Factores que Afectan la Percepción de Dolor ¿Cómo Influyen en la Toma de Decisiones Clínicas durante el Proceso de Rehabilitación Kinesiológica? / Factors That Affect Pain Perception: How Do They Influence Clinical Decision Making During the Kinesiological Rehabilitation Process?

Introducción. La percepción del dolor es un fenómeno complejo y subjetivo. Comprender los factores que afectan en la percepción del dolor es crucial en el contexto de la toma de decisiones clínicas durante el proceso de rehabilitación kinesiológica. Objetivo. Exponer los factores que afectan la percepción del dolor, desde la perspectiva del modelo biopsicosocial y discutir sus implicancias para la toma de decisiones clínicas. Métodos. Se describen factores que afectan la percepción de dolor, separados en biológicos como la injuria, sexo, genética y edad, psicológicos como creencias, catastrofismo, kinesiofobia, afectividad negativa, calidad de sueño, atención, afrontamiento y autoeficacia; y socio-culturales como soporte social, rol de género, etnia, aculturación y estatus socioeconómico. Luego se discute cómo estos factores impactan en las decisiones clínicas del profesional kinesiólogo. Finalmente, se entregará un análisis de las barreras y facilitadores descritos por la literatura científica respecto al uso del modelo biopsicosocial.

Background. The perception of pain is a complex and subjective phenomenon. Thus, understanding the factors that influence pain perception is crucial in the context of clinical decision-making during the kinesic rehabilitation process. The objective of this article is to expose the factors that affect the perception of pain, from the perspective of the biopsychosocial model and discuss its implications for clinical decision making during this process. Initially, the biological, psychological and sociocultural factors that affect the perception of pain with the greatest presence in the scientific literature are described. It is discussed how these factors impact the clinical decisions of the kinesiologist professional. Finally, an analysis of the barriers and facilitators described by the scientific literature regarding the use of the biopsychosocial model will be provided.

Rendimiento en los Juegos Panamericanos de Santiago 2023: Predicción mediante método de suavización exponencial simple

El objetivo del presente trabajo es analizar el desempeño deportivo de la delegación chilena en los Juegos Panamericanos celebrados entre los años 1951 y 2023, haciendo uso de datos retrospectivos y proyectivos a través de series temporales de tiempo. Para esto se empleó un diseño cuantitativo, no experimental y longitudinal de tendencias y un método de suavización exponencial simple, que utiliza promedios históricos y que permite realizar una predicción o comportamiento futuro basado en una media ponderada de los valores actuales y de los pasados. A partir de los resultados obtenidos, fue posible concluir que, en las últimas décadas, la ubicación de Chile en el ranking de los Juegos Panamericanos se ha estabilizado en torno a un onceavo lugar, posición pronosticada para Santiago 2023. Manteniéndose condiciones similares, el desempeño deportivo general y específico no tendría un quiebre exponencial de la tendencia y los resultados no resultan favorables, específicamente en lo que respecta a la obtención de medallas de oro y la posición general de la delegación.

The objective of this paper is to analyze the sports performance of the Chilean delegation in the Pan American Games held between 1951 and 2023, using retrospective and projective data through time series. For this purpose, a quantitative, non-experimental and longitudinal design of trends and a simple exponential smoothing method was used, which uses historical averages and allows a prediction or future behavior based on a weighted average of current and past values. From the results obtained, it was possible to conclude that, in recent decades, Chile's position in the Pan American Games ranking has stabilized around eleventh place, a position predicted for Santiago 2023. Maintaining similar conditions, the general and specific sporting performance would not have an exponential break in the trend and the results are not favorable, specifically in terms of obtaining gold medals and the overall position of the delegation.

O objetivo deste artigo é analisar o desempenho esportivo da delegação chilena nos Jogos Pan-Americanos realizados entre 1951 e 2023, usando dados retrospectivos e projetivos por meio de séries temporais. Para isso, foi utilizado um desenho quantitativo, não experimental e longitudinal de tendências e um método de suavização exponencial simples, que utiliza médias históricas e permite uma previsão do comportamento futuro com base em uma média ponderada dos valores atuais e passados. Com base nos resultados obtidos, foi possível concluir que, nas últimas décadas, a posição do Chile no ranking dos Jogos Pan-Americanos se estabilizou em torno do 11º lugar, posição prevista para Santiago 2023. Mantendo-se condições semelhantes, o desempenho esportivo geral e específico não teria uma quebra exponencial na tendência e os resultados não são favoráveis, especificamente em termos de conquista de medalhas de ouro e posição geral da delegação.

Pain and Psychological Readiness to Return to Sport in Elite Volleyball Players: A Cross-Sectional Study.

