Efficacy and safety of phospholipid nanoparticles (VBI-S) in reversing intractable hypotension in patients with septic shock: a multicentre, open-label, repeated measures, phase 2a clinical pilot trial.

Background: Since the 1990's attempts to favorably modulate nitric oxide (NO) have been unsuccessful. We hypothesized that because NO is lipophilic it would preferentially localize into intravascularly infused hydrophobic nanoparticles, thereby reducing its bioavailability and adverse effects without inhibiting its production. We aimed to determine the efficacy and safety of intravenous infusion of a fluid comprised of hydrophobic phospholipid nanoparticles (VBI-S) that reversibly absorb NO in the treatment of hypotension of patients in severe septic shock. Methods: This is a multicentre, open-label, repeated measures, phase 2a clinical pilot trial done at six hospital centers in the USA. Patients in severe septic shock were enrolled after intravenous fluid therapy had failed to raise mean arterial blood pressure (MAP) to at least the generally accepted level of 65 mmHg, requiring the use of vasopressors. The primary endpoint of this study is the proportion of patients in whom MAP increased by at least 10 mmHg. VBI-S was administered intravenously to patients as boluses of 100 ml, 200 ml, 400 ml, and 800 ml at 999 ml/min until the blood pressure goal was reached after which the infusion was stopped, and the MAP was recorded. All patients who received any volume of VBI-S were included in the primary and safety analysis. The study is registered with ClinicalTrials.gov, NCT04257136. Findings: Between February 17, 2020 and January 3, 2023, 20 eligible patients were enrolled in the study. In all 20 (100%) patients, the goal of increasing MAP by at least 10 mmHg using VBI-S was achieved (p = 0.0087, effect size = 0.654). Mean VBI-S volume required to meet the primary goal was 561.0 ± 372.3 ml. The goal of lowering vasopressor dose was also achieved (p = 0.0017). Within 48 h or less after VBI-S, there was a statistically significant improvement in oxygenation, serum creatinine, clotting variables, procalcitonin, lactic acid, and the sequential organ failure assessment (SOFA) score. At 24 h and 48 h following administration of VBI-S, 12/15 (80%) and 9/12 (75%) patients developed hyperlipidemia, respectively. No severe adverse events of VBI-S were observed, and there were no treatment-related deaths. Interpretation: These preliminary findings suggest the safety and efficacy of VBI-S in treating hypotension in patients with septic shock. However, a definitive mortality benefit cannot be demonstrated without a randomized controlled study. Funding: The Naval Medical Research Command-Naval Advanced Medical Development program via the Medical Technology Enterprise Consortium.

Comparing the efficacy of corticosteroids among patients with community-acquired pneumonia in the ICU versus non-ICU settings: A systematic review and meta-analysis.

BACKGROUND: Despite the potential of corticosteroids in treating community-acquired pneumonia (CAP), conflicting evidence exists regarding their effect on mortality. To address this gap and provide new insights, we conducted a pre-specified subgroup meta-analysis of corticosteroid use in CAP patients, focusing on the ICU versus non-ICU subsets. METHODS: We searched PubMed, Cochrane Central Register of Controlled Trials and SCOPUS from inception to May 2023 for randomized controlled trials (RCTs). The primary outcomes of interest were mortality, need for mechanical ventilation, need for ICU admission, and treatment failure. Secondary outcomes analysed were the need for hospital readmission, length of hospital stay, length of ICU stay, gastrointestinal (GI) bleeding, secondary infections, and hyperglycaemic events. The results were analysed through the random-effects model. A p-value < 0.05 was considered significant. RESULTS: Eighteen randomized controlled trials (n = 4472) analyzing patients withCAP were included. Our results suggest that corticosteroids significantly reduced the incidence of mortality (RR: 0.66; 95 % CI: 0.54, 0.81; P = <0.0001) and need for mechanical ventilation (RR: 0.57; 95 % CI: 0.44, 0.73; P = <0.00001). It was also observed that corticosteroids significantly decrease the lengths of ICU (MD: -1.67; 95 % CI: -2.97, -0.37; P = 0.01) and hospital stay (MD: -1.94; 95 % CI: -2.89, -0.98; P = 0.0001), while increasing the number of hyperglycemic events (RR: 1.68; 95 % CI: 1.32, 2.12; P = <0.0001) and hospital readmissions (RR: 1.19; 95 % CI: 1.04, 1.37; P = 0.01). CONCLUSIONS: The results of this meta-analysis demonstrate that corticosteroids yield improved outcomes in CAP patients with regard to reduced mortality and the need for mechanical ventilation. It highlights the need for further large-scale RCTs with the proposed, specific stratifications.

Retrospective Case Series of Cocaine-Associated Plasma Cell Orificial Mucositis.

