RESUMEN
Balneotherapy, using heated natural mineral waters at 36-38 °C, presents a comprehensive treatment approach for Fibromyalgia Syndrome (FMS). This study aims to assess the effect of balneotherapy in reducing pain intensity, disability, and depression in patients with FMS. We want to assess this effect at just four time-points: immediately at the end of the therapy, and at 1, 3, and 6 months of follow-up. Following PRISMA guidelines, we conducted an aggregate data meta-analysis, registered in PROSPERO CRD42023478206, searching PubMed Medline, Science Direct, CINAHL Complete, Scopus, and Web of Science until August 2023 for relevant randomized controlled trials (RCTs) that assess the effect of balneotherapy on pain intensity, disability, and depression in FMS patients. Methodological quality was assessed using the Cochrane methodology, and the pooled effect was calculated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI) in a random-effects model. Sixteen RCTs were included in the meta-analysis. Balneotherapy is effective in reducing pain intensity (SMD - 1.67; 95% CI -2.18 to -1.16), disability (SMD - 1.1; 95% CI -1.46 to -0.7), and depression (SMD - 0.51; 95% CI -0.93 to -0.9) at the end of the intervention. This effect was maintained at 1, 3, and 6 months for pain intensity and disability. Balneotherapy improves both pain intensity and disability in patients with FMS, providing evidence that its positive effects are sustained for up to 6 months of follow-up. Nevertheless, it is important to note that the improvement in depression varies across different temporal phases.
RESUMEN
Asphyxia during birth is one of the three leading causes of neonatal morbidity and mortality among newborns carried to term. The objective of this study was to evaluate the measurement of the foetal scalp blood pH as a measure of foetal status, evaluating: cord gases, meconium-stained fluid, APGAR score or the need for neonatal resuscitation in pregnant women undergoing caesarean sections. A cross-sectional study was carried out over a period of 5 years (2017-2021) at the Hospital de Poniente (southern Spain). A total of 127 pregnant women participated from whom a foetal scalp blood pH sample was taken and used to indicate the need for an urgent caesarean section. The results showed a correlation between the pH of the scalp blood and the pH of the umbilical cord artery, umbilical cord vein (Rho of Spearman arterial pH: 0.64, p < 0.001; Rho of Spearman venous pH: 0.58, p < 0.001) and the APGAR test one minute after delivery (Spearman's Rho coefficient of 0.33, p < 0.01). These results suggest that the foetal scalp pH should not be considered a foolproof method to indicate an urgent caesarean section. Foetal scalp pH sampling can be used as a complementary test, in conjunction with cardiotocography, to indicate whether an emergency caesarean section is necessary due to loss of foetal well-being.