[How many patients with inflammatory rheumatic diseases have the technical prerequisites for video consultations and are also willing to use this to carry out visits by medical specialist visits?] / Wie viele Patienten mit entzündlich rheumatischen Erkrankungen haben die technischen Voraussetzungen für Videosprechstunden und sind bereit, fachärztliche Visiten so durchzuführen?

BACKGROUND: The currently disseminating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and limited capacities in outpatient rheumatological care, pose questions about possible alternatives to clinical visits, also in view of the digital revolution. It is unclear whether and to what extent patients with inflammatory rheumatic diseases are willing and in a position to deal with the new media, such as video consultation. METHODS: In the middle of the pandemic in May 2020 outpatients were surveyed using a standardized questionnaire in order to document their possibilities and willingness to participate in a video consultation. The treating physicians were asked whether carrying out a video consultation was considered to be a possible and meaningful option. RESULTS: Overall, 232 patients with inflammatory rheumatic diseases were surveyed (64.7% female, average age 54.0 ± 15.2 years), seropositive (n = 58) and seronegative (n = 51) rheumatoid arthritis (RA), spondyloarthritis (SpA, n = 77) including axial SpA (axSpA) and psoriatic arthropathy (PsA) as well as collagenosis and vasculitis (CoV, n = 46). The mean duration of disease was 5.5 ± 8.2 years, whereby in 75 patients (32.3%) it was the first diagnosis. The mean disease activity (0-10, subjective patient self-estimation) was 4.7 ± 2.5. Overall, 176 patients were basically aware of the possibility to carry out video consultations (75.9%) and 166 considered that they were technically capable to participate (71.6%) but only 131 were principally willing to participate (56.5%). Logistic regression analyses showed that the willingness to participate in video consultations decreased with increasing age (ß = 0.28, p = 0.01). According to the medical estimation video consultations were thought to be principally possible for 161 patients for technical reasons (69.4%) and for 127 for medical reasons (54.7%); however, a video consultation within the framework of treatment was only considered to be meaningful by the physician for 76 patients (32.8%). CONCLUSION: Not all patients can or want to participate in video consultations and the willingness declines with increasing age. The estimation of the meaningfulness of video consultations by physicians was also limited to approximately one third of the patients surveyed. This must be taken into consideration for the future planning of video consultations.

[How well are patients with inflammatory rheumatic diseases protected against measles?] / Wie gut sind Patienten mit entzündlich rheumatischen Erkrankungen gegen Masern geschützt?

BACKGROUND: Patients with inflammatory rheumatic diseases have an increased risk of infections due to the autoimmune disease but also due to the immunosuppressive medication. Although vaccinations are known to be effective in the primary prophylaxis of infections, the vaccination rate in Germany is generally too low. Due to the recently increasing, sometimes epidemic-like occurrence of measles, the administration of live vaccine against measles has recently become required by law. OBJECTIVE: How many patients with inflammatory rheumatic diseases are currently sufficiently protected against measles? METHOD: Between December 2017 and October 2018 patients with inflammatory rheumatic diseases at the Ruhrgebiet Rheumatism Center were prospectively and consecutively included. Data on the disease and treatment at the level of substance classes, patient history of vaccination and infections were collated. All information on vaccinations were controlled in the vaccination certificate. Antibodies against measles were determined using ELISA. The threshold for sufficient protection against measles was set at 150 mIU/ml. RESULTS: Out of 975 patients 540 (55.4%) could present a vaccination certificate. In 201 patients with a certificate (37.2%) vaccination had been documented since birth. Overall, 45 out of 267 patients born after 1970 (16.9%) had sufficient protection against measles. The patient history of measles in childhood showed no differences between patients with and without protective measles IgG antibodies. Protective measles IgG antibodies were detected in 901 out of 928 patients with measurement of the measles IgG antibody level (97.1%). The different principles of action of the current immunosuppressive treatments had no influence on this. CONCLUSION: These data show that at least 2.9% of the patients did not have sufficient protection against measles. Interestingly, the majority of patients born after 1970 had protective antibodies despite the lack of vaccination against measles. The efforts in primary and also in the specialist medical care should be urgently strengthened in order to be able to guarantee an adequate infection prophylaxis in particularly endangered patients.

[Epionics SPINE-use of an objective method to examine spinal mobility in patients with axial spondyloarthritis]. / Epionics SPINE ­ Anwendung einer objektiven Untersuchungsmethode der Wirbelsäulenbeweglichkeit bei Patienten mit axialer Spondyloarthritis.

