A simple method to assess freezing of gait in Parkinson's disease patients

Freezing of gait (FOG) can be assessed by clinical and instrumental methods. Clinical examination has the advantage of being available to most clinicians; however, it requires experience and may not reveal FOG even for cases confirmed by the medical history. Instrumental methods have an advantage in that they may be used for ambulatory monitoring. The aim of the present study was to describe and evaluate a new instrumental method based on a force sensitive resistor and Pearson's correlation coefficient (Pcc) for the assessment of FOG. Nine patients with Parkinson's disease in the "on" state walked through a corridor, passed through a doorway and made a U-turn. We analyzed 24 FOG episodes by computing the Pcc between one "regular/normal" step and the rest of the steps. The Pcc reached ±1 for "normal" locomotion, while correlation diminished due to the lack of periodicity during FOG episodes. Gait was assessed in parallel with video. FOG episodes determined from the video were all detected with the proposed method. The computed duration of the FOG episodes was compared with those estimated from the video. The method was sensitive to various types of freezing; although no differences due to different types of freezing were detected. The study showed that Pcc analysis permitted the computerized detection of FOG in a simple manner analogous to human visual judgment, and its automation may be useful in clinical practice to provide a record of the history of FOG.

Anthropometric midarm measurements can detect systemic fat-free mass depletion in patients with chronic obstructive pulmonary disease

Our objective was to determine whether anthropometric measurements of the midarm (MA) could identify subjects with whole body fat-free mass (FFM) depletion. Fifty-five patients (31% females; age: 64.6 ± 9.3 years) with mild/very severe chronic obstructive pulmonary disease (COPD), 18 smokers without COPD (39% females; age: 49.0 ± 7.3 years) and 23 never smoked controls (57% females; age: 48.2 ± 9.6 years) were evaluated. Spirometry, muscle strength and MA circumference were measured. MA muscle area was estimated by anthropometry and MA cross-sectional area by computerized tomography (CT) scan. Bioelectrical impedance was used as the reference method for FFM. MA circumference and MA muscle area correlated with FFM and biceps and triceps strength. Receiver operating characteristic curve analysis showed that MA circumference and MA muscle area cut-off points presented sensitivity and specificity >82% to discriminate FFM-depleted subjects. CT scan measurements did not provide improved sensitivity or specificity. For all groups, there was no significant statistical difference between MA muscle area [35.2 (29.3-45.0) cm²] and MA cross-sectional area values [36.4 (28.5-43.3) cm²] and the linear correlation coefficient between tests was r = 0.77 (P < 0.001). However, Bland-Altman plots revealed wide 95% limits of agreement (-14.7 to 15.0 cm²) between anthropometric and CT scan measurements. Anthropometric MA measurements may provide useful information for identifying subjects with whole body FFM depletion. This is a low-cost technique and can be used in a wider patient population to identify those likely to benefit from a complete body composition evaluation.

Geochemistry and mineralogical association of heavy metal contaminants in fine grained sediment, Welland River, Southern Ontario /

