Effects of mobilization with movement on pain and range of motion in patients with unilateral shoulder impingement syndrome: a randomized controlled trial.

OBJECTIVE: The purpose of this study was to compare the immediate effects of mobilization with movement (MWM) to a sham technique in patients with shoulder impingement syndrome. METHODS: A randomized controlled trial was performed. Forty-two patients (mean ± SD age, 55 ± 9 years; 81% female) satisfied eligibility criteria, agreed to participate, and were randomized into an MWM group (n = 21) or sham manual contact (n = 21). The primary outcome measures including pain intensity, pain during active range of motion, and maximal active range of motion were assessed by a clinician blinded to group allocation. Outcomes were captured at baseline and after 2 weeks of MWM treatment or sham intervention. The primary analysis was the group × time interaction. RESULTS: The 2×2 analysis of variance revealed a significant group × time interaction for pain intensity during shoulder flexion (F = 7.054; P = .011), pain-free shoulder flexion (F = 32.853; P < .001), maximum shoulder flexion (F = 18.791; P < .01), and shoulder external rotation (F = 7.950; P < .01) in favor of the MWM group. No other significant differences were found. CONCLUSIONS: Patients with shoulder impingement syndrome who received 4 sessions of MWM exhibited significantly better outcomes for pain during shoulder flexion, pain-free range of shoulder flexion, maximal shoulder flexion, and maximal external rotation than those patients who were in the sham group.

Phonon dominated heat conduction normal to Mo/Si multilayers with period below 10 nm.

Thermal conduction in periodic multilayer composites can be strongly influenced by nonequilibrium electron-phonon scattering for periods shorter than the relevant free paths. Here we argue that two additional mechanisms-quasiballistic phonon transport normal to the metal film and inelastic electron-interface scattering-can also impact conduction in metal/dielectric multilayers with a period below 10 nm. Measurements use the 3ω method with six different bridge widths down to 50 nm to extract the in- and cross-plane effective conductivities of Mo/Si (2.8 nm/4.1 nm) multilayers, yielding 15.4 and 1.2 W/mK, respectively. The cross-plane thermal resistance is lower than can be predicted considering volume and interface scattering but is consistent with a new model built around a film-normal length scale for phonon-electron energy conversion in the metal. We introduce a criterion for the transition from electron to phonon dominated heat conduction in metal films bounded by dielectrics.

Biochemical biomarkers for multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is the most frequent demyelinating disease of the central nervous system. Although there is currently no definite cure for MS, new therapies have recently been developed based on a continuous search for new biomarkers. DEVELOPMENT: MS diagnosis relies on the integration of clinical, imaging and laboratory findings as there is still no singlepathognomonicclinical feature or diagnostic laboratory biomarker. The most commonly laboratory test used is the presence of immunoglobulin G oligoclonal bands (OCB) in cerebrospinal fluid of MS patients. This test is now included in the 2017 McDonald criteria as a biomarker of dissemination in time. Nevertheless, there are other biomarkers currently in use such as kappa free light chain, which has shown higher sensitivity and specificity for MS diagnosis than OCB. In addition, other potential laboratory tests involved in neuronal damage, demyelination and/or inflammation could be used for detecting MS. CONCLUSIONS: CSF and serum biomarkers have been reviewed for their use in MS diagnosis and prognosis to stablish an accurate and prompt MS diagnosis, crucial to implement an adequate treatment and to optimize clinical outcomes over time.

Attitudes of Non-Disabled Pupils towards Disabled Pupils to Promote Inclusion in the Physical Education Classroom.

Inclusive education for disabled people is becoming increasingly important globally. Improving the factors that support the inclusion of people with disabilities in education is one of the main objectives. In addition to teachers, another major factor is how the attitudes of students without disabilities affect those with disabilities, which should be considered in maintaining an inclusive classroom climate. The aim of the study was to analyse the attitudes of non-disabled students towards the inclusion disabled students in Physical Education (PE) and to investigate differences according to gender and school location. A total of 805 girls and boys participating in PE in public secondary schools (12-18 years old) in Extremadura were analysed through the AISDPE (Attitudes towards the Inclusion of Students with Disabilities in PE) questionnaire. The results show students without disabilities have positive attitudes towards the inclusion of students with disabilities. The majority were female. No significant differences were found regarding the location of the school. There are positive attitudes towards the inclusion of students with disabilities in the PE classroom, but these could be improved, especially in aspects more related to cognitive factors. For this, it is necessary for teachers to provide their students with the necessary tools and knowledge to better understand the possibilities and difficulties presented to students with disabilities, thus promoting a more inclusive classroom.

[Family planning in men and women with multiple sclerosis. Analysis of the Andalusian Registry (2018-2022)]. / Planificación familiar en hombres y mujeres con esclerosis múltiple. Análisis del Registro Andaluz (2018-2022).

