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1.
Rehabilitación (Madr., Ed. impr.) ; 54(3): 211-214, jul.-sept. 2020. ilus
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET1-6074

RESUMO

La epicondilitis es una entidad que provoca discapacidad y tiende a cronificar. Histológicamente, existen lesiones degenerativas en el tendón extensor común del antebrazo, visibles mediante ecografía o resonancia magnética. Existen diversas medidas terapéuticas conservadoras, incluida la infiltración con corticoide por referencia anatómica; pero en ocasiones fracasan, y los pacientes son propuestos para cirugía. La ecografía como herramienta terapéutica permite realizar procedimientos sin apertura cutánea sobre los tendones. En 2006, se publicó la realización de una tenotomía percutánea ecoguiada para el tratamiento de la epicondilitis crónica. La técnica, mostrada hasta ahora por cirujanos y radiólogos, intenta transformar un proceso degenerativo crónico con fallo en la reparación, en un proceso inflamatorio agudo con perspectivas de autorregeneración. Nuestro objetivo es describir 5 casos clínicos de epicondilitis con fracaso de las medidas terapéuticas habituales, en los que se realiza una tenotomía percutánea ecoguiada en la propia consulta, con resultados favorables


Epicondylitis causes disability and tends to become chronic. Histologically, degenerative lesions are found in the common extensor tendon, which are visible on ultrasound or magnetic resonance imaging. Several conservative therapeutic measures are available, including corticosteroid infiltration by anatomical landmark. However, these measures sometimes fail, in which case patients are proposed for surgery. Ultrasound is a therapeutic tool that allows procedures on tendons to be performed without skin incisions. The technique of ultrasound-guided percutaneous tenotomy for the treatment of chronic epicondylitis was first reported in 2006. This procedure, demonstrated to date by surgeons and radiologists, attempts to transform a chronic degenerative process with failure to repair into an acute inflammatory process with self-regeneration. The aim of this study was to describe 5 cases of epicondylitis that failed to respond to routine therapeutic measures, in which we used ultrasound-guided percutaneous tenotomy with favourable results

3.
Artigo em Inglês | MEDLINE | ID: mdl-32663479

RESUMO

OBJECTIVES: To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. DESIGN: Randomized, single-blind, controlled trial. SETTING: A Spanish nursing home in the autonomous community of Extremadura, Spain. PARTICIPANTS: An initial sample was created by recruiting 148 older adult volunteers. The final sample (N=42) was randomly divided into 2 groups. INTERVENTIONS: Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), with each session lasting 55 minutes. MAIN OUTCOME MEASURES: Timed Up and Go (TUG), Cooper, Tinetti, 1-leg stance, and the Morse Fall Scale (MFS). RESULTS: Analysis of variance showed a time × group interaction in TUG score (F=10.41, P=.002), Cooper test (F=5.94, P=.019), Tinetti score (F=6.41, P=.015), and MFS scores (F=5.24, P=.028). Differences between groups were achieved for TUG scores (d=0.76), Tinetti scores (d=1.12), 1-leg stance test scores (d=0.77), and MFS scale scores (d=0.85). In the experimental group, within-group analyses showed pre- to post-treatment differences for TUG scores (d=0.72), Cooper test scores in meters (d=0.18), Tinetti scores (d=0.60), 1-leg stance scores (d=0.55), and MFS scores (d=0.42). CONCLUSIONS: A proprioceptive exercise program demonstrated significant improvements compared with the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program.

4.
Rehabilitacion (Madr) ; 54(3): 211-214, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32563618

RESUMO

Epicondylitis causes disability and tends to become chronic. Histologically, degenerative lesions are found in the common extensor tendon, which are visible on ultrasound or magnetic resonance imaging. Several conservative therapeutic measures are available, including corticosteroid infiltration by anatomical landmark. However, these measures sometimes fail, in which case patients are proposed for surgery. Ultrasound is a therapeutic tool that allows procedures on tendons to be performed without skin incisions. The technique of ultrasound-guided percutaneous tenotomy for the treatment of chronic epicondylitis was first reported in 2006. This procedure, demonstrated to date by surgeons and radiologists, attempts to transform a chronic degenerative process with failure to repair into an acute inflammatory process with self-regeneration. The aim of this study was to describe 5 cases of epicondylitis that failed to respond to routine therapeutic measures, in which we used ultrasound-guided percutaneous tenotomy with favourable results.

