Influence of instrumentation on the surgical time to implant a total knee prosthesis. / Influencia de la instrumentación sobre el tiempo quirúrgico para implantar una prótesis total de rodilla.

OBJECTIVE: To demonstrate if there is a difference in the time that the surgery is prolonged to implant a knee prosthesis according to the instrumentation system used. MATERIAL AND METHODS: Retrospective analysis of the duration of 243 interventions (skin-to-skin time and ischemia time) performed by the same surgeon. Seventy-two cases operated with conventional instruments (IC), 68 by means of computer assisted surgery (CAS) and 103 with personalized instrumentation system (PSI). RESULTS: IC skin-to-skin time 87,85 min (SD 11,86). IC ischemia time 94,44 min (SD 11,49). Computer assisted surgery skin-to-skin time 123,46 min (SD 11,27). Computer assisted surgery ischemia time 129,63 min (SD 11,37). PSI skin-to-skin time 78,69 min (SD 13,06). PSI ischemia time 84,63 min (SD 12,06). There is a significant difference between PSI and the other instrumentation systems (p 0,000). CONCLUSIONS: In our study, the time consumption for the implantation of a knee prosthesis has been significantly lower when cutting blocks have been used, than when we have used other systems.

Monitoring of glycolytic activity secondary to ischaemia in knee replacement surgery. / Monitorización de la actividad glucolítica secundaria a isquemia en cirugía sustitutiva de rodilla.

OBJECTIVES: To non-invasively assess tissue lesion secondary to ischaemia applied during knee replacement surgery. Secondary objectives: to assess whether this lesion correlates with the duration of ischaemia and whether instrumental and gender variables influence it. MATERIAL AND METHODS: Prospective cohort study. Pre and postoperative serum lactate levels have been determined as an indicator of glycolytic activity secondary to ischaemia in 88 patients. Serum lactate determination was performed by reactive strips of enzymatic-amperometric detection on capillary blood. RESULTS: Preoperative serum lactate levels (mean and SD): 2.467±1.036 mmol/L. Postoperative serum lactate levels: 3.938±2.018 mmol/L. Ischaemia time 102.98±18.25minutes. Postoperative serum lactate levels were significantly higher than preoperative lactate levels. There are no statistical differences according to the time that the ischaemia was prolonged, gender or type of instrumentation used. CONCLUSIONS: In our study, postoperative serum lactate values were significantly higher than preoperative lactate values, with no correlation to the duration of ischaemia during knee replacement surgery.

Analysis of uni and bi-parental markers in mixture samples: Lessons from the 22nd GHEP-ISFG Intercomparison Exercise.

Since 1992, the Spanish and Portuguese-Speaking Working Group of the ISFG (GHEP-ISFG) has been organizing annual Intercomparison Exercises (IEs) coordinated by the Quality Service at the National Institute of Toxicology and Forensic Sciences (INTCF) from Madrid, aiming to provide proficiency tests for forensic DNA laboratories. Each annual exercise comprises a Basic (recently accredited under ISO/IEC 17043: 2010) and an Advanced Level, both including a kinship and a forensic module. Here, we show the results for both autosomal and sex-chromosomal STRs, and for mitochondrial DNA (mtDNA) in two samples included in the forensic modules, namely a mixture 2:1 (v/v) saliva/blood (M4) and a mixture 4:1 (v/v) saliva/semen (M8) out of the five items provided in the 2014 GHEP-ISFG IE. Discrepancies, other than typos or nomenclature errors (over the total allele calls), represented 6.5% (M4) and 4.7% (M8) for autosomal STRs, 15.4% (M4) and 7.8% (M8) for X-STRs, and 1.2% (M4) and 0.0% (M8) for Y-STRs. Drop-out and drop-in alleles were the main cause of errors, with laboratories using different criteria regarding inclusion of minor peaks and stutter bands. Commonly used commercial kits yielded different results for a micro-variant detected at locus D12S391. In addition, the analysis of electropherograms revealed that the proportions of the contributors detected in the mixtures varied among the participants. In regards to mtDNA analysis, besides important discrepancies in reporting heteroplasmies, there was no agreement for the results of sample M4. Thus, while some laboratories documented a single control region haplotype, a few reported unexpected profiles (suggesting contamination problems). For M8, most laboratories detected only the haplotype corresponding to the saliva. Although the GHEP-ISFG has already a large experience in IEs, the present multi-centric study revealed challenges that still exist related to DNA mixtures interpretation. Overall, the results emphasize the need for further research and training actions in order to improve the analysis of mixtures among the forensic practitioners.

