Título del artículo:

Follicular thyroid carcinoma with signet ring cell morphology: Fine-needle aspiration cytology, histopathology, and immunohistochemistry

Thyroid follicular neoplasms with signet ring cell morphology represent a challenging cytological and histopathologic diagnosis. The low frequency of these neoplasms and their broad differential diagnosis contribute to this difficult scenario. Here, we present an exceptionally rare case of thyroid follicular carcinoma with signet ring cell morphology in a 62-year-old female. We analyze the characteristics in fine-needle aspiration cytology, histopathology, and immunohistochemistry and compare our results in a discussion with previous literature reports. © 2013 Springer Science+Business Media New York.

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Endocrine Pathology

Título del artículo:

Glioblastoma Metastasis to Parotid Gland and Neck Lymph Nodes: Fine-Needle Aspiration Cytology with Histopathologic Correlation

Glioblastoma (GBM) is one of the most highly aggressive neoplasms of the central nervous system. Extra-cranial metastases in GBM are rare. Here we present the case of a 26-year-old man with extra-cranial metastasis of a frontal lobe GBM to the parotid gland, cervical lymph nodes, and bones, with initial diagnosis made by fine needle aspiration cytology (FNAC) of the parotid gland. FNAC is a reliable technique in the study of primary and secondary parotid gland neoplasms, allowing a presumptive diagnosis in difficult cases. We correlate the cytologic, histopathologic, and immunohistochemical findings in this case and discuss previous literature reports. © 2013 Springer Science+Business Media New York.

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Head and Neck Pathology

Título del artículo:

The role of environment and epigenetics in hypertension

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Expert Review of Cardiovascular Therapy

Título del artículo:

A necklace sonar with adjustable scope range for assisting the visually impaired

A sonar based device with tactile feedback was developed to improve the mobility and independence of visually impaired individuals. It features a transceiver/receiver, a potentiometer, a microcontroller, a rechargeable polymer lithium ion battery, and a Nokia Cell phone vibrator. All components are commercially available and housed in a custom acrylic package with 86 mm × 34 mm × 12 mm in dimension, and 120 grms in weight. Additionally, the device features an adjustable detection scheme for user customization of distance range, and a tactile feedback system that avoids interference with auditory sensory information. The device was tested for its navigational efficacy in an artificial indoor environment, and in a live outdoor setting. Ten subjects (9 males and 1 female), with a mean age of 35 years-old (range: 17 to 52) were presented with a series of navigational tasks resulting in considerable reduction of head, shoulder, chest, and arms collisions during their locomotion. We conclude that this device greatly improves the mobility and safety of visually impaired individuals. © 2013 IEEE.

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Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS

Título del artículo:

Prospective Urban Rural Epidemiology (PURE) study: Baseline characteristics of the household sample and comparative analyses with national data in 17 countries

Background The PURE study was established to investigate associations between social, behavioural, genetic, and environmental factors and cardiovascular diseases in 17 countries. In this analysis we compare the age, sex, urban/rural, mortality, and educational profiles of the PURE participants to national statistics. Methods PURE employed a community-based sampling and recruitment strategy where urban and rural communities were selected within countries. Within communities, representative samples of adults aged 35 to 70 years and their household members (n = 424,921) were invited for participation. Results The PURE household population compared to national statistics had more women (sex ratio 95.1 men per 100 women vs 100.3) and was older (33.1 years vs 27.3), although age had a positive linear relationship between the two data sources (Pearson\'s r = 0.92). PURE was 59.3% urban compared to an average of 63.1% in participating countries. The distribution of education was less than 7% different for each category, although PURE households typically had higher levels of education. For example, 37.8% of PURE household members had completed secondary education compared to 31.3% in the national data. Age-adjusted annual mortality rates showed positive correlation for men (r = 0.91) and women (r = 0.92) but were lower in PURE compared to national statistics (7.9 per 1000 vs 8.7 for men; 6.7 vs 8.1 for women). Conclusions These findings indicate that modest differences exist between the PURE household population and national data for the indicators studied. These differences, however, are unlikely to have much influence on exposure-disease associations derived in PURE. Further, incidence estimates from PURE, stratified according to sex and/or urban/rural location will enable valid comparisons of the relative rates of various cardiovascular outcomes across countries.