Importance: Plasma cell orificial mucositis (PCOM) associated with cocaine use is an emerging, rare condition that has become a concern in Spain in recent years. Limited knowledge exists regarding this novel condition. Objectives: To delineate the clinicopathologic characteristics of this emerging entity and establish a novel approach in the differential diagnosis of cocaine-associated lesions. Design, Setting, and Participants: A descriptive, retrospective, multicenter case series of 10 patients diagnosed with cocaine-associated PCOM was conducted in Spain from April 2020 to March 2023. Main Outcomes and Measures: Patient demographic, clinical, histopathologic, and treatment data were collected. Results: A total of 10 patients (6 [60%] male; median [range] age, 45.5 [36-66] years) presenting with exudative ulcerated plaques were identified for this study. The lesions had raised and erythematous edges over the nostril and a median (range) evolution time of 9 (2-24) months. Septal or palate perforations were observed in 4 (40%) of the patients. Biopsies revealed a dense inflammatory infiltrate of plasma cells in the dermis without atypia and with eosinophils. All patients reported recent cocaine use. Three urine tests detected cocaine but found no presence of amphetamines or opiates. Six patients improved with corticosteroid therapy. Up to 60% of patients were lost to follow-up. Conclusions and Relevance: This case series describes the clinicopathologic characteristics of PCOM, an emerging entity associated with cocaine use in Spain, and demonstrates a novel approach in the differential diagnosis of cocaine-associated lesions. To date, cocaine-associated skin lesions have been reported as neutrophilic dermatoses and vasculitis. The appearance of a plasma cell infiltrate changes what has been described in the medical literature so far. PCOM is a benign condition of unknown cause characterized by a proliferative polyclonal plasma cell infiltrate. A comprehensive differential diagnosis workup is required to reach this exclusionary diagnosis. Several irritants have been documented in cases of PCOM, and a hypersensitivity mechanism has been proposed. Since the initial report of cocaine-associated PCOM in Spain, its incidence has experienced a surge in the country. The cause of this phenomenon may be attributed to newly unidentified adulterants. The administration of corticosteroids and discontinuation of cocaine use are the sole treatments that have demonstrated efficacy. Clinicians should be vigilant regarding this emerging condition and conduct inquiries into cocaine use. Additional research is required to clarify the pathophysiology of this emerging condition.

A portable geometry-independent tomographic system for gamma-ray, a next generation of nuclear waste characterization.

One of the main activities of the nuclear industry is the characterisation of radioactive waste based on the detection of gamma radiation. Large volumes of radioactive waste are classified according to their average activity, but often the radioactivity exceeds the maximum allowed by regulators in specific parts of the bulk. In addition, the detection of the radiation is currently based on static detection systems where the geometry of the bulk is fixed and well known. Furthermore, these systems are not portable and depend on the transport of waste to the places where the detection systems are located. However, there are situations where the geometry varies and where moving waste is complex. This is especially true in compromised situations.We present a new model for nuclear waste management based on a portable and geometry-independent tomographic system for three-dimensional image reconstruction for gamma radiation detection. The system relies on a combination of a gamma radiation camera and a visible camera that allows to visualise radioactivity using augmented reality and artificial computer vision techniques. This novel tomographic system has the potential to be a disruptive innovation in the nuclear industry for nuclear waste management.

Catalytic ammonia reforming: alternative routes to net-zero-carbon hydrogen and fuel.

Ammonia is an energy-dense liquid hydrogen carrier and fuel whose accessible dissociation chemistries offer promising alternatives to hydrogen electrolysis, compression and dispensing at scale. Catalytic ammonia reforming has thus emerged as an area of renewed focus within the ammonia and hydrogen energy research & development communities. However, a majority of studies emphasize the discovery of new catalytic materials and their evaluation under idealized laboratory conditions. This Perspective highlights recent advances in ammonia reforming catalysts and their demonstrations in realistic application scenarios. Key knowledge gaps and technical needs for real reformer devices are emphasized and presented alongside enabling catalyst and reaction engineering fundamentals to spur future investigations into catalytic ammonia reforming.

Impacto de un programa de actividad física musicalizada sobre la aptitud física de ancianas / Impact of musicalized physical activity program on the physical fitness of elderly women

Introducción: El envejecimiento es un proceso natural consecuencia de múltiples factores moleculares y celulares que producen un deterioro de la aptitud física. Objetivo: Determinar el impacto de un programa de actividad física musicalizada en la aptitud física de ancianas colombianas. Métodos: Estudio cuasiexperimental realizado en 49 ancianas de Bucaramanga, Colombia. Se implementó un programa de actividad física musicalizada de 10 semanas. La composición corporal, la capacidad aeróbica y la fuerza de miembros inferiores se determinaron mediante el Índice de Masa Corporal, las pruebas de seis minutos de caminata, y sentarse y levantarse de una silla, respectivamente. Las variables fueron analizadas en medidas de tendencia central o frecuencias según su naturaleza. Para determinar la existencia de una diferencia estadísticamente significativa, se usaron las pruebas t-student y exacta de Fischer. El nivel de significancia fue de p≤0,05. Resultados: Luego de la implementación del programa, se evidenció una disminución de 0,71 kg/m2 en la media de IMC, un aumento de 2,14 en la media de repeticiones en la prueba de resistencia a la fuerza y un incremento de 39,89 en la media de metros alcanzados en la prueba de capacidad aeróbica. Así mismo, aumentó el número de mujeres que pasaron a la categoría funcional en los niveles de fuerza y capacidad aeróbica y el número de mujeres que alcanzaron un peso normal. Las diferencias anteriormente mencionadas fueron estadísticamente significativas. Conclusiones: El programa de actividad física musicalizada mejoró la composición corporal y aumentó los niveles de fuerza muscular y capacidad aeróbica(AU)