INTRODUCTION: The Andalusian Registry of Pregnancies in patients with multiple sclerosis is the largest Spanish registry on multiple sclerosis (MS) and family planning. For the first time, it includes information on the fertility of men with MS. The influence of the use of a disease-modifying treatment (DMT) on the health of the foetus/newborn and the impact of breastfeeding on MS are also analysed. SUBJECTS AND METHODS: This is a multicentre, prospective and observational study. Recruitment of patients took place between December 2018 and December 2020. Women were followed up for one year after delivery. Altogether 100 women and 16 men were included, with a total of 103 newborn infants. RESULTS: The annualised relapse rate of the women with MS decreased significantly during pregnancy (from 0.23 to 0.065). A total of 11.2% of patients resorted to assisted reproductive techniques in order to conceive a child. No association was found between the use of a DMT at conception and/or pregnancy and the risk of miscarriage, prematurity or low birth weight. Over half the women with MS (54.2%) chose to breastfeed (26.7% of them while on a DMT). CONCLUSIONS: MS does not affect the fertility of men. Neither does the use of a DMT at the time of conception affect their fertility or their children's health. Assisted reproductive techniques did not have a negative impact on the course of MS. Breastfeeding is a common practice among women with MS and there is no evidence of positive or negative effects on disease progression.

TITLE: Planificación familiar en hombres y mujeres con esclerosis múltiple. Análisis del Registro Andaluz (2018-2022).Introducción. El Registro Andaluz de Embarazos en pacientes con esclerosis múltiple (EM) es el mayor registro español sobre EM y planificación familiar. Por primera vez se incluye información sobre la fertilidad de hombres con EM. También se analizan la influencia del uso de un tratamiento modificador de la enfermedad (TME) en la salud del feto o recién nacido y el impacto de la lactancia materna en la EM. Sujetos y métodos. Es un estudio observacional, prospectivo y multicéntrico. El reclutamiento de pacientes se hizo entre diciembre de 2018 y diciembre de 2020. El seguimiento de las mujeres tras el parto fue de un año. Se incluyó a 100 mujeres y 16 hombres, con un total de 103 recién nacidos. Resultados. La tasa anualizada de brotes de las mujeres con EM descendió durante el embarazo de forma significativa (de 0,23 a 0,065). Un 11,2% de los pacientes recurrieron a técnicas de reproducción asistida para conseguir la gestación. No se encontró relación entre el uso de un TME en la concepción y/o embarazo y el riesgo de aborto, prematuridad o bajo peso al nacer. El 54,2% de las mujeres con EM optaron por dar lactancia (el 26,7% de ellas usando un TME). Conclusiones. La EM no afecta a la fertilidad de los hombres. Tampoco influye en ésta, ni en la salud de sus hijos, el uso de un TME en el momento de la concepción. Las técnicas de reproducción asistida no impactaron negativamente en la evolución de la EM. La lactancia se impone como una práctica habitual entre las mujeres con EM y no se evidencian efectos positivos o negativos sobre la evolución de la enfermedad.

[Tumour form of neurocysticercosis in a patient with prostate carcinoma]. / Forma tumoral de neurocisticercosis en un paciente con carcinoma de próstata.

INTRODUCTION: Neurocysticercosis is a parasitic infection of the central nervous system caused by contact with the eggs of the parasite Taenia solium, which subsequently lodge in brain and eye tissue. It manifests itself in the form of cystic lesions scattered throughout the brain parenchyma that are usually small in size and, depending on their stage of development, may appear with associated oedema or with calcifications inside them. CASE REPORT: We report the case of a 63-year-old male visiting due to constitutional symptoms, generalised pain and confusion. A cranial computed axial tomography (CAT) scan showed a right frontoparietal lesion with a cyst-like appearance and surrounding oedema, as well as several smaller lesions with calcifications inside them. Given the pseudotumoural appearance, an extension study was performed and a prostatic adenocarcinoma with universal bone metastases was detected. Treatment with antiparasitic medication and dexamethasone was started, with a good initial response, which later worsened with the onset of left hemiparesis. In the follow-up CAT scan, an increase in the right frontoparietal lesion with increased oedema was observed, related to the inflammatory response to the treatment. After a new course of antiparasitic drugs, the patient maintained a sustained and stable clinical response. CONCLUSIONS: The unusual feature of this case was a rare presentation of neurocysticercosis in the form of a pseudotumoural lesion. Few cases have been reported in the literature, and it is important to maintain a high level of clinical and radiological suspicion, as this type of lesion may be more resistant to the penetration of antiparasitic drugs and require longer treatment and even surgery.

TITLE: Forma tumoral de neurocisticercosis en un paciente con carcinoma de próstata.Introducción. La neurocisticercosis es una infección parasitaria del sistema nervioso central que se produce por contacto con los huevos del parásito Taenia solium, que posteriormente se acantona en el tejido cerebral y ocular. Se manifiesta en forma de lesiones quísticas dispersas por el parénquima cerebral que suelen ser de pequeño tamaño y, dependiendo del estadio evolutivo en el que se presenten, pueden aparecer con edema asociado o con calcificaciones en su interior. Caso clínico. Varón de 63 años que consulta por cuadro constitucional, dolores generalizados y confusión. En la tomografía axial computarizada (TAC) craneal se visualiza una lesión frontoparietal derecha de 4 cm de diámetro, de aspecto quístico y edema circundante, así como varias lesiones de menor tamaño con calcificaciones en su interior. Dado el aspecto pseudotumoral, se realiza un estudio de extensión y se detecta un adenocarcinoma prostático con metástasis óseas universales. Se comienza un tratamiento con antiparasitarios y dexametasona con buena respuesta inicial, y empeora posteriormente con la aparición de una hemiparesia izquierda. En la TAC de control se observa un aumento de la lesión frontoparietal derecha con mayor edema, en relación con la respuesta inflamatoria con el tratamiento. Tras un nuevo ciclo de antiparasitarios, mantiene una respuesta clínica sostenida y estable. Conclusiones. Este caso tiene la peculiaridad de una forma de presentación poco frecuente de neurocisticercosis en forma de lesión pseudotumoral. Existen pocos casos descritos en la bibliografía, y es importante mantener un alto nivel de sospecha clínica y radiológica, ya que este tipo de lesiones puede ser más resistente a la penetración de antiparasitarios y precisar un tratamiento más prolongado e incluso quirúrgico.

[Quantitative salivary gland scintigraphy in head and neck cancer patients following radiotherapy]. / Gammagrafía salival cuantitativa en pacientes con cáncer de cabeza y cuello tratados con radioterapia.

OBJECTIVE: To assess the role of quantitative salivary gland scintigraphy (SGS) in the detection of functional impairment of salivary glands in patients with head and neck cancer treated with radiotherapy (RT). MATERIAL AND METHODS: We studied 19 patients (17 men), mean age 62.4 years (44-75). Three studies were performed to each patient: baseline, 3 and 18 months after RT. SGS was acquired for 25 minutes following injection of 3.7 MBq/kg of (99m)Tc-pertechnetate with lemon juice at the end of minute 15. Excretion fraction (EF), counts per minute/pixel/MBq (CMPM) and uptake percentage were obtained from time-activity curves from ROIs placed over parotid (PG) and submandibular glands (SMG) and related to the doses received by the PG. RESULTS: EF showed a significant reduction from the baseline to the 3 months study (p<0.001) for the PG and SMG and from the baseline to the 18 months study for the SMG (p<0.001). A significant improvement of EF was seen from the 3 months to the 18 months study for the PG (p<0.05). CMPM did not change significantly from the baseline to the 3 months and 18 months studies for the PG and showed a significant reduction (p<0.01) for the SMG from the baseline to 18 months study. The uptake percentage did not change significantly between studies. A moderate association was observed between the doses to PG and the 3m study parameters. CONCLUSIONS: EF was more sensitive than uptake in assessing post-RT impairment of salivary function. In addition, it reflected functional recovery of parotid glands over time.

Cost-Effectiveness of "Tele-Square Step Exercise" for Falls Prevention in Fibromyalgia Patients: A Study Protocol.

BACKGROUND: Women with fibromyalgia (FM) have 2.5 falls per year compared to the 0.5 falls in people without FM. This fact poses a significant health expense. Square Stepping Exercise (SSE) is a balance training system that has been shown to be effective in preventing falls in the elderly. However, there are neither studies in people with FM nor studies that apply SSE through video-conferencing (Tele-SSE). The objectives of this project are 1) to investigate the applicability, safety, decrease in the number of falls, and incremental cost-effectiveness ratio of prevention of falls program through Tele-SSE in women with FM, and 2) to study the transfer of obtained results to the public and private socio-health economy of Extremadura. Methods/Design: A randomized controlled trial with experimental (Tele-SSE) and control (usual treatment) groups will be carried out. The application of Tele-SSE will be performed for 12 months (three times per week) and one additional follow-up month after the intervention. A focus group including agents to identify key points to transfer the findings to the public and private sectors in Extremadura. One-hundred and eighteen women with FM will be recruited and randomly distributed into the two groups: Experimental (Tele-SSE; n = 59) and control group (Usual care; n = 59). Primary outcome measures will be: 1) Applicability; 2) safety; 3) annual number of falls; and 4) incremental cost-effectiveness ratio. Secondary outcomes will be: 1) Balance; 2) fear of falling; 3) socio-demographic and clinical information; 4) body composition; 5) physical fitness; 6) physical activity and sedentary behavior; 7) quality of life-related to health, mental health, and positive health; 8) pain; 9) disability level; 10) cognitive aspects; and 11) depressive symptoms. Regarding the focus group, the acceptability of the Tele-SSE will be evaluated in social-sanitary agents and will include Tele-SSE in their services offer. A statistical analysis will be carried out by treatment intention and protocol. In addition, a cost-effectiveness analysis from the perspective of the health system will be performed. DISCUSSION: This project aims to improve the efficiency and equity of physical therapy services based on tele-exercise in preventing falls in people with FM. Furthermore, orientations will be given in order to transfer the obtained findings into the social-sanitary system and market.

