Escuela de espalda: una forma sencilla de mejorar el dolor y los hábitos posturales / Back school: A simple way to improve pain and postural behaviour

INTRODUCCIÓN: El dolor inespecífico de espalda en niños y adolescentes es muy prevalente. El objetivo de este estudio es presentar un programa de Escuela de espalda juvenil (EDEJ) y sus resultados en nuestro servicio. MATERIAL Y MÉTODO: Estudio observacional y prospectivo con 139 pacientes, remitidos a la consulta de raquis juvenil por dolor, deformidad o asimetría en la espalda. VARIABLES: edad, sexo, dolor, adopción de posturas correctas, actividad deportiva, adherencia a la EDEJ y percepción de estos parámetros por sus padres. Se midieron las variables mediante una escala numérica del dolor y una encuesta administradas en la primera sesión y a los 3 meses tras la EDEJ. RESULTADOS: El estudio fue completado por 119 pacientes (78 mujeres y 41 hombres) con una edad media ± desviación estándar de 13,97±2,29 años (9-20). La mediana de la intensidad del dolor se redujo de 3 a 0 a los 3 meses tras EDEJ (p < 0,0001). Aumentaron los pacientes que mejoraron su actitud postural, del 21 al 83% (p < 0,0001). No se confirmó un aumento de práctica deportiva post-EDEJ, aunque su práctica habitual se relacionó con una mejoría de dolor post-EDEJ (p < 0,02). La realización de los ejercicios no asoció disminución del dolor. Existió mala correlación entre la valoración de padres e hijos sobre el dolor post-EDEJ. CONCLUSIÓN: Un programa de escuela de espalda podría contribuir a disminuir el dolor inespecífico de espalda y mejorar los hábitos posturales en jóvenes

INTRODUCTION: Non-specific back pain in children and adolescents has a high prevalence. The aim of this study is to show a Juvenile Back School (JBS) programme and its results in our hospital. MATERIAL AND METHOD: A total of 139 patients referred to a Juvenile Back School for advice due to of pain, deformity or back asymmetry were included in a prospective observational study. VARIABLES: age, gender, pain, correct postures, sports activities, adherence to JBS and appreciation of these parameters by their parents. Variables were measured with a numerical pain scale and with a survey completed in the first session and 3 months after finishing the JBS. RESULTS: A total of 119 patients finished the study (78 female and 41 male).The average was 13.97±2.29 years (9-20). Three months after JBS, the median pain intensity was reduced from 3 to 0 (P<0.0001). There was an improvement in patient postures from 21% to 83% (P<0.0001). Patients did not increase their sport activity after the JBS, although its regular practice was linked with pain improvement after JBS (P<0.02).Performing exercises did not lead to a decrease in pain. There was a poor correlation between parents and children in the evaluation of post-JBS pain. CONCLUSION: A back school programme could probably contribute to reduce non-specific back pain and improve postural behaviour in young people

[Back school: a simple way to improve pain and postural behaviour]. / Escuela de espalda: una forma sencilla de mejorar el dolor y los hábitos posturales.

INTRODUCTION: Non-specific back pain in children and adolescents has a high prevalence. The aim of this study is to show a Juvenile Back School (JBS) programme and its results in our hospital. MATERIAL AND METHOD: A total of 139 patients referred to a Juvenile Back School for advice due to of pain, deformity or back asymmetry were included in a prospective observational study. VARIABLES: age, gender, pain, correct postures, sports activities, adherence to JBS and appreciation of these parameters by their parents. VARIABLES were measured with a numerical pain scale and with a survey completed in the first session and 3 months after finishing the JBS. RESULTS: A total of 119 patients finished the study (78 female and 41 male).The average was 13.97±2.29 years (9-20). Three months after JBS, the median pain intensity was reduced from 3 to 0 (P<.0001). There was an improvement in patient postures from 21% to 83% (P<.0001). Patients did not increase their sport activity after the JBS, although its regular practice was linked with pain improvement after JBS (P<.02).Performing exercises did not lead to a decrease in pain. There was a poor correlation between parents and children in the evaluation of post-JBS pain. CONCLUSION: A back school programme could probably contribute to reduce non-specific back pain and improve postural behaviour in young people.

Desarticulación coxofemoral por fascitis necrotizante y síndrome del shock tóxico estreptocócico / Coxofemoral disarticulation by necrotizing fasciitis and streptococcal toxic shock syndrome

La fascitis necrotizante es una infección rápidamente progresiva de la piel y los tejidos blandos, asociada a una rápida destrucción y necrosis de la fascia y de la grasa, que se acompaña de importante toxicidad sistémica y alta mortalidad. Supone la forma más grave de infección de partes blandas, y en un tercio de los pacientes da lugar a la aparición de shock y fracaso multiorgánico. Existen 2 tipos: tipo I, polimicrobiana, en la que existen factores predisponentes para su aparición, y la tipo II o estreptocócica en jóvenes sin comorbilidad asociada. El diagnóstico es clínico y no debe retrasarse la exploración quirúrgica, ya que su pronóstico depende en gran medida de un diagnóstico precoz y de un tratamiento agresivo inmediato. Presentamos un caso de fascitis necrotizante tipo II de miembro inferior derecho complicada con un síndrome del shock tóxico estreptocócico y que fue necesario realizar una desarticulación de cadera (AU)

Necrotizing fasciitis is a rapidly progressive infection of the skin and soft tissue characterized by widespread necrosis of the subcutaneous tissue and the fascia, which usually involves severe systemic toxicity and high index of mortality. This disease is the most serious form of skin and soft tissue infection. About one third of the patients develops shock and multiorgan failure. There are two types: type I, polymicrobial, for which there are predisposing risk factors and type II, or streptococcal in young patients without associated comorbidity. The diagnosis is based on the clinical manifestations and surgical intervention should not be delayed as its prognosis largely depends on an early diagnosis and immediate aggressive treatment. We report the case of a patient with necrotizing fasciitis type II of the lower right limb, who suffered streptococcal toxic shock syndrome and in whom hip disarticulation was required (AU)

Use of platelet-rich plasma in the treatment of bisphosphonate-related osteonecrosis of the jaw.

