Título del artículo:

Laboratory tests for antiphospholipid syndrome diagnosis in pregnant women

Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of autoantibodies against proteins bound to negatively charged phospholipids. Obstetric antiphospholipid syndrome (APS) is characterized as an acquired autoimmune disorder associated with different obstetric complications, defined as a state of hyper-coagulability, which causes a wide range of complications associated with placental insufficiency including recurrent gestational loss, fetal death, preeclampsia, preterm deliv-ery, among others. Its diagnosis is based on the Sidney criteria which include adverse obstetric history such as: (i) three consecutive miscarriages and spontaneous abor-tions prior to 10 weeks gestation (ii) fetal loss on one or more occasions at 10 weeks gestation and (iii) fetal death or preterm delivery due to eclampsia or severe preeclamp-sia or placental insufficiency prior to 34 weeks gestation, and laboratory findings such as (i) two positive tests for lupus anticoagulant (LA) at least 12 weeks apart (ii) two positive results for acL IgG or IgM at least 12 weeks apart and (iii) two positive results for 2GPI IgG or IgM at least 12 weeks apart. The laboratory tests give rise to an antibody profile related to the risk of complications; thus establish-ing as a high-risk profile, the presence of AL accompanied or not by high titers for acL or aβ2GPI. On the other hand, it is important to perform a differential diagnosis with other thrombotic microangiopathies with implications in pregnancy and to rule out the presence of different enti-ties that may course with production of antiphospholipid antibodies. Based on these aspects and the severity of the syndrome under study, articles are required to determine the importance of the laboratory tests used for the diagnosis of antiphospholipid syndrome in pregnant women.

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Revista Latinoamericana de Hipertension

Título del artículo:

Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center

Introduction: gestational diabetes mellitus (GDM) com-monly appears between the second and third trimesters of pregnancy as a result of hormonal changes that induce a transitory state of insulin resistance (IR) in the mother, allowing a greater supply of glucose to the fetus. After GDM, thyroid disease is the most common endocrine dis-order in obstetrics, with an incidence of 5-10%. Some studies speak of the existence of a relationship between diabetes and thyroid disorders (TA) but the results remain controversial, limiting the analysis of the effects that both diseases could have on the development of pregnancy. Therefore, the identification of patients at risk, prevention and timely treatment, constitute one of the priority issues in public health. Objective: in this study, the prevalence of GDM and AT in pregnant women attended in a specialized center for maternal and child diagnosis was analyzed. Materials and methods: retrospective research, based on the exploration of medical records in the period from 2016 to 2020, with a probabilistic sample of 388 pregnant women (n=388). For the diagnosis of GDM, the results of the O’sullivan test, oral glucose tolerance test (OGTT) and fasting blood glucose were taken into account. Thyroid alteration was identified from TSH values, but only 120 pregnant women reported results for this test (n=120). Descriptive measures and simple frequency distributions were calculated. To establish the relationship between GDM and AT, the chi-square test was applied with a statistical significance of p=0.05. Results:the prevalence of GDM was 10.6% (n=41) and of AT 17.5% (n=21). 19% of the pregnant women simultaneously presented GDM and AT with a predominance of a tendency to hyperthyroidism. No significant association was found between GDM and AT (p=0.537). Conclusion: This pilot study confirms that GDM and AT are conditions frequently present in pregnant women. Although there could be a risk of develop-ing GDM in patients with AT, studies with a larger sample number are suggested to clarify this relationship.