Pain is modulated by multiple factors. A relevant psychological process peculiar to athletes and which could be associated with pain is Psychological Readiness to Return to Sport (PRRS). The analysis of this association in competition context is particularly important. OBJECTIVE: To determine the correlation between the PRRS and pain intensity in elite volleyball players during their participation in a continental sporting event. METHODS: A cross-sectional study was conducted. Data from 107 male volleyball players (23.50 ± 4.08 years of age) participating in the South American Volleyball Championship were used. The athletes answered a self-report questionnaire on the day the championship began regarding their history of injuries in the previous six months. The athletes who declared injuries were asked about the current pain intensity using the Pain Numeric Rating Scale (NRS) and Psychological Readiness to Return to Sport using the Injury-Psychological Readiness to Return to Sport scale (I-PRRS). RESULTS: 43.93% (n = 47) of the athletes (23.70 ± 3.54 years) reported an injury in the six months prior to the championship. They presented a median on the NRS of three (interquartile range (IQR), 2-5), and 54 (IQR, 46-58) on the I-PRRS. The Spearman's Rho correlation test showed an inversely and moderate correlation (rs = -0.36; p = 0.011; CI: -0.64--0.08) between pain intensity and PRRS. CONCLUSIONS: In male elite volleyball players who participate in a Continental Championship in South America, higher levels of PRRS was correlated to lower pain intensity.

Effects of a specific injury prevention neuromuscular training program for young female dancers. A randomized-controlled trial.

To assess the effects of a specific injury prevention neuromuscular training programme (IPP) on balance and lower-limb asymmetry in female competitive dancers (age 12-20 years; height 1.57 ± 0.06 m; weight 24.27 ± 2.79 kg) were randomly allocated to an active general control (GIPP, n = 7) and specific (SIPP n = 7) group. Both programmes were conducted for 6 weeks, with a frequency of three sessions per week. Dynamic balance and lower-limb asymmetry were assessed before and after the intervention. A greater improvement in right-leg total balance (86.6[84.0-90.5] vs 93.8[86.7-99.4];p = 0.035), left-leg total balance(87.8[81.0-89.1] vs 93.6[90.6-100.0];p = 0.013), left-leg anterior balance (71.9[69.1-72.2] vs 74.6[72.0-77.3];p = 0.041), left-leg posteromedial balance (80.5[72.9-83.3] vs 85.9[83.0-94.0];p = 0.048), and left-leg posterolateral balance (79.5[70.4-84.5] vs 85.0[80.0-88.5];p = 0.048) was observed in the SIPP group compared to the GIPP group. No other significant intra-group changes nor inter-group differences were noted. Therefore, compared to a GIPP, a SIPP induced greater improvements in lower-limb dynamic balance in female dancers, potentially leading to greater reduction in lower-limb injury risk.

Factores de Riesgo relacionados al Síndrome de Estrés Medial Tibial en Corredores Competitivos: Una Revisión Sistemática / Risk Factors related to Medial Tibial Stress Syndrome in Competitive Runners: A Systematic Review

Introducción. El síndrome de estrés tibial medial (SEMT) tiene una alta prevalencia entre corredores y genera un negativo impacto funcional. Un gran número de factores de riesgo se asocian con el desarrollo de SEMT, sin embargo, no existe claridad de cuales factores desencadenan la lesión en esta población. Objetivo. Identificar los factores de riesgo relacionados al SEMT en corredores sintetizando la información en una revisión sistemática. Métodos. Se realizó una búsqueda de estudios de cohorte y, casos y controles, en idioma inglés y español, en distintas bases de datos tales como Pubmed, EMBASE, EBSCO, SPORTDiscus, Scopus y Web of Science. Se incluyeron estudios con población de corredores de cross-country y track and field. Se analizaron factores de riesgo asociados a SEMT. Además, Se extrajeron datos como diseño y duración del estudio, definición del SEMT utilizada, características de la población y método diagnóstico. Se evaluó la calidad metodológica con el "NIH Quality Assessment Tool". Resultados. Cinco estudios y 43 factores de riesgo fueron analizados. 18 factores de riesgo presentaron una asociación significativa con SEMT. Los estudios tuvieron entre 64,3-85,7% de calidad metodológica. Los factores de riesgo más analizados fueron sexo, caída del navicular, índice de masa corporal, talla, peso, rango de dorsiflexión de tobillo y rotación de cadera en el plano transverso. Conclusión. Nuestra revisión no permitió determinar un factor de riesgo de SEMT, ya que los resultados entre los estudios fueron contradictorios o solo un estudio mostraba resultados significativos.

