Incidencia de obesidad en alumnos de las escuelas de ciencias del deporte, tecnología médica y medicina humana de la universidad Alas Peruanas.

Objetivos. Estimar la incidencia de obesidad en alumnos de 16 a 28 años de edad, que ingresaron a la Universidad Alas Peruanas, en el año 2011.  Método. Se registró el peso y talla del universo de ingresantes a las Escuelas Académico Profesionales de Ciencias del Deporte, Tecnología Médica y Medicina Humana (nº=302). En todos ellos se determinó el Índice de Masa Corporal (IMC) de acuerdo con metodología estándar internacional.  Resultados. Se estudiaron 302 personas, entre 16 y 28 años de edad. 49 personas (16,2%) con Índice de Masa Corporal entre 16k/m2 a 19k/m2. 177 personas (58,6%) con Índice de Masa Corporal entre 20k/m2 a 24k/m2. 58 personas (19,2%) con Índice de Masa Corporal entre 25k/m2 a 29k/m2. 16 personas (5,2%) con Índice de Masa Corporal entre 30k/m2 a 35k/m2 y 02 personas (0,7%) con Índice de Masa Corporal entre 36k/m2 a 40k/m2. Conclusiones. El más alto porcentaje 177 personas (58,6%), se encuentran dentro del peso normal. Le siguen 58 personas (19,2%) con sobrepeso, luego 49 personas (16,2%) en el parámetro de desnutrición, 16 personas (5,2%) con obesidad leve y el más bajo porcentaje 02 personas (0,7%), con obesidad mórbida

Electrocardiogram sensitivity in left ventricular hypertrophy according to gender and cardiac mass

BACKGROUND: Several factors are known to interfere with electrocardiogram (ECG) sensitivity when diagnosing Left Ventricular Hypertrophy (LVH), with gender and cardiac mass being two of the most important ones OBJECTIVE: To evaluate the influence of gender on the sensitivity of some of the criteria used to detect LVH, according to the progression of ventricular hypertrophy degree. METHODS: According to gender and the degree of LVH at the echocardiogram, the patients were divided in three groups: mild, moderate and severe LVH. ECG sensitivity to detect LVH was assessed between men and women, according to the LVH degree. RESULTS: Of the 874 patients, 265 were males (30.3%) and 609, females (69.7%). The [(S + R) X QRS], Sokolow-Lyon, Romhilt-Estes, Perugia and strain criteria showed high discriminatory power in the diagnosis of LVH between men and women in the three groups with LVH, with a superior performance in the male population and highlighting the importance of the [(S + R) X QRS] and Perugia scores. Conclusion: The diagnostic sensitivity of the ECG increases with the cardiac mass. The examination is more sensitive in men, highlighting the importance of the [(S + R) X QRS] and Perugia scores. CONCLUSION: The diagnostic sensitivity of the ECG increases with the cardiac mass. The examination is more sensitive in men, highlighting the importance of the [(S + R) X QRS] and Perugia scores.FUNDAMENTO: Sabe-se que vários fatores interferem na sensibilidade do Eletrocardiograma (ECG) no diagnóstico da Hipertrofia Ventricular Esquerda (HVE), sendo o gênero e a massa cardíaca alguns dos principais. OBJETIVO: Avaliar a influência do sexo na sensibilidade de alguns dos critérios utilizados para a detecção de HVE, de acordo com a progressão do grau de hipertrofia ventricular. MÉTODOS: De acordo com o gênero e com o grau de HVE ao ecocardiograma, os pacientes foram divididos em três grupos: HVE leve, moderada e severa. Avaliou-se a sensibilidade do ECG para detectar HVE entre homens e mulheres, conforme o grau de HVE. RESULTADOS: Dos 874 pacientes, 265 eram homens (30,3%) e 609, mulheres (69,7%). Os critérios [(S + R) X QRS], Sokolow-Lyon, Romhilt-Estes, Perúgia e padrão strain mostraram alto poder discriminatório no diagnóstico de HVE entre homens e mulheres nos três grupos de HVE, com desempenho superior na população masculina e destaque para os escores [(S + R) X QRS] e Perúgia. CONCLUSÃO: A sensibilidade diagnóstica do ECG é maior com o aumento da massa cardíaca. O exame é mais sensível entre homens, destacando-se os escores [(S + R) X QRS] e Perúgia.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

The S1S2S3 electrocardiographic pattern — Prevalence and relation to cardiovascular and pulmonary diseases in the general population

Background: There is lack of studies exploring the incidence and association with diseases of the S1S2S3 electrocardiogram (ECG) pattern in the general population. Subjects and methods: This population study included 6299 individuals aged 30+, and explored the prevalence and association between S1S2S3 and cardiovascular and pulmonary diseases. Criteria for the S1S2S3-I and S1S2S3-II ECG pattern were fulfilled when there was an S wave in the leads I, II and III, and the S-wave amplitude was greater than the R-wave amplitude in one or two of the leads, respectively. Results: The S1S2S3-I ECG pattern was found in 2332 subjects (36.9%). After age adjustment, hypertension was associated with S1S2S3-I (Odds ratio [OR] 1.25, 95% CI 1.12–1.41, p < 0.001). This age-adjusted association was statistically significant among men but not among women (OR 1.37, 1.16–1.62, p < 0.001 and OR 1.13, 0.97–1.33, p = 0.126, respectively). The S1S2S3-II ECG pattern was present in 193 subjects (3.1%). After age adjustment, heart failure proved to be associated with S1S2S3-II (OR 1.85, 1.18–2.90, p = 0.007). Dividing the population by sex, resulted in a statistically significant age-adjusted association for men but not for women (OR 2.30, 1.22–4.33, p = 0.010 and OR 1.59, 0.83–3.03, p = 0.159, respectively). Interactions with sex were statistically non-significant. Conclusion: In the general adult population, the prevalence of the S1S2S3 ECG pattern is markedly affected by the diagnostic ECG criteria. The S1S2S3-I pattern was associated with hypertension, while S1S2S3-II was associated with heart failure, and both associations were enhanced in men. The associations with other studied cardiovascular and pulmonary diseases were minor and not clinically useful for risk stratification.publishedVersionPeer reviewe

Geometric patterns of left ventricular hypertrophy and electrocardiography

Universidade Federal de São Paulo, Escola Paulista Med, Dept Hemodynam & Intervent Cardiol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Sect Lipids Atherosclerosis & Vasc Biol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Sect Hypertens Heart Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Hemodynam & Intervent Cardiol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Sect Lipids Atherosclerosis & Vasc Biol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Sect Hypertens Heart Dis, São Paulo, BrazilWeb of Scienc

Risk factors for mortality in patients with COVID-19 needing extracorporeal respiratory support.

When indicating ECMO in patients with COVID-19, centre case volume, age, driving pressure and the duration of symptoms (not the length of MV) should be taken into account. Large drainage cannula and high PEEP levels during the first days are recommended. https://bit.ly/3DGjGk