Caracterización del paciente geriátrico portador de nódulos de tiroides

Fundamento: las enfermedades de la glándula tiroidea son comunes en los adultos mayores y, muchas veces, cursan inadvertidas. Objetivo: caracterizar clínica y ultrasonográficamente a los pacientes geriátricos portadores de nódulo de tiroides. Métodos: se realizó un estudio observacional descriptivo de corte transversal, en el Servicio de Geriatría del Hospital General Docente Martín Chang Puga de la provincia de Camagüey, durante los años 2019 al 2022. Se incluyeron los 48 gerontes atendidos en el servicio y diagnosticados con enfermedad nodular del tiroides. Los datos se obtuvieron de las historias clínicas de los pacientes. Se analizaron las variables edad (por grupos de edades), sexo, color de la piel, manifestaciones clínicas y diagnóstico ecográfico. Resultados: el grupo etario de mayor afectación estuvo entre 60 a 69 años con predominio del femenino y del color blanco de la piel. La astenia prevaleció dentro de las manifestaciones clínicas. En el diagnóstico ecográfico prevaleció el nivel I, según el Thyroid Imaging Reporting and Data System. Conclusiones: la alta prevalencia de las enfermedades del tiroides, en especial en el adulto mayor, hace necesario la realización de un cribado para el diagnóstico ecográfico, al ser una prueba diagnóstica beneficiosa, fiable y a un bajo costo en Atención Primaria de Salud.

Foundation: thyroid gland diseases are common in older adults and often go unnoticed. Objective: to characterize clinically and ultrasonographically geriatric patients with thyroid nodule. Methods: a cross-sectional descriptive observational study was carried out in the Martín Chang Puga Teaching General Hospital geriatrics service in Camagüey province, from 2019 to 2022. 48 elderly were the universe made up who attended in the service, and were diagnosed with nodular thyroid disease. The data was obtained from the patients' medical records, the age groups; sex, skin color, clinical manifestations, and ultrasound diagnosis were the analyzed variables. Results: the most affected age group was between 60 and 69 years old, with a predominance of females and white skin color. Asthenia prevailed within the clinical manifestations. In the ultrasound diagnosis, level I prevailed, according to the Thyroid Imaging Reporting and Data System. Conclusions: the high prevalence of thyroid diseases, especially in the elderly, makes it necessary to perform a screening for ultrasound diagnosis, as it is a beneficial, reliable and low-cost diagnostic test in Primary Health Care.

Comparative Analysis of a Modified Secondary Healing Protocol for Fingertip Amputations and Non-microsurgical Reconstruction Techniques.

Objective To describe and compare the results obtained with a secondary healing protocol for fingertip amputations and their relationship to injury severity according to the Allen classification. Methods Medical records of 127 fingertip injuries were revised, and a retrospective, comparative, analytical study the amputations treated conservatively was performed. Injury characteristics, healing time, and complications were described and analyzed. Results Between April 2017 and May 2019, 127 fingertip injuries were treated conservatively. The average age of the sample was of 28.33 years. The average healing time was of 4.31 weeks. The complications during the follow-up were observed in 18.9% ( n = 24) of the cases, but none require revision treatment. A statistically significant relationship between the development of complications and treatment revision according to the Allen classification was not found ( p ≥ 0.05). Conclusion The proposed secondary healing protocol has shown to be safe and effective in types 1 to 3 fingertip amputations in the Allen classification, and it should be included as a therapeutic option even in injuries of greater extension than those that have traditionally been limited to.

Comparative Analysis of a Modified Secondary Healing Protocol for Fingertip Amputations and Non-microsurgical Reconstruction Techniques / Análise comparativa de um protocolo de cicatrização secundária modificado para amputações das pontas dos dedos e técnicas de reconstrução não microcirúrgicas

Abstract Objective To describe and compare the results obtained with a secondary healing protocol for fingertip amputations and their relationship to injury severity according to the Allen classification. Methods Medical records of 127 fingertip injuries were revised, and a retrospective, comparative, analytical study the amputations treated conservatively was performed. Injury characteristics, healing time, and complications were described and analyzed. Results Between April 2017 and May 2019, 127 fingertip injuries were treated conservatively. The average age of the sample was of 28.33 years. The average healing time was of 4.31 weeks. The complications during the follow-up were observed in 18.9% (n= 24) of the cases, but none require revision treatment. A statistically significant relationship between the development of complications and treatment revision according to the Allen classification was not found (p ≥ 0.05). Conclusion The proposed secondary healing protocol has shown to be safe and effective in types 1 to 3 fingertip amputations in the Allen classification, and it should be included as a therapeutic option even in injuries of greater extension than those that have traditionally been limited to.

