Título del artículo:

Characterization of the disability in a sample of children with Cerebral Palsy from Bucaramanga and its metropolitan area, Colombia

Background: The occurrence of CP in industrialized countries ranges from 2 to 2.5 cases for every 1,000 live births, the prevalence of low birth weight, maternal conditions, obstetric and inbreeding have been decisive. This condition leads to limitations and restrictions in different roles an individual can play in society which can be facilitated or inhibited according to the different factors of the context in which it operates, therefore the condition of physical harm has to a disability. Objective. To determine the sociodemographic, neonatal history, disability status and level of gross motor function in children with cerebral palsy 2-12 years of Bucaramanga and its metropolitan area. Material and methods. We performed a cross-sectional study with a sample of 60 participants selected for convenience. The level of gross motor function was assessed using the classification system of the gross motor function (GMFCS). The analysis calculated absolute and relative frequencies. Results. The largest age group was between 6 and 12 years 61.6%, 50% were female and the majority belonged to the socioeconomic stratum 2 (43.3%), representing the lower class stratification as in Colombia; 56, 7% of children lived with both parents, found that 55% of households had >1 y <2 Current legal minimum monthly wage and the health system was the most common tax (65%). According to the classification with GMFCS, we found that 38.3% of children were at level V, 25.0% in Level I, Level IV 16.7%, 13.3% in level III and level II 6.7%. Body structures most affected were the central nervous system with 78.3%, followed by deficiencies in the structures for movement (upper and lower limbs) with 20.0%. Conclusion. It is found that the severity of gross motor function is directly related to functional abilities, the need for elements of support and caregiver.

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Revista Facultad de Medicina

Título del artículo:

Association between obesity and low muscular and cardiorespiratory capacity, cardiometabolic risk factors in Colombian children

Objective: To examine the association between cardio respiratory and muscular fitness and the presence of obesity and other cardiovascular and metabolic risk factors in school children. Material and method: Cross-sectional study, conducted in 336 school children (boys and girls) in grade 5° and 6° of public schools in the city of Bucaramanga, Colombia. Results: Significant inverse correlations were found between body mass index (BMI) and grip strength adjusted for weight (-0532) (P <0.001), long jump (-0248) (P <0.001) and Yo-Yo test (-0.321) (P <0.001). The maximum grip strength was correlated inversely with systolic blood pressure (SBP) (-0115) (p <0.05). Conclusion: Obesity assessed by BMI and body fat percent is inversely related with muscular and cardio respiratory fitness in Colombian school children.

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Trauma (Spain)

Título del artículo:

Primary esophageal meningioma: First literature report

We have described a primary esophageal meningioma (MG) clinical case diagnosed in a 62-year-old woman; also, we review the literature about extracranial MGs. To our knowledge, this is the first case report of an extracranial MG occurring primarily in the esophagus. These are benign neoplasms reported classically in the central nervous system (CNS). The extrancranial MGs have histopathologic and inmunohistochemical features identical to those observed in CNS MGs; thus, the main diagnostic hurdle is to keep it in the differential for lesions occurring outside the CNS. © 2013 Lippincott Williams & Wilkins.

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Journal of Clinical Gastroenterology

Título del artículo:

Serological and molecular markers for Hepatitis B virus in university students

Introduction: Reports from the World Health Organization (WHO) show that the prevalence of hepatitis B virus (HBV) infections varies by geographical region and risk group. Purpose: The purpose of this study was to determine the prevalence of HBV infections, as well as the vaccination status, among university students from Bucaramanga. Methodology: This was a cross sectional study conducted in 2010 which included 1298 students from five universities. Serological markers for HBV infection were detected using ELISA. Viral genomes were detected with nested polymerase chain reaction (PCR). Results: Active infections were established in 0.15% of the study population, and this finding was confirmed by PCR. Resolved infections were identified in 0.60% of the population. Isolated anti-HBc antibodies were found, 30.2% of vaccinated individuals. 67.9% of the study population was susceptible. No occult HBV was detected. Conclusions: The low prevalence of HBV infections reported in this study contrasts with the intermediate epidemiological pattern described in the region. We found poor vaccination coverage and absence of occult hepatitis B among these university students. © 2012 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología.

