ABSTRACT
INTRODUCCIÓN: La dinamometría es un método de evaluación de la fuerza muscular (FM) reproducible, barato y sencillo, que en conjunto con otras determinaciones presenta alta sensibilidad y especificidad en la detección precoz de variaciones en el estado nutricional. OBJETIVOS: Evaluar factores relacionados con disminución de la FM en pacientes en hemodiálisis (HD).MATERIAL Y MÉTODOS: Se realizó un estudio de corte transversal, unicéntrico. Se analizaron variables clínicas: sexo, edad, tensión arterial, peso, pérdida de peso significativa a los 3 y 6 meses previos, índice de masa corporal (IMC), ganancia interdialítica, tiempo en HD, condición de diabético, ingesta energética y proteica, de laboratorio (hemoglobina, hepatograma, ionograma, calcio, fósforo, lipidograma, proteinograma, transferrina) y fuerza prensil (pre y posdiálisis y en ambos brazos) medida por dinamometría. Se compararon los valores de FM con los de una población sana, considerando como alterados aquellos por debajo del percentilo 10. Se consideró promedio, mediana, desvío estándar y análisis mediante test de Student y Chi cuadrado según correspondiera. Se consideró significativo una p<0.05. RESULTADOS: Participaron 73 pacientes. Un 47.95% presentó baja FM con una significativa disminución de fuerza entre el brazo del acceso vascular y el contralateral (p 0,00019). De las variables estudiadas, el mayor tiempo en HD (p 0,026), menor IMC (p 0,046) tuvieron diferencia significativa entre los que tuvieron FM normal vs disminuida. Conclusiones: La disminución de la FM en pacientes en HD es muy frecuente y se relacionó con mayor tiempo en HD y menor IMC
INTRODUCTION: Dynamometry is a cheap, simple and easily reproduced method to assess muscle strength (MS), which, like other processes of obtaining measurements, displays high sensitivity and specificity for the early detection of any change in the nutritional status. OBJECTIVES: To evaluate factors concerning the reduction in MS in patients undergoing hemodialysis (HD). METHODS: A single center, cross-sectional study was carried out. The following clinical variables were analyzed: sex, age, blood pressure, weight, significant weight loss within the last 3 6 months, body mass index (BMI), weight gain in between dialysis sessions, hemodialysis treatment time, diabetes, energy and protein intake. Other factors taken into account were: laboratory findings (hemoglobin, hepatogram, electrolyte panel, calcium test, phosphate test, lipid profile, protein analysis, transferrin saturation) and hand grip strength (before and after dialysis, on both arms) measured through dynamometry. The patients' muscle strength values were compared to those of healthy subjects. Values below the 10th percentile were regarded as abnormal. Mean, median, standard deviation as well as the X2 and the Student's t tests were considered where applicable. A p<0.05 constituted a significant value. RESULTS: There were 73 patients included in this study and 47.95% of them showed low MS with significant strength loss on the arm having the vascular access when compared to the other arm (p 0.00019). A longer hemodialysis treatment time (p 0.026) and a lower BMI (p 0.046) were found to be the two variables with the highest impact on MS. CONCLUSIONS: Muscle strength loss in patients undergoing hemodialysis is very common and is associated with a longer HD treatment time and a lower BMI
Subject(s)
Humans , Nutrition Assessment , Mechanical Dynamization , Homeopathic Clinical-Dynamic Prognosis , Muscle Strength , Muscle Strength Dynamometer , Renal DialysisABSTRACT
Analisando os diferentes movimentos de uma lima endodôntica durante a preparaçäo de um canal radicular percebe-se a existência de um complexo de movimentos complicados. O sucesso de uma peça de mäo automatizada para uso endodôntico está condicionada à sua capacidade de reproduzir o Canal Finder System como um importante recurso auxiliar na preparaçäo de um canal radicular
Subject(s)
Mechanical Dynamization , Root Canal Therapy/instrumentation , Dental InstrumentsABSTRACT
De 1850 a 1920, coincidindo com o avanco da ciencia e tecnologia da Revolucao Industrial, alguns homeopatas tentaram construir maquinasque economizariam trabalho, pelas quais eles poderiam gerar potencias elevadas. Este artigo descreve estas invencoes, das quais temos ouvido muito, mas no geralpouco sabemos