72 research outputs found
Prevalence of self-reported overweight-obesity and its association with socioeconomic and health factors among older Mexican adults
OBJECTIVE: To investigate the prevalence of obesity and its association with socioeconomic factors and comorbidities in a population-based study.
MATERIAL AND METHODS: Data were examined from 4,605 persons ages 60 and older that participated in the 2001 Mexican Health and Aging Study, conducted in rural and urban communities in Mexico. The prevalence of obesity (according to self-reported weight and height) was obtained, stratified by age, and logistic regression was used to study cross-sectional associations between obesity and socioeconomic factors.
RESULTS: Of the population studied, 20.9% were classified as obese and the prevalence diminishes with age. Overall, women were more likely than men to be obese. Lower educational level was associated with lower risk of overweight. In both men and women, obesity was more common between subjects with hypertension (OR 1.38 and 1.71, respectively) and long-distance walk limitation (OR 2.08 and 2.21, respectively).
CONCLUSION: In older Mexican adults, hypertension and long-distance walk limitation were independent associated factors for higher prevalence of obesity.
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Objetivo: Estudiar la prevalencia de obesidad y su asociación con factores socioeconómicos y comorbilidades.
Material y métodos: Se analizaron los datos de 4 605 personas de 60 años y más que participaron en el Estudio Nacional sobre Salud y Envejecimiento en México 2001 (ENASEM 2001) en zonas rurales y urbanas. La prevalencia de obesidad (peso y talla autorreportados) se obtuvo estratificada por edad y mediante una regresión logística se asoció con factores socioeconómicos.
Resultados: 20.9% se clasificaron como obesos y la prevalencia disminuyó con la edad. En general las mujeres tuvieron mayor probabilidad de ser obesas. Una baja escolaridad se asoció con menor riesgo de sobrepeso. En hombres y mujeres la obesidad se asoció con hipertensión (RM 1.38 y 1.71 respectivamente) y con dificultad para caminar (RM 2.08 y 2.21 respectivamente).
Conclusión: En la población de edad avanzada en México la hipertensión y la dificultad para caminar varias cuadras se asoció con mayor prevalencia de obesidad
Visualización de conceptos abstractos en programación estructurada
En este trabajo se tocan una serie de características que permiten comprender los problemas a los que se enfrentan los estudiantes de programación estructurada. Y se propone una novedosa metodología que permite la visualización de los conceptos abstractos que la constituyen. En este caso se utiliza la teoría de Forbus y su razonamiento cualitativo, a través del cual se pretende llevar el concepto abstracto a un plano físico. Con la llegada de la tecnología y las computadoras a principios de los años noventa, se inició la investigación del aprendizaje interactivo a través de la visualización. Lo que se presenta en este artículo es la investigación que tiene como objetivo general, desarrollar mini – teorías articuladas sobre el dominio de los conceptos abstractos de programación mediante el análisis de los modelos mentales del experto en programación y el razonamiento cualitativo, utilizando eventos de la vida cotidiana. Implementado con la ayuda de recursos didácticos como: el robot Sphero, un juguete tecnológico que puede ser programado (es decir, controlado) por medio de una computadora o dispositivo móvil utilizando la aplicación de programación visual Sphero Edu.Coordinación de Posgrado de Ciencias y Artes para el Diseño
Changes in the arrhythmic profile of patients treated for heart failure are associated with modifications in their myocardial perfusion conditions
Background: Heart failure (HF) patients can benefit from a proper RS. We had observed
that they show an increase in the number of arrhythmias during the first year of pharmacological
treatment.
Methods: We carried out a prospective observational study in which patients in an HF Clinic
were included when they had follow-up Holter monitoring. Patients also had a baseline myocardial
perfusion scan (Tc99 sestaMIBI/dypiridamole) and a control scan.
Results: We included 90 patients with follow-up Holter and 35 with scintigraphy, for analysis.
Fifty-six (62.2%) were men and the average age was 60.8 ± 14.6 years. Follow-up periods
were divided by six-month intervals up to 18 months or more, an increase in premature
ventricular contractions (PVCs) occurred in the six-month to one-year period (1915.4 ±
± 4686.9 vs. 2959 ± 6248.1, p = 0.09). In the one-year to 18-month control, PVCs went from
781.6 ± 1082.4 to 146.9 ± 184.1, p = 0.05. The increase in PVCs correlated with a reduction
in scintigraphy-detected ischemic territories, 5.64 ± 5.9 vs. 3.18 ± 3 (p = 0.1) and a gain in
those showing a reverse redistribution pattern (0.18 ± 0.6 vs. 2.09 ± 4.01, p = 0.1). Necrotic
territories and time domain heart rate variability did not show significant changes.
Conclusions: PVCs increase during the first year of HF treatment, and then they tend to
diminish and stabilize. These changes seem to correlate with changes in the perfusion state of
the patient. While ischemic territories decrease, reverse redistribution increases, showing that
endothelial dysfunction could have a relevant role in arrhythmia generation, possibly because
of membrane instability of recovered hibernating myocardium. (Cardiol J 2008; 15: 261-267
The effect of L-arginine and citrulline on endothelial function in patients in heart failure with preserved ejection fraction
Background: To evaluate the effect of the amino acids L-arginine and citrulline on endothelial
function in patients in stable diastolic and right heart failure using photoplethysmography.
Methods: Thirty patients from the Heart Failure Clinic of the Instituto Nacional de Ciencias
Médicas y Nutrición "Salvador Zubirán" underwent photoplethysmography using the hyperemia
technique. Index finger flow was assessed at baseline and after ischemia every 30 s by maximum
amplitude time (MAT), total time of the curve (TT) and the index of the two (MAT/TT < 30
= normal) before and after the administration of L-arginine (8 g/day in two doses, n = 15) or
citrulline (3 g/day in one dose, n = 15) for 60 days in addition to optimal pharmacological
treatment.
Results: There were no statistically significant differences between the two groups at baseline.
After the intervention, the MAT/TT index of all patients normalized in each evaluation period
with statistically significant differences. Basal L-arginine group = 38.75 ± 11.52, final
23.32 ± 6.08, p = 0.007 and basal citrulline group = 41.4 ± 13.47, final 23.65 ± 6.74, p = 0.007
at 60–90 s. Post-ischemia: basal L-arginine 36.60 ± 11.51, final 18.81 ± 15.13, p = 0.004 and
basal citrulline = 49.51 ± 15.17, final 27.13 ± 7.87, p = 0.003.
Conclusions: The administration of L-arginine and citrulline has a beneficial effect on
endothelial function as shown by the normalized MAT/TT index. It probably improves systemic
and pulmonary hemodynamics, which could help in the treatment of diastolic heart
failure. (Cardiol J 2010; 17, 5: 464-470
Improvement of ventricular function in systolic heart failure patients with oral L-citrulline supplementation
Background: The utility of L-arginine and L-citrulline in treatment of arterial hypertension by
increasing vascular oxide nitric availability has been demonstrated. Photoplethysmography,
a simple and low-cost optical technique, makes it possible to assess vascular function and to
detect changes in blood flow, pulse and swelling of the microvascular tissular space. The aim of
the study was to evaluate the effect of L-citrulline supplementation on functional class, ejection
fraction and peripheral blood flow in patients with systolic heart failure.
Methods: Thirty-five stable outpatients attending the Heart Failure Clinic at the INCMNSZ
underwent clinical evaluation, radioisotopic ventriculography and photoplethysmography before and
at the end of 4 months. They were randomized into two groups: experimental group, with oral
L-citrulline supplementation (3 g/day, n = 20) and control group, without supplementation (n = 15).
Results: In the experimental group the left ventricular ejection fraction (LVEF) increased
20.3% at rest and 12.7% with stress, as well as the right ventricular ejection fraction at rest of
15.10% and 14.88% with stress. In addition, functional class improved in 35%, and the
maximum amplitude time/total time (MAT/TT) index decreased 23.1%. These changes were
statistically significant compared with the control group.
