Lesiones musculares deportivas: correlación entre anatomía y estudio por imágenes / Muscle injuries in sports: imaging study

Un gran segmento de la población participa en actividades deportivas. Las lesiones musculares corresponden a aproximadamente un tercio de las lesiones deportivas. Las demandas recreacionales y profesionales de la sociedad moderna exigen un diagnóstico precoz y preciso, para un adecuado tratamiento y seguimiento, dadas las implicancias económicas y mediáticas, especialmente en deportistas de elite. La imagenología tiene un rol fundamental en la evaluación de estas lesiones. Permite evaluar localización, extensión, severidad y estimar pronóstico, así como también el seguimiento para determinar el retorno deportivo. En este artículo se revisa la anatomía microscópica y macroscópica muscular, la fisiología, los tipos de lesiones y su representación en imágenes, tanto en ultrasonido (US), como en resonancia magnética (RM). Se mencionan distintas clasificaciones descritas en la literatura y se propone una nueva nomenclatura y descripción, basada principalmente en la anatomía muscular, la localización y cuantificación de las lesiones.

A large segment of the population participates in sporting activities. Muscle injuries account for approximately one-third of the injuries. The recreational and professional demands of modern society require an early and precise diagnosis of these, for an adequate treatment and follow-up, given the economic and media implications, especially in elite athletes1. Imaging plays a fundamental role in the evaluation of these lesions. It allows evaluation location, extent, severity and estimations of prognosis, as well as the follow-up to determine the return to sport. This article reviews the microscopic and macroscopic muscle anatomy, the physiology, types of lesions and their representation in images, both in ultrasound (US) and magnetic resonance (MRI). Different classifications described in the literature are mentioned and a nomenclature and description is proposed, based mainly on the muscle anatomy, localization and type of injury.

Aspectos económicos y epidemiológicos de los trastornos de ansiedad generalizada: una revisión de la literatura / Economic and epidemiologic aspects of generalized anxiety disorder: a review of the literature

Introducción. El objetivo es determinar la prevalencia estimada, las pautas de tratamiento más utilizadas en el trastorno de ansiedad generalizada (TAG) en España y los costes asociados a este trastorno en diversos países. Métodos. Búsqueda en bases de datos especializadas en economía y salud. Resultados. De 32 referencias seleccionadas, 6 estudios tienen datos sobre prevalencia y 3 de pautas de tratamiento en España, 11 estudios de costes asociados a la enfermedad a nivel internacional y los 20 artículos restantes tienen un interés general por razones de contexto o metodología. Conclusiones. El TAG es un trastorno mental con alta prevalencia. Según algunos autores, infradiagnosticado. No se dispone de un tratamiento satisfactorio a largo plazo. Genera elevados costes sanitarios y humanos. La frecuente comorbilidad, las diferentes definiciones y las metodologías utilizadas limitan la comparabilidad, la síntesis de los resultados y dificulta las estimaciones válidas de prevalencia y costes (AU)

Introduction. The objective is to assess the prevalence and treatment patterns of generalized anxiety disorder (GAD) in Spain as well as the cost associated to this disorder in different countries. Methods. A search in the literature of health and economics databases was conducted. Results. In regards to the 32 references selected, 6 studies had data on the prevalence of GAD and 3 on treatment patterns in Spain and 11 studies on the costs associated to the disease on an international level. The remaining 20 studies were of general interest for methodological or contextual reasons. Conclusions. GAD is a mental disorder with high prevalence. According to some authors, it is probably underdiagnosed. No appropriate long term treatment is available. High health care and social costs are associated to GAD. The frequent presence of comorbidity, different definitions and methodologies used in the studies limits the comparability and synthesis of the results. It also makes it difficult to obtain valid estimations of prevalence and costs (AU)

[Economic and epidemiologic aspects of generalized anxiety disorder: a review of the literature]. / Aspectos económicos y epidemiológicos de los trastornos de ansiedadgeneralizada: una revisión de la literatura.

INTRODUCTION: The objective is to assess the prevalence and treatment patterns of generalized anxiety disorder (GAD) in Spain as well as the cost associated to this disorder in different countries. METHODS: A search in the literature of health and economics databases was conducted. RESULTS: In regards to the 32 references selected, 6 studies had data on the prevalence of GAD and 3 on treatment patterns in Spain and 11 studies on the costs associated to the disease on an international level. The remaining 20 studies were of general interest for methodological or contextual reasons. CONCLUSIONS: GAD is a mental disorder with high prevalence. According to some authors, it is probably underdiagnosed. No appropriate long term treatment is available. High health care and social costs are associated to GAD. The frequent presence of comorbidity, different definitions and methodologies used in the studies limits the comparability and synthesis of the results. It also makes it difficult to obtain valid estimations of prevalence and costs.

Colonoscopía virtual: realidad en un hospital público / Virtual colonoscopy: reality in a public hospital

Colon cancer is the third cause of death by cancer in Chile. Virtual CT colonoscopy (VC) is a non-invasive imaging technique in development. The most common indications of VC are screening of colonic polyp, incomplete conventional colonoscopy and staging of colorectal tumors. The objective of our study is to show our experience with this method in the Radiology Unit of Hospital Padre Hurtado. We reviewed 15 VC, corresponding to 15 patients (10 female and 5 male), with ages between 18 and 75. Six exams showed no significant findings (40%), 4 diverticular diseases (26,6%), 3 colon cancers (20%), and 2 familial polyposis (13,3%). VC proved to be an accesible method, well tolerated by the patients, less invasive than conventional colonoscopy and with no complications in our series. It also constitutes for us an excellent study method in patients where conventional colonoscopy is incomplete. We obtained an adecuate correlation with conventional colonosocopy, when this method was performed. Evaluation of the data obtained from VC requires a trained radiologist and, in some occasions, prolonged time for analysis and interpretation of the results.

El cáncer de colon es la tercera causa de muerte por cáncer en Chile. La colonoscopía virtual (CV) es una técnica de imagen no invasiva en desarrollo. Sus indicaciones habituales son: screening y detección de pólipos en el colon, colonoscopía convencional fallida o incompleta y, etapificación de tumores colorrectales. El objetivo de nuestro trabajo fue mostrar nuestra experiencia con este método diagnóstico en el Servicio de Imagenología del Hospital Padre Hurtado. Se revisaron 15 exámenes de CV que correspondieron a 15 pacientes (10 mujeres y 5 hombres), con edades entre 18 y 75 años. Los estudios mostraron 6 casos sin hallazgos patológicos significativos (40%), 4 enfermedades diverticulares (26,6%), 3 neoplasias de colon (20%) y 2 poliposis familiares (13,3%). La colonoscopía por TC resultó ser una técnica accesible, bien tolerada por los pacientes, menos invasiva que la fibrocolonoscopía y sin complicaciones. Además, para nosotros constituye un excelente método de estudio, sobretodo en aquellos pacientes en los cuales la fibrocolonoscopía resultó fallida o incompleta. Se obtuvo una buena correlación con colonoscopía convencional, cuando ésta se pudo realizar. El post-proceso de los datos requiere de entrenamiento del radiólogo y, algunas veces, tiempo prolongado para el análisis e interpretación de los resultados.

[Retroperitoneal fibromatosis: report of a case]. / Fibromatosis mesentérica: caso clínico-imagenológico y revisión bibliográfica.

We report a 42 years old female that presented with abdominal pain and no palpable mass. Imaging abdominal ultrasound, CAT scan and magnetic resonance showed a solid tumor located in the retroperitoneum. The patient was operated on excising the tumor. Pathological examination of the surgical piece disclosed a retroperitoneal fibromatosis or desmoid tumor. Postoperative evolution of the patient was uneventful and she was discharged 12 days after the surgical procedure.

Fibromatosis mesentérica: caso clínico-imagenológico y revisión bibliográfica / Retroperitoneal fibromatosis: Report of one case

We report a 42 years old female that presented with abdominal pain and no palpable mass. Imaging abdominal ultrasound, CAT scan and magnetic resonance showed a solid tumor located in the retroperitoneum. The patient was operated on excising the tumor. Pathological examination of the surgical piece disclosed a retroperitoneal fibromatosis or desmoid tumor. Postoperative evolution of the patient was uneventful and she was discharged 12 days after the surgical procedure.

[Chemical composition of 2 wild vegetable species compared with chard]. / Estudio de la composición química, de dos especies vegetales silvestres en comparación con acelga.

The nutritional quality of two wild vegetable species, Kochia scoparia (Ks) and Chenopodium album (Cha) was evaluated and compared with Beta vulgaris var. cicla(chard) (Bv), in order to propose their domestication as alternative protein sources. Chemical percentual analysis (AOAC), gaseous chromatography fatty acid determination, and antinutrient searching (by chemical, enzymatic and immunological method) were performed. Protein quality was determined by the following indexes: net protein utilization (NPU), true digestibility (tD) and biological value (BV). The three species exhibited similar protein concentration values, 25.8, 25.0 and 22.1 g/100 g for Ks, Cha and Bv, respectively. Kochia scoparia showed the highest value for fatty acid analysis (82%), with predominance of linolenic acid. Since the samples were subjected to boiling, the amounts of antinutrients found can be considered to be within levels not affecting health. As regards the biological quality, the obtained values for Ks, Cha and Bv, respectively, were: NPU: 68.0 +/- 0.4, 55.0 +/- 6.1 and 56.0 +/- 4.2; tD 70.0 +/- 0.7, 71.0 +/- 4.0 and 76.0 +/- 8.2; BV: 97, 77 and 74. The analysis of the biological quality indexes gave highest nitrogen profit for Ks. These results indicate that Kochia scoparia is suitable for the objective proposed.

Estudio de la composición química, de dos especies vegetales silvestres en comparación com acelga / The study of the chemical composition of 2 wild vegetable species in comparison with chard

El propósito de este estudio fue evaluar la calidad nutricional de dos especies vegetales silvestres Kochia scoparia (Ks) y Chenoposium album (Cha) y comparalas con Beta vulgaris var. cicla (acelga) (Bv), con la finalidad de proponer la domesticación de las mismas, para introducirlas como fuente proteica alternativa. Se realizó la evaluación químico porcentual (AOAC), determinación de ácidos grasos por cromatografía gaseosa, la investigacón de antinutrientes (Métodos químicos, enzimáticos e inmunológicos) y mediante 'los índices de utilización proteica (NPU), digestibilidad verdadera (tD) y valor biológico (BV) (Miller y Bender), se determinó la calidad proteica. Se trabajó con muestras sometidas a cocción. El estudio de la concentración proteica, reveló valores similares para los tres vegetales Ks 25.8, Cha 25.0, Bv 22.1 g/100 g. Del análisis de ácidos grasos se observó un alto porcentaje de ácidos grasos insaturados correspondiendo el mayor 82 por ciento a Kochia scoparia, con predominio de ácido linolénico. Al trabajarse con material cocido los tenores de antinutrientes pueden considerarse en niveles que no comprometen la salud. Con respecto a la calidad biológica se obtuvieron los siguientes datos para Ks, Cha, Bv: NPU 68.0 + 0.4, 55.0 + 6.1, 56.0 + 4.2; tD 70.0 + 0.7, 71.0 + 4.0, 76.0 + 8.2; BV 97, 77 y 74 respectivamente. Del análisis de los indicadores por los cuales se evaluó la calidad biológica se encontró un mayor aprovechamiento nitrogenado en Ks. Por lo que Kochia scoparia cumpliría el objetivo previamente propuesto.

Nutrient and antinutrient composition of Amaranthus muricatus.

The chemical and nutritional composition of the aerial parts of Amaranthus muricatus was assessed. This is a wild plant growing well in arid and poor soil, which are not suitable for cereals. The material under study was boiled, dried and ground and then evaluated for chemical, nutritional and antinutritional properties. Protein concentration of the amaranth flour was 15.74 g/100 g and total dietary fiber content was high (53.81 g/100 g), with 79% coming from insoluble dietary fiber. The calcium content was 1533 mg/100 g and the Ca/P ratio (5.94) was markedly higher than the value suggested in the 1989 Recommended Dietary Allowances. Fifty-nine percent of the fatty acids present were unsaturated with linoleic acid accounting for 40% of the total fatty acid content. Nitrate, hemagglutinin, trypsin inhibitor and saponin contents were within the non-critical values. Net protein utilization (NPU), true digestibility (tD) and biological value (BV) measurements indicated a nitrogen gain of 74% that of casein. The results of this study indicate a nutritive potential for the A. muricatus leaves, therefore, domestication of this plant is suggested along with assessment of its chemical and nutritional properties.

[The population of Catalonia, 1991-2015. A proposal of denominators]. / La població de Catalunya, 1991-2015. Una proposta de denominadors.