This investigation of geochemistry and mineralogy of heavy metals in fine grained (<63^m) sediment of the Welland River was imdertaken to: 1) describe metal dispersion patterns relative to a source, identify minerals forming and existing at the outfall region and relate sediment particle size to chemistry; 2) to delineate sample handling, preparation and evaluate, modify and develop analytical methods for heavy metal analysis of complex environmental samples. Ajoint project between Brock University and Geoscience Laboratories was initiated to test a contaminated site of the Welland River at the base of Atlas Speciality Steels Co. Methods were developed and utilized for particle size separation and two acid extraction techniques: 1) Partial extraction; 2) Total extraction. The mineralogical assessment identified calcite, dolomite, quartz and clays. These minerals are typical of the carbonate-shale rock basement of the Niagara Peninsula. Minerals such as, mullite and ferrocolumbite were found at the outfall region. These are not typical of the local geology and are generally associated with industrial pollutants. Partial and total extraction techniques were used to characterize the sediments based on chemical distribution, elemental behaviour and analytical differences. The majority of elements were lower in concentration in the partial extraction technique; suggesting these elements are bound in an acid extractable phase (exchangeable, organic and carbonate phases). The total extraction technique yielded higher elemental concentrations taking difficult oxides and silicates into solution. Geochemical analyses of grain size separates revealed that heavy metal (Co, Ni, V, Mn, Fe, Ba) concentrations did not increase with decreasing grain size. This is a function of the anthropogenic mill scale input into the river. The background elements (Sc, Y, Sr, Mg, Al and Ti) showed an increase in concentration to the finest grain size suggesting that it is directly related to the local mineralogy and geology. Dispersion patterns ofmetals fall into two distinct categories: 1) the heavy metals (Co, Cu, Ni, Zn, V and Cr), and 2) the background elements (Be, Sc, Y, Sr, Al and Ti). The heavy metals show a marked increase in the outfall region, while the background elements show a significant decrease at the outfall. This pattern is attributed to a "dilution effect" ofthe natural sediments by the anthropogenic mill scale sediments. Multivariant statistical analysis and correlation coefficient matrix results clearly support these results and conclusions. These results indicate the outfall region ofthe Welland River is highly contaminated with to heavy metals from the industrialized area of Welland. A short distance downstream, the metal concentrations return to baseline geochemical levels. It appears, contaminants rapidly come out of suspension and are deposited in close proximity to the source. Therefore, it is likely that dredging the sediment from the river may cause resuspension of contaminated sediments, but may not distribute the sediment as far as initially anticipated.

The effects of moisture, cation concentration, temperature, density and composition of soils on their electrical resistivity

The effects. of moisture, cation concentration, dens ity , temper~ t ure and grai n si ze on the electrical resistivity of so il s are examined using laboratory prepared soils. An i nexpen si ve method for preparing soils of different compositions was developed by mixing various size fractions i n the laboratory. Moisture and cation c oncentration are related to soil resistivity by powe r functions, whereas soil resistiv ity and temperature, density, Yo gravel, sand , sil t, and clay are related by exponential functions . A total of 1066 cases (8528 data) from all the experiments were used in a step-wise multiple linear r egression to determine the effect of each variable on soil resistivity. Six variables out of the eight variables studied account for 92.57/. of the total variance in so il resistivity with a correlation coefficient of 0.96. The other two variables (silt and gravel) did not increase the · variance. Moisture content was found to be - the most important Yo clay. variable- affecting s oil res istivi ty followed by These two variables account for 90.81Yo of the total variance in soil resistivity with a correlation ~oefficient ·.of 0 . 95. Based on these results an equation to ' ~~ed{ ct soil r esist ivi ty using moisture and Yo clay is developed . To t est the predicted equation, resistivity measurements were made on natural soils both in s i tu a nd i n the laboratory. The data show that field and laboratory measurements are comparable. The predicted regression line c losely coinciqes with resistivity data from area A and area B soils ~clayey and silty~clayey sands). Resistivity data and the predicted regression line in the case of c layey soils (clays> 40%) do not coincide, especially a t l ess than 15% moisture. The regression equation overestimates the resistivity of so i l s from area C and underestimates for area D soils. Laboratory prepared high clay soils give similar trends. The deviations are probably caused by heterogeneous distribution of mo i sture and difference in the type o f cl ays present in these soils.

Moderators of the Relationship between Family Caregiver Proxy-Ratings and Person with Dementia Self-Ratings of Quality of Life

As the dementia spectrum lacks any viable cure, quality of life is typically regarded as an essential measure of assessing the clinical course and evaluating interventions. With caregivers typically providing this rating to health professionals, the literature has noted inconsistencies between caregiver and person with dementia (PwD) ratings of quality of life and suggested several factors may moderate the rating relationship. To investigate this, an intraclass correlation coefficient was calculated to observe rating agreement and moderator regression analysis was conducted to explore potential moderators. Potential moderators of caregiver burden, caregiver age, caregiver income, PwD IADLs/ADLs, PwD education, PwD cognitive impairment, PwD depressive symptom severity, PwD behavioural symptom severity, as well as relationship between caregiver and PwD. Utilizing secondary data from 107 recruited dyads, analyses conducted found fair agreement between caregivers and those with dementia while none of the hypothesized factors were found to moderate the rating relationship.

