Use of Ozone Therapy in Diabetic Foot Ulcers.

INTRODUCTION: ozone therapy is a therapy composed of ozone. This gas is in the atmosphere with various general effects: direct disinfectant and trophic effects and a systemic antibacterial and antiviral effect. This gas also improves blood circulation, makes glucose metabolism more effective, improves erythrocyte metabolism, and improves fatty acid metabolism. OBJECTIVE: Provide evidence of the effectiveness of ozone therapy in wounds of patients with diabetic foot. Analyze the effectiveness of ozone therapy compared to other treatments to achieve good wound healing in patients with diabetic foot. To study the benefits of the use of ozone therapy in ulcers of patients. Analyze the management of ozone therapy and other treatments to achieve healing of ulcers in patients. METHODOLOGY: A bibliographic review focused on articles published between November 2014 and June 2023 was carried out. The following databases were consulted: Pubmed (Medline), Dialnet, Google Scholar, Web of Science (WOS), Scielo, and Scopus. RESULTS: After applying the article selection criteria and evaluating the quality of the methodology, a total of 17 articles were obtained. The results affirm ozone therapy as promising for the treatment of wounds in patients with diabetic foot. CONCLUSIONS: the evidence has been able to determine that ozone therapy is adequate for the treatment of diabetic foot ulcers. In addition, the therapy has been shown to be effective, safe, and beneficial, with few adverse effects for the treatment of diabetic foot ulcers.

Afectaciones del miembro inferior en sujetos que realizan kick-boxing: estudio descriptivo / Affections of the lower limb in subjects that perform kick-boxing: descriptive study

Introducción: El kick-boxing es un deporte que se practica de pie, el cual consiste en aplicar golpes a un rival utilizando los brazos, las manos, los codos, las piernas y los pies, mediante puñetazos, patadas, empujes y barridos. Los objetivos son identificar las lesiones que se producen con mayor prevalencia en los sujetos en función del sexo y los años de práctica del kick-boxing. Pacientes y métodos: La muestra la componen 37 sujetos de diferentes centros de Extremadura (25 sujetos hombres y 12 mujeres, 67.7 % y 32.42 %, respectivamente), los cuales fueron explorados por un único explorador tres veces, donde se valoraría musculatura, ligamentos y patologías presentes. Resultados: Casi el 60 % de los sujetos han padecido alguna vez una lesión. Las lesiones más frecuentes son queratopatías, fracturas, esguinces y, en menor medida, tendinopatías. Los años de la práctica del kick-boxing tienen una asociación altamente significativa con la presencia de lesiones (p valor = 0.005). Conclusión: El comportamiento del pie en el kick-boxing es similar en ambos sexos (no existe diferencia entre hombres y mujeres). Además, es destacable según la estadística que cuanto mayor es el tiempo de práctica de kick-boxing, mayor es la probabilidad de presentar lesiones (AU)

Introduction: Kick-boxing is a sport that is practiced standing up, which consists of applying blows to an opponent using the arms, hands, elbows, legs and feet, through punches, kicks, pushes and sweeps. The objectives are to identify the injuries that occur with the highest prevalence in subjects based on sex and years of kick-boxing practice. Patients and methods: The sample is made up of 37 subjects from different centers in Extremadura (25 male subjects and 12 female subjects, 67.7 % and 32.42 %, respectively). Which were explored by a single explorer three times, where the musculature, ligaments and present pathologies would be evaluated. Results: Almost 60 % of the subjects have ever suffered an injury. The most frequent injuries are keratopathies, fractures, sprains and, to a lesser extent, tendinopathy. Years of kick-boxing practice has a highly significant association with the presence of injuries (p value = 0.005). Conclusion: The behavior of the foot in kick-boxing is the same for both men and women. And that the greater the number of years practicing kick-boxing, the greater the probability of presenting injuries (AU)

Estimación de la osificación de los huesos del pie sobre población extremeña. Estudio observacional / Estimation of the ossification of the bones of the foot about the population of Extremadura. Observational study