5.
Rev. esp. anestesiol. reanim ; 67(5): 253-260, mayo 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-186843

RESUMO

En diciembre del 2019, la Comisión Municipal de Salud y Sanidad de Wuhan (provincia de Hubei, China) informó de una serie de casos de neumonía de etiología desconocida. El 7 de enero del 2020, las autoridades chinas identificaron como agente causante del brote un nuevo tipo de virus de la familia Coronaviridae, denominado SARS-CoV-2. Desde entonces, se han notificado miles de casos con una diseminación global. Las infecciones en humanos provocan un amplio espectro clínico que va desde infección leve del tracto respiratorio superior, hasta síndrome de distrés respiratorio agudo grave y sepsis. No existe un tratamiento específico para SARS-CoV-2, motivo por lo que los aspectos fundamentales son establecer medidas adecuadas de prevención y el tratamiento de soporte y manejo de las complicaciones


In December 2019, the Wuhan Municipal Health and health Commission (Hubei Province, China) reported a series of cases of pneumonia of unknown etiology. On January 7, 2020, the Chinese authorities identified as a causative agent of the outbreak a new type of virus of the Coronaviridiae family, called SARS-CoV-2. Since then, thounsands of cases have been reported with global dissemination. Infections in humans cause a broad clinical spectrum ranging from mild upper respiratory tract infection, to severe acute respiratory distress syndrome and sepsis. There is not specific treatment for SARS-CoV-2, which is why the fundamental aspects are to establish adequate prevention measures and support treatment and management of complications


Assuntos
Humanos , Infecções por Coronavirus/complicações , Vírus da SARS/patogenicidade , Coronavirus/patogenicidade , Procedimentos Cirúrgicos Operatórios/métodos , Precauções Universais/métodos , Assistência Perioperatória/métodos , Vírus da SARS/classificação , Transmissão de Doença Infecciosa , Padrões de Prática Médica , Gestão da Segurança/métodos
6.
Artigo em Inglês | MEDLINE | ID: mdl-32388877

RESUMO

OBJECTIVES: To compare the capacity of the first-trimester combined screening for preeclampsia (PE) to predict early-onset and preterm PE when biomarkers were assessed before or after 11 weeks of gestation. METHODS: This prospective cohort study was conducted at Vall d'Hebron University Hospital (Barcelona) from October 2015 to September 2017. Recorded at the first-trimester scan were demographic characteristics, obstetric history, maternal history and biophysical markers (mean uterine artery pulsatility index and mean arterial blood pressure). Maternal serum concentration of pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PlGF) were assessed from the first-trimester routine blood test (at 8+0 to 13+6 weeks). Women were classified into two groups depending on the moment of the biomarkers' assessment: before or after 11 weeks. Probability scores for early-onset and preterm PE were calculated by using two different algorithms: a multivariate Gaussian distribution model and the Fetal Medicine Foundation competing risk model. Receiver operating characteristic curves and detection rates at a fixed 5% and 10% false-positive rates were instigated to compare the performance of these algorithms. RESULTS: Among the 2,641 women, biomarkers were assessed at <11 WG in 1,675 (63.4%) and at ≥11 WG in 966 (36.6%). Of these, 90 women (3.41%) developed PE, including 11 cases (0.42%) of early-onset PE and 30 (1.14%) of preterm PE. Before 11 WG, 5 cases (45.5%) of early-onset and 16 (53.3%) of preterm PE were identified and 6 cases (54.5%) of early-onset and 14 (46.7%) of preterm PE above 11 WG. For prediction of early-onset and preterm PE by using the Gaussian algorithm, no differences were observed between the areas under the curve (AUC) when biomarkers were obtained before or after 11 weeks. For prediction of early-onset and preterm PE according to the FMF algorithm, no differences were observed between AUC with all combinations used for risk calculation when biomarkers were obtained before or after 11 weeks except for the combination of PAPP-A and MAP to predict early-onset PE, which showed greater AUC when PAPP-A was measured at ≥11 weeks. CONCLUSIONS: Prediction of early-onset and preterm PE is similar when biomarkers are measured before or after 11 weeks. This allows the use of a two-step approach for PE risk assessment which permits immediate risk calculation at the moment of the first-trimester scan. This article is protected by copyright. All rights reserved.