Étude pharmacogénomique sur l’utilisation de la warfarine en pratique clinique réelle

Contexte: Bien que plusieurs algorithmes pharmacogénétiques de prédiction de doses de warfarine aient été publiés, peu d’études ont comparé la validité de ces algorithmes en pratique clinique réelle. Objectif: Évaluer trois algorithmes pharmacogénomiques dans une population de patients qui initient un traitement à la warfarine et qui souffrent de fibrillation auriculaire ou de problèmes de valves cardiaques. Analyser la performance des algorithmes de Gage et al., de Michaud et al. ainsi que de l’IWPC quant à la prédiction de la dose de warfarine permettant d’atteindre l’INR thérapeutique. Méthodes: Un devis de cohorte rétrospectif fut utilisé afin d’évaluer la validité des algorithmes chez 605 patients ayant débuté une thérapie de warfarine à l’Institut de Cardiologie de Montréal. Le coefficient de corrélation de Pearson ainsi que l’erreur absolue moyenne ont été utilisés pour évaluer la précision des algorithmes. L’exactitude clinique des prédictions de doses fut évaluée en calculant le nombre de patients pour qui la dose prédite était sous-estimée, idéalement estimée ou surestimée. Enfin, la régression linéaire multiple a été utilisée pour évaluer la validité d’un modèle de prédiction de doses de warfarine obtenu en ajoutant de nouvelles covariables. Résultats : L’algorithme de Gage a obtenu la proportion de variation expliquée la plus élevée (R2 ajusté = 44 %) ainsi que la plus faible erreur absolue moyenne (MAE = 1.41 ± 0.06). De plus, la comparaison des proportions de patients ayant une dose prédite à moins de 20 % de la dose observée a confirmé que l’algorithme de Gage était également le plus performant. Conclusion : Le modèle publié par Gage en 2008 est l’algorithme pharmacogénétique le plus exact dans notre population pour prédire des doses thérapeutiques de warfarine.

The Nursing Intensity Critical Care Questionnaire (NICCQ) : Validation Study in Cardiac Surgery Patients

Nurse Managers need today more than ever instruments that can be used to justify the billions of dollars that are invested in the healthcare sector annually. The objective of the study was to establish the validity and reliability of the Nursing Intensity Critical Care Questionnaire (NICCQ) in a cardiac surgery intensive care unit (CSICU) of a tertiary hospital. An expert panel evaluated the questionnaire’s content validity while generalizability theory was used to estimate the G and D coefficients. Decision studies enabled the investigators to determine if the current ward functioning of having one nurse rate one patient is adequate. Also, exploratory factorial analyses (EFA) preceded by principal component analyses (PCA) looked at establishing the factorial structure for the NICCQ. Finally, the NICCQ was correlated with a severity of illness score known as the Acute Physiology And Chronic Health Evaluation II (APACHE II) to estimate the correlation between patient illness and nursing intensity of care. The NICCQ was used by nurses using a sample of patients who had undergone cardiac surgery and were hospitalized on a CSICU of a tertiary teaching hospital. A convenience sample of nurses and patients on the CSICU was used to reflect the procedures and usual functioning of the unit. Each item on the questionnaire measured nursing intensity of care using a three point ordinal scale (Light, Moderate, and Severe) for the first 11 items, and a five point ordinal scale for the global assessment item (including the intermediate categories light/moderate and moderate/severe). The questionnaire proved to be both valid and able to be generalized to all nurses working in the CSICU. Overall results showed that 94.4% of the item generalizability coefficients indicated acceptable to excellent reliability, with most (86.1%) being larger than .90. The EFA established a simple 4 factor structure that explained little of the variance (32%). A correlation coefficient of 0.36 indicated that patient’ severity of illness is somewhat correlated with nursing intensity of care. The study showed that the NICCQ is a valid questionnaire with a generalizability coefficient that is large enough to be used by nurses’ managers for administrative purposes. Further research using larger samples would be needed to further test the factor structure of the NICCQ.

