Assessing the effect of prophylactic ankle taping on ankle and knee biomechanics during landing tasks in healthy individuals: A cross-sectional observational study

ABSTRACT BACKGROUND: Current research supports the fact that prophylactic ankle taping (AT) is effective in preventing ankle injuries in amateur and elite sports athletes. OBJECTIVE: This study aimed to investigate the effect of AT on balance, knee valgus during drop jump and single-leg countermovement jump (SL-CMJ) landings, and ankle range of motion (ROM) restriction in healthy participants. DESIGN AND SETTING: A cross-sectional observational study was conducted at the Universidad Europea de Madrid, Madrid, Spain. METHODS: Participants: Thirty-nine healthy individuals participated in this study and performed the movements under two conditions (with and without tape). Outcome measurements: ankle ROM, balance, SL-CMJ height, flight time, ground time, and knee valgus. Before any intervention, a random process was developed with a 1:1 allocation ratio, and the participants were assigned to groups A (tape-no tape) and B (no tape-tape). RESULTS: Significant differences between tape and no-tape moments were observed for drop jump knee valgus flexion (P = 0.007), with an increase in knee valgus in participants with ankle taping. Similarly, the Y-balance testshowed a significant decrease in all variables (P = 0.001 and), ankle dorsiflexion (P = 0.001) in participants with ankle taping. CONCLUSIONS: AT is effective for immediate ankle ROM restriction. However, an increase in knee valgus during drop jump task and a decrease in lower limb balance were observed during drop jump task. Based on these results, it can be concluded that AT application in healthy individuals should not be recommended as it results in increase in injury risk factors.

Is ankle taping effective to limit the ankle dorsiflexion in a single-training session? An observational study in semi-professional basketball players

ABSTRACT BACKGROUND: Ankle taping (AT) is effective in preventing ankle sprain injuries in most common sports and is employed in rehabilitation and prevention sports. OBJECTIVE: This study aimed to investigate the effectiveness of AT to restricting excessive frontal plane ankle movements in semi-professional basketball players throughout the training session. DESIGN AND SETTING: A cross-sectional study was performed at the Universidad Europea de Madrid. METHODS: Forty male and female semi-professional basketball players were divided into two groups. The ankle dorsiflexion range of motion (ROM) and interlimb asymmetries in a weight-bearing lunge position were evaluated at four time points: 1) with no tape, 2) before practice, at 30 min of practice, and 3) immediately after practice. RESULTS: In male basketball players, no differences were observed in the right and left ankles between the baseline and 30 min and between baseline and 90 min of assessment. In female athletes, significant differences were reported between baseline and pre-training assessments for the right ankle and also significant differences between baseline and 90 min in both ankles. CONCLUSIONS: Ankle taping effectively decreased the ankle dorsiflexion ROM in male and female basketball players immediately after application. However, ROM restriction was very low after 30 and 90 min, as assessed in a single basketball practice. Therefore, the classic taping method should be revised to develop new prophylactic approaches, such as the implementation of semi-rigid bracing techniques or the addition of active stripes during training or game pauses.

Assessment and indicators of kinematic behavior and perceived fatigability

SUMMARY OBJECTIVE: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task. METHODS: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale. RESULTS: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger. CONCLUSION: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure.

Tratamiento quirúrgico del leiomiosarcoma de vena cava inferior

Introducción: La baja incidencia del leiomiosarcoma de la vena cava inferior dificulta tanto la estandarización del diagnóstico como el tratamiento. Objetivo: Presentar el manejo realizado en nuestro centro de un paciente que desarrolló un leiomiosarcoma de vena cava inferior, una patología de baja incidencia y que las posibilidades de realizar un rescate quirúrgico son muy bajas. Resultados: Se presenta el caso de un paciente de 54 años con una tumoración sólida en porción infrarrenal y yuxtarrenal de vena cava inferior de 71 × 76 × 117 mm compatible con leiomiosarcoma de vena cava, con infiltración de uréter derecho que ocasiona uropatía obstructiva derecha grado I-II sin alteración de la función renal, que fue resecada y reconstruida mediante prótesis sin complicaciones. Discusión: Se discute la fisiopatología, el diagnóstico y manejo en relación con el caso presentado. Conclusión: la baja incidencia de estos tumores dificulta tanto la estandarización del diagnóstico como del tratamiento, aunque la cirugía sigue siendo el tratamiento de elección.

