VO2(%) and MFO are independent protective factors for IR. No association was found between FATmax and IR.
Background: Obesity is associated with insulin resistance (IR). Through exercise insulin resistant obese patients can effectively improve their cardiorespiratory fitness (CRF). The effect of exercise on patients CRF can be determined by oxygen pulse (PO2) analysis. Despite its usefulness, there is limited literature on PO2 analysis in patients with obesity and insulin resistance. Objective: The goal of the present study is to evaluate the relation between PO2 and IR in sedentary obese women. Methods: 55 women were submitted to a maximal exercise test for evaluation of maximal oxygen consumption and PO2. The subjects with a Homeostatic model assessment of IR index greater or equal to 2.5 were considered as insulin-resistant. Participants were divided into 2 groups, IR group (n=35) and Non-IR group (n=20). Results: IR group had lower values of PO2 relative to body weight (11.0±1.7 versus 12.6±1.4 ml∙kg∙beats-1, p=0.001) and relative to lean mass (21.7±2.9 versus 23.2±2.8 ml∙kg∙beats-1, p=0.038) than Non- IR group. No statistical differences were found in maximal oxygen consumption between groups (Non IR=1.53±0.27 L∙min-1, IR=1.51±0.28 L∙min-1; p=0.386). PO2 relative to body weight and HOMA-IR was inversely correlated (p<0.001; r=-0.465). Logistic regression analysis showed an association between PO2 relative to weight (p=0.001, OR=0.47) and fat free mass (p=0.01, OR=0.73), both models adjusted by age. Conclusions: This study demonstrates a relation between HOMA-IR and PO2. Our results suggest that PO2 could be a protective factor against insulin resistance.
Cognitive impairment probably related to repeated episodes of hypoglycemia.Report of one case Menos de 10% de las causas de demencia se consideran reversibles. Entre estas condiciones se cuentan alteraciones tiroideas, déficit de vitamina B12, hidrocéfalo normotensivo, hematoma subdural crónico, neurosífilis, VIH y desórdenes psiquiátricos como la pseudodemencia depresiva 1 . We report a 78 year-old diabetic woman, treated with gliburide and met-formin, consulting in the emergency room for a non fluctuating impairment in conscious-Una causa poco reconocida es el deterioro cognitivo producido por hipoglicemias recurrentes. Presentamos un caso clínico que destaca la importancia de reconocer dicho diagnóstico, especialmente considerando los objetivos de metas terapéuticas estrictas preconizados por las guías actuales y por la potencial reversión de los sín-tomas y la prevención de daño cognitivo crónico que implicaría su oportuno diagnóstico y manejo. Caso clínicoMujer de 78 años, autovalente, independiente en actividades de la vida diaria, con escolaridad completa, tiene antecedentes de hipertensión arterial, hipotiroidismo, hipoacusia y diabetes mellitus tipo 2 (DM 2) manejada con glibenclamida 10 mg y metformina 1.700 mg al día, con lo cual lograba glicemias capilares adecuadas.Fue llevada por familiares al Servicio de Urgencia, para evaluación por compromiso cualitativo de conciencia, no fluctuante, de más de 24 hrs de evolución, sin signos de focalización y con recuperación espontánea completa. Su familia señaló
Background: The constant increase of factors associated with the presence of resistant strains makes empirical antibiotic selection a challenge in patients hospitalized for community-acquired urinary tract infection. We characterized the type of bacteria and their antimicrobial susceptibility pattern in cultures obtained from adult patients that needed hospitalization for this disease in two tertiary hospitals in Chile. Methods: We conducted a cross-sectional study in adults hospitalized for community-acquired urinary tract infection between 2017 and 2022. A total of 830 patients were included. All patients with positive cultures were included in the analysis. Results: Escherichia coli was the most frequent infectious agent (68.1%), followed by Klebsiella spp. (17.7%) and Enterococcus faecalis (6.7%). Among Enterobacteriaceae strains, 35.2%, 19.7% and 27.2% were resistant to first, second and third-generation cephalosporin, respectively. 36.9% were resistant to ciprofloxacin and 1.8% to amikacin. Gram-positive bacteria were resistant to oxacillin and ampicillin in 25% and 18%, respectively. Conclusion: We detected a high prevalence of community-acquired urinary tract infections caused by bacteria resistant to commonly used antibiotics in adult patients that need to be hospitalized. In view of this, we believe that current medical guidelines should be reviewed and updated.
Objetivos: Determinar el estado nutricional y su relación con los hábitos alimentarios y la actividad física en los estudiantes de la I.E.N° 1168 “Héroes del Cenepa”. Diseño: Estudio analítico, transversal. Institución: Facultad Medicina, UNMSM, e Instituto Nacional Materno Perinatal. Participantes: Estudiantes de tercero, cuarto y quinto de secundaria. Intervenciones: En una muestra de 192 estudiantes, de ambos sexos, del I. E. Héroes del Cenepa, Cercado de Lima, se realizó prueba piloto para validación de instrumentos. La recolección datos fue con cuestionario autodesarrollado sobre valoración del estado nutricional, con medición de peso y talla, IMC e índice cintura cadera (ICC). Principales medidas de resultados: Determinación del estado nutricional, hábitos alimentarios y actividad física. Resultados: El 34% de estudiantes tenía estado nutricional normal. El 25% presentó trastornos nutricionales: 18% sobrepeso y 7% obesidad. El 58% de estudiantes con riesgo de sobrepeso y obesidad era varón, 42% mujer. El 34% presentó hábitos alimentarios adecuados y 66% deficientes. El 78% tenía actividad física vigorosa y 6% sedentaria. Conclusiones: No se encontró relación entre el estado nutricional (IMC e ICC) con la actividad física y hábitos alimentarios. Es necesario mejorar los hábitos alimentarios en los estudiantes y explorar otros factores determinantes de la obesidad y sobrepeso en adolecentes.
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