Abstract Introduction: practice of physical activity and the ketogenic diet monitoring can have a double effect in helping in processes of weight loss and improvement of body composition and lipid profile. Objective: the objective of this review was to investigate the work done with obese patients who undertook a ketogenic diet and a physical exercise program, as well as to calculate the overall effect size in terms of improvements in fat mass, through a meta-analysis. Methods: the selection of studies was based on the following criteria: experimental studies; a) experimental studies (randomized controlled designs) and quasi-experimental (e.g. pre-test/post-test); b) studies with low-carbohydrate diet (< 30%) or very low in carbohydrates (5-10%) (< 50 g Ch) and/or high in fats (> 35%); c) studies were admitted exclusively with subjects that facility overweight or obesity (BMI > 25; and d) with measurements of body composition and/or Lipid profile at the beginning and end of the intervention. Results: for the methodological review, 7 articles and 3 reviews were analyzed. All studies, whether by establishing aerobic or strength training and show significant weight loss in all outcomes. Conclusions: comparing different types of exercise, we could say that interventions based on endurance exercise reported a decrease in muscle mass, however there was a maintenance, and even an increase, in studies with resistance exercises. Meta-analysis showed significant results at the global level with a medium heterogeneity, therefore, there will be greater reduction of fat mass in groups that realize diets with low carbohydrates and exercise that in those who do not undertake this type of diet, and those only perform exercise.

Resumen Introducción: la práctica de actividad física y el seguimiento de una dieta cetogénica pueden suponer un doble efecto con mejores resultados en los procesos de pérdida de peso y mejora de la composición corporal y perfil lipídico. Objetivo: el objetivo de esta revisión fue investigar los trabajos realizados con pacientes obesos que siguen una dieta cetogénica y un programa de ejercicio físico, así como calcular el tamaño del efecto en cuanto a las mejoras en la masa grasa, a través de un metaanálisis. Métodos: la selección de estudios se basó en los siguientes criterios: estudios experimentales; a) estudios experimentales (diseños controlados aleatorizados) y cuasi-experimentales (por ejemplo: pre-test/post-test); b) estudios con dieta baja en carbohidratos (< 30%) o muy baja en carbohidratos (5-10%) (< 50 g Ch) y/o alta en grasas (> 35%); c) se admitieron estudios exclusivamente con sujetos que padecieran sobrepeso u obesidad (IMC > 25 y/o enfermedad metabólica relacionada; y d) con mediciones de composición corporal y/o perfil lipídico al principio y al final de la intervención. Resultados: se analizaron 7 artículos y 3 revisiones. Comparando los diferentes tipos de ejercicio se podría afirmar que destaca la disminución de masa muscular en aquellos en los que las intervenciones son con ejercicio aeróbico, manteniéndose e incluso aumentando, en los estudios donde se realizó un ejercicio de fuerza. El metaanálisis nos muestra una reducción significativa de la masa grasa con una heterogeneidad media, por lo tanto, habrá mayor reducción de masa grasa en grupos que realizan dieta baja en carbohidratos y ejercicio que en los que no realizan dieta o tan solo realizan ejercicio. Conclusiones: la combinación de dieta cetogénica y ejercicio físico puede reducir la masa grasa en comparación con realizar solo dieta o solo ejercicio físico.

An annotated list of the triatomine species present in French Guiana is given. It is based on field collections carried out between 1993-2008, museum collections and a literature review. Fourteen species, representing four tribes and six genera, are now known in this country and are illustrated (habitus). Three species are recorded from French Guiana for the first time: Cavernicola pilosa, Microtriatoma trinidadensis and Rhodnius paraensis. The two most common and widely distributed species are Panstrongylus geniculatus and Rhodnius pictipes. The presence of two species (Panstrongylus megistus and Triatoma maculata) could be fortuitous and requires confirmation. Also, the presence of Rhodnius prolixus is doubtful; while it was previously recorded in French Guiana, it was probably mistaken for R. robustus. A key for French Guiana's triatomine species is provided.

A survey was carried out on 1487 individuals to assess the seroprevalence of Trypanosoma cruzi infection in French Guiana. The overall prevalence of T. cruzi specific IgG was 0.5%. In multivariate analysis, residence in areas where housing is favorable for the presence of triatomine bugs was the only factor associated with the presence of T. cruzi antibodies. These results have implications for public health since blood donors are not routinely screened for T. cruzi infection in French Guiana.

A cross section of a human population (501 individuals) selected at random, and living in a Bolivian community, highly endemic for Chagas disease, was investigated combining together clinical, parasitological and molecular approaches. Conventional serology and polymerase chain reaction (PCR) indicated an active transmission of the infection, a high seroprevalence (43.3%) ranging from around 12% in < 5 years to 94.7% in > 45 years, and a high sensitivity (83.8%) and specificity of PCR. Abnormal ECG tracing was predominant in chagasic patients and was already present among individuals younger than 13 years. SAPA (shed acute phase antigen) recombinant protein and the synthetic peptide R-13 were used as antigens in ELISA tests. The reactivity of SAPA was strongly associated to Trypanosoma cruzi infection and independent of the age of the patients but was not suitable neither for universal serodiagnosis nor for discrimination of specific phases of Chagas infection. Anti-R-13 response was observed in 27.5% only in chagasic patients. Moreover, anti-R13 reactivity was associated with early infection and not to cardiac pathology. This result questioned previous studies, which considered the anti-R-13 response as a marker of chronic Chagas heart disease. The major clonets 20 and 39 (belonging to Trypanosoma cruzi I and T. cruzi II respectively) which circulate in equal proportions in vectors of the studied area, were identified in patients' blood by PCR. Clonet 39 was selected over clonet 20 in the circulation whatever the age of the patient. The only factor related to strain detected in patients' blood, was the anti-R-13 reactivity: 37% of the patients infected by clonet 39 (94 cases) had anti-R13 antibodies contrasting with only 6% of the patients without clonet 39 (16 cases).