Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial

ABSTRACT BACKGROUND: Hypoxemia and pulmonary complications are common after upper abdominal surgery (UAS). OBJECTIVE: To examine whether inclusion of autogenic drainage (AD) in chest physiotherapy after UAS confers additional benefits in improving blood gases and reducing postoperative pulmonary complications (PPCs). DESIGN AND SETTING: Randomized controlled study conducted at Kasr Al-Ainy teaching hospital, Egypt. METHODS: A randomized controlled trial was conducted on 48 subjects undergoing elective UAS with high risk of developing PPCs. The study group received AD plus routine chest physiotherapy (deep diaphragmatic breathing, localized breathing and splinted coughing) and the control group received routine chest physiotherapy only. The outcomes included arterial blood gases measured at the first and seventh postoperative days, incidence of PPCs within the first seven days and length of hospital stay. RESULTS: Baseline characteristics were similar between groups. In the AD group, SaO2, PaO2, PaCO2 and HCO3 significantly improved (P < 0.05) while in the physiotherapy group, only SaO2 and PaO2 significantly improved (P < 0.05). Nonetheless, significant differences in post-treatment SaO2 and PaO2 between the groups were observed. The overall incidence of PPCs was 16.66% (12.5% in the AD group and 20.8% in the physiotherapy group) (absolute risk reduction -8.3%; 95% confidence interval, CI, -13.5 to 29.6%), with no significant difference between the groups. The AD group had a significantly shorter hospital stay (P = 0.0001). CONCLUSION: Adding AD to routine chest physiotherapy after UAS provided a favorable blood gas outcome and reduced the length of hospital stay. It tended to reduce the incidence of PPCs. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04446520.

Diversity of helminth parasites of freshwater fish in the headwaters of the Coatzacoalcos River, in Oaxaca, Mexico.

We documented the diversity of helminth parasites of 25 fish species from 8 families occurring in the headwaters of the Coatzacoalcos river basin. This river flows along the border between the states of Oaxaca and Veracruz, in the region of the Isthmus of Tehuantepec, in south-eastern Mexico, and in northern Central America. We recorded 48 species, representing 44 genera and 29 helminth families. Six of the 25 fish species were examined for helminths for the first time; 60 new host records were reported. Nematodes and trematodes were the most abundant taxonomic groups. The helminth fauna from our study area consists of primarily central American species. Most species recorded from this area have also been captured from freshwater bodies between the Isthmus of Tehuantepec and the Isthmus of Panama. However, three species, including an acanthocephalan and two nematodes, are likely endemic to this area. We argue that, in contrast to the presence of larval helminths, which mostly depends on the geographical location of water bodies, adult helminths are an integral and consistent component of the regional community. Data on taxonomic composition and distribution of helminth fauna reported in this paper, contribute to a better understanding of this faunal component in northern Central America (CA). Furthermore, knowledge of helminth parasites of freshwater fish from Neotropical Mexico and CA facilitates prediction of which parasite species is likely to infect fish in a specific geographical area.

Effects of a psychological skill training program on anxiety levels in top karate athletes / Efeitos de um programa de treino de habilidade psicológica sobre os níveis de ansiedade em atletas de caratê de elite / Efectos de un programa de entrenamiento de habilidad psicológica sobre los niveles de ansiedad en atletas de karate de élite

ABSTRACT Introduction To achieve an improvement in self-regulation, and consequently competitive performance, it is necessary to evaluate psychological skills training programs. It was hypothesized that the introduction of autogenic training and guided imagery could bring about positive changes in anxiety and self-confidence, as compared to regular training and competitive activities. Objective To investigate the effects of a psychological skills training program on the optimization of anxiety and self-confidence. Methods Twenty-four athletes from the Serbian national karate team were divided into experimental (EXP) and control (CON) groups. During eight weeks, both groups underwent an identical karate training and competing program. The program was adapted for top karate athletes according to their daily routines and the specific demands of the activity. In addition, the EXP group underwent the psychological skills training program, based on autogenic training and guided imagery. The Competitive State Anxiety Inventory-2 was used to measure the multidimensional construct of the state of anxiety, and the Movement Imagery Questionnaire-3 to assess individual ability to imagine movements. Results Repeated measures ANOVA results indicated a difference in anxiety levels between the EXP and CON groups after the intervention. Further analysis indicated a decrease in cognitive anxiety and an increase in self-confidence among participants from the EXP group. Conclusion The applied psychological skills program had a positive effect on anxiety optimization and self-confidence levels in top karate athletes. As emotional self-regulation is also crucial for athletes of other sports, the implementation of this intervention can be recommended, provided that it is adapted to the specific characteristics of each sport. Level of evidence II; Therapeutic studies - Investigating treatments results.