Introduction: Aging is a natural process resulting from multiple molecular and cellular factors producing deterioration of physical fitness. Objective: To determine the impact of a musicalized physical activity program on the physical fitness of elderly Colombian women. Methods: A quasi-experimental study carried out in 49 elderly women from Bucaramanga, Colombia. We implemented a 10-week musicalized physical activity program. Body composition, aerobic capacity, and lower limb strength were determined by Body Mass Index, six-minute walk, and chair sitting and standing tests, respectively. The variables were analyzed in measures of central tendency or frequencies according to their nature. To determine the existence of a statistically significant difference, the t-student and Fischer's exact tests were used. The level of significance was p ≤ 0.05. Results: After implementing the program, the mean BMI decreased by 0.71 kg/m2, the mean number of repetitions increased by 2.14 in the strength resistance test and the average reached meters increased by 39 .89 in the aerobic capacity test. Likewise, the number of women who moved into the functional category in strength and aerobic capacity levels and the number of women who reached a normal weight increased. The aforementioned differences were statistically significant. Conclusions: The musicalized physical activity program improved body composition and increased levels of muscle strength and aerobic capacity(AU)

Photonic crystal integrated logic gates and circuits.

This paper presents and demonstrates the three logic processing levels based on complementary photonic crystal logic devices through photonic integrated circuit modeling. We accomplished a set of logic circuits including AND, OR, NAND, NOR, XOR, FAN-OUT, HALF ADDER, and FULL ADDER based on photonic crystal slab platforms. Furthermore, we achieved efficient all-optical logic circuits with contrast ratios as high as 5.5 dB, demonstrated in our simulation results, guaranteeing well-defined output power values for logic representations; a clock-rate up to 2 GHz; and an operating wavelength at λ ≈ 1550 nm. Thus, we can now switch up for high computing abstraction levels to build photonic integrated circuits rather than isolated gates or devices.

COVID 19 and high pregnancy and perinatal complications in Panama.

OBJECTIVES: To report the maternal and neonatal results of patients infected with COVID-19 in Panama. METHODS: The study is based on the analysis of pregnant women with COVID-19, in five hospitals in the Republic of Panama. The inclusion criteria were: patients with or without symptoms, positive RT-PCR for SARS-CoV-2 in the period from March 23 to 6 months after, whose births were attended in one of those five hospitals and who signed the consent. Data were obtained at the time of diagnosis of the infection and at the time of termination of pregnancy for the mother and newborn. RESULTS: Two hundred and fifty-three patients met the inclusion criteria. Most were diagnosed in the third trimester (89.3%). 10.3% of the patients presented in a severe form of COVID-19. The most frequent complication was pre-eclampsia and if we add gestational hypertension they represent 21.2%; most of the patients terminated the pregnancy by cesarean section (58%). 26.9% (95% CI 21.3-32.9%) of the births were premature, and perinatal mortality was 5.4% (95% CI 3.0-9.0%). There was a need for mechanical ventilation in 5.9% (95% CI 3.6-9.6%) of the cohort and there were four maternal deaths (1.6% - 95% CI 0.6-4.0%). CONCLUSIONS: This study of pregnant women infected with COVID-19 and diagnosed with RT-PCR shows serious maternal complications such as high admission to the ICU, need for mechanical ventilation and one death in every 64 infected. Frequent obstetric complications such as hypertension, premature rupture of membranes, high rate of prematurity, and perinatal lethality were also seen.

Rendimiento académico y tiempo de lectura en estudiantes universitarios de cultura física, deporte y recreación / Academic Performance And Reading Time In University Students Of Physical Culture, Sports And Recreation

Introducción: Los universitarios colombianos registran bajos niveles de lectura. Esta problemática es causada en parte por políticas de gobierno inadecuadas para el fomento de la lectura e incide en los resultados de las pruebas Saber Pro. Objetivo: Establecer la asociación entre el rendimiento académico y el tiempo de lectura académica semanal de una muestra de estudiantes universitarios de cultura física, deporte y recreación. Métodos: Estudio transversal analítico realizado en 149 estudiantes matriculados en el periodo 2018-II. Se realizaron análisis descriptivos, bivariados y múltiples usando modelos de regresión logística. Para establecer el tiempo de lectura se aplicó un cuestionario ad hoc. En el caso del rendimiento académico se consultó el promedio de notas acumulado del Sistema Académico de la universidad. Resultados: La mediana de promedio acumulado de calificaciones de los participantes fue de 3,90/5,0, RI: 0,5 (mujeres: 4,15; RI: 0,35; hombres: 3,9; RI: 0,4; p = 0,0038). La mediana de lectura semanal fue de 60 minutos RI: 150 (mujeres: 122,5; RI: 120; hombres: 60, RI: 160; p = 0,0139). Después de ajustar por sexo, edad y nivel socioeconómico, tener un promedio superior a 3,9/5,0 resultó asociado con más minutos de lectura semanal (OR: 1,004, IC 95 por ciento: 1,001 - 1,007, p = 0,007). Conclusiones: Las mujeres registran más tiempo de lectura semanal y mejor promedio académico que los hombres. Los estudiantes que tienen más minutos de lectura semanal tienen mayor probabilidad de tener un promedio acumulado mayor o igual a 3,9 sobre 5,0(AU)

Introduction: Colombian university students show low reading levels. This problem is caused in part by inadequate government policies to promote reading and affects the results of Saber Pro tests. Objective: Establish the association between academic performance and weekly academic reading time of a sample of university students of Physical Culture, Sports and Recreation. Methods: Cross-sectional analytical study conducted in 149 students enrolled in the period 2018-II. Descriptive, bivariate and multiple analyses were performed using logistic regression models. To establish the reading time, an ad hoc questionnaire was applied. In the case of academic performance, the accumulated grades average of the university's Academic System was consulted. Results: The median cumulative grades average of the participants was 3.90/5.0, IR: 0.5 (women: 4.15; RI: 0.35; men: 3.9; RI: 0.4; p = 0.0038). The median weekly reading was 60 minutes RI: 150 (women: 122.5; RI: 120; men: 60, RI: 160; p = 0.0139). After adjusting by sex, age and socioeconomic status, having an average above 3.9/5.0 was associated with more weekly reading minutes (OR: 1.004, 95 percent CI: 1.001 - 1.007, p = 0.007). Conclusions: Women have more weekly reading time and better academic average than men. Students who have more weekly reading minutes are more likely to have a cumulative average greater than or equal to 3.9 out of 5.0(AU)

Prevalencia de factores de riesgo metabólico en estudiantes universitarios latinoamericanos: una revisión sistemática / Prevalence of metabolic risk factors in Latin American college students: A systematic review

RESUMEN Objetivo Describir la prevalencia de factores de riesgo de tipo metabólico en estudiantes universitarios latinoamericanos a través de una revisión sistemática. Metodología Se realizó una revisión sistemática de artículos en las bases de datos electrónicas de SciELO, PubMed y Google Académico. La búsqueda incluyó referencias publicadas a partir del año 2006 en idiomas español, portugués e inglés que describieran prevalencias de los factores de riesgo mencionados en población universitaria latinoamericana. Resultados Un total de 245 referencias fueron recuperadas, de las cuales 60 fueron seleccionados para su análisis. Los estudiantes universitarios en Latinoamérica presentaron una prevalencia de factores de riesgo metabólicos que, en algunos casos, fue similar a la de la media poblacional en general. Conclusiones Es necesario que la comunidad universitaria y los Gobiernos latinoamericanos planteen estrategias que promuevan estilos de vida saludables tendientes a reducir la adquisición de conductas de riesgo durante la vida universitaria.

ASBTRACT Objective To describe the prevalence of metabolic risk factors in Latin American university students through a systematic review. Methodology A systematic review of articles was carried out in electronic databases SciELO, PubMed and Google Scholar. Search included references, published from 2006 in Spanish, Portuguese, and English, that described the prevalence of risk factors in Latin American college population. Results 245 references were retrieved, of which 60 were selected for analysis. University students in Latin America showed a prevalence of metabolic risk factors that, in some cases, was like that of the population average. Conclusions The university community and Latin American governments must propose strategies to promote healthy lifestyles aimed at reducing the acquisition of risky behaviours during university life.

Cirugía de la anquilosis temporomandibular en pacientes pediátricos / Temporo mandibular joint ankylosis surgery in pediatric patients

Introducción: la anquilosis temporomandibular se caracteriza por la limitación en la apertura bucal, lo que conlleva alteraciones estéticas, de la masticación, el lenguaje y respiratorias. El objetivo del reporte es describir las características clínicas de los pacientes y evaluar resultados del tratamiento quirúrgico para la anquilosis temporomandibular. Materiales y métodos: presentamos un estudio observacional, descriptivo y retrospectivo en el que se revisaron las historias clínicas e imágenes de todos los pacientes operados de anquilosis de la articulación temporomandibular desde enero 2008 a diciembre de 2016. Resultados: se intervinieron 44 casos, cuya etiología principal eran los traumatismos (70,5 %), con predominio femenino en el 77,3 % de los casos y la presentación unilateral como la más frecuente con el 70,5 % del total. La edad de mayor frecuencia de presentación fue entre 6 a 10 años con el 47,7 % de los casos. La cirugía más realizada fue la condilectomía con coronoidectomía en el 79,5 % de los casos. Como complicación más frecuente se encontró la parálisis de la rama palpebral en el 13,7 %, y obteniendo un 6 % de recidiva. Discusión: los resultados presentados son similares a otras publicaciones, ya que se reprodujo el tratamiento protocolizado mundialmente y no se encontraron diferencias significativas en cuanto a etiología, edad, tratamiento realizado y complicaciones. Conclusiones: la anquilosis temporomandibular es una patología que requiere de un tratamiento quirúrgico que logre la resección del bloque anquilótico, así como la asociación de otras técnicas quirúrgicas como la realización de un colgajo para disminuir la posibilidad de recidiva y distracción ósea para restablecer la anatomía mandibular.