Introduction: The low incidence of leiomyosarcoma of the inferior vena cava hinders both the standardization of diagnosis and treatment. Objective: To present the management carried out in our center of a patient who developed an inferior vena cava leiomyosarcoma, a low incidence pathology with uncertain surgical rescue. Results: 54-year-old patient with a solid tumor in the infrarenal and juxtarenal portions of the inferior vena cava of 71 × 76 × 117 mm compatible with leiomyosarcoma of the vena cava, with infiltration of the right ureter that causes right obstructive uropathy grade I-II without kidney function changes; tumour was resected and continuity reconstructed with a prosthesis without complications. Discussion: The pathophysiology, diagnosis and management are commented. Conclusion: the low incidence of these lesions makes it difficult to standardize both diagnosis and treatment, although surgery remains the treatment of choice.

Conjunctival collagen crosslinking for the management of bleb leak

The purpose of this article is to evaluate the effectiveness of collagen crosslinking of filtering blebs with 0.1% riboflavin stimulated with ultraviolet A radiation in a case of a thin-walled filtering bleb with leakage following an episode of late blebitis. The time to cessation of the bleb leakage was studied, as well as the intraocular pressure, the visual acuity, and the presence of adverse effects during 4 years of follow-up after treatment. A single session of crosslinking was effective in resolving the leakage of the filtering bleb. There were no adverse effects. The intraocular pressure and the visual acuity remained stable after 4 years of follow-up. Collagen crosslinking with 0.1% riboflavin stimulated with ultraviolet A radiation may prove to be a simple, painless, non-invasive, and repeatable treatment of the leaking bleb with the aim of strengthening the collagen fibers of the conjunctiva and avoiding more invasive surgical treatments.

Análisis cualitativo de los perfiles de egreso en procesos de aseguramiento de la calidad de carreras de Nutrición y Dietética en Chile

Antecedentes: La evaluación de los perfiles de egreso es uno de los aspectos centrales en la acreditación de carreras en Chile, por cuanto su formulación y aplicación en los procesos formativos influyen en sus niveles de pertinencia y calidad. Objetivo: Evidenciar las fortalezas y debilidades del diseño y aplicación de los perfiles de egreso de las carreras de Nutrición y Dietética en Chile, a partir de los resultados de sus procesos de acreditación. Materiales y métodos: Estudio transversal, descriptivo, cualitativo. Se identificaron, en las resoluciones de acreditación entre los años 2004 y 2016, las fortalezas y debilidades de los perfiles de egreso y las contradicciones entre lo declarado y lo ejecutado por los programas. Las carreras se ordenaron en dos grupos según el tiempo de acreditación: i) de dos a cuatro años y ii) de 5 o más años. Usando el software Atlas.ti 7.0 se determinaron los patrones y diferencias conceptuales en los juicios evaluativos de los perfiles de egreso. Resultados: Existe una alta variabilidad entre carreras en los contenidos y aplicación de los perfiles de egreso. Ella se asocia a las capacidades instaladas en las instituciones y a los tiempos de acreditación de la carrera. Existen carreras con déficit en el cumplimiento de competencias, conocimientos y habilidades. Conclusiones: Los contenidos y aplicación de perfiles de egreso son muy heterogéneos y su aplicación se asocia al tiempo de acreditación de la carrera. Es necesario limitar la alta dependencia a la demanda y estimular mayores compromisos institucionales.

Background: Assessment of the graduate profiles is one of the key aspects of program accreditation in Chile, therefore, their development and application in training processes have an impact on their relevance and quality. Objective: To demonstrate the strengths and weaknesses of the design and application of graduate profiles of Nutrition and Dietetics degree programs in Chile, on the basis of the outcomes of their accreditation processes. Materials and methods: Cross-sectional, descriptive, qualitative study. Strengths and weaknesses of graduate profiles, and inconsistencies between what was stated and what was actually implemented in the programs were identified in the accreditation resolutions issued between 2004 and 2016. Degree programs were classified in two groups, according to accreditation years: i) two to four years, and ii) five or more years The Atlas.ti 7.0 software was used to determine patterns and conceptual differences in the evaluative judgement of graduate profiles. Results: There was a high variability in the content and application of graduate profiles between degree programs. This was associated with the institutions' installed capacities and with accreditation years awarded to the program. Some programs were not compliant with the required competencies, knowledge and skills. Conclusions: The content and application of graduate profiles are highly heterogeneous, and its application is associated to accreditation years of the program. It is necessary to limit high dependency on demand to encourage stronger institutional commitments.