Étude rétrospective évaluant le VEGF comme biomarqueur d’athérosclérose mesurée par coronarographie quantitative et ultrason intra-vasculaire

Introduction : Puisque le VEGF promeut l’inflammation et la néovascularisation des plaques athérosclérotiques, il pourrait contribuer à l’athérogénèse. Cependant, les données cliniques tentant de lier le VEGF à la maladie cardiaque athérosclérotique (MCAS) sont controversées. Nous avons investigué l’association entre les niveaux de VEGF et la sévérité de la MCAS. Méthode : Nous avons effectué une étude rétrospective transversale : 56 patients présentant une MCAS stable et 112 patients avec un syndrome coronarien aigue (SCA) ont été étudiés. Nous avons investigué la relation entre la charge athérosclérotique et les niveaux sériques de VEGF en utilisant la coronarographie par analyse quantitative (QCA) et avons évalué la morphologie des plaques athérosclérotiques en utilisant l’imagerie intravasculaire ultrasonore (IVUS). Résultats : Les niveaux de VEGF étaient plus bas chez les patients avec SCA que chez ceux avec MCAS stable. On observe une corrélation positive entre les niveaux de VEGF et le fardeau de la MCAS stable mesurée par le QCA Cumulative Coronary Stenosis Score - CCSS (Pearson r= 0,423 et p = 0,001). En analyse multivariée, les niveaux sériques de VEGF demeuraient prédicteurs du CCSS (p=0,003) des patients avec une MCAS stable. Nous avons observé une corrélation positive entre les niveaux de VEGF et le volume de plaque (Spearman r = 0.381, p = 0.035) ainsi que le pourcentage de volume d’athérome (Spearman r = 0.466, p = 0.008) mesurés par IVUS. Conclusions : Notre étude suggère un usage potentiel des niveaux sérique de VEGF comme biomarqueur de MCAS.

A Comparative Study of Convective Parameterization Schemes in WRF-NMM Model

Severe local storms, including tornadoes, damaging hail and wind gusts, frequently occur over the eastern and northeastern states of India during the pre-monsoon season (March-May). Forecasting thunderstorms is one of the most difficult tasks in weather prediction, due to their rather small spatial and temporal extension and the inherent non-linearity of their dynamics and physics. In this paper, sensitivity experiments are conducted with the WRF-NMM model to test the impact of convective parameterization schemes on simulating severe thunderstorms that occurred over Kolkata on 20 May 2006 and 21 May 2007 and validated the model results with observation. In addition, a simulation without convective parameterization scheme was performed for each case to determine if the model could simulate the convection explicitly. A statistical analysis based on mean absolute error, root mean square error and correlation coefficient is performed for comparisons between the simulated and observed data with different convective schemes. This study shows that the prediction of thunderstorm affected parameters is sensitive to convective schemes. The Grell-Devenyi cloud ensemble convective scheme is well simulated the thunderstorm activities in terms of time, intensity and the region of occurrence of the events as compared to other convective schemes and also explicit scheme

Soft Computing Approach for Optimization of siRNA Efficiency Prediction for Post-transcriptional Gene Silencing

