Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study.

BACKGROUND: Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE: To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS: Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS: Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS: In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

[Influence of posture in musicians. A literature review]. / Influencia de la postura en el músico. Una revisión bibliográfica.

Playing-related musculoskeletal disorders represent a commitment to the health and competence of musicians. This review aimed to analyse how musician's posture influences instrumental practice and the appearance of musculoskeletal disorders related to musical performance. To do this, a literature search was carried out in the Medline, CINAHL and Web of Science, and Pubmed databases, obtaining 14 valid articles after application of the inclusion and exclusion criteria. Several authors analysed posture during instrumental practice, posture and interpretive quality, and the appearance of musculoskeletal disorders related to musical performance and postural quality, based on distinct variables such as the instrument and interpretive anxiety. Posture seems to be one of the most important risk factors, influencing both musculoskeletal and interpretive levels. Physiotherapy could be effective for prevention and treatment.

Assessment of male urinary incontinence postprostatectomy through the Consultation on Incontinence Questionnaire-Short Form.

OBJECTIVE: The objective of this study is to assess the correlation between the urinary incontinence results of the ICIQ-SF, and those obtained in the 1-hour and 24-hour pad tests, in a sample of men that underwent prostatectomy. MATERIAL AND METHODS: A prospective observational study was carried out in patients from the Integrated Management Area of Vigo (EOXI de Vigo) who underwent prostatectomy and suffered from urinary incontinence in the post-surgery period. Loss of urine was assessed by means of the 1-hour and 24-hour pad tests and the ICIQ-SF. A comparative analysis of the questionnaire findings was performed for both urinary incontinence tests. RESULTS: A correlation is observed between the ICIQ-SF and the amount of urine loss in the 1-hour and the 24-hour pad tests. However, the severity of urine loss established by instruments is less consistent. The 24-hour pad test is the one that obtained better correlation with the ICIQ-SF. CONCLUSIONS: The ICIQ-SF should be validated in a male population after prostatectomy in order to reinterpret the severity values observed in the different instruments studied. LEVEL OF EVIDENCE: 4.

[Circumstances that may decrease the reliability of instruments to assess male urinary incontinence]. / Circunstancias que pueden disminuir la fiabilidad de los instrumentos para valorar la incontinencia urinaria masculina.

OBJECTIVE: To identify situations that may alter the results of the 1-hour and 24-hour Pad test and the short-form International Consultation in Incontinence Questionnaire (SF-ICIQ). PARTICIPANTS: Five physiotherapists, who conducted the interviews and treatment of 81 patients undergoing radical prostatectomy. METHOD: A qualitative descriptive phenomenological study was carried out, using a focus group technique with five people (4 women and 1 man) responsible for the treatment and assessment of patients with urinary incontinence after prostatectomy. Recordings were transcribed and the Atlas.ti7 programme was used to carry out the coding of the variables. RESULTS: Important factors were identified in the use of measuring instruments for the diagnosis and assessment of urinary incontinence in all the tools used. CONCLUSIONS: Some situations can modify the objectivity of the various tests for the assessment of urinary incontinence. Some of the factors identified were lower fluid intake, less activity, use of manual clamp or urinals to avoid leakage, as well as the interference of certain drugs.

Correlation between the 1-hour and 24-hour pad test in the assessment of male patients with post-prostatectomy urinary incontinence.

INTRODUCTION: This study is aimed at studying the correlation between the 1-hour and 24-hour pad tests for urinary incontinence following prostatectomy; the second objective is to check whether the severity level established by both tests is adequate for male urinary incontinence. MATERIAL AND METHODS: The study population includes patients who had undergone prostatectomy at a single center between February 2015 and December 2016, using 159 measurements consisting of 24-hour and 1-hour pad tests, belonging 45 patients. Both tests have been performed according to the protocol standardized by the International Continence Society. Once all the data have been obtained, the levels marked by each of the pads have been established, and the statistical analysis has started. RESULTS: The relationship between the amounts recorded in grams by the two test is highly significant (P=0.000), however, when comparing the incontinence levels established by each test (mild, moderate and severe), discrepancies have been found. The median of the severe cases in the 24-hour pad test was 389.5 grams, and in the 1-hour pad test was 92 grams. So, patient's loss values are well above the cut-off point defined for severe urinary incontinence in both 24-hour (50 grams) and 1-hour pad test (75 grams). CONCLUSIONS: There is a diagnostic discrepancy between the 24-hour pad test and the 1-hour pad test in terms of defined urinary incontinence severity levels. In our opinion, these levels should be redefined for male urinary incontinence since the amount of urine loss is well above the threshold established for severe incontinence. LEVEL OF EVIDENCE: 4.

