Efecto de un programa de intervención basado en reaprendizaje motor sobre el nivel de calidad de vida relacionado con la salud en adultos con hemiparesia

Determinar el efecto de un programa de intervención basado en reaprendizaje motor sobre el nivel de calidad de vida relacionada con la salud en adultos con hemiparesia. Materiales y métodos: Se realizó un ensayo clínico de alcance cuasi-experimental bajo el enfoque empírico-analítico en donde se intervinieron 69 personas con hemiparesia de diferentes etiologías de las ciudades de Bogotá, Medellín, Cali, Barranquilla, Manizales, Pereira, Neiva, Popayán y Tunja, entre otras, de los cuales 34 hicieron parte del grupo control quienes recibieron un programa de terapia convencional y 35 personas hicieron parte del grupo experimental quienes recibieron un programa de reaprendizaje motor por seis semanas, tres veces por semana, con el fin de determinar su efecto sobre el nivel de calidad de vida relacionada con la salud (CVRS), la cual fue evaluada con el instrumento WHOQOL-BREF antes y después de la intervención. El procesamiento de la información se realizó mediante el programa estadístico SPSS versión 22.0 (Statistical Package for the Social Science). Resultados: Después de intervenir con un programa convencional y un programa de reaprendizaje motor, ni en el grupo control ni en el experimental se encontraron diferencias estadísticamente significativas entre el post-test y el pre-test en la valoración global de la CVRS (CVRS Global), a pesar de la significancia marginal observada en el grupo experimental en el cual se obtuvo una mejoría media de tres puntos (p=0,056), Sin embargo, se evidenciaron diferencias significativas en la dimensión salud física del grupo experimental y en la dimensión CVRS general de ambos grupos (p<0,05), en el cual el grupo experimental percibió una mejoría media de 8 puntos en contraste con 6 puntos del grupo control. Conclusiones: A pesar que no existen diferencias estadísticamente significativas en cuanto a resultados de CVRS entre la aplicación de un programa de reaprendizaje motor vs la terapia convencional aplicado a personas con hemiparesia, es importante tener presente que tanto los programas de reaprendizaje motor como la terapia convencional, tienen efectos positivos en diferentes dominios de la calidad de vida.To determine the effect of an intervention program based on motor relearning on the level of health-related quality of life in adults with hemiparesis.Materials and Methods: A clinical trial of quasi-experimental scope was carried out under the empirical-analytical approach in which 69 people with hemiparesis of different etiologies were intervened in the cities of Bogotá, Medellín, Cali, Barranquilla, Manizales, Pereira, Neiva, Popayán and Tunja, among others, of which 34 were part of the control group who received a conventional therapy program and 35 people were part of the experimental group who received a motor relearning program for six weeks, three times per week, in order to determine its effect on the level of health-related quality of life (HRQOL), which was evaluated with the WHOQOL-BREF instrument before and after the intervention. The information was processed using the statistical program SPSS version 22.0 (Statistical Package for the Social Science).Results: After intervening with a conventional program and a motor relearning program, neither the control nor the experimental group found statistically significant differences between the post-test and the pre-test in the global assessment of HRQOL (Global HRQoL), despite the marginal significance observed in the experimental group in which an average improvement of three points was obtained (p = 0.056), however, significant differences were found in the physical health dimension of the experimental group and in the overall HRQL dimension of both groups (p <0.05), in which the experimental group perceived an average improvement of 8 points in contrast to 6 points of the control group.Conclusions: Although there are no statistically significant differences in terms of HRQOL results between the application of a motor relearning program vs conventional therapy applied to people with hemiparesis, it is important to keep in mind that both motor relearning programs and conventional therapy have positive effects in different domains of quality of life

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Factores ambientales relacionados con la actividad física en universitarios de una institución en Barranquilla, Colombia

The objective of the study is to characterize the socio-environmental factors related to physical activity in university students in Colombia. The research team conducted a cross-sectional study among health sciences students between 18 and 35 years old. Through a stratified sample, we randomly selected 418 subjects for the application of the IPAQ and ECAVE questionnaire that evaluated the level of physical activity and the quality of their neighborhood. Results indicated that 39.1% (IC95 34.9-44.5) are inactive; regarding the urban environment, the areas for walking (51.43%), parks and green areas (49.7%), sports facilities in their place of study (66.74%), cycle routes (71.29%), and pedestrian paths (63.6%) are not suitable for the realization of physical activity; 49.5% perceive negatively the accessibility and availability of public facilities. In conclusion, the appreciation of the infrastructure and environmental conditions is a determining factor for the practice of physical activity in university students.La investigación tiene como objetivo caracterizar los factores socioambientales relacionados con la actividad física en estudiantes de una institución de educación superior en Barranquilla, Colombia. Se realizó un estudio transversal en estudiantes de ciencias de la salud entre 18 y 35 años. Mediante un muestreo estratificado, se seleccionó aleatoriamente una muestra de 418 estudiantes para la aplicación de los cuestionarios IPAQ y ECAVE, que evaluaron el nivel de actividad física y la calidad del vecindario para su práctica, respectivamente. Los resultados indicaron que 39,1% (IC95 34,9-44,5) son inactivos; respecto al entorno urbano, las zonas para caminar (51,43%), parques y zonas verdes (49,7%), instalaciones deportivas en el lugar de estudio (66,74%), ciclovías (71,29%) y senderos peatonales (63,6%) no son adecuados para la realización de actividad física, y el 49,5% percibe negativamente la accesibilidad y disponibilidad de las instalaciones públicas. En conclusión, la apreciación de la infraestructura y las condiciones ambientales es un factor determinante para la práctica de actividad física en universitario

Acute stress and fear scales during the COVID-19 pandemic: development and evaluation in a Costa Rican sample

Objective: In the context of the pandemic due to SARS-CoV-2, concerns were raised about how to adequately assess its impact on the wellbeing of the population. The main reason of this paper is to present the preliminary results of psychometric properties of measures created to evaluate such impact. Method: We created and adapted several assessment instruments, and validated them with a volunteer sample of 699 adults (+18), inhabitants of Costa Rica, who filled out an online questionnaire on mental health consequences of the pandemic during September 2020. Results: The results provided evidence of validity and reliability for the new scales developed. Also, they show a negative correlation between resilient coping and acute stress, which could be considered evidence of discriminant validity. Conclusion: In this order, the measures showed acceptable  psychometric properties with the evaluated sample. Future research is needed to gather more evidence of reliability and validity in probabilistic samples

Acute effects of resistance training on postprandial lipemia in overweight postmenopausal women

Introducción. La magnitud de la lipemia postprandial es un indicador de riesgo cardiovascular, en especial en mujeres con actividad hormonal reducida. Los ejercicios resistidos (ER) podrían ser un factor que influencie las concentraciones de lípidos después de consumir alimentos. Objetivo. Determinar los efectos agudos sobre la lipemia postprandial de mujeres postmenopáusicas que tiene la realización de sesiones de ER de alto y bajo volumen, en comparación a un grupo control. Materiales y métodos. Después de una evaluación inicial (antropometría, perfil lipídico y fitness muscular), 32 mujeres fueron divididas aleatoriamente en tres grupos: uno con ER de alto volumen (n=11), otro con ER de bajo volumen (n=11) y un grupo control sin ER (n=10). 12 horas después de los ejercicios se suministró un compuesto nutricional hiperlipídico y se analizó la lipemia postprandial cada hora durante 5 horas. Resultados. Los diferentes volúmenes de ER no redujeron de manera importante los marcadores lipémicos (colesterol total, triglicéridos, LDL y VLDL) (p>0.05) ni aumentaron las concentraciones plasmáticas de HDL (p>0.05). Conclusiones. Las sesiones de ER no afectaron los marcadores lipémicos postprandiales, aunque sí mostraron resultados clínicos relevantes en los grupos experimentales (reducción de LDL-VLDL y aumento de HDL en momentos específicos).Introduction: The magnitude of postprandial lipemia is an indicator of cardiovascular risk, especially in women with reduced hormonal activity. Resistance training (RT) may be a factor influencing lipid concentrations after eating. Objective: To determine the acute effects of high and low volume RT sessions on postprandial lipemia in postmenopausal women compared to a control group. Materials and methods: After an initial assessment (anthropometry, lipid profile and muscle fitness), 32 women were randomly divided into three groups: one with high volume of RT (n=11), another with low volume of RT (n=11) and a control group without RT (n=10). 12 hours after the completion of the training, a hyperlipidic nutritional compound was administered and postprandial lipemia was analyzed every hour for 5 hours. Results: The different RT volumes did not significantly reduce lipemic markers (total cholesterol, triglycerides, LDL and VLDL) (p>0.05) nor did they increase plasma HDL concentrations (p>0.05). Conclusions: RT sessions did not affect postprandial lipemic markers, although they did show relevant clinical results in the experimental groups (reduction of LDL-VLDL and increase of HDL at specific times)

Immunocompromised patients with acute respiratory distress syndrome : Secondary analysis of the LUNG SAFE database

The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p &lt; 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p &lt; 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013