Utilización de la yoga en la mejora del peso corporal y flujo pico espiratorio de personas con sobrepeso y obesidad

The present investigation is of the quasi-experimental type of temporal series design interrupted with a group with repeated measures of pretest and posttest. The objective of the same was the evaluation of a Yoga training program on the effects on the Peak Expiratory Flow (PEF) and on overweight-obesity of female patients who attended the Mutual Aid Groups of the Secretary of Health in Manzanillo, Mexico. The intervention group consisted of 15 women with an average age of 46 years (16) without chronic non-communicable diseases, the program was designed for 6 with two weekly sessions of 40 minutes each (80 min per week). The instruments used to verify the progress in the PEF and the BMI are: clinical history, portable flowmeters and a minimum protocol of weight and height Quetelet´s formula to determine the BMI, as well as an interview at the end of the intervention to know aspects about participation in the intervention. Among the main findings, there was a significant progress in Peak Expiratory Flow (PEF) after the intervention, the participants were able to make a deeper inhalation and a greater exhalation.  The results show positive effects on the PEF after a 6-week program with specific yoga work to improve breathing, but not for BMI and changes in body weight.  La presente investigación es de tipo cuasiexperimental de diseño serie temporal interrumpida con un grupo con medidas repetidas de pretest y postest. El objetivodel mismo, fue la evaluación de un programa de entrenamiento de Yoga sobre los efectosen elFlujo Pico Espiratorio (PEF) yen sobrepeso-obesidad de pacientes femeninos que asistieron a los Grupos de Ayuda Mutua de la Secretaria de Salud en Manzanillo, México. El grupo de intervención estuvo integrado por 15 mujeres con un promedio de edad de 46 años (±16) sin enfermedades crónicas no transmisibles, el programa se diseñó para 6 semanas con dos sesiones semanales de 40 minutos cada una (80 min por semana). Los instrumentos utilizados para verificar el progreso en el PEF e IMC fueron,historia clínica, flujometros portátiles y un protocolo mínimo de toma de peso y talla y la fórmula de Quetelet para determinar el IMC, así como, una entrevista al final de la intervención para conocer aspectos sobre la participación en la intervención. Entre los principales hallazgos se evidencia un progreso significativo en Flujo Pico Espiratorio (PEF) posterior a la intervención, las participantes fueron capaces de hacer una inspiración más profunda y una espiración mayor. Los resultados muestran efectos positivos en el PEF posterior a un programa de 6 semanas con trabajo de yoga específico para la mejora de respiración, pero no para disminución de IMC y cambios en el peso corporal

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Bipolar multiplex families have an increased burden of common risk variants for psychiatric disorders.

Multiplex families with a high prevalence of a psychiatric disorder are often examined to identify rare genetic variants with large effect sizes. In the present study, we analysed whether the risk for bipolar disorder (BD) in BD multiplex families is influenced by common genetic variants. Furthermore, we investigated whether this risk is conferred mainly by BD-specific risk variants or by variants also associated with the susceptibility to schizophrenia or major depression. In total, 395 individuals from 33 Andalusian BD multiplex families (166 BD, 78 major depressive disorder, 151 unaffected) as well as 438 subjects from an independent, BD case/control cohort (161 unrelated BD, 277 unrelated controls) were analysed. Polygenic risk scores (PRS) for BD, schizophrenia (SCZ), and major depression were calculated and compared between the cohorts. Both the familial BD cases and unaffected family members had higher PRS for all three psychiatric disorders than the independent controls, with BD and SCZ being significant after correction for multiple testing, suggesting a high baseline risk for several psychiatric disorders in the families. Moreover, familial BD cases showed significantly higher BD PRS than unaffected family members and unrelated BD cases. A plausible hypothesis is that, in multiplex families with a general increase in risk for psychiatric disease, BD development is attributable to a high burden of common variants that confer a specific risk for BD. The present analyses demonstrated that common genetic risk variants for psychiatric disorders are likely to contribute to the high incidence of affective psychiatric disorders in the multiplex families. However, the PRS explained only part of the observed phenotypic variance, and rare variants might have also contributed to disease development

Effects of movement artifacts in nuclear hybrid modalities for image diagnostic

In the obtention of medical images, the patients' movement can modify the identification of the body components in an image. The combination of imaging techniques may not always be a solution to improve the imaging quality; therefore, an artifact analysis is commonly required prior to applying an imaging procedure in patients. In this work, we systematically evaluated the movements' artifacts caused by the patients' breathing during the images acquisition and their impact on the fusion of SPECT and CT modalities. We used a specific phantom placed on a platform to emulate the respiratory movement, finding artifacts not appreciable under the standard condition used to obtain the SPECT images due to its low spatial resolution. The artifacts produced a deformation of elements on the images. Therefore, image processing was necessary to identify the registration accuracy with SPECT and CT modalities in two states (phantom at rest and for a phantom with simulated respiratory movements). A systematic difference was obtained for the first case (11.7 mm), and a range of (7.4 mm to 16.1 mm) for the second one. For the volumes' evaluation, the optimal threshold value for CT was 0.40 and for SPECT was 0.25, giving a rapid solution to reduce the artifacts' impact on medical images