Actualización del síndrome de atrapamiento del nervio pudendo: enfoque anatómico-quirúrgico, diagnóstico y terapéutico / Update in pudendal nerve entrapment syndrome: an approach anatomic-surgical, diagnostic and therapeutic

Introducción: El síndrome de atrapamiento del nervio pudendo (SANP) es un gran desconocido y suele ser mal diagnosticado o confundido con otras patologías. Fue descrito por primera vez por Amarenco en 1987. La manifestación clínica clásica es la neuralgia del pudendo, un dolor neuropático del área genital. Objetivos: Dar a conocer su existencia a los profesionales de la urología a través de una revisión sistemática de la bibliografía existente y sus posibilidades de diagnostico y tratamiento. Material y método: Realizamos una búsqueda bibliográfica a través de la base de datos «Pubmed» utilizando los términos «Pudendal nerve», «Pudendal nerve entrapment síndrome», «Pelvic floor neuropathic pain», «Pelvic floor myofascial síndrome», «Pudendal nerve decompression». Asimismo, seleccionamos los trabajos en lengua inglesa, española y francesa, revisando también los artículos que dichos trabajos refieren. Resultados: Se desarrollan los aspectos más destacados del síndrome: anatomía, etiología, fisiopatología, diagnostico clínico, ecodoppler de la arteria pudenda interna, estudios electrofisiológicos, criterios diagnósticos, terapéutica médica, tratamiento con fisioterapia y tratamiento quirúrgico. Conclusión: Es una causa poco frecuente de dolor en el suelo pélvico y afecta en gran medida la calidad de vida de los pacientes. Hoy, disponemos de herramientas diagnósticas y terapéuticas que nos permiten tratar este síndrome invalidante con buenos resultados (AU)

Introduction: The syndrome of pudendal nerve entrapment (SANP) is widely unknown and often misdiagnosed or confused with other diseases. It was first described by Amarenco in 1987. The classic clinical manifestation is pudendal neuralgia, a neuropathic pain in the genital area. Objectives: To make known its existence to the urology professionals through a systematic review of existing literature and its potential for diagnosis and treatment. Materials and methods: We performed a literature search through the database “Pubmed” using the terms “Pudendal nerve”, “Pudendal nerve entrapment syndrome,” “Pelvic floor neuropathic pain”, “Pelvic floor myofascial syndrome,” “Pudendal nerve decompression”. Also, selected works in English, Spanish and French, also reviewing the articles relate this work. Results: We develop the highlights of the syndrome: anatomy, etiology, pathophysiology, clinical diagnosis, ecodoppler of internal pudendal artery, electrophysiological studies, diagnostic criteria, medical therapy, physical therapy treatments and surgery. Conclusion: It is an uncommon cause of pain in the pelvic floor and greatly affects quality of life of patients. Today, we have diagnostic and therapeutic tools that allow us to treat this disabling syndrome with good results (AU)

[Update in pudendal nerve entrapment syndrome: an approach anatomic-surgical, diagnostic and therapeutic]. / Actualización del síndrome de atrapamiento del nervio pudendo: enfoque anatómico-quirúrgico, diagnóstico y terapéutico.

