Intervention to promote physical activity in children aged 5 to 10 at the Eladio Roldós Barreiro XXI Educational Unit, Santo Domingo, 2024

The aim of this study was to implement an intervention to promote physical activity in children from 5 to 10 years of age at the Eladio Roldós Barreiro XXI Educational Unit. A quantitative, descriptive and basic purpose study was applied, with a pre-experimental longitudinal design. The sample consisted of 78 children selected intentionally. Two instruments were used: the “Weekly physical activity frequency questionnaire” and the “Perception and barriers to children\u27s physical activity questionnaire”. The results showed that the percentage of children who were not physically active decreased by 54%, while those who exercised between 3 and 6 times a week increased by 38%. There was also a 33% increase in active participation during physical education classes, and a 31% increase in physical activity outside school hours, mainly after school and on weekends. Perceived barriers to exercise decreased by 31%, reflecting greater willingness to engage in movement. It is concluded that the intervention was effective in reducing sedentary lifestyles, improving the frequency and intensity of physical activity and establishing more active habits in students, highlighting the importance of programs adapted to the school level to strengthen children\u27s physical and emotional well-being

Osteitis pubis in athletes: How should it be treated during professional competition?

Introduction Osteitis pubis, also known as pubalgia, is a mainly chronic injury, very common, which significantly affects the career of athletes, mainly men and young athletes, reappearing repeatedly because it occurs in an area that is constantly active in sports life, making it difficult to rest and thus generating numerous recurrences. Objectives Establish a proper management to treat this injury, taking into account the high competitiveness, and understand and know which is the most effective treatment method between surgical and conservative. Materials and methods A complete investigation will be carried out from different articles and studies carried out by health professionals about different treatments of osteitis pubis and at what time of the injury they were performed, from these to draw a conclusion according to the different results. Results: Different studies were reviewed,76 athletes with a diagnosis of pubalgia, were treated with conservative methods averaging a return to activity between 3 and 6 months depending on the stage of the injury. Injection therapy showed positive results in some patients at 3-8 weeks, while other patients after 25 weeks of injection did not benefit. 198 patients were studied for surgical treatment, on average, prior to surgery, presented preoperative symptoms for 15 months and averaged a recovery time of 9 months to regain competitiveness. Conclusion: OP should be treated according to the type of lesion of each patient, it should always be started with conservative treatment, ignoring infiltrative therapies, it should not wait more than 3 months to opt for surgical treatment

Effects of physical and cognitive exercise on the independence of older adults in the period 2013-2023. Systematic review

The aging of the population is an increasingly relevant reality in modern society, which implies the need to understand how to extend the functionality and independence of older adults, aspects related to quality of life. The best known factors are physical and cognitive exercise. This article aimed to conduct a systematic review on the effects of physical and cognitive exercise on the independence of older adults during the period 2013-2023. The methodology employed was the systematic review of the literature, limited to original studies conducted on older adults as study subjects. It was found that most articles focused on physical exercise, even some used physical exercise as an activity to improve the cognitive status of older adults. The results were based on the analysis of 13 selected articles, most of which were published in Spanish and focused on Spanish and Latin American populations. Physical exercises demonstrated the best results in terms of independence, showing significant improvements in participants\u27 abilities and skills. Similarly, the importance of cognitive stimulation in older adults was recognized. In conclusion, both physical and cognitive exercise have positive effects on the functional independence in older adults

Causal factors of sudden death in young athletes

It is undeniable that physical activity provides multiple benefits, both for general health and cardiovascular health, but on rare occasions, sudden cardiac death can occur in athletes even without previous symptoms. Regarding the causes and incidences, there are different studies from various countries and regions that present different results, due to the cultural variations in each country and their practiced sports. Moreover, in some countries, like Italy for example, screenings for conditions such as hypertrophic cardiomyopathy are implemented more frequently compared to other countries. Sudden death involves a broad spectrum of associated pathologies, and in athletes or individuals under 35 years old, the most common causes are primary cardiomyopathies, cardiac channelopathies, and congenital anomalies of the coronary arteries.Objectives: Know the main causes of sudden cardiac death in young athletes. Material and methods: This work is a systematic review of the literature, where different studies and articles will be analyzed to compile the most relevant and up-to-date information regarding the main causes of sudden death in young athletes. The search will be conducted through databases such as PubMed, SciELO, and the Argentine Society of Cardiology\u27s website. Results: Based on the results obtained, it was observed that the most common causes of sudden death in young athletes vary depending on the region where the studies were conducted. This variation is mainly due to sociocultural factors that influence how a given society behaves and which sports are practiced. Conclusion: Although it is a rare event with low incidence, sudden cardiac death is a catastrophic event that, in most cases, leads to death. However, it is an event that can be prevented, and with the correct therapeutic intervention in the first few minutes, it can be successfully reversed. But to achieve this, it is necessary to understand the topic and be aware of its main causes to act correctly and efficiently