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Revista Colombiana de Gastroenterologia

Título del artículo:

Environmental Profile of a Community\'s Health (EPOCH): An Ecometric Assessment of Measures of the Community Environment Based on Individual Perception

Background: Public health research has turned towards examining upstream, community-level determinants of cardiovascular disease risk factors. Objective measures of the environment, such as those derived from direct observation, and perception-based measures by residents have both been associated with health behaviours. However, current methods are generally limited to objective measures, often derived from administrative data, and few instruments have been evaluated for use in rural areas or in low-income countries. We evaluate the reliability of a quantitative tool designed to capture perceptions of community tobacco, nutrition, and social environments obtained from interviews with residents in communities in 5 countries. Methodology/ Principal Findings: Thirteen measures of the community environment were developed from responses to questionnaire items from 2,360 individuals residing in 84 urban and rural communities in 5 countries (China, India, Brazil, Colombia, and Canada) in the Environmental Profile of a Community\'s Health (EPOCH) study. Reliability and other properties of the community-level measures were assessed using multilevel models. High reliability (>0.80) was demonstrated for all community-level measures at the mean number of survey respondents per community (n = 28 respondents). Questionnaire items included in each scale were found to represent a common latent factor at the community level in multilevel factor analysis models. Conclusions/ Significance: Reliable measures which represent aspects of communities potentially related to cardiovascular disease (CVD)/risk factors can be obtained using feasible sample sizes. The EPOCH instrument is suitable for use in different settings to explore upstream determinants of CVD/risk factors. © 2012 Corsi et al.

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PLoS ONE

Título del artículo:

Risk factors for preeclampsia in women from Colombia: A case-control study

Background: Preeclampsia (PE) is a multi-causal disease characterized by the development of hypertension and proteinuria in the second half of pregnancy. Multiple risk factors have been associated with the development of PE. Moreover, it is known that these risk factors vary between populations from developed and developing countries. The aim of this study is to identify which risk factors are associated with the development of preeclampsia (PE) among Colombian women. Methods: A multi-centre case-control study was conducted between September 2006 and July 2009 in six Colombian cities. Cases included women with PE (n = 201); controls were aged-matched pregnant women (n = 201) without cardiovascular or endocrine diseases for a case-control ratio of 1:1. A complete medical chart, physical examination and biochemical analysis were completed before delivery. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) of potential risk factors associated with PE. Results: The presence of factors present in the metabolic syndrome cluster such as body mass index >31 Kg/m2 (OR = 2.18; 1.14-4.14 95% CI), high-density lipoprotein <1.24 mmol/L (OR = 2.42; 1.53-3.84 95% CI), triglycerides >3.24 mmol/L (OR = 1.60; 1.04-2.48 95% CI) and glycemia >4.9 mmol/L (OR = 2.66; 1.47-4.81 95%CI) as well as being primigravidae (OR = 1.71; 1.07-2.73 95% CI) were associated with the development of PE, after adjusting for other variables. Conclusion: Factors present in the cluster of metabolic syndrome and primigravidity were associated with a greater risk of PE among Colombian women. Understanding the role of this cluster of risk factors in the development of PE is of crucial importance to prevent PE and remains to be determined. © 2012 Reyes et al.