INTRODUCTION: The syndrome of pudendal nerve entrapment (SANP) is widely unknown and often misdiagnosed or confused with other diseases. It was first described by Amarenco in 1987. The classic clinical manifestation is pudendal neuralgia, a neuropathic pain in the genital area. OBJECTIVES: To make known its existence to the urology professionals through a systematic review of existing literature and its potential for diagnosis and treatment. MATERIAL AND METHODS: We performed a literature search through the database Pubmed using the terms Pudendal nerve, Pudendal nerve entrapment syndrome, Pelvic floor neuropathic pain, Pelvic floor myofascial syndrome, Pudendal nerve decompression. Also, selected works in English, Spanish and French, also reviewing the articles relate this work. RESULTS: We develop the highlights of the syndrome: anatomy, etiology, pathophysiology, clinical diagnosis, ecodoppler of internal pudendal artery, electrophysiological studies, diagnostic criteria, medical therapy, physical therapy treatments and surgery. CONCLUSION: It is an uncommon cause of pain in the pelvic floor and greatly affects quality of life of patients. Today, we have diagnostic and therapeutic tools that allow us to treat this disabling syndrome with good results.

[Myofascial pain syndrome in the pelvic floor: a common urological condition]. / Síndrome de dolor miofascial del suelo pélvico: una patología urológica muy frecuente.

INTRODUCTION: Myofascial pain syndrome in the pelvic floor is a very common condition in the urological field and is often ignored or misdiagnosed. OBJECTIVES: To present the prevalence of this syndrome to professionals of urology through a systematic review of existing literature and its potentials for diagnosis and treatment. MATERIALS AND METHODS: We performed a literature search through the database "Pubmed" using the terms "Trigger points", "myofascial pain", "referred pain", "infiltrations" and "physical therapy", to which we add the term "pelvic floor". Then, we select the works in English, Spanish and French that we might like. RESULTS: We develop the highlights of the syndrome: anatomy, etiology, anatomical-clinical correlation, epidemiology, perpetuating factors, diagnosis, medical therapy and physiotherapy treatment. CONCLUSION: It is the most common cause of pain in the pelvic floor and greatly affects quality of life of patients. Nowadays, we have diagnostic and therapeutic tools that allow us to treat this disabling syndrome with good results.

Síndrome de dolor miofascial del suelo pélvico: una patología urológica muy frecuente / Myofascial pain syndrome in the pelvic floor: A common urological condition

Introducción: El síndrome de dolor miofascial de suelo pélvico es una entidad nosológica muy frecuente en el campo urológico y suele ser ignorada o mal diagnosticada. Objetivos: Dar a conocer la prevalencia de este síndrome a los profesionales de la urología a través de una revisión sistemática de la bibliografía existente y sus posibilidades de diagnóstico y tratamiento. Materiales y métodos: Realizamos una búsqueda bibliográfica a través de la base de datos «Pubmed» utilizando los términos «trigger points», «myofascial pain», «referred pain», «infiltrations» y «physical therapy», a los que añadimos el término «pelvic floor». Entonces, seleccionamos los trabajos en lengua inglesa, española y francesa que nos podrían interesar. Resultados: Se desarrollan los aspectos más destacados del síndrome: anatomía, etiología, correlación anatomoclínica, epidemiología, factores de perpetuación, diagnóstico, terapéutica médica y tratamiento con fisioterapia. Conclusión: Es la causa más frecuente de dolor en el suelo pélvico y afecta, en gran medida, la calidad de vida de los pacientes. Hoy, disponemos de herramientas diagnósticas y terapéuticas que nos permiten tratar este síndrome invalidante con buenos resultados (AU)

Introduction: Myofascial pain syndrome in the pelvic floor is a very common condition in the urological field and is often ignored or misdiagnosed. Objectives: To present the prevalence of this syndrome to professionals of urology through a systematic review of existing literature and its potentials for diagnosis and treatment. Materials and methods: We performed a literature search through the database "Pubmed" using the terms "Trigger points", "myofascial pain", "referred pain", "infiltrations" and "physical therapy", to which we add the term "pelvic floor". Then, we select the works in English, Spanish and French that we might like. Results: We develop the highlights of the syndrome: anatomy, etiology, anatomical-clinical correlation, epidemiology, perpetuating factors, diagnosis, medical therapy and physiotherapy treatment. Conclusion: It is the most common cause of pain in the pelvic floor and greatly affects quality of life of patients. Nowadays, we have diagnostic and therapeutic tools that allow us to treat this disabling syndrome with good results (AU)

Efecto de la intervención farmacéutica en la higiene y la calidad del sueño en pacientes mayores de 65 años con insomnio / Effect of pharmaceutical intervention on hygiene and quality of sleep in patients over 65 years of age with insomnia

Con el paso de los años, la arquitectura del sueño se altera considerablemente. El insomnio es uno de los problemas de salud más prevalentes en los ancianos y provoca una disminución de la calidad de vida. La higiene del sueño puede ser una forma adecuada de mejorar los perfiles de sueño y, por tanto, la calidad de éste. El farmacéutico puede contribuir positivamente en este aspecto educando al paciente y evitando la aparición de resultados negativos de la medicación. Objetivo: Determinar la existencia de cambios en la calidad e higiene del sueño tras la intervención farmacéutica en pacientes mayores de 65 años que acuden a la oficina de farmacia para solicitar medicamentos para el tratamiento del insomnio. Resultados: La variación de higiene del sueño media tras la intervención farmacéutica fue de 2,43 puntos (IC 95%: 1,65-3,20), y la variación de calidad del sueño media tras la intervención farmacéutica fue de -1,51 puntos (IC 95%: -2,39, -0,63). Conclusiones: La intervención farmacéutica mejora la higiene y la calidad del sueño en los pacientes mayores de 65 años (AU)

As people age, their sleep architecture changes considerably. Insomnia is one of the most prevalent health conditions among the elderly and results in a decreased quality of life. Sleep hygiene may be a suitable approach to improving sleep profiles and, therefore, the quality of sleep. Pharmacists can contribute positively in terms of this aspect by educating the patient and preventing the negative outcomes associated with medication. Object: To determine the existence of changes in the quality and hygiene of sleep after pharmaceutical intervention in patients older than 65 years that go to the pharmacy to request medication to treat insomnia. Results: After pharmaceutical intervention, there was a mean variation in sleep hygiene of 2.43 points (95% CI: 1.65, 3.20), and the mean variation in quality of sleep was -1.51 (95% CI: -2.39, -0.63). Conclusion: Pharmaceutical intervention increased both the hygiene and quality of sleep in patients older than 65 years of age (AU)

Angiomiolipoma renal causante de trombo en cava y Síndrome de Budd-Chiari secundario / Renal angiomyolipoma causing inferior vena cava thrombus and secondary Budd-Chiari's syndrome

Objetivo: Se aporta un caso de angiomiolipoma renal con tres peculiaridades: origen en seno renal, trombo en cava hasta ostium de aurícula derecha y presentación clínica en forma de síndrome de Budd-Chiari. Métodos: Se realiza una presentación y comentarios de las características del caso clínico. Resultados/Conclusiones: El angiomiolipoma renal es un tumor benigno mesenquimal, poco frecuente (2-6.4% de los tumores renales), de predominio en el sexo femenino. Habitualmente surge en el parénquima renal, siendo infrecuente su origen en el seno renal. Puede afectar a estructuras venosas formando trombo tumoral en vena renal y en vena cava inferior, llegando incluso a aurícula derecha. Habitualmente es asintomático, constituyendo un hallazgo incidental en técnicas diagnósticas de imagen, pero su presentación clínica varía desde el dolor en flanco (lo más frecuente) hasta el TEP fatal, siendo excepcional su presentación como síndrome de Budd-Chiari. Debido al riesgo de TEP y muerte, el tratamiento quirúrgico (nefrectomíaradical y trombectomía) del AML con trombo en cava está indicado aun cuando sea asintomático (AU)

Objective: We report one case of renal angiomyolipoma with three characteristics: renal sinus origin, inferior vena cava tumor thrombus reaching the right atrium and Budd-Chiari syndrome. METHODS: The characteristics of the case are presented and discussed. Results/conclusions: Renal angiomyolipoma is a benign mesenchymal tumor. It is an uncommon tumor (2-6.4% of all kidney tumors), with a female predominance. Angiomyolipoma most often originate from the renal parenchyma but they can rarely originate from the renal sinus. They can involve the renal vein, the inferior vena cava and even the right atrium as a tumor thrombus. Angiomyolipoma commonly present as an incidental finding on radiographic studies, but the clinical presentation varies from flank pain to fatal pulmonary tumor embolism. The Budd-Chiari syndrome is an extremely rare presentation. Because of the risk of potentially fatal cardiopulmonary embolism and death, surgical treatment radical nephrectomy plus tumor thrombectomy) of these lesions is indicated even when they are asymptomatic (AU)

[Technical and economic reasons to set up robotic surgery in a public health system (Spanish model)]. / Razones técnicas y económicas para la implantación de la Cirugía Robótica en un Sistema Público de Salud (modelo Español).