Planificación familiar en hombres y mujeres con esclerosis múltiple. Análisis del Registro Andaluz (2018-2022) / Family planning in men and women with multiple sclerosis. Analysis of the Andalusian Registry (2018-2022)

Introducción: El Registro Andaluz de Embarazos en pacientes con esclerosis múltiple (EM) es el mayor registro español sobre EM y planificación familiar. Por primera vez se incluye información sobre la fertilidad de hombres con EM. También se analizan la influencia del uso de un tratamiento modificador de la enfermedad (TME) en la salud del feto o recién nacido y el impacto de la lactancia materna en la EM. Sujetos y métodos: Es un estudio observacional, prospectivo y multicéntrico. El reclutamiento de pacientes se hizo entre diciembre de 2018 y diciembre de 2020. El seguimiento de las mujeres tras el parto fue de un año. Se incluyó a 100 mujeres y 16 hombres, con un total de 103 recién nacidos. Resultados: La tasa anualizada de brotes de las mujeres con EM descendió durante el embarazo de forma significativa (de 0,23 a 0,065). Un 11,2% de los pacientes recurrieron a técnicas de reproducción asistida para conseguir la gestación. No se encontró relación entre el uso de un TME en la concepción y/o embarazo y el riesgo de aborto, prematuridad o bajo peso al nacer. El 54,2% de las mujeres con EM optaron por dar lactancia (el 26,7% de ellas usando un TME). Conclusiones: La EM no afecta a la fertilidad de los hombres. Tampoco influye en ésta, ni en la salud de sus hijos, el uso de un TME en el momento de la concepción. Las técnicas de reproducción asistida no impactaron negativamente en la evolución de la EM. La lactancia se impone como una práctica habitual entre las mujeres con EM y no se evidencian efectos positivos o negativos sobre la evolución de la enfermedad.(AU)

Introduction: The Andalusian Registry of Pregnancies in patients with multiple sclerosis is the largest Spanish registry on multiple sclerosis (MS) and family planning. For the first time, it includes information on the fertility of men with MS. The influence of the use of a disease-modifying treatment (DMT) on the health of the foetus/newborn and the impact of breastfeeding on MS are also analysed. Subjects and methods: This is a multicentre, prospective and observational study. Recruitment of patients took place between December 2018 and December 2020. Women were followed up for one year after delivery. Altogether 100 women and 16 men were included, with a total of 103 newborn infants. Results: The annualised relapse rate of the women with MS decreased significantly during pregnancy (from 0.23 to 0.065). A total of 11.2% of patients resorted to assisted reproductive techniques in order to conceive a child. No association was found between the use of a DMT at conception and/or pregnancy and the risk of miscarriage, prematurity or low birth weight. Over half the women with MS (54.2%) chose to breastfeed (26.7% of them while on a DMT). Conclusions: MS does not affect the fertility of men. Neither does the use of a DMT at the time of conception affect their fertility or their children’s health. Assisted reproductive techniques did not have a negative impact on the course of MS. Breastfeeding is a common practice among women with MS and there is no evidence of positive or negative effects on disease progression.(AU)

Revisión sistemática de programas de intervención para promover hábitos saludables de actividad física y nutrición en escolares españoles / Systematic review of intervention programmes to promote healthy physical activity and nutrition habits in Spanish school children

