218 research outputs found

    Astronomía, gravitación y modelos cosmológicos

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    Resumen. La humanidad ha planteado diversas teorías respecto a su visión cósmica a través del tiempo. En este trabajo se expone en forma sucinta la historia de las teorías cosmológicas. Se parte de las primeras ideas acerca del universo hasta llegar a la teoría general de la relatividad

    Obeso metabólicamente normal

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    Introduction: Obesity is a public health problem that tends to increase and compromises the health of people. Objectives: To determine the prevalence of metabolically normal obese (OMN) subjects depending on the presence of cardiovascular risk factors in an adult population showing obesity and morbid obesity. Design: Observational, descriptive and cross-section study. Setting: Department of Endocrinology, Hospital Dos de Mayo, Lima, Peru. Participants: Obese adults without metabolic diseases. Interventions: the study was conducted during the period between April 2009 and May 2010 in all adults consulting for obesity and who declared not having type 2 diabetes mellitus, arterial hypertension or dyslipidemia. Weight, height and waist circumference (WC) were obtained, and body mass index (BMI) was calculated. Those who had 30 kg/m2 or more were included in the study. Insulin, glucose and lipid profile were determined. Metabolic syndrome was determined through measurement of glucose, HDL-C, triglycerides and WC. Insulin resistance (IR) was diagnosed through glucose and insulin resistance homeostasis model assessment (HOMA-IR). Two groups were distinguished: obese with BMI of 30 to 39.9 kg/m2, and obese with BMI 40 kg/m2 and more. Statistical analysis was performed using student t test and chi -square with a 95% confidence interval and a significance level of < 0.05. Main outcome measures: Average and standard deviation variables. Prevalence of OMN and OMnotN. Results: From the 158 subjects, 91.2 % were female The OMN and OMnotN groups showed statistically significant difference in weight, height, WC, insulin and HOMA-IR. OMN prevalence was 7% in all obese and 7.3 and 6.4% in the BMI groups (Wildman criteria), while it was 13%, 15.5 and 2.1 % respectively by Meiggs criteria. Conclusions: The study showed the presence of a reduced number of obese subjects considered OMN by the criteria used.Introducción: La obesidad es un problema de Salud Pública que tiende a incrementarse y que compromete la salud de las personas. Objetivos: Conocer la prevalencia de obesos metabólicamente normales (OMN) en función de la presencia de factores de riesgo cardiovascular en una población adulta que presenta obesidad y obesidad mórbida Diseño: Estudio observacional, descriptivo y de corte transversal. Lugar: Servicio de Endocrinología, Hospital Dos de Mayo, Lima. Perú Participantes: Personas adultas sin enfermedades metabólicas. Intervenciones: En el período abril de 2009 a mayo de 2010, se estudió a todas aquellas personas adultas que consultaron por obesidad y que dijeron no presentar diabetes mellitus tipo 2, hipertensión arterial y dislipidemias. Se les pesó, talló y se midió su circunferencia de cintura (CC). Con las dos primeras se calculó el índice de masa corporal y quienes tenían 30 kg/m2 o más ingresaron al estudio. Se les midió insulina, glucosa y perfil lipídico. Con la glucosa, c-HDL, triglicéridos y la CC se determinó el síndrome metabólico y con la insulina y la glucosa el modelo homeostático de evaluación de la resistencia en insulina (HOMA-IR). con la finalidad de identificar resistencia a la insulina (RI). Se dividió el grupo en dos: obesos de 30 a 39,9 kg/m2 y 40 kg/m2 y más. El análisis estadístico se efectuó con las pruebas de t-student y de chi-cuadrado, con un intervalo de confianza de 95% y nivel de significancia <0,05. Principales medidas de resultados: Promedio y desviación estándar de las variables estudiadas y prevalencia de OMN y OMnoN. Resultados: La población estudiada alcanzó a 158 personas, de las cuales 91,2% correspondió al género femenino. Entre las diferencias entre los dos grupos OMN y OMnoN, referente a las variables antropométricas y bioquímicas, tuvieron significación estadística el peso, talla, CC, insulina y el HOMA-IR. La prevalencia de OMN, de acuerdo a Wildman, fue 7% en el total de obesos y 7,3 y 6,4% en los grupos OMN y OMnoN, mientras según los criterios de Meiggs, fue 13%, 15,5 y 2,1%, respectivamente. Conclusiones: El estudio mostró la presencia de un reducido número de obesos que fueron caracterizados como OMN