Use of Cannabis in people with autism spectrum disorder

Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impaired communication, social interaction, and repetitive or stereotyped behaviors in those affected. It presents with a wide range of symptoms, which can vary from mild to severe.Method: a search was conducted in the PubMed, SciELO databases, and the book Cannabis Medicinal. Articles were downloaded from the cited platforms to make the appropriate citations and references in Portuguese, Spanish, and English, covering the last 5 years.Results: The use of medicinal cannabis in treating Autism Spectrum Disorder (ASD) has shown potential in improving symptoms such as hyperactivity, aggression, self-harm, sleep disturbances, and anxiety. Recent studies highlight that cannabinoids, particularly cannabidiol (CBD), may be a safe and effective option for relieving these symptoms and improving patients\u27 quality of life. However, it is essential to have more robust and long-term research to assess its safety and adverse effects. Despite promising results, the need for professional monitoring and individualized treatment is emphasized to optimize benefits and mitigate possible risks.Conclusions: this treatment is highly individualized and personalized, encompassing not only pharmacological interventions but also dietary adjustments, supplements, and social behavior strategies, with cannabis use being a supplementary alternative

Neurological complications in patients with Human Immunodeficiency Virus infection at the Japanese Hospital in Santa Cruz, Bolivia

Introduction: Neurological involvement is common among patients with Human Immunodeficiency Virus (HIV) infection. Between 40 and 60% will develop symptomatic neurological complications with high morbidity and mortality at some point. Objective: To analyze the clinical-epidemiological characteristics of patients with HIV infection who develop neurological complications at the Japanese Hospital of Santa Cruz de la Sierra in the period between March 2019 and February 2022.Methods: Observational, descriptive, prospective, cross-sectional study. Universe and Sample: Patients admitted through the Emergency Service of the Japanese Hospital with a confirmed diagnosis of Human Immunodeficiency Virus Disease during the period between March 2019 and February 2022Results and discussion: A total of 42 patients were evaluated, the majority of whom were men and had a younger average age. For both sexes, the majority of patients reported having a source of employment. Regarding sexual orientation, almost all women reported being heterosexual, while men were more variable, with the majority being bisexual. Three clinical syndromes were identified at admission. The frequency of focal syndrome was dominant in women, but was not significantly different from the others. In men, meningeal syndrome and focal syndrome were the dominant ones, significantly exceeding non-focal syndrome. Ten neurological complications were identified, cerebral toxoplasmosis was the most frequent, followed by cerebral cryptococcosis and meningeal tuberculosis. Considering all patients in general, their typical hospital stay was 11 days with a range between 2 and 56 days. Of the 42 patients evaluated, it was only possible to measure the CD4 status for 27.Conclusions: The young male population with employment in the city of Santa Cruz with aberrant sexual behavior was the most affected. Focal syndrome was the most frequent form of presentation, in the form of cerebral toxoplasmosis. Severely low levels of immunosuppression were found in the study population. Hospital stay is variable and is longer in cases of focal syndrome and meningeal syndrome. We consider it important to continue the present study, which will allow us to increase the sample size

Pharmacological prophylaxis of choice in venous thromboembolic disease in major orthopedic surgery: aspirin vs LMWH and other anticoagulants

Introduction: Venous thromboembolic disease, deep vein thrombosis and pulmonary embolism are important causes of long-term morbidity and mortality, and are preventable. The risk of VTE is established in patients who will undergo major orthopedic surgery, given by factors such as the duration of surgery and reduced perioperative mobility.Studies show that without pharmacological thrombo prophylaxis, VTE rates are significant. For this reason, it is essential to establish an effective thrombo prophylaxis protocol to prevent VTE without significantly increasing the risk of bleeding. There is no evidence with strong results regarding the drug of choice for thrombo prophylaxis, but currently meta-analyses and systematic reviews establish aspirin as an effective, accessible and low-cost option, with low risk of postoperative bleeding in low-risk patients.Aspirin is an easy-to-administer drug, does not require blood monitoring and is well tolerated, with an excellent safety profile. However, there are some theories that newer oral agents may have higher risks of bleeding, such as major hemorrhages and complications from postsurgical wounds.  Therefore, there is still considerable debate about which agents should be preferred in terms of effectiveness and lower risk of bleeding.Objectives: To establish the drug of choice for thromboprophylaxis in VTE in patients undergoing major orthopedic surgery.Materials and methods: A bibliographic search and analysis was carried out, only 15 articles were suitable for the research, articles from international databases such as PubMed, Scopus and Cinahl were used.Results: There were no significant differences in the risk of VTE (OR = 0.93; 95% CI: 0.69-1.26; p = 0.64), DVT (OR = 0.72; 95% CI: 0.43-1.20; p = 0.21) or PTE (OR = 1.13; 95% CI: 0.86-1.49; p = 0.38) between the groups that received LMWH prophylaxis and those that received aspirin. Nor were significant differences found in mortality (p = 0.30), bleeding (p = 0.22), or surgical wound complications (p = 0.85) between the two groups.Conclusion: aspirin is at least as safe and effective a drug for thromboprophylaxis as OACs and LMWH

