Efectividad de los protocolos de fisioterapia para pacientes con dolor lumbar crónico. Una revisión sistemática / Effectiveness of physiotherapy protocols for patients with chronic low back pain: A systematic review

Introducción: El dolor lumbar crónico es una de las principales causas de incapacidad laboral en el mundo. Requiere un abordaje interdisciplinario para la evolución del paciente. Hasta el momento, no existe consenso en el manejo del dolor lumbar crónico, lo que generó la inquietud de esta revisión sistemática. Objetivo: Identificar la efectividad de los protocolos de fisioterapia en el manejo del dolor lumbar crónico. Metodología: Se realizó una búsqueda sistemática en las bases de datos Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari y LILACS, Google Scholar, Teseo y PROSPERO, desde el inicio de las bases hasta agosto de 2021. Los criterios de selección se definieron según la intervención y el tema del artículo. Resultados: Se incluyeron 26 estudios en la síntesis cualitativa, se excluyeron artículos que no cumplieran con los criterios de inclusión. Se encontró efecto en el control del dolor y la disminución de la discapacidad y las principales intervenciones son: fortalecimiento muscular del Core y miembros inferiores, estiramiento de miembros inferiores, movilidad lumbopélvica y educación o escuela de espalda. La frecuencia en el tratamiento osciló entre 2 y 3 veces por semana durante 5 semanas. Conclusiones: Se encontró mayor efectividad en el tiempo de control del dolor y la disminución de la discapacidad, relacionados principalmente con el fortalecimiento muscular del Core y las estrategias educativas.(AU)

Introduction: Chronic low back pain is one of the main causes of incapacity for work in the world. It requires an interdisciplinary approach for the evolution of the patient. Until now, there is no consensus on the management of chronic low back pain, which generated the concern of this systematic review. Aim: To identify the effectiveness of physiotherapy protocols in the management of chronic low back pain. Methodology: A systematic search was carried out in the Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari and LILACS, Google Scholar, Teseo and PROSPERO databases, from the beginning of the databases until August, 2021. The selection criteria were defined according to the intervention and topic of the article. Results: Twenty-six studies were included in the qualitative synthesis, articles that did not meet the inclusion criteria were excluded. An effect was found in the control of pain and the reduction of disability and the main interventions are: muscular strengthening of the core and lower limbs, stretching of the lower limbs, lumbopelvic mobility and education or back school. The treatment frequency ranged from 2 to 3 times per week for 5 weeks. Conclusions: Greater effectiveness was found in pain control time and disability reduction, mainly related to core muscle strengthening and educational strategies.(AU)

Ability of six Latin American antivenoms to neutralize the venom of mapaná equis (Bothrops atrox) from Antioquia and Chocó (Colombia).

This investigation compared the ability of six Latin American antivenoms (monovalent antibothropic INS, Santafé de Bogotá; polyvalent INS; polyvalent probiol, Santafé de Bogotá; antibothropic Instituto Butantan, IB, São Paulo, Brazil; polyvalent Instituto Clodomiro Picado, ICP, San José, Costa Rica; polyvalent MYN, Mexico) to neutralize various pharmacological and enzymatic effects of Bothrops atrox venom from Antioquia and Chocó, north-west of Colombia. Our results demonstrated conspicuous differences in the ability of the six antivenoms. In terms of neutralization of lethality, the highest efficacy was observed in the polyvalent INS and the lowest in the polyvalent MYN antivenom. All antivenoms were highly effective in the neutralization of hemorrhage, polyvalent INS and probiol being the highest. In the neutralization of edema-forming activity, the most effective antivenom was the polyvalent (ICP); monovalent (INS) and polyvalent (MYN) were the least effective. All antivenoms were effective in the neutralization of the myotoxic activity of B. atrox venom, the most effective being the polyvalent (INS) and antibothropic (IB). Defibrinating activity was neutralized by all antivenoms; polyvalent (MYN) showed the lowest efficiency. Polyvalent (ICP) antivenom had the highest neutralizing ability against the indirect hemolytic effect of B. atrox venom; polyvalent (MYN) did not neutralize this enzymatic activity. Overall, the polyvalent antivenom (INS) showed the highest neutralizing ability.

Responses to excess dietary magnesium as affected by experimental Eimeria acervulina infection or by dietary ammonium chloride ingestion in the chick.

Three experiments were conducted to investigate the effect of experimental Eimeria acervulina infection on excess Mg ingestion in the chick and to investigate the effect of NH4Cl addition to the diet on the coccidiosis X Mg interaction. Two Mg sources were evaluated, MgO and MgSO4 X 7H2O. Gain, efficiency of feed utilization, bone ash percent (BAP), bone Ca and duodenal pH were lower in coccidiosis-infected chicks than in uninfected chicks. However, bone P and bone Mg levels were higher as a result of the coccidial infection. Bone Mg levels were higher and bone Ca levels and BAP were lower in chicks fed excess dietary Mg, either as the oxide or sulfate forms. Gain and feed efficiency of chicks fed excess Mg, as MgO but not as MgSO4 X 7H2O, were lower than in chicks fed the basal level of Mg. Coccidiosis X Mg interactions were observed in bone Mg and bone Ca concentration data; bone Mg uptake was greater when high dietary Mg and the coccidial infection were in combination. In some instances, a similar interactive effect was observed in bone Ca concentration data; bone Ca loss tended to be greater as a result of the combination of high dietary Mg and the coccidial infection.

Muerte subita. Estudio prospectivo de un ano en Medellin-Colombia. / Sudden death. Prospective study of 1 year in Meddellin-Colombia

El estudio prospectivo de un ano (1982) de las muertes subitas e inesperadas que fueron estudiadas en el Instituto de Medicina Legal de Medellin - Colombia, demostro que el 13.9% fueron en ninos; el 4.9% en adolescentes, y el 81.1% en adultos. Hubo 61.4% hombres y 38.5% mujeres. En adultos las causas mas frecuentes fueron las cardiovasculares (52.5%), seguidas por las de origen del sistema nervioso central(19.3%) Se noto incidencia significativa de cifras altas de glicemia y de problemas alcoholicos en personas que murieron subitamente.En 2.2%, a pesar de los estudios post-mortem, de los estudios histologicos, de las pruebas toxicologicas y bioquimicas,no pudo determinarse la causa de la muerte

Trauma fatal del sistema nervioso central. Estudio clinico y patologico. / Fatal trauma of central nervous system. Clinical and pathological study

Un estudio consecutivo de 100 casos de trauma encefalocraneano fatal en pacientes que alcanzaron a tener evaluacion neurologica, demostro que las causas mas frecuentes en nuestro medio fueron los accidentes de transito, las caidas y las lesiones por proyectil de arma de fuego. Fue notorio el predominio del sexo masculino (90%). No hubo signos externos de trauma en el 14%, ni fracturas en el 29%; en 28% hubo hematoma extradural; hematoma subdural en 44%.Se presento un 4% de meningitis post-traumatica y un absceso; en 5% existio como complicacion hidrocefalia bilateral y simetrica, y aneurisma post-traumatico en uno. La trombosis de los senos venosos se presento en 3% y hubo 2% de oclusiones de vasos arteriales