Pollen counts influence web searches for asthma and rhinitis

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Airborne olive pollen counts are not representative of exposure to the major olive allergen Ole e 1.

Pollen is routinely monitored, but it is unknown whether pollen counts represent allergen exposure. We therefore simultaneously determined olive pollen and Ole e 1 in ambient air in Córdoba, Spain, and Évora, Portugal, using Hirst-type traps for pollen and high-volume cascade impactors for allergen. Pollen from different days released 12-fold different amounts of Ole e 1 per pollen (both locations P < 0.001). Average allergen release from pollen (pollen potency) was much higher in Córdoba (3.9 pg Ole e 1/pollen) than in Évora (0.8 pg Ole e 1/pollen, P = 0.004). Indeed, yearly olive pollen counts in Córdoba were 2.4 times higher than in Évora, but Ole e 1 concentrations were 7.6 times higher. When modeling the origin of the pollen, >40% of Ole e 1 exposure in Évora was explained by high-potency pollen originating from the south of Spain. Thus, olive pollen can vary substantially in allergen release, even though they are morphologically identical.

Conocimiento previo sobre fisioterapia que presentan los alumnos de nuevo ingreso de la Escuela Universitaria de Fisioterapia de Pontevedra / Previous knowledge about Physical Therapy that present the new entrance students in Pontevedra¿s Physical Therapy University School

Objetivos: El presente trabajo pretende dar una visión del conocimiento sobre fisioterapia que presentaron los alumnos de nuevo ingreso de la Escuela Universitaria de Fisioterapia de Pontevedra (Universidad de Vigo) desde el año académico 2001-2002 hasta el 2006-2007. Se comparó estos datos con trabajos previos acerca del mismo tema, tanto propios como de otros autores. Material y métodos: Se realizó el estudio mediante cuestionario de 25 ítems que se presentó a los alumnos de nuevo ingreso en su primer día en la escuela. Resultados: Se constató una mejora en el grado de conocimiento de la fisioterapia, pero no suficiente como para dejar la labor de educación que estamos llevando a cabo desde la instauración de la diplomatura de Fisioterapia en la Universidad de Vigo. Conclusiones: Es necesario insistir en la corrección de determinados errores y en rellenar las lagunas de conocimiento existentes(AU)

Objectives: The present work aims to provide a view of the knowledge that new studentsto the University School of Physiotherapy of Pontevedra (University of Vigo) had regardingthe academic years 2001–2002 to 2006–2007. These data were compared with previousworks on the same thematic by the authors of this article as well as by other authors. Material and methods: The study was conducted with a 25-item questionnaire filled outby the new students on their first day in the School.Outcomes: Improvement in the degree of knowledge about Physiotherapy was observed.However it was not sufficient to stop the educational task we have been carrying out sincethe university studies of Physiotherapy were established in the University of Vigo. Conclusions: It is necessary to insist on the correction of certain errors and on filling in thelaps in the existing knowledge(AU)

Estado actual de la investigación en fisioterapia en los centros universitarios españoles / Current status of research in physiotherapy in Spanish university centers

En el presente artículo se presenta una visión del estado actual de desarrollo de la investigación dentro del área de la Fisioterapia en España. Metodología: Se pasó un cuestionario por correo-e a responsables del área en cada centro universitario español que imparte la titulación. Se recibió contestación de 28 de los 38 centros existentes. Resultados: Se ha constatado que en 7 de esos 28 centros no se desarrolla ninguna línea ni proyecto de investigación, y que en los otros 21 centros universitarios se está trabajando en 122 líneas de investigación y se han desarrollado 31 proyectos de investigación o se está en ello. Discusión y conclusiones: La investigación en España dentro de la Fisioterapia está todavía en sus inicios. Para su desarrollo es necesario más implicación de los distintos protagonistas: profesores del área, fisioterapeutas, Administración, Universidad

The present article shows a vision of the state of development of the research inside the area of the Physical Therapy in Spain. Methodology: We mailed a questionnaire to persons in charge of the area in every Spanish university in which this career is teached. We received answers from 28 of all 38 existing centers. Outcomes: We have found that in 7 of these 28 centers no line or investigation project is developed, and that in the other 21 university centers teachers are working in 122 investigation lines and 31 research projects have been developed or are still being developed. Discussion and conclusions: Investigation in Spain inside the Physical Therapy is still in the beginnings. For a further its development it is necessary more implication of the different protagonists: teachers of the area, physiotherapists, Administration, University

Fisioterapia respiratoria en los balnearios / Respiratory Physiotherapy in the spas