    Cardiovascular risk in infants overweight and obese

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    El sobrepeso y la obesidad conducen a la aparición de comorbilidades como la diabetes mellitus tipo 2, hipertensión arterial, dislipidemias. Objetivos: Determinar la presencia de riesgo cardiovascular en niños y adolescentes con sobrepeso y obesidad, por género y grupos de edad. Diseño: Estudio descriptivo, transversal. Participantes: Niños y adolescentes, de ambos géneros, comprendidos entre los 5 a 18 años. Intervención: El diagnóstico de sobrepeso y obesidad se hizo de acuerdo a la clasificación de Must y col. con los siguientes criterios: de 85 a 95 para el sobrepeso y más de 95 percentil obesidad. En sangre se determinó el perfil lipídico, glucosa e insulina; con estas dos últimas se determinó el índice HOMA, para identificar resistencia a la insulina (RI), mediante la ecuación de Matthew, el síndrome metabólico (SM) con la referencia de Cook y las dislipidemias (D) con las sugerencias de Friedman y de Daniels. Principales medidas de resultados: Riesgo cardiovascular. Resultados: Los obesos presentan mayores riesgos cardiovasculares que los que tienen sobrepeso: RI 77,8%, SM 22,2%; D: colesterol total (CT) 64,4%, C-HDL 33,3%, C-LDL 19,5% y triglicéridos (Tg) 40%. El género masculino, independientemente de su estado nutricional, tuvo mayor riesgo que el femenino: RI 74,1%, SM 22,2%, D: CT 63%, C-HDL 37%, C-LDL 36% y Tg 40,7%. En cuanto a la edad, en los mayores de 10 años se ha encontrado RI en 78% y C-HDL 31,7%; los demás factores de riesgo fueron mayores en los menores de 10 años. Conclusiones: Los riesgos afectaron más a los obesos que a los que tenían sobrepeso, más al género masculino y, en cuanto a la edad, los mayores de 10 años presentaron mayor prevalencia de RI y de C-HDL bajo. A mayor IMC más riesgo cardiovascular, lo que compromete muy seriamente la salud y que se hace más preocupante porque su aparición es a temprana edad.Overweight and obesity lead the occurrence of comorbidities such as type 2 diabetes mellitus, hypertension, anddyslipidemias. Objectives: To determine the presence of cardiovascular risk in children and adolescents overweight and obese,by gender and age groups. Design: Cross sectional study. Participants: Children and adolescents of both genders, 5-18 year-old.Interventions: Diagnosis of overweight and obesity was done according to Must et al. classification with the following criteria: 85 to 95for overweight and more than 95 percentile for obesity. Serum lipid profile, glucose and insulin were analyzed, and with the latter twoHOMA index was determined to identify insulin resistance (IR), using Matthew´s equation, the metabolic syndrome (MS) with referenceto Cook and dyslipidemias (D) with Friedman and Daniels’ suggestions. Main outcome measures: Cardiovascular risk. Results: Obesechildren had higher cardiovascular risks than overweight: IR 77.8%, SM 22.2%, D: total cholesterol (TC) 64.4%, HDL-C 33.3%, LDL-C19.5% and triglycerides (Tg) 40%. Males had higher risk than females regardless of nutritional status: IR 74.1%, SM 22.2%, D: TC63%, HDL-C 37%, LDL-C 36%, Tg 40.7%. Children over 10 had IR 78% and HDL-C 31.7%; other risk factors were higher in thoseunder 10 years. Conclusions: Risks affected obese more than overweight children, more to males, and those over 10 years had higherprevalence of IR and low HDL-C. With higher BMI more cardiovascular risk and serious health compromise, worrisome because ofearly age onset

    The accuracy of the MMSE in detecting cognitive impairment when administered by general practitioners: A prospective observational study

