilución isotópica con deuterio sería el método más sensible para estimar grasa corporal en estudios de investigación ya que muestra la mejor concordancia con el gold estándar del modelo multicompartimental (AU)

Introduction: In Chile, the prevalence of obesity in schoolchildren is 21.3%. The study and individual intervention of this malnutrition, it is necessary to have not only global indicators of nutritional status, but also indicators that give information on body composition. Objective: To compare estimates of body fat isotopic dilution, plethysmography and radiographic absorptiometry 4C model in overweight schoolchildren. Methods: We worked with 61 obese (BMI > p 95) of both sexes, between 8 and 13 years, enrolled in a school in a district of the city of Santiago. The multicompartmental body composition determination, considered isotopic dilution, plethysmography and radiographic absorptiometry. Using as a reference standard four compartment model of Fuller. Results: In both sexes, the method showed better agreement with the reference of 4 compartments was isotope dilution (r = 0.98, p < 0.01). In children, the isotopic dilution underestimates body fat in -0.40 kg. By contrast, DEXA and plethysmography overestimate body fat by 0.81 kg and 1.89 kg respectively. In women, all methods overestimate body fat, with less emphasis isotopic dilution value 0.46 kg, 0.52 kg after DEXA and plethysmography 1.31 kg. Conclusions: The deuterium isotopic dilution would be the most sensitive method for estimating body fat in research studies because it shows the best agreement with the gold standard multicompartmental model (AU)

Consumo de alcohol en los pacientes que acudieron por consulta externa del Hospital Vargas de Caracas durante el período Marzo - Mayo 2008

El consumo de alcohol en nuestro país constituye un problema de salud pública relacionado con el desarrollo de eventos que afectan la esfera biopsicosocial del individuo. Objetivo: Caracterizar los patrones de consumo de alcohol en personas de 14 años y más que consultaron a los servicios de gastroenterología, Medicina Interna, Endocrinología y Cirugía del Hospital Vargas de Caracas. Pacientes y Métodos: El levantamiento de los datos se realizó durante el trimestre marzo-mayo 2008, en horario matutino y vespertino, de lunes a viernes. Se entrevistó una muestra intencional, heterogénea de 450 pacientes. Se aplicó una encuesta de preguntas abiertas en la cual se incluyeron los datos de identificación (nombre, apellido, sexo, edad, teléfono), consumo de alcohol (edad de inicio, número de tragos, frecuencia) y las preguntas del Test de Cage. Para medir el consumo de alcohol se utilizó una clasificación que permitió conocer el riesgo de Alcoholismo. Resultados: Se realizaron un total de 450 encuestas, en 149 pacientes masculinos y 301 femeninos. Del total de la muestra se identificaron 186 pacientes que consumen alcohol y 264 que no consumen, con un 41,55% y 58,45% respectivamente. El riesgo alto de consumo de alcohol estuvo presente en 16 pacientes y el consumo perjudicial en 50 pacientes, con un 8,60% y 26,88% respectivamente. Cabe destacar, que el riesgo alto de consumo fue mas elevado en el sexo femenino 10,34%, mientras que el consumo perjudicial en el sexo masculino con 43,87%. Conclusiones: El consumo de alcohol en los pacientes que acudieron a las Consultas Externas del Hospital Vargas de Caracas es alto, en un 41,55 % de los encuestados, con un riesgo de consumo de alcohol de 35,48 %.

Alcohol intake in our country is a public health problem related with the development of many events that affect the bio - psychosocial area of the patients. Objective: Characterize the patterns of alcohol intake in people from 14 years old on; that attended the gastroenterology, Internal Medicine, Endocrinology and Surgery Divisions at the Hospital Vargas in Caracas. Patients and Methods: the data was collected during March-May 2008, in the morning and afternoon, from Monday through Friday. Interviews were done in an intentional, heterogeneous sample of 450 patients. An opened questions survey was applied, in which the identification data (name, last name, sex, age, telephone), alcohol intake were included (age of beginning, number of drinks, frequency), as well as the Cage Test questions. In order to measure alcohol intake, we used a classification that allowed knowing the risk of Alcoholism. Results: A total of 450 surveys were made, in 149 male patients and 301 females. Of the total of the sample, 186 patients consume alcohol and 264 do not, 41.55% and 58.45% respectively. 16 patients, presented with high risk of alcohol intake and 50 patients with severe intake, 8.60% and 26.88% respectively. It is important to stress out that females presented a high risk of intake (10.34%), whereas the detrimental intake in males was 43.87%. Conclusions: Alcohol intake in patients who attended "Hospital Vargas de Caracas" outpatient clinic is high, with a 41.55% of the patients, and an alcohol intake risk of 35.48 %.