Objetivos: La estimación de la edad de un individuo es un tema de interés dentro del ámbito de la Medicina Legal y Forense. Una de las herramientas más utilizadas para este fin es la Radiología. Los objetivos son la cuantificación de las edades de osificación de cada hueso del pie y determinar si existe relación entre la osificación de los huesos y el sexo del individuo. Pacientes y métodos: La población de estudio se compuso de 2476 radiografías digitales, pertenecientes a un total de 816 sujetos en periodo de crecimiento. El análisis de las imágenes se realizó mediante la aplicación del método validado y diseñado para la estimación de la edad en meses sobre la radiografía del esqueleto del pie.Resultados: Sí existe diferencia en la osificación ósea de la población extremeña frente a la literatura (p valor < 0.05). Todos los huesos que forman el Tarso poseen significación estadística en la comparación por sexos a excepción del cuboides, el cuneiforme medial y el cuneiforme lateral. Conclusiones: Sí existe diferencia significativa en la osificación de hueso del pie entre sexos y entre poblaciones de diferente raza.(AU)

Objectives: The estimation of the age of an individual is a topic of interest within the field of Legal and Forensic Medicine. One of the most used tools for this purpose is Radiology. The objectives of the present work are the quantification of the ages of ossification of each bone of the foot and to determine if there is a relationship between the ossification of the bones and the sex of the individual.Patients and methods: The study population was made up of 2476 digital radiographs, belonging to a total of 816 subjects in the growth period. The analysis of the images was carried out by applying the method validated and designed for the estimation of age in months on the X-ray of the skeleton of the foot. Results: If there is a difference in the bone ossification of the population of Extremadura compared to the literature (p value < 0,05). All the bones that form the tarsus have statistical significance in the comparison by sex, except for the Cuboid, the Medial Cuneiform and the Lateral Cuneiform. Conclusions: If there is a significant difference in foot bone ossification between sexes and between populations of different races.(AU)

Funcionalidad del miembro inferior de los nadadores en relación con el estilo de nado: estudio descriptivo observacional / Functionality of the lower limb of swimmers in relation to swimming style: descriptive observational study

Objetivo: La natación es una disciplina deportiva que requiere de una exigencia funcional por parte de todo el aparato locomotor. A pesar de ser un deporte que se realiza en un entorno sin carga, la participación de los miembros inferiores es imprescindible para el rendimiento del nado. El objetivo principal es determinar si los años de especialización por estilos de nado influyen, o no, en el perfil funcional del miembro inferior de los nadadores. Pacientes y métodos: El estudio se lleva a cabo en 25 nadadores de entre 10 y 19 años pertenecientes a un club de natación español. Los datos a tener en cuenta son: sexo, edad, IMC, estilo predominante, entre otros, además de los valores obtenidos tras la exploración clínica individual, que consta de siete pruebas. Resultados: El estilo de nado en el que el nadador se encuentra especializado no parece influir significativamente sobre la funcionalidad de los miembros inferiores, (p valor mayor a 0.05, Prueba Kruskal-Wallis), valores comprendidos entre 0.13 y 0.87.Conclusión: Se puede concluir que los años de especialización en un estilo de nado concreto, no influyen en el perfil funcional del miembro inferior de los nadadores participantes en este estudio.(AU)

Objective: Swimming is a sports discipline that requires a functional demand from the entire musculoskeletal system. Despite being a sport that takes place in an environment without load, the participation of the lower limbs is essential for swimming performance. The main objective is to determine if the years of specialization by swimming styles influence or not, the functional profile of the lower limb of swimmers. Patients and methods: The study is carried out in 25 swimmers between 10 and 19 years old belonging to a spanish swimming club. The data to take into account are: sex, age, BMI, predominant style, among others, in addition to the values obtained after the individual clinical examination, which consists of seven tests. Results: The swimming style in which the swimmer is specialized does not seems to influence significantly the functionality of the lower limbs, (p-value greater than 0.05, Kruskal-Wallis test), values between 0.13-0.87). Conclusion: It can be concluded that the years of specialization in a specific swimming style do not influence the functional profile of the lower limb of the swimmers participating in this study.(AU)

The Effectiveness of Negative Pressure Therapy: Nursing Approach.

INTRODUCTION: Complex wounds require advanced techniques for their management and care. Wound care costs are high, so healthcare professionals need to be aware of available therapies. Negative pressure therapy is a technology for which more and more data on its effectiveness in complex wounds are being collected. OBJECTIVE: The objectives of this review were to analyze if the application of negative pressure therapy in complex wounds is effective; to compare the effectiveness of negative pressure therapy with other conventional treatments, as well as its combination with other therapies; and to evaluate the quality of life of patients undergoing negative pressure therapy and collect their main characteristics. METHODOLOGY: A bibliographic review focused on articles published between November 2015 and June 2022 was carried out. The following databases were consulted: PubMed (Medline), Google Scholar, Web of Science (WOS), Scielo and Scopus. RESULTS: The most used pressures in the studies coincide at -125 mmHg and in the range of -125 mmHg to -150 mmHg. In the pediatric population, pressure levels vary by age group. A pressure of -75 to -125 mmHg is recommended for children over 12 years of age, and -50 to -75 mmHg is recommended for children under 2 years of age. CONCLUSIONS: Negative pressure therapy stands out for its rapid rate of granulation, the prevention and effective treatment of infections, the variety and malleability of dressings, its various applications and the possibility of using it with other therapies to accelerate wound closure.