Tratamiento quirúrgico de la fibromatosis agresiva en relación con cesárea previa / Surgical treatment of aggressive fibromatosis in relation to previous cesarean section

Introducción. Los tumores desmoides son lesiones de los tejidos blandos, histológicamente benignas, poco frecuentes y con gran agresividad local y carencia de potencial metastásico. Se relacionan estrechamente con antecedentes traumáticos o quirúrgicos, como la cesárea, y su tratamiento generalmente es quirúrgico. Métodos. Presentamos una serie de tres pacientes intervenidas en nuestro centro durante el año 2020. Se revisan sus antecedentes y se describe su tratamiento. Resultados. En todas nuestras pacientes se encontró algún antecedente quirúrgico, dos cesáreas y una resección de un disgerminoma. El tratamiento empleado fue la resección quirúrgica con márgenes libres y reparación del defecto mediante malla. Conclusiones. El tumor desmoide es una patología poco frecuente, su diagnóstico se realiza mediante exámenes imagenológicos y se confirma con el estudio histológico; es importante hacer el diagnóstico diferencial con el sarcoma. La cirugía radical sigue siendo el tratamiento de elección, aunque algunos autores proponen el tratamiento conservador.

Introduction. Desmoid tumors are soft tissue lesions, histologically benign, rare and with great local aggressiveness and lack of metastatic potential. They are closely related to traumatic or surgical history such as caesarean section. Their treatment is generally surgical. Methods. We present a case series of three patients operated on in our center during the year 2020. Their history is reviewed and their type of treatment is presented. Results. In all our patients, surgical history was found (two caesarean sections and one resection of a dysgerminoma). The treatment used was surgical resection with free margins and mesh repair of the defect. Conclusions. Desmoid tumor is a rare pathology; its diagnosis is made by imaging studies, and confirmed by histology. It is important to make a differential diagnosis with sarcoma. Radical surgery remains the treatment of choice, although some authors propose conservative treatment.

A 120-second stretch improves postural control and plantar pressure: quasi-experimental study

ABSTRACT BACKGROUND: There are no studies on long-term bilateral calf stretching in relation to balance and plantar pressure. OBJECTIVES: To demonstrate that there is better control of posture and pressures after continuous stretching of the posterior calf muscles. DESIGN AND SETTING: Pre and post-intervention study conducted in a private clinic. METHODS: We measured static footprints and stabilometry before and after continuous passive plantar flexor stretching of duration 120 seconds, among 24 healthy subjects. RESULTS: We found differences in Y displacement with eyes closed (P = 0.010), but not among other variables with eyes closed: X displacement (P = 0.263); surface (P = 0.940); laterolateral speed displacement (P = 0.279); and anteroposterior speed displacement (P = 0.914). There were also no differences in eyes-open variables: X displacement (P = 0.341); Y displacement (P = 0.491); surface (P = 0.167); laterolateral speed displacement (P = 0.852); and anteroposterior speed displacement (P = 0.079). The plantar pressures in the heel (maximum pressure, P = 0.048; mean pressure, P = 0.001) and in the midfoot (maximum pressure, P = 0.004; mean pressure, P = 0.004) were reduced, but not in the forefoot (maximum pressure, P = 0.391; mean pressure, P = 0.225). The surface became larger in the forefoot (P = 0.000) and midfoot (P = 0.021). CONCLUSIONS: Continuous static stretching of plantar flexors for 120 seconds improved stance balance and reduced plantar pressures (maximum and mean) in the rearfoot and midfoot. It also increased the surface in the midfoot and forefoot. TRIAL REGISTRATION: at clinicaltrials.gov, under the number NTC03743168.

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud / Becoming better: the need for immediate action to address obesity. A position statement from health professionals

resumen está disponible en el texto completo

Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.