Hallazgos endoscópicos en pacientes con síntomas cardinales de enfermedad de reflujo gastroesofágico

La enfermedad de reflujo gastroesofágico (ERGE) es una enfermedad recurrente relacionada con el flujo retrógrado del contenido gástrico al esófago, con o sin daño tisular a dicho nivel. La Hernia Hiatal (HH) se asocia con ERGE, y se ha relacionado con grados severos de la enfermedad (Esofagitis Erosiva Severa y Esófago de Barrett). Objetivo: Describir la presencia y las alteraciones a nivel de la mucosa esofágica reportadas endoscópicamente en los pacientes que consultan con síntomas de ERGE al servicio de Gastroenterología del Hospital Vargas. Pacientes y métodos: estudio descriptivo de corte transversal, en el cual se evaluaron hallazgos endoscópicos de pacientes que acudieron con síntomas de ERGE a las consultas del servicio de gastroenteologia del Hospital Vargas entre enero-mayo de 2007. Resultados: de 674 pacientes encuestados, 204 pacientes (59 hombres y 145 mujeres)presentaron síntomas de ERGE, a 60 de ellos se les realizó videogastroscopia de manera aleatoria, reportando 23,33% (14 pacientes) con ERGE erosiva, 1,66% (1paciente) con tu submucoso de esófago, 6,66% con esófago Barret y 75% (45 pacientes) sin alteraciones esofágicas. 23 (38,33%) con hernia hiatal, 8 de ellos con esofagitis erosiva. Conclusiones: Nuestro trabajo confirma el valor de la endoscopia digestiva superior en la evaluación de pacientes con síntomas cardinales de ERGE.

Gastro-esophageal reflux disease (GERD) is a recurrent disease related with retrograde progression of gastric contents to the esophagus with or without mucosal damage at this level. Hiatal hernia is associated with GERD and it has been related with severe grades of the disease (severe erosive esophagitis and BarrettÊs esophagus). Aims: to describe the presence of endoscopic features in GERD patientss with cardinals symptoms attended at the Gastroenterology Division of the Vargas Hospital in Caracas. Patients and Methods: this was a descriptive, transversal cohort study in which endoscopic findings in patients with GERD symptoms were evaluated, at the Gastroenterology Service, between January and May 2007. Results: of 674 patients interviewed, 204 patients (59 men and 145 women) presented GERD symptoms; to 60 of them an upper endoscopy randomly was performed. 23,33% (14 patients) had erosive GERD, 1,66% (1 patient) a submucous esophageal tumor, 6,66 % with BarrettÊs esophagus and 75% (45 patients) without esophageal changes, 23 (38,33%) with hiatal hernia, 8 of them with erosive esophagitis. Conclusion: our study supports the importance of performing an upper endoscopy in patients with cardinals symptoms of GERD.

Experiencia en la colocación de prótesis endoscópica en patología biliopancreática

Desde hace dos décadas esta descrita la utilidad de las prótesis endoscópicas, en patología biliopancreática. Objetivo: Mostrar la experiencia del Servicio de Gastroenterología del Hospital Vargas de Caracas en la colocación de prótesis endoscópicas en la patología biliopancreática, describiendo características demográficas, patologías más frecuentes, tasa de éxito en su colocación y complicaciones. Pacientes y Métodos: Estudio descriptivo, retrospectivo. Se revisaron datos de los informes de CPRE de pacientes hospitalizados y ambulatorios evaluados en la institución desde enero 1998 hasta abril 2007. Resultados: Se incluyeron 248 procedimientos de 110 mujeres y 73 hombres, 242 correspondieron a colocación de prótesis biliares (234 de teflón o plástico y 8 autoexpansibles metálicas) y 6 prótesis pancreáticas. Las indicaciones mas frecuentes para la colocación de prótesis fueron: patologías neoplásicas (47%), lesiones de la vía biliar post-quirúrgicas o traumáticas (22%) y litiasis biliar (17%). El éxito de la colocación de la prótesis fue del 99,1%. Se reportaron complicaciones en 4% de los procedimientos, con mayor frecuencia la colangitis (2%) y una mortalidad del 0%. Conclusión: La colocación de prótesis endoscópicas en patologías biliopancreáticas es un procedimiento seguro, con un bajo porcentaje de complicaciones y mortalidad.