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American Heart Journal

Título del artículo:

Dysfunctional chemosensation in myasthenia gravis: A systematic review

Objectives: Myasthenia gravis has traditionally been viewed as a disorder that solely affects the neuromuscular junction within the peripheral nervous system. However, there is now evidence that the cholinergic dysfunction of this disorder may be more widespread than previously believed. This article provides a systematic review of the studies that examined smell and taste function in myasthenia gravis. Methods: We analyzed studies that reported chemosensory function alterations in patients with myasthenia gravis. PubMed, MEDLINE, Web of Science, EMBASE, and SciELO, searched to identify articles published from January 1950 through December 2012, were supplemented by relevant articles. The following information was identified from each article: the number of patients, number of controls (if any), clinical stage of patients, neurological involvement, serological state, taste or smell involvement, chemosensory test used, and country of publication. Results: Ten studies reporting smell and taste function and dysfunction in patients with myasthenia gravis were identified, most of which were case reports commenting on apparent abnormalities in the taste system. The sole empirical study that investigated taste function, however, was negative, suggesting that some reports of taste loss may reflect olfactory loss. One study clearly documented olfactory dysfunction in patients with myasthenia gravis, dysfunction most likely attributable to altered central nervous system cholinergic function. Conclusions: Chemosensory dysfunction has been reported in a number of patients with myasthenia gravis. Given the close association between complaints of taste dysfunction and loss of flavor sensations secondary to olfactory system damage, quantitative testing should be used to accurately assess the nature and degree of the dysfunction present in this debilitating disorder. © 2013 by Lippincott Williams and Wilkins.

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Journal of Clinical Neuromuscular Disease

Título del artículo:

Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome

The present document has been prepared by a group of experts, members of cardiology, endocrinology, internal medicine, nephrology and diabetes societies of Latin American Countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high- risk population, usually underestimated and undertreated. These recommendations results from presentation and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming both physicians and patients from effectively adhering to guideline recommendations.

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Anales Venezolanos de Nutricion

Título del artículo:

Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries

IMPORTANCE: Hypertension is the most important preventable cause of morbidity and mortality globally, yet there are relatively few data collected using standardized methods. OBJECTIVE: To examine hypertension prevalence, awareness, treatment, and control in participants at baseline in the Prospective Urban Rural Epidemiology (PURE) study. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study of 153 996 adults (complete data for this analysis on 142 042) aged 35 to 70 years, recruited between January 2003 and December 2009. Participants were from 628 communities in 3 high-income countries (HIC), 10 upper-middle-income and low-middle-income countries (UMIC and LMIC), and 4 low-income countries (LIC). MAIN OUTCOMES AND MEASURES: Hypertensionwas defined as individuals with self-reported treated hypertension or with an average of 2 blood pressure measurements of at least 140/90 mm Hg using an automated digital device. Awareness was based on self-reports, treatment was based on the regular use of blood pressure-lowering medications, and control was defined as individuals with blood pressure lower than 140/90 mm Hg. RESULTS: Among the 142 042 participants, 57 840 (40.8%; 95%CI, 40.5%-41.0%) had hypertension and 26 877 (46.5%; 95%CI, 46.1%-46.9%) were aware of the diagnosis. Of those who were aware of the diagnosis, the majority (23 510 [87.5%; 95%CI, 87.1%-87.9%] of those who were aware) were receiving pharmacological treatments, but only a minority of those receiving treatment were controlled (7634 [32.5%; 95% CI, 31.9%-33.1%]). Overall, 30.8%, 95%CI, 30.2%-31.4%of treated patients were taking 2 or more types of blood pressure-lowering medications. The percentages aware (49.0% [95% CI, 47.8%-50.3%] in HICs, 52.5% [95% CI, 51.8%-53.2%] in UMICs, 43.6% [95% CI, 42.9%-44.2%] in LMICs, and 40.8% [95% CI, 39.9%-41.8%] in LICs) and treated (46.7% [95% CI, 45.5%-47.9%] in HICs, 48.3%, [95% CI, 47.6%-49.1%] in UMICs, 36.9%, [95% CI, 36.3%-37.6%] in LMICs, and 31.7% [95% CI, 30.8%-32.6%] in LICs) were lower in LICs compared with all other countries for awareness (P <.001) and treatment (P <.001). Awareness, treatment, and control of hypertension were higher in urban communities compared with rural ones in LICs (urban vs rural, P <.001) and LMICs (urban vs rural, P <.001), but similar for other countries. Low education was associated with lower rates of awareness, treatment, and control in LICs, but not in other countries. CONCLUSIONS AND RELEVANCE: Among a multinational study population, 46.5%of participants with hypertension were aware of the diagnosis, with blood pressure control among 32.5% of those being treated. These findings suggest substantial room for improvement in hypertension diagnosis and treatment.