Radical prostatectomy (RP) is today, in any of its four approaches (perineal (PRP), retropubic (ARP), laparoscopic (LRP) or robotic (RRP), the standard surgical treatment in localized prostate cancer. It looks clear that the minimum invasive approaches (laparoscopy and robotics) are able to reduce hospital stay as well as blood loss and therefore transfusion requirement. Also, laparoscopic results at mid and robotics at short term, seem to indicate, that both are safe oncologically and able to obtain same or even superior, functional results. Our objective has been to evaluate the economic impact that these techniques have to consider their definitive implantation, as well as the advantages and disadvantages of its potential implementation in our health system.

[Radical prostatectomy: open, laparoscopic and robotic. Looking for a new gold standard?]. / Prostatectomia radical abierta, laparoscópica y robótica: En busca de un nuevo gold standard?

INTRODUCTION: It is well known that radical prostatectomy (RP) is an excellent option in localized prostatic cancer especially from oncological control point of view. The efforts, during last decades, of the urological community in this field have been addressed in trying to improve functional outcomes (urinary and sexual morbidity) after the procedure. From the beginning of this century, three managements (open, robotic and laparoscopic) have been coexisting trying to get and prove the best results. The objective of this review has been to make the most exhaustive, rigorous and objective updating with the functional and oncological outcomes from the three (RP) techniques. MATERIAL AND METHODS: We have centered the comparison in four sections: perioperative, oncological outcomes, functional results and economic costs. With this purpose a systematic search was made in the following registers: PubMed, OVID, EMBASE and Cochrane Library, with the following terms: Retropubic RP. open RP, laparoscopic RP, robotic RP, Sexual function, urinary incontinence, quality of life, economic costs. At author's criteria, a total of 73 references were selected, that were individually analyzed. RESULTS: Whatever the technique is, the mortality related to the procedure is extremely low, with little postoperative pain and minimum analgesic requirements. The oncological results are similar, measured in surgical margin terms: Open RP (14-20%), Laparoscopic RP (7.4-21.9%) and robotic RP (5.7-17.3%). Concerning functional results (sexual function and urinary continence), it is difficult to establish comparisons due to the multitude of existing byas (non randomized studies, different methods and measurement scales, different definitions, etc.) In the uni-insitutional studies, results seem to be equivalent. CONCLUSIONS: Laparoscopic and robotic RP series are still pending of mature outcomes, related to long term biochemical control and functional results. It seems that with these managements, blood loss and transfusion needs are minor compared to open surgery. Robotic technology adds very interesting advantages that could have an important role in homogenize the minimally invasive management, but are still pending of validation at medium and long term.

Razones técnicas y económicas para la implantación de la Cirugía Robótica en un Sistema Público de Salud (modelo español) / Technical and economic reasons to set up robotic surgery in a public health system (Spanish model)

La prostatectomía radical (PR) en cualquiera de sus cuatro abordajes (perineal (PRP), retropúbico (PRA), laparoscópico (PRL) o robótico (PRR)) es hoy en día, el estándar de tratamiento quirúrgico del cáncer de próstata en estadios localizados. Parece claro, que los abordajes mínimamente invasivos (laparoscopia y robótica) son capaces de disminuir la estancia hospitalaria así como la pérdidas sanguíneas y por tanto la necesidad de transfusión. Asimismo, los resultados a medio plazo de la laparoscopia y a corto plazo de la robótica, parecen indicar, que son igual de seguras oncológicamente y capaces de conseguir los mismos o incluso superiores, resultados funcionales. Nuestro objetivo ha sido evaluar el impacto económico que tienen estas técnicas para considerar su definitiva implantación, así como las ventajas e inconvenientes de su potencial implantación en nuestro Sistema Sanitario