Background. Medial tibial stress syndrome (MTSS) has a high prevalence among runners and creates a major functional impact. A large number of risk factors are associated with the development of MTSS, which are not conclusive in this population. Objective: To identify the risk factors associated with MTSS in runners summarizing the gathered data through a systematic review. Methods. A search for cohort and case-control studies retrieved from different databases was conducted in English and Spanish. Studies with cross-country, track, and field runners were covered, in which risk factors associated with MTSS will be analyzed. The extracted data included: the design and duration of the study, the definition of MTSS currently used, the characteristics of the population, the analyzed risk factors, and the diagnostic method. The methodological quality was screened through the use of the "NIH Quality Assessment Tool". Results. Five studies and 43 risk factors were analyzed. Eighteen risk factors had a significant association with MTSS. The studies had a methodological quality of 64.3 -85.7%. The most analyzed risk factors were gender, navicular drop, body mass index, height, weight, range of ankle dorsiflexion and hip rotation in the transverse plane. Conclusion. Our review did not allow us to determine a risk factor for SEMT, since the results between the studies were contradictory or only one study showed significant results.

Psychometric Properties of the PCS and the PCS-4 in Individuals With Musculoskeletal Pain.

BACKGROUND: The factor structure of the Pain Catastrophizing Scale (PCS) has rarely been adequately analyzed (e.g., performing principal component analyses rather than factorial approximations). We aimed to evaluate the psychometric properties of the PCS through a variety of exploratory and confirmatory factorial approaches. METHOD: Three hundred ninety-four Chilean patients with musculoskeletal pain were included (age, M = 49.61, SD = 18.00; 71.57% women). Eight factorial models were proposed to analyze the structure of the data. In addition, validity evidence of the PCS based on relationships with other variables were analyzed considering pain intensity and kinesiophobia. RESULTS: The results suggest a unidimensional structure. Models with more than one dimension exhibited undesirable factor loadings or inadequate indices of fit. Based on these results, a short version of the scale composed of 4 items is proposed (PCS-4). The PCS-4 scores demonstrated high levels of invariance between sex, chronicity, and education groups and also were associated with pain and kinesiophobia. CONCLUSIONS: The results of the PCS-4 Spanish version showed evidence of reliability and validity for adequately measuring pain catastrophizing in Chileans who suffer from musculoskeletal pain. The PCS-4 is a short form that should be explored in future studies (e.g., in other Spanish-speaking populations).

Trail running injury risk factors: a living systematic review.

OBJECTIVE: To review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running. DESIGN: Living systematic review. Updated searches will be done every 6 months for a minimum period of 5 years. DATA SOURCES: Eight electronic databases were searched from inception to 18 March 2021. ELIGIBILITY CRITERIA: Studies that investigated injury risk factors and/or reported the epidemiology of injury in trail running. RESULTS: Nineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7-61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe. CONCLUSION: Limited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.

Transcutaneous Vagal Stimulation in Knee Osteoarthritis (TRAVKO): Protocol of a Superiority, Outcome Assessor- and Participant-Blind, Randomised Controlled Trial.

Current treatments for knee osteoarthritis (KOA) are partially effective. It is, therefore, necessary to find new strategies that can complement the existing ones. In this scenario, transcutaneous vagal stimulation (TVS) neurophysiological effects could be a helpful solution. However, there is no evidence of the efficacy of TVS in KOA. This trial aims to assess the efficacy of TVS in decreasing pain in participants aged 55 years or older with KOA. A randomised controlled, two-arm, double-blind (participants and outcome assessors) and clinical superiority trial will be conducted for 70 patients with KOA. All the participants will carry out an exercise program. It consists of 12 sessions over four weeks. In addition, they will be randomly assigned to (1) active TVS plus physical exercise or (2) sham TVS plus physical exercise. The application of active TVS consists of electronic stimulation of the auricular concha using a portable device. Sham TVS condition consists of the stimulation of the earlobe that does not cause neurophysiological effects. The primary outcome is the reduction in pain intensity. Additionally, functional capacity, physical performance, pain-related interference, pain-related distress, quality of life in older adults and global change will be measured. Assessments will be conducted at the beginning of the study (baseline), at the end of the intervention and after 1 and 3 months of follow-up. This trial will generate evidence regarding the efficacy of TVS in pain perception in individuals with KOA. This information will serve as an input in the clinical decision-making on the use or non-use of TVS in individuals with KOA. Thus, if the efficacy of TVS is confirmed, a new therapeutic tool may be included in the rehabilitation of individuals with KOA.