Allergic rhinitis improvement after septorhinoplasty in a sample of allergic rhinitis patients with septal deviation: a quasi-experimental study

ABSTRACT BACKGROUND: Allergic rhinitis (AR) is a chronic inflammatory disease that affects almost 30% of the adult population. OBJECTIVE: To describe and compare the evolution of symptoms in patients diagnosed with AR and septal deviation prior to and following septoplasty (STP). DESIGN AND SETTING: Quasi-experimental study developed in A Coruña University Hospital. METHODS: Patients aged 18-65 years who had been diagnosed with AR and septal deviation were recruited. Obstruction airflow was evaluated before and after surgery, by means of anterior rhinomanometry (RNM). Severity symptoms and quality of life were assessed using a visual analogue scale (VAS) and the ESPRINT questionnaire, respectively. RESULTS: A total of 50 subjects underwent STP and 42 were included in this study. Their mean age at the time of surgery was 34.16 ± 9.74 years (range 18-64). Significant reductions in mean VAS and ESPRINT were observed after surgery (P < 0.01). These outcomes were considered to represent an overall improvement in quality of life. The RNM results also improved significantly, from mean values of 478.07 ± 165.4 cm3/s before STP to 826.4 ± 175.5 cm3/s afterwards (P < 0.01). CONCLUSIONS: The negative correlations of VAS and ESPRINT with RNM, from before and to after STP, demonstrate the efficacy of scales and questionnaires as objective methods for determining obstruction in the absence of rhinomanometry. Patients with allergic rhinitis and septal deviation showed improvements in obstruction severity and medication use after STP.

Self-reported depression and anxiety among COPD patients. A case-control study

Abstract BACKGROUND: Anxiety and depression are the most prevalent mental disorders worldwide. However, the exact mechanisms linking chronic obstructive pulmonary disease (COPD) with depression and anxiety have not been identified. OBJECTIVES: To compare self-reported depression and anxiety among patients diagnosed with COPD in relation to healthy controls. DESIGN AND SETTING: Case control study at a public hospital institution in Spain. METHODS: We designed a case-control study. Patients were recruited using a consecutive sampling method from a single institution. Two groups were created: COPD and healthy controls. Data on medical history and demographic background were collected from the medical records. Self-reported depression levels were assessed using Beck's depression inventory (BDI). Self-reported anxiety was measured using the State-trait anxiety inventory (STAI). RESULTS: Fifty-two patients with COPD and fifty healthy patients were included in this study. BDI scores were higher for COPD patients (10.23 ± 6.26) than in the control group (5.2 ± 6.56). STAI-state scores were higher for COPD patients (41.85 ± 12.55) than for controls (34.88 ± 9.25). STAI-trait scores were higher for COPD patients (41.42 ± 10.01) than for controls (34.62 ± 9.19). CONCLUSIONS: This study showed that there were higher levels of depression and anxiety among COPD patients than among healthy controls.

Definición de displasia broncopulmonar propuesta por la Comisión Neo SOCHINEP / Definition of bronchopulmonary dysplasia proposed by the Neo SOCHINEP Commission

La displasia broncopulmonar (DBP) es la enfermedad crónica más frecuente del recién nacido prematuro. Los avances en su prevención y tratamiento han permitido una mayor sobrevida de prematuros más pequeños, pero su incidencia se ha mantenido estable en el tiempo, con una fisiopatología y presentación clínica que abarca un amplio espectro y que difiere de la DBP descrita originalmente hace más de 50 años. Aún existen controversias en su definición, la que se ha establecido en base al tratamiento, específicamente al requerimiento de soporte respiratorio. Las definiciones más utilizadas son el requerimiento de oxígeno por 28 días y a las 36 semanas de edad gestacional corregida (EGC). Recientemente se ha propuesto definirla en base al requerimiento de ventilación mecánica a las 36 semanas de EGC, lo que identificaría a los prematuros con DBP más grave y mayor probabilidad de complicaciones respiratorias y neurológicas en los 2 primeros años de vida. Nuestro objetivo en la comisión de Neo-SOCHINEP es el de recomendar la definición y clasificación que nos parece más adecuada para identificar a los prematuros portadores de DBP, considerando los aspectos fisiopatológicos, del compromiso de la función pulmonar y consecuencias prácticas de la definición en nuestro medio. También proponemos la definición del requerimiento de oxígeno en el prematuro cuando esta en neonatología, las condiciones e interpretación de la saturometría contínua cuando está pronto al alta y el seguimiento de la oxigenoterapia posterior al alta.

