Efectos del entrenamiento funcional sobre el consumo máximo de oxígeno, fuerza y resistencia muscular, composición corporal y calidad de vida en sujetos entre 18 y 40 años: una revisión de la literatura

59 p.Actualmente los niveles de sedentarismo y obesidad mundial han ido en aumento, entre las barreras más importantes para realizar actividad física está la falta de tiempo y carencia de instalaciones adecuadas disponibles cercanas a su entorno (Ramírez, et al 2016). El entrenamiento funcional (EF) ya sea, en circuito, entrenamiento funcional de alta intensidad (HIFT) y entrenamiento contra resistencia corporal, ha cobrado mayor relevancia durante la última década, pues consiste en la combinación de ejercicio aeróbico con entrenamiento de fuerza generando adaptaciones metabólicas, musculares y respiratorias sobre el consumo máximo de oxígeno (VO2max), fuerza y resistencia muscular, composición corporal y calidad de vida y es por eso que el propósito de este estudio es revisar en base a la literatura los efectos del entrenamiento funcional sobre las variables mencionadas anteriormente en adultos entre 18 y 40 años. Se realizó una búsqueda en inglés, portugués y español en las bases de datos PUBMED, SCOPUS, SCIELO y Web of science, de los últimos 10 años, utilizando los términos de búsqueda High intensity functional training, Sedentary, Obesity, Body composition, Circuit Training, Muscular strength, Muscle mass, Fat mass, Oxygen consumption, Quality of life, Overweight, Functional training, Bodyweight Resistance training. De un total de 1.579 fueron seleccionados 6 artículos que según la escala de PEDro son de regular a buena calidad. Como conclusión falta evidencia científica, sin embargo, la disponible indica que el EF mejora parámetros de aptitud física, aumentando el VO2máx, fuerza y resistencia muscular, además de mejoras en la composición corporal y calidad de vida. // ABSTRACT: Currently the levels of sedentary lifestyle and global obesity have been increasing, among the most important barriers to physical activity is the lack of time and lack of adequate facilities available close to their environment (Ramirez, et al 2016). Functional training (FT), whether in circuit, high intensity functional training (HIFT) and training against body resistance, has gained greater relevance during the last decade as it consists of the combination of aerobic exercise with strength training generating metabolic adaptations, muscles and respiratory disorders on maximum oxygen consumption (VO2max), muscle strength and endurance, body composition and quality of life and that is why the purpose of this study is to review the effects of functional training on the mentioned variables based on the literature previously in adults between 18 and 40 years. A search was carried out in English, Portuguese and Spanish in PUBMED, SCOPUS, SCIELO and Web of science databases for the last 10 years, using the search terms High intensity functional training, Sedentary, Obesity, Body composition, Circuit Training , Muscular strength, Muscle mass, Fat mass, Oxygen consumption, Quality of life, Overweight, Functional training, Bodyweight Resistance training. From a total of 1,579, 6 articles were selected that according to the PEDro scale are of fair to good quality. In conclusion, scientific evidence is lacking, however, the available evidence indicates that FT improves physical fitness parameters, increasing VO2max, muscle strength and endurance, as well as improvements in body composition and quality of life

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P<0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P<0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally