Abstract: What does the truth of a judgment consist of, according to F. H. Bradley? What is its ultimate nature? In particular, how does such a property relate to reality? At least three interpretive theses have been offered: (i) that Bradley defended a theory of truth as coherence; (ii) that, rather, Bradley defended a robust variant of the identity theory of truth; and (iii) that, in any case, Bradley rejected the correspondence theory of truth. In this article I question these three theses and argue that the position defended by Bradley is perfectly compatible with a weak variant of the correspondence theory of truth. This, by the way, makes his position vulnerable to certain objections. Bradley’s merit consists not so much in having answered them satisfactorily as in having anticipated them and assumed them as eventual consequences of his position. Abstract F H nature particular reality offered i (i coherence ii (ii rather iii (iii case This way objections Bradleys s

Resumen: ¿En qué consiste la verdad de un juicio, según F. H. Bradley? ¿Cuál es su naturaleza última? En particular, ¿cómo se relaciona dicha propiedad con la realidad? Al menos tres tesis interpretativas se han ofrecido: (i) que Bradley defendió una teoría de la verdad como coherencia; (ii) que, más bien, Bradley defendió una variante robusta de la teoría de la verdad como identidad; y (iii) que, en cualquier caso, Bradley rechazó la teoría de la verdad como correspondencia. En este artículo cuestiono estas tres tesis y argumento que la posición defendida por Bradley es perfectamente compatible con una variante débil de la teoría de la verdad como correspondencia. Esto, por cierto, hace que su posición sea vulnerable a ciertas objeciones. El mérito de Bradley consiste no tanto en haberlas respondido satisfactoriamente como en haberlas anticipado y asumido como eventuales consecuencias de su posición. Resumen juicio F H Cuál última particular cómo realidad ofrecido i (i coherencia ii (ii bien identidad iii (iii caso correspondencia Esto cierto objeciones

Abstract My aim in this article is to defend the essential core of the theories of truth that understand truth as identity, namely: that the truth-bearer is the truth-maker. In particular, I am interested in defending the version of Hornsby (1997) and McDowell (1994) against the attacks made by Dodd (1995; 1999; 2008). My defense is applicable to previous versions belonging to this family of theories, especially to that of Moore (1899; 1902).

Resumen Mi objetivo en este artículo es defender el núcleo esencial de las teorías de la verdad que entienden la verdad como identidad, a saber: que el portador de verdad es el hacedor de verdad. En particular, me interesa defender la versión de Hornsby (1997) y McDowell (1994) en contra de los ataques realizados por Dodd (1995; 1999; 2008). Mi defensa es aplicable a versiones previas pertenecientes a esta familia de teorías, especialmente a la de Moore (1899; 1902).

RESUMO Meu objetivo aqui é mostrar como o Argumento Cosmológico (AC) é abalado por uma de suas próprias premissas: o Princípio da Razão Suficiente (PRS). Primeiramente, explico que tipo de AC tenho em mente (I). Em segundo lugar, explico uma objeção modal tradicional contra o PRS que é, em última instância, baseado em nossas intuições a favor da contingência (II). Em terceiro lugar, mostro como essa objeção modal clama por questionar o necessitário e, em seguida, reformulo o AC em termos mais neutros (III). Em quarto lugar, utilizando esta versão mais neutra do AC, argumento que o problema principal com o PRS vai além de suas consequências aparentemente necessitárias. Como mostra um argumento usado por Bradley, abraçar a via racionalista que subjaz ao PRS parece nos dedicar a uma forma de Monismo Radical também (IV). Finalmente, concluo mostrando como esse resultado, em última instância, mina o próprio AC (V). (AC premissas PRS. . (PRS) Primeiramente I. I (I) lugar instância II. II (II) e seguida III. III (III) necessitárias Bradley IV. IV (IV) Finalmente resultado V. V (V) (PRS (I (II (III (IV (V

ABSTRACT My aim here is to show how the Cosmological Argument (CA) is undermined by one of its own premises: the Principle of Sufficient Reason (PSR). Firstly, I explain the type of CA that I am thinking about (I). Secondly, I explain a traditional modal objection against the PSR, which is ultimately based upon our intuitions in favor of contingency (II). Thirdly, I show how this modal objection begs the question against the necessitarian, and then I reformulate the CA in more neutral terms (III). Fourthly, using this more neutral version of the CA, I argue that the main problem with the PSR goes way beyond its apparent necessitarian consequences. As an argument used by Bradley shows, embracing the rationalist path that underlies the PSR seems to commit us to a form of Radical Monism too (IV). Finally, I conclude by showing how this result ultimately undermines the CA itself (V). (CA premises PSR. . (PSR) Firstly I. (I) Secondly II. II (II) Thirdly III. III (III) Fourthly consequences shows IV. IV (IV) Finally V. V (V) (PSR (I (II (III (IV (V

En este artículo reivindico una explicación subestimada sobre proposiciones estructuradas adoptada por el joven Moore y el joven Russell, según la cual las proposiciones son fragmentos estructurados no representacionales de la realidad, compuestos por otros fragmentos no representacionales de la realidad. En primer lugar, presento los desiderata estándar para proposiciones y el objetivo de mi artículo. En segundo lugar, discuto la explicación estándar de las proposiciones estructuradas, que las entiende como entidades representacionales complejas de algún tipo. En tercer lugar, reviso las objeciones contra la explicación estándar de las proposiciones estructuradas y las razones para considerar las proposiciones como entidades representacionales simples. En cuarto lugar, muestro cómo la explicación subestimada de las proposiciones estructuradas que reivindico puede hacer el trabajo.

In this paper, I vindicate a neglected account of structured propositions embraced by the young Moore and the young Russell, according to which propositions are structured non-representational chunks of reality composed of other non-representational chunks of reality. Firstly, I present the standard desiderata for propositions and the focus of my paper. Secondly, I discuss the standard account of structured propositions, which understands them to be complex representational entities of some sort. Thirdly, I go through the objections against that standard account of structured propositions and the reasons for considering propositions to be simple representational entities. Fourthly, I show how the neglected account of structured propositions that I vindicate can do the job.

In Chile, colorectal cancer ranks third in incidence and fifth in mortality. Half of these patients have liver metastases at the diagnosis, and only 30% of them are resectable. Despite the development of many complex hepatobiliary procedures to achieve the total resection of metastases, the long-term survival with these techniques is not good. Liver transplantation is an alternative to treat unresectable liver metastasis from colorectal cancer with a good outcome. Several prognostic scores allow the selection of patients with good tumor biology. These patients have better overall and disease-free survival after liver transplantation. The use of immunosuppressive treatment doesn't increase recurrence, and even the pattern of tumor growth is slower in liver transplant recipients. The purpose of this review is to summarize the current evidence in this topic and to highlight the need for a formal protocol for liver transplantation for unresectable colorectal liver metastases, using living donors or marginal grafts to avoid competition with the rest of the national waiting list.

RESUMO Contexto O escore de Rockall é a escala de prognóstico mais amplamente usada para avaliar o risco de complicações de sangramento gastrointestinal superior não varicoso. Vários estudos foram conduzidos em populações adultas com sangramento gastrointestinal superior não varicoso em diferentes partes do mundo, com achados conflitantes quanto à extensão da associação entre o escore e alguns desfechos de morbimortalidade. Há também controvérsias em relação ao melhor ponto de corte para a pontuação. Além disso, não foram realizados estudos que validem essa pontuação na Colômbia. Objetivo Avaliar o desempenho diagnóstico do escore de Rockall na previsão de ressangramento e mortalidade em pacientes com sangramento gastrointestinal superior não varicoso. Métodos Um estudo de coorte prospectivo foi conduzido em pacientes que necessitaram de endoscopia digestiva alta (EDA) para sangramento não varicoso. Os escores de Rockall pré e pós-endoscopia foram calculados e os resultados, incluindo mortalidade, mortalidade associada ao sangramento gastrointestinal superior não varicoso e ressangramento intra-hospitalar foram determinados nos pontos de tempo de 1 e 3 meses. A associação entre os escores e esses desfechos foram avaliados pelo teste de chi2 ou Fisher, enquanto a habilidade de discriminação do escore foi determinada pelas áreas sob a curva ROC (AUC). Alta capacidade de discriminação foi considerada existente nos casos em que uma AUC ≤0,7 com α=0,05 poderia ser rejeitada. Resultados No geral, 177 pacientes foram analizados. Os desfechos hospitalares em 1 e 3 meses foram de 12%, 17% e 23% para mortalidade geral, 6%, 12% e 15% para mortalidade com hemorragia digestiva alta e 19%, 30% e 37% para ressangramento. O escore de Rockall pós-endoscopia foi associado aos três desfechos nos três momentos avaliados, enquanto o escore pré-endoscopia foi associado apenas à mortalidade geral nos três momentos, e ressangramento em 1 e 3 meses. Em relação à capacidade de discriminação, embora a AUC fosse maior do que o esperado pela aleatoriedade (0,5) em todos os casos, apenas uma AUC ≤0,7 foi rejeitada no escore pós-endoscopia para mortalidade com hemorragia digestiva alta intra-hospitalar (AUC =0,901; 95%IC: 0,845—0,958), em 1 mês (AUC =0,836; 95%IC 0,717—0,954) e em 3 meses (AUC =0,869; 95%IC: 0,771—0,967), e para ressangramento em 1 mês (AUC =0,793; 95%IC: 0,725—0,861) e aos 3 meses (AUC =0,806; 95%IC: 0,741—0,871). Conclusão Foi encontrada associação entre o escore de Rockall, ressangramento e mortalidade em pacientes com hemorragia digestiva alta não varicosa. Apenas o escore pós-endoscopia teve alta capacidade preditiva para ressangramento e mortalidade por sangramento gastrointestinal superior não varicoso.

ABSTRACT Background Rockall score is the most widely used prognostic scale for assessing risk of complications from non-varicose upper gastrointestinal bleeding (UGIB). Several studies have been conducted in adult populations with non-varicose UGIB in different parts of the world, with conflicting findings regarding the extent of association between the score and some morbidity and mortality outcomes. Also, there is controversy regarding the best cut-off point for the score. Moreover, no studies validating this score in Colombia have been carried out. Objective To assess the diagnostic performance of the Rockall score in predicting rebleeding and mortality in patients with non-varicose UGIB. Methods A prospective cohort study was conducted in patients requiring upper gastrointestinal endoscopy (UGIE) for non-varicose bleeding. The pre-and post-endoscopy Rockall scores were calculated and outcomes, including mortality, UGIB-associated mortality and in hospital rebleeding were determined at the 1 and 3-month time points. The association between the scores and these outcomes was assessed using the chi2 or the Fisher test, whereas the discrimination ability of the score was determined using the areas under the ROC curve (AUC). High discrimination ability was considered to exist in cases in which an AUC ≤0.7 with α=0.05 could be rejected. Results Overall, 177 patients were analyzed. In-hospital outcomes at 1 and 3 months were 12%, 17% and 23% for general mortality, 6%, 12% and 15% for UGIB mortality, and 19%, 30% and 37% for rebleeding. The post-endoscopy Rockall score was associated with the three outcomes at the three time points assessed, while the pre-endoscopy score was only associated with general mortality at the three time points, and rebleeding at 1 and 3 months. Regarding discrimination ability, although the AUC was greater than expected by randomness (0.5) in all cases, only one AUC ≤0.7 was rejected in the post-endoscopy score for in-hospital UGIB mortality (AUC=0.901; 95%CI: 0.845—0.958), at 1 month (AUC=0.836; 95%CI: 0.717—0.954) and at 3 months (AUC=0.869; 95%CI: 0.771—0.967), and for rebleeding at 1 month (AUC=0.793; 95%CI: 0.725—0.861) and at 3 months (AUC=0.806; 95%CI: 0.741—0.871). Conclusion An association was found between the Rockall score and rebleeding and mortality in patients with non-varicose UGIB. Only the post-endoscopy score had a high predictive ability for rebleeding and UGIB mortality.

Resumen Objetivos: validar el rendimiento diagnóstico del puntaje PERC para descartar embolia pulmonar en pacientes de bajo riesgo a gran altitud (>2500 msnm). Metodología: estudio de corte transversal con análisis de prueba diagnóstica en pacientes mayores de 18 años con sospecha diagnóstica de embolia pulmonar al ingreso o durante la hospitalización llevado a toma de angiotomografía de tórax desde agosto de 2009 hasta enero de 2020 en un centro de tercer nivel ubicado en la Sabana de Bogotá, se evaluó el rendimiento del puntaje PERC (Embolism Rule-Out Criteria) calculado con una SatO2<95% y una SatO2<90% en pacientes con diferentes niveles de riesgo según los puntajes de Wells, Ginebra y Pisa para embolia pulmonar. Resultados: mil ochenta y siete ingresaron al análisis final, 42% con EP Se encontró para los pacientes clasificados de bajo riesgo por el puntaje de Wells un ACOR para el PERC calculado con SatO2<95% de 0.56 (IC-95%:0.50-0.62) (p=0.049), y para el PERC calculado con SatO2<90% de 0.60 (IC-95%:0.54-0.66) (p=0.002), el ACOR para sujetos clasificados de bajo riesgo por el puntaje de Ginebra con un PERC calculado con SatO2<95% fue de: 0.53 (IC-95%:0.45-0.60) (p=0.459) y para un PERC calculado con SatO2<90% fue de: 0.55 (IC-95%:0.47-0.62) (P=0.218), el ACOR para sujetos clasificados con menos de 10% de probabilidad para EP por el puntaje de Pisa con un PERC calculado con SatO2<95% fue de: 0.54 (IC-95%:0.44-0.64)(p=0.422) y para un PERC calculado con SatO2<90% fue de: 0.56 (IC-95%:0.46-0.66)(p=0.236). Conclusiones: el puntaje PERC calculado con una saturación de oxígeno <90% tiene un rendimiento diagnóstico similar al puntaje PERC calculado con una saturación de oxígeno <95% para descartar EP en pacientes clasificados en bajo riesgo con puntaje de Wells a gran altitud (>2500 msnm). (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.2010).

Abstract Objectives: to validate the diagnostic yield of the PERC score for ruling out pulmonary embolism in low-risk patients at high altitudes (>2500 meters above sea level [ASL]). Methods: a cross-sectional study with diagnostic test analysis in patients over the age of 18 with suspected pulmonary embolism on admission or during hospitalization, who underwent chest computed tomography angiography between August 2009 and January 2020 in a tertiary care hospital located on the Bogotá savannah. The yield of the PERC score was assessed, calculated with an SaO2<95% and an SaO2<90% in patients with different risk levels according to the Wells, Geneva and Pisa scores for pulmonary embolism. Results: one thousand eighty-seven were included in the final analysis, 42% with PE. Patients classified as low-risk using the Wells score had a PERC ACOR calculated with SaO2<95% of 0.56 (95%CI:0.50-0.62) (p=0.049), and calculated with SaO2<90% of 0.60 (95%CI:0.54-0.66) (p=0.002). The ACOR for subjects classified as low-risk using the Geneva score, with a PERC calculated with SaO2<95%, was: 0.53 (95%CI:0.45-0.60) (p=0.459) and for a PERC calculated with SaO2<90% it was: 0.55 (95%CI:0.47-0.62) (P=0.218). The ACOR for subjects with a less than 10% probability of PE according to the Pisa score classification, with a PERC calculated with SaO2<95%, was: 0.54 (95%CI:0.44-0.64)(p=0.422), and for a PERC calculated with SaO2<90% it was: 0.56 (95%CI:0.46-0.66)(p=0.236). Conclusions: the PERC score calculated with an oxygen saturation <90% has a similar diagnostic yield to the PERC score calculated with an oxygen saturation <95% for ruling out PE in patients classified as low-risk by the Wells score at high altitudes (>2,500 meters ASL). (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.2010).

Abstract In “The Nature of Judgment” (1899), G. E. Moore defends the strange thesis according to which “[i]t seems necessary… to regard the world as formed of concepts”. Philosophers have offered distinct understandings of this proposal, in particular of what Moorean concepts really are. In this article I discuss and reject three of them: one, according to which Moorean concepts are universals within the framework of a bundle theory of concrete particulars (Nelson, 1962; Baldwin, 1990); a second one, according to which Moorean concepts are particulars within a mereological framework of analysis (Bell, 1999); and a third one, according to which Moorean concepts are a sui generis category, resulting from his alleged rejection of the substance (particular)/attribute (universal) distinction (MacBride, 2018). I end by defending my own understanding, which highlights the openly Platonic stance of the young G. E. Moore.

Resumen En “The Nature of Judgment” (1899), G. E. Moore defiende la extraña tesis según la cual “[p]arece necesario… entender al mundo como formado de conceptos”. Los filósofos han ofrecido distintas comprensiones de esta propuesta, en particular de lo que los conceptos mooreanos realmente son. En este artículo discuto y rechazo tres de ellas: una, según la cual los conceptos mooreanos son universales dentro del marco de una teoría del cúmulo sobre particulares concretos (Nelson, 1962; Baldwin, 1990); una segunda, según la cual los conceptos mooreanos son particulares dentro de un marco de análisis mereológico (Bell, 1999); y una tercera, según la cual los conceptos mooreanos son una categoría sui generis, resultante del supuesto rechazo de la distinción substancia (particular)/atributo (universal) (MacBride 2018). Finalizo defendiendo mi propia comprensión, que resalta la postura abiertamente platónica del joven G. E. Moore.

Abstract: My aim in this paper is to explore the limits of a conception of metaphysical explanation based on the Principle of Sufficient Reason (PSR). For this purpose, I will focus on one of the alleged counter-intuitive consequences of an unrestricted application of the PSR, namely: Radical Monism. First, I will articulate such a conception of metaphysical explanation. Then, I will explain how is it that from a famous argument that rests on the PSR (i.e., Bradley’s regress) Radical Monism indeed seems to follow. Right away, I will argue against the natural reaction that such argument triggers, namely: that we shall accept pluralism and relations as brute facts. Finally, I will sketch a qualified version of the PSR that allows us to avoid Radical Monism without compromising the essential content of the PSR.

Resumen: En este artículo pretendo explorar los límites de una concepción de explicación metafísica basada en el Principio de Razón Suficiente (PRS). Para ello me concentraré en una de las consecuencias contraintuitivas que supuestamente se siguen de una aplicación irrestricta del PRS, a saber: el Monismo Radical. Primero, articularé dicha concepción de explicación metafísica. Luego, explicaré cómo es que de un famoso argumento que descansa sobre el PRS (el regreso de Bradley) parece efectivamente seguirse el Monismo Radical. En seguida, argumentaré en contra de la natural reacción frente a dicho argumento, a saber: aceptar el pluralismo y las relaciones como hechos brutos últimos. Finalmente, esbozaré una versión cualificada del PRS, PRS*, que nos permite sortear el Monismo Radical sin necesidad de renunciar al contenido esencial del PRS.

Abstract According to McGinn (2012), the aim of philosophy is to discover essences through conceptual analysis, and it qualifies as a game in Suits’ sense (1978; 2014). However, everything in Suits’ definition of game seems to exclude from its scope McGinn’s definition of philosophy. Here I criticise McGinn’s definition and offer a more comprehensive one. Incidentally, this definition will allow us to include philosophy within the class of activities that do satisfy Suits’ definition of game.

Resumen Según McGinn (2012), el fin de la filosofía es descubrir esencias mediante el análisis conceptual, y ella califica como un juego en el sentido de Suits (1978, 2014). Sin embargo, todo en la definición de juego de Suits parece dejar fuera de su alcance a la definición de filosofía de McGinn. Aquí someto a revisión crítica la definición de McGinn y propongo una más comprensiva. Incidentalmente, esta definición nos permitirá incluir a la filosofía dentro de la clase de actividades que sí satisfacen la definición de juego de Suits.

Abstract: In this article I attempt to give an account of the thesis according to which composition is identity and of the criticisms that might be formulated against it. According to a weak version of the thesis, composition, in virtue of being analogous in important respects to identity, is as ontologically innocent as identity. According to the strong version of the thesis, composition is literally a species of the generic relation of identity, and is as ontologically innocent as any species of identity. As we will see, the weak version begs the question or incurs in a non sequitur; and the strong version is incoherent and faces a dilemma. Thus, composition is not identity: one thing cannot be identical to many things.

Resumen: En este artículo intento dar cuenta de la tesis según la cual composición es identidad y de las críticas que pueden formularse en contra de la misma. Según la versión débil de la tesis, composición, por el hecho de ser análoga a identidad en ciertos respectos importantes, es tan ontológicamente inocente como identidad. Según la versión fuerte de la tesis, composición es literalmente una especie de la relación genérica de identidad, y es tan ontológicamente inocente como toda especie de identidad. Como veremos, la versión débil incurre en una petición de principio o en un non sequitur; y la version fuerte es incoherente y enfrenta un dilema. Así, composición no es identidad: una cosa no puede ser idéntica a varias cosas.