Resumo Objetivo Descrever e comparar os resultados obtidos com um protocolo de cicatrização secundária para amputações das pontas dos dedos e sua relação com a gravidade da lesão de acordo com a classificação de Allen. Métodos Foram revisados os prontuários clínicos de 127 lesões nas pontas dos dedos, e realizou-se um estudo retrospectivo, comparativo e analítico das amputações tratadas de forma conservadora. Foram descritas e analisadas as características da lesão, o tempo de cicatrização, e as complicações. Resultados Entre abril de 2017 e maio de 2019, foram tratadas de forma conservadora 127 lesões nas pontas dos dedos. A idade média da amostra era de 28,33 anos. O tempo médio de cicatrização foi de 4,31 semanas. As complicações apresentadas durante o acompanhamento afetaram 18,9% (n = 24) dos casos, porém nenhum exigiu tratamento de revisão. Não foi encontrada relação estatisticamente significativa entre o desenvolvimento das complicações e a revisão do tratamento de acordo com a classificação de Allen (p ≥ 0,05). Conclusão O protocolo de cicatrização secundária proposto mostrou-se seguro e eficaz nas amputações das pontas dos dedos conforme os tipos de 1 a 3 da classificação de Allen, e deve ser incluída como opção terapêutica mesmo em lesões de maior extensão do que aquelas tradicionalmente limitadas.

Lifestyle Factors Influencing Dietary Patterns of University Professors.

The objectives of this study are to identify eating patterns of university professors and to assess the relationships among sociodemographic factors in relation to lifestyle and physical activity. It is a cross-sectional, descriptive-correlational, and observational study with a representative sample of 127 educators, which covers almost the total population of university professors belonging to one of the campuses of the University of Granada (Spain). Two eating patterns were identified a posteriori through explanatory factor analysis: a Western pattern characterised by the consumption of dairy products, eggs, meat, sausages, refined oils, and butter, sugar, processed baked goods, and sugar-containing beverages and alcoholic drinks, and a Mediterranean pattern based on olive oil, fish, fruits, nuts, vegetables, pulses, cereals, and honey, which explain the 20.102 and 17.411 of variance, respectively. Significant differences are observed between the two genders with respect to anthropometric characteristics (weight and size, p < 0.001 in both cases) and to nutritional status (p = 0.011). Origin (p = 0.022) and level of physical activity (p = 0.010) were significantly related to adherence to a Western diet pattern. In the case of the Mediterranean diet pattern, significant differences are observed according to the professors' type of bachelor's degree (p = 0.37). This study provides evidence on factors having an impact on adherence to eating patterns of professors of the University of Granada, and it suggests that programmes addressed to such groups should be developed to promote health.

Atribuciones profesionales en el ejercicio para la salud de la Sociedad Española de Medicina del Deporte / Professional attributions in the exercise for the health of the Spanish Society of Sports Medicine

La práctica regular de ejercicio físico es extraordinariamente efectiva en el manejo de un número creciente de patologíascrónicas algunas de ellas con una prevalencia de magnitud pandémica, por lo que la sociedad debe asumir la incorporaciónde la actividad física como estrategia de salud para prevenir y para servir como tratamiento complementario de la enfermedad.La medicina y la fisioterapia tienen un papel primordial en el manejo del ejercicio para la salud y también, fuera de la sanidad,las titulaciones de ciencias de la actividad física y el deporte ocupan un papel muy destacado en este ámbito de trabajo.Desde la sanidad, la medicina y la fisioterapia tienen un papel primordial en el manejo del ejercicio para la salud y también,fuera de la sanidad, las titulaciones de ciencias de la actividad física y el deporte ocupan un papel muy destacado en la pro-moción y ejecución de estrategias para el fomento de la salud.Estas profesiones han venido ocupando una posición en el abordaje de este problema que, en algunas ocasiones, ha supuestopuntos de fricción respecto a su papel, responsabilidades y función. Por otra parte, existe la necesidad de resolver la cuestiónde los ámbitos competenciales de las profesiones manteniendo la voluntad de reconocer simultáneamente los crecientesespacios competenciales compartidos interprofesionalmente y los muy relevantes espacios específicos de cada profesión.Este documento parte de la necesidad de abordar la incorporación del ejercicio en la prevención y manejo de la enfermedadde una forma sólida y consistente, considerando la aportación de las profesiones implicadas desde la óptica del trabajo mul-tidisciplinar y con una colaboración no conflictiva sino cooperativa, transparente y respetuosa y, siempre, con el objetivo deservir a la sociedad de la forma más efectiva posible, definiendo de una forma clara cuáles con las atribuciones profesionalesde la medicina, de la fisioterapia y de las ciencias...(AU)

The regular practice of physical exercise is extraordinarily effective in the management of a growing number of chronic diseases,some of them with a prevalence of pandemic magnitude, for which the society must assume the incorporation of physicalactivity as a health strategy to prevent and to serve as a complementary treatment of the disease.Not only medicine and physiotherapy play a fundamental role in the management of exercise for health but also, outside ofhealth, Sports science and physical education degree is crucial in this field of work.From a health point of view, medicine and physiotherapy have a primary role in the management of exercise for health andalso, outside of health, sports science and physical education degree occupy a very prominent role in the promotion andimplementation of strategies for the promotion of health.These professions have been occupying a position in addressing this problem that, on some occasions, has led to points offriction with respect to their role, responsibilities and function. On the other hand, there is a need to resolve the question ofthe professions’ areas of competence while maintaining the will to simultaneously recognize the growing areas of competenceshared interprofessionally and the highly relevant areas specific to each profession.This document is based on the need to address the incorporation of exercise in the prevention and management of disease ina solid and consistent way, considering the contribution of the professions involved from the perspective of multidisciplinarywork and with a non-conflictual but cooperative, transparent and respectful collaboration. In addition, this collaborationshould always aim at serving society in the most effective way possible, clearly defining the professional attributions of me-dicine, physiotherapy and physical activity and sport sciences in everything related to the use of exercise as a tool for health.(AU)

Medical arguments for and against the liberalization of doping / Argumentos médicos a favor y en contra de la liberalización del dopaje

The use of doping has been banned for almost a century due to the risk involved to the athlete's health. Since then, the criterion of prohibiting substances has been reinforced to improve performance, becoming a rarely controversial issue nowadays. However, opinions defending the liberalization of doping has been sometimes given based on various arguments. One of the most common is the impossibility of completely eradicating doping and that this can be safe, from the point of view of health, if it is done by qualified doctors. This paper presents the arguments against the liberalization of doping from a medical point of view, contemplating various aspects. Those related to the use of substances such as: lack of clear criteria for inclusion in the list of prohibited substances and the unclear margin between the use of medication for treatment and for doping. Arguments related to health protection such as: the risk of sport for the athlete, the healthy sport, doping substances have few health risks, the use of medications, allow genetic doping because it is inevitable, risks of self-medication or use of medication without a prescription. Arguments related to sports performance such as: Doping products do not improve performance, doping is comparable to other performance improvement techniques, match genetic differences among athletes. And other arguments such as: prohibition favours doping, the control of doping increases the risks of doping itself, the high cost of anti-doping fight or the few anti-doping resources. The proposal for liberalization of doping under medical control is analyzed and discussed as well as the effects of liberalization on children and adolescents. At the end the medical ethical aspects related to doping are presented to conclude with the opposition of the medical profession against doping and its liberalization

El dopaje está prohibido desde hace casi un siglo debido al riesgo que implica para la salud del deportista. Desde entonces, el criterio de prohibición de sustancias se ha reforzado para mejorar el rendimiento, convirtiéndose en un tema poco controvertido en la actualidad. Sin embargo, a veces se han emitido opiniones en defensa de la liberalización del dopaje basadas en diversos argumentos. Uno de los más habituales es la imposibilidad de erradicar por completo el dopaje y que éste puede ser seguro, desde el punto de vista de la salud, si lo practica médicos titulados. Este artículo presenta los argumentos en contra de la liberalización del dopaje desde el punto de vista médico, contemplando diversos aspectos. Los relacionados con el uso de sustancias tales como: falta de criterios claros para su inclusión en la lista de sustancias prohibidas y el margen poco claro entre el uso de medicamentos para tratamiento y dopaje. Argumentos relacionados con la protección de la salud como: el riesgo del deporte para el deportista, el deporte sano, las sustancias dopantes tienen pocos riesgos para la salud, el uso de medicamentos, permitir el dopaje genético porque es inevitable, los riesgos de automedicación o uso de medicación sin prescripción. Argumentos relacionados con el rendimiento deportivo tales como: los productos antidopaje no mejoran el rendimiento, el dopaje es comparable a otras técnicas de mejora del rendimiento, diferencias genéticas entre los deportistas. Y otros argumentos como: la prohibición favorece el dopaje, el control del dopaje aumenta los riesgos del dopaje, el alto coste de la lucha antidopaje o los escasos recursos antidopaje. Se analiza y discute la propuesta de liberalización del dopaje bajo control médico y los efectos de la liberalización en niños y adolescentes. Al final se presentan los aspectos éticos médicos relacionados con el dopaje para concluir con la oposición de la profesión médica al dopaje y su liberalización

Rabdomiolisis inducida por esfuerzo / Exertional Rhabdomyolysis

La rabdomiolisis es un síndrome clínico caracterizado por la destrucción de tejido muscular estriado y el vertido del contenido intracelular del mismo que cursa con dolor muscular por miositis, pérdida de fuerza y edema muscular. Se caracteriza pro la elevación muy importante de creatinquinasa, mioglobina, lactato deshidrogenada y puede provocar importantes complicaciones, fundamentalmente renales. En función de las cifