Fiabilidad intraexaminador e interexaminador de Clinometer para medir el rango de movimiento en pacientes con artrosis de cadera / Test–retest and inter-rater reliability of Clinometer for measuring range of motion in patients with hip osteoarthritis

Objetivo Evaluar la fiabilidad intraexaminador e interexaminador de la aplicación Clinometer para medir el rango de movimiento (RDM) de la cadera en pacientes con artrosis de cadera y su correlación con el goniómetro universal. Métodos Se diseñó un estudio de medidas repetidas en el que se incluyeron 35 pacientes con artrosis de cadera. Se registró el RDM de rotación interna, externa, flexión y extensión de cadera mediante la aplicación Clinometer por 2 examinadores independientes. Se calculó la fiabilidad intraexaminador e interexaminador utilizando el coeficiente de correlación intraclase, y se calculó el error estándar de medición y el cambio mínimo detectable. Se utilizó el coeficiente de correlación de Pearson para correlacionar la aplicación Clinometer con el goniómetro universal. Resultados La aplicación Clinometer mostró una fiabilidad excelente tanto intraexaminador (coeficiente de correlación intraclase: 0,82-0,96) como interexaminador (coeficiente de correlación intraclase: 0,81-0,95) para todos los RDM de la cadera valorados. La correlación entre este instrumento y el goniómetro universal mostró ser fuerte para todos los RDM de la cadera (r>0,70). Conclusión La aplicación Clinometer ha mostrado unos niveles de fiabilidad excelentes para la medición del RDM de rotación interna, externa, flexión y extensión de la cadera en pacientes con artrosis y presenta una fuerte correlación con el goniómetro universal (AU)

Objective To evaluate the test–retest and inter-rater reliability of the application Clinometer for measuring the hip range of motion (ROM) in patients with hip osteoarthritis and its correlation with the universal goniometer. Methods A blinded repeated measured was carried out with 35 patients with hip osteoarthritis. Hip internal rotation, external rotation, flexion and extension ROM were measured using Clinometer app by 2 independents raters. The intraclass correlation coefficient was used to calculate the test–retest reliability and inter-rater reliability. The standard error measurement and minimal detectable change were also calculated. The Pearson's correlation coefficient was used to correlate the app with the universal goniometer. Results Clinometer application achieved excellent test–retest reliability (intraclass correlation coefficient: 0.82-0.96) and inter-rater reliability (intraclass correlation coefficient: 0.81-0.95) in all the ROMs assessed. The correlation analysis with the universal goniometer showed strong correlation values (r>0.70) in all the ROMs assessed. Conclusion Clinometer application presented excellent test–retest reliability and inter-rater reliability for the measurement of hip ROM in patients with hip osteoarthritis. The smartphone application showed a strong correlation compared to universal goniometer (AU)

¿Es el estiramiento pasivo del cuádriceps igual de efectivo que el autoestiramiento en jugadores de fútbol? Ensayo clínico aleatorizado / Is quadriceps passive stretching as effective as self-stretching in soccer athletes? Randomized clinical trial

Objetivo Comparar los efectos de un estiramiento pasivo del músculo cuádriceps frente a un autoestiramiento en la flexibilidad de los músculos del muslo y el rango de movimiento (ROM) de la cadera en jugadores de fútbol. Métodos Se diseñó un ensayo clínico aleatorizado en el que se incluyeron 34 jugadores de fútbol amateur con déficit de flexibilidad en el músculo cuádriceps. Los jugadores fueron aleatorizados en dos grupos (grupo estiramiento o grupo autoestiramiento). Cada participante recibió una única sesión de estiramiento pasivo o autoestiramiento del cuádriceps en su pierna dominante. Se valoró la flexibilidad del cuádriceps mediante el test de Ely, la flexibilidad de los isquiotibiales mediante el Passive Knee Extension test, y ROM de flexión y extensión de la cadera. Resultados Ambos grupos mostraron un aumento estadísticamente significativo de la flexibilidad del cuádriceps, de la flexibilidad de los isquiotibiales y del ROM de extensión de la cadera sin diferencias significativas entre ellos (p>0,05). El grupo estiramiento mostró unos tamaños del efecto grandes en la flexibilidad y el ROM de extensión (d>0,8), siendo superiores a los registrados en el grupo autoestiramiento. Conclusiones La flexibilidad de los músculos cuádriceps e isquiotibiales, así como el ROM de extensión de cadera aumentaron tras el estiramiento y el autoestiramiento del músculo cuádriceps. Los tamaños del efecto mostrados por el grupo estiramiento fueron superiores a los del grupo autoestiramiento (AU)

Objective To compare the effects of quadriceps passive stretching or quadriceps self-stretching in muscle flexibility and hip range of motion (ROM) in football athletes. Methods A randomized clinical trial was carried out. Thirty-four football athletes with lack of flexibility in the quadriceps muscle were included and randomized in two groups (Stretching group or self-stretching group) and received a single session of quadriceps passive stretching or quadriceps self-stretching in the dominant lower limb. The outcome variables were: quadriceps flexibility measured with the Ely's test, hamstring flexibility measured with the Passive Knee Extension test and hip flexion and extension ROM. Results Both groups achieved a statistically significant improvement of quadriceps flexibility, hamstrings flexibility and hip extension ROM without statistically significant differences between them (p>0.05). The stretching group reported large effect sizes in muscle flexibility and hip extension ROM (d>0.8), and the effect sizes of the stretching group were higher than the self-stretching group. Conclusions Flexibility of the quadriceps and hamstring muscles as well as hip extension ROM increased after stretching and self-stretching of the quadriceps muscle. The effect sizes shown by the stretching group were higher than those of the self-stretching group (AU)

Prevalence of celiac disease in Argentina: screening of an adult population in the La Plata area.

OBJECTIVES: Up to now, the epidemiological characteristic of celiac disease among adults in South America remains unknown. The present prospective screening was designed to determine the prevalence of celiac disease in adults from the general population in an urban area of Argentina. METHODS: Between January. 1998, and May, 2000, all couples attending a centralized laboratory for an obligatory prenuptial examination in the La Plata area were offered participation in a screening program for celiac disease. The study included 2000 subjects (996 women; median age 29 yr, range 16-79 yr). All individuals completed a clinical questionnaire at the time that serum samples were obtained. A three-step screening protocol was used, as follows: 1) all samples were tested for antigliadin antibodies (AGAs) (type IgA and IgG); 2) samples that were IgA AGA positive were tested for antiendomysial antibody (EmA type IgA); samples that were positive for AGA-G but negative for IgA AGAs were tested for total IgA serum levels and EmA type IgG; and 3) subjects who were EmA-positive were referred for intestinal biopsy. RESULTS: At the end of the screening we detected 10 subjects who were EmA-A positive and two others who were IgA-deficient (both were EmA-G positive). Up to now, 11 of the 12 subjects (including nine EmA-positive and two IgA-deficient subjects) had endoscopic intestinal biopsies showing the characteristic celiac histology. The remaining EmA-positive individual was considered to be affected by celiac disease. The overall prevalence assessed was 1:167 (6.0 x 1000 subjects; 95% CI = 3.1-10.5). Eight of the 12 (67%) subjects were female (1:124; 8.0 x 1000; 95% CI = 3.5-15.8) and four (33%) were male (1:251; 4.0 x 1000; 95% Cl = 1.1-10.2). Although eight new patients were considered to be asymptomatic, three presented with a subclinical course and one was classically symptomatic. Only one patient had been previously diagnosed with celiac disease. CONCLUSIONS: Our screening protocol showed a very high prevalence of celiac disease for an urban area of Argentina that is ethnically similar to 90% of the general population of the country. The prevalence among women was double that for men, and the heterogeneous clinical picture of new patients showed predominance of asymptomatic cases.

[HCV prevalence in health workers]. / Prevalencia de HBV en el personal de salud.

The risk of HBV infections in health workers and the different prevalence according to the hospital activities has been shown in a great number of papers. In order to establish the prevalence of serological HBV markers in health workers fron high complexity hospital, we have analyzed 730 inquiries refilled in the period 1994-1995 before receiving the antihepatitis B vaccine. We studied 730 health workers, 282 (38.8%) males and 447 (61.2%) females with a mean age of 40.1 years old. We found 75/730 (10.2) serums antiçHBc reactives. The found prevalence was significantly larger than the one found in blood donors. The analysis of the prevalence according to the hospital activities showed that the infirmary personnel is the only with anti-HBc prevalence significantly superior to the blood donors, and the other health workers prevalence. Differences in the anti-HBc prevalence between the physicians specialties were not found. Our results agree with other publications that clearly show that health workers are a risk group for HBV infection. However, what attracts attention in the analyzed population is that the only ones with anti-HBc prevalence significantly superior to the blood donors' and the other health workers prevalence were the nurses, suggesting that nurses are the only health workers that have risk of HBV infections.