Conclusions: Citrulline supplementation significantly improved the LVEF, the endothelial
function (MAT/TT index) and functional class. Citrulline can be an important co-adjuvant in
the treatment of stable and stable systolic heart failure patients
The effect of left ventricular dysfunction on right ventricle ejection fraction during exercise in heart failure patients: Implications in functional capacity and blood pressure response
Background: The aim of this study was to assess the effect of left ventricular dysfunction on
right ventricular ejection fraction during exercise in heart failure patients and its implications
in functional capacity and blood pressure response.
Methods: In a cross-sectional study 65 patients with heart failure were included. Left and
right ventricular ejection fractions were evaluated by radio-isotopic ventriculography. All subjects
underwent an exercise treadmill test (Bruce modified protocol). Systolic and diastolic
blood pressures were also recorded.
Results: From the total population, 38 (58.46%) showed a significant increase (≥ 5%) in left
ventricular ejection fraction (LVEF) and 27 (41.5%) showed a significant decrease in LVEF
(≥ 5%) after the stress test. Patients with a significant reduction in LVEF during stress had
lower exercise tolerance (4.1 ± 2.5 vs. 6.1 ± 2.5 METs, p = 0.009) compared to those who
showed an increase in LVEF. Diastolic blood pressure was higher at rest among those who had
a reduced LVEF during stress (83 ± 12.2 vs. 72.6 ± 12.2 mm Hg, p = 0.035) and during
exercise (95 ± 31.3 vs. 76.9 ± 31.3 mm Hg, p = 0.057), as well as mean arterial pressure in the
same group (97.1 ± 11.6 mm Hg, p = 0.05). In addition, this group decrease of –8.8 ± 51.6%
in the right ventricular ejection fraction after exercise compared to an increase of 27.3 ±
± 49.1% (p = 0.007) among the patients with an increase in LVEF.
Conclusions: Biventricular systolic dysfunction during exercise is associated with higher rest
and stress blood pressure and worse functional capacity
Microalbuminuria in systolic and diastolic chronic heart failure patients
Background: Microalbuminuria is considered a major risk factor predisposing to cardiovascular
morbidity and mortality. Microalbuminuria levels in patients with or without diabetes
have been associated with a higher risk of chronic heart failure (HF). However, there are
limited data regarding prevalence of microalbuminuria in chronic heart failure and its prognostic
value. The aim of this study was to assess the occurence of microalbuminuria in chronic
heart failure patients as well as its association with clinical, echocardiographic, and body
composition markers.
Methods: In a cross-sectional study, we included 72 chronic heart failure patients (NYHA I-III)
on standard HF therapy. All patients had an echocardiogram and body composition by vector
bioelectric impedance analysis (measured by Body Stat Quad Scan).
Results: The studied population consisted of 64% men at mean age of 62.6 ± 15.1 years.
Patients were divided into systolic and diastolic HF groups. Microalbuminuria was observed
in 40% of diastolic and 24% systolic HF patients (p = 0.04). Microalbuminuria was present
in more patients with volume overload (80 vs. 21.9%, p = 0.002), with a worse phase angle and
lower serum albumin (4.7 vs. 5.9° and 3.5 vs. 4.0 mg/dl, p = 0.02) and higher pulmonary
arterial pressure compared with patients without microalbuminuria in systolic HF patients.
There was no significant association between frequency of microalbuminuria and ejection
fraction. In the diastolic HF group, the presence of microalbuminuria was not associated with
any known risk factor.
Conclusions: Microalbuminuria was more frequent in diastolic than systolic HF patients. In
systolic HF patients microalbuminuria was associated with factors known to be markers of
worse prognosis. (Cardiol J 2008; 15: 143-149
Reversible changes of electrocardiographic abnormalities after parathyroidectomy in patients with primary hyperparathyroidism
Background: Several studies have reported that primary hyperparathyroidism is a risk factor
of higher cardiovascular mortality, mainly because hyperparathyroidism is related to arterial
hypertension, arrhythmias, structural heart abnormalities and activation of the renin–angiotensin–
aldosterone system. However, very few studies have shown the electrocardiographic
changes that occur after parathyroidectomy. That was the aim of this study.
Methods: We studied 57 consecutive patients with primary hyperparathyroidism surgically
treated. Electrocardiogram, serum electrolytes, parathyroid hormone, creatinine and albumin
measures were obtained before and after surgery and were compared.
Results: The most common basal electrocardiographic abnormalities were left ventricular
hypertrophy (LVH, 24.6%), conduction disturbances (16.3%), and short QT and QTc intervals.
After surgery, a QTc interval lengthening and a tendency of T wave shortening were
observed, as well as an inverse association between QTc interval and serum levels of magnesium
and corrected calcium. There were no differences in LVH and conduction disturbances
after surgery.
Conclusions: Primary hyperparathyroidism is an important factor in the development of
electrocardiographic abnormalities in this population, some of which are not corrected after
parathyroidectomy. Further studies are required to demonstrate what factors are associated with
persistence of electrocardiographic disturbances after surgery
Prognostic value of cardiac troponin T elevation is independent of renal function and clinical findings in heart failure patients
Background: The aim of this study is to determine the prevalence and prognostic value of
elevated cardiac troponin (cTnT) and its association with clinical characteristics according to
renal function status in patients with stable heart failure.
Methods: In a prospective observational study, 152 consecutive patients from the Heart
Failure Clinic of the INCMNSZ were followed for a period of 42 months. All underwent
clinical evaluation, echocardiography, and determination of body composition by electric
bioimpedance to identify hypervolemia. Concentrations of cTnT were quantified by
immunoassay with electrochemoluminescence and ≥ 0.02 ng/mL levels were considered
elevated. Also glomerular filtration rate (eGFR) was estimated using the Cockcroft-Gault
equation.
Results: Elevated cTnT was significantly associated with increased all-cause mortality in the
observational period even after adjusting for eGFR < 60 mL/min/1.73 m2 and clinical findings
such as hypertension, functional class, loop diuretics, angiotensin converting enzyme
inhibitors, pulmonary pressure and hypervolemia in Cox regression analysis with a hazard
ratio of 4.58 (95% confidence interval: 1.84–11.45).
Conclusions: Heart failure patients with elevated cardiac-specific troponin T are at increased
risk of death independently of the presence of chronic kidney disease. (Cardiol J 2010;
17, 1: 42-48
Effect of L-arginine or L-citrulline oral supplementation on blood pressure and right ventricular function in heart failure patients with preserved ejection fraction
Background: The effect of L-arginine and L-citrulline on blood pressure and right ventricular
function in heart failure patients with preserved ejection fraction (HFpEF) is unknown.
We have therefore evaluated, in a randomized clinical trial, the effect of these aminoacids in
chronic outstanding and stable patients with HFpEF.
Methods and results: All patients underwent an echocardiogram and radioisotopic ventriculography
rest/exercise, and were randomized in a consecutive manner to the L-arginine
group (n = 15; 8 g/day); and the citrulline malate group (n = 15; 3 g/day). The duration of
follow-up was two months. The principal echocardiographic finding was a statistically significant
decrease in pulmonary artery pressure in the L-arginine (56.3 ± 10 vs 44 ± 16.5 mm Hg,
p < 0.05) and the citrulline (56.67 ± 7.96 vs 47.67 ± 8.59 mm Hg, p < 0.05) groups.
Duration on treadmill and right ventricular ejection fraction post exercise increased, while
diastolic and systolic artery pressure decreased significantly in both groups. There were no
other statistically significant differences between the groups.
Conclusions: Administration of L-arginine and citrulline to patients with HFpEF improved
right ventricular function by increasing right ventricular ejection fraction, and probably decreasing
systolic pulmonary artery pressure. (Cardiol J 2010; 17, 6: 612-618
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