Bronchopulmonary dysplasia (BPD) is the most frequent chronic disease of the premature newborn. Advances in its prevention and treatment have allowed a greater survival of smaller preterm infants, but its incidence has remained stable over time, with a pathophysiology and clinical presentation that covers a wide spectrum and differs from the BPD originally described more than 50 years ago. There are still controversies in its definition, which has been established based on the treatment, specifically the requirement of respiratory support. The most used definitions are the oxygen requirement for 28 days and at 36 weeks of postmenstrual age (PMA). It has recently been proposed a definition based on the requirement of mechanical ventilation at 36 weeks of PMA, which would identify premature infants with more severe BPD and a greater probability of respiratory and neurological complications in the first 2 years of life. Our objective in the Neo-SOCHINEP commission is to recommend the definition and classification that we believe is most appropriate to identify premature infants with BPD, considering the pathophysiological aspects, the compromised lung function, and practical consequences of the definition in our medium. We also propose the definition of the oxygen requirement in premature infants when they are in neonatology, the conditions and interpretation of continuous saturation when they are soon discharged, and the follow-up of post-discharge oxygen therapy.

Sobrevida en una cohorte con diagnóstico de tuberculosis en Colombia / Survival at cohort diagnosed with tuberculosis in Colombia

Introducción: La tuberculosis es una patología infecciosa crónica cuya incidencia es elevada en países en vía de desarrollo, sin embargo, es limitada la información y los estudios que analizan la mortalidad y sobrevida a largo plazo. Metodología: estudio de cohorte retrospectivo, en pacientes con diagnóstico de tuberculosis mayores de 18 años, el ingreso fue de manera consecutiva hasta completar el periodo de estudio. Se analizó la sobrevida y mortalidad a través del estimador Kaplan ­ Meier por la prueba de log Rank. Resultados: ingresaron 329 sujetos, la mortalidad a los 30 días fue de 11,9% y al año del 24,6%, la tuberculosis pulmonar fue el tipo más frecuente con en el 70,2%. Los hallazgos al examen físico relacionados con mortalidad fueron la caquexia (p<0,001) y el edema en extremidades (p<0,001). La sobrevida general fue del 87,2% a los 30 días y del 72,9% al año. En los pacientes con tuberculosis pulmonar la sobrevida fue del 85,8% a los 30 días y del 72,8% al año. Conclusión: La tasa de sobrevida a un año en pacientes hospitalizados por tuberculosis es baja, la edad avanzada, desnutrición, PaO2/FiO2 menor de 300, proteína c reactiva mayor de 45 mg/dL, enfermedad cerebrovascular y enfermedad vascular periférica fueron variables que se asociaron con una mayor mortalidad(AU)

Background: Tuberculosis is a chronic infectious pathology whose incidence is high in developing countries, however, information and studies that analyze mortality and long-term survival are limited. Methodology: retrospective cohort study, in patients with a diagnosis of tuberculosis older than 18 years, admission was consecutive until completing the study period. Survival and mortality were analyzed using the Kaplan-Meier estimator by the log Rank test. Results: 329 subjects were admitted, mortality at 30 days was 11.9% and at one year 24.6%, pulmonary tuberculosis was the most frequent type with 70.2%. Physical examination findings related to mortality were cachexia (p<0.001) and extremity edema (p<0.001). Overall survival was 87.2% at 30 days and 72.9% at one year. In patients with pulmonary tuberculosis, survival was 85.8% at 30 days and 72.8% at one year. Conclusion: The one-year survival rate in patients hospitalized for tuberculosis is low, advanced age, malnutrition, PaO2/FiO2 less than 300, c-reactive protein greater than 45 mg/dL, cerebrovascular disease and peripheral vascular disease were variables that were associated with higher mortality(AU)

Correlación diagnóstica entre fibrolaringoscopia y videoendoscopia digestiva alta en pacientes con reflujo gastroesofágico y reflujo laringofaríngeo / Diagnostic Correlation Between Fiberlaringoscopy and Upper Gastrointestinal Video Endoscopy in Patients with Gastroesophagic Reflux and Laryngopharyngeal Reflux