Psychometric Properties of the PCS and the PCS-4 in Individuals With Musculoskeletal Pain / Propiedades Psicométricas de la PCS y PCS-4 en Individuos con DolorMusculoesquelético

Background: The factor structure of the Pain Catastrophizing Scale (PCS)has rarely been adequately analyzed (e.g., performing principal componentanalyses rather than factorial approximations). We aimed to evaluate thepsychometric properties of the PCS through a variety of exploratory andconfirmatory factorial approaches. Method: Three hundred ninety-fourChilean patients with musculoskeletal pain were included (age, M = 49.61,SD = 18.00; 71.57% women). Eight factorial models were proposed toanalyze the structure of the data. In addition, validity evidence of the PCSbased on relationships with other variables were analyzed considering painintensity and kinesiophobia. Results: The results suggest a unidimensionalstructure. Models with more than one dimension exhibited undesirablefactor loadings or inadequate indices of fit. Based on these results, a shortversion of the scale composed of 4 items is proposed (PCS-4). The PCS-4scores demonstrated high levels of invariance between sex, chronicity, andeducation groups and also were associated with pain and kinesiophobia.Conclusions: The results of the PCS-4 Spanish version showed evidenceof reliability and validity for adequately measuring pain catastrophizing inChileans who suffer from musculoskeletal pain. The PCS-4 is a short formthat should be explored in future studies (e.g., in other Spanish-speakingpopulations).

Antecedentes: la estructura factorial de la Escala deCatastrofización del Dolor (PCS) rara vez se ha analizado adecuadamente. Elobjetivo de este estudio fue evaluar las propiedades psicométricas del PCSa través de diferentes enfoques factoriales exploratorios y confirmatorios.Método: se incluyeron trescientos noventa y cuatro pacientes chilenos condolor musculoesquelético (edad, M=49,61; DE=18,00; 71,57% mujeres). Sepropusieron ocho modelos factoriales. Asimismo, se analizó la evidencia devalidez de la PCS basada en relaciones con otras variables considerando laintensidad del dolor y la kinesiofobia. Resultados: los resultados sugierenuna estructura unidimensional. Los modelos con más de una dimensiónmostraron cargas factoriales o índices de ajuste inadecuados. A partir deestos resultados se propone una versión corta de la escala compuesta por4 ítems (PCS-4). Las puntuaciones de PCS-4 mostraron altos niveles deinvarianza entre sexos, cronicidad del dolor y niveles educativos. La PCS-4también se asoció con otras medias de dolor y kinesiofobia. Conclusiones:los resultados de la PCS-4 versión en español mostraron evidencia defiabilidad y validez para medir adecuadamente el catastrofismo del dolor enchilenos con dolor musculoesquelético. El PCS-4 es una forma corta quedebería explorarse en estudios futuros (por ejemplo, en otras poblacioneshispanoparlantes).

The Effect of Sleep Quality on Pain in Chilean Individuals with Musculoskeletal Disorders.

Poor sleep quality (SQ) negatively affects pain associated with musculoskeletal disorders (MSD). As the level of economic development of a country determines its sanitary conditions, these can influence the sleep-pain relationship; therefore, it is relevant to generate evidence in the population with MSD in developing countries. This cross-sectional study sought to determine the effect of poor SQ on pain in Chilean individuals with MSD, controlling for sex and duration of pain (in months). METHOD: A total of 228 individuals were included. SQ was measured with the Pittsburg Sleep Quality Index (PSQI), pain (intensity, interference and distress relative to pain) was measured with visual analog scales. Structural equation modeling (SEM) was performed to analyze the effect of SQ on pain. RESULTS: A high frequency of poor SQ was present in the studied group, and was more prevalent in women. The SEM model evidenced that poor SQ predicts greater pain. Sex influences sleep quality and pain, but not pain duration. CONCLUSIONS: These findings indicate that poor SQ predicts higher pain in MSD and that women exhibit worse SQ and more significant pain than men. Our findings support that SQ should be considered in the comprehensive approach to pain in individuals with MSD.

Effect of adduction during glenohumeral external rotation exercises in the scapulohumeral muscles / Efecto de la adducción durante ejercicios de rotación externa glenohumeral en los músculos escapulohumerales

SUMMARY: The effect of adduction during glenohumeral external rotation (ER) exercises on the scapulohumeral muscles is controversial. The aim of this study was to evaluate the effect of carrying out adduction during external rotation exercises in low and high shoulder positions on the electromyographic (EMG) activity of the infraspinatus (IS), middle deltoid (MD), and posterior deltoid (PD) muscles. EMG activity of the IS, MD, and PD muscles of 20 healthy participants was evaluated. Subjects performed 6 ER exercises that combined two factors: i) different adduction pressures according to biofeedback unit (0, 5 and 10 mmHg), and ii) low and high shoulder position. The pressure was controlled using a biofeedback unit. The low and high shoulder positions were 20? and 90? of abduction. In the low shoulder position, the activity of the IS muscle increased as the pressure on the biofeedback unit increased and the MD and PD muscles presented the highest activity at 10 mmHg. In the high shoulder position, the activity of the IS muscle was higher at 0 and 10 mmHg, the MD muscle presented higher activity at 5 mmHg, and PD muscle activity did not vary with the pressure. The addition of adduction at a pressure of 5 mmHg in the low shoulder position promotes is activity. Likewise, adduction at a pressure of 10 mmHg will promote activity of the IS, MD, and PD.

