Efectos de los ejercicios pliométricos en pacientes postoperatorio de rotura del tendón calcáneo

It is known about the rupture of the Achilleus tendon since ancient Greece, which has been increasing in recent years, therefore, it seeks to implement better tools for its treatment, one of them being plyometric exercises. Meta-analysis type studies, randomized and experimental controlled trials observed that the application of plyometric exercises in most of the participants improved the quality of the tendon, increasing elasticity and decreasing its stiffness (p <0.01) in 14 studies and in the remaining 3 studies. , did not improve the structure of the tendon, however, it did improve its symptoms and functionality in late studies (p <0.01). The application of plyometric exercises is an additional tool to treat subjects undergoing an operation to rupture the Achilles tendon, which must be applied in the final stages of rehabilitation, improving tissue stiffness, increasing functionality and reducing chronic pain.De la ruptura del tendón Aquileo se tiene conocimiento desde la antigua Grecia, la cual ha ido en aumento en los últimos años, por ende, se busca implementar mejores herramientas para el tratamiento de la misma, siendo una de ellas los ejercicios pliométricos. Estudios tipo meta-análisis, ensayos controlados aleatorizados y experimentales observaron que la aplicación de ejercicios pliométricos en la mayoría de los participantes mejoraba la calidad del tendón, aumentando elasticidad y disminuyendo su rigidez  (p<0.01) en 14 estudios y en los 3 estudios restantes, no mejoraba la estructura del tendón, sin embargo, mejoraba la sintomatología y funcionalidad del mismo en estudios tardíos (p<0.01). La aplicación de ejercicios pliométricos es una herramienta adicional para tratar a los sujetos sometidos a una operación de ruptura de tendón Aquileo, el cual debe ser aplicado en estadios finales en rehabilitación, mejorando la rigidez del tejido, aumentando la funcionalidad y disminuyendo el dolor crónico

Imagen corporal y práctica de actividades físico-deportivas en estudiantes de nivel secundaria

The aim of the study is to value body image, the practice of physical-sport activities, and the perception of the health in school age adolescents in middle school. A non-experimental, descriptive, comparative and correlational study design is presented. The subject population of the study is a sample of 416 middle school students from the city San Nicolas de los Garza, N. L. Mexico selected by random sampling and stratified by gender and grade level, with an age between 12 and 15 years (13,14 ± 0,87), of which 216 are male and 200 are female; with an average weight of 53,63 ± 10,33 kg, a height of 1,59 ± 8,44 m and a BMI of 21 ± 3,03. The questionnaire Body Shape Questionnaire (BSQ-8A) was used, with 8 items and a response scale of 1 to 6 (where 1 is never and 6 is always), grouped in cut off points based on the concern of the body image: < 19 never, 19-25 slight, 26-33 moderate, >33 marked. The instrument has good psychometric properties. The statistical program SPSS v24 and LISREL were used for the analysis of the data. In general, Mexican adolescent students have an important concern for their body image, especially in women and those who perceive poor health, people who have a higher practice of physical-sports activities show a positive attitude towards their own body.El objetivo del estudio es valorar la imagen corporal, la práctica de actividades físico-deportivas y la percepción de la salud en escolares adolescentes de educación secundaria. Se presenta un diseño de estudio de tipo no experimental, descriptivo, comparativo y correlacional. La población objeto de estudio es una muestra de 416 estudiantes de educación secundaria de la ciudad de San Nicolás de los Garza, N. L. México seleccionados mediante un muestreo aleatorio y estratificado por género y grado escolar, con una edad entre 12 y 15 años (13,14 ± 0,87), de los cuales 216 son hombres y 200 mujeres, con un peso promedio de 53,63 ± 10,33 kg, una estatura de 1,59 ± 8,44 m y un IMC de 21 ± 3,03. Se utilizó el cuestionario Body Shape Questionnaire (BSQ-8A), con 8 ítems y una escala de respuesta de 1 a 6 (donde 1 es nunca y 6 siempre), agrupados en puntos de corte sobre la procupación de la imagen corporal: < 19 ninguna, 19-25 leve, 26-33 moderada, > 33 marcada. El instrumento cuenta con buenas propiedades psicométricas. Para el análisis de los datos se utilizó el programa estadístico SPSS v24 y LISREL. En general los estudiantes adolescentes mexicanos tienen una preocupación importante de su imagen corporal, especialmente en las mujeres y los que perciben una mala salud, y esta no es determinante de la práctica de actividades físico-deportivas.O objetivo do estudo é avaliar a imagem corporal, a prática de atividades físico-desportivas e a percepção de saúde em alunos adolescentes do ensino médio. Apresenta-se um desenho de estudo não experimental, descritivo, comparativo e correlacional. A população alvo é uma amostra de 416 estudantes do ensino médio da cidade de San Nicolás de los Garza, N. L. México, selecionado por amostragem aleatória e estratificado por gênero e série escolar, com idade entre 12 e 15 anos (13,14 ± 0,87), dos quais 216 são homens e 200 mulheres, com peso médio de 53,63 ± 10,33 kg, altura de 1,59 ± 8,44 m e IMC de 21 ± 3,03. Foi utilizado o Body Shape Questionnaire (BSQ-8A), com 8 itens e uma escala de resposta de 1 a 6 (onde 1 nunca é e 6 sempre), agrupados em pontos de corte na preocupação com a imagem corporal: < 19 nenhum, 19-25 leve, 26-33 moderado, > 33 marcado. O instrumento tem boas propriedades psicométricas. O programa estatístico SPSS v24 e LISREL foram utilizados para a análise dos dados. Em geral, os estudantes adolescentes mexicanos têm uma preocupação importante com a sua imagem corporal, especialmente nas mulheres e naqueles que percebem a falta de saúde, e isso não é determinante para a prática de atividades físico-desportivas

Depresión y ansiedad en falla cardíaca: ¿existen diferencias según el grupo muscular rehabilitado? Ensayo clínico aleatorizado (Strong Hearts Trial)

Introduction: heart failure is considered the disease of the millennium, its mortality is increasing worldwide. The population with heart failure and depressive disease has a prevalence of 25%.Objective: to determine the differences in strength training for upper versus lower limbs as a treatment to decrease levels of depression and anxiety in patients with heart failure.Methods: 3-year randomised controlled trial with 920 heart failure patients in three groups (aerobic exercise, aerobic exercise plus upper limb training and aerobic exercise plus lower limb training). Haematological samples were taken to determine blood glucose levels and lipid profile. In addition, tests were performed for aerobic capacity, maximum heart rate, anthropometry, depression, anxiety, and clinical and hemodynamic parameters. The tests were performed before and after 24 60-minute training sessions, three times a week, for two months.Results: depression levels were reduced by 52% in the operated groups, as well as 59% in the anxiety levels.Conclusions: when comparing the effects of lower limb strength training versus upper limb strength training on depression and anxiety levels, aerobic exercise plus upper limb strength training proved to be the most effective in reducing them.Introducción: la insuficiencia cardíaca es considerada la enfermedad del milenio, su mortalidad va en aumento en el mundo. La población con insuficiencia cardíaca y enfermedad depresiva se presenta con una prevalencia del 25%. Objetivo: determinar las diferencias en el entrenamiento de fuerza para miembros superiores versus inferiores como tratamiento para disminuir los niveles de depresión y ansiedad en pacientes con falla cardíaca.Métodos: ensayo controlado aleatorizado de tres años con 920 pacientes con falla cardíaca distribuidos en tres grupos (ejercicio aeróbico, ejercicio aeróbico más entrenamiento miembros superiores y ejercicio aeróbico más entrenamiento de miembros inferiores). Se realizaron muestras hematológicas para determinar los niveles de glucemia y el perfil lipídico. Además, pruebas para capacidad aeróbica, frecuencia cardíaca máxima, antropometría, depresión, ansiedad y parámetros clínicos y hemodinámicos. Las pruebas se realizaron antes y después de 24 sesiones de entrenamiento de 60 minutos, tres veces por semana, durante dos meses. Resultados: se disminuyeron los niveles de depresión en un 52% en los grupos intervenidos, al igual que un 59% en los niveles de ansiedad. Conclusiones: al comparar los efectos del entrenamiento de fuerza para miembros inferiores versus miembros superiores ante los niveles de depresión y ansiedad el ejercicio aeróbico más entrenamiento de fuerza en miembro superior resultó ser el más efectivo para disminuirlos

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Imagem corporal e prática de atividades físico-desportivas em alunos do ensino secundário