The utility of the endoscopic stent have been described for two decades in the biliopancreatic diseases. Aims: To show the Gastroenterology Division of the Hospital Vargas de Caracas experience in placing endoscopic stents in biliopancreatic diseases, describing demographic characteristics more frequent diseases, success rates and complications. Patients and Methods: descriptive and retrospective trial. Features of the reports of PEPR of hospitalized and ambulatory patients seen in the institution from January 1998 to april 2007 were reviewed. Results: 248 procedures from 110 women and 73 men were included, 242 had a biliar stent (234 of Teflon or plastic and 8 metallic selfexpanded) and 6 had pancreatic stents. The more frequent indications for placing the stents were: Tumoral disease, (47%), traumatic or post-surgical lesions of the biliary tract (22%) and biliary stones (17%). The success rate of the placing of stents was 99.1%. The procedureÊs complication rate reported was 4%, being colangitis the most frequent with 2% and a 0% mortality. Conclusion: the placing of endoscopic stents in biliopancreatic diseases is a safe procedure, with a low rate of complications and mortality.

Prevalencia de enfermedad por reflujo gastroesofágico en población adulta del área metropolitana de Caracas Venezuela

La enfermedad por reflujo gastroesofágico (ERGE) es uno de los trastornos gastrointestinales con mayor prevalencia; afecta del 10 a 15% de la población general constituyendo una causa frecuente de consulta. Sin embargo, existen pocos reportes acerca de la prevalencia de ERGE en la población general. Objetivos: Determinar la prevalencia de ERGE en la población general adulta del área metropolitana de Caracas y estudiar algunos factores asociados a esta enfermedad. Materiales y métodos: Estudio de corte transversal, realizado en la población general adulta del área metropolitana de Caracas en abril de 2007. Se utilizó una encuesta basada en criterios clínicos epidemiológicos de acuerdo a consensos latinoamericanos y europeos sobre la ERGE. Para el análisis de los resultados se calcularon promedios, medianas y porcentajes. Resultados: De 389 sujetos encuestados, 223 fueron mujeres (57,3%) y 166 hombres (42,7%). El promedio de edad fue 33,89 años. La prevalencia de síntomas cardinales en la ERGE fue 19,02%. En los sujetos con ERGE encontramos que 47,3% ingerían licor al menos un vez al mes, y 21,6% referían hábitos tabáquicos. Conclusión: Se determinó que la prevalencia de la ERGE en la población general adulta del área Metropolitana de Caracas fue de 19,02% encontrándose asociación con el hábito alcohólico.

Gastroesophageal reflux disease (GERD) is one of the gastrointestinals problems with higher prevalence; it affects 10 to 15% of the general population being a frequent cause of medical visit. Nevertheless, there is low number of reports about GERD prevalence. Objectives: to determine GERD prevalence in adult population of the Caracas Metropolitan Area and study some related factors to this disease. Materials and methods: Study of transversal cut, made in adult population in Caracas Metropolitan Area in April 2007. A poll based in clinical and epidemiological criteria in accordance with a Latin- American and European consensus about GERD was used. To analize the results averages, medians and percentages were calculated. Results: of 389 subjects surveyed, 223 were women (57,3%) and 166 were men (42,7%). The mean age of the patients was 33 years old. The cardinals symptoms prevalence was 19,02%. In subjects with GERD we found that 47,3% drank alcohol at least once a week, and 21,6% were smokers. In Conclusion, we found that GERD prevalence in adult population of the Caracas Metropolitan Area was 19, 02% finding a relationship with alcoholic habit.