RESUMEN: El efecto de la aducción durante los ejercicios de rotación externa (RE) glenohumeral sobre los músculos escapulohumerales es controversial. El objetivo de este estudio fue evaluar el efecto de la realización de la aducción durante los ejercicios de rotación externa en posiciones bajas y altas del hombro sobre la actividad electromiográfica (EMG) delos músculos infraespinoso (IS), deltoides medio (DM) y deltoides posterior (DP). Se evaluó la actividad EMG de los músculos IS, MD y PD de 20 participantes sanos. Los sujetos realizaron 6 ejercicios de RE que combinaron dos factores: i) diferentes presiones de aducción de acuerdo con la unidad de biorretroalimentación (0, 5 y 10 mmHg), y ii) posición del hombro baja y alta. La presión se controló mediante una unidad de biorretroalimentación. Las posiciones del hombro baja y alta fueron de 20? y 90? de abducción. En la posición del hombro bajo, la actividad del músculo IS aumentó a medida que aumentaba la presión sobre la unidad de biorretroalimentación y los músculos MD y PD presentaron la actividad más alta a 10 mmHg. En la posición del hombro alto, la actividad del músculo IS fue mayor a 0 y 10 mmHg, el músculo MD presentó mayor actividad a 5 mmHg y la actividad del músculo PD no varió con la presión. La adición de aducción a una presión de 5 mmHg en la posición baja del hombro promueve la actividad del músculo IS. Asimismo, la aducción a una presión de 10 mmHg promoverá la actividad del IS, MD y PD.

Clinical characteristics and evolution of hematological patients and COVID-19 in Argentina: a report from the Argentine Society of Hematology.

Individuals with malignancies and COVID-19 have a lower survival compared with the general population. However, the information about the impact of COVID-19 on the whole hematological population is scarce. We aimed to describe the 30th day overall survival (OS) after COVID-19 infection in patients with a hematological disease in Argentina. A completely anonymous survey from the Argentine Society of Hematology was delivered to all the hematologists in Argentina; it started in April 2020. A cut-off to analyze the data was performed in December 2020 and, finally, 419 patients were reported and suitable for the analysis (average age: 58 years, 90% with malignant diseases). After the COVID-19 diagnosis, the 30-day OS for the whole population was 80.2%. From the entire group (419), 101 (24.1%) individuals required intensive care unit admission, where the 30-day OS was 46.6%. Among allogeneic stem cell transplant recipients, the 30-day OS was 70.3%. Factors associated with a low OS were two or more comorbidities, an active hematological disease and history of chemotherapy. In individuals with the three factors, the 30-day OS was 49.6% while the 30-day OS in those without those factors was 100%. Patients with hematological diseases have a higher mortality than the general population. This group represents a challenge and requires careful decision-making of the treatment in order not to compromise the chances of cure.

El presente estudio tuvo por objetivo primario conocer la mortalidad de pacientes con enfermedad hematológica que presentaron infección por COVID-19 en Argentina. Para ello se difundió una encuesta desde la Sociedad Argentina de Hematología (SAH) entre los hematológos para informar sobre los pacientes con enfermedades hematológicas y diagnóstico de infección por SARS- CoV-2, entre el 19/4/2020, y el 7/12/2020. Se incluyeron individuos de todas las edades con diagnóstico de enfermedad hematológica benigna o maligna e infección por SARS-CoV-2 confirmada por técnica de RTPCR. Se analizaron 419 pacientes (mediana 58 años; 90% enfermedades malignas). La supervivencia al día 30 fue de 80.2%. La supervivencia fue menor en aquellos que requirieron internación (74.2%), cuidados intensivos (46.6%) y asistencia respiratoria mecánica (36.8%). Entre los trasplantados alogénicos la supervivencia fue 70.3%. Los factores vinculados a la supervivencia global fueron las comorbilidades, el estado de la enfermedad al momento de la infección y el antecedente de quimioterapia. Se pudo establecer un score en el que aquellos que tuvieron un puntaje de 4 alcanzaron una supervivencia del 49.6% al día 30, mientras que la de los pacientes con score 0 fue del 100% a 30 días. En comparación con la población general, los pacientes con enfermedades hematológicas presentan una mayor mortalidad vinculada al COVID-19, motivo por el cual es primordial definir pautas destinadas a disminuir la exposición de los mismos sin comprometer las posibilidades de beneficiarse del tratamiento de la enfermedad de base.