The Podoprint® plantar pressure platform: Evaluation of reliability and repeatability, and determination of the normality parameters.

INTRODUCTION: The Podoprint® pressure platform system is widely used in routine podiatric clinical practice to measure plantar pressures. It allows non-invasive examination of the patient, and provides fast results with high levels of precision, reliability, and repeatability. Once these conditions have been demonstrated, the clinical and/or research use of baropodometry allows results to be obtained in the field of podology that are far from inconsiderable. The study was designed to evaluate the repeatability and reliability of the platform, and to identify the normal foot pressure parameters. METHODS: Records were collected from 52 random healthy individuals, 10 men and 42 women, in two sessions separated by one week. The study variables were: maximum pressure, mean pressure, support surface areas (heel, midfoot, and forefoot), and contact time. Repeatability and reliability were evaluated by calculating the interclass correlation coefficient (ICC) and the coefficient of variation (CV) in the three tests. RESULTS: The ICCs showed moderate to good repeatability for the variables of interest, and the CVs were all less than 18%. The maximum pressure was under the forefoot (mean 2675.4 ± 513.8 g/cm2). The mean contact time of the steps was 0.72 ± 0.07 s. CONCLUSIONS: The Podoprint® system is a reliable tool for evaluating the distribution of plantar pressures in the dynamic study of the barefoot gait of healthy individuals.

Pathophysiological Behaviour of the Climber's Foot versus the General Population: A Prospective Observational Study.

Sport climbing is becoming increasingly popular, with people of all types and ages practising it. The feet suffer a lot of pressure with the sport climbing gesture, which in the long run can produce alterations in the first metatarsophalangeal joint or in the first radius of the foot. Objective: To observe and quantify the behaviour of the foot in climbing subjects compared to a group of non-climbing subjects, comparing the pressures, first metatarsophalangeal joint and first radius of the foot. Method: This is a non-experimental and observational, cross-sectional, descriptive and prospective research. The study sample consisted of 105 subjects (42 males and 63 females). The control group consisted of 52 subjects and the climbing group consisted of 53 subjects. Different exploratory tests were carried out on all the subjects, such as: mobility of the metatarsophalangeal joint and first radius of the foot and the study of plantar pressures in different areas of the study. Results: No significant difference was found between left and right foot measurements (p > 0.05). The pressures of the same foot are significant, both at static and dynamic stages for both groups. The maximum pressure in the climbing group was under the first metatarsal head, while in the control group it was under the second metatarsal head. There were significant differences in the mobility of the first metatarsal joint and the first radius between the two groups. Conclusion: It can be seen that the group of climbers has less plantar pressure than the control group. They also have altered mobility of the first radius and the first metatarsophalangeal joint.

Epidemiological Study of Foot Injuries in the Practice of Sport Climbing.

BACKGROUND: Climbing is a multidisciplinary sport, where the main objective is to reach the highest point of a rock wall or to reach the end of an established route. There are different types of modalities: sport climbing and traditional climbing. The risks and precautions taken with respect to this sport will directly affect the epidemiology of injuries related to its practice. The present study was designed to identify and characterize the most frequent injuries in the feet of climbers and to determine if there is a relationship between the injuries that appear and the time spent practicing the sport. METHODS: A total of 53 people were collected, 32 men and 21 women, corresponding to the climbers of the FEXME (Extremadura Federation of Mountain and Climbing). To determine the diagnoses, exploratory tests, classified according to the variables to be studied, are carried out: inspection variables and questionnaire variables. RESULTS: The average number of years of climbing was seven years, and the average number of hours of training per week was 6.6 h. Some type of alterations were presented in 70% of the respondents, and foot pain was present during climbing in 45% of the participants. The p-value showed a relationship between years of climbing and the occurrence of chronic foot injuries (p = 0.035), however, there is no relationship between the occurrence of injuries and chronological age. CONCLUSION: We can see that the most frequent injuries in the practice of climbing are claw toes, dermal alterations such as bursitis of the first toe and hallux limitus, followed by hallux valgus. Similarly, only a significant relationship was found between the number of years of climbing and the appearance of foot injuries.