In patients with actively bleeding gastric varices, the treatment of choice is the endoscopic use of sclerosing agents such as cyanoacrylate. We report a 69-year-old man who, after being treated with cyanoacrylate, suffered from recurrent febrile episodes. After an extensive study and broad-spectrum antibiotic treatment, discarding other presumably infectious focus, the superinfection of the cyanoacrylate plug was suspected, and its surgical removal was decided. A partial gastrectomy of the gastric fundus, a splenectomy, and a distal pancreatectomy were performed. The patient evolved without fever and without new episodes of bacteremia, but with decompensation of his cirrhosis manifested by ascites, spontaneous bacterial peritonitis, pneumonia, and collections in the pancreatic bed. These complications were managed with medical treatment consisting in a long course of broad-spectrum antibiotics. Thereafter, the patient evolved satisfactorily.

Abstracts: Introduction: Highly trained athletes show structural cardiac changes as adaptation to overload. Rise in remodeling biomarkers and myocardial fibrosis after intense exercise in athletes has been evidenced; however, the behavior of these biomarkers according to pre-competition training level has not been evaluated. Objective: To evaluate fibrosis biomarkers levels and right ventricle function in marathon runners according to their previous training level, in the period prior to a marathon race and immediately after it. Methods: Thirty-six healthy male marathon runners were included. Subjects were grouped according to their previous training level: Group 1 (G1): ≥100 km/week and Group 2 (G2): <100 km/week. Transthoracic echocardiography along with plasmatic levels of galectin-3 and amino terminal propeptide of type III procollagen (PIIINP) were measured one week previous and immediately after the marathon. Results: Post-effort right ventricle systolic function decreased in G2, together with a significant elevation of PIIIPNP (61±16 to 94±24 ng/mL, p=0.01). These changes were not observed in G1 (from 65±11 to 90±29 ng/mL, p=0.10). Plasma galectin-3 increased significantly in both groups immediately post-exercise (6.8±2.2 to 19.7±4.9 ng/mL, p=0.012, and 6.0±1.1 to 19.4±5.9 ng/mL, p=0.01, in G1 and G2. respectively). Conclusion: Less trained athletes evidenced higher post marathon levels of PIIIPNP which is associated with a decreased global right ventricle function. Plasma galectin-3 levels increased significantly after intense exertion regardless of the intensity of previous training.

Resumen: Introducción: Atletas altamente entrenados muestran cambios cardíacos estructurales como adaptación a la sobrecarga, producto del ejercicio repetitivo y extenuante. Se han evidenciado elevación de biomarcadores de remodelado y fibrosis miocárdica posterior al ejercicio intenso en atletas. Sin embargo, el comportamiento de estos biomarcadores según el nivel de entrenamiento previo no se ha evaluado. Objetivo: Investigar biomarcadores de fibrosis y función ventricular derecha en maratonistas con distinto nivel de entrenamiento previo. Métodos: Se incluyeron 36 maratonistas hombres, sanos, que completaron 42 km en la maratón de Santiago. Se dividieron según entrenamiento previo en dos grupos, Grupo 1 (G1): ≥100 km/semana y Grupo 2 (G2): <100 km/semana. Se realizó ecocardiografía transtorácica y se evaluaron niveles plasmáticos de galectina-3 y del propéptido amino terminal del procolágeno tipo III (PIIINP) en la semana previa a la carrera e inmediatamente posterior a ésta. Resultados: Posterior a la maratón, la función sistólica del ventrículo derecho disminuyó en el grupo G2 junto con un aumento significativo de los niveles plasmáticos de PIIIPNP (61±16 a 94±24 ng/mL, p=0,01). Estos cambios no se observaron en el grupo G1 (65 ± 11 a 90±29 ng/mL, p=0,10). Los niveles plasmáticos de galectina-3 aumentaron significativamente en ambos grupos posterior al ejercicio (6,8±2,2 a 19,7±4,9 ng/mL, p 0,012 y 6,0±1,1 a 19,4 ± 5,9 ng/mL, p 0,01) en los grupos G1 y G2, respectivamente). Conclusiones: Atletas con menor grado de entrenamiento, presentan posterior a una maratón un significativo aumento de productos de degradación del colágeno (PIIIPNP) asociado a disminución de la función del ventrículo derecho. Los niveles de galectina-3 plasmática aumentan significativamente en ambos grupos post-esfuerzo independiente del entrenamiento previo.