Post-transcriptional gene silencing by RNA interference is mediated by small interfering RNA called siRNA. This gene silencing mechanism can be exploited therapeutically to a wide variety of disease-associated targets, especially in AIDS, neurodegenerative diseases, cholesterol and cancer on mice with the hope of extending these approaches to treat humans. Over the recent past, a significant amount of work has been undertaken to understand the gene silencing mediated by exogenous siRNA. The design of efficient exogenous siRNA sequences is challenging because of many issues related to siRNA. While designing efficient siRNA, target mRNAs must be selected such that their corresponding siRNAs are likely to be efficient against that target and unlikely to accidentally silence other transcripts due to sequence similarity. So before doing gene silencing by siRNAs, it is essential to analyze their off-target effects in addition to their inhibition efficiency against a particular target. Hence designing exogenous siRNA with good knock-down efficiency and target specificity is an area of concern to be addressed. Some methods have been developed already by considering both inhibition efficiency and off-target possibility of siRNA against agene. Out of these methods, only a few have achieved good inhibition efficiency, specificity and sensitivity. The main focus of this thesis is to develop computational methods to optimize the efficiency of siRNA in terms of “inhibition capacity and off-target possibility” against target mRNAs with improved efficacy, which may be useful in the area of gene silencing and drug design for tumor development. This study aims to investigate the currently available siRNA prediction approaches and to devise a better computational approach to tackle the problem of siRNA efficacy by inhibition capacity and off-target possibility. The strength and limitations of the available approaches are investigated and taken into consideration for making improved solution. Thus the approaches proposed in this study extend some of the good scoring previous state of the art techniques by incorporating machine learning and statistical approaches and thermodynamic features like whole stacking energy to improve the prediction accuracy, inhibition efficiency, sensitivity and specificity. Here, we propose one Support Vector Machine (SVM) model, and two Artificial Neural Network (ANN) models for siRNA efficiency prediction. In SVM model, the classification property is used to classify whether the siRNA is efficient or inefficient in silencing a target gene. The first ANNmodel, named siRNA Designer, is used for optimizing the inhibition efficiency of siRNA against target genes. The second ANN model, named Optimized siRNA Designer, OpsiD, produces efficient siRNAs with high inhibition efficiency to degrade target genes with improved sensitivity-specificity, and identifies the off-target knockdown possibility of siRNA against non-target genes. The models are trained and tested against a large data set of siRNA sequences. The validations are conducted using Pearson Correlation Coefficient, Mathews Correlation Coefficient, Receiver Operating Characteristic analysis, Accuracy of prediction, Sensitivity and Specificity. It is found that the approach, OpsiD, is capable of predicting the inhibition capacity of siRNA against a target mRNA with improved results over the state of the art techniques. Also we are able to understand the influence of whole stacking energy on efficiency of siRNA. The model is further improved by including the ability to identify the “off-target possibility” of predicted siRNA on non-target genes. Thus the proposed model, OpsiD, can predict optimized siRNA by considering both “inhibition efficiency on target genes and off-target possibility on non-target genes”, with improved inhibition efficiency, specificity and sensitivity. Since we have taken efforts to optimize the siRNA efficacy in terms of “inhibition efficiency and offtarget possibility”, we hope that the risk of “off-target effect” while doing gene silencing in various bioinformatics fields can be overcome to a great extent. These findings may provide new insights into cancer diagnosis, prognosis and therapy by gene silencing. The approach may be found useful for designing exogenous siRNA for therapeutic applications and gene silencing techniques in different areas of bioinformatics.

Validación de la escala de calidad de vida MELASQoL, en un grupo de pacientes colombianas con melasma