Clinical characteristics and evolution of hematological patients and COVID-19 in Argentina: a report from the Argentine Society of Hematology / Características clínicas y evolución de pacientes hematológicos y COVID-19 en Argentina: datos de la Sociedad Argentina de Hematología

Abstract Individuals with malignancies and COVID-19 have a lower survival compared with the general population. However, the information about the impact of COVID-19 on the whole hematological population is scarce. We aimed to describe the 30th day overall survival (OS) after COVID-19 infection in pa tients with a hematological disease in Argentina. A completely anonymous survey from the Argentine Society of Hematology was delivered to all the hematologists in Argentina; it started in April 2020. A cut-off to analyze the data was performed in December 2020 and, finally, 419 patients were reported and suitable for the analysis (average age: 58 years, 90% with malignant diseases). After the COVID-19 diagnosis, the 30-day OS for the whole population was 80.2%. From the entire group (419), 101 (24.1%) individuals required intensive care unit admission, where the 30-day OS was 46.6%. Among allogeneic stem cell transplant recipients, the 30-day OS was 70.3%. Factors associated with a low OS were two or more comorbidities, an active hematological disease and history of chemotherapy. In individuals with the three factors, the 30-day OS was 49.6% while the 30-day OS in those without those factors was 100%. Patients with hematological diseases have a higher mortality than the general population. This group represents a challenge and requires careful decision-making of the treatment in order not to compromise the chances of cure.

Resumen El presente estudio tuvo por objetivo primario conocer la mortalidad de pacientes con enfermedad hematológica que presentaron infección por COVID-19 en Argentina. Para ello se difundió una encuesta desde la Sociedad Argentina de Hematología (SAH) entre los hematológos para informar sobre los pacientes con enfermedades hematológicas y diagnóstico de infección por SARS- CoV-2, entre el 19/4/2020, y el 7/12/2020. Se incluyeron individuos de todas las edades con diagnóstico de enfermedad hematológica benigna o maligna e infección por SARS-CoV-2 confirmada por técnica de RT-PCR. Se analizaron 419 pacientes (mediana 58 años; 90% enfermedades malignas). La supervivencia al día 30 fue de 80.2%. La supervivencia fue menor en aquellos que requirieron internación (74.2%), cuidados intensivos (46.6%) y asistencia respiratoria mecánica (36.8%). Entre los trasplantados alogénicos la supervivencia fue 70.3%. Los factores vinculados a la supervivencia global fueron las comorbilidades, el estado de la enfermedad al momento de la infección y el antecedente de quimioterapia. Se pudo establecer un score en el que aquellos que tuvieron un puntaje de 4 alcanzaron una supervivencia del 49.6% al día 30, mientras que la de los pacientes con score 0 fue del 100% a 30 días. En comparación con la población general, los pacientes con enfermedades hematológicas presentan una mayor mortalidad vinculada al COVID-19, motivo por el cual es primordial definir pautas destinadas a disminuir la exposición de los mismos sin comprometer las posibilidades de beneficiarse del tratamiento de la enfermedad de base.

Frequency of Injury and Illness in the Final 4 Weeks before a Trail Running Competition.

We aimed to (i) determine self-reported injury and illness frequency in trail runners 4 weeks preceding competition; (ii) compare athletes with and without injury/illness by sex, age, body mass index (BMI) and competition distance; (iii) describe mechanism of injury, anatomical region (injury)/organ system (illness) involved, consequences of injury on preparation and self-perception of injury severity; (iv) compare anatomical region (injury) and organ system (illness) by sex. A total of 654 trail runners (age 36.2, IQR 30.6-43.0; 36.9% females) participated in this retrospective cross-sectional study by completing a self-reported questionnaire. Injury and illness frequency rates were 31.3% (n = 205, CI: 27.7-35.0%) and 22.3% (n = 146, CI: 19.1-25.7%), respectively. No significant difference was found between injured vs. non-injured or ill vs. non-ill study participants by sex, age, BMI and competition distance. Regarding injuries, gradual onset (41.6%) and knee (33.2%) were the most indicated mechanism and anatomical region of injury. At least 85.4% of trail runners changed their training following injury and 79% indicated that their injury would affect their competition performance. Regarding illness, the respiratory tract was the most frequent organ system involved (82.9%). Male and female participants reported similar proportions of anatomical regions (injury) and organ systems (illness) affected. These results could help to generate education strategies and appropriate medical support before and during these competitions.