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Revista Latinoamericana de Hipertension

Título del artículo:

Cardiovascular risk factors and death in South America

We present cardiovascular disease (CVD) incidence and mortality rates reported for South America stratified by country, sex, and urban/rural location in a multinational cohort included in the Population Urban Rural Epidemiological Study (PURE). This study included 24,718 participants from 51 urban and 49 rural communities in Argentina, Brazil, Chile, and Colombia and the mean follow-up was 10.3 years. CVD incidence and mortality rates were calculated for the total cohort and in subpopulations. Hazard ratios and population attributable fractions (PAFs) for CVD and death were examined for 12 modifiable risk factors, grouped as metabolic (hypertension, diabetes, abdominal obesity, and high non-HDL cholesterol), behavioural (smoking, alcohol, diet quality, and physical activity) and other (education, household air pollution, strength, and depression). The leading causes of death were CVD (31.1%), cancer (30.6%), and respiratory diseases (8.6%). Approximately 72% of the PAFs for CVD and 69% of the PAFs for deaths were attributed to 12 modifiable risk factors. For CVD, the main PAFs were due to hypertension (18.7%), abdominal obesity (15.4%), smoking (13.5%), low muscle strength (5.6%), and diabetes (5.3%). For death, the main PAFs were smoking (14.4%), hypertension (12.0%), low educational level (10.5%), abdominal obesity (9.7%), and diabetes (5.5%). Cardiovascular diseases, cancer, and respiratory diseases account for more than two-thirds of deaths in South America. Men have consistently higher CVD rates and mortality than women. A large proportion of CVD and premature deaths could be avoided by controlling metabolic risk factors and smoking, which are the main risk factors in the region for both CVD and all-cause mortality.

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Clinica e Investigacion en Arteriosclerosis

Título del artículo:

STUDY OF THE EFFECT OF Zr3Fe ADDITION ON HYDROGEN STORAGE BEHAVIOR OF Ti2CrV ALLOYS

The aim of this study was to improve the first hydrogenation behavior of Ti2CrV alloy, with the Zr3Fe addition. The Ti2CrV + X% Zr3Fe (X= 0, 2, 4, 6, 8, and 10) system were studied. The compositions were synthesized by arc-melting. The powder was characterized by scanning electron microscopy and x-ray diffraction. In the as-cast samples, microstructure reveals a single bcc structure for Ti2CrV, and the presence of a Zr-rich area for the samples with Zr3Fe addition. The hydride fcc phase for 6%, 8% and 10% addition of Zr3Fe was confirmed by x-ray diffraction. We found that when at least 6% of Zr3Fe is added to the alloy, the first hydrogenation is improved not only in terms of hydrogen storage capacity but also kinetics. The sample with 6% of Zr3Fe absorbs its maximum capacity of 4.2 wt.% in approximately 8 minutes at room temperature without any heat treatment.

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Proceedings of WHEC 2022 - 23rd World Hydrogen Energy Conference: Bridging Continents by H2

Título del artículo:

FROM FOSSIL FUEL ENERGY TO HYDROGEN ENERGY: TRANSFORMATION OF FOSSIL FUEL ENERGY ECONOMIES INTO HYDROGEN ECONOMIES THROUGH SOCIAL ENTREPRENEURSHIP

Social entrepreneurship plays a crucial role in global sustainable development, enhancing the quality of life and preserving environmental, human, and social capital. However, when it relates to the energy transition, it faces numerous challenges and experiences conflicts in terms of costs, technological innovation, public policies. This study seeks to illustrate one of the new alternative energy schemes which could replace fossil fuels in the future: hydrogen. This transformation would result in significant social impacts, leading to the question, “how should it be done?” Social entrepreneurship can integrate socio-economic actors and agents and help them to devise and implement new forms of energy innovation. Therefore, a descriptive qualitative methodology was designed, that allows us to analyze the process of building entrepreneurship with a social vision and to propose a model that enables the transition from fossil economies to the hydrogen economies. Among the most significant results, stands out the importance of the support of the three primary axes of each country and the role of social entrepreneurship as a key element for the transition. The discussion contributes to the debate on the path that academia should lead, and the fundamental role of entrepreneurship based on social conscience as a driver of change.