El objetivo del estudio es valorar la imagen corporal, la práctica de actividades físico-deportivas y la percepción de la salud en escolares adolescentes de educación secundaria. Se presenta un diseño de estudio de tipo no experimental, descriptivo, comparativo y correlacional. La población objeto de estudio es una muestra de 416 estudiantes de educación secundaria de la ciudad de San Nicolás de los Garza, N. L. México seleccionados mediante un muestreo aleatorio y estratificado por género y grado escolar, con una edad entre 12 y 15 años (13,14 0,87), de los cuales 216 son hombres y 200 mujeres, con un peso promedio de 53,63 10,33 kg, una estatura de 1,59 8,44 m y un IMC de 21 3,03. Se utilizó el cuestionario Body Shape Questionnaire (BSQ-8A), con 8 ítems y una escala de respuesta de 1 a 6 (donde 1 es nunca y 6 siempre), agrupados en puntos de corte sobre la procupación de la imagen corporal: 33 marcada. El instrumento cuenta con buenas propiedades psicométricas. Para el análisis de los datos se utilizó el programa estadístico SPSS v24 y LISREL. En general los estudiantes adolescentes mexicanos tienen una preocupación importante de su imagen corporal, especialmente en las mujeres y los que perciben una mala salud, y esta no es determinante de la práctica de actividades físico-deportivas.ABSTRACT: The aim of the study is to value body image, the practice of physical-sport activities, and the perception of the health in school age adolescents in middle school. A non-experimental, descriptive, comparative and correlational study design is presented. The subject population of the study is a sample of 416 middle school students from the city San Nicolas de los Garza, N. L. Mexico selected by random sampling and stratified by gender and grade level, with an age between 12 and 15 years (13,14 0,87), of which 216 are male and 200 are female; with an average weight of 53,63 10,33 kg, a height of 1,59 8,44 m and a BMI of 21 3,03. The questionnaire Body Shape Questionnaire (BSQ-8A) was used, with 8 items and a response scale of 1 to 6 (where 1 is never and 6 is always), grouped in cut off points based on the concern of the body image: 33 marked. The instrument has good psychometric properties. The statistical program SPSS v24 and LISREL were used for the analysis of the data. In general, Mexican adolescent students have an important concern for their body image, especially in women and those who perceive poor health, people who have a higher practice of physical-sports activities show a positive attitude towards their own body.RESUMO: O objetivo do estudo é avaliar a imagem corporal, a prática de atividades físico-desportivas e a percepção de saúde em alunos adolescentes do ensino médio. Apresenta-se um desenho de estudo não experimental, descritivo, comparativo e correlacional. A população alvo é uma amostra de 416 estudantes do ensino médio da cidade de San Nicolás de los Garza, N. L.México, selecionado por amostragem aleatória e estratificado por gênero e série escolar, com idade entre 12 e 15 anos (13,14 0,87), dos quais 216 são homens e 200 mulheres, com peso médio de 53,63 10,33 kg, altura de 1,59 8,44 m e IMC de 21 3,03. Foi utilizado o Body Shape Questionnaire (BSQ-8A), com 8 itens e uma escala de resposta de 1 a 6 (onde 1 nunca é e 6 sempre), agrupados em pontos de corte na preocupação com a imagem corporal: 33 marcado. O instrumento tem boas propriedades psicométricas. O programa estatístico SPSS v24 e LISREL foram utilizados para a análise dos dados. Em geral, os estudantes adolescentes mexicanos têm uma preocupação importante com a sua imagem corporal, especialmente nas mulheres e naqueles que percebem a falta de saúde, e isso não é determinante para a prática de atividades físico-desportivas

Clínica Integrada - ME210 - 202101

Curso de especialidad, de la carrera de medicina, de carácter teórico- práctico del ciclo 7, en el que los estudiantes integran conocimientos previos con la anamnesis, el examen físico y establecen el diagnostico por síndromes o problemas y el plan de trabajo. El curso de Clínica integrada busca desarrollar las competencias generales de comunicación escrita y comunicación oral(nivel 2) y las competencias específicas de práctica clínica-diagnóstico (nivel 2) y profesionalismo-sentido ético y legal y responsabilidad profesional(nivel 2). La integración de conocimientos en la historia clínica, permitirá al estudiante, plantear un adecuado diagnóstico, plan de trabajo para la atención de su futuro paciente