Introducción: el reflujo laringofaríngeo (RLF) se origina por el flujo retrógrado de contenido gástrico hacia la faringe, pero es una entidad diferente de la enfermedad por reflujo gastroesofágico (ERGE). El objetivo del estudio fue determinar la correlación entre los signos endoscópicos de la fibrolaringoscopia y la videoendoscopia digestiva alta (VEDA). Material y métodos: estudio observacional, retrospectivo y analítico. Se incluyeron pacientes que consultaron por sintomatología de RLF y ERGE. Los hallazgos visualizados por fibrolaringoscopia flexible, VEDA y biopsia de mucosa gástrica de cada paciente se compararon con la prueba de chi-cuadrado (χ²). Se consideró significativo un valor de p ≤ 0,05. Resultados: se incluyeron 318 pacientes entre 18 y 84 años. Se encontró que el 100 % de los pacientes con esofagitis tenía laringitis (p = 0,001); el 100 % de los pacientes con hernia hiatal tenían RLF (p = 0,001); el 97 % de los pacientes con Helicobacter pylori en la mucosa gástrica tenían RLF (p = 0.001). El 71 % de los pacientes con hernia hiatal tenían esofagitis (p = 0,001). Se encontró una asociación lineal entre la edad y la hernia hiatal con la edad y el RLF (p = 0,03). Conclusiones: en este estudio, los signos encontrados en la fibrolaringoscopia tuvieron una asociación estadística con la VEDA. Aproximadamente el 90 % de los pacientes con signos de laringitis tuvo una correlación con algún grado de esofagitis, esófago de Barrett, hernia hiatal y Helicobacter pylori. También se encontró que la laringitis por RLF y la hernia hiatal se relacionaron directamente con el incremento de la edad.

Introduction: Laryngopharyngeal reflux (LPR) is caused by the retrograde flow of gastric contents towards the pharynx, but it is a different entity from gastroesophageal reflux disease (GERD). The objective of the study was to determine the relationship between the endoscopic signs of fiber laryngoscopy and upper gastrointestinal video endoscopy. Material and methods: Observational, retrospective and analytical study. Patients who consulted for LPR and GERD symptoms were included. The findings visualized by flexible fiber laryngoscopy, upper gastrointestinal video endoscopy and gastric mucosal biopsy of each patient were compared with the Chi-square (χ²) test. A value of p ≤ 0.05 is estimated significantly. Results: 318 patients between 18 and 84 years old were included. A relationship was found in 100% of the patients with esophagitis had laryngitis (p = 0.001); 100% of the patients with hiatal hernia had LPR (p = 0.001); 97% of patients with Helicobacter pylori in the gastric mucosal have LPR (p= 0.001); 71% of patients with hiatal hernia had esophagitis (p = 0.001). A linear association was found between age and hiatal hernia with age and LPR. (p = 0.03). Conclusions: In this study, the signs found in fiber laryngoscopy had a statistical association with the upper gastrointestinal video endoscopy. Approximately 90% of patients with signs of laryngitis had correlation with some degree of esophagitis, Barrett's esophagus, hiatal hernia and Helicobacter pylori. It was also found that LPR and hiatal hernia were directly related to increasing age

Manejo de conflictos de interés en control del tabaco: situación en las Américas / Managing conflicts of interest in tobacco control: situation in the Americas / Manejo de conflitos de interesse no controle do tabaco: situação nas Américas

RESUMEN El presente informe especial describe tanto la metodología para el cálculo del indicador sobre adopción de mecanismos eficaces para evitar la interferencia de la industria tabacalera o de aquellos que defienden sus intereses, establecido en la "Estrategia y plan de acción para fortalecer el control del tabaco en la Región de las Américas 2018-2022", así como del estado de adopción de estos mecanismos en los países de la Región para el año 2019, y su progreso desde 2016. Se encontró que, para el 2019, de los 35 Estados Miembros de la Organización Panamericana de la Salud (OPS), 13 cuentan con normativa que establece medidas específicas al manejo de conflicto de interés para funcionarios y empleados públicos con competencia en políticas de control del tabaco. Asimismo, 7 han implementado medidas relacionadas, pero no específicas, y 14 no han implementado ninguna medida. Si bien se muestra un avance en relación con año 2016, los esfuerzos deben ser redoblados para alcanzar la meta de 20 Estados Miembros con mecanismos de identificación y manejo de conflictos de interés, establecida en la Estrategia y plan de acción. Cabe destacar que contar con normativa referida al tema no agota, ni mucho menos, concluye el cumplimiento de todas las obligaciones que emanan del artículo 5.3 del Convenio Marco de la Organización Mundial de la Salud para el Control del Tabaco. La Secretaría de OPS, en cumplimiento de lo solicitado por los Estados Miembros, desarrolló la metodología para el cálculo del indicador y sistematizó los hallazgos que son presentados.

