Changes in Lipoinflammation Markers in People with Obesity after a Concurrent Training Program: A Comparison between Men and Women

Obesity is related to low-grade systemic inflammation. This state of inflammation is characterized by the alteration in adipokine regulation, which may lead to a situation of cardiometabolic risk. The aim of this study was to evaluate the effects of a concurrent training program on markers of lipoinflammation in adult people with obesity, comparing the response to the training between men and women. A quasi-experimental, quantitative, and longitudinal study with a pre-post intervention was conducted. An 8-week concurrent training program was carried out, in which 26 individuals with obesity participated (mean ± SD; age = 46.38 ± 4.66) (BMI = 36.05 ± 4.99) (12 men and 14 women). Before and after the intervention period, blood samples were taken by percutaneous puncture. The blood levels of adiponectin and leptin were evaluated. Significant differences were obtained in the adiponectin-leptin ratio (A/L ratio) of the entire sample (p = 0.009, ES = 0.53), which indicates a decrease in the risk of cardiovascular diseases and lipoinflammation. There were no significant differences in the improvements observed after the training in A/L ratio between women (A/L change = +63.5%) and men (A/L change= +59.2%). It can be concluded that the combination of aerobic exercise and resistance training induced an improvement in markers of lipoinflammation and cardiometabolic risk in the individuals with obesity evaluated in this study

Obesity as a complex chronic disease

Obesity is a chronic disease of multifactorial origin, with a high prevalence worldwide that is associated with potentially serious complications and that requires a multidisciplinary approach. Due to its high clinical impact and high health cost. Obesity is a global health problem, being considered one of the most serious and prevalent non communicable diseases of the 21st century. The aim of this review is to present the current approaches to the physiopathology of obesity, with adipose tissue as its focus. We argue that a thorough understanding of the alterations that occur in the adipose tissue in situations of obesity can provide a strong basis upon which building prevention and treatment strategie

Efecto de un programa de ejercicio físico sobre la condición física y la grasa visceral en personascon obesidad

Obesity can be defined as an imbalance between calorie intake and energy expenditure as a result weight gain.Currently is accepted that obesity is one of the major social and health problems worldwide and its prevalence is continuously increasing.Visceral fat is considered as a pathogenic factor in obesity. Objective. The main was to evaluate the effect of concurrent training onphysical fitness in people with obesity, body composition and visceral fat area. Methods. 30 obese people participated in this study.They conducted an adapted and controlled concurrent training program during eight weeks. Physical fitness tests (muscular resistance,cardiorespiratory fitness, flexibility) and body composition measure were applied before and after the intervention period. Results.Improvement was observed on physical fitness variables. Muscle strength, both in the lower extremities (p = .001) and upper extremities(right arm p = .001 and left arm p = .002). Also, the walking speed (p = .001) and agility (p = .001) increased significantly. All bodycomposition variables improved significantly. While fat mass, body weight, BMI and visceral fat area decreased considerably (p <.001),fat free mass and muscle mass increased significantly (p = .001). Conclusion. Concurrent training program improves significantly bodycomposition in obese people, which are related with levels muscular strength enhanced, and conduces significant decrease in visceral fatLa obesidad se puede definir como un desequilibrio entre la ingesta de calorías y el gasto de energía con resultado del aumento de peso. Actualmente se acepta que la obesidad es uno de los principales problemas sociales y de salud en todo el mundo ysu prevalencia aumenta continuamente. La grasa visceral se considera un factor patogénico en la obesidad. Objetivo. Fue evaluar el efecto del entrenamiento concurrente sobre la condición física, la composición corporal y el área de grasa visceral en personas con obesidad. Métodos. 30 personas con obesidad participaron en este estudio. Realizaron un programa de entrenamiento concurrente adaptado y controlado durante ocho semanas. Se realizaron test de condición física (resistencia muscular, aptitud cardiorrespiratoria y flexibilidad)y de la composición corporal antes y después del período de intervención. Resultados. Se observó mejoría en variables de condición física relacionadas con la fuerza muscular, tanto en las extremidades superiores (brazo derecho p =.001 y brazo izquierdo p =.002) como en las inferiores (p = .001). También aumentó significativamente la velocidad de la marcha (p =.001) y la agilidad (p =.001). Todas las variables de composición corporal mejoraron significativamente. Mientras que la masa grasa, el peso, el IMC y el área de grasa visceral disminuyeron considerablemente (p < .001). La masa magra y masa muscular aumentaron significativamente (p =.001). Conclusión. El programa de entrenamiento concurrente mejora significativamente la composición corporal en personas obesas, que están relacionadas con los niveles de fuerza muscular mejorada y conduce a una disminución significativa de la grasa visceral