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PLoS ONE

Título del artículo:

Angiogenic imbalance and plasma lipid alterations in women with preeclampsia from a developing country

Background: An imbalance between anti-angiogenic factors (e.g. soluble vascular endothelial growth factor receptor-1 (s-FLT1) and soluble endoglin (s-Eng)) and pro-angiogenic factors (e.g. placental growth factor (PlGF)) as well as increased oxidized low-density lipoprotein (ox-LDL) concentrations have been associated with preeclampsia (PE). Risk factors associated with the development of PE, however, are known to be different between developed and developing countries. The aim of the study was to determine the levels of s-FLT1, s-Eng, PIGF, and ox-LDL in women with PE from a developing country. Methods: A multi-center casecontrol study was conducted. One hundred and forty three women with PE were matched by age and parity with 143 healthy pregnant women without cardiovascular or endocrine diseases. Before delivery, blood samples were taken and serum was stored until analysis. Results: Women with PE had lower concentrations of PIGF (p < 0.0001) and higher concentrations of s-Eng (p = 0.001) than healthy pregnant women. There were no differences between the groups regarding ox-LDL or s-FLT1. Women with early onset PE had higher s-FLT1 concentrations (p = 0.0004) and lower PIGF concentrations (p < 0.0001) than their healthy pregnant controls. Women with late onset PE had higher concentrations of s-Eng (p = 0.005). Women with severe PE had higher concentrations of s-Eng (p = 0.0008) and ox-LDL (p = 0.01), and lower concentrations of PIGF (p < 0.0001). Conclusions: Women with PE from a developing country demonstrated an angiogenic imbalance and an increased rate of LDL oxidation. Findings from this study support the theory that PE is a multifactorial disease, and understanding differences in these subpopulations may provide a better target to approach future therapies. © 2012 Informa UK, Ltd.

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Growth Factors

Título del artículo:

Is the angioimmunoblastic T-Cell lymphoma beneficial to avoid CD4 ⁺ lymphopenia and other AIDS manifestations in patients infected with human immunodeficiency virus?

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Clinical Lymphoma, Myeloma and Leukemia

Título del artículo:

Nutritional status among women with pre-eclampsia and healthy pregnant and non-pregnant women in a Latin American country

Aims: Pre-eclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. It has been proposed that, among other risk factors, the nutritional status of women can lead to the endothelial dysfunction that characterizes this entity. The aim of the present study was to compare the nutritional status of women with PE with healthy pregnant and non-pregnant women. Material and Methods: A multicenter case-control study was carried out. Between September 2006 and July 2009, 201 women with PE were compared with 201 pregnant, and 201 non-pregnant aged-matched women without cardiovascular or endocrine diseases. A clinical history and physical examination was performed. Fasting blood samples were drawn to measure serum glucose and lipid profile. The nutritional status of participants was assessed using a food frequency questionnaire. Results: The average age of womenwas 26.6 ± 7.2 years. Compared to healthy pregnant controls, women with PE had a higher body mass index, higher fasting blood glucose levels, higher triglycerides, and lower high-density lipoprotein cholesterol levels. Women with PE had a higher intake of carbohydrates, energy intake and cereal compared to healthy pregnant and non-pregnant controls. A conditional logistic regression demonstrated that carbohydrate and sodium intake are associated with PE development. Conclusions: Diets of women with PE were characterized by higher energy and carbohydrate intake compared to normal pregnant and non-pregnant women. This suggests that higher carbohydrate and sodium intake increases the risk of PE among women in Colombia. © 2012 Japan Society of Obstetrics and Gynecology.

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Journal of Obstetrics and Gynaecology Research

Título del artículo:

Complex choristoma of the lacrimal caruncle: A case report of an unusual congenital tumor with clinical and histopathological classification

Rare congenital tumors can be localized in the peribulbar area. Here we report an unusual case presented in a 3-year-old child with a history of a congenital tumor in the lacrimal caruncle of the right eye, associated with epiphora and constant discomfort. A surgical resection was performed, and the final histopathological diagnosis was lacrimal caruncle complex choristoma. Choristomas are growths of apparently normal tissue in an abnormal location, which can be situated anywhere in the body, including ocular and peribulbar structures. These almost unknown congenital tumors constitute the most common conjunctival tumors in children and can be interpreted clinically as different lesions, which are only differentiated through precise histopathological analysis. © 2012 Springer Science+Business Media B.V.

