Preeclampsia is a disorder specific of the human being that appears after 20 weeks of pregnancy, characterized by new onset of hypertension and proteinuria. Abnormal placentation and reduced placental perfusion associated to impaired trophoblast invasion and alteration in the compliance of uterine spiral arteries are the early pathological findings that are present before the clinical manifestations of preeclampsia. Later on, the endothelial and vascular dysfunction responsible of the characteristic vasoconstriction of preeclampsia appear. Different nutritional risk factors such as a maternal deficit in the intake of calcium, protein, vitamins and essential fatty acids, have been shown to play a role in the genesis of preeclampsia, but also an excess of weight gain during pregnancy or a pre-pregnancy state of obesity and overweight, which are associated to hyperinsulinism, insulin resistance and maternal systemic inflammation, are proposed as one of the mechanism that conduce to endothelial dysfunction, hypertension, proteinuria, thrombotic responses, multi-organ damage, and high maternal mortality and morbidity. Moreover, it has been demonstrated that pregnant women that suffer preeclampsia will have an increased risk of future cardiovascular disease and related mortality in their later life. In this article we will discuss the results of studies performed in different populations that have shown an interrelationship between obesity and overweight with the presence of preeclampsia. Moreover, we will review some of the common mechanisms that explain this interrelationship, particularly the alterations in the L-arginine/nitric oxide pathway as a crucial mechanism that is common to obesity, preeclampsia and cardiovascular diseases.

Despite the availability of efficient methods to evaluate blood pressure (BP) and of safe and efficient medication to treat and control hypertension, the levels of awareness, treatment and control are very low globally, particularly in low- and middle-income countries. To highlight the importance of improving these rates, the International Society of Hypertension (ISH) endorsed by the World Hypertension League have implemented the May Measurement Month initiative. We present here the results obtained in Colombia. The Fundación Oftalmológica de Santander (FOSCAL) led the implementation of this strategy in Colombia and 11 departments participated. The data collection followed the guidelines of the ISH. The information collected was compiled for the report generation and the submission to the Technical Secretariat of the ISH. Data cleaning was performed locally by FOSCAL. Data were collated and analysed centrally. A total of 22 258 participants (58.8% female) were included in the analysis. Mean age was 40.9 ± 17.7 years. Age and sex-standardized BP excluding participants receiving BP medications was 118/74.3 mmHg, and in those on treatment 125/78 mmHg. High BP was present in 5036 (22.8%) individuals, 1637 of 18 644 (8.8%) who were not receiving anti-hypertensive medications were hypertensive, and 961 of 3359 (28.6%) receiving treatment were not controlled. These results highlight the need to develop innovative promotion strategies at individual and population levels to increase the awareness of the importance of BP, and the consequences of not having well-controlled hypertension. This initiative is an effective and easy to implement strategy that should be maintained in the coming years.

Objetivos. Evaluar la concordancia entre la autoevaluación del desarrollo puberal mediante la escala de Tanner realizada por adolescentes, comparado con la evaluación efectuada por un médico entrenado. Materiales y métodos. Los datos de 244 adolescentes fueron recolectados como parte del proyecto SIMAC. En la línea de base incluimos una evaluación antropométrica y del desarrollo puberal, con una autoevaluación por parte de los participantes. Resultados. Incluimos 229 adolescentes de 12 a 17 años. La concordancia entre la autoevaluación y la evaluación clínica de la escala de Tanner presentó un acuerdo obtenido de 88,3% y un coeficiente kappa ponderado de 0,554. La autoevaluación en mujeres demostró una concordancia buena (kappa pond =0,653), y en varones una concordancia moderada (kappa pond =0,464). La única variable con una influencia significativa sobre la capacidad de acuerdo fue el sexo; la probabilidad de desacuerdo en los varones fue 63% mayor que en las mujeres, independiente de edad, talla y peso (IC 95%:1,18-2,26). Conclusiones. La autoevaluación no fue lo suficientemente precisa para reemplazar el examen médico, sobre todo en los varones. Se requieren más estudios en relación con este tema, reconociendo el impacto que podría llegar a tener la autoevaluación del desarrollo sexual.

Objetivo. Describir los facilitadores y barreras que influyen en la participación en la actividad física (AF) de adolescentes escolarizados. Métodos. Análisis cualitativo desde un enfoque fenomenológico con la participación de 20 adolescentes escolarizados entre 12 y 16 años, que mediante entrevistas semiestructuradas y grupos focales conversaron sobre temas relacionados con la práctica, beneficios, entornos e influencia y compañía frente a la AF. La información fue procesada con el programa NVivo Pro. Resultados. La práctica de AF se limitaba a las clases de educación física en la mayoría de los casos. El compañero principal en la AF extracurricular era el padre del mismo sexo. La AF representaba una oportunidad para romper con la rutina diaria, el disfrute, mejorar la salud física y mental, y mejorar la contextura corporal. La falta de tiempo por compromisos académicos fue la razón principal para no realizar AF. Los espacios públicos no siempre estaban disponibles, a menudo no se consideraban seguros. En la escuela, el espacio y las instalaciones eran inadecuados, y el uso estaba restringido. Conclusiones. La escuela es un punto de convergencia importante para la práctica de AF, lo que sugiere la necesidad de fortalecer el plan de estudios de educación física. A pesar de esto, se percibe que la AF interfiere con las actividades académicas. El vecindario también es un espacio importante para la AF y las mejoras en la seguridad y el atractivo estético de las áreas recreativas públicas tienen el potencial de aumentar el nivel de práctica de AF.

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A B S T R A C TUretero-appendicular fistulas represents a rare entity, closely related to appendicitis and are usually encountered intraoperatively. A literature review showed six published cases -only one of them involving a pediatric patient. We describe the case of a ten year-old girl with history of recurrent urinary tract infections (UTIs) since the age of three. Following a six-year asymptomatic period, she was referred for evaluation after a new diagnosis of UTI complicated by a right distal ureteral stone. The patient underwent ureteroscopy and laser stone fragmentation. During the endoscopic procedure a mature, well-epithelialized ureteral tract to the peritoneal cavity was encountered. The procedure was converted to open exploration through a right Gibson incision, where an appendicular phlegmon associated with an uretero-appendicular fistula with passing of faecoliths to the ureteral lumen was found. An appendectomy was performed along with primary fistula closure. Uretero-appendicular fistulas represent a rare entity. Our case highlights the relation between this type of fistula with appendicitis, its unexpected intraoperative diagnosis and the unusual presentation, as the patient did not present clinical findings compatible with acute abdomen.