Association between sleep quality and pain in young amateur athletes / Asociación entre calidad del sueño y dolor en jóvenes atletas amateurs / Associação entre qualidade do sono e dor em jovens atletas amadores

ABSTRACT Introduction: It has been shown that there is a close association between sleep quality and pain. In young athletes, sleep disorders and pain have a particularly high prevalence; however, the relationship between them has not been widely studied. Objective: To study the association between sleep quality and pain in young athletes. Methods: A cross-sectional study was conducted in which 71 young amateur athletes (39 males) were included. The mean age was 16.9 ± 1.2 years, with 6.5 ± 3.2 years of sports practice and 5.2 ± 1.2 hours of training per week. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The participants were classified according to sleep quality, as PSQI-I = without sleep disorders, PSQI-II = requiring medical assistance and PSQI-III = requiring medical assistance and treatment. Also, pain intensity was assessed on the Numerical Rating Scale, both at rest (NRSr) and during sports activity (NRSs), along with pain duration. Results: The individuals classified as PSQI-III presented higher NRSr (Mdn = 2.0; IQR = 4.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.04) and higher NRSs (Mdn = 4.0; IQR = 5.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.03) than the individuals classified as PSQI-I. No differences were observed in relation to pain duration. The PSQI score was positively but weakly associated with NRSr (rs = 0.24, p=0.046) and NRSs (rs = 0.27, p = 0.03) but not with pain duration. Conclusion: Young athletes with lower levels of sleep quality show higher levels of pain at rest and during sports practice. Therefore, sleep quality and pain should be considered in the routine assessment of young athletes, by technical and health teams. Level of evidence III; type of study: Cross-sectional .

RESUMEN Introducción: Se demostró que existe estrecha relación entre calidad del sueño y dolor. En atletas jóvenes, los disturbios del sueño y dolor tienen prevalencia bastante alta, sin embargo, la relación entre ellos no fue ampliamente estudiada. Objetivo: Estudiar la asociación entre calidad del sueño y dolor en atletas jóvenes. Métodos: Fue realizado un estudio transversal, en el cual fueron incluidos 71 atletas jóvenes amateurs (39 hombres). El promedio de edad fue de 16,9 ± 1,2 años, con 6,5 ± 3,2 años de práctica deportiva y 5,2 ± 1,2 horas de entrenamiento por semana. La calidad del sueño fue evaluada por medio del Índice de Calidad del Sueño de Pittsburgh (PSQI). Los participantes fueron clasificados de acuerdo con la calidad del sueño, PSQI-I= sin disturbios del sueño, PSQI-II= requiere atención médica y PSQI-III= requiere atención médica y tratamiento. Además, la intensidad del dolor fue evaluada en la Escala de Evaluación Numérica en reposo (EANr) y durante la actividad deportiva (EANe), juntamente con la duración del dolor. Resultados: Los individuos clasificados como PSQI-III presentaron mayor valor en el EANr (Mdn = 2,0; IQR = 4,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,04) y EANe mayores (Mdn = 4,0; IQR = 5,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,03) que los individuos clasificados con PSQI-I. No fue observada ninguna diferencia con relación a la duración del dolor. El puntaje del PSQI fue positivo y con débil asociación a EANr (rs = 0,24, p=0.046) y EANe (rs = 0,27, p = 0,03), pero no con la duración del dolor. Conclusión: Los atletas jóvenes con niveles más bajos de calidad del sueño tienen niveles más elevados de dolor en reposo y durante la práctica deportiva. Por lo tanto, la calidad del sueño y el dolor deben ser considerados por los equipos técnicos y de salud en la evaluación rutinaria de atletas jóvenes. Nivel de evidencia III;Tipo de estudio: Transversal.

RESUMO Introdução: Demonstrou-se que existe estreita associação entre qualidade do sono e dor. Em atletas jovens, distúrbios do sono e dor têm prevalência bastante alta, no entanto, a relação entre eles não foi amplamente estudada. Objetivo: Estudar a associação entre qualidade do sono e dor em atletas jovens. Métodos: Foi realizado um estudo transversal, no qual foram incluídos 71 atletas jovens amadores (39 homens). A média de idade foi de 16,9 ± 1,2 anos, com 6,5 ± 3,2 anos de prática esportiva e 5,2 ± 1,2 horas de treinamento por semana. A qualidade do sono foi avaliada por meio do Índice de Qualidade do Sono de Pittsburgh (PSQI). Os participantes foram classificados de acordo com a qualidade do sono, PSQI-I = sem distúrbios do sono, PSQI-II = requer atendimento médico e PSQI-III = requer atendimento médico e tratamento. Além disso, intensidade da dor foi avaliada na Escala de Avaliação Numérica em repouso (EANr) e durante a atividade esportiva (EANe), juntamente com a duração da dor. Resultados: Os indivíduos classificados como PSQI-III apresentaram maior valor no EANr (Mdn = 2,0; IQR = 4,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,04) e EANe maiores (Mdn = 4,0; IQR = 5,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,03) do que os indivíduos classificados com PSQI-I. Nenhuma diferença foi observada com relação à duração da dor. O escore do PSQI foi positivo e com fraca associação a EANr (rs= 0,24, p=0.046) e EANe (rs= 0,27, p = 0,03), mas não com a duração da dor. Conclusão: Atletas jovens com níveis mais baixos de qualidade do sono têm níveis mais elevados de dor em repouso e durante a prática esportiva. Portanto, a qualidade do sono e a dor devem ser consideradas pelas equipes técnicas e de saúde na avaliação rotineira de atletas jovens. Nível de evidência III; Tipo de estudo: Transversal.

