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Unveiling the relationship: Sacroiliac Joint Dysfunction as an Overlooked Factor in Lumbar Back Pain

Introduction: The Sacroiliac joint (SIJ) is a crucial connection found between the sacrum and ilium. It plays a vital role in transferring forces during physical activity, such as running. Its biomechanical function is crucial for ensuring stability, as it is supported by ligaments and pelvic floor muscles that work together to ensure this for individuals. However, SIJ dysfunction can be linked to lower back pain, which is a condition that affects around 70-85% of Western society. Causes: SIJ dysfunction originates from various factors, such as abnormal motion or malalignment. These conditions can arise from multiple causes: arthritis, trauma, or nontypical gait patterns. Diagnosis: Physical examinations are included in the diagnosis of SIJ dysfunction. They are called FABER, compression, distraction, thigh thrust, and Gaenslen. Three provocative test results are oftentimes required for a diagnosis. Other methods of diagnosis are also used, like X-rays, MRIs, and joint injections. Misdiagnosis: Nevertheless, although multiple methods exist to diagnose SIJ dysfunction, it is very commonly misdiagnosed. This is because the condition mimics symptoms of other conditions, and its etiology is overlooked. Treatment: When diagnosed, SIJ dysfunction can be treated through a range of measures. Either conservative treatments can be done, like physical therapy and NSAIDs, or more invasive procedures, such as surgical interventions, can be used to treat SIJ dysfunction. Conclusion: SIJ dysfunction is a prevalent, misdiagnosed condition that affects many individuals. This review highlights the importance of raising awareness among the public and clinicians to ensure an accurate diagnosis and treatment is given to patients.

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Prevalence of Dyslipidemia in Military Students and Military Personnel Attending Primary Care in Ecuador and Correlation with Anthropometric Values


 
 
 
 Objective: to establish the prevalence of dyslipidemia and its relationship with the body mass index, waist-height index and waist circumference in students of the higher technology specialization in military sciences, as well as military personnel who work at the University of the Armed Forces of Ecuador - ESPE.
 Methodology: this was an analytical, non-experimental study with a sample of 495 second-year students of the Superior Technology Specialization in Military Sciences and 196 military personnel who work at ESPE.Results: The study found 8,48 % (n: 42) prevalence of general dyslipidemia in students, differentiated by hypercholesterolemia 1,82 % (n: 9), hypertriglyceridemia 6,26 % (n: 31) and mixed dyslipidemia 0,4 % (n: 2). Additionally, it found 58,67 % (n: 115) prevalence of general dyslipidemia in professional military personnel, with hypercholesterolemia 9,18 % (n: 18), hypertriglyceridemia 25,51 % (n: 50) and mixed dyslipidemia 23,98 % (n: 47). Finally, the lower limit to diagnose dyslipidemia for body mass index in students was 25,67 kg/m2, for waist circumference 76,5 cm and for waist height ratio 0,47, and in professional military personnel, body mass index of 26,3 kg/m2, waist circumference of 86 cm and waist height ratio of 0,52.
 Conclusions: the students and military personnel studied have a significantly low prevalence of dyslipidemia compared to the general student and military personnel population and the values of WC and WHtR were seen to be good predictors of dyslipidemia in military personnel but not in the students.
 
 
 

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Proposing categories for retrospective secondary research on treatment adherence


 
 
 
 Psychological studies of treatment adherence have established: 1) indica- tor models—requency of consultation, the prevalence of medication intake over any other treat- ment, attendance at therapeutic and rehabilitation sessions—; 2) determining models—sex, age, income, level of education, reading comprehension, interpersonal relationships—; 3) mediating mod- els—beliefs, attitudes, knowledge, intentions, and strategies—. Objective: to establish categories for the study of treatment adherence in literature published between 2015–2019, considering the occupational health climate. Method: secondary research using a selection of 38 indexed sources in Latin American repositories—Dialnet, Latindex, Publindex, Redalyc, and Scielo—and the variables reported in the state of the art. Results: the model specification included four explanatory hypotheses of dependence relationship trajectories of six variables—demands, social support, control, effort, reward, and adherence—taken from the literature review. Discussion: regarding the indicator, determining, and mediating models, we recommend including the work culture, quality of life, and subjective well-being variables in the specified model to examine the process that goes from the workplace culture to reinserting workers after accidents and diseases. Conclusion: the new model specification would include explanatory hypotheses of variable correlation trajectories to establish differences between organizations that provide social security and companies with workplace flexibility and their effects on their workers’ occupational health.
 