Introduction: Temporomandibular ankylosis limits the mandibular function, decreasing the buccal opening, with aesthetic alterations as well as chewing language and even respiratory disfunction. Objective: To describe the patients clinical paticularities and evaluate the surgical treatment results for this pathology. Design: Observacional, descriptive and retrospective study. Methods: We reviewed the medical histories and images of all the patients who underwent temporomandibular ankylosis release from January 2008 to December 2016. Results: It involved 44 cases, being the main etiology injuries in a 70.5%, with predominance of the female sex in the 77.3% and the unilateral presentation with the 70.5% of the cases. Ages between 6 to 10 years were the most frequent ones with 47.7%. The surgery most performed was the condilectomia with coronoidectomy in 79.5% of the cases. The most frequent complication was the palpebral branch paralysis in 13.7% and we had a 6% of ankylosis recurrence. Discussion: Our results are similar to other publications when reproducing the worldwide protocolized treatment, without finding significant differences in terms of etiology, age of presentation, treatment carried out and complications. Conclusions: Temporomandibular ankylosis is a condition that requires surgical treatment, which is aimed to anatomical and functional restoration. Wide bone resection complemented with other surgical techniques such as flap interposition to minimize the relapse possibility and bone distraction to restore the mandibular anatomy.

Complementary photonic crystal integrated logic devices.

We theoretically propose and demonstrate through numerous simulations complementary photonic crystal integrated logic (CPCL) devices. Simulation results provide demonstration of a highly efficient clock rate, higher than 20 GHz, guaranteeing operation at both input and output with the same wavelength (around λ=1550nm). The proposed devices show well-defined output power values representing the two logic states 1 and 0, with a contrast ratio as high as 6 dB. The results presented here provide countless possibilities for future research, targeting the development of photonic crystal logic and communications systems with CPCLs acting as the core hardware devices.

Nivel académico y aplicación de parámetros de seguridad en programas de ejercicio físico en ancianos / Academic background and application of safety parameters in physical exercise programs for the elderly

Introducción: El conocimiento idóneo en ciencias del ejercicio físico de los instructores de los programas ejercicio físico comunitario es importante para garantizar la seguridad y calidad de los programas para adultos mayores. Objetivo: Analizar el nivel de formación de los instructores y la frecuencia de aplicación de dos parámetros de seguridad para la implementación de programas de ejercicio físico para el adulto mayor. Métodos: Estudio transversal, analítico, realizado con 115 instructores de grupos de adultos mayores de Bucaramanga, Colombia. Para la recolección de la información se utilizó un cuestionario ad hoc. Las variables se analizaron en medidas de tendencia central o frecuencias según su naturaleza. Se utilizó la prueba exacta de Fischer para explorar la asociación entre las variables de interés. El nivel de significancia fue de p ≤ 0,05. Resultados: El 18,22 por ciento de los instructores encuestados posee titulación en Ciencias del Ejercicio Físico. Se encontró una mayor frecuencia de aplicación de método de selección de aptitud para la realización de actividad física, con diferencias estadísticamente significativas, en los sujetos titulados (p = 0,032) y en aquellos que recibieron capacitación formal en ejercicio físico en el adulto mayor (p = 0,002). Los sujetos titulados exigieron con mayor frecuencia una valoración médica (p=0,036). Conclusiones: La mayoría de los instructores reportaron no aplicar los parámetros de seguridad para la implementación de un programa de ejercicio físico. Sin embargo, hubo una mayor frecuencia de aplicación en instructores titulados y en aquellos con capacitación formal en ejercicio físico para el adulto mayor(AU)

Introduction: Suitable knowledge about physical culture sciences by community exercise instructors is important to ensure the safety and quality of programs for the elderly. Objective: Analyze the academic background of instructors and the frequency of application of two safety parameters in the implementation of physical exercise programs for the elderly. Methods: An analytical cross-sectional study was conducted of 155 instructors of groups of elderly people in Bucaramanga, Colombia. An ad hoc questionnaire was used to collect the information. The variables were analyzed as measures of central tendency or frequencies, depending on their nature. Fisher's exact test was used to explore the association between the variables of interest. The significance level was p ≤ 0.05. Results: Of the instructors surveyed, 18.22 percent had a degree in Physical Exercise Sciences. A higher frequency was found of the application of the selection method based on aptitude to conduct physical activity, with statistically significant differences between graduated subjects (p = 0.032) and those who had received formal training in physical exercise for the elderly (p = 0.002). Medical assessment was more often requested by graduated subjects (p=0.036). Conclusions: Most instructors reported not to apply the safety parameters for implementation of a physical exercise program. However, application was more frequent by graduated instructors and those with formal training in physical exercise for the elderly(AU)

COVID-19 y embarazo. Revisión y actualización / COVID-19 and pregnancy. Review and update / COVID-19 and pregnancy. Review and update

