Effectiveness of Mud-Pack Therapy and Mud-Bath Therapy in Osteoarthritis: A Systematic Review.

OBJECTIVES: Osteoarthritis has a tremendous socioeconomic impact in terms of drug spending, hospital admissions, work productivity, and temporary or permanent incapacity. Mud therapy has been discussed as potential conservative treatment options for osteoarthritis. However, findings from several trials still remain controversial. For this reason, we aimed to systematically review the highest evidence provided by published trials to estimate the clinical effect of mud-pack and mud-bath therapy for the treatment of osteoarthritis. METHODS: We searched PubMed, PEDro, and the Cochrane CENTRAL Register for Controlled Trials for articles published between 2000 and 2020 using the terms "orthopedics," "orthopaedics," "musculoskeletal," "osteoarthritis," and "mud bath," "mud pack." RESULTS: Of the 19 studies included, 15 examined the effects of mud-bath therapy in knee osteoarthritis treatment. One study focused on the treatment effect of mud bath on hand osteoarthritis, another study examined treatment effects in hip and knee osteoarthritis, and two studies enrolled patients with chronic low back pain caused by lumbar spine osteoarthritis. We systematically reviewed the data obtained from the literature and summarized the results on the basis of the main outcomes. The results show significant improvements in function, quality of life, and perceived pain for patients with osteoarthritis. CONCLUSION: Results of randomized controlled trials suggest that mud therapy is part of a promising integrated and synergistic multidisciplinary approach in combination with other treatment forms like pharmacotherapy or physiotherapy.Die sozio-ökonomischen Auswirkungen der Arthrose sind immens. Heiltorfbehandlungen sind seit einiger Zeit als mögliche Ergänzung der konservativen Therapieoptionen dieser Erkrankung Gegenstand wissenschaftlicher Untersuchungen. Ziel dieser Studie war es, die aktuellen Erkenntnisse zur Heiltorftherapie bei Arthrose zusammenzufassen.Wir führten eine systematische Literaturrecherche der Datenbanken Pubmed, PEDro und Cochrane CENTRAL Register of Controlled Trials durch. Hierbei wurden Artikel, die zwischen 2000 und 2020 publiziert wurden und mit den Schlagwörtern "orthopedics", "orthopaedics", "musculoskeletal", "osteoarthritis" und "mud-bath", "mud-pack" assoziiert waren, erfasst.Von den 19 näher untersuchten Studien beschäftigten sich 15 mit den Effekten der Heiltorftherapie bei Patienten mit Kniearthrose, eine Studie untersuchte Patienten mit Arthrose der Hand, eine weitere Studie untersuchte die Auswirkung der Therapie bei Arthrose der Hüfte. 2 Studien untersuchten den Effekt der Moorbäder bei Patienten mit chronischen Rückenschmerzen. Insgesamt zeigten sich signifikante Verbesserungen der Funktion, Lebensqualität und Schmerzlinderung bei den Patienten unter Heiltorftherapie.Die Ergebnisse der randomisierten, kontrollierten Studien zeigen, dass die Heiltorftherapie eine vielversprechende Ergänzung in einem multidisziplinären Ansatz der Arthrosetherapie ist.

Interculturalidad: más allá de la diversidad Reflexiones y experiencias en contextos latinoamericanos / Interculturality: beyond diversity Reflections and experiences in Latin American contexts