Clinical Management of Intraosseous Access in Adults in Critical Situations for Health Professionals.

There are health professionals who are unaware of the ideal management of the intraosseous route, despite the fact that it has been scientifically considered an alternative to the peripheral venous route when the patient is in critical condition. Thanks to continuous development, there has been a need to provide emergency services with materials that manage to provide satisfactory care, despite the difficulties faced by health personnel. OBJECTIVES: The objective of this systematic bibliographic review is to update the theoretical and practical knowledge and strategies for the insertion and proper management of the intraosseous route as an emergency vascular access for nursing professionals. Data sources, study eligibility criteria: The search for the articles was carried out in various scientific databases with the help of a search string (January 2015 and May 2021), which combined the keywords and Boolean operators. STUDY APPRAISAL AND SYNTHESIS METHODS: Eighteen articles were chosen after a review of 1920 database articles, following the application of the inclusion and exclusion criteria. RESULTS: Intraosseous infusion is an effective and safe technique, which increases patient survival. Therefore, it is of crucial importance that all nursing professionals know how to handle the different intraosseous devices in situations in which it is not possible to achieve immediate peripheral venous access. Conclusions and implications of key findings: It is of great need to have devices or fast and effective alternatives that allow us to develop safe interventions by health professionals.

Efficacy of Interventions Based on the Use of Information and Communication Technologies for the Promotion of Active Aging.

Nowadays, the study of how new media and technologies can be used to carry out health education by bringing these tools closer to the elderly population is interesting. It is a way of offering them access not only to greater knowledge, but to greater communication and relationship with their surroundings, a range of new possibilities and resources at their disposal that also represent a way to reduce the generation gap and bring them closer to the rest of the community. Objectives: to evaluate and analyze the studies that show the efficacy of interventions based on the use of information and communication technologies for the promotion of active aging in people older than or equal to 65 years who live in the community. Data sources, study eligibility criteria: the search for the articles was carried out from January 2012 to March 2021, in 6 databases (Pubmed, Cochrane Library, Scopus, Scielo, Google Academic and WOS) based on the clinical question, using the keywords derived from the DeCS and MeSH thesauri, combined with the Boolean operators "AND", "NOT" and "OR". The search was limited to publications from the last 9 years, in English and Spanish. Results: after applying the selection criteria and evaluating the quality of the methodology, 7.91% (n = 17) of the 215 results were included with filters: 7 systematic review, 5 of Cohorts and 5 of Randomized Controlled Trial. Conclusions and implications of key findings: the use of communication technologies reduces the feeling of loneliness, as well as the use of virtual reality to exercise, train memory or perform rehabilitation. The most difficult barrier to overcome is the prior ignorance of the majority of the elderly to the technology that is overcome by working as a team throughout the community, especially in the health and educational sector, as well as the family or social nucleus.

Influence of creams with different urea concentrations on plantar skin hydration.

INTRODUCTION: The skin is the body's outermost organ, and one of its main functions is to provide protection against potential infections. Hydration is related to the proper functioning of the skin, hindering the appearance of wounds or cracks which could lead to the occurrence of infections or other dermatological alterations. The skin of the foot is thicker than that of the rest of the body due to the load it supports, and it is more complicated to maintain. The intention of this study was to evaluate the efficacy of different concentrations of urea (5% and 20%) in hydrating the foot compared to a placebo cream. METHODS: The study was carried out with 60 subjects of ages from 20 to 35 years in age. The experimental protocol was initiated by creating three randomized groups (1:1:1), each being treated with a different cream: placebo, 5% urea cream, and 20% urea cream. The examination was carried out using a non-invasive instrument (Corneometer CM 825®) that detects the skin surface hydration. RESULTS: Analysis of the hydration of the different study zones according to the cream used showed no significant differences between the placebo and 5% urea for the first MTH and heel, but a significant difference for the fifth MTH. There were significant differences in all study areas between the placebo and 20% urea creams, but none between the 5% urea and 20% DISCUSSION/CONCLUSION: The conclusion drawn was that skin hydration was greater with the 20% urea cream versus the placebo, but there were no differences found when comparing either the 20% and 5% urea creams or the placebo and 5% urea creams.