OBJECTIVES: The purpose of population projection is to have available data in the absence of it and to forecast characteristics and structure of the population. The objective is to obtain the population of Catalonia by age and sex from 1991 to 2015. METHODS: The components method was used to obtain the population projection with an unique demographic scenario characterized by a low Catalonian population aging. The demographic hypotheses assume a stability in the mortality, a moderate increase in the fertility with a delay in the schedule and a slight net migration. RESULTS: In 2015 the projected population under the combination of hypotheses would be decreased in 13.37% for ages less than 15, in 2.27% for ages 15 through 64 and for people over 65 it would increase in 39.29%. The major impact of aging would be observed in female with an increasing in the average of age from 39.29 in 1991 to 44.14 in 2015. The projected population would be 933,540 for the youngest group, 4,004,226 for the adult group and 1,112,732 for the aged group. CONCLUSIONS: These results show a progressive aging of the Catalonian population due to a reduction of the youngest and an increasing of the oldest age groups.

[Comparison of two sources on mortality information in a retrospective cohort study on occupational cancer]. / Concordancia entre dos fuentes de información sobre causas de mortalidad en un estudio de seguimiento retrospectivo de cáncer ocupacional.

In the context of a historical cohort study among workers in the pulp and paper industry, we examined the agreement between the underlying cause of death obtained from municipal mortality files and from the mortality register of Catalonia (n = 50 pairs). The percentage of simple agreement (P0) for major causes of death was 76%. The agreement and the Kappa index was higher for external causes (P0 = 98%; K = 0.87) and for cancer (P0 = 90%; K = 0.79). The agreement was moderate for mortality from circulatory diseases (K = 0.57). Agreement between 3 digit ICD codes was 48% but was higher for deaths from cancer (P0 = 67%). These results indicate that information on major causes of death and on specific causes of cancer retrieved from municipal mortality files may be used for the follow-up of historical cohort studies.

[The impact of AIDS in the global mortality in Catalonia, 1981-1993]. / Impacto del sida en la mortalidad global de Cataluña, 1981-1993.

OBJECTIVES: To compare the evolution of the principal causes of death in Catalonia, Spain and to assess the impact of AIDS as a contributing factor to the increase of mortality in young people in Catalonia. METHODS: Data from the mortality register of Department of Health in Catalonia has been used. We have compared the principal causes of death in Catalonia for the global population and for the group of 20 to 39 year olds. We have calculated the potential years of life lost (PYLL) between the ages of 13 to 65. RESULTS: Since the first case of AIDS in 1981, AIDS has been the cause of death with the most important increase for the global population in Catalonia. AIDS is the sixth cause of death and the first cause of PYLL. For the young population in Catalonia (aged 20-39) AIDS became, in 1993, the first cause of death. From 1992 to 1993 the PYLL due to AIDS increased 5% in men and 51% in women. CONCLUSIONS: The present situation has led AIDS being the first cause of death among young population. The collaboration between mortality registers and AIDS registers is absolutely essential to assess more accurately the impact of AIDS on the mortality of population.

[Mortality in Catalonia: description and comparison by age and sex]. / La mortalitat a Catalunya: descripció i comparació per edat i sexe.

OBJECTIVE: To assess the fit of the parametric mortality laws proposed by Heligman and Pollard to the mortality experience of Catalonia (Spain) with the goal of describing and comparing mortality by age and gender, in the time periods 1985-86 and 1990-91. DATA AND METHODS: The data were obtained from the official mortality Registry and population Census for the respective years. Observed conditional probabilities of dying by age and gender were adjusted using the parametric mortality laws formulated by Heligman and Pollard. These laws provide information about mortality characteristics in childhood, in youth and in adults. Goodness of fit of the models was assessed using chi-square, sign, and Steven's tests. Significant outliners were also determined and considered in the analysis. RESULTS: In Catalonia from 1985-86 to 1990-91 the probability of dying increased among people aged 16 to 40 years, this being higher in males as compared to females. For people older than 40 years of age the probability of dying in males did not change, but decreased for females. In this time period, the probability of dying slightly decreased during childhood. The life expectancy at birth for males decreased from 74.12 years in 1985-86 to 73.85 years in 1990-91. In contrast, the life expectancy at birth for females increased from 80.08 years in 1985-86 to 80.88 in 1990-91, thus widening mortality differences by gender. CONCLUSIONS: Heligman and Pollard laws of mortality are useful in describing mortality by age and gender, as well as in analyzing the evolution of mortality over time. The unfavorable evolution of mortality among young men living in Catalonia has contributed to reversing the trend of life expectancy at birth in the twentieth century.