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    <p>Abstract</p> <p>Background</p> <p>The Mini-Mental State Examination (MMSE) has contributed to detecting cognitive impairment, yet few studies have evaluated its accuracy when used by general practitioners (GP) in an actual public-health setting.</p> <p>Objectives</p> <p>We evaluated the accuracy of MMSE scores obtained by GPs by comparing them to scores obtained by Alzheimer's Evaluation Units (UVA).</p> <p>Methods</p> <p>The study was observational in design and involved 59 voluntary GPs who, after having undergone training, administered the MMSE to patients with symptoms of cognitive disturbances. Individuals who scored ≤ 24 (adjusted by age and educational level) were referred to Alzheimer's Evaluation Units (UVA) for diagnosis (including the MMSE). UVAs were unblinded to the MMSE score of the GP. To measure interrater agreement, the weighted Kappa statistic was calculated. To evaluate factors associated with the magnitude of the difference between paired scores, a linear regression model was applied. To quantify the accuracy in discriminating no cognitive impairment from any cognitive impairment and from Alzheimer's disease (AD), the ROC curves (AUC) were calculated.</p> <p>Results</p> <p>For the 317 patients, the mean score obtained by GPs was significantly lower (15.8 vs. 17.4 for the UVAs; p < 0.01). However, overall concordance was good (Kappa = 0.86). Only the diagnosis made by the UVA was associated with the difference between paired scores: the adjusted mean difference was 3.1 for no cognitive impairment and 3.8 for mild cognitive impairment. The AUC of the scores for GPs was 0.80 (95%CI: 0.75–0.86) for discriminating between no impairment and any impairment and 0.89 (95%CI: 0.84–0.94) for distinguishing patients with AD, though the UVA scores discriminated better.</p> <p>Conclusion</p> <p>In a public-health setting involving patients with symptoms of cognitive disturbances, the MMSE used by the GPs was sufficiently accurate to detect patients with cognitive impairment, particularly those with dementia.</p

    The Test Your Memory cognitive screening tool: sociodemographic and cardiometabolic risk correlates in a population-based study of older British men.

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    OBJECTIVE: This study aimed to examine the association of Test Your Memory (TYM)-defined cognitive impairment groups with known sociodemographic and cardiometabolic correlates of cognitive impairment in a population-based study of older adults. METHODS: Participants were members of the British Regional Heart Study, a cohort across 24 British towns initiated in 1978-1980. Data stemmed from 1570 British men examined in 2010-2012, aged 71-92 years. Sociodemographic and cardiometabolic factors were compared between participants defined as having TYM scores in the normal cognitive ageing, mild cognitive impairment (MCI) and severe cognitive impairment (SCI) groups, defined as ≥46 (45 if ≥80 years of age), ≥33 and <33, respectively. RESULTS: Among 1570 men, 636 (41%) were classified in the MCI and 133 (8%) in the SCI groups. Compared with participants in the normal cognitive ageing category, individuals with SCI were characterized primarily by lower socio-economic position (odds ratio (OR) = 6.15, 95% confidence interval (CI) 4.00-9.46), slower average walking speed (OR = 3.36, 95% CI 2.21-5.10), mobility problems (OR = 4.61, 95% CI 3.04-6.97), poorer self-reported overall health (OR = 2.63, 95% CI 1.79-3.87), obesity (OR = 2.59, 95% CI 1.72-3.91) and impaired lung function (OR = 2.25, 95% CI 1.47-3.45). A similar albeit slightly weaker pattern was observed for participants with MCI. CONCLUSION: Sociodemographic and lifestyle factors as well as adiposity measures, lung function and poor overall health are associated with cognitive impairments in late life. The correlates of cognitive abilities in the MCI and SCI groups, as defined by the TYM, resemble the risk profile for MCI and Alzheimer's disease outlined in current epidemiological models. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons, Ltd

    Intersection between metabolic dysfunction, high fat diet consumption, and brain aging