Mortality in mechanical ventilation in prone position in patients with acute respiratory distress síndrome

Introduction: Prone ventilation has been shown to improve oxygenation and lung mechanics in patients with acute respiratory distress syndrome, but I consider it necessary to delve deeper into the relationship between the prone position and mortality. Objectives: To evaluate whether the prone position decreases the risk of mortality in adult patients with acute respiratory distress syndrome vs. supine ventilation, in a global and segmented manner, as well as to know the main adverse effects related to it. Material and methods: A meta-analysis of randomized controlled clinical trials comparing patients in the prone vs. supine position was performed with a search in Pubmed, Embase, Cochrane Library and LILACS, and mortality, hospital stay, days of mechanical ventilation and adverse effects were evaluated. Results: Seven randomized controlled clinical trials were included in the analysis. The prone position showed a non-significant tendency to decrease mortality when analyzed globally. When stratified by subgroups, a significant decrease in the risk of mortality was found in patients: 1) ventilated with low tidal volume, 2) prolonged prone position, and 3) established before 48 hours of disease progression in severe hypoxemia. The adverse effects related to prone position were the development of pressure ulcers and orotracheal tube obstruction. Conclusion: Prone position ventilation is a safe strategy and reduces mortality in patients with severe oxygenation impairment. It should be established early, for prolonged periods, and associated with a protective ventilation strategy

Decompressive Craniectomy As A Treatment In Patients With Cranio-Brain Trauma At The Central Hospital Of Maracay

The general objective: To evaluate decompressive craniectomy (DC) as a treatment in patients with traumatic brain injury (TBI) at the Central Hospital of Maracay. January-July 2024. Materials and Methods: The study is descriptive, prospective and cross-sectional. Glasgow and Marshall coma scale, clinical characteristics and imaging findings were applied. Results: 15 patients aged 49±23.5 years, 93% male, were studied. The main cause of TBI was a motorcycle accident and another (53.3%). Before CD, 80% had moderate TBI, 66.66% had normal pupils, 46.67% entered II and 33,33% were placed in IV on the Marshall scale. Subdural hematoma and epidural hematoma predominated with 26.67% in each case. The midline deviation was 8.5±2.4 mm. The CD application time was 11±9.6 hours. After CD, 46.66% and 26.67% were classified as having moderate and mild TBI respectively. 40% had normal pupils, 20% died and 66.67% were not admitted to the Intensive Care Unit. Although the results were favorable after CD, the differences did not show statistical significance (p≥0.05) so it is recommended to expand the sampling. Conclusion: The results suggest that decompressive craniectomy is recommended as a treatment in patients with traumatic brain injury, with satisfactory results in ages 20-40 years and moderate and mild TBI on the Glasgow scale. However, in patients over 60 years of age and a Glasgow scale score of less than 9 points, the results may be unfavorable

Respiratory Rehabilitation Programs in Portugal: Rapid Review

Introduction: Respiratory rehabilitation is an essential intervention in the management of respiratory diseases, focusing on physical symptoms and psychological aspects that pharmacological therapy alone cannot resolve. The aim of this review was to map the existing evidence on respiratory rehabilitation programs implemented in Portugal. Method: A rapid literature review was carried out, following the recommendations of Cochrane Rapid Reviews, PICoS strategy and PRISMA guidelines. Evidence was sought regarding the implementation of programs, services offered and user needs. The search included EBSCOHost and B-on databases, with study selection by two independent reviewers. Results: Twelve articles were included, presenting a high level of evidence and medium to high methodological quality. Inductive thematic analysis revealed central topics: program organization, accessibility, transition pathways, benefits, structures, management, and user perspectives. Conclusion: Several variables influence the success of programs, such as high costs, geographic inequalities, insufficient supply and limited capacity of the hospital network. Alternatives such as home-based programs, telerehabilitation and community initiatives show promise for expanding access to and effectiveness of respiratory rehabilitation. These findings suggest that the integration of innovative approaches can contribute to overcoming current limitations, promoting improvements in patients\u27 quality of life. Future studies should confirm evidence.   Keywords: Respiratory Diseases; Respiratory Rehablitation; Respiratory Rehabilitation Services