ABSTRACT This special report describes the methodology for calculating the indicator for the adoption of effective mechanisms to counter interference by the tobacco industry and those who work to further its interests, as established in the Strategy and Plan of Action to Strengthen Tobacco Control in the Region of the Americas 2018-2022; the report also presents the status of adoption of these mechanisms in the countries of the Region as of 2019, and progress since 2016. It was found that, as of 2019, of the 35 Pan American Health Organization (PAHO) Member States 13 had regulations establishing specific measures for managing conflicts of interest for government officials and employees with responsibility for tobacco control policies; seven had implemented related but nonspecific measures; and 14 had not implemented any measure. Although there has been progress since 2016, efforts must be redoubled to reach the target of 20 Member States having mechanisms for the identification and management of conflicts of interest, as established in the Strategy and Plan of Action. It should be noted that having regulations on the subject does not fulfill, nor by any means fully meet, all the obligations arising from Article 5.3 of the World Health Organization Framework Convention on Tobacco Control. The PAHO Secretariat, in response to requests by Member States, developed the methodology for calculation of the indicator and systematized the findings that are presented.

RESUMO Este relatório especial descreve tanto a metodologia de cálculo do indicador sobre a adoção de mecanismos eficazes para evitar a interferência da indústria do tabaco ou daqueles que defendem seus interesses, estabelecida na "Estratégia e plano de ação para fortalecer o controle do tabagismo na Região das Américas 2018-2022", quanto a situação da adoção desses mecanismos nos países da Região para o ano de 2019, e seu progresso desde 2016. Constatou-se que, até 2019, dos 35 Estados Membros da Organização Pan-Americana da Saúde (OPAS), 13 possuíam regulamentações que estabelecem medidas específicas para o manejo de conflitos de interesse para funcionários públicos responsáveis por políticas de controle do tabaco. Da mesma forma, 7 haviam implementado medidas relacionadas, mas não específicas, e 14 não haviam implementado nenhuma medida. Embora haja avanços em relação a 2016, os esforços devem ser redobrados para atingir a meta estabelecida na estratégia e no plano de ação de 20 Estados Membros com mecanismos de identificação e gestão de conflitos de interesse. Vale destacar que ter regulamentação sobre o tema não esgota, muito menos conclui, o cumprimento de todas as obrigações que emanam do artigo 5.3 da Convenção-Quadro da Organização Mundial da Saúde para o Controle do Tabaco. A Secretaria da OPAS, em cumprimento ao que foi solicitado pelos Estados Membros, desenvolveu a metodologia para o cálculo do indicador e sistematizou os resultados aqui apresentados.

Influence of foot pain on frailty symptoms in an elderly population: a case-control study

ABSTRACT BACKGROUND: Frailty is a condition that can increase the risk of falls. In addition, foot disorders can negatively influence elderly people, thus affecting their condition of frailty. OBJECTIVE: To determine whether foot pain can influence a greater degree of frailty. DESIGN AND SETTING: Cross-sectional descriptive study conducted at the University of Valencia, Valencia, Spain. METHODS: A sample older than 60 years (n = 52), including 26 healthy subjects and 26 foot pain patients, was recruited. Frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS). RESULTS: There were statistically significant differences in the total EFS score and in most of its subscales, according to the Mann-Whitney U test (P < 0.05). In addition, foot pain patients presented worse scores (higher 5-Frailty scores) than did healthy patients, regarding matched-paired subjects (lower EFS scores). With regard to the rest of the measurements, there were no statistically significant differences (P > 0.05). The highest scores (P < 0.001) were for fatigue on the 5-Frailty scale and the EFS, and for the subscale of independence function in EFS. CONCLUSIONS: These elderly patients presented impairment relating to ambulation and total 5-Frailty score, which seemed to be linked to the presence of frailty syndrome and foot disorders.

Influence of unstable shoes on women with lumbopelvic postpartum pain: randomized clinical trial

ABSTRACT BACKGROUND: Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth. OBJECTIVES: To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period. DESIGN AND SETTING: Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center. METHODS: A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform. RESULTS: The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed. CONCLUSIONS: Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anterior stability speed and anterior COP at nine weeks.