Introducción. La obesidad infantil es uno de los problemas de salud pública más graves del siglo XXI, originado porque los niños crecen en un entorno en el que no se fomenta la práctica deportiva. Esto es debido al cambio en el tipo de alimentación y al aumento del sedentarismo. Objetivo. Describir y analizar los principales programas de intervención, basados en la promoción de hábitos saludables (Nutrición y Actividad Física) en la población infantil y las principales estrategias utilizadas para su implantación en los centros educativos españoles. Materiales y métodos. Se ha realizado un estudio transversal descriptivo mediante el empleo de una revisión sistemática de la literatura realizada en el mes de octubre de 2022. La población de estudio fue el alumnado de entre 6 y 12 años escolarizados en centros de Educación Primaria de España. Resultados. Se ha identificado que las intervenciones educativas sobre nutrición y/o actividad física realizadas en los centros educativos, resultan positivas en la mejora de los hábitos de alimentación y la práctica físico-deportiva entre los escolares. Discusión. Además, combinando las temáticas de nutrición y actividad física, se fomenta la consecución de hábitos saludables, con el objetivo de prevenir la obesidad y el sedentarismo. A su vez, fomentando la participación de las familias en los programas de intervención se obtiene un resultado positivo en la efectividad de las intervenciones. Conclusiones. La mayor parte de los programas de intervención analizados demuestran su eficacia a la hora de modificar los hábitos alimentarios, además, se produce un aumento del nivel de actividad física, evitando el sedentarismo entre los escolares, y, por ende, disminuir el riesgo de obesidad(AU)

Introduction: Childhood obesity is one of the most serious public health problems of the 21st century, because children are growing up in an environment where sport is not encouraged. This is due to changes in dietary patterns and an increase in sedentary lifestyles. Objective. Describe and analyze the main intervention programs, based on the promotion of healthy habits (Nutrition and Physical Activity) in the child population and the main strategies used for their implementation in Spanish schools. Material and methods. A descriptive cross-sectional study based on a systematic review of the literature carried out in October 2022. The study population was pupils aged between 6 and 12 years old attending primary schools in Spain. Results. It has been identified that educational interventions on nutrition and/or physical activity carried out in schools are positive in improving eating habits and physical activity among schoolchildren. Discussion. In addition, by combining the topics of nutrition and physical activity, healthy habits are encouraged, with the aim of preventing obesity and sedentary lifestyles. In turn, by encouraging the participation of families in the intervention programmes, a positive result is obtained in the effectiveness of the interventions. Conclusions. Most of the intervention programmes analysed demonstrate their effectiveness in modifying eating habits, as well as increasing the level of physical activity, avoiding sedentary lifestyles among schoolchildren and, therefore, reducing the risk of obesity(AU)

Forma tumoral de neurocisticercosis en un paciente con carcinoma de próstata / Tumour form of neurocysticercosis in a patient with prostate carcinoma

INTRODUCCIÓN: La neurocisticercosis es una infección parasitaria del sistema nervioso central que se produce por contacto con los huevos del parásito Taenia solium, que posteriormente se acantona en el tejido cerebral y ocular. Se manifiesta en forma de lesiones quísticas dispersas por el parénquima cerebral que suelen ser de pequeño tamaño y, dependiendo del estadio evolutivo en el que se presenten, pueden aparecer con edema asociado o con calcificaciones en su interior. CASO CLÍNICO: Varón de 63 años que consulta por cuadro constitucional, dolores generalizados y confusión. En la tomografía axial computarizada (TAC) craneal se visualiza una lesión frontoparietal derecha de 4 cm de diámetro, de aspecto quístico y edema circundante, así como varias lesiones de menor tamaño con calcificaciones en su interior. Dado el aspecto pseudotumoral, se realiza un estudio de extensión y se detecta un adenocarcinoma prostático con metástasis óseas universales. Se comienza un tratamiento con antiparasitarios y dexametasona con buena respuesta inicial, y empeora posteriormente con la aparición de una hemiparesia izquierda. En la TAC de control se observa un aumento de la lesión frontoparietal derecha con mayor edema, en relación con la respuesta inflamatoria con el tratamiento. Tras un nuevo ciclo de antiparasitarios, mantiene una respuesta clínica sostenida y estable. CONCLUSIONES: Este caso tiene la peculiaridad de una forma de presentación poco frecuente de neurocisticercosis en forma de lesión pseudotumoral. Existen pocos casos descritos en la bibliografía, y es importante mantener un alto nivel de sospecha clínica y radiológica, ya que este tipo de lesiones puede ser más resistente a la penetración de antiparasitarios y precisar un tratamiento más prolongado e incluso quirúrgico