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Proceedings of WHEC 2022 - 23rd World Hydrogen Energy Conference: Bridging Continents by H2

Título del artículo:

Management considerations for the strategic direction of research in universities

The objective was to develop mana gerial considerations on which to base the strategic direction of research in universities. It was a qualitative study, of bibliographic design, explanatory level and under the hermeneutic-dialectic method, developed on the basis of texts and background on the university academy. The results reveal that in the global context, there are still weaknesses in the management of research in universities, which determines the need for strategic direction. Management considerations point to the inexorable transposition of research, going from academic activity to missionary, productive and competitive strategy of the university.

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Aibi, Revista de Investigacion Administracion e Ingenierias

Título del artículo:

Physical Exercise Effects on Cardiovascular Autonomic Modulation in Postmenopausal Women—A Systematic Review and Meta-Analysis

Background: The cardioprotective effect of physical exercise has been demonstrated in several studies. However, no systematic or updated analysis has described the effects of physical exercise on cardiovascular autonomic modulation in postmenopausal women. Aim: to describe the effects of physical exercise on cardiovascular autonomic modulation in postmenopausal women. Methods: The Scopus, PubMed, and Embase databases were searched for randomized clinical trials published between January 2011 and December 2021, and regarding the effects of physical exercise on cardiovascular autonomic modulation in postmenopausal women. Two independent authors processed the citations. The methodological quality was evaluated using the PEDRo scale. Results: Of the 91 studies identified, only 8 met the inclusion criteria, of which 7 had fair or poor methodological quality. The analyzed studies investigated the effects of functional training, whole-body vibration, muscular resistance, stretching, and aerobic exercises performed at home or at the gym. The majority of these exercise modalities showed improvements in heart-rate variability (HRV) indices and in the low-frequency band of blood pressure variability. The meta-analysis shows that exercise increased the standard deviation of instantaneous beat-to-beat variability (SD1) (mean difference (MD) = 3.99; 95% confidence interval (CI) = 1.22 to 6.77, n = 46; I2: 0%) and the standard deviation of long-term variability (SD2) (MD = 11.37; 95% CI = 2.99 to 19.75; n = 46; I2: 0%). Conclusions: Aerobic exercise and some nonconventional training modalities may have beneficial effects on cardiovascular autonomic modulation in postmenopausal women. More high-quality studies are still needed to further confirm their efficacy and safety.

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International Journal of Environmental Research and Public Health

Título del artículo:

The psyllid fauna (Hemiptera: Psylloidea) of vegetable fields in Brazil

Some psyllids transmit ‘Candidatus Liberibacter solanacearum’ (Lso), the causal agent of devastating plant diseases of cultivated Solanaceae and Apiaceae. The recent detection of Bactericera cockerelli and Lso in Ecuador seriously threatens these crops in South America. There, neither the role of native psyllids in the Lso epidemiology nor the psyllid fauna of vegetables are known. With the aim to identify potential vectors and risk scenarios for the spread of Lso in South America, a survey of the psyllid fauna of Solanaceae and Apiaceae crops and associated weeds was conducted in Brazil. Samples were taken at 29 localities in four states. A total of 2857 specimens were sampled, representing at least 37 species of 23 genera and seven families. The most frequent species on carrot, chilli pepper and potato were Russelliana solanicola, R. capsici and Isogonoceraia divergipennis, respectively. Immatures of R. capsici were found on chilli pepper and of R. solanicola on carrot and potato, confirming these plants as hosts. The two psyllid species have been suspected previously to transmit plant pathogens of unknown identity. Russelliana solanicola is one of the few polyphagous species. Here the species is reported for the first time from carrot. Recent collections in Rio Grande do Sul suggest that Solanum laxum represents the original host of R. capsici, which subsequently shifted to chilli pepper. Both, adaptation to agricultural crops and the possibility of ability to transmit pathogens, make the two Russelliana species dangerous potential vectors of Lso and other plant pathogens in South America.

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Revista Brasileira de Entomologia

Título del artículo:

Exploring the potential of eco-friendly silver nanoparticles to inhibit azole-resistant clinical isolates of Candida spp.

The antimicrobial activity and biological efficiency of silver nanoparticles (AgNps) have been widely described and can be modeled through stabilizing and reducing agents, especially if they exhibit biocidal properties, which can enhance bioactivity against pathogens. The selective action of AgNps remains a major concern. In this regard, the use of plant extracts for the green synthesis of nanoparticles offers advantages because it improves the toxicity of Nps for microorganisms and is harmless to normal cells. However, biological evaluations of the activity of AgNps synthesized using different reducing agents are determined independently, and comparisons are frequently overlooked. Thus, we investigated and compared the antifungal and cytotoxic effects of two ecological AgNps synthesized from Moringa oleifera aqueous leaf extract (AgNp-M) and glucose (AgNp-G) against azole-resistant clinical isolates of Candida spp. and nontumor mammalian cells. Synthesized AgNps exhibited an antifungal effect on planktonic cells of drug-resistant C. albicans and C. tropicalis (MIC 0.21–52.6 µg/mL). The toxicity was influenced by size. However, the use of M. oleifera extracts allows us to obtain AgNps that are highly selective and nongenotoxic to Vero cells due to modifications of the shape and surface. Therefore, these results suggest that AgNp-M has antimicrobial potential and deserves further investigation for biomedical applications.

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Journal of Environmental Science and Health - Part A Toxic/Hazardous Substances and Environmental Engineering

Título del artículo:

Didactic strategy for the training of software testing in the IT professional

Training in software testing is relevant at different levels of engineering education, since this activity is knowledge-intensive and relevant to the quality of software products. A definition of competences is necessary to establish differentiated occupational outlets in the labor field. In the software industry it is necessary to recognize the competences to define training profiles of the academic programs associated to the software testing value chain through training strategies according to the demands of the productive sector and the challenges of higher education. Therefore, this study presents the results of a process that validates with the academy and the industry the occupational profiles and competencies of the software testing process to establish a student-centered teaching and learning process through an educational environment that calls for the experiential learning model and the maker culture.

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Aibi, Revista de Investigacion Administracion e Ingenierias

Título del artículo:

The Global Alliance for Chronic Diseases researchers’ statement on non-communicable disease research with Indigenous peoples

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The Lancet Global Health

Título del artículo:

Ultra-processed foods and mortality: analysis from the Prospective Urban and Rural Epidemiology study

BACKGROUND: Higher intake of ultra-processed foods (UPFs) has been associated with increased risk of CVD and mortality in observational studies from Western countries but data from non-Western countries are limited. OBJECTIVES: We aimed to assess the association between consumption of UPFs and risk of mortality and major CVD in a cohort from multiple world regions. DESIGN: This analysis includes 138,076 participants without a history of CVD between the ages of 35 and 70 y living on 5 continents, with a median follow-up of 10.2 y. We used country-specific validated food-frequency questionnaires to determine individuals\' food intake. We classified foods and beverages based on the NOVA classification into UPFs. The primary outcome was total mortality (CV and non-CV mortality) and secondary outcomes were incident major cardiovascular events. We calculated hazard ratios using multivariable Cox frailty models and evaluated the association of UPFs with total mortality, CV mortality, non-CV mortality, and major CVD events. RESULTS: In this study, 9227 deaths and 7934 major cardiovascular events were recorded during the follow-up period. We found a diet high in UPFs (≥2 servings/d compared with 0 intake) was associated with higher risk of mortality (HR: 1.28; 95% CI: 1.15, 1.42; P-trend < 0.001), CV mortality (HR: 1.17; 95% CI: 0.98, 1.41; P-trend = 0.04), and non-CV mortality (HR: 1.32; 95% CI 1.17, 1.50; P-trend < 0.001). We did not find a significant association between UPF intake and risk of major CVD. CONCLUSIONS: A diet with a high intake of UPFs was associated with a higher risk of mortality in a diverse multinational study. Globally, limiting the consumption of UPFs should be encouraged.

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The American journal of clinical nutrition

Título del artículo:

Capacity-building and continuing professional development in healthcare and rehabilitation in low- and middle-income countries—a scoping review protocol

Background: A recent world health report suggests that there is a growing rehabilitation human resource crisis. This review focuses on the capacity-building needed to meet present and future rehabilitation challenges in low- and middle-income countries (LMICs). Capacity-building is the process by which individuals and organizations obtain, improve, and retain the skills, knowledge, tools, equipment, and other resources needed to do their jobs competently. The objectives of this review are (1) to determine how capacity-building has been defined, implemented, and evaluated in LMICs and (2) to provide an overview of the effectiveness of capacity-building initiatives. Methods: In the first of seven stages, we will refine and delimit the research. Then, we will identify relevant studies by searching five biomedical databases, two rehabilitation databases, three regional databases, and three databases of gray literature. Two independent reviewers will then select the studies using a priori selection criteria. We will exclude incomplete records, records published prior to 2000 for databases and 2010 for gray literature, and records written in languages other than English or Spanish. We will also exclude records focusing on entry-to-practice programs in academic settings. For Objective 1, using qualitative analysis software, we will extract and analyze text from included records that define or explains capacity building. For Objective 2, using an online file-sharing platform, one reviewer will extract data describing the effectiveness of capacity-building interventions and a second reviewer will verify the accuracy, with disagreements resolved by consensus. The results will be collated using tables and charts. After synthesizing the results, we will discuss the practicality and applicability of the findings with partners from Honduras and Colombia. We will use several formats and venues including presentations and publications in English and Spanish to present our results. Discussion: To our knowledge, this will be the first attempt to systematically identify knowledge of capacity-building and rehabilitation in LMICs. This scoping review results will offer unique insights concerning the breadth and depth of literature in the area. It is anticipated that results from this scoping review will guide efforts in future capacity-building efforts in rehabilitation in LMICs. Review registration: Busch AJ, Deprez D, Bidonde J, Ramírez PA, Araque EP. Capacity building and continuing professional development in healthcare and rehabilitation in low- and middle-income countries—a scoping review. 2021. https://doi.org/10.17605/OSF.IO/7VGXU.

Acerca de la revista donde se publicó este artículo:

Systematic Reviews

Título del artículo:

Author Correction: Global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity (Nature Food, (2022), 3, 9, (694-702), 10.1038/s43016-022-00594-9)

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Nature Food

Título del artículo:

The effect of bariatric surgery on metabolic syndrome: A retrospective cohort study in Colombia

Introduction and Objective: Metabolic syndrome (MetS) represents a group of metabolic abnormalities. It is currently a pandemic, and its prevalence is on the rise. MetS has a direct relationship with obesity, for this reason, bariatric and metabolic surgery has been proposed as a method to simultaneously control obesity and MetS. However, in Colombia the results of this intervention are unknown. This study aims to compare metabolic syndrome before and after bariatric surgery in a Colombian population. Methods: Retrospective cohort study conducted in a highly complex institution in Colombia, where comparing the prevalence of metabolic syndrome in patients who underwent bariatric surgery during a 1-year follow-up period, between January 2015 and December 2019. Of these patients, 48 underwent Roux-en-Y gastric bypass, and 32 underwent sleeve gastrectomy by laparoscopic technique. Results: A total of 80 patients were included, of which 67.5% were women and the mean age was 42.8 ± 12.9 years. The most frequent preprocedure comorbidities were arterial hypertension (36.2%), dyslipidemia (32.4%), and sleep apnea (20%). After bariatric surgery, the prevalence of metabolic syndrome decreased from 66.2% to 3.7% (p < 0.05). In addition, a reduction in the Homeostatic Model Assessment for Insulin Resistance score from 77.5% to 22.5% was observed during the follow-up period. HbA1c, creatinine, and thyroid-stimulating hormone, were the only parameters without significant changes. Conclusions: Metabolic and bariatric surgery is an effective treatment for weight reduction, with a high impact in reducing the prevalence of metabolic syndrome and insulin resistance in the short and medium term in the Colombian population.

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Health Science Reports

Título del artículo:

Associations of Antibiotics, Hormonal Therapies, Oral Contraceptives, and Long-Term NSAIDS With Inflammatory Bowel Disease: Results From the Prospective Urban Rural Epidemiology (PURE) Study

Background & Aims: Several medications have been suspected to contribute to the etiology of inflammatory bowel disease (IBD). This study assessed the association between medication use and the risk of developing IBD using the Prospective Urban Rural Epidemiology cohort. Methods: This was a prospective cohort study of 133,137 individuals between the ages of 20 and 80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed up prospectively at least every 3 years. The main outcome was the development of IBD, including Crohn\'s disease (CD) and ulcerative colitis (UC). Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) were evaluated. Results are presented as adjusted odds ratios (aORs) with 95% CIs. Results: During a median follow-up period of 11.0 years (interquartile range, 9.2–12.2 y), there were 571 incident IBD cases (143 CD and 428 UC). Incident IBD was associated significantly with baseline antibiotic (aOR, 2.81; 95% CI, 1.67–4.73; P =.0001) and hormonal medication use (aOR, 4.43; 95% CI, 1.78–11.01; P =.001). Among females, previous or current oral contraceptive use also was associated with IBD development (aOR, 2.17; 95% CI, 1.70–2.77; P <.001). Nonsteroidal anti-inflammatory drug users also were observed to have increased odds of IBD (aOR, 1.80; 95% CI, 1.23–2.64; P =.002), which was driven by long-term use (aOR, 5.58; 95% CI, 2.26–13.80; P <.001). All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusions: Antibiotics, hormonal medications, oral contraceptives, and long-term nonsteroidal anti-inflammatory drug use were associated with increased odds of incident IBD after adjustment for covariates.

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Clinical Gastroenterology and Hepatology

Título del artículo:

Peutz-Jeghers syndrome: Case report

Peutz-Jeghers syndrome is an autosomal dominant hereditary disease characterized by multiple hamartomatous-type gastrointestinal polyps associated with mucocutaneous hyperpigmentation. A case of a 25-year-old male patient with a history of right hemicolectomy due to ileocolonic intussusception secondary to a giant polyp in the terminal ileum is reported. This patient consulted for rectal bleeding, with evidence on physical examination of dark brown hyperchromatic lesions on the buccal mucosa. A total colonoscopy was performed, noting multiple polyps. Endoscopic mucosectomy was conducted on some of them, being histopathologically compatible with hamartomatous polyps.

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Revista Colombiana de Gastroenterologia

Título del artículo:

Importance of health spending in the Base of the Pyramid (BoP) population in Táchira, Venezuela

Introduction. This research analyzes whether health is among the three main expenditures that a household allocates from its income in the population at the base of the pyramid (BoP) and whether there is an association with people belonging to different socioeconomic levels of the BoP in the state of Táchira, Venezuela. Methods. Data was obtained from a structured questionnaire applied to a sample of 1,398 households in the Táchira region, Venezuela, which were classified by socioeconomic levels through the construction of a global synthetic index that, through scales, allows segmenting households by poverty conditions, from the most intense poverty condition to the most favorable non-poverty condition respectively, resulting in 675 households at the base of the pyramid. Results. For households at BoP levels 2 and 3, health expen ditures are presented in greater proportion than in level 1, with a value of 55.74% and 51.77%, respectively, while in level 1 only 26.67% of households included health ex-penditures among the top three, likewise there is evidence of association between the BoP level and the categories of expenditures on housing, public services, health, and education. Conclusions. The results of this research also confirm the theory that the BoP population is heterogeneous due to socio-cultural differences, evidenced in the association that exists between health expenditure and socioeconomic level, when rejecting the hypothesis of independence, which means that the proportion of households that consider health expenditure important varies depending on which level of the BoP they are in.

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Revista Latinoamericana de Hipertension

Título del artículo:

Bibliometric Analysis on the Smart University Concept

The smart university concept seeks to improve the quality of life by applying information technologies in a comprehensive, intensive, and sustainable way. It is an emerging concept, where little attention has been paid so far to the quantitative description of its evolution. The main objective of this article is to present the results of a bibliometric analysis around the emerging concept of smart university. It includes citation analysis, keyword networks, journal co-citation networks, references, and most cited authors. For this paper, a computer tool was used as a support to identify and visualize the intellectual structure of the smart university concept and its relationships retrieved from the Dimensions.ai. platform.

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Lecture Notes in Networks and Systems

Título del artículo:

Burden and types of support for family caregivers serving patients with chronic disease

Introduction: An increase in chronic noncommunicable disease has been evidenced worldwide in this century; patients Abstract present with longer-lasting and more complex pathologies, generating dependence, requiring a caregiver at home; while different skills are required to improve care competencies. Objective: To identify types of support used by the family caregivers of patients with chronic noncommunicable disease and their relation with the caregivers’ burden. Materials and Methods: Quantitative-approach, cross-sectional and analytical study, applying these tools: “Characterization of the patient-caregiver dyad and Caregiver’s Zarit Burden Interview”. The population comprised 62 dyads. OR were calculated in logistic regression. Results: 19.35% (12) of caregivers showed an intense level of burden, 20.97% (13) showed a light burden, and 59.68% (37) had no burden. Caregivers with intense burden state there is 0% of psychological and social support. The relevant variables in the burden level were daily hours of care OR = 1.14 (CI 95%: 1.01; 1.33), the higher the level of knowledge of the computer, the lower the possibility of increase in the level of burden with raw OR= 0.14 (CI95%: 0.02; 0.91), and adjusted OR = 0.07 (CI 95%: 0.007; 0.68). Discussion: It is critical to continue investigating aspects that will reduce the caregivers’ burden, keep them healthy and under appropriate conditions to perform their role. Conclusions: It is necessary to strengthen the different types of support for family caregivers to reduce the burden level related to their work. .

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Revista Cuidarte

Título del artículo:

Effects of a Polypill, Aspirin, and the Combination of Both on Cognitive and Functional Outcomes: A Randomized Clinical Trial

Importance: Vascular risk factors are associated with cognitive decline but studies addressing individual risk factors have not demonstrated an effect of risk factor management on the preservation of cognition. Few trials have examined the effect of vascular risk factor management on function. Objective: To determine if a polypill could reduce cognitive and functional decline in people with risk factors but without manifest cardiovascular disease. Design, Setting, and Participants: The International Polycap Study 3 (TIPS-3) was a 2 × 2 × 2 factorial randomized clinical trial. Hospital and community-based centers in 8 countries recruited and followed up participants between July 30, 2012, and September 30, 2020. A total of 5713 individuals were randomly assigned to treatment groups, and 2098 people 65 years or older at intermediate risk of cardiovascular disease completed a cognitive assessment and were included in the analyses. Interventions: Polypill (antihypertensives and a statin), aspirin, or a combination of both treatments. Main Outcomes and Measures: Cognitive and functional assessments completed at baseline, 2 years, and study end. The primary outcome was the effect of a polypill compared with placebo and a polypill plus aspirin compared with double placebo on the composite outcome of the proportion of participants in each group who experienced a substantive decrease (>1.5 SD change) in cognitive or functional abilities. Results: Of the 2389 study participants older than 65 years, a total of 2098 (88%; mean [SD] age, 70.1 [4.5] years; 1266 female individuals [60%]) completed the baseline and follow-up assessment. A total of 1796 participants (86%) had hypertension, and 680 participants (32%) had impaired fasting plasma glucose levels. Mean (SD) baseline systolic blood pressure was 146.1 (17.7) mm Hg, and mean (SD) low-density lipoprotein cholesterol (LDL-C) level was 124.3 (40.7) mg/dL and decreased by 5.7 mm Hg and 24 mg/dL, respectively, among those assigned to the polypill group. During a 5-year follow-up, there were no significant differences between treatment groups in the number of participants who experienced substantive cognitive decline (356 assigned polypill, 328 assigned placebo) or dementia (2 assigned polypill, 4 assigned placebo). Functional decline was reduced during follow-up for those assigned to polypill compared with placebo (mean [SD] country-standardized adjusted follow-up Standard Assessment of Global Everyday Activities [SAGEA] scores, 0.06 [0.03] vs 0.15 [0.03]; P =.01) and polypill plus aspirin compared with double placebo (mean [SD] country-standardized adjusted follow-up SAGEA scores, 0.01 [0.04] vs 0.14 [0.04]; P =.01). Conclusions and Relevance: In this randomized clinical trial of patients 65 years or older with vascular risk factors, a polypill, with or without aspirin, was not associated with reduced cognitive outcomes but was associated with reduced functional decline..