La balneoterapia está recuperando en los últimos años el esplendor que alcanzó en épocas pasadas, y no sólo por el incremento de clientes, sino también porque la utilización de su potencial curativo y preventivo ha mejorado, se ha actualizado y se están incorporando profesionales como los fisioterapeutas, que con la aportación de sus conocimientos terapéuticos optimizan los recursos naturales de la balneoterapia. Al escribir este artículo hemos querido describir cómo se tratan actualmente muchas de estas afecciones en los balnearios y el papel que la fisioterapia y los fisioterapeutas pueden y deben tener en ellos, así como las diversas indicaciones y formas de administración de las aguas mineromedicinales en las afecciones respiratorias (AU)

In recent years, balneotherapy is recovering the splendor which had reached in ancient ages and not only due to the customers increase but because the use of its curative and preventive potential has improved and brought up to date. Professionals like physiotherapists are involving and with the contributión of their therapeutics knowledge, they optimize the natural resources of balneotherapy. On writing this article, have whith breathing pathology and show up a series of facts which help to describe how a lot of these troubles are at present treated at health resorts, the role that physiotherapy and physiotherapists can and should have at health resorts, as well as several signs and ways of administration of mineral and medicinal waters on breathing troubles (AU)

Comportamiento del dolor y el uso de la estimulación eléctrica nerviosa transcutánea en el postoperatorio de cirugías torácicas / Pain behaviour and use of transcutaneous electric nervous stimulation in the thoracic surgery postoperative period

El presente trabajo se caracteriza como un estudio-caso; su objetivo es investigar la evolución de la sintomatología dolorosa postoperatoria en pacientes sometidos a cirugía torácica utilizando la estimulación eléctrica nerviosa transcutánea (TENS) como forma analgésica. La muestra fue constituida por cinco individuos, tres de sexo masculino con edad media de 39 años y dos del sexo femenino con edad media de 45 años, los cuales se sometieron a cirugía torácica (toracotomía posterolateral).Se utilizó como instrumento de evaluación del dolor una escala numérica y el cuestionario McGill (1) y se procedió a una evaluación preoperatoria, acompañamiento quirúrgico, acompañamiento postoperatorio inmediato (PO) con evaluación del dolor, aplicación de la TENS, acompañamiento durante la intervención fisioterapéutica y reevaluación del dolor. La TENS se mostró eficiente en la reeducación de la sintomatología dolorosa que presentaban los pacientes (AU)

[Survival of patients with myasthenia gravis after thymectomy. Analysis of 100 cases]. / Supervivencia en pacientes con miastenia gravis después de la timectomía. Análisis de 100 casos.

In order to evaluate the survival of patients with myasthenia gravis (MG) after thymectomy (T), 100 patients with MG in which T had been performed between 1967 and 1995 were studied. Patients were divided into different groups for their analysis: patients with thymoma (TI), 22 cases; and patients without thymoma (NTI), 78 cases. In addition those patients belonging to the latter group were further separated according to the date of their surgery into two other subgroups: patients operated before 1980 (A80), 43 cases; and after 1980 (D80), 35 cases; trying to evaluate the prognostic implications of the therapeutical advances achieved over the last 15 years. The population studied was composed mainly of women (78%) but with a slight predominance of men in TI. The mean age was 29.47 years (range 10-70) for the entire population, with a tendency toward older ages in TI (mean 46 years, range 23-70). The mean follow-up period was 4.3 years (range 0.08-23.2) without significant differences between TI and NTI. The results showed that the overall mortality rate was 16/100 (16%) [Fig. 1], with nine of those deaths corresponding to TI (9/22, 40.91%) and only the remaining seven to NTI (7/78, 8.97%). These differences in mortality rate between TI and NTI were statistically significant in all the specific times of follow-up analyzed up to 10 years after surgery (p < 0.05) [Fig. 2]. Notoriously, all deaths in NTI occurred in the A80 subgroup giving a p value < 0.001 when compared with D80 [Fig. 3]. In terms of morbidity, 55/100 (55%) reached complete clinical remission (CCR) defined by the complete absence of symptoms related to MG: 8/22 (36.36%) in TI and 47/78 (60.25%) in NTI [Fig. 4]. Most interestingly the differences were statistically significant (p < 0.01) when the rates of CCR in A80 and D80 were compared for all the times assessed [Fig. 5-6-7-8]. It can be concluded that the best results in survival in MG after T are obtained in patients without thymoma and also that the benefits of the rational use of modern therapeutic modalities, including surgery and immunosuppression with drugs, can offer those patients high possibilities of leading completely normal lives.