Felipe Pino

Índice cintura estatura y agregación de componentes cardiometabólicos en niños y adolescentes de Santiago

BACKGROUNDnWaist to height ratio and ultrasensitive C-reactive protein are predictors of the presence of the metabolic syndrome in children.nnnAIMnTo determine the proportional risk of metabolic syndrome component clustering in children, using waist to height ratio and ultrasensitive C-reactive protein.nnnMATERIAL AND METHODSnAnthropometric measures, blood pressure, fasting serum lipid profile, blood glucose and ultrasensitive C-reactive protein were determined in 209 children aged 11.5 ± 2 years (50% females). The presence of the metabolic syndrome as a function of waist to height ratio and C-reactive protein was modeled using logistic regression equations. The risk of clustering one, two or more components of the metabolic syndrome was calculated.nnnRESULTSnMetabolic syndrome was present in 5% of all children and 18% of those that were obese. The cut off points for waist to hip ratio and ultrasensitive C-reactive protein were 0.55 and 0.61 mg/L, respectively. For each 0.01 increment in waist to height ratio, the odds ratio of increasing one component of the metabolic syndrome was 1.2 (1.15-1.25) or 15 to 25%. The odds ratio for log-transformed ultrasensitive C-reactive protein was 1.62 (1.26-2.09). Excluding waist circumference, the odds ratio of adding one or more components of the metabolic syndrome was 1.05 (1.01-1.09) per 0.01 increment in waist to height ratio, but the odds ratio for C-reactive protein was no longer significant.nnnCONCLUSIONSnWaist to height ratio and ultrasensitive C-reactive protein predict the risk of clustering components of the metabolic syndrome in these children.

Hipertensión arterial: el factor de riesgo más importante para grosor íntima-media carotídeo elevado y placa carotídea en adultos de Santiago

BACKGROUNDnCarotid intima media thickness (CIMT) is a marker of cardiovascular damage that can be modified by traditional risk factors.nnnAIMnTo determine attributable risk factors for a high CIMT among healthy adults.nnnMATERIAL AND METHODSnA sample of 1270 individuals (636 males and 634 females) aged 44 ± 11 years, was studied. Blood pressure, weight, height, lipid profile and blood glucose were measured in all. CIMT and the presence of atherosclerotic plaques were determined by carotid ultrasound. Standard criteria were used to define hypertension, dyslipidemia and diabetes.nnnRESULTSnMean CIMT in the sample studied was 0.62 ± 0.01 mm and percentile 75 was 0.67. The most important risk factor for a CIMT over percentile 75 and the presence of atherosclerotic plaques was hypertension with attributable risks of 54 and 57%, respectively.nnnCONCLUSIONSnIn this sample, the main risk factor for a high CIMT was hypertension.

Validación de un puntaje de riesgo cardiovascular en niños españoles aplicado a una población de escolares de Santiago de Chile

BACKGROUNDnA cardiovascular risk score for children, that includes traditional risk factors, obesity, sedentary habits and a family history of cardiovascular disease, has been recently proposed by Spanish researchers.nnnAIMnTo apply this score in school age children in Santiago de Chile and correlate its results with markers of subclinical atherosclerotic disease.nnnMATERIAL AND METHODSnRetrospective analysis of data obtained from 209 children, aged 11.5 ± 2 years, studied between 2005 and 2006. Weight, height, blood pressure, ultrasound measurement of carotid intimamedia thickness and fow mediated dilatation of brachial artery and ultrasensible C reactive protein (us PCR) were measured. The Spanish cardiovascular risk score was calculated and correlated with ultrasound parameters and C reactive protein.nnnRESULTSnAccording to the score, 173 children (83%) had a low cardiovascular risk, 28 (13%) an intermediate risk and 8 (4%) a high risk. There was no association between the cardiovascular risk score and carotid intima-media thickness, fow mediated arterial dilatation and us PCR.nnnCONCLUSIONSnNo significant association was observed between the proposed cardiovascular risk score and early markers of atherosclerotic disease in this group of children.