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    Deleterious neurochemical, structural, and behavioral alterations are a seemingly unavoidable aspect of brain aging. However, the basis for these alterations, as well as the basis for the tremendous variability in regards to the degree to which these aspects are altered in aging individuals, remains to be elucidated. An increasing number of individuals regularly consume a diet high in fat, with high‐fat diet consumption known to be sufficient to promote metabolic dysfunction, although the links between high‐fat diet consumption and aging are only now beginning to be elucidated. In this review we discuss the potential role for age‐related metabolic disturbances serving as an important basis for deleterious perturbations in the aging brain. These data not only have important implications for understanding the basis of brain aging, but also may be important to the development of therapeutic interventions which promote successful brain aging.Fil: Uranga, Romina Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Bruce Keller, Annadora J.. State University of Louisiana; Estados UnidosFil: Morrison, Christopher D.. State University of Louisiana; Estados UnidosFil: Fernandez Kim, Sun Ok. State University of Louisiana; Estados UnidosFil: Ebenezer, Philip J.. State University of Louisiana; Estados UnidosFil: Zhang, Le. State University of Louisiana; Estados UnidosFil: Dasuri, Kalavathi. State University of Louisiana; Estados UnidosFil: Keller, Jeffrey N.. State University of Louisiana; Estados Unido

    "The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

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    <p>Abstract</p> <p>Background</p> <p>The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries.</p> <p>Methods</p> <p>A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India). All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF) calculated.</p> <p>Results</p> <p>The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%). Other substantial contributors were limb impairment (9%, 1%-46%), stroke (8%, 2%-17%), and depression (8%, 1%-27%).</p> <p>Conclusion</p> <p>The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in middle income countries (MIC). The prevention and control of chronic neurological and neuropsychiatric diseases and the development of long-term care policies and plans should be urgent priorities.</p

    Dementia as a determinant of social and health service use in the last two years of life 1996-2003

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    <p>Abstract</p> <p>Background</p> <p>Dementia is one of the most common causes of death among old people in Finland and other countries with high life expectancies. Dementing illnesses are the most important disease group behind the need for long-term care and therefore place a considerable burden on the health and social care system. The aim of this study was to assess the effects of dementia and year of death (1998-2003) on health and social service use in the last two years of life among old people.</p> <p>Methods</p> <p>The data were derived from multiple national registers in Finland and comprise all those who died in 1998, 2002 or 2003 and 40% of those who died in 1999-2001 at the age of 70 or over (n = 145 944). We studied the use of hospitals, long-term care and home care in the last two years of life. Statistics were performed using binary logistic regression analyses and negative binomial regression analyses, adjusting for age, gender and comorbidity.</p> <p>Results</p> <p>The proportion of study participants with a dementia diagnosis was 23.5%. People with dementia diagnosis used long-term care more often (OR 9.30, 95% CI 8.60, 10.06) but hospital (OR 0.33, 95% CI 0.31, 0.35) and home care (OR 0.50, 95% CI 0.46, 0.54) less often than people without dementia. The likelihood of using university hospital and long-term care increased during the eight-year study period, while the number of days spent in university and general hospital among the users decreased. Differences in service use between people with and without dementia decreased during the study period.</p> <p>Conclusions</p> <p>Old people with dementia used long-term care to a much greater extent and hospital and home care to a lesser extent than those without dementia. This difference persisted even when controlling for age, gender and comorbidity. It is important that greater attention is paid to ensuring that old people with dementia have equitable access to care.</p

    Children's and adolescents' rising animal-source food intakes in 1990-2018 were impacted by age, region, parental education and urbanicity

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    Animal-source foods (ASF) provide nutrition for children and adolescents physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the worlds child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 1519 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes. (c) 2023, The Author(s)

    Incident type 2 diabetes attributable to suboptimal diet in 184 countries

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    The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.814.4 million) incident T2D cases, representing 70.3% (68.871.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.027.1%)), excess refined rice and wheat intake (24.6% (22.327.2%)) and excess processed meat intake (20.3% (18.323.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.487.7%)) and Latin America and the Caribbean (81.8% (80.183.4%)); and lowest proportional burdens were in South Asia (55.4% (52.160.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally. (c) 2023, The Author(s)
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