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JAMA

Título del artículo:

Protein Engineering of Bacillus thuringiensis δ-Endotoxins

Protein engineering of insecticidal Bt δ-endotoxins is a powerful tool for designing novel Cry toxins with altered properties, including changing the toxin\'s specificity. By following some elementary rules governing the structure/function relationship, it has been possible to create new toxins with modified properties including increased toxicity and binding affinity, enhanced ion-transport activity, and changes in insect specificity. These methods have also produced valuable information and have led to an improved understanding of the mode of action of these important biopesticides. The results discussed in this chapter derive from rational molecular design where protein structure is modified by incorporating single or multiple amino acid substitutions aimed at modifying specific protein functions. In this review, we analyze several protein modifications that have been successfully used for creating stable, functional proteins with minimal structural alterations. The understanding and proper use of protein engineering approaches may help in implementing appropriate pest management strategies by improving the efficacy of these toxins against insect pests.

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Bacillus thuringiensis Biotechnology

Título del artículo:

Reliability of a questionnaire to determine non-specific low back pain and its characteristics in school children aged 7 to 12 years

Objective: To assess the test-retest reliability of a questionnaire to determine nonspecific low back pain (NLBP) and its characteristics in schoolchildren aged 7 to 12 years. Metodology: An evaluation of diagnostic technologies was done in 84 schoolchildren (9.2 ± 1.6 years), 50 % girls, selected for convenience. The questionnaire was administered by individual interview, twice, with an interval of 2 to 4 days. We calculated the Intraclass Correlation Coefficient (CCI 2.1) to quantitative variables and Coheńs and Weighted Kappa Index to qualitative variables with their respective confidence intervals at 95 % (CI95 %). Results: The prevalence was 20.2 % and 17.9 % in the first and second evaluation, respectively. The reliability of the questions that determine prevalence of NLBP was very good (k = 0.85, 95 % CI 0.69 - 1.00, n = 84); The number of days with NLBP in the last month got a fair reliability (CCI = 0.36; 95 % CI -0.009-0.70), while the duration asked by four categories of response was very good (k = 1.00; IC95 % 1.00-1.00), the intensity assessed by Wong-Baker F aces Pain Rating Scale was very good (ICC = 0.82, 95 % CI 0.54 - 0.93). In relation to consult a professional for back pain, Kappa indices ranged from k = 0.46 and k = 1.0. In the second evaluation, the children showed shorter duration of pain (3.9 days) and lower intensity (2.0). Discussion: The importance of reliability evaluation of the questionnaire to determine DLI and its characteristics is that there can be a valid measure unless the measure has some degree of reliability. The questionnaire to determine NLBP and their characteristics in schoolchildren aged 7 to 12 years is sufficiently reproducible for use in population studies.

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Revista de la Sociedad Espanola del Dolor

Título del artículo:

Report of 2 cases of primary epithelioid hemangioendothelioma of the external iliac vein

The epithelioid hemangioendothelioma (EHE) is a rare type of endothelial neoplasm found mainly in soft tissues and visceral organs and in extraordinary cases in large veins like the iliac veins. Currently, there is an active discussion in which EHE behavior, classification, new diagnostic tools, and treatment procedures are proposed. Here, we present 2 cases of EHE and discuss our experience in diagnosis and treatment of this neoplasm. © The Author(s) 2013.

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Vascular and Endovascular Surgery

Título del artículo:

A Repeated Measures Experiment of Green Exercise to Improve Self-Esteem in UK School Children

Exercising in natural, green environments creates greater improvements in adult\'s self-esteem than exercise undertaken in urban or indoor settings. No comparable data are available for children. The aim of this study was to determine whether so called \'green exercise\' affected changes in self-esteem; enjoyment and perceived exertion in children differently to urban exercise. We assessed cardiorespiratory fitness (20 m shuttle-run) and self-reported physical activity (PAQ-A) in 11 and 12 year olds (n = 75). Each pupil completed two 1.5 mile timed runs, one in an urban and another in a rural environment. Trials were completed one week apart during scheduled physical education lessons allocated using a repeated measures design. Self-esteem was measured before and after each trial, ratings of perceived exertion (RPE) and enjoyment were assessed after completing each trial. We found a significant main effect (F (1,74), = 12.2, p<0.001), for the increase in self-esteem following exercise but there was no condition by exercise interaction (F (1,74), = 0.13, p = 0.72). There were no significant differences in perceived exertion or enjoyment between conditions. There was a negative correlation (r = -0.26, p = 0.04) between habitual physical activity and RPE during the control condition, which was not evident in the green exercise condition (r = -0.07, p = 0.55). Contrary to previous studies in adults, green exercise did not produce significantly greater increases in self-esteem than the urban exercise condition. Green exercise was enjoyed more equally by children with differing levels of habitual physical activity and has the potential to engage less active children in exercise. © 2013 Reed et al.

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PLoS ONE

Título del artículo:

Situational leadership in nursing in a health institution in Bucaramanga, Colombia

Introduction: In nursing, it is crucial to know the leadership style required in each situation to act as a leader. The clinical nurse must have an effective leadership style that suits the situations presented during the performance of their functions, in order to achieve the objectives in the care of the patient and family. Objectives: To describe the situational leadership styles present in nurses in hospital departments, including intensive care, according to the theory of Hersey and Blanchard and to determine the relationship between leadership styles and occupational variables. Methodology: A cross-sectional descriptive study was conducted on a sample population of 107. nurses working in clinical areas of hospital and intensive care in two health institutions. The Dr. Herman Bachenheimer situational leadership tool was applied to nursing staff. Results: The nurses at the hospital area (61) and intensive care (46) have mainly a guide-leadership style (35.4%), followed by a participative style (33.9%) and manager-style (27.9%). Delegation leadership style (2.8%) was not present in clinical nurses. There is no significant relationship between leadership styles and the time working in the institution. A statistically significant relationship was found between leadership styles and length of management experience in the clinical area (P=. .011). Conclusions: The predominant leadership style of hospital nurses is to guide, and for intensive care nurses it is participatory. © 2012 Elsevier España, S.L.

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Enfermeria Clinica

Título del artículo:

Inter-rater reliability of the body alignment systematic observation form in college students

Objective: To estimate the inter-rater reliability of the Body Alignment Systematic Observation Form (BASOF) applied to young adults in a private university in Bucaramanga (Colombia). Methodology: A study of diagnostic tests was performed in a sample of 123 college students, aged 18 to 29, who met the inclusion criteria. Three examiners (an expert in posture, a physiotherapist with experience and a last semester student of physiotherapy) performed the postural examination, analyzing 7 printed photographs: one posterior, two right laterals, two left laterals and two anterior. We studied 63 deficiencies, which were registered in the BASOF. Results: The inter-rater reliability to determine postural deficiencies ranged from poor to acceptable. The level obtaining the best reliability according to the global Kappa index was the posterior one in which 26.5% of the deficiencies obtained a kappa Index greater than 0.40. The scoliosis in S variable had the highest reliability with a kappa value of 1.00, obtained on the item expert vs student on the posterior plane. Conclusions: The low inter-rater reliability leads to the conclusion that postural examination by direct observation method is not suitable for use in research. However, it allows the practitioner to detect marked postural deficiencies and therefore should not be excluded from the physiotherapy examination. Moreover, the BASOF can become a useful tool in the future academic career in physical therapy to establish methodically the process of observing body alignment. © 2012 Asociación Española de Fisioterapeutas.

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Fisioterapia

Título del artículo:

Current status of research and barriers to evidence-based practice in colombian physiotherapists

Introduction: Scientific evidence based practice (SEBP) is defined as a process whose objective is the selection of the best scientific arguments to solve the problems occurring in the clinical practice. This study has aimed to evaluate the current status of the investigation and the principal barriers existing for the Columbian physiotherapists to incorporate SEBP. Material and methods: A cross-sectional, multicenter and descriptive study was performed in 221 Colombian physiotherapists with no previous training in SEBP. An 18-item survey divided into 3 differentiated sections was applied. These sections were: 1) degree information, 2) application of SEBP and 3) areas and lines of professional and investigational work. In addition, sociodemographic information data were collected. Results: Average age was 26.6. ±. 6.1 years; 76% of those surveyed had a professional degree and only 3.2% a master\'s degree. A total of 43.4% of those surveyed looked for information in primary and secondary sources while 28.5% stated they never did so. Searcy was performed in Altavista, Google, Hotbot, Lycos by 55.7% and only 13% used Tesauros. 48.9% stated they had carried out descriptive type studies, 10.4% experimental and 3.2% case-controls. Of those surveyed, 10.9% developed projected in critical care, 7.2% in articular disease and 4.5% in neurological disorder. Conclusion: This study confirms the scarce scientific activity and barriers that limit including SEPB in physiotherapy professionals in Colombia. Multiple strategies of change will be necessary to facilitate the inclusion of activities aimed at the improvement of professional expertise in this material. © 2012 Asociación Española de Fisioterapeutas.

Acerca de la revista donde se publicó este artículo:

Fisioterapia

Título del artículo:

Inflammation and hypertension: Are there regional differences?

Hypertension is a chronic disease with global prevalence and incidence rapidly increasing in low and medium income countries. The surveillance of cardiovascular risk factors, such as hypertension, is a global health priority in order to estimate the burden and trends, to appropriately direct resources, and to measure the effect of interventions. We propose here that the adoption of Western lifestyles in low and middle incomes countries has dramatically increased the prevalence of abdominal obesity, which is the main source of proinflammatory cytokines, and that the vascular systemic inflammation produced by adipose tissue contributes to the development of hypertension. The concentration of proinflammatory cytokines is higher in the Latin American population than that reported in developed countries, suggesting a higher susceptibility to develop systemic low-degree inflammation at a given level of abdominal obesity. These particularities are important to be considered when planning resources for health care programs. Moreover, studying these singularities may provide a better understanding of the causes of the burden of cardiovascular risk factors and the remarkable variability in the prevalence of these medical conditions within and between countries. © 2013 Patricio López-Jaramillo et al.

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International Journal of Hypertension

Título del artículo:

Evidence of the effectiveness of median nerve glide for treatment of carpal tunnel syndrome

Objective: To determine the effectiveness of the median nerve glide for treatment of carpal tunnel syndrome. Search methods: A systematic review of the CENTRAL, MEDLINE, EMBASE, CINAHL, and PEDro data bases was conducted. The search included randomized, controlled trials with adult patients diagnosed of carpal tunnel syndrome. Studies published from January 2000 to February 2012 were included. Results of the search: Thirteen articles were located and reviewed. Finally, 6 studies that met the inclusion criteria of this study were analyzed. The neural glide techniques, conservative treatments (ultrasound, paraffin, tendon glide) and splinting were compared. Conclusions: There is moderate evidence supporting the use of median nerve glide techniques for the treatment of carpal tunnel syndrome. © 2012 Asociación Española de Fisioterapeutas.

Acerca de la revista donde se publicó este artículo:

Fisioterapia

Título del artículo:

Aged garlic extract improves adiponectin levels in subjects with metabolic syndrome: A double-blind, placebo-controlled, randomized, crossover study

Background. Garlic (Allium sativum) has been shown to have important benefits in individuals at high cardiovascular risk. The aim of the present study was to evaluate the effects of the administration of aged garlic extract (AGE) on the risk factors that constitute the cluster of metabolic syndrome (MS). Methods and Design. Double-blind, crossover, randomized, placebo-controlled clinical trial to assess the effect of 1.2 g/day of AGE (Kyolic), for 24 weeks of treatment (12 weeks of AGE and 12 weeks of placebo), on subjects with MS. Results. The administration of AGE increased the plasma levels of adiponectin (P=0.027). No serious side effects associated with the intervention were reported. Conclusion. The present results have shown for the first time that the administration of AGE for 12 weeks increased plasma adiponectin levels in patients with MS. This suggests that AGE might be a useful, novel, nonpharmacological therapeutic intervention to increase adiponectin and to prevent cardiovascular (CV) complications in individuals with MS. © 2013 Diego Gómez-Arbeláez et al.

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Mediators of Inflammation

Título del artículo:

Relationship between the social participation of children with disabilities and the satisfaction of their parents

Objectives: to determine the association between the social participation of the children with disabilities and the satisfaction of their parents with it. Methods: cross-sectional study conducted in eighty 5 to 13 years-old children (9±2.7 years) with disabilities, who lived in the metropolitan area of Bucaramanga and conveniently selected. The life-habit scale assessment was used. Spearman\'s correlation coefficient was estimated (p). Results: the global scoring of social participation was 6±2.3 and of the satisfaction of the parents with their children\'s social participation was 3.6±0.7. The habit with the highest correlation coefficient was communication (p= 0.83) and that with the lowest coefficient was personal relationships (p= 0.44). In the global scoring, very good correlation was found between the social participation and the satisfaction of the parents with this participation (p= 0.82) Conclusions: at the time of putting forward objectives and treatments, both the social participation and the satisfaction of parents with it should be taken into consideration jointly rather than separately.

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Revista Cubana de Pediatria

Título del artículo:

Molecular characterization of cry1, cry2, cry3 y cry4 genes in bacillus thuringiensis isolates and determination of its bioinsecticide activity in Aedes aegypti larvae

Chemical insecticides can be toxic and cause environmental degradation. Therefore, biological control of insects represents an alternative of low ecological impact. Bacillus thuringiensis is a spore-forming Gram-positive bacterium that produces parasporal crystals of a proteic nature, formed by delta endotoxins that are toxic to a large number of insects and are biodegradable and innocuous to other species. In the present work 13 native strains of B. thuringiensis were isolated from soil samples and identified by selective methods and the BBL CRYSTAL method. In the molecular characterization utilizing specific primers for the identification of cry1, cry2, cry3 y cry4 genes, eight isolates presented the cry3 gene and two presented the cry2 gene. These two latter isolates were used in a bioassay on Aedes aegypti larvae to determine their toxic effect, showing that the preliminary toxicity essay of the BtUDES2 isolate presented a lethality of 56.67%. When determining the lethal concentration of this same isolate, an average lethal concentration of 11.4333ng·ml-1 and a total lethal concentration of 17.1542ng·ml-1 were found.

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Interciencia

Título del artículo:

The goal of blood pressure in the hypertensive patient with diabetes is defined: Now the challenge is go from recommendations to practice

The recent Latin American and European guidelines published this year has proposed as a goal for blood pressure control in patients with diabetes type 2 a value similar or inferior to 140/90 mmHg. High blood pressure is the leading cause of cardiovascular diseases and deaths globally. Although once hypertension is detected, 80% of individuals are on a pharmacologic therapy only a minority is controlled. Diabetes also is a risk factor for other serious chronic diseases, including cardiovascular disease. Whether specifically targeting lower fasting glucose levels can reduce cardiovascular outcomes remains unknown. Hypertension is present in 20% to 60% of patients with type 2 diabetes, depending on age, ethnicity, obesity, and the presence of micro or macro albuminuria. High blood pressure substantially increases the risk of both macro and micro vascular complications, doubling the risk of all-cause mortality and stroke, tripling the risk of coronary heart disease and significantly hastening the progression of diabetic nephropathy, retinopathy, and neuropathy. Thus, blood pressure lowering is a major priority in preventing cardiovascular and renal events in patients with diabetes and hypertension. During many years the BP goals recommended in patients with diabetes were more aggressive than in patients without diabetes. As reviewed in this article many clinical trials have demonstrated not only the lack of benefits of lowering the BP below 130/80 mmHg, but also the J-shaped relationship in DM patients. Overall we discuss the importance of define the group of patients in whom significant BP reduction could be particularly dangerous and, on the other hand, those with a high risk of stroke who could benefit most from an intensive hypotensive therapy. In any case, the big challenge now is avoid the therapeutic inertia (leaving diabetic patients with BP values of 140/90 mmHg or higher) at all costs, as this would lead to an unacceptable toll in terms of human lives, suffering, and socioeconomic costs. © 2014 Lopez-Jaramillo et al.; licensee BioMed Central Ltd.

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Diabetology and Metabolic Syndrome

Título del artículo:

Latin american consensus on hypertension in patients with diabetes type 2 and metabolic syndrome

The present document has been prepared by a group of experts, members of Cardiology, Endocrinology, Internal Medicine, Nephrology and Diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high- risk population, usually underestimated and undertreated. These recommendations results from presentation and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming both physicians and patients from effectively adhering to guideline recommendations. © 2013 Elsevier España, S.L. y SEA.

Acerca de la revista donde se publicó este artículo:

Clinica e Investigacion en Arteriosclerosis

Título del artículo:

Point process heartbeat dynamics assessment of neurocardiogenic syncope in children

The underlying mechanisms that lead to syncope are still unclear, especially in children. In this work, we applied a novel point-process model to study timevarying heartbeat dynamics and to characterize autonomic changes that occur prior to a syncopal event. Twentysix children with history compatible with neurocardiogenic syncope (NCS) and a positive head up tilt table test (HUT) were included in the study. ECG and blood pressure signals were recorded during rest and the diagnostic HUT. Using self-developed software, a decrease of > 30% of the median systolic blood pressure during HUT compared to rest was selected as the onset of the syncopal event. After ECG peak detection and correction of ectopic beats, we modeled the time between R-wave events as a history dependent inverse Gaussian (IG) and applied the pointprocess framework to compute several measures related with HRV. We tested for significant changes in these measures for three consecutive two-minute time intervals previous to the syncopal event. Of all measures, only the mean of the heart rate probability density function, μHR, and the scale parameter of the IG probability density function, ζ0(t), presented a statistically significant increase prior to syncope, providing novel features associated with the statistical properties of heartbeat generation that could be critical to predict and explain the occurrence of syncope.

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Computing in Cardiology

Título del artículo:

Relevance of economical evaluation of medications: The metoprolol case

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Revista Colombiana de Cardiologia

Título del artículo:

Reliability of Arm Curl and Chair Stand tests for assessing muscular endurance in older people

Objective: to assess the test-retest reliability and level of agreement between measures of the 30 second (30-s) Arm Curl and 30-s Chair Stand test in a sample of older adults from Bucaramanga. Materials and methods: a study of evaluation of diagnostic technology was done. Both tests were administered by the same evaluator to 111 adults older than 59 year-old (70,4 ± 7,3), on two occasions, with an interval of time between measures of 4 to 8 days. In the analysis, test-retest reliability was determined using the Intraclass Correlation Coefficient ICC= 2,1 with their confidence interval 95% (95%IC) respective. The agreement level was established by the Bland and Altman method. Results: the test-retest reproducibility of the 30-s Arm Curl test was very good ICC= 0,88 and to the Chair Stand test was good ICC= 0,78. The agreement was very good for both tests of muscle endurance. The 95% limits of agreement were between -3,8 and 3,2 stands to 30-s Chair Stand test and between -3,1 and 2,8 curls to 30-s Arm Curl test. Conclusion: the 30-s Arm Curl and 30-s Chair Stand test have good reliability and agreement to assess muscle endurance in older adults functionally independent.

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Revista Ciencias de la Salud