Panniculus carnosus, remanentes vestigiales en la región axilar

Las variaciones anatomicas de los elementos musculares de la region axilar son poco frecuentes y, generalmente, se encuentran olvidadas en los textos modernos de anatomia. Sin embargo, cuando existen, presentan un serio escollo para el cirujano, ya que alteran los hitos anatomicos de referencia para el abordaje de los importantes elementos vasculares y neurales de la region. Desde el siglo XIX algunos autores han descrito una variedad de pequenos fasciculos musculares originados en el Panniculus carnosus, que se disponen en relacion con los elementos neurovasculares de la axila. En esta ocasion presentamos un hallazgo efectuado en un cadaver, de sexo masculino, utilizado con fines docentes en el Departamento de Anatomia de la Escuela de Medicina de la Pontificia Universidad Catolica de Chile. En la region axilar derecha, se observa un fasciculo muscular que se extiende desde la apofisis coracoides, dispuesto por delante del musculo subescapular y pasando por detras del paquete neurovascular de la axila. En su trayecto, este fasciculo toma intima relacion con el nervio axilar y con la porcion distal de la arteria subescapular. El musculo aberrante termina como una expansion aponeurotica, dispuesta ventral al tendon del latisimo del dorso, que se funde con la fascia axilar.

Ventilation and Architectural Design Strategies for Cooling Office Buildings in Different Climates of Chile

In Office buildings in Chile, cooling energy demand is higher than heating demand. The climate of the country show important differences between cities by the ocean and those of interior regions. Main cities of Central Chile are Santiago and Valparaiso, both located at around 33°S. Santiago presents a Mediterranean climate, with a high temperature oscillation between day and night during cooling period. Valparaiso, by the coast, shows lower temperature fluctuation compared with Santiago during identical period. In order to define design strategies for energy efficiency of office buildings in mentioned cities, a sensitivity study has been made, considering variables like window to wall ratio, type of windows (clear and selective glazing, including low e, single and double glazing), use and type of external solar protection (ESP) and use of nocturnal or diurnal ventilation. In opaque facades, thermal insulation is considered. In case of walls, in order to increase thermal inertia external insulation is assumed. The sensitivity analysis is developed considering a square building containing office rooms on all four orientations. This 10 story building has been specially proposed and designed for this analysis. Methodology considers an evaluation of heating and cooling demand of the building in both cities. For this purpose, simulation software under dynamic conditions has been used (TAS). The lowest cooling energy demand is reached when using the lowest window to wall ratio (20 %), with ESP in east, west and north oriented glazed areas. In fact, fully glazed facades in both cities are not recommended. Nocturnal ventilation was highly effective for decreasing cooling demand in both cities. In the case of Valparaiso, due to relatively low temperature during cooling period (maximum lower than 26 °C), diurnal ventilation for cooling purposes is also effective.

Diagnóstico y manejo de la hipoglicemia en adultos diabéticos hospitalizados: evaluación de competencias en un equipo profesional multidisciplinario de salud

Background: A tight glycemic control of hospitalized patients increases the risk of hypoglycemia, whose management is not always optimal. Aim: To assess the hypoglycemia management competences of a multidisciplinary team in a clinical hospital. Material and Methods: An anonymous questionnaire about hypoglycemia management was answered by 11 staff physicians, 42 residents and 28 nurses of the department of medicine and critical care unit ofa university hospital. Results: Respondents had a mean of 60% of correct answers, without significant differences between groups. The capillary blood glucose level that defines hypoglycemia was known by most of the respondents, but the value that defines severe episodes was known only by 60%. The initial management and follow up was well known only for severe episodes. Less than 50%o knew the blood glucose value that required continuing with treatment. Conclusions: Although most professionals are able to recognize hypoglycemia, the knowledge about is management if insufficient.