Association between walking pace and diabetes: findings from the Chilean National Health Survey 2016-2017

Background: Walking pace is a well-known indicator of physical capability, but it is also a strong predictor of type 2 diabetes (T2D). However, there is a lack of evidence on the association between walking pace and T2D, specifically, within developing countries such as Chile. Aim: To investigate the association between self-reported walking pace and T2D in the Chilean adult population. Methods: 5520 Chilean participants (aged 15 to 90 years, 52.1% women) from the Chilean National Health Survey 2016–2017 were included in this cross-sectional study. Both walking pace (slow, average, and brisk) and diabetes data were collected through self-reported methods. Fasting blood glucose (reported in mg/dl) and glycosylated haemoglobin A (HbA1c) scores were determined via blood exams. Results: In the unadjusted model, and compared to people who reported a slow walking pace, those with average and brisk walking pace had lower blood glucose levels (β = −7.74 mg/dL (95% CI: −11.08 to −4.40) and β = −11.05 mg/dL (95% CI: −14.36 to −7.75), respectively) and lower HbA1c (β = −0.34% (95% CI: −0.57 to −0.11) and β= −0.72% (95% CI: −0.94 to −0.49)), respectively. After adjusting for sociodemographic, Body Mass Index and lifestyle factors, the association between glycaemia and HbA1c remained only for brisk walkers. Both the average and brisk walker categories had lower odds of T2D (OR: 0.59 (95% CI: 0.41 to 0.84) and (OR 0.48 (95% CI: 0.30 to 0.79), respectively). Conclusion: Brisk walkers were associated with lower blood glucose and HbA1c levels. Moreover, average to brisk walking pace also showed a lower risk for T2D

Evidence of paleoecological changes and Mousterian occupations at the Galeria de las Estatuas site, Sierra de Atapuerca, northern Iberian plateau, Spain

Here we present a new site in the Sierra de Atapuerca (Burgos, Spain): Galeria de las Estatuas (GE), which provides new information about Mousterian occupations in the Iberian Plateau. The GE was an ancient entrance to the cave system, which is currently closed and sealed by a stalagmitic crust, below which a detritic sedimentary sequence of more than 2 m is found. This has been divided into five litostratigraphic units with a rich assemblage of faunal and lithic remains of clear Mousterian affinity. Radiocarbon dates provide minimum ages and suggest occupations older than 45 C-14 ka BP. The palynological analysis detected a landscape change to increased tree coverage, which suggests that the sequence recorded a warming episode. The macromammal assemblage is composed of both ungulates (mainly red deer and equids) and carnivores. Taphonomic analysis reveals both anthropic, and to a lesser extent, carnivore activities. The GE was occupied by Neanderthals and also sporadically by carnivores. This new site broadens the information available regarding different human occupations at the Sierra de Atapuerca, which emphasizes the importance of this site-complex for understanding human evolution in Western Europe

Impact of uterine manipulator on oncological outcome in endometrial cancer surgery

Background: There are limited data available to indicate whether oncological outcomes might be influenced by the uterine manipulator, which is used at the time of hysterectomy for minimally invasive surgery in patients with endometrial cancer. The current evidence derives from retrospective studies with limited sample sizes. Without substantial evidence to support its use, surgeons are required to make decisions about its use based only on their personal choice and surgical experience. Objective: To evaluate the use of the uterine manipulator on oncological outcomes after minimally invasive surgery, for apparent early-stage endometrial cancer. Study Design: We performed a retrospective multicentric study to assess the oncological safety of uterine manipulator use in patients with apparent early-stage endometrial cancer, treated with minimally invasive surgery. The type of manipulator, surgical staging, histology, lymphovascular space invasion, International Federation of Gynecology and Obstetrics stage, adjuvant treatment, recurrence, and pattern of recurrence were evaluated. The primary objective was to determine the relapse rate. The secondary objective was to determine recurrence-free survival, overall survival, and the pattern of recurrence. Results: A total of 2661 women from 15 centers were included; 1756 patients underwent hysterectomy with a uterine manipulator and 905 without it. Both groups were balanced with respect to histology, tumor grade, myometrial invasion, International Federation of Gynecology and Obstetrics stage, and adjuvant therapy. The rate of recurrence was 11.69% in the uterine manipulator group and 7.4% in the no-manipulator group (P<.001). The use of the uterine manipulator was associated with a higher risk of recurrence (hazard ratio, 2.31; 95% confidence interval, 1.27–4.20; P=.006). The use of uterine manipulator in uterus-confined endometrial cancer (International Federation of Gynecology and Obstetrics [FIGO] I–II) was associated with lower disease-free survival (hazard ratio, 1.74; 95% confidence interval, 0.57–0.97; P=.027) and higher risk of death (hazard ratio, 1.74; 95% confidence interval, 1.07–2.83; P=.026). No differences were found regarding the pattern of recurrence between both groups (chi-square statistic, 1.74; P=.63). Conclusion: In this study, the use of a uterine manipulator was associated with a worse oncological outcome in patients with uterus-confined endometrial cancer (International Federation of Gynecology and Obstetrics I–II) who underwent minimally invasive surgery. Prospective trials are essential to confirm these results

Accuracy and Survival Outcomes after National Implementation of Sentinel Lymph Node Biopsy in Early Stage Endometrial Cancer

