Characterization of patients with an anatomopathological diagnosis of cerebrovascular disease

Introduction: In Cuba, cerebrovascular diseases (CVD) are very common non-communicable chronic conditions. Objectives: Characterize patients from intensive care unit with a pathological diagnosis of CVD. Methods: Observational, descriptive and transversal study in a sample of 176 patients. Variables: Age (19-39 years, 40-59 years, 60-100 years), sex, type of CVD (hemorrhagic, ischemic), APACHE II scale (= 15, > 15 score) and Glasgow coma on admission (= 8, > 8 score), mechanical ventilation (yes, no), length of stay (= 7, > 7 days) and direct cause of death. Frequencies, measures of central tendency, chi-square and Student's t tests (significance level of 5%) were calculated. Results: Hemorrhagic cerebrovascular disease, male sex (52.8%) and the age group of 60-100 years (64.8%) predominated. The mean age was 63.8 years. The average value of the APACHE II and Glasgow scales was 21.6 and 6.5. 97.6% received mechanical ventilation. The mean stay was 7.0 days. Severe cerebral edema was the main cause of direct death (79.3%). Conclusions: There is a predominance of hemorrhagic CVD, in male patients, aged 60-100 years, APACHE II score > 15, Glasgow score = 8, ventilated patients, stay = 7 days and intense cerebral edema

Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial

Background: A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. Methods/design: Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11–17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75–85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55–75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. Discussion: The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources.The HEPAFIT study was carried out with the financial support of Instituto Colombiano para el Desarrollo de la Ciencia y la Tecnología “Francisco José de Caldas” COLCIENCIAS (code 59700 and no 122277757900). Katherine González-Ruíz receive a scholarship from Universidad del Rosario, Colombia, Escuela de Medicina y Ciencias de la Salud, to do a Doctorate. This article presents independent research commissioned by COLCIENCIAS under its Program Grants for Applied Research funding scheme (Convocatoria 777–2017)

The Beaker phenomenon and the genomic transformation of northwest Europe

From around 2750 to 2500 bc, Bell Beaker pottery became widespread across western and central Europe, before it disappeared between 2200 and 1800 bc. The forces that propelled its expansion are a matter of long-standing debate, and there is support for both cultural diffusion and migration having a role in this process. Here we present genome-wide data from 400 Neolithic, Copper Age and Bronze Age Europeans, including 226 individuals associated with Beaker-complex artefacts. We detected limited genetic affinity between Beaker-complex-associated individuals from Iberia and central Europe, and thus exclude migration as an important mechanism of spread between these two regions. However, migration had a key role in the further dissemination of the Beaker complex. We document this phenomenon most clearly in Britain, where the spread of the Beaker complex introduced high levels of steppe-related ancestry and was associated with the replacement of approximately 90% of Britain’s gene pool within a few hundred years, continuing the east-to-west expansion that had brought steppe-related ancestry into central and northern Europe over the previous centuries

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Efectos de un programa de ejercicios sobre el metabolismo hepático, la grasa hepática y la salud cardiovascular en adolescentes con sobrepeso/obesidad de Bogotá, Colombia (el estudio HEPAFIT): protocolo de estudio para un ensayo controlado aleatorio

16 páginasAbstract Background A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. Methods/design Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11–17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75–85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55–75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. Discussion The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources.Abstracto Fondo Una proporción considerable de los jóvenes contemporáneos tiene un alto riesgo de sufrir trastornos relacionados con la obesidad, como enfermedades cardiovasculares, síndrome metabólico o enfermedad del hígado graso no alcohólico (NAFLD). Aunque existe evidencia consistente de los efectos positivos de la actividad física en varios aspectos de la salud, la mayoría de los adolescentes en Colombia son sedentarios. Es, por tanto, importante implementar estrategias que generen cambios en el estilo de vida. El estudio HEPAFIT tiene como objetivo examinar si un programa de ejercicio de 6 meses tiene beneficios para el contenido de grasa hepática y los resultados de salud cardiovascular entre adolescentes con sobrepeso u obesidad de Bogotá, Colombia. Métodos/diseño En total, 100 adolescentes sedentarios (de 11 a 17 años) con sobrepeso u obesidad que asisten a dos escuelas públicas en Bogotá, Colombia, se incluirán en un ensayo controlado aleatorio de grupos paralelos. Los adolescentes serán asignados aleatoriamente a un grupo de intervención siguiendo uno de cuatro planes de estudio: (1) el plan de estudios de educación física estándar (60 minutos por semana de actividad física, n = 25) de intensidad baja a moderada; (2) un plan de estudios de educación física de alta intensidad (HIPE, n = 25), que consiste en juegos de resistencia y resistencia y actividades no competitivas, como correr, yincanas, levantar objetos, empujar, luchar o arrastrar objetos, durante sesiones de 60 minutos , tres veces por semana, con un objetivo de gasto energético de 300 a 500 kcal/sesión al 75-85% de la frecuencia cardíaca máxima (FCmáx); (3) un plan de estudios de educación física de intensidad baja a moderada (LIPE, n = 25) que consiste en juegos de resistencia y resistencia y actividades no competitivas (por ejemplo, perseguir, correr, driblar o saltar) durante sesiones de 60 minutos, tres veces por semana con un objetivo de gasto energético de 300 kcal/sesión al 55-75% FCmáx; y (4) un plan de estudios combinado HIPE y LIPE (n = 25). Las intervenciones HIPE, LIPE y combinadas se realizaron además del plan de estudios estándar de educación física. El resultado principal de eficacia es el contenido de grasa del hígado, medido por el parámetro de atenuación controlada 1 semana después del final del programa de intervención. Discusión El enfoque traslacional puede ser adecuado para recopilar nueva información en un entorno escolar sobre los posibles efectos de las intervenciones de actividad física para reducir el contenido de grasa del hígado y mejorar los perfiles metabólicos y la salud cardiometabólica de los adolescentes con sobrepeso u obesidad. Esto puede conducir a un uso más eficiente de los recursos de educación física escolar

Additional file 1: of Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial

Non-traditional biomarkers. (DOCX 19 kb

Additional file 2: of Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial

SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents. (DOC 125 kb

Crisis socioambiental y cambio climático

En el terreno de las ciencias sociales el monopolio del objeto pobreza ha tenido entre sus consecuencias bipolares más relevantes la concentración en un tema de alta significación como problema social universal y la diversidad de aristas desde la que este es construido y evaluado, pero a la vez ello ha significado un estrechamiento del alcance de tales ciencias, por el abandono o subvaloración de otros objetos de mayor densidad teórica y radicalidad crítica (como desigualdades desarrollo, conflicto, estructuras clasistas, entre otros) en las que el pensamiento social de la región había construido una tradición y una mirada propia que pueden considerarse aportes a las ciencias sociales en general

Crisis socioambiental y cambio climático

En el terreno de las ciencias sociales el monopolio del objeto pobreza ha tenido entre sus consecuencias bipolares más relevantes la concentración en un tema de alta significación como problema social universal y la diversidad de aristas desde la que este es construido y evaluado, pero a la vez ello ha significado un estrechamiento del alcance de tales ciencias, por el abandono o subvaloración de otros objetos de mayor densidad teórica y radicalidad crítica (como desigualdades desarrollo, conflicto, estructuras clasistas, entre otros) en las que el pensamiento social de la región había construido una tradición y una mirada propia que pueden considerarse aportes a las ciencias sociales en general