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International Ophthalmology

Título del artículo:

Integral Care Guidelines for the prevention, early detection and treatment of pregnancy, partum and puerperium complications: Section on toxoplasmosis in pregnancy

Toxoplasma infection was selected for the development of recommendations for its prevention, diagnosis and therapy as a part of the clinical practice guideline for the prevention, early detection and treatment of the complications of pregnancy, developed y sponsored by the Department of Science, Technology and Innovation, Colciencias and Health and Social Protection Ministry of Health in Colombia. Infection by Toxoplasma gondii that occurs during pregnancy may end up in serious complications for the fetus and important sequelae for the newborn. A clinical guideline based on the best available scientific evidence, with emphasis on Colombian references, was performed. Experts on parasitology, neonatology and infectious diseases (adult and pediatric) developed the recommendations. Recommendations are proposed to be followed by healthcare professionals in pregnancy care programs all around the country, with the aim of lowering the morbidity and mortality related to this disease. Specific recommendations for the diagnosis starting in first trimester of the pregnancy, recommendations for prevention in women not infected with the parasite, identification of infection in the fetus or the newborn and recommendations for treatment in those settings are done. © 2012 ACIN.

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Infectio

Título del artículo:

The influence of cardiac rehabilitation on acute myocardial infarction patients\' readmission rate in Santander, Colombia

Objective Estimating the effect of post-infarction cardiac rehabilitation (CR) on readmission/re-hospitalization rates according to intervention level. Method This was a prospective cohort study of patients diagnosed as suffering acute myocardial infarction (AMI). Data concerning infarction severity, previous illness, medical history, hospital course, Killip classification, length of hospital stay and condition on discharge. Medical records and telephone contact were used to confirm whether a patient had received CR and ascertain pertinent components. Follow-up was extended to one year. Results 96 AMI patients of both genders were included; information about CR was available for 72 of them,5 of whom had received CR based only on physical activity. 49 patients received complete CR based on education, physical activity, psychological and nutritional assessment. 18 patients had not received CR. One death and 10 new admissions/hospitalizations were recorded during follow-up. A Poisson regression model showed that patients who had received CR based only on physical activity presented significantly higher re-hospitalization rates than patients who had received a complete CR scheme (rate ratio 5.89:1.14-30.4995 % CI; p=0.04). Conclusions A multidisciplinary approach must bead opted to CR involving physical activity, education and psychological and nutritional assessment.

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Revista de Salud Publica

Título del artículo:

Prevalence and characterization of the population in condition of disability in los santos (Santander, Colombia), 2011

Objective: To determine the prevalence and characterize the condition of disabled people in the municipality Los Santos, Santander in 2010 and 2011. Materials and methods: A descriptive study was conducted using the tool of record \"Survey of Persons with Disabilities and its attendant\". Physiotherapy and bacteriology students from University of Santander (UDES), previously trained, collected the information by interview. We use descriptive statistics applying central tendency measures and absolute and relative frequencies. Results: We found 108 people with disabilities; the prevalence of disability in this population was 1.3% (95% CI 1.1 -1.6), the place with the highest prevalence was Los Teres (9.4%; 95% CI 5.1-15.5). Of the 108 disabled people, 48% were female and 47.2% were between 15 and 44 years old. The body structure more impairment was nervous system with a 64.8% and general tasks and demands were the most affected (57.4%). Problems with services, transport systems and policies, social security, health, and education were the main facilitator (57.4%). Conclusion: Disability as a public health problem affecting the activities, participation and performance of the people with disabilities decreasing their individual development and opportunities for integration into society.