RESUMEN Objetivo . Buscar toda la información y evidencia disponible sobre el SARS-CoV-2 -que surgió en estos primeros 4 meses de 2020y el embarazo. Metodología . Revisión sistemática en las bases de datos PubMed y Google Scholar, hasta el 25 de abril de 2020. Se buscó artículos publicados relacionados con mujeres embarazadas infectadas con SARS-CoV-2. No hubo restricción de idioma. La búsqueda se extendió a las referencias de los artículos encontrados. Resultados . La enfermedad COVID-19 en mujeres embarazadas se caracteriza porque más del 90% de las pacientes evoluciona en forma leve, 2% requiere ingresar a las unidades de cuidados intensivos. Una muerte materna ha sido reportada. La prematuridad es alrededor de 25%, con predominio de recién nacidos prematuros tardíos; aproximadamente el 9% se complica con rotura prematura de membranas; la mortalidad perinatal es baja o similar a la de la población general y no se ha demostrado la transmisión vertical. Conclusiones . Los ginecólogos obstetras deben prepararse para atender cada vez más casos con COVID-19 y, por lo tanto, es necesario tener su conocimiento. La enfermedad evoluciona de la misma manera que en las no embarazadas, genera mayor prematuridad, no se ha demostrado la transmisión vertical, pero hay altas posibilidades de transmisión horizontal durante el parto vaginal.

ABSTRACT Objective : To search for all the information and available evidence on infection with SARS-CoV-2, a virus that appeared during the first 4 months of 2020, and pregnancy. Methods : Systematic review in PubMed and Google Scholar databases until April 25, 2020. We searched for published articles related to pregnant women infected with SARS-CoV-2. There was no language restriction. The search was extended to the references of the articles found. Results : In pregnant women with COVID-19, more than 90% of patients evolve mildly, 2% require intensive care. One maternal death has been reported. Prematurity occurs in approximately 25% of the cases, with predominance of late preterm infants; premature rupture of membranes presents in about 9%. Perinatal mortality is lower or similar to that of the general population, and vertical transmission has not been shown. Conclusions : Obstetrician-gynecologists must prepare to attend more cases with COVID-19 and therefore they need to know this disease. COVID-19 progresses similarly in pregnant and non-pregnant women, although it is associated to prematurity. While vertical transmission has not been demonstrated, horizontal transmission during vaginal birth is very likely.

Actividad física, composición corporal y capacidad músculo-esquelética en adolescentes escolarizados de Floridablanca, Colombia / Physical activity, body composition and musculoskeletal capacity of teenage students from Floridablanca, Colombia

Introducción: La inactividad física es un factor de riesgo comportamental asociado a enfermedades crónicas no transmisibles. La composición corporal y la capacidad músculo-esquelética son componentes de la aptitud física orientada a la salud. Objetivo: Determinar la correlación entre la composición corporal y la capacidad músculo-esquelética de la población de estudio. Métodos: Estudio correlacional realizado en 102 estudiantes adolescentes. Las variables se analizaron en medidas de tendencia central o frecuencias según su naturaleza. Se utilizó la prueba T de Student y exacta de Fischer para establecer diferencias estadísticamente significativas entre las variables continúas y categóricas respectivamente. Se calculó coeficiente de Pearson para establecer una posible correlación en las variables de interés. El nivel de significancia fue de p ≤ 0,05. Resultados: El 76,47 por ciento de los participantes no cumple con las recomendaciones de actividad física para la salud. El 16,66 por ciento de los estudiantes presentan sobrepeso/obesidad y el 26,47 por ciento presenta un porcentaje de grasa en riesgo para la salud. El 48,08 por ciento de los adolescentes presentan niveles de fuerza resistencia saludables. Se determinó una correlación negativa entre el porcentaje de grasa y la fuerza explosiva del tren inferior (p = 0,0000), y la fuerza resistencia del tren superior (p = 0,0000) Conclusiones: La mayoría de los estudiantes son físicamente inactivos, un poco más de la cuarta parte y la mitad de la población de estudio presenta un porcentaje de grasa y niveles de fuerza resistencia del tren superior poco saludables. Se estableció una correlación negativa entre el porcentaje de grasa y los niveles de fuerza de los participantes(AU)

Introduction: Physical inactivity is a behavioral risk factor for chronic non-communicable diseases. Body composition and musculoskeletal capacity are component parts of a health-oriented physical condition. Objective: Determine the correlation between body composition and musculoskeletal capacity in the study population. Methods: A correlational study was conducted of 102 teenage students. Variables were analyzed as measures of central tendency or frequencies, depending on their nature. Student's t-test and Fischer's exact test were used to establish statistically significant differences between continuous and categorical variables, respectively. Pearson's coefficient was estimated to establish a possible correlation in the variables of interest. The significance level was p ≤ 0.05. Results: Of the total participants 76.47 percent do not comply with the recommendations about physical activity for health. 16.66 percent of the students are overweight / obese and 26.47 percent have a health-risky fat percentage. 48.08 percent of the teenagers display healthy resistance strength levels. A negative correlation was determined between fat percentage and explosive strength of the lower body (p = 0.0000) and resistance strength of the upper body (p = 0.0000). Conclusions: Most of the students are physically inactive. A bit over one fourth and half the study population have unhealthy fat percentages and upper body resistance strength levels. A negative correlation was established between the fat percentage and the strength levels of participants(AU)

Estudio correlacional sobre la actividad física y conducta sedentaria en senderistas de Bucaramanga, Colombia / Correlational Study about Physical Activity and Sedentary Behaviour in Hikers from Bucaramanga, Colombia

Introducción: La inactividad física es un factor de riesgo comportamental que se define como la realización de menos de 150 minutos de actividad física a la semana de intensidad moderada, por otra parte, la conducta sedentaria hace referencia al tiempo que se permanece sentado o acostado en reposo. Objetivo: Determinar la correlación existente entre los niveles de actividad física, en cada uno de los dominios, y la conducta sedentaria de los senderistas de Bucaramanga, y área metropolitana. Métodos: Estudio correlacional realizado en 170 senderistas de Bucaramanga y área metropolitana. Las variables se analizaron en medidas de tendencia central o frecuencias según su naturaleza. Se utilizó la prueba U de Mann-Whitney para establecer diferencias estadísticamente significativas entre las variables categorías y continúas de interés. Se calculó coeficiente de Pearson para establecer una posible correlación en las variables de interés. El nivel de significancia fue de p ≤ 0,05. Resultados: Se registró una prevalencia nula de inactividad física en la población de estudio. No se encontraron diferencias estadísticamente significativas al analizar las medianas de actividad física en cada uno de los dominios según sexo. El dominio de mayor realización de actividad física fue el del tiempo libre. Se estableció una correlación negativa entre la conducta sedentaria y la cantidad de actividad física y el gasto energético semanal. Conclusiones: La totalidad de los senderistas encuestados son físicamente activos y cumplen ampliamente con las recomendaciones de actividad física para la salud de la OMS, además de registrar bajos niveles de conducta sedentaria. Se determinó una correlación negativa entre la conducta sedentaria y la cantidad de actividad física y el gasto energético semanal(AU)

Introduction: physical inactivity is a behavioral risk factor that is defined as the realization of less than 150 moderate intensity physical activity per week, oh the other hand, sedentary behavior has to do with the time a person spend sitting or lying down. The objective of this study was to determine if there is a correlation between physical activity levels, in each domain, and the sedentary behavior of hikers from Bucaramanga, and its metropolitan area. Methods: correlational study carried out in 170 hikers from Bucaramanga and its metropolitan area. Variables were analyzed using central tendencies measures or frequencies according to its nature. U - Mann-Whitney test was utilized to establish differences statistically significant between categorical and continuous variables of interest. Pearson coefficient was calculated to establish a possible correlation between variables of interest. Significant level was of p ≤ 0.05 Results: a non-existent prevalence of physical inactivity was registered in hikers. No differences statistically significant were found when analyzing physical activity medians in each domain according to sex. Free time was the domain in which participants reported more physical activity. A negative correlation was established between sedentary behavior and the quantity of physical activity and weekly energy expenditure. Conclusions: All hikers interviewed are physically active and widely fulfill WHO recommendations on physical activity for health, besides, participants reported low levels of sedentary behavior. A negative correlation was stablished between sedentary behavior and the quantity of physical activity and weekly energy expenditure(AU)

Composición corporal en senderistas de Bucaramanga y área metropolitana, Colombia / Body composition of hikers from Bucaramanga and its metropolitan area in Colombia

Introducción: El senderismo es un tipo de actividad física en la naturaleza que consiste en recorrer senderos señalizados. Una composición corporal poco saludable es considerada por la Organización Mundial de la Salud como un factor de riesgo biológico asociado a enfermedades no transmisibles. Objetivo: Determinar la composición corporal en senderistas de Bucaramanga y área metropolitana. Métodos: Se realizó un estudio transversal analítico en 133 senderistas con una edad promedio de 51,28 años. Se determinó la composición corporal a través del Índice de Masa Corporal, el porcentaje de grasa y la circunferencia de la cintura. Las variables se analizaron en medidas de tendencia central o frecuencias según su naturaleza. Para establecer diferencias estadísticamente significativas se utilizaron la prueba exacta de Fischer y t-student el nivel de significancia fue de p < 0,05. Resultados: La mediana de años de práctica del senderismo fue de 4 años. El 93,23 por ciento de los participantes practica el senderismo con frecuencia semanal. EL 52,63 por ciento de los participantes presenta sobrepeso/obesidad. El 33,08 por ciento presenta obesidad abdominal y el 31,58 por ciento de los senderistas registra obesidad con relación al porcentaje de grasa. Al analizar por género no se encontraron diferencias estadísticamente significativas. Conclusiones: Los senderistas presentan niveles de sobrepeso-obesidad, obesidad central y obesidad por porcentaje de grasa similares a los de la población en general. Se recomienda la implementación de un programa de educación nutricional. Se sugiere para próximos trabajos de investigación profundizar en los demás componentes de la condición física orientada a la salud y factores de riesgo biológicos(AU)