Ejercicio físico, obesidad e inflamación

La obesidad es una enfermedad crónica de origen multifactorial, con una elevada prevalencia a nivel mundial que se asocia a complicaciones potencialmente graves y que precisa de un enfoque multidisciplinar por su gran repercusión clínica y elevado coste sanitario. El interés actual de la lipoinflamación o inflamación crónica asociada a la obesidad deriva del conocimiento de las alteraciones y remodelado que se produce en el tejido adiposo, con la participación de múltiples factores y elementos implicados en todo el proceso. En la obesidad, los niveles circulantes de marcadores inflamatorios son elevados. La evidencia actual apoya que el entrenamiento físico, como el ejercicio aeróbico y de fuerza a largo plazo, reduce la inflamación crónica, especialmente en individuos obesos con altos niveles de biomarcadores inflamatorios y que este efecto es independiente de la pérdida de peso inducida por el ejercicio. Existen varios mecanismos a través de los cuales el ejercicio reduce la inflamación crónica, incluyendo su efecto sobre el tejido muscular para generar mioquinas antiinflamatorias. Sin embargo, el tipo, intensidad, y volumen de ejercicio ideal para mejorar este estado de inflamación crónica y obesidad no está claramente definido y necesita de investigación adicional

Characterization of Pathogenic and Nonpathogenic Fusarium oxysporum Isolates Associated with Commercial Tomato Crops in the Andean Region of Colombia

In Colombia, tomato production under protected conditions represents an important economic contribution to the agricultural sector. Fusarium wilt diseases, caused by pathogenic formae speciales of the soil-borne fungus Fusarium oxysporum Schltdl., cause significant yield losses in tomatoes throughout the world. Investigation of the F. oxysporum&ndash;tomato pathosystem in Colombia is required to develop appropriate alternative disease management. In this study, 120 fungal isolates were obtained from four different departments in the Central Andean Region in Colombia from tomato crops with symptoms of wilt disease. A molecular characterization of the fungal isolates was performed using the SIX1, SIX3, and SIX4 effector genes of Fusarium oxysporum f. sp. lycopersici W.C. Snyder &amp; H.N. Hansen (Fol). Additionally, we developed a new specific marker to distinguish between Fusarium oxysporum f. sp. radicis-lycopersici Jarvis &amp; Shoemaker (Forl) and Fol isolates. Furthermore, a phylogenetic analysis using the Translation Elongation Factor 1-alpha (EF1a) gene was performed with the collected isolates. Two isolates (named Fol59 and Fol-UDC10) were identified as Fol race 2, four isolates were identified as Forl, six isolates were identified as F. solani, and most of the isolates were grouped within the F. oxysporum species complex. The phylogenetic tree of EF1a showed that most of the isolates could potentially correspond to nonpathogenic strains of F. oxysporum. Additional pathogenicity assays carried out with Fol59 and Fol-UDC10 confirmed that both isolates were highly virulent strains. This study represents a contribution to the understanding of the local interaction between tomatoes and F. oxysporum in Colombia

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&lt;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&lt;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