RESUMO Introdução Para a melhoria da autorregulação e, consequentemente, do desempenho competitivo, faz-se necessário avaliar os programas de treino das habilidades psicológicas. Foi formulada a hipótese de que os treinos autogênico e de visualização guiada poderiam induzir alterações positivas na ansiedade e na autoconfiança, quando comparados à prática das atividades regulares de treino-competição. Objetivo Investigar os efeitos de um programa de treino de habilidades psicológicas na otimização da ansiedade e da autoconfiança. Métodos Foram divididos em Grupos Experimental (EXP) e Controle (CON) 24 atletas da equipe nacional de caratê da Sérvia. Ao longo de 8 semanas, ambos os grupos foram submetidos a um programa de treino e competição idêntico. O programa foi adaptado para atletas de elite de caratê de acordo com suas rotinas diárias e as demandas específicas da modalidade. Adicionalmente, o grupo EXP participou do programa de treino de habilidades psicológicas, baseado no treino autogênico e na visualização guiada. Foram utilizados o Inventário de Estado de Ansiedade Competitiva-2, para medir o constructo multidimensional do estado de ansiedade, e o Questionário de Imagens de Movimento-3, para avaliar a habilidade individual para imaginar os movimentos. Resultados Os resultados da ANOVA por medidas repetidas indicaram diferença nos níveis de ansiedade dos Grupos EXP e CON após a intervenção. Análise mais profunda indicou redução da ansiedade cognitiva e aumento da autoconfiança nos participantes do Grupo EXP. Conclusão O programa habilidades mentais aplicado apresentou efeito positivo na otimização da ansiedade e dos níveis de autoconfiança dos caratecas de elite. Uma vez que a autorregulação do estado psicológico também é crucial para atletas de outras modalidades, a implementação desta intervenção pode ser recomendada, desde que adaptada às suas especificidades. Nivel de evidência II; Estudos terapêticos - investigação dos resultados do tratamento.

RESUMEN Introducción Para la mejora de la autorregulación y, consiguientemente, del desempeño competitivo, se hace necesario evaluar los programas de entrenamiento de las habilidades psicológicas. Fue formulada la hipótesis de que los entrenamientos autógeno y de visualización guiada podrían inducir alteraciones positivas en la ansiedad y en la autoconfianza, cuando comparados a la práctica de las actividades regulares de entrenamiento-competición. Objetivo Investigar los efectos de un programa de entrenamiento de habilidades psicológicas en la optimización de la ansiedad y de la autoconfianza. Métodos Fueron divididos en Grupos Experimental (EXP) y Control (CON) 24 atletas del equipo nacional de karate de Serbia. A lo largo de 8 semanas, ambos grupos fueron sometidos a un programa de entrenamiento y competición idéntico. El programa fue adaptado para atletas de élite de karate de acuerdo con sus rutinas diarias y las demandas específicas de la modalidad. Adicionalmente, el grupo EXP participó en el programa de entrenamiento de habilidades psicológicas, basado en el entrenamiento autógeno y en la visualización guiada. Fueron utilizados el Inventario de Estado de Ansiedad Competitiva-2, para medir el constructo multidimensional del estado de ansiedad, y el Cuestionario de Imágenes de Movimiento-3, para evaluar la habilidad individual para imaginar los movimientos. Resultados Los resultados de ANOVA por medidas repetidas indicaron diferencia en los niveles de ansiedad de los Grupos EXP y CON después de la intervención. Un análisis más profundo indicó reducción de la ansiedad cognitiva y aumento de la autoconfianza en los participantes del Grupo EXP. Conclusión El programa de habilidades mentales aplicado presentó efecto positivo en la optimización de la ansiedad y de los niveles de autoconfianza de los karatecas de élite. Dado que la autorregulación del estado psicológico también es crucial para atletas de otras modalidades, puede ser recomendada la implementación de esta intervención, desde que sea adaptada a sus especificidades. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.