Abstract: Background: Exercise reduces cardiovascular mortality and generates cardiac remodeling. High training loads can induce adverse cardiac remodeling, and its associated cardiac remodeling. Therefore, interleukin 6 (IL 6) and malondialdehyde (MDA), biomarkers of inflammatory response and oxidative stress respectively, may have a role in stratifying this risk. Objective: To assess the activity of IL-6 and MDA in response to a marathon race in athletes with different previous training status. Subjects And Methods: Prospective, single-blind study involving 16 male athletes that finished the Santiago Marathon (42 k), allocated into two groups according to their previous training: Group 1 (G1, n: 8) with high training (≥ 100 km/weekly) and Group 2 (G2, n: 8) with low training (< 100 km/weekly). Before and after the race serum levels of IL-6, MDA and transthoracic Doppler echocardiography for cardiac chamber quantification and left ventricle deformation (longitudinal strain) were measured. Mann-Whitney, Wilcoxon, and Kruskal-Wallis tests were used to assess statistical significance. Results: Age G1: 38.13±7.18 years-old vs G2: 40.38±6.63 years-old (NS). Marathon finishing time G1: 185.75±14.87 min vs G2: 219.75±24.92 min (p<0.01). Left ventricle mass G1: 91±21 g/m2 vs G2: 73±12 g/m2 (p<0.01). Left atrium volume G1: 39.4±12.6 ml/m2 vs 30.6±4.6 ml/m2 (p<0.01). LVEF G1: 55.8±3.3% vs G2: 58.6±6.7% (NS). MDA G1: PRE 0.17±0.13 uM/L, POST 0.67±0.59 uM/L, G2: PRE 0.29±0.24 uM/L, POST 1.01±1.15 uM/L (p<0.01). IL-6 G1: PRE 2.50±1.35 pg/ml, POST 93.91±27.23 vs G2: PRE 4.65±5.89 pg/ml, POST 97.83±30.72 pg/ml (NS). Conclusion: Physical exercise generates a rise in biomarkers (IL-6, MDA). Athletes with high-intensity training level have a diminished oxidative stress response post effort and greater cardiac remodeling.

Resumen: Introducción: El ejercicio físico reduce la mortalidad cardiovascular y genera remodelado cardíaco. Altas cargas de entrenamiento pueden generar remodelado cardíaco adverso. Biomarcadores (BMC) de inflamación Interleukina 6 (IL-6) y de estrés oxidativo Malondialdehído (MDA), potencialmente pueden caracterizar la respuesta al esfuerzo. Objetivo: Evaluar actividad de IL-6 y MDA en respuesta a una maratón en atletas con distinto nivel de entrenamiento y remodelado cardíaco asociado. Sujetos y Métodos: Estudio prospectivo, simple ciego, incluyó 16 atletas que completaron la maratón de Santiago (42 k), separados según entrenamiento previo, grupo 1 (G1, n: 8): Alto ≥ 100 km/semana y grupo 2 (G2, n: 8): Bajo <100 km/semana). Se obtuvo pre y post maratón: niveles de IL-6, MDA y ecocardiografía Doppler transtorácica (ETT); cuantificando cámaras cardíacas izquierdas, derechas y deformación del ventrículo izquierdo (strain longitudinal). Se utilizaron las pruebas de Mann-Whitney, Wilcoxon y Kruskal-Wallis. Resultados: Edad G1: 38.13±7.18 años vs G2: 40.38±6.63 años (NS). Tiempo maratón G1: 185.75±14.87 min vs G2: 219.75±24.92 min (p<0.01). Masa del ventrículo izquierdo G1: 91±21 g/m2 vs G2: 73±12 g/m2 (p<0.01). Volumen aurícula izquierda G1: 39.4±12.6 ml/m2 vs 30.6±4.6 ml/m2 (p<0.01). FEVI G1: 55.8±3.3% vs G2: 58.6±6.7% (NS). MDA G1: PRE 0.17±0.13 uM/L, POST 0.67±0.59 uM/L, G2: PRE 0.29±0.24 uM/L, POST 1.01±1.15 uM/L (p<0.01). IL-6 G1: PRE 2.50±1.35 pg/ml, POST 93.91±27.23 pg/ml vs G2: PRE 4.65±5.89 pg/ml, POST 97.83±30.72 pg/ml (NS). Conclusión: El ejercicio físico aumenta los BMC de inflamación y estés oxidativo (IL-6, MDA). Un entrenamiento físico de alta intensidad disminuye la respuesta de estrés oxidativo y se asocia a un mayor remodelado cardíaco.