Evolutionary Echoes: A Four-Day Fasting and Low-Caloric Intake Study on Autonomic Modulation and Physiological Adaptations in Humans.

This study evaluates the psychophysiological response to a simulated hunter-gatherer endurance task with restricted caloric intake over four days. It assesses changes in body composition, autonomic modulation, and physical and cognitive performance. Participants underwent daily 8 h fasted walks followed by a 150 kcal meal to replicate hunter-gatherer activity and dietary patterns. Measurements of metabolic, respiratory, and subjective well-being, along with heart rate variability (HRV) monitoring, were conducted pre- and post-activity to evaluate the impact of endurance activity under caloric restriction. We found weight loss, decreased body and visceral fat, and reduced skeletal muscle mass and water percentage. High sympathetic activation and stable urinary markers, except for increased proteinuria, indicated stress responses and muscular degradation. Elevated perceived exertion post-exercise with good adaptation to prolonged effort underlines the body's adaptability to ancestral lifestyle conditions, highlighting the connection among endurance, nutrition, and psychophysiological health.

The Role of Adipokines in Health and Disease.

Adipokines are cell-signaling proteins secreted by adipose tissue that has been related to a low-grade state of inflammation and different pathologies. The present review aims to analyze the role of adipokines in health and disease in order to understand the important functions and effects of these cytokines. For this aim, the present review delves into the type of adipocytes and the cytokines produced, as well as their functions; the relations of adipokines in inflammation and different diseases such as cardiovascular, atherosclerosis, mental diseases, metabolic disorders, cancer, and eating behaviors; and finally, the role of microbiota, nutrition, and physical activity in adipokines is discussed. This information would allow for a better understanding of these important cytokines and their effects on body organisms.

Mis-Dis Information in COVID-19 Health Crisis: A Narrative Review.

BACKGROUND: In this narrative review, we address the COVID-19 pandemic mis-dis information crisis in which healthcare systems have been pushed to their limits, with collapses occurring worldwide. The context of uncertainty has resulted in skepticism, confusion, and general malaise among the population. Informing the public has been one of the major challenges during this pandemic. Misinformation is defined as false information shared by people who have no intention of misleading others. Disinformation is defined as false information deliberately created and disseminated with malicious intentions. OBJECTIVE: To reach a consensus and critical review about mis-dis information in COVID-19 crisis. METHODS: A database search was conducted in PsychINFO, MedLine (Pubmed), Cochrane (Wiley), Embase and CinAhl. Databases used the MeSH-compliant keywords of COVID-19, 2019-nCoV, Coronavirus 2019, SARS-CoV-2, misinformation, disinformation, information, vaccines, vaccination, origin, target, spread, communication. RESULTS: Both misinformation and disinformation can affect the population's confidence in vaccines (development, safety, and efficacy of vaccines, as well as denial of the severity of SARS-CoV infection). Institutions should take into account that a great part of the success of the intervention to combat a pandemic has a relationship with the power to stop the misinformation and disinformation processes. The response should be well-structured and addressed from different key points: central level and community level, with official and centralized communication channels. The approach should be multifactorial and enhanced by the collaboration of social media companies to stop misleading information, and trustworthy people both working or not working in the health care systems to boost the power of the message. CONCLUSIONS: The response should be well-structured and addressed from different key points: central level and community level, with official and clearly centralized communication channels. The approach should be multifactorial and enhanced from the collaboration of social media companies to stop misleading information, and trustworthy people both working and not working in the health care systems to boost the power of a message based on scientific evidence.

¿Cómo lograr la excelencia sanitaria en la atención del paciente con enfermedad renal crónica? Desarrollo de vías clínicas para los estadios iniciales de la enfermedad

Las vías clínicas (VC) son instrumentos desarrollados para planificar y coordinar la secuencia de los procedimientos clínicos y administrativos necesarios para conseguir la máxima calidad asistencial. La rápida difusión de las VC en Estados Unidos explica que más del 60% de los hospitales usen estos documentos para sus procesos más frecuentes, lo que contrasta con su escasa implementación en Colombia y países de Latinoamérica. Las VC se ajustan según los cambios que representa el enfoque en procesos y se orientan a optimizar una mejor atención al paciente.

The clinical pathways are instruments developed to plan and coordinate the sequence of clinical and administrative procedures necessary to achieve the highest quality of care. Its rapid spread in the USA. USA explains that more than 60% of hospitals use clinical pathways for their most frequent processes. This contrasts with its poor implementation in Colombia and the countries of the Region of the Americas. The Clinical Pathways adjust with the change represented by the focus on processes, aimed at optimizing better patient care.

The Impact of the COVID-19 Pandemic on Mental Disorders. A Critical Review.