Assessment of changes in the electrical activity of the brain during general anesthesia using portable electroencephalography / Evaluación de los cambios de la actividad eléctrica cerebral durante anestesia general usando electroencefalografía portable

Abstract Introduction The analysis of the electrical activity of the brain using scalp electrodes with electroencephalography (EEG) could reveal the depth of anesthesia of a patient during surgery. However, conventional EEG equipment, due to its price and size, are not a practical option for the operating room and the commercial units used in surgery do not provide access to the electrical activity. The availability of low-cost portable technologies could provide for further research on the brain activity under general anesthesia and facilitate our quest for new markers of depth of anesthesia. Objective To assess the capabilities of a portable EEG technology to capture brain rhythms associated with the state of consciousness and the general anesthesia status of surgical patients anesthetized with propofol. Methods Observational, cross-sectional study that reviewed 10 EEG recordings captured using OpenBCI portable low-cost technology, in female patients undergoing general anesthesia with propofol. The signal from the frontal electrodes was analyzed with spectral analysis and the results were compared against the reports in the literature. Results The signal captured with frontal electrodes, particularly α rhythm, enabled the distinction between resting with eyes closed and with eyes opened in a conscious state, and sustained anesthesia during surgery. Conclusions It is possible to differentiate a resting state from sustained anesthesia, replicating previous findings with conventional technologies. These results pave the way to the use of portable technologies such as the OpenBCI tool, to explore the brain dynamics during anesthesia.

Resumen Introducción El análisis de la actividad eléctrica cerebral mediante electrodos ubicados sobre el cuero cabelludo con electroencefalografía (EEG) podría permitir conocer la profundidad anestésica de un paciente durante cirugía. Sin embargo, los equipos de EEG convencionales, por su precio y tamaño, no son una alternativa práctica en quirófanos y los equipos comerciales usados en cirugía no permiten acceder a la actividad eléctrica. Disponer de tecnologías portables y de bajo costo aumentaría el número de investigaciones sobre la actividad cerebral bajo anestesia general y facilitaría la búsqueda de nuevos marcadores para la profundidad anestésica. Objetivo Evaluar la capacidad de una tecnología EEG portable de adquirir ritmos cerebrales relacionados con el estado consciente y el estado de anestesia general de pacientes en cirugía anestesiados con propofol. Métodos Estudio observacional de corte transversal en el que se analizaron datos de 10 registros EEG obtenidos mediante tecnología portable y de bajo costo OpenBCI, de pacientes de sexo femenino que fueron sometidas a anestesia general con propofol. La señal obtenida de los electrodos frontales se analizó mediante análisis espectral y se contrastaron los resultados con lo descrito en la literatura. Resultados La señal obtenida con electrodos frontales, especialmente el ritmo α, permitió diferenciar el reposo con ojos cerrados y ojos abiertos en estado consciente, del estado de mantenimiento de la anestesia durante cirugía. Conclusiones Se logra la diferenciación de estado de reposo y de mantenimiento de la anestesia replicando hallazgos previos de tecnologías convencionales. Estos resultados abren la posibilidad de utilizar las tecnologías portables como el OpenBCI para investigar la dinámica cerebral durante la anestesia.

Intra and intersession repeatability and reliability of dynamic parameters in pressure platform assessments on subjects with simulated leg length discrepancy. A cross-sectional research

ABSTRACT BACKGROUND: Leg length discrepancy (LLD) may play a key role in exercise biomechanics. Although the Podoprint platform has been used in dynamic pressure studies, there are no data regarding the reliability and repeatability of dynamic measurements under simulated LLD conditions. OBJECTIVES: To determine the intra and intersession repeatability and reliability of dynamic parameters of the Podoprint pressure platform under simulated LLD conditions. DESIGN AND SETTING: Observational cross-sectional study at a public university. METHODS: Thirty-seven healthy volunteers participated in this study. LLD was simulated using ethyl vinyl acetate plantar lifts with heights of 5 mm, 10 mm, 15 mm and 20 mm located under the right shoe of each volunteer. The procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Stance time, mean pressure and peak pressure measurements were registered in three trials for each foot and each LLD level. Data were collected during two separate testing sessions, in order to establish intrasession and intersession reliability. RESULTS: The intraclass correlation coefficients (ICCs) for intrasession reliability ranged from 0.775 to 0.983 in the first session and from 0.860 to 0.985 in the second session. The ICCs for intersession reliability ranged from 0.909 to 0.990. Bland-Altman plots showed absence of systematic measurement errors. CONCLUSIONS: The results from this study indicate that the Podoprint platform is a reliable system for assessing dynamic parameters under simulated LLD conditions. Future studies should evaluate plantar pressures under LLD conditions, in association with exercise, biomechanics and musculoskeletal disorders.