Radical prostatectomy (RP) is today, in any of its four approaches (perineal (PRP), retropubic (ARP), laparoscopic (LRP) or robotic (RRP), the standard surgical treatment in localized prostate cancer. It looks clear that the minimum invasive approaches (laparoscopy and robotics) are able to reduce hospital stay as well as blood loss and therefore transfusion requirement. Also, laparoscopic results at mid and robotics at short term, seem to indicate, that both are safe oncologically and able to obtain same or even superior, functional results. Our objective has been to evaluate the economic impact that these techniques have to consider their definitive implantation, as well as the advantages and disadvantages of its potential implementation in our Health System

Prostatectomía radical abierta, laparoscópica y robótica: ¿en busca de un nuevo gold standard? / Radical prostatectomy: open, laparoscopic and robotic. Looking for a new gold standard?

Introducción: En bien conocido que la prostatectomía radical (PR) es una opción excelente como tratamiento del cáncer de próstata localizado, desde el punto de vista de control oncológico. Desde hace décadas los esfuerzos de la comunidad urológica en este campo, se centran en intentar mejorar los resultados funcionales (morbilidad urinaria y sexual) tras este procedimiento. Desde el inicio de este siglo, conviven tres abordajes (abierto, robótico y laparoscópico) que hasta nuestros días pugnan por intentar alcanzar y demostrar los mejores resultados. El objetivo de esta revisión ha sido hacer una puesta al día lo más exhaustiva, rigurosa y objetiva posible, sobre los resultados oncológicos y funcionales que consiguen las tres técnicas (abordajes) de PR. Material y métodos: Hemos centrado la comparativa en cuatro apartados: resultados perioperatorios, resultados oncológicos, resultados funcionales y costes económicos. Para ellos se realizó unas búsqueda sistemática en los siguientes registros: PubMed, OVID, EMBASE y Cochrane Library, con los siguiente términos: PR Retropúbica, PR Abierta, PR Laparoscópica, PR Robótica, Función Sexual, Incontinencia Urinaria, Calidad de Vida, Costes Económicos. Se seleccionaron un total de 73 referencias, a criterio de los autores, que fueron analizadas individualmente. Resultados: La mortalidad relacionada con el procedimiento es extremadamente baja con cualquiera de las técnicas, con poco dolor postoperatorio y mínimos requerimientos analgésicos. Los resultados oncológicos, medidos en términos de márgenes quirúrgicos son comparables: PR Abierta (14-20%), PR Laparoscópica (7,4-21,9%) y PR Robótica (5,7-17,3%). En relación a resultados funcionales (función sexual y continencia urinaria) es difícil establecer comparaciones debidos a la multitud de sesgos existentes (estudios no randomizados, diferentes métodos y escalas de medida, diferentes definiciones, etc).En los estudios uni-institucionales, los resultados parecen ser equivalentes. Conclusiones: Las series de PR Laparoscópica y Robótica aún carecen de resultados maduros en términos de control bioquímico y resultados funcional a largo plazo. Parece que con estos abordajes la pérdida sanguínea y la necesidad de transfusión es menor que en cirugía abierta. La tecnología robótica aporta ventajas muy interesantes, que podrían tener un papel en homogeneizar los resultados del abordaje mínimamente invasivo, pero que aguardan validación a medio y largo plazo

Introduction: It is well known that radical prostatectomy (RP) is an excellent option in localized prostatic cancer especially from oncological control point of view. The efforts, during last decades, of the urological community in this field have been addressed in trying to improve functional outcomes (urinary and sexual morbidity) after the procedure. From the beginning of this century, three managements (open, robotic and laparoscopic) have been coexisting trying to get and prove the best results. The objective of this review has been to make the most exhaustive, rigorous and objective updating with the functional and oncological outcomes from the three (RP) techniques. Material and methods: We have centered the comparison in four sections: perioperative, oncological outcomes, functional results and economic costs. With this purpose a systematic search was made in the following registers: PubMed, OVID, EMBASE and Cochrane Library, with the following terms: Retropubic RP, open RP, laparoscopic RP, robotic RP, Sexual function, urinary incontinence, quality of life, economic costs. At author’s criteria, a total of 73 references were selected, that were individually analyzed. Results: Whatever the technique is, the mortality related to the procedure is extremely low, with little postoperative pain and minimum analgesic requirements. The oncological results are similar, measured in surgical margin terms: Open RP (14-20%), Laparoscopic RP (7.4-21.9%) and robotic RP (5.7-17.3%). Concerning functional results (sexual function and urinary continence), it is difficult to establish comparisons due to the multitude of existing byas (non randomized studies, different methods and measurement scales, different definitions, etc.) In the uni-insitutional studies, results seem to be equivalent. Conclusions:Laparoscopic and robotic RP series are still pending of mature outcomes, related to long term biochemical control and functional results. It seems that with these managements, blood loss and transfusion needs are minor compared to open surgery. Robotic technology adds very interesting advantages that could have an important role in homogenize the minimally invasive management, but are still pending of validation at medium and long term

Valoración de la musculatura isquiosural en personas mayores / Measurement of hamstring flexibility in older adults

Objetivo: valorar la extensibilidad isquiosural en personas mayores. Material y métodos: se valoraron 177 sujetos (13 varones y 164 mujeres) que asistían a clases de mantenimiento, con edades comprendidas entre los 43 y los 80 años. La edad media fue de 63,4 ± 6,7 años, la talla media 161 ± 10 cm y el peso medio 74 ± 5,6 kg. La extensibilidad isquiosural se evaluó mediante el test de elevación de la pierna recta. Resultados: la media de flexión de la cadera derecha fue de 72 ± 13,2o y la de la cadera izquierda fue de 72,4 ± 13,8o. No se encontraron diferencias significativas entre los valores obtenidos con el test de la elevación de la pierna recta medido en el lado derecho y en el izquierdo. Para la pierna derecha, el 48,02% presentó valores dentro de la normalidad, el 28,81% presentó valores de cortedad grado I y el 23,16% de cortedad grado II; para la pierna izquierda el 49,94% presentó valores dentro de la normalidad, el 29,94% presentó valores de cortedad grado I y el 22,03% de cortedad grado II. Conclusiones: la mitad de los adultos y mayores que participaron en este estudio presentaron cortedad de la musculatura isquiosural, y se apreció un mayor incremento de la cortedad isquiosural conforme aumentaba la edad (AU)

Objective: to evaluate hamstring flexibility in older adults. Materials and methods: a total of 177 subjects (13 men and 164 women) aged between 43 and 80 years old (mean age = 63.4 ± 6.7 years) who attended fitness classes were evaluated. The mean height was 161 ± 10 cm and the mean weight was 74 ± 5.6 kg. Hamstring flexibility was evaluated using the straight leg raise test. Results: the mean flexion in the right hip was 72o ± 13.2o and the mean flexion of the left hip was 72.4o ± 13.8o. No significant differences were found in the values obtained from the straight leg raise test in the left and right legs. For the right leg, 48.02% of the subjects’ values were within the normal range, while 28.81% showed grade I shortness, and 23.61% showed grade II shortness. For the left leg, 49.94% showed normal values, 29.94% showed grade I shortness, and 22.03% showed grade II shortness. Conclusions: half of the adults and elderly individuals that took part in the present study had hamstring shortness, which increased in frequency with age (AU)

[Infection for papillomavirus in the man. Current state]. / Infección por papillomavirus en el hombre. Estado actual.

The Virus of the Human Papiloma (HPV), classically he/she has been related with infections of sexual transmission and processes wicked oncologists of the feminine genital apparatus and with less frequency of the masculine one. The new technical diagnostics, based on molecular biology (by means of polymerase chain reaction), they help to a better epidemic approach, an improvement in the I diagnose viral, and a correct therapeutic focus. The object of this work is to revise the current state of the HPV from the points of view etiopathogenics, epidemic, clinical, diagnosis, therapeutic and preservative.

Distribución de los urólogos en España: situación actual y estimación de necesidades futuras mediante un modelo predictivo

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