Recommendations for the sale and promotion of dermocosmetic treatments at the office.

A novel chapter in current medical settings is the promotion and attention of esthetic aspects rather than health issues by health professionals. The human aspiration related to the search for personal beauty has generated new scenarios in medical practice. The Committee on Ethics and Transparency in the Physician-Industry Relationship (CETREMI) of the National Academy of Medicine of Mexico has analyzed this phenomenon and has issued recommendations directed both to medical professionals and to producers and potential consumers of esthetic procedures.

Un capítulo novedoso es la atención y promoción por parte de médicos especialistas de aspectos relacionados con procedimientos estéticos, más que con la salud. La aspiración humana de la búsqueda de la belleza personal ha generado nuevos escenarios en la labor médica. El Comité de Ética y Transparencia en la Relación Médico Industria (CETREMI) de la Academia Nacional de México ha revisado esta circunstancia y emite recomendaciones tanto a los médicos como a los productores y potenciales consumidores de procedimientos estéticos.

Importancia del cuadro básico de medicamentos en la prescripción médica / Importance of the list of essential medicines in medical prescription

Resumen La implementación en instituciones de salud de un cuadro básico permite adquirir y administrar una larga lista de medicamentos que presenta a los médicos las alternativas de tratamiento, así como la descripción académica colegiada de indicaciones, dosis, efectos secundarios, interacciones y análisis de costo-beneficio, con lo que se facilita la prescripción médica y la administración de insumos para la salud. El Comité de Ética y Transparencia en la Relación Médico-Industria emite diversas recomendaciones para la optimización de los beneficios generados por los cuadros básico de medicamentos.

Abstract The implementation of an essential medicines list in health institutions allows acquiring and administering a long list of drugs that offers treatment alternatives to physicians, as well as a collegiate academic description of indications, doses, side effects, interactions and cost-benefit analyses, thus facilitating medical prescription and administration of health products. The Committee of Ethics and Transparency in the Physician-Industry Relationship issues several recommendations for optimizing the benefits generated by essential medicines lists.

Automedicación y autoprescripción / Self-medication and self-prescription

Resumen La automedicación y la autoprescripción son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violación a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicación en realidad lo son de la autoprescripción.

Abstract Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription.

La receta médica: ¿reflejo condicionado o reflexión consciente? / Medical prescription: conditioned reflex or conscious reflection?

Resumen Extender una receta o indicar un tratamiento suele ser la última parte de la consulta médica. Este proceso crucial puede desvirtuarse debido a múltiples factores como capacidad prescriptiva limitada, exceso de trabajo y falta de reflexión o tiempo. La información insuficiente acerca del paciente o del tratamiento afecta el proceso prescriptivo y propicia errores que pueden ser graves para la salud del enfermo. La Academia Nacional de Medicina, en consonancia con la Organización Mundial de la Salud, hace énfasis en hacer del proceso prescriptivo un ejercicio de reflexión.

Abstract Writing a prescription or indicating a treatment is usually the last part of medical consultation. This crucial process can be undermined by multiple factors such as limited prescriptive ability, overwork, and lack of reflection or time. Insufficient information about the patient or the treatment affects the prescriptive process and leads to errors that can be serious for patient health. The National Academy of Medicine, in line with the World Health Organization, emphasizes the relevance of making the prescriptive process a reflective exercise.

Recomendaciones para la venta y promoción en el consultorio de tratamientos dermocosméticos / Recommendations for the sale and promotion of dermocosmetic treatments at the office

Resumen Un capítulo novedoso es la atención y promoción por parte de médicos especialistas de aspectos relacionados con procedimientos estéticos, más que con la salud. La aspiración humana de la búsqueda de la belleza personal ha generado nuevos escenarios en la labor médica. El Comité de Ética y Transparencia en la Relación Médico Industria (CETREMI) de la Academia Nacional de México ha revisado esta circunstancia y emite recomendaciones tanto a los médicos como a los productores y potenciales consumidores de procedimientos estéticos.

Abstract A novel chapter in current medical settings is the promotion and attention of esthetic aspects rather than health issues by health professionals. The human aspiration related to the search for personal beauty has generated new scenarios in medical practice. The Committee on Ethics and Transparency in the Physician-Industry Relationship (CETREMI) of the National Academy of Medicine of Mexico has analyzed this phenomenon and has issued recommendations directed both to medical professionals and to producers and potential consumers of esthetic procedures.