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Salud Uninorte

Título del artículo:

Fibromyalgia is characterized by altered frontal and cerebellar structural covariance brain networks

Altered brain morphometry has been widely acknowledged in chronic pain, and recent studies have implicated altered network dynamics, as opposed to properties of individual brain regions, in supporting persistent pain. Structural covariance analysis determines the inter-regional association in morphological metrics, such as gray matter volume, and such structural associations may be altered in chronic pain. In this study, voxel-based morphometry structural covariance networks were compared between fibromyalgia patients (N = 42) and age- and sex-matched pain-free adults (N = 63). We investigated network topology using spectral partitioning, which can delineate local network submodules with consistent structural covariance. We also explored white matter connectivity between regions comprising these submodules and evaluated the association between probabilistic white matter tractography and pain-relevant clinical metrics. Our structural covariance network analysis noted more connections within the cerebellum for fibromyalgia patients, and more connections in the frontal lobe for healthy controls. For fibromyalgia patients, spectral partitioning identified a distinct submodule with cerebellar connections to medial prefrontal and temporal and right inferior parietal lobes, whose gray matter volume was associated with the severity of depression in these patients. Volume for a submodule encompassing lateral orbitofrontal, inferior frontal, postcentral, lateral temporal, and insular cortices was correlated with evoked pain sensitivity. Additionally, the number of white matter fibers between specific submodule regions was also associated with measures of evoked pain sensitivity and clinical pain interference. Hence, altered gray and white matter morphometry in cerebellar and frontal cortical regions may contribute to, or result from, pain-relevant dysfunction in chronic pain patients.

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NeuroImage: Clinical

Título del artículo:

Effects of functional training program in core muscles in women with fibromyalgia

Objective: To evaluate the effects of a program of functional muscles core training targeting women with fibromyalgia. Materials and methods: A quasi-experimental type trial was conducted, before and after an intervention, for 20 days, often three days/week, 60 minutes each session. In a single-group of eight women, changes in muscle strength, pain, quality of life related to health and physical activity were evaluated. Results: An increase in repetitions of the test trunk fexion, time on the left and right bridge testing lateral and prone bridge the test were found. All features of pain decreased, and, according to the S-FIQ, a decrease in morning fatigue, stiffness and anxiety was reported. Also Met’s/minute-weeks increased after intervention. Conclusion: These data suggest that functional program core muscle training is effective in increasing muscle strength, pain modulation, functional performance optimization, and increased levels of physical activity in women with fibromyalgia.

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Revista Ciencias de la Salud

Título del artículo:

Health related quality of life and urinary incontinence in women with overweight and obesity in Bucaramanga, Colombia

Objective: To determine the association between quality of life health-related (HRQL) and urinary incontinence (UI) in a population of overweight women in the urban area of Bucaramanga, Colombia. Materials and methods: An analytic cross-sectional study was conducted in March and May 2012. The sample consisted of 63 randomly selected women; median age was 46 years with a minimum of 18 and maximum of 65 years, 76% were overweight, and 24% obese. We assessed the HRQL with the SF-36 questionnaire and lower urinary tract symptoms quality of life questionnaire (ICIQ-FLUTSqol). Urinary incontinence was assessed using the International Consultation on Incontinence questionnaire, short form (ICIQ-IU Short Form). Results: The overall prevalence of UI was 39.7%; 28.6% was Stress UI, mixed UI 11.1%. There were no statistically signifcant differences in the eight dimensions of SF-36 in women with and without UI. The dimension with lowest score in women with IU was Energy-Fatigue (63.4). The HRQL scores assessed with ICIQ-FLUTSqol questionnaire was 27 with a minimum of 20 and a maximum of 55. Conclusion: In women with overweight, we do not found statistically signifcant differences in the eight dimensions of HR-QOL when comparing women with and without UI.

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Revista Ciencias de la Salud

Título del artículo:

Epidemiology, risk factors and genotypes of HBV in HIV-infected patients in the northeast region of Colombia: High prevalence of occult hepatitis B and F3 subgenotype dominance