El objetivo del estudio consistió en validar la escala de calidad de vida MELASQOL al idioma español en un grupo de mujeres colombianas con melasma. La muestra de estudio correspondió a 80 pacientes, las cuales asistieron a consulta de medicina estética de la IPS Quinta de Mutis de la Universidad del Rosario, por presentar melasma, se les pidió su participación y datos de ubicación telefónica para aplicarles la escala traducida al idioma español (MELASQOL-t) mediante la guía QoLMs (guidelines for cross-cultural adaptation of health-related), para validación de escalas propuesta por la OMS, en un segundo contacto vía telefónica. Una vez obtenida la respuesta telefónica a la escala de todas las pacientes, se procesaron los datos para validación mediante análisis estadístico; bajo los parámetros de congruencia interna, validez de criterio y reproducibilidad. Solo con una pequeña parte (n=10) de la muestra se efectuó un tercer contacto telefónico con fines estadísticos. El promedio de edad del grupo estudiado correspondió a 40±12 años, el estrato socioeconómico de mayor frecuencia fue el tres (3), con mayor distribución en el nivel educativo de estudios universitarios completos, se obtuvieron para los criterios de validación los siguientes datos: congruencia interna con a-cronbach=0.88, validez con rs=0.70-p<0.001 y reproducibilidad con coeficiente de correlación intraclase =0.959 (IC 95%: 0.986, p<0.001). La conclusión principal fue que la escala MELASQOL traducida al idioma español se validó bajo criterios adecuados, obteniendo buenos índices para medir calidad de vida en el grupo de mujeres colombianas con melasma estudiadas.

Retinoscopía estática: variabilidad interobservadores entre docentes y estudiantes de optometría en una institución universitaria de Bogotá D.C.

Introducción: el gold estándar para el error refractivo es la retinoscopía. Los docentes de optometría al evaluar estudiantes, aceptan una diferencia de ±0,50D en la refracción pero no se ha evaluado estadísticamente si es adecuado para ametropías bajas y altas. El objetivo fue cuantificar el grado de concordancia interobservadores en retinoscopía estática entre docentes y estudiantes, para ametropías altas y bajas. Metodología: estudio de concordancia entre 4 observadores en 40 ojos, 20 con ametropías altas y 20 con bajas; muestreo no probabilístico por conveniencia. Análisis estadístico con coeficiente de correlación intraclase, confiabilidad 95%, poder 90%, y con método gráfico de límites de acuerdo al 95%. Resultados: concordancia para el equivalente esférico entre docentes 0,96 y entre estudiantes 0,56. En estudiantes concordancia de 0,89 para defectos refractivos bajos y docentes 0,96 para defectos altos. Concordancia entre cuatro examinadores 0,78, defectos bajos 0,86 y para altos 0,67. Margen de error entre docentes ±0,87D y estudiantes ±3,15D. En defectos bajos ±0,61D para docentes y ±0,80D para estudiantes y en defectos altos ±1,10D y ±4,22D respectivamente. Discusión: hubo mayor confiabilidad en retinoscopía entre profesionales experimentados. Se comparó la concordancia entre docentes y estudiantes, por eso puede haberse encontrado menor concordancia que la descrita por otros estudios que compararon entre profesionales a pesar haber sido elegidos por sus buenas calificaciones. Se deben formular estrategias de enseñanza que permitan reducir los márgenes de error obtenidos y mejorar la concordancia entre docentes y estudiantes.

Parámetros cuantitativos de la resonancia magnética cerebral en esclerosis múltiple y su correlación con la discapacidad

A pesar del amplio uso de la resonancia magnética en la esclerosis múltiple no se ha logrado una adecuada correlación clínico-imagenológica en esta enfermedad. Objetivo: Determinar la correlación del volumen normalizado de sustancia gris y del volumen de lesiones hipointensas en T1 obtenidos a partir de la resonancia magnética cerebral con la escala de discapacidad extendida en pacientes con diagnóstico de esclerosis múltiple. Materiales y métodos: Estudio retrospectivo en pacientes con diagnóstico de esclerosis múltiple de la Fundación Cardioinfantil. Se obtuvieron los resultados de la escala de discapacidad expandida así como análisis cuantitativo de las imágenes correspondientes de resonancia magnética por medio de la herramienta SIENA. Se cuantificaron el volumen del parénquima cerebral, sustancia gris, sustancia blanca y volumen de lesiones hipointensas en T1. Posteriormente, se relacionaron estos resultados con la escala de discapacidad extendida de Kurtzke previamente obtenida. Para el análisis estadístico se emplearon el test correlación de Spearman y t de Student y Hotelling. Resultados: Se incluyeron 58 pacientes, encontrándose correlaciones estadísticamente significativas entre la escala de discapacidad extendida y volumen de parénquima cerebral, volumen de sustancia gris y volumen de lesiones hipointensas en T1; de 0.384, 0.386 y 0.39. No se encontró una relación entre el volumen de sustancia blanca y la escala de discapacidad. Conclusiones: Existe una correlación clínico-imagenológica moderada en la esclerosis múltiple. La cuantificación de los parámetros propuestos en este estudio podría ser utilizada como herramienta en el seguimiento de la enfermedad y monitorización de nuevos tratamientos.

Concordancia de presión sistólica pulmonar estimada por ultrasonografía y cateterismo cardíaco derecho en pacientes candidatos a trasplante cardíaco

Introducción: A los pacientes con Insuficiencia Cardíaca (IC) estadio D candidatos a trasplante cardiaco se les realiza la determinación de las presiones de la arteria pulmonar por CCD considerada como prueba de oro. Se decidió conocer si la medición de las presión de la arteria pulmonar obtenidas por ECO TT tenían concordancia con las obtenidas por el CCDen estos paciente que fueron evaluados para trasplante cardiaco. Metodología: Se realizó una recolección retrospectiva de los datos consignados en las historias clínicas de todos los pacientes que fueron receptores de un trasplante cardiaco en la FCI-IC desde septiembre del 2005 hasta Mayo del 2013 y se determinó la concordancia entre la presión sistólica pulmonar evaluado por ECO TT y CCD. Resultados: Se incluyeron 46 pacientes. El 76,1% son hombres y con edad promedio de 46,4 ± 13,1. La PSAP estimada por CCD fue 48,3 ± 13,1 mmHg Vs 45,1 ± 12,1 mmHg por ECO TT. La fracción de eyección fue 15,1 ± 4,06% (IC: 13,95-16,36). El 75,9% de los pacientes tenían HTP moderada y severa. La concordancia entre la PSAP determinada por ambos métodos fue 0,475 (I,C: 0.256 - 0.694), y el coeficiente de correlación intraclase fue de 0,090, indicando una baja concordancia entre los dos métodos. Discusión: La determinación de las presiones pulmonares determinada por ECO TT tiene mala concordancia con las obtenidas por CCD. No se debe usar este estudio para excluir los pacientes candidatos a trasplante cardiaco ni para evaluar las variaciones de las misma en la evolución de la enfermedad.

Presión arterial en preescolares de la localidad de Usaquén en Bogotá

Introducción: La hipertensión arterial es un problema de salud pública tanto en países industrializados como en vía de desarrollo. Su prevalencia en la infancia viene en aumento por lo que es relevante determinarla en niños preescolares a nivel local. Objetivo: Determinar la prevalencia de hipertensión arterial en niños de tres a cinco años de una cohorte de 14 hogares infantiles del ICBF de la localidad de Usaquén en Bogotá. Materiales y métodos: Se realizó un estudio de corte transversal analítico, utilizando la base de datos de un ensayo aleatorizado y controlado del año 200913, y se evaluaron las cifras de tensión arterial de acuerdo a sexo, edad, talla y su correlación con el IMC con un nivel de confianza del 95% y precisión del 1%. Se calcularon las medias, desviaciones estándar, percentiles y prevalencia. Resultados: Se obtuvo una muestra de 1035 casos, encontrándose una prevalencia de 4,5% de HTA sistólica, 10,4% de diastólica, ambas en estadio I; teniendo en cuenta tanto sistólica como diastólica, fue de 11,6% en estadio I. Se determinaron los valores de presión arterial sistólica y diastólica en cuartiles de acuerdo a edad, sexo y talla. El coeficiente de correlación entre el IMC y los niveles de presión arterial sistólica y diastólica fueron de 0.0992 y 0.0362 respectivamente. Conclusión: La prevalencia de HTA general fue de 11,6%, predominando la diastólica en estadio I en niños preescolares. No se encontró correlación entre el IMC y las cifras de tensión arterial sistólica y diastólica.