In the World Health Organization, less-than-healthy body composition is a biological risk factor for non-communicable diseases. Objective: Determine the body composition of hikers from Bucaramanga and its metropolitan area. Methods: An analytical cross-sectional study was conducted of 133 hikers, mean age 51.28 years. Body composition was determined by body mass index, fat percentage and waist circumference. Variables were analyzed as measures of central tendencies or frequencies, depending on their nature. Statistically significant differences were established by Fisher's exact test and Student's t-test, with a significance level of p < 0.05. Results: Mean time of hiking practice was 4 years. Of the total participants, 93.23 percent practice hiking with a weekly frequency, 52.63 percent are overweight / obese, 33.08 percenthave abdominal obesity, and 31.58 percent are obese in terms of fat percentage. No statistically significant differences were found between the sexes. Conclusions: Levels of overweight / obesity, central obesity, and fat percentage obesity among hikers are similar to those of the general population. It is recommended to implement a nutrition education program. It is suggested that future research approaches the remaining components of physical condition in the light of health and biological risk factors(AU)

Assessment of Prevention Research Measuring Leading Risk Factors and Causes of Mortality and Disability Supported by the US National Institutes of Health.

Importance: No studies to date have examined support by the National Institutes of Health (NIH) for primary and secondary prevention research in humans and related methods research that measures the leading risk factors or causes of death or disability as outcomes or exposures. Objective: To characterize NIH support for such research. Design and Setting: This serial cross-sectional study randomly sampled NIH grants and cooperative agreements funded during fiscal years 2012 through 2017. For awards with multiple subprojects, each was treated as a separate project. Study characteristics, outcomes, and exposures were coded from October 2015 through February 2019. Analyses weighted to reflect the sampling scheme were completed in March through June 2019. Using 2017 data from the Centers for Disease Control and Prevention and 2016 data from the Global Burden of Disease project, the leading risk factors and causes of death and disability in the United States were identified. Main Outcomes and Measures: The main outcome was the percentage of the NIH prevention research portfolio measuring a leading risk factor or cause of death or disability as an outcome or exposure. Results: A total of 11 082 research projects were coded. Only 25.9% (95% CI, 24.0%-27.8%) of prevention research projects measured a leading cause of death as an outcome or exposure, although these leading causes were associated with 74.0% of US mortality. Only 34.0% (95% CI, 32.2%-35.9%) measured a leading risk factor for death, although these risk factors were associated with 57.3% of mortality. Only 31.4% (95% CI, 29.6%-33.3%) measured a leading risk factor for disability-adjusted life-years lost, although these risk factors were associated with 42.1% of disability-adjusted life-years lost. Relatively few projects included a randomized clinical trial (24.6%; 95% CI, 22.5%-26.9%) or involved more than 1 leading cause (3.3%; 95% CI, 2.6%-4.1%) or risk factor (8.8%; 95% CI, 7.9%-9.8%). Conclusions and Relevance: In this cross-sectional study, the leading risk factors and causes of death and disability were underrepresented in the NIH prevention research portfolio relative to their burden. Because so much is already known about these risk factors and causes, and because randomized interventions play such a vital role in the development of clinical and public health guidelines, it appears that greater attention should be given to develop and test interventions that address these risk factors and causes, addressing multiple risk factors or causes when possible.

Tratamiento quirúrgico del angiofibroma nasofaríngeo juvenil en pacientes pediátricos / Juvenile nasopharyngeal angiofibroma surgical treatment in paediatric patients

Introducción y objetivos: El nasoangiofibroma juvenil es una neoplasia benigna sumamente vascularizada de tratamiento complejo, tanto en su preparación quirúrgica como en la cirugía a realizar, los riesgos y las recurrencias. El objetivo es analizar el manejo y tratamiento quirúrgico para el nasoangiofibroma juvenil. Materiales y métodos: Se revisaron las historias clínicas e imágenes de los pacientes intervenidos por la especialidad de cirugía de cabeza, cuello y maxilofacial con resultado de proceso patológico compatible con nasoangiofibroma juvenil, en el periodo comprendido entre enero de 2008 a diciembre de 2016. Resultados: Se intervinieron 61 casos, todos ellos tratados con el mismo acceso quirúrgico por medio de una osteotomía Le Fort I. La totalidad de los pacientes fue de sexo masculino, con un promedio de edad de 13,3 años. Se utilizó la clasificación de Andrew-Fish para la estadificación de los casos, obteniendo los grados ii y i la mayor cantidad de casos. Conclusiones: El abordaje descrito provee un acceso quirúrgico extenso, el cual es adecuado para los diferentes estadios de la tumoración. Requiere de experiencia para poder llevar a cabo la resección de la tumoración con el menor sangrado posible

Introduction and objectives: The juvenile nasopharyngeal angiofibroma is a highly vascularised benign neoplasm of complex treatment in its surgical preparation, surgery to be performed, risks and recurrences. The aim of the study was to analyze the management and surgical treatment for the pathology of juvenile nasoangiofibroma. Materials and methods: We reviewed the clinical histories and images of the patients who underwent surgery with a pathology result of juvenile nasoangiofibroma in the period from January 2008 to December 2016. Results: Sixty-one cases were treated; all of them treated using the same surgical access by means of a Le Fort I osteotomy. All of the patients were male, with an average age of 13.3 years. The Andrew-Fish classification was used for staging the cases, most were staged as grade II and I. Conclusions: The described approach provided extensive surgical access, which was adequate for the different stages of the tumour. It requires experience to be able to resect the tumour with the least possible bleeding