Introduction: Chronic hepatitis B virus (HBV) infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission. Objectives: Our aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI) among patients infected with HIV in a northeastern Colombian city. Methods: A cross-sectional study was conducted with 275 HIV-positive patients attending an outpatient clinic in Bucaramanga, Colombia during 2009-2010. Blood samples were collected and screened for serological markers of HBV (anti-HBs, anti-HBc and HBsAg) through ELISA assay. Regardless of their serological profile, all samples were tested for the HBV S gene by nested-PCR and HBV genotypes were determined by phylogenetic inference. Clinical records were used to examine demographic, clinical, virological, immunological and antiretroviral therapy (ART) variables of HIV infection. Results: Participants were on average 37±11 years old and 65.1% male. The prevalence of HIV-HBV coinfection was 12% (95%CI 8.4-16.4) of which 3.3% had active HBV infection and 8.7% OBI. The prevalence of HIV-HBV coinfection was associated with AIDS stage and ART treatment. Sequence analysis identified genotype F, subgenotype F3 in 93.8% of patients and genotype A in 6.2% of patients. A C149R mutation, which may have resulted from failure in HBsAg detection, was found in one patient with OBI. Conclusions: The present study found a high prevalence of HIV-HBV coinfection with an incidence of OBI 2.6-fold higher compared to active HBV infection. These findings suggest including HBV DNA testing to detect OBI in addition to screening for HBV serological markers in HIV patients.

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PLoS ONE

Título del artículo:

Anthropometric characteristics and physical performance of Colombian elite male wrestlers

Background: Wrestling was an important part of the ancient Olympic Games and is still one of the most popular events of the modern Olympic Games. Studies indicate that general physiologic profile of successful wrestlers is high anaerobic power and capacity, muscular strength, above average aerobic power, exceptional flexibility, fat free mass, and a mesomorphic somatotype. Objectives: The objective of the present study was to evaluate anthropometric characteristics and physical performance of elite male wrestlers. Patients and Methods: The Colombian Wrestling Team was evaluated while in preparation for the Olympic Games (n = 21; age, 27.9 ± 6.7 years). Athletes were tested on anthropometric and fitness parameters: body composition, somatotype distribution according to Heath-Carter, aerobic capacity, vertical jump, and anaerobic power. Results: The evaluations showed a mean body fat percentage of 13.6% ± 3.0% (95% CI, 12.2%-15%), muscle mass of 46.4% ± 2.2% (95% CI, 45.4%-47.4%), Ponderal index of 41.0 ± 1.8 (95% CI, 40.2-41.8), body adiposity index (BAI) 25.1 ± 3.6 (95% CI, 23.5-26.8), and somatotype distribution mesomorphic-ectomorph (5.3-1.6-3.8). Mean aerobic capacity was 45.9 ± 6.6 mL/kg/min (95% CI, 42.8-48.9), vertical jump was 36.4 ± 6.6 cm (95% CI, 11.8-16.6), and anaerobic power was 92.6 ± 19.5 kg/s (95% CI, 83.7-101.5). Conclusions: These results provided a profile of elite wrestlers that could be used as training targets for developing athletes. The results may also provide information for training and tactical planning.

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Asian Journal of Sports Medicine

Título del artículo:

The impact of the fifa 11+ training program on injury prevention in football players: A systematic review

The FIFA 11+ is a simple, and easy to implement, sports injury prevention program comprising a warm up of 10 conditioning exercises. The aim of this systematic review was to evaluate the impact of the FIFA 11+ on injury incidence, compliance and cost effectiveness when implemented among football players. MEDLINE, EMBASE and Scopus databases were searched using the search terms “FIFA 11+”, “football”, “soccer”, “injury prevention”, and “The 11”. The titles and abstracts were screened by two independent reviewers and the data were filtered by one reviewer using a standardized extraction form and thereafter checked by another one. The risk of bias and the methodological quality of the studies were evaluated through the PEDro score and Critical Appraisal Skills Programme (CASP). A total of 911 studies were identified, of which 12 met the inclusion criteria of the review. The FIFA 11+ has demonstrated how a simpleexercise program completed as part of warm-up can decrease the incidence of injuries in amateur footba players. In general, considerable reductions in the number of injured players, ranging between 30% and 70%, have been observed among the teams that implemented the FIFA 11+. In addition, players with high compliance to the FIFA 11+ program had an estimated risk reduction of all injuries by 35% and show significant improvements in components of neuromuscular and motor performance when participating in structured warm-up sessions at least 1.5 times/week. Most studies had high methodological quality and a low risk of bias. Given the large number of people who play football at amateur level and the detrimental impact of sports injuries on a personal and societal level, the FIFA 11+ can be considered as a fundamental tool to minimize the risks of participation in a sport with substantial health benefits.