7.
Br J Surg ; 107(7): 801-811, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32227483

RESUMO

BACKGROUND: The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed to propose an acceptable definition and severity grading system for lymphatic complications based on their management strategy. METHODS: Relevant literature published in MEDLINE and Web of Science was searched systematically. A consensus for definition and a severity grading was then sought between 20 high-volume transplant centres. RESULTS: Lymphorrhoea/lymphocele was defined in 32 of 87 included studies. Sixty-three articles explained how lymphatic complications were managed, but none graded their severity. The proposed definition of lymphorrhoea was leakage of more than 50 ml fluid (not urine, blood or pus) per day from the drain, or the drain site after removal of the drain, for more than 1 week after kidney transplantation. The proposed definition of lymphocele was a fluid collection of any size near to the transplanted kidney, after urinoma, haematoma and abscess have been excluded. Grade A lymphatic complications have a minor and/or non-invasive impact on the clinical management of the patient; grade B complications require non-surgical intervention; and grade C complications require invasive surgical intervention. CONCLUSION: A clear definition and severity grading for lymphatic complications after kidney transplantation was agreed. The proposed definitions should allow better comparisons between studies.

8.
Appl Radiat Isot ; 159: 109085, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32250758

RESUMO

The radiolanthanide 161Tb is being studied as an alternative to 177Lu for targeted radionuclide tumor therapy. Both ß--particle emitters show similar chemical behavior and decay characteristics, but 161Tb delivers additional conversion and Auger electron emissions that may enhance the therapeutic efficacy. In this study, the half-life of 161Tb was determined by a combination of three independent measurement systems: reference ionization chamber (CIR, chambre d'ionization de référence), portable ionization chamber (TCIR) and a CeBr3 γ-emission detector with digital electronics. The half-life determined for 161Tb is 6.953(2) days, showing a significant improvement in the uncertainty, which is one order of magnitude lower, with a deviation of 0.91% from the last nuclear data reference value. The previous large uncertainty of the half-life had a direct impact on activity measurements. Now it is no more an obstacle to a primary standardization.

9.
Rev Esp Anestesiol Reanim ; 67(5): 253-260, 2020 05.
Artigo em Inglês, Espanhol | MEDLINE | ID: covidwho-11307

RESUMO

In December 2019, the Wuhan Municipal Health and health Commission (Hubei Province, China) reported a series of cases of pneumonia of unknown etiology. On January 7, 2020, the Chinese authorities identified as a causative agent of the outbreak a new type of virus of the Coronaviridiae family, called SARS-CoV-2. Since then, thounsands of cases have been reported with global dissemination. Infections in humans cause a broad clinical spectrum ranging from mild upper respiratory tract infection, to severe acute respiratory distress syndrome and sepsis. There is not specific treatment for SARS-CoV-2, which is why the fundamental aspects are to establish adequate prevention measures and support treatment and management of complications.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Assistência Perioperatória/métodos , Pneumonia Viral/terapia , China , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia
11.
Rev Esp Anestesiol Reanim ; 67(5): 253-260, 2020 05.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32197787

RESUMO

In December 2019, the Wuhan Municipal Health and health Commission (Hubei Province, China) reported a series of cases of pneumonia of unknown etiology. On January 7, 2020, the Chinese authorities identified as a causative agent of the outbreak a new type of virus of the Coronaviridiae family, called SARS-CoV-2. Since then, thounsands of cases have been reported with global dissemination. Infections in humans cause a broad clinical spectrum ranging from mild upper respiratory tract infection, to severe acute respiratory distress syndrome and sepsis. There is not specific treatment for SARS-CoV-2, which is why the fundamental aspects are to establish adequate prevention measures and support treatment and management of complications.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Assistência Perioperatória/métodos , Pneumonia Viral/terapia , China , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia
14.
Arch Soc Esp Oftalmol ; 95(3): 120-129, 2020 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31980324

RESUMO

OBJECTIVE: To analyse the safety and effectiveness of the oral administration of a commercialised supplement containing R-alpha lipoic acid, taurine, vitamins C and E, lutein, zeaxanthin, zinc, copper and docosahexaenoic acid, in patients with primary open angle glaucoma (POAG), and in control subjects. MATERIAL AND METHODS: A prospective study of cases and controls was carried out, including 30 participants of both genders that were divided into: POAG Group (n=15) and a control group (CG; n=15), assigned to the oral intake of NuaDHA preparations Vision® (1 pill/day)+NuaDHA 1000 (2 pills/day) for 6 months. Participants were interviewed, ophthalmologically examined, and peripheral blood was taken for routine analysis and the determination of the pro-oxidant (malondialdehyde) and total antioxidant status. Statistical analysis was performed using the SPSS 22.0 program. RESULTS: After 6 months of supplementation, there was a significant increase in the plasma total antioxidant status (1.073±0.090mM vs 1.276±0.107mM, P=.028), along with a parallel decrease in malondialdehyde (7.066±1.070µM vs 2.771±0.462µM, P=.005) in the POAG group. The malondialdehyde also decreased in the control group (6.17±1.336 vs. 2.51±0.391, P=.028). The Schirmer test improved (20-30%) and the subjective dry eye signs/symptoms noticeably decreased in the POAG group versus the CG. CONCLUSIONS: Formulations containing antioxidant vitamins, R-alpha lipoic acid and docosahexaenoic acid, administered for 6 consecutive months, counteracted the oxidative stress by further stabilising the morphological/functional parameters of both the ocular surface and the glaucoma, without presenting with adverse effects or intolerances.

16.
J Perinatol ; 40(2): 226-231, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31767979

RESUMO

OBJECTIVE: Determine the suitability of transcutaneous bilirubin (TCB) as a tool to assess the effectiveness of phototherapy on patched skin. STUDY DESIGN: A prospective observational study was conducted. We covered a fragment of skin (sternum) with a photo-opaque patch. Several simultaneous TCB and TSB measurements were performed with the JM-105 bilirubinometer. Bland and Altman test evaluated the agreement between bilirubin levels. RESULT: A total of 217 patients were studied, 48.8% were preterm. The mean difference between TSB and TCB before the start of treatment was 1.07 mg/dL. During phototherapy, differences on covered skin were 0.52, 0.27, and 0.39 mg/dL at 24, 48, and 72 h of therapy respectively. The best correlation was observed at 48 h in preterm infants. CONCLUSION: The measurement of TCB on patched skin (PTCB) is useful for monitoring the response to phototherapy in term and preterm infants. We use a patch with a removable flap that eases successive measures without disturbing the patients.

19.
Rehabilitacion (Madr) ; 53(4): 240-246, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31813421

RESUMO

OBJECTIVE: Subacromial pain syndrome is a clinical picture characterised by pain located around the acromion triggered or exacerbated by shoulder movements. Ultrasound is a suitable imaging technique to evaluate the soft tissues occupying the subacromial space. The aim of this study was to describe the ultrasound findings in patients diagnosed with chronic subacromial pain syndrome by age, sex, and time since onset. MATERIAL AND METHODS: We conducted a retrospective study of patients diagnosed with chronic SDS who underwent shoulder ultrasound. The variables studied were age, sex, affected side, time since onset, sonographic findings and ultrasound diagnosis. A descriptive study of the variables and statistical inference was performed with the chi-square test. RESULTS: A total of 253 clinical histories of patients who underwent shoulder ultrasound were reviewed. Of these, 100 were selected who met the pre-established criteria. Involvement was bilateral in 5 of them and consequently the total number of ultrasound scans reviewed was 105. Differences were found between ultrasound finding by age, but not by sex or time since onset. CONCLUSIONS: The findings of this study indicate that there is good clinical-radiological correlation between subacromial pain syndrome and ultrasound findings. The structure most frequently involved in the origin of the pain was the supraspinatus tendon. Differences were found by age but not by sex or the time since onset.