The COVID-19 pandemic has impacted the lives of the worldwide population. Citizens suffer the social, economic, physiological, and psychological effects of this pandemic. Primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages were used for a consensus critical review. The method was a narrative review of the available literature to summarize the existing literature addressing mental health concerns and stressors related to the COVID-19 pandemic. The main search engines used in the present research were PubMed, SciELO, and Google Scholar. We found the pandemic has had a direct impact on psychopathologies such as anxiety, increasing its ratios, and depression. Other syndromes such as burnout and post-traumatic stress disorder have increased with the pandemic, showing a larger incidence among medical personnel. Moreover, eating disorders and violence have also increased. Public authorities must prepare healthcare systems for increasing incidences of mental pathologies. Mental health apps are one of the tools that can be used to reach the general population.

Performance of Fuzzy Multi-Criteria Decision Analysis of Emergency System in COVID-19 Pandemic. An Extensive Narrative Review.

The actual coronavirus disease 2019 (COVID-19) pandemic has led to the limit of emergency systems worldwide, leading to the collapse of health systems, police, first responders, as well as other areas. Various ways of dealing with this world crisis have been proposed from many aspects, with fuzzy multi-criteria decision analysis being a method that can be applied to a wide range of emergency systems and professional groups, aiming to confront several associated issues and challenges. The purpose of this critical review was to discuss the basic principles, present current applications during the first pandemic wave, and propose future implications of this methodology. For this purpose, both primary sources, such as scientific articles, and secondary ones, such as bibliographic indexes, web pages, and databases, were used. The main search engines were PubMed, SciELO, and Google Scholar. The method was a systematic literature review of the available literature regarding the performance of the fuzzy multi-criteria decision analysis of emergency systems in the COVID-19 pandemic. The results of this study highlight the importance of the fuzzy multi-criteria decision analysis method as a beneficial tool for healthcare workers and first responders' emergency professionals to face this pandemic as well as to manage the created uncertainty and its related risks.

Implementación de una guía de práctica clínica para la detección oportuna y el diagnóstico de trastornos de la conducta alimentaria en adolescentes y adultos en el servicio de consulta externa y prioritaria de un hospital mental público de Colombia / Implementation of clinical practice guidelines for the timely detection and diagnosis of eating disorders in adolescents and adults in the outpatient and priority department of a public psychiatric hospital in Colombia

RESUMEN Objetivo: Implementar una guía de práctica clínica para la detección oportuna y el diagnóstico de los trastornos de la conducta alimentaria en adolescentes y adultos en los servicios de consulta prioritaria y consulta externa de un hospital mental público de Barranquilla, Colombia. Se identificaron barreras para el acceso a la guía implementada. Métodos: Para identificar guías de práctica clínica basadas en la evidencia que implementar, se hicieron búsquedas sistemáticas en bases de datos internacionales de organismos desarrolladores o compiladores de guías de práctica clínica y en bases de datos que recogieran literatura científica sobre temas relacionados con trastornos de la conducta alimentaria. Conclusiones: Las dos guías para realizar la selección final por consenso de un equipo multidisciplinario del hospital fueron: «Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders¼ y «Guía de práctica clínica sobre trastornos de la conducta alimentaria de Catalunya¼, que finalmente fue la elegida por consenso. No existe aún para los profesionales de la salud una guía de práctica clínica implementada en el servicio de consulta externa y prioritaria de los hospitales colombianos para los trastornos de la conducta alimentaria.

ABSTRACT Objective: To implement clinical practice guidelines (CPGs) for the timely detection and diagnosis of eating disorders in adolescents and adults in the priority outpatient department of a public psychiatric hospital in Barranquilla, Colombia. Barriers to access to the implemented guidelines were identified. Methods: For the identification of evidence-based CPGs to be implemented, systematic searches were carried out in international databases of development agencies or compilers of clinical practice guidelines, and in databases that contained scientific literature on issues related to eating disorders. Conclusions: The two guidelines shortlisted for the final selection by consensus of a multidisciplinary team at the hospital were the "Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders" and the "Guía de práctica clínica sobre trastornos de la conducta alimentaria de Catalunya", the latter being finally chosen by consensus. There are not yet CPGs implemented for health professionals in the priority outpatient department of Colombian hospitals for eating disorders.

Implementation of clinical practice guidelines for the timely detection and diagnosis of eating disorders in adolescents and adults in the outpatient and priority department of a public psychiatric hospital in Colombia. / Implementación de una guía de práctica clínica para la detección oportuna y el diagnóstico de trastornos de la conducta alimentaria en adolescentes y adultos en el servicio de consulta externa y prioritaria de un hospital mental público de Colombia.

OBJECTIVE: To implement clinical practice guidelines (CPGs) for the timely detection and diagnosis of eating disorders in adolescents and adults in the priority outpatient department of a public psychiatric hospital in Barranquilla, Colombia. Barriers to access to the implemented guidelines were identified. METHODS: For the identification of evidence-based CPGs to be implemented, systematic searches were carried out in international databases of development agencies or compilers of clinical practice guidelines, and in databases that contained scientific literature on issues related to eating disorders. CONCLUSIONS: The two guidelines shortlisted for the final selection by consensus of a multidisciplinary team at the hospital were the "Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders" and the "Guía de práctica clínica sobre trastornos de la conducta alimentaria de Catalunya", the latter being finally chosen by consensus. There are not yet CPGs implemented for health professionals in the priority outpatient department of Colombian hospitals for eating disorders.