Background. Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setting and oncologic outcomes according to the volume of nodal disease. Patients and Methods. A total of 29 Spanish centers participated in this retrospective, multicenter registry including patients with endometrial adenocarcinoma at preoperative early stage who had undergone SLN biopsy between 2015 and 2021. Each center collected data regarding demographic, clinical, histologic, therapeutic, and survival characteristics. Results. A total of 892 patients were enrolled. After the surgery, 12.9% were suprastaged to FIGO 2009 stages III-IV and 108 patients (12.1%) had nodal involvement: 54.6% macrometastasis, 22.2% micrometastases, and 23.1% isolated tumor cells (ITC). Sensitivity of SLN biopsy was 93.7% and false negative rate was 6.2%. After a median follow up of 1.81 years, overall surivial and disease-free survival were significantly lower in patients who had macrometastases when compared with patients with negative nodes, micrometastases or ITC. Conclusions. In our nationwide cohort we obtained high sensitivity of SLN biopsy to detect nodal disease. The oncologic outcomes of patients with negative nodes and low-volume disease were similar after tailoring adjuvant treatments. In total, 22% of patients with macrometastasis and 50% of patients with micrometastasis were at low risk of nodal metastasis according to their preoperative risk factors, revealing the importance of SLN biopsy in the surgical management of patients with early stage EC

Association of leisure time and occupational physical activity with obesity and cardiovascular risk factors in Chile

The aim of this study was to investigate the association between physical activity (PA), both occupational (OPA) and during leisure time (LTPA), with obesity and cardiovascular risk factors in Chilean adults. 5,157 participants from the Chilean National Health Survey 2009–2010 were included in this study. OPA and LTPA levels were assessed using the Global Physical Activity Questionnaire. The association between both PA with obesity and cardiovascular risk factors was determined using logistic regression. Our findings showed a significant trend between higher LTPA and lower odds for obesity (OR 0.64 [95% CI: 0.53; 0.76], central obesity 0.52 [0.44; 0.61]) and other cardiovascular risk factors including diabetes (OR: 0.72 [0.55; 0.94]), hypertension (OR: 0.59 [0.50; 0.71]) and metabolic syndrome (OR: 0.62 [0.50; 0.78]). In contrast, OPA was only associated with lower odds of diabetes (OR: 0.79 [0.65; 0.98]) and hypertension (0.85 [0.74; 0.98]). In conclusion, LTPA was associated with a lower risk of all major cardiovascular risk factors, whereas OPA was only associated with a lower risk of diabetes and hypertension

Factores asociados a crisis convulsiva febril en niños peruanos

"Introducción: La convulsión febril es el trastorno neurológico más frecuente en la infancia y el más común en la práctica neurológica pediátrica. Tiene una etiología multifactorial. En el Perú existen estudios aislados que reportan similares factores de riesgo. Objetivo: Determinar los factores asociados a convulsiones febriles en niños atendidos en el Hospital Regional Lambayeque, Perú. Métodos: Se realizó un estudio de casos y controles en pacientes de 6 meses a 5 años en el servicio de consulta externa de Neuropediatría y emergencias, del 2015 al 2018 del Hospital Regional de Lambayeque. La muestra se constituyó por 32 casos y 32 controles emparejados 1:1 por sexo y edad. Se utilizó un cuestionario para recolectar información general, clasificación de las convulsiones febriles y posibles factores de riesgo. Se estimaron odds ratio crudos (ORc) y ajustados (ORa) mediante modelos de regresión logística simple y múltiple, respectivamente. Resultados: La mayoría de los pacientes que presentaron episodios de convulsión febril tuvieron 13-24 meses de edad (46,9 %). Se evidenció una menor probabilidad de convulsión febril en aquellos pacientes con comorbilidades congénitas (ORa: 0,17; IC 95 %: 0,03-0,93). Los pacientes que tenían diarrea aguda infecciosa (ORa: 8,16; IC 95 %: 1,37-48,55) e infección respiratoria aguda alta (ORa: 12,49; IC 95 %: 1,89-82,42) tenían una mayor probabilidad de convulsión febril. Conclusiones: Padecer de diarrea aguda infecciosa e infecciones respiratorias agudas altas aumentan la probabilidad de desarrollar convulsión febril. Por el contrario, tener una comorbilidad congénita reduce la probabilidad de esta condición.

Factores asociados a crisis convulsiva febril en niños peruanos

"Introducción: La convulsión febril es el trastorno neurológico más frecuente en la infancia y el más común en la práctica neurológica pediátrica. Tiene una etiología multifactorial. En el Perú existen estudios aislados que reportan similares factores de riesgo. Objetivo: Determinar los factores asociados a convulsiones febriles en niños atendidos en el Hospital Regional Lambayeque, Perú. Métodos: Se realizó un estudio de casos y controles en pacientes de 6 meses a 5 años en el servicio de consulta externa de Neuropediatría y emergencias, del 2015 al 2018 del Hospital Regional de Lambayeque. La muestra se constituyó por 32 casos y 32 controles emparejados 1:1 por sexo y edad. Se utilizó un cuestionario para recolectar información general, clasificación de las convulsiones febriles y posibles factores de riesgo. Se estimaron odds ratio crudos (ORc) y ajustados (ORa) mediante modelos de regresión logística simple y múltiple, respectivamente. Resultados: La mayoría de los pacientes que presentaron episodios de convulsión febril tuvieron 13-24 meses de edad (46,9 %). Se evidenció una menor probabilidad de convulsión febril en aquellos pacientes con comorbilidades congénitas (ORa: 0,17; IC 95 %: 0,03-0,93). Los pacientes que tenían diarrea aguda infecciosa (ORa: 8,16; IC 95 %: 1,37-48,55) e infección respiratoria aguda alta (ORa: 12,49; IC 95 %: 1,89-82,42) tenían una mayor probabilidad de convulsión febril. Conclusiones: Padecer de diarrea aguda infecciosa e infecciones respiratorias agudas altas aumentan la probabilidad de desarrollar convulsión febril. Por el contrario, tener una comorbilidad congénita reduce la probabilidad de esta condición.