20.
Med. infant ; 26(4): 358-363, dic. 2019. Tab
Artigo em Espanhol | LILACS | ID: biblio-1047047

RESUMO

Introducción: Según el Plan Nacional de Prevención del Embarazo no Intencional en la Adolescencia en Argentina, 109 mil adolescentes y 3 mil niñas menores de 15 años, tienen un hijo cada año. Los factores son múltiples, pero el más importante y frecuente es la falta de educación sexual integral. Objetivos: 1- Evaluar el conocimiento sobre salud sexual y reproductiva antes y después de un taller dirigido a madres y padres internados con sus hijos. 2- Detectar si hubo diferencia entre los padres y madres según la edad. Material y métodos: estudio observacional, descriptivo, analítico, longitudinal, prospectivo y antes- después. Se incluyeron madres y padres con sus hijos internados que realizaron el taller por primera vez. Los padres y madres participantes fueron categorizados en función de la edad en menores de 19 años y 11 meses (Gr1= adolescentes) e igual o mayor a 20 años (Gr2= jóvenes/adultos). Se analizaron las variables: edad, sexo, lugar de residencia, si recibió información sobre salud sexual y reproductiva y cuál fue la fuente de la misma. Se aplicó una encuesta autoadministrada con 12 preguntas sobre métodos anticonceptivos, infecciones de transmisión sexual (ITS) y derechos sexuales y reproductivos y se analizaron los datos antes y después de la intervención. Resultados: Se encuestaron a 116 padres que cumplían los criterios y accedieron a participar. (Gr1 = 24 y Gr2 = 92) Mediana de edad: 22 años (15-47). Un 53% refirió haber recibido anteriormente información, 30% de la escuela observándose un desconocimiento previo de la temática antes del taller independiente de la edad. La intervención realizada en el taller aumentó significativamente los conocimientos en ambos grupos. Conclusión: La estrategia educativa debe centrarse en participación e integración. La metodología de taller es la más adecuada, ya que facilita el debate y posibilita la adquisición de competencias y habilidades, además de aportar conceptos teóricos (AU)


Introduction: According to the National Unintentional Pregnancy Prevention Plan in Adolescence in Argentina, yearly 109 thousand adolescents and 3 thousand girls under 15 years of age give birth. Multiple factors are involved; however, the most common and important is the lack of integrated sexual education. Objectives: 1- To evaluate the knowledge on sex and reproductive health before and after a a workshop addressed to mothers and fathers of hospitalized children. 2- To detect if there was a difference between mothers and fathers regarding age. Material and methods: A prospective, longitudinal, analytical, descriptive, observational beforeand-after study was conducted. Mothers and fathers of hospitalized children who participated in the workshop for the first time were included. The participating mothers and fathers were categorized according to age into younger than 19 years and 11 months (Gr1= adolescents) and 20 years or older (Gr2= young/adults). The following variables were analyzed: age, sex, place of origin, whether or not the person received sex and reproductive health education, and the source of sex and reproductive health information. A selfadministered survey was used with 12 questions on contraceptive methods, sexually transmissible diseases (STDs), and sex and reproductive rights and data were analyzed before and after the intervention. Results: 116 parents who met the inclusion criteria and agreed to participate were surveyed. (Gr1 = 24 and Gr2 = 92) Median age: 22 años (15-47). Overall, 53% reported having received prior information. 30% of whom had received information at school. A previous lack of knowledge on the topic was observed before attending the workshop regardless of age. The intervention of the workshop significantly increased the knowledge in both groups. Conclusion: The educational strategy should be focused on participation and integration. The methodology of a workshop is the most adequate as it facilitates debate and acquisition of competencies and skills and additionally provides theoretical concepts (AU)


Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Pais/educação , Gravidez na Adolescência/prevenção & controle , Educação Sexual/métodos , Direitos Sexuais e Reprodutivos , Planejamento Familiar , Saúde Sexual/educação , Estudos Prospectivos , Inquéritos e Questionários , Estudos Longitudinais
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