Dynamics of Population Immunity Due to the Herd Effect in the COVID-19 Pandemic.

The novel Coronavirus 2 Severe Acute Respiratory Syndrome (SARS-Cov-2) has led to the Coronavirus Disease 2019 (COVID-19) pandemic, which has surprised health authorities around the world, quickly producing a global health crisis. Different actions to cope with this situation are being developed, including confinement, different treatments to improve symptoms, and the creation of the first vaccines. In epidemiology, herd immunity is presented as an area that could also solve this new global threat. In this review, we present the basis of herd immunology, the dynamics of infection transmission that induces specific immunity, and how the application of immunoepidemiology and herd immunology could be used to control the actual COVID-19 pandemic, along with a discussion of its effectiveness, limitations, and applications.

Caracterización epidemiológica de pacientes con malaria, notificados por un asegurador en salud en Colombia, 2016-2017 / Epidemiological characterization of patients with malaria notified by a health insurer in Colombia, 2016-2017

Introducción: La malaria es un problema de salud pública para Colombia, con comportamiento endémico/epidémico y variación entre las diferentes áreas de transmisión. Objetivo: Describir las características epidemiológicas de pacientes con malaria, notificados por un asegurador en salud en Colombia durante los años 2016 y 2017. Métodos: Estudio descriptivo, en el que se revisó de forma retrospectiva la base de datos de todos los casos de malaria notificados por un asegurador en salud en Colombia durante los años 2016 y 2017. Se realizó un análisis descriptivo, teniendo en cuenta la naturaleza de las variables. Las variables cualitativas se analizaron a partir de las frecuencias absolutas y relativas. Se usó el test de chi cuadrado para comparar las diferencias entre proporciones, en todos los casos se estableció un valor p< 0,05 como significativo. Los datos se analizaron en el programa SPSS versión 19. Resultados: Durante el período de observación se notificaron 26 017 casos de malaria; el 50 por ciento (13 014) eran hombres y el 50 por ciento (13 003) mujeres. Los grupos etarios más afectados fueron los adultos jóvenes (26,37 por ciento), escolares (15,04 por ciento), preescolares (12,75 por ciento) y adolescentes iniciales (12,18 por ciento). La mayoría de los pacientes estudiados eran indígenas y mulatos; trabajadores no calificados, que residían y fueron notificados en el departamento del Chocó. En cuanto a las características clínicas y paraclínicas se encontró que el 95,9 por ciento de los pacientes eran sintomático, las especies parasitaria más frecuentemente fueron P. falciparum (58,86 por ciento) y P. vivax (35,95 por ciento) y en menor frecuencia P. malariae (0,06 por ciento). Se registró complicaciones en 410 pacientes, estas eran principalmente de tipo hematológicas (56,3 por ciento); sin embargo, también se registraron complicaciones cerebrales, renales, hepáticas y pulmonares. Durante los dos años se observó brotes epidémicos entre las semanas 6 a la 31, y posteriormente se observó un descenso en la notificación de casos. Conclusiones: Este estudio encontró una marcada diferencia en la incidencia de casos de malaria notificados por el asegurador objeto de estudio entre los años 2016 y 2017; la mayoría de estos casos eran por P. falciparum y se registraron en el departamento de Chocó(AU)

Introduction: Malaria is a health problem in Colombia. Its behavior is endemic / epidemic and variation is observed between the different transmission areas. Objective: Describe the epidemiological characteristics of patients with malaria notified by a health insurer in Colombia during the years 2016 and 2017. Methods: A descriptive study was conducted in which a retrospective review was performed of the database of all the malaria cases notified by a health insurer in Colombia during the years 2016 and 2017. A descriptive analysis was done taking into account the nature of the variables. Qualitative variables were analyzed in terms of absolute and relative frequencies. The chi-square test was used to compare the differences between proportions. A value of p< 0.05 was set as significant in all cases. The software SPPS version 19 was used for data analysis. Results: During the observation period a total 26 017 malaria cases were notified, of whom 50 percent were men (13 014) and 50 percent were women (13 003). The most affected age groups were young adults (26.37 percent), schoolchildren (15.04 percent), pre-schoolers (12.75 percent) and preadolescents (12.18 percent). Most of the patients studied were indigenous and mulatto, unskilled workers, and lived or were notified in the department of Chocó. With respect to clinical and paraclinical characteristics, it was found that 95.9 percent of the patients were symptomatic. The most common parasite species were P. falciparum (58.86 percent) and P. vivax (35.95 percent) and to a lesser degree P. malariae (0.06 percent). Complications were recorded in 410 patients. These were mainly hematological (56.3 percent), but brain, kidney, liver and lung complications were also found. During the two study years, epidemic outbreaks were observed between weeks 6 and 31, followed by a decrease in the number of case notifications. Conclusions: The study found a marked difference in the incidence of malaria cases notified by the study insurer between the years 2016 and 2017. Most of these cases were due to P. falciparum and were recorded in the department of Chocó(AU)