INTRODUCTION: Neurocysticercosis is a parasitic infection of the central nervous system caused by contact with the eggs of the parasite Taenia solium, which subsequently lodge in brain and eye tissue. It manifests itself in the form of cystic lesions scattered throughout the brain parenchyma that are usually small in size and, depending on their stage of development, may appear with associated oedema or with calcifications inside them. CASE REPORT: We report the case of a 63-year-old male visiting due to constitutional symptoms, generalised pain and confusion. A cranial computed axial tomography (CAT) scan showed a right frontoparietal lesion with a cyst-like appearance and surrounding oedema, as well as several smaller lesions with calcifications inside them. Given the pseudotumoural appearance, an extension study was performed and a prostatic adenocarcinoma with universal bone metastases was detected. Treatment with antiparasitic medication and dexamethasone was started, with a good initial response, which later worsened with the onset of left hemiparesis. In the follow-up CAT scan, an increase in the right frontoparietal lesion with increased oedema was observed, related to the inflammatory response to the treatment. After a new course of antiparasitic drugs, the patient maintained a sustained and stable clinical response. CONCLUSIONS: The unusual feature of this case was a rare presentation of neurocysticercosis in the form of a pseudotumoural lesion. Few cases have been reported in the literature, and it is important to maintain a high level of clinical and radiological suspicion, as this type of lesion may be more resistant to the penetration of antiparasitic drugs and require longer treatment and even surgery

Efectos de la imaginería motora aplicada durante el periodo de inmovilización o posquirúrgico en miembro superior: una revisión sistemática / Effects of motor imagery applied during upper limb immobilisation and / or after surgery: A systematic review

Objetivo: El objetivo de esta revisión sistemática fue resumir toda la evidencia relativa a los efectos de la imaginería motora realizada durante el periodo de inmovilización después de una lesión o en el inmediato posquirúrgico y los efectos sobre el dolor, la fuerza, la función y el rango articular. Métodos: Se hicieron búsquedas sistemáticas en todos los idiomas y en 4 bases de datos: PubMed, OtSeeker, Cinhal, WOS y PEDro. Se seleccionaron los estudios elegibles publicados hasta noviembre de 2018. Se incluyeron ensayos clínicos aleatorizados que investigaron los efectos de la intervención de imaginería motora durante el periodo de inmovilización después de una lesión o en el inmediato posquirúrgico de miembro superior. Se utilizó la escala PEDro de calidad metodológica. Resultados: Se seleccionaron 4 ensayos clínicos aleatorizados, 2 con calidad metodológica buena y 2 con calidad metodológica insuficiente. El rango articular se evaluó en los 4ensayos, el dolor en 2, la fuerza en 3 y en uno la función. Se observaron cambios positivos en el grupo de imaginería motora en el rango articular en 3 estudios: 2 de calidad metodológica buena (n = 40 y n = 18) y uno de calidad insuficiente (n = 18); en el dolor, en un estudio de calidad buena (n = 40); en la fuerza en 2 estudios: uno de calidad buena (n = 40) y uno de insuficiente (n = 18) y en la función, en uno de calidad buena (n = 40). Conclusiones: Los resultados muestran beneficios positivos en el uso de imaginería motora aplicándola inmediatamente después del periodo posquirúrgico o en personas sanas simulando una inmovilización

Objective: The objective of this systematic review was to make a detailed examination of all the evidence concerning the effects of motor imagery (MI) performed during the immobilisation period after an injury, or in the immediate postoperative period, and the effects on pain, strength, function, and joint range. Methods: Systematic searches were conducted in all languages and in 4 electronic databases: PubMed, OTseeker, Cinahl, WOS and PEDro. Eligible studies published up to November 2018 were selected. Randomised controlled trials that investigated the effects of a motor imagery intervention performed during the period of immobilisation after an injury, or in the immediate postoperative upper limb were included. methodological quality was assessed using the PEDro scale. Results: Four randomised clinical trials were selected, 2 with good methodological quality and 2 with insufficient methodological quality. The joint range was evaluated in the 4 trials, pain in 2, strength in 3, and function in one. Positive changes were observed in the group of motor imagery in the joint mobility in 3 studies: 2 of good methodological quality (n = 40 and n = 18) and one insufficient (n= 18), in pain in one study of good quality (n = 40), in strength in 2 studies: one good quality (n = 40) and 1 insufficient (n = 18) and in function in 1 of good quality (n = 40). Conclusions: The results show positive benefits in the use of motor imagery applied immediately after the postoperative period or in healthy people simulating an immobilisation

Fiabilidad de un test isométrico de rodilla en mujerescon fibromialgia mediante test-retest de 12 semanas / Reliability of an isometric knee test in women with fibromialgia using the 12-week test-retest

Propósito: El objetivo de este estudio fue analizar la fiabilidad del pico torque obtenido conun protocolo de valoración de la fuerza isométrica de flexores y extensores de rodilla.Material y método: Un total de 16 mujeres con fibromialgia (FM) (edad 54,9 ± 12,1) participaronen este estudio. El diseño consistió en un test-retest de 12 semanas de duración y laevaluación del pico torque isométrico se realizó con un dinamómetro isocinético (Biodexsystem 3). La evaluación consistió en 3 acciones máximas de contracción isométrica de losmúsculos extensores y flexores de rodilla. Se calcularon los índices de fiabilidad relativa(mediante coeficiente de correlación intraclase o CCI) y absoluta (mediante error estándarde medida o SEM y mínima diferencia real o SRD).Resultados y conclusión: El pico torque isométrico evaluado a través del dinamómetro isocinéticoes replicable tanto para los flexores como para los extensores de la rodilla. Este estudio muestradatos sobre el mínimo cambio real del pico torque en acciones isométricas de los extensoresy flexores de rodilla, que pueden ayudar en la interpretación de los resultados obtenidos enterapias basadas en actividad física, en personas con FM, de varias semanas de duración.

Objective: The aim of this study was to analyze the reliability of peak torque assessed using an isometric strength protocol of knee flexor and extensor muscles.Material and methods: A total of 16 women with Fibromyalgia (FM) (aged 54.9 ± 12.1) participated in this study. The design consisted of a 12-week test-retest, and isometric peak torque was assessed using an isokinetic dynamometer (Biodex system 3). The evaluation consisted of 3 maximal isometric contractions of knee extensor and flexor muscles. Relative intraclass correlation coefficient ICC) and absolute (standard error of measurement SEM and smallest real difference SRD) reliability indices were calculated.Result and conclusions: Isometric peak torque assessed using isokinetic dynamometer is reliable in knee flexor and extensor muscles. This study presents data on the smallest real difference of peak torque in isometric actions of knee flexor and extensor muscles, which can help interpreting results obtained in physical activity based therapies in individuals with FM of several weeks duration.

Results of consevative treatment of breast cancer in low risk women with hypofractionated radiotherapy

Objetivos: Actualmente la irradiación de toda la mama después de una intervención quirúrgica conservadora sigue siendo un procedimiento estándar en el cáncer de mama, en la que clásicamente se administra una dosis de 50 Gy con fraccionamiento de 2 Gy. Sin embargo, diferentes dosis y fraccionamiento han demostrado al menos la misma eficacia. El objetivo principal del estudio fue determinar la tasa de recidiva local en pacientes sometidas a cirugía conservadora y radioterapia postoperatoria hipofraccionada. Los objetivos secundarios fueron la incidencia y el grado de toxicidad aguda y tardía. Pacientes y métodos: Desde enero de 2004 a diciembre de 2006, se seleccionó a 122 pacientes para radioterapia hipofraccionada con las características siguientes: edad ≥ 50 años, estadio temprano, margen de resección libre de tumor y espesor de la mama < 23 cm. La dosis administrada fue 42,5 Gy con fraccionamiento de 2,66 Gy por sesión. Resultados: Con una mediana de seguimiento de 58,29 meses, 116 (95,08%) pacientes están vivas: 114 libres de enfermedad y 2 con metástasis óseas. La recidiva local a 5 años fue 1,64% y sólo un caso (0,81%) presentó recidiva regional. Hubo un 2,46% de pacientes con segundo tumor primario y un 4,91% con metástasis. La toxicidad, tanto aguda como tardía, ha sido leve. Conclusiones: La radioterapia hipofraccionada en pacientes de riesgo bajo proporciona los mismos beneficios que el tratamiento clásico con una baja toxicidad aguda y tardía (AU)

Aims: Whole breast irradiation, typically administered at a dose of 50 Gy in 2 Gy fractions after conservative surgery, continues to be a standard procedure in breast cancer. However, different doses and fractionation have shown to be at least as effective. The main objective of this study was to determine the rate of local recurrence in patients undergoing conservative surgery and hypofractionated postoperative radiotherapy. The secondary objectives were to determine the incidence and grade of both acute and delayed toxicity. Patients and methods: From January 2004 to December 2006, 122 patients who had the following characteristics were selected to receive hypofractionated radiotherapy to the whole breast: age ≥ 50 years, early stage, tumour free resection margins ≥ 10 mm, thickness of the breast ≤ than 23 cm. The total dose was 42.5 Gy with fractionation of 2.66. Results: With a median follow up of 58.29 months, 116 (95.08%) patients were alive: 114 were free of disease and 2 had metastases. The 5 year local recurrence rate was 1.64%, and only in one case (0.81%) there was a regional recurrence. Only 2.46% of the patients developed a second primary tumour. Distant metastases were present in 4.91%. Toxicity, both acute and late, was mild (grade 1-2). Conclusions: Hypofractionated radiotherapy, in patients with low risk breast cancer after conservative surgery, provides the same benefits as the classical treatment with a low acute, as well as and delayed, toxicity (AU)

Gammagrafía salival cuantitativa en pacientes con cáncer de cabeza y cuello tratados con radioterapia / Quantitative salivary gland scintigraphy in head and neck cancer patients following radiotherapy