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JAMA Neurology

Título del artículo:

PREVENTION OF RESPIRATORY INFECTIONS IN HEALTH CARE INSTITUTIONS IN THE DEPARTMENT OF NORTE DE SANTANDER, COLOMBIA

Objective: To prevent acute respiratory infections in health care institutions by means of the implementation of the program “Smile to tenderness: Education and health hand in hand with early childhood”. Materials and methods: A descriptive observational study with a mixed approach in 40 state institutions of the Department of Norte de Santander, Colombia was carried out with the participation of educational agents, parents, administrative staff, girls and boys. Actions were designed for the implementation of the program including workshops, seminars, dramatizations, puppet functions, consultancies and trainings. Leaflets, posters and stickers were delivered based on key practices of the comprehensive child disease strategy. Results: A total of 1331 parents, 242 educators, 108 administrative collaborators and 4781 children were benefited. The “key sanitation practice” proved to be an indispensable tool for the prevention of acute respiratory infection. Conclusion: Behaviors for the control of modifiable risk factors of respiratory infections were evidenced which allowed to raise awareness in the population on the adoption of healthy measures and practices.

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Hacia la Promocion de la Salud

Título del artículo:

Adding nuance to dietary prescriptions: does sodium reduction benefit people already losing weight?

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Journal of Human Hypertension

Título del artículo:

Prevalence and Factors Associated with Bullying in Adolescents

Introduction: Bullying is a complex and multifactorial social phenomenon, which refers to the exposure of different forms of abuse on a repetitive, systematic and intentional basis. Objective: To determine the prevalence and factors associated with bullying in adolescents at three public educational institutions. Materials and Methods: A cross-sectional analytical study was conducted with 816 adolescents covering sixth to ninth grades from three educational institutions in Bucaramanga, Colombia, who were evaluated in 2014 through self-administered questionnaires. Results: 84.2% of the school-going adolescents reported having witnessed any type of violence, of which 33.8% were victims and 22.3% were aggressors. Verbal violence prevailed at 80.1%, followed by physical violence at 47.7% and psychological violence at 36.9%. No relationship was found in the bivariate analysis between bullying and gender, school, school hours, academic year, type of family and their role as witnesses and victims. An association was found in the bivariate and multivariate analysis between school bullying and gender, type of family, smoking and consumption of energy drinks in the aggressor role. Discussion: The identification of the variables associated with school bullying facilitates prioritizing and guiding decisions that will be made regarding this issue. Conclusions: School bullying is a complex phenomenon that requires the articulation of the academic community, parents, healthcare professionals and local authorities.

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