Platelet-rich plasma is a concentrate of growth factors and osteoconductive proteins, which can play a major role in bone biology by accelerating and enhancing bone repair and regeneration. This paper describes the results of using platelet-rich plasma in the management of bisphosphonate-associated necrosis of the jaw. Eight patients with a diagnosis of bisphosphonate-associated necrosis of the jaw were surgically treated for debridement and removal of necrotic bone, followed by application of autologous platelet concentrate enriched with growth factors and primary suture of the wound. Patients underwent periodic clinical and radiological follow-up examinations. All patients showed clinical improvement and oral lesions resolved 2-4 weeks after treatment. After an average 14-month follow up period, patients remained asymptomatic. Although not conclusive, the combination of necrotic-bone curettage and platelet-rich-plasma to treat refractory osteonecrosis of the jaw yielded promising results.

Experimental study of the ferroelastic phase transition in urea/n-heptadecane composite.

An experimental study of the ferroelastic phase transition in urea/n-heptadecane CO(NH2)2/C17H40 composite around the structural phase transition undergone by this crystal at 159 K is presented. The temperature dependence of the macroscopic spontaneous strain and the optical birefringence around this temperature has been determined. A phenomenological model limited to the hexagonal-orthorhombic change of the urea sublattice leads to a linear relation between these quantities and the phase transition entropy. The experimental data agree with this description exception made of the near vicinity of the phase transition, where the influence of the alkane chain ordering processes cannot be excluded.

Phase transitions in the urea/n-nonadecane system by calorimetric techniques.

A calorimetric study of urea/n-nonadecane, CO(NH(2))(2)/C(19)H(40), and the deuterated derivatives, CO(ND(2))(2)/C(19)D(40) and CO(NH(2))(2)/C(19)D(40), around the structural phase transition temperature is presented. For this purpose differential scanning (DSC), temperature-modulated (AC) and adiabatic calorimetry have been used and the obtained results are compared. Leaving apart the noticeable peak associated with the main phase transition at 158.5, 149.4 and 154 K respectively, small anomalies of the specific heat are found at lower temperatures and their corresponding entropic and enthalpic changes are reported. Heating and cooling experiments show the influence of the temperature rate and the thermal history on the detailed profile of the specific heat traces. The presence of thermal hysteresis and latent heat as a way to characterize the order of the phase transitions is discussed. Finally, a tentative approach to the urea and the alkyl chain contributions to the specific heat and their influence on the phase transition mechanisms is presented.

Mid-term results in total hip arthroplasty with the basic noncemented hip prosthesis.

The Basic (IQL-Biomet, Valencia, Spain) hip prosthesis was used in 430 implant procedures, of which 417 had mean follow-up of 6 years. Radiographic follow-up was performed at 1, 3, 6, and 12 months postoperatively, and annually thereafter. The average Harris hip score improved from 35.7 preoperatively to 90.9 postoperatively. Clinical results after 2 years of follow-up showed 6% thigh pain, which decreased to 2% at 6 years. Radiographic evaluation demonstrated 22 cases of calcar resorption, 14% of which had distal pedestal formation. Heterotopic ossification was noted radiographically in 36%. These mid-term results obtained with the Basic prosthesis are similar to the findings of other series and warrant its use.

X-ray diffraction study of the phase transition of K2Mn2(BeF4)3: a new type of low-temperature structure for langbeinites.

The potassium manganese tetrafluoroberyllate langbeinite compound has been studied in the temperature range 100-300 K. Using DSC measurements, a phase transition has been detected at 213 K. The space group of the low-temperature phase was determined to be P112(1) using X-ray diffraction experiments and optical observations of the domain structure. The b axis is doubled with respect to the prototypic P2(1)3 cubic phase. Lattice parameters were determined by powder diffraction data [a = 10.0690 (8), b = 20.136 (2), c = 10.0329 (4) A, gamma = 90.01 (1) degrees ]. A precise analysis of the BeF(4) tetrahedra in the low-temperature phase shows that two independent tetrahedra rotate in opposite directions along the doubled crystallographic axis. A symmetry mode analysis of the monoclinic distortion is also reported. This is the first report of the existence of such a phase transition in K(2)Mn(2)(BeF(4))(3) and also of a new type of low-temperature structure for langbeinite compounds.

Suburban Areas in Developing Countries and Their Relationship to Groundwater Pollution: A Case Study of Mar del Plata, Argentina

/ Human activities carried out in suburban areas in many developing countries are directly related to groundwater pollution. The main objective of this paper is to analyze the relationship between land use and groundwater pollution in the suburban area of Mar del Plata (Argentina). We identified three elements that are endangering the quality of groundwater: horticultural activity, urban solid waste disposal sites, and sewage disposal on land. Fifty wells in an area of 175 km2 were sampled in order to verify the impact of these problems on groundwater. All samples were analyzed for major ions, and about 30 of them for fecal coliforms and heavy metals. Nineteen samples were selected for pesticide analyses. The average nitrate content was 80 mg/liter, eight times the regional background value. Fecal coliforms were detected in 60% of the analyzed samples. Zinc content and a high Cl-/HCO3- ratio were observed in the surroundings of the solid waste disposal area. Moreover, lindane and heptachlor pesticides were detected in ten samples.KEY WORDS: Suburban areas; Groundwater pollution; Groundwater management; Argentina