Objetivo. Determinar el papel de la gammagrafía salival (GS) cuantitativa en la detección de alteraciones funcionales de las glándulas salivales en pacientes con cáncer de cabeza y cuello tratados con radioterapia (RT). Material y métodos. Se estudió a 19 pacientes (17 varones) con edad media de 62,4 años (44–75). Se realizaron tres estudios a cada paciente: basal, a los 3 y a los 18 meses tras la RT. La gammagrafía salival se realizó con 3,7MBq/kg de 99mTc-pertecnetato durante 25 minutos y zumo de limón al final del minuto 15. Se calculó la fracción de excreción (FE), las cuentas máximas/minuto/píxel/MBq (CMPM), el porcentaje de captación a partir de las curvas actividad/tiempo de áreas de interés sobre ambas glándulas parótidas (GP) y glándulas submaxilares (GSM) y la influencia de las dosis recibidas por las parótidas. Resultados. La FE mostró una disminución significativa del estudio basal a los 3 meses (p<0,001), tanto en las GP como en las GSM, y a los 18 meses en las GSM (p<0,001). Se observó un aumento significativo de la FE del estudio a los 3 meses al de los 18 meses (p<0,05). Resultados. La CMPM no cambió significativamente en las GP desde el estudio basal a los de 3 y 18 meses, pero sí en las GSM con disminución significativa (p<0,01) desde el estudio basal al de 18 meses. El porcentaje de captación no cambió significativamente. Se observó correlación moderada entre la dosis a parótidas y los parámetros a los 3 meses post-RT (p<0,05). Conclusiones. La FE presentó mayor sensibilidad que la captación al efecto de la RT sobre la función salival, mostrando, además, recuperación funcional a lo largo del tiempo en las GP(AU)

Objective. To assess the role of quantitative salivary gland scintigraphy (SGS) in the detection of functional impairment of salivary glands in patients with head and neck cancer treated with radiotherapy (RT). Material and methods. We studied 19 patients (17 men), mean age 62.4 years (44–75). Three studies were performed to each patient: baseline, 3 and 18 months after RT. SGS was acquired for 25 minutes following injection of 3.7MBq/kg of 99mTc-pertechnetate with lemon juice at the end of minute 15. Material and methods. Excretion fraction (EF), counts per minute/pixel/MBq (CMPM) and uptake percentage were obtained from time-activity curves from ROIs placed over parotid (PG) and submandibular glands (SMG) and related to the doses received by the PG. Results. EF showed a significant reduction from the baseline to the 3 months study (p<0.001) for the PG and SMG and from the baseline to the 18 months study for the SMG (p<0.001). A significant improvement of EF was seen from the 3 months to the 18 months study for the PG (p<0.05). Results. CMPM did not change significantly from the baseline to the 3 months and 18 months studies for the PG and showed a significant reduction (p<0.01) for the SMG from the baseline to 18 months study. The uptake percentage did not change significantly between studies. A moderate association was observed between the doses to PG and the 3m study parameters. Conclusions. EF was more sensitive than uptake in assessing post-RT impairment of salivary function. In addition, it reflected functional recovery of parotid glands over time(AU)

Higiene de manos de los fisioterapeutas: prevención de infecciones nosocomiales / Hand hygiene in physiotherapists: prevention of nosocomial infections

Introducción: se entiende por infección nosocomial aquella que se adquiere en el hospital y que no estaba presente ni en período de incubación cuando el paciente ingresó. Las infecciones nosocomiales producen una alta morbimortalidad en los pacientes e incrementan los costes relacionados con los cuidados sanitarios. En una unidad de fisioterapia, se produce un aumento en el número de sesiones de tratamiento, y una limitación de la mejora funcional conseguida tras la finalización de éste.Objetivo: destacar la importancia de la correcta higiene de manos, tanto por su alta eficacia como por su bajo coste, como medida de prevención de la transmisión de microorganismos patógenos.Material y métodose realiza una búsqueda bibliográfica en las bases de datos de PubMed, PEDro y en The Cochrane Library.Conclusiones: la desinfección higiénica de manos con soluciones hidroalcohólicas es la más efectiva para reducir la contaminación bacteriana de las manos(AU)

Introduction:Nosocomial infection is defined as that acquired in the hospital that was not present in either the incubation stage or on admission. Nosocomial infection causes high morbidity and mortality in patients and an increase in health care costs. This causes a rise in the number of treatment sessions and places a limitation on the functional improvement achieved after its completion in a physiotherapy unit.Objective: To draw attention on the importance of appropriate hand hygiene due to its high effectiveness as well as its low cost in order to prevent transmission of pathogenic microorganisms.Material and methodA research of the literature was carried out through PubMed, PEDro, and The Cochrane library.Conclusions: Hand disinfection with an alcohol-based solution is the most effective measure to remove bacterial hand contamination(AU)