Axial spondylarthritis (axSpA) is a chronic inflammatory disease of the spine that can be associated with loss of physical function, mobility and upright postural impairment. Established tools for the assessment of function that are largely based on subjective perception are semiquantitatively recorded by standardized questionnaires (Bath ankylosing spondylitis functional index, BASFI), while measurement of spinal mobility of patients with axSpA is based on physical examination of various movement regions particularly the axial skeleton (Bath ankylosing spondylitis metrology index, BASMI). Recently, a performance test has been added to assess the range of motion and speed of certain tasks (AS performance-based improved test, ASPI); however, since these tests have limited reliability and reproducibility, more objective tests would be desirable. In this study the spinal mobility of patients with axSpA was quantified using the Epionics SPINE device (ES) and data were evaluated using the outcome measures in rheumatology (OMERACT) criteria. The ES automatically measures various patterns of spinal movements using electronic sensors, which also assess the range and speed of carrying out movements. Patients with back pain from other causes and persons without back pain served as controls. The measurement results obtained with ES differed between the groups and correlated with BASMI values (r = 0.53-0.82, all p = <0.03). Patients with radiographically detectable axSpA had more limited and slower mobility than those with non-radiographically detectable axSpA. Overall, the results presented here suggest that ES measurements represent a valid and objective measurement procedure of spinal mobility for axSpA patients.

Malnutrición por exceso y riesgo cardiometabólico en escolares de segundo y tercero medio de la comuna de Lota de Chile / Malnutrition by excess and cardiometabolc risk in second and third grade children of Lota county of Chile

Adolescent overweight is a widespread problem which increases the risk of developing metabolic diseases. The objective of this study was to associate metabolic syndrome and cardiovascular risk in a school in the district of Lota. A cross-sectional study with simple random probability sampling in 286 children, 14 and 18 years was taken. Prevalence of malnutrition was established, and Pearson correlation was performed. The correlations were: weight and height, 0.55; weight and waist circumference 0.87; weight and body mass index 0.86; height and waist circumference 0.39; height and body mass index 0.047; body mass index and waist circumference 0.80. The presence of the metabolic syndrome conditions the presence of nutritional diseases, meaning that anthropometric indicators may be suitable for identifying the presence of cardiometabolic risk in adolescents.

La malnutrición por exceso en el adolescente es un problema prevalente y aumenta el riesgo de desarrollar enfermedades metabólicas. El objetivo de este estudio fue asociar el síndrome metabólico y el riesgo cardiovascular en escolares de la comuna de Lota de Chile. Estudio de corte transversal, muestreo probabilístico aleatorio simple, se tomó una muestra de 286 niños, de 14 y 18 años de edad. Se estableció la prevalencia de malnutrición, y se realizó una correlación de Pearson. Las correlaciones fueron: peso y talla de 0.55; peso y circunferencia de cintura 0,87; el peso y el índice de masa corporal de 0,86; la talla y la circunferencia de cintura de 0,39; la talla e índice de masa corporal de 0,047; índice de masa corporal y circunferencia de cintura 0,80. El índice de masa corporal, la circunferencia de cintura y el peso, se agrupan en un diagnóstico efectivo. El síndrome metabólico posee una relación que condiciona la presencia de patologías nutricionales, significa que los indicadores antropométricos pueden ser adecuados para identificar la presencia de riesgo cardiometabólico en adolescentes.

Problemas de adherencia a dietoterapia en pacientes hipertensos pehuenches / Problems of adherence to diet therapy in hypertensive pehuenche patients

Background: Hypertension is a disease with a high national prevalence which increases in sectors where there are indigenous populations. The complexity of the disease lies in the behavior that must be maintained to effectively adhere to medication and diet therapy. Objective: To understand the cultural factors that are associated with problems of adherence to diet therapy in hypertensive pehuenches. Methods: Qualitative study in hypertensive patients who do not adhere to diet therapy. We interviewed 42 individuals in the municipality of Alto Bio Bio for 6 months, analyzing them using semantic structural analysis completed with the saturation point of speech. Results: Discourse analysis showed the following results: a) ethnic foods have a symbolic value, b) ethnic foods are described as "natural" in opposition to any food that does not occur in their environment, although they are based in a high consumption of fats, proteins and carbohydrates, c) nonexistent biochemical properties ascribed to ethnic foods justify their use. Conclusion: there are cultural differences between the prescription of the nutritionist and the eating behavior of pehuenches, which affect non-compliance with diet and disease complications.

Introducción: La hipertensión arterial es una patología con una alta prevalencia nacional que aumenta en sectores con poblaciones indígenas. La complejidad de la enfermedad radica en la conducta que se debe mantener para adherir eficazmente al tratamiento farmacológico y dietoterápico. Objetivo: Comprender los factores culturales que se asocian a los problemas de adherencia a la dietoterapia en pacientes hipertensos pehuenches. Metodología: Estudio cualitativo, en pacientes hiper-tensos pehuenches que no adhieren a Dietoterapias. Se entrevistó a 42 pehuenches de la Comuna de Alto Bio Bío durante 6 meses. El análisis de los datos se realizó mediante análisis semántico estructural. La muestra se logró mediante el punto de saturación. Resultados: El análisis de discurso arroja los siguientes resultados: a) los alimentos étnicos tienen un valor simbólico b) los alimentos étnicos son calificados como "naturales" en contraposición a cualquier alimento que no se produzca en su medio, aunque se basan en un alto consumo de grasas, proteínas y carbohidratos, c) a los alimentos étnicos se les atribuye propiedades bioquímicas inexistentes con los cuales se justifica su consumo. Conclusión: Existen diferencias culturales entre la prescripción del nutricionista y lo realizado por pehuenches que inciden en el no cumplimiento de la dietoterapia y complicación de la enfermedad.

Percepción de la función profesional del nutricionista por parte de los usuarios de atención primaria / Perception of the nutritionist's professional function from primary care users

Research to assess the role or to describe the functions of the health personnel from the perspective of the patients is not common in the health area; however, its study allows a valid feedback in defining both a professional profile and setting targets. The objective of this investigation was to describe the most important dimensions that external users consider when defining "socially and subjectively" the professional nutritionist. This was a phenomenological qualitative study using semi-structured interviews with 28 users of Conception health centers. The sample was qualitative and operates through saturation point, semantic analysis was structural. As a result, we obtained the description of the role of the nutritionist classified in the dimensions in which patients recognize the work, confirming some of its functions and discovering the importance of other ancillary and secondary consideration.

Las investigaciones que evalúan el rol o describen funciones del personal de salud desde la visión de los pacientes no son comunes en el área sanitaria, sin embargo su estudio permite una retroalimentación válida al momento de definir tanto un perfil profesional como el establecimiento de metas para éstos. El objetivo de la investigación fue describir las dimensiones más importantes que los usuarios externos consideran al momento de definir "social e intersubjetivamente" al profesional nutricionista. Se efectuó un estudio cualitativo fenomenológico, mediante entrevistas semi-estructuradas a 28 usuarios de centros de salud de Concepción, muestralmente se operó cualitativamente mediante punto de saturación, su análisis es semántico estructural. Se obtuvo como resultado la descripción de la función del nutricionista clasificado en las dimensiones que los pacientes reconocen en su quehacer profesional, ratificando algunas de sus funciones y descubriendo la importancia de otras consideradas anexas y secundarias.

Determinación no experimental de la conducta sedentaria en escolares / Not experimental determination of sedentary behavior in school-age children

Sedentary lifestyle encourages the emergence of health problems among the population. The school population is at a stage of independence that stimulates the appearance of this condition. The definition of sedentary is unclear, as it is the classification of physical inactivity. Not only is defined as the absence of physical activity, but also considers leisure time activities. The purpose of this systematic review of literature is to describe the concepts related to the actual determination of sedentary life style in school. The results show that there is a definition of sedentary lifestyle associated with activities in school. However, there is no consensus on how to determine physical inactivity in school. There are no empirical methods for determining physical inactivity by recording the time spent on leisure activities that are fairly reliable.

El sedentarismo favorece la aparición de problemas de salud en la población. La población escolar está en una etapa de independencia que genera la aparición de esta condición. La definición de sedentarismo está poco clara, lo mismo ocurre con la clasificación de sedentarismo. No solo se define como la ausencia de actividad física, también considera actividades destinada al tiempo de ocio. La manera en que se determina el sedentarismo, es identificando aquellos individuos que son inactivos. El propósito de esta revisión es describir los conceptos relacionados con la determinación no experimental del sedentarismo en escolares. Se realiza una revisión sistemática de la literatura. Los resultados muestran que existe una definición de sedentarismo y se la asocia a escolares. La forma de determinar el sedentarismo en escolares no está consensuada. Existen métodos no experimentales que permiten determinar el sedentarismo, registrando el tiempo destinado a actividades de ocio que son bastante confiables.