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International Journal of Environmental Research and Public Health

Título del artículo:

A novel method to evaluate the community built environment using photographs - Environmental profile of a community health (Epoch) Photo neighbourhood evaluation tool

Background: Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used to study communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluate features of the built environment of communities using a standard set of photos. In this report we describe the method of photo collection, photo analysis instrument development and inter-rater reliability of the instrument. Methods/Principal Findings: A minimum of 5 photos were taken per community in 86 communities in 5 countries according to a standard set of instructions from a designated central point of each community by researchers at each site. A standard pro forma derived from reviewing existing instruments to assess the built environment was developed and used to score the characteristics of each community. Photo sets from each community were assessed independently by three observers in the central research office according to the pro forma and the inter-rater reliability was compared by intra-class correlation (ICC). Overall 87% (53 of 60) items had an ICC of≥0.70, 7% (4 of 60) had an ICC between 0.60 and 0.70 and 5% (3 of 60) items had an ICC ≤0.50. Conclusions/Significance: Analysis of photos using a standardized protocol as described in this study offers a means to obtain reliable and reproducible information on the built environment in communities in very diverse locations around the world. The collection of the photographic data required minimal training and the analysis demonstrated high reliability for the majority of items of interest.

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PLoS ONE

Título del artículo:

Cardiovascular risk and events in 17 low-, middle-, and high-income countries

BACKGROUND: More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. METHODS: We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater risk-factor burden). Participants were followed for incident cardiovascular disease and death for a mean of 4.1 years. RESULTS: The mean INTERHEART Risk Score was highest in high-income countries, intermediate in middle-income countries, and lowest in low-income countries (P<0.001). However, the rates of major cardiovascular events (death from cardiovascular causes, myocardial infarction, stroke, or heart failure) were lower in high-income countries than in middle- and low-income countries (3.99 events per 1000 person-years vs. 5.38 and 6.43 events per 1000 person-years, respectively; P<0.001). Case fatality rates were also lowest in high-income countries (6.5%, 15.9%, and 17.3% in high-, middle-, and low-income countries, respectively; P = 0.01). Urban communities had a higher risk-factor burden than rural communities but lower rates of cardiovascular events (4.83 vs. 6.25 events per 1000 person-years, P<0.001) and case fatality rates (13.52% vs. 17.25%, P<0.001). The use of preventive medications and revascularization procedures was significantly more common in high-income countries than in middle- or low-income countries (P<0.001). CONCLUSIONS: Although the risk-factor burden was lowest in low-income countries, the rates of major cardiovascular disease and death were substantially higher in low-income countries than in high-income countries. The high burden of risk factors in high-income countries may have been mitigated by better control of risk factors and more frequent use of proven pharmacologic therapies and revascularization. Copyright © 2014 Massachusetts Medical Society.

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New England Journal of Medicine

Título del artículo:

Association of urinary sodium and potassium excretion with blood pressure

BACKGROUND: Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown. METHODS: We studied 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen and were used as surrogates for intake. We assessed the relationship between electrolyte excretion and blood pressure, as measured with an automated device. RESULTS: Regression analyses showed increments of 2.11 mm Hg in systolic blood pressure and 0.78 mm Hg in diastolic blood pressure for each 1-g increment in estimated sodium excretion. The slope of this association was steeper with higher sodium intake (an increment of 2.58 mm Hg in systolic blood pressure per gram for sodium excretion >5 g per day, 1.74 mm Hg per gram for 3 to 5 g per day, and 0.74 mm Hg per gram for <3 g per day; P<0.001 for interaction). The slope of association was steeper for persons with hypertension (2.49 mm Hg per gram) than for those without hypertension (1.30 mm Hg per gram, P<0.001 for interaction) and was steeper with increased age (2.97 mm Hg per gram at >55 years of age, 2.43 mm Hg per gram at 45 to 55 years of age, and 1.96 mm Hg per gram at <45 years of age; P<0.001 for interaction). Potassium excretion was inversely associated with systolic blood pressure, with a steeper slope of association for persons with hypertension than for those without it (P<0.001) and a steeper slope with increased age (P<0.001). CONCLUSIONS: In this study, the association of estimated intake of sodium and potassium, as determined from measurements of excretion of these cations, with blood pressure was nonlinear and was most pronounced in persons consuming high-sodium diets, persons with hypertension, and older persons. Copyright © 2014 Massachusetts Medical Society.