 
 

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Hypovitaminosis D and Calcium Intake in Adult Population

Background: Daily dietary calcium intake below the requirements has been related to lowlevels of vitamin D (Vit-D) and osteoarticular diseases. Objective: To determine the prevalence of Vit-D deficiency in the general population living in Bogotá, its relationship to dietary calcium intake, and the influence of socio-demographic factors and sunlight exposure. Materials and methods: In a pro-spective cohort of the general population (randomly selected), excluding individuals with conditions affecting calcium absorption or adequate Vit-D action, the prevalence of hypovitaminosis D (95 % ci) and regular consumption of calcium (rci, mg/day) is measured according to socio-demographic, anthropometric, biochemical, and sunlight exposure variables. A multiple regression model is implemented (no intercept) to predict Vit-D concentration based on the factors described. Results: Ninety-seven patients are included, 61 % of which are women, with a median age of 23 years, a weight of 65 kg (iqr: 55.2–70.5), a height of 165 cm ± 8.9, and bmi of 22.8 kg/m2 (iqr: 21.2–25.2). The rci was 393.7 mg/day, less than the benchmark for Colombian adults (p < 0.001); serum calcium concentration was 9.7 mg/dL. The mean Vit-D concentration (95 % ci) was 23.7 ng/mL (22.6–24.7); hypovitaminosis D was identified in 87 % of the sample (80.6–94.7 %), 24.7 % were classified as poor (15.6–33.8 %) and 62.9 % as insufficient (52.8–73 %). Vit-D concentration was predicted in a quadratic function by the interaction between sex, sunlight exposure, and rci (R2 > 90 %). Conclusion: The suspected high prevalence of Vit-D deficiency is confirmed in the general Colombian adult population as a result of low dietary calcium intake, demographic factors, and sunlight exposure.

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Complejidad de la expresión de genes asociados a obesidad en el tejido adiposo humano

Objetivo: analizar la complejidad de la expresión génica en tejido adiposo de genes asociados con obesidad, mediante simulación computacional con diferentes herramientas bioinformáticas. Métodos: después de una búsqueda bibliográfica en PubMed, se seleccionaron 37 genes asociados con obesidad con fold change mayor a 1,5. A partir del cálculo de valores de los z-score obtenidos de experimentos de micromatrices de ADN de muestras de tejido adiposo de personas obesas y de control, se construyó una red de interacción con el programa Cytoscape 3.2. La información detallada sobre las características genómicas de estos genes se extrajo de las bases de datos Genome Browser de la UCSC y del NCBI. Utilizando herramientas de análisis de multivariado, se hizo un análisis de componentes principales y uno de agrupación. Resultados: la red construida mostró que los genes con mayor número de interacciones fueron: 1) el factor nuclear respiratorio (NRF1), 2) el canal activado de potasio activado por calcio alfa 1 (KCNMA1) y 3) la sintasa de ácidos grasos (FASN). Los que tuvieron mayores valores de expresión fueron: 1) el factor de crecimiento endotelial vascular A (VEGFA), 2) la dioxigenasa dependiente de alfa-cetoglutarato (FTO) y 3) el regulador de crecimiento neuronal 1 (NEGR1). Las proteínas IL6, BDNF y HLC tuvieron los mayores valores de interacción con IL6R, NRF1 y ACACB, respetivamente. Las categorías ontológicas más importantes se relacionaron con procesos metabólicos de lipoproteínas, el ciclo de los ácidos tricarboxílicos, la activación de las MAP-quinasas y la cascada JNK. Conclusiones: en su conjunto los resultados obtenidos de sobreexpresión diferencial de genes asociados con el metabolismo de lípidos en el tejido adiposo de personas obesas podría ser un criterio para discriminar a nivel de diagnóstico esta patología.

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