Este libro tiene como origen las diversas reflexiones originadas por la ejecución de un trabajo de investigación en el área de la salud con comunidades indígenas de la Amazonia colombiana denominado: "Estrategia de Atención Primaria en Salud con enfoque intercultural e investigación Acción Participativa para la prevención del cáncer de cuello uterino en el resguardo indígena de El Paujil" (Colombia) y desarrollado por lideresas pertenecientes a la región e investigadores de las universidades Fundación Universitaria de Ciencias de la Salud, FUCS; Universidad de Ciencias Aplicadas y Ambientales, UDCA; y Universidad El Bosque, con la cofinanciación del Ministerio de Ciencia, Tecnología e Innovación de Colombia. Los avances del proyecto permitieron explorar las visiones sobre diversos temas de algunas comunidades indígenas de la Amazonia, en especial, los relacionados con la salud de las mujeres y sus roles en las familias y en las comunidades. El trabajo conjunto, mediante una metodología de investigación participativa alrededor de la prevención del cáncer de cuello uterino, incluyó en primer lugar el análisis de la interculturalidad como un enfoque que coincide con los postulados de respeto por los valores culturales y las diferencias.

This book has as origin the diverse reflections originated by the execution of a research work in the area of health with indigenous communities of the Colombian Amazon called: "Primary Health Care Strategy with intercultural approach and Participatory Action Research for the prevention of cervical cancer in the indigenous reservation of El Paujil" (Colombia) and developed by leaders belonging to the region and researchers from the universities Fundación Universitaria de Ciencias de la Salud, FUCS; Universidad de Ciencias Aplicadas y Ambientales, UDCA; and Universidad El Bosque, with co-financing from the Ministry of Science, Technology and Innovation of Colombia. The progress of the project made it possible to explore the views on various topics of some indigenous communities in the Amazon, especially those related to women's health and their roles in the families and communities. The joint work, through a participatory research methodology on cervical cancer prevention, included first of all the analysis of interculturality as an approach that coincides with the postulates of respect for cultural values and differences.

Racism against Totonaco women in Veracruz: Intercultural competences for health professionals are necessary.

Racism is a neglected but relevant cause of health disparities within multi-ethnic societies. Different types of racism and other expressions of discrimination must be recognized, critically analyzed, and actively reverted. This paper is based on anthropological fieldwork conducted in three medical facilities in the indigenous region Sierra de Totonacapan in the highlands of Veracruz in Mexico and analyzes maternal health and identifies levels of racism as perceived by female indigenous patients. Applying a theoretical framework that defines racism at three levels, namely, institutionalized, personally mediated, and internalized racism. We empirically distinguish and acknowledge human rights omissions and violations and then analyze the sources of racism in close relation to an intersectional view on gender-, class-, and race-based forms of discrimination. Finally, in addition to investment in health goods and skilled birth attendants, we propose an intercultural competence approach to manage racism, among other ideologies. This approach targets health professionals as conscious, reflexive, and transformative actors of intercultural interactions with culturally diverse patients.

BACE1 is a newly discovered protein secreted by the pancreas which cleaves enteropeptidase in vitro.

CONTEXT: Activity of beta-site APP-cleaving enzyme1 (BACE1) is required for the generation of beta-amyloid peptides, the principal constituents of plaques in the brains of patients with Alzheimer's disease. Strong BACE1 expression has also been described in pancreatic tissue. OBJECTIVE: The aim of the present study was to reveal the cell type-specific expression of BACE1 in the pancreas and to identify a substrate for BACE1 in this organ. METHODS: RT-PCR of microdissected rat pancreatic tissue was carried out in order to analyze BACE1 expression within pancreatic acini. Pancreatic juice was examined by western blot analysis and by an enzymatic activity assay in order to reveal the presence of secreted BACE1. Database analysis suggested enteropeptidase as a putative substrate for BACE1 in pancreatic juice. In vitro digestion of enteropeptidase by BACE1 was performed to demonstrate this cleavage. RESULTS: We demonstrate the expression of BACE1 in the islets of Langerhans and at the apical pole of pancreatic acinar cells. Recombinant BACE1 cleaves enteropeptidase in vitro. Furthermore, some results suggested the presence of BACE1 enzymatic activity in pancreatic juice and pancreatic tissue. DISCUSSION: We hypothesize that enteropeptidase is a BACE1 substrate in vivo. If so, BACE1 could protect the pancreas from premature trypsinogen activation due to the occasionally occurring reflux of enteropeptidase.