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New England Journal of Medicine

Título del artículo:

Urinary sodium and potassium excretion, mortality, and cardiovascular events

BACKGROUND: The optimal range of sodium intake for cardiovascular health is controversial. METHODS: We obtained morning fasting urine samples from 101,945 persons in 17 countries and estimated 24-hour sodium and potassium excretion (used as a surrogate for intake). We examined the association between estimated urinary sodium and potassium excretion and the composite outcome of death and major cardiovascular events. RESULTS: The mean estimated sodium and potassium excretion was 4.93 g per day and 2.12 g per day, respectively. With a mean follow-up of 3.7 years, the composite outcome occurred in 3317 participants (3.3%). As compared with an estimated sodium excretion of 4.00 to 5.99 g per day (reference range), a higher estimated sodium excretion (≥7.00 g per day) was associated with an increased risk of the composite outcome (odds ratio, 1.15; 95% confidence interval [CI], 1.02 to 1.30), as well as increased risks of death and major cardiovascular events considered separately. The association between a high estimated sodium excretion and the composite outcome was strongest among participants with hypertension (P=0.02 for interaction), with an increased risk at an estimated sodium excretion of 6.00 g or more per day. As compared with the reference range, an estimated sodium excretion that was below 3.00 g per day was also associated with an increased risk of the composite outcome (odds ratio, 1.27; 95% CI, 1.12 to 1.44). As compared with an estimated potassium excretion that was less than 1.50 g per day, higher potassium excretion was associated with a reduced risk of the composite outcome. CONCLUSIONS: In this study in which sodium intake was estimated on the basis of measured urinary excretion, an estimated sodium intake between 3 g per day and 6 g per day was associated with a lower risk of death and cardiovascular events than was either a higher or lower estimated level of intake. As compared with an estimated potassium excretion that was less than 1.50 g per day, higher potassium excretion was associated with a lower risk of death and cardiovascular events. Copyright © 2014 Massachusetts Medical Society.

Acerca de la revista donde se publicó este artículo:

New England Journal of Medicine

Título del artículo:

Association of handgrip strength to cardiovascular mortality in pre-diabetic and diabetic patients: A subanalysis of the ORIGIN trial

Acerca de la revista donde se publicó este artículo:

International Journal of Cardiology

Título del artículo:

Athletic performance and birth month: Is the relative age effect more than just selection bias?

The aim of this study was to determine if month of birth affects performance in 3 tests of physical function in children and adolescents. We measured cardiorespiratory fitness, handgrip strength and lower-body power expressed them relative to (whole year) age then compared scores between calendar year birth-months. We also expressed test performance as the likelihood of achieving criterion-referenced fitness standards. There were significant main effects of birth-month for cardiorespiratory fitness (F=4.54, p<0.001), strength (F=6.81, p<0.001) and power (F=3.67, p<0.001). Children born in November were fitter and more powerful than those born at other times, particularly the summer months (April, May and June). October-born children were stronger than those born in all months except September and November. This relationship was evident despite controlling for decimal age and despite no significant inter-month differences in anthropometric characteristics. There is a clear physical advantage for those born in the autumn and this may explain some of the bias in sports selection attributed to the relative age effect, particularly when the British school-year (September) cut-off is used.

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International Journal of Sports Medicine