Rotator cuff debridement compared with rotator cuff repair in arthroscopic treatment of calcifying tendinitis of the shoulder: A systematic review and meta-analysis. / Desbridamiento frente a reparación asociada del manguito rotador en el tratamiento artroscópico de la tendinitis calcificante del hombro: una revisión sistemática y metaanálisis.

INTRODUCTION: Although conservative treatment of calcific tendinopathy has a high success rate, arthroscopic excision of the calcific deposit is occasionally necessary. Controversy exists as to whether the remaining rotator cuff defect can be left in situ or should be repaired to achieve better functional outcomes. This study aimed to compare the results of debridement versus debridement combined with suturing in arthroscopic surgery for calcific tendinopathy. METHODOLOGY: MEDLINE, EMBASE, Cochrane Library, and Web of Science were searched from inception to February 2023 for articles on arthroscopic treatment of calcific tendinopathy. Functional outcomes (VAS, ASES, UCLA, and Constant) and the number of complications were analyzed. The effect size was calculated using Cohen's d-index. RESULTS: Twenty-one studies were included, including a total of 1172 patients aged between 44.7 and 55 years. The mean follow-up time was 24.7 months. The combined ES estimates for the total score of the VAS, ASES, UCLA, and Constant scales were very strong (>1.0) for both debridement and combined debridement with suture. The ES estimates for the number of total complications were 1.75 (95% CI: 0.08-3.43, I2 = 0%) for debridement and 9.07 (95% CI: -0.03-18.17, I2 = 50.4%) for combined debridement with suture. CONCLUSIONS: Both arthroscopic procedures improve the total score significantly on the EVA, ASES, UCLA, and Constant scales. However, a higher proportion of complications was observed in the group that performed suturing. In this regard, we must consider whether it is really necessary to repair all partial tears after the calcified deposits removal.

Infection control in long term care institutions for the elderly: A reflection document on the situation in Spain.

A progressively increasing percentage of the elderly live during the last years of their lives in nursing homes. Although these institutions are intended to mimic life at home as much as possible, they have characteristics that make them quite similar to a "nosocomiun", i.e. an establishment for the treatment of the sick. The very coexistence among the elderly, the fact of sharing caregivers and the very significant exposure to third parties, together with the frequent predisposing diseases to infection in this population, make infection frequent among residents and also easily transmissible. This leads us to ask what can be done to prevent infection in this environment and more specifically what is the state of the art of the matter in a Western European nation such as ours. The Board of Trustees of the Health Sciences Foundation has asked itself a series of questions on the subject of infection prevention in Nursing Homes, the structure of procedures, the legislation available, compliance with the measures indicated, the best indicators of the processes and therefore, the need to promote in Spain a document of recommendations to avoid infections in this poplation whose morbidity and mortality need not be highlighted. To this end, a multidisciplinary group of experts in different aspects of this problem has been convened and asked the proposed questions. The questions were discussed by the group as a whole and led to a series of conclusions agreed upon by the participants. The results of the meeting are reported below.

Reliability study in five languages of the translation of the pain behavioural scale Doloplus.

Non-verbal pain assessment scales are useful tools for pain evaluation in persons with communication disorders and moderate-severe dementia. The Doloplus was one of the first scales to be developed and validated as a pain assessment tool in older adults with dementia. This study aims at evaluating the translation of the Doloplus scale in five languages, as regards test-retest and inter-rater reliability. Results show that both tests are good or excellent for the English, Italian, Portuguese and Spanish versions and moderate for the Dutch version. These results bring a unique opportunity to include the translated Doloplus scale in daily assessment of elderly persons with communication disorders, and future studies should focus on enriching the validation of the scale in each language.

Factores de riesgo para la enfermedad meningocócica en la infancia. Estudio controlado en una población de un hospital de área en Portugal / Risk factors for meningococcus disease in the child. Controlled study in a population of an area hospital in Portugal

La Neisseria meningitidis es una causa importante de morbilidad y mortalidad en nuestro medio. Con el objetivo de evaluar la existencia de factores de riesgo para la enfermedad meningocócica en las Áreas de Salud de Amadora y Sintra se realizó un estudio retrospectivo, casos-control, en niños menores de 15 años de edad, internados desde el 1 de enero de 1997 hasta el 31 de diciembre de 2001. Se investigaron: edad, sexo, mes de ingreso, lactancia materna, asistencia a guarderías/escuelas, número de personas convivientes en el domicilio, número de habitaciones en el domicilio, hábitos tabáquicos de los padres, frecuencia por parte de los padres de bares/discotecas y grandes superficies comerciales. De un total de 56 casos, se verificó un predominio de la enfermedad en los menores de 6 años (85,7 por ciento), en el Sexo masculino (57 por ciento) y en los meses de enero a abril (53,6 por ciento). En el análisis multivariado (regresión logística) la enfermedad meningocócica estaba asociada de forma independiente al tabaquismo de la madre (o.r. 6,2 IC: 2,12 -18,35) y a la frecuentación de los padres a los centros comerciales (o.r. 4,6 IC: 1,45 - 14,37), bares y discotecas (o.r. 4,4IC: 1,57 - 12,54). El estudio confirma por tanto factores de riesgo ya anteriormente conocidos y otros todavía no descritos (AU)

Fibra en la alimentación infantil / Fiber in children's nutrition

La dieta habitual en las sociedades industrializadas, rica en grasas y pobre en fibra, parece contribuir a la aparición de patología cardiovascular y algunos tipos de cáncer. La modificación de los hábitos dietéticos se torna por lo tanto un imperativo de salud pública.Para una mayor eficacia esas alteraciones deben ser iniciadas en la edad pediátrica. Las fibras alimenticias son químicamente heterogéneas y su acciones fisiológicas son también diversas. Las fibras solubles atrasan el tránsito intestinal y al ser fermentadas por las bacterias del colon producen ácidos grasos de cadena corta que desempeñan un papel metabólico importante. Las fibras insolubles aceleran el tiempo de tránsito y aumentan el bolo fecal. El aporte diario recomendado, entre los 3 y 20 años de edad, por American Health Fundation como la edad + 5 en gramos parece lo más apropiado. Estudios en los EE.UU.y Europa occidental demuestran que la mayoría de los niños consumen menos fibras que esas recomendaciones. Además de la prevención de enfermedades en el adulto el incremento de las fibras en la dieta tiene un papel en el tratamiento de algunas patologías pediátricas: obesidad, estreñimiento, dolor abdominal recurrente, diabetes. Ese incremento debe ser realizado en forma de alimentos ricos en fibra (frutas, cereales, verduras) que contienen proporciones diversas de fibra soluble e insoluble, bien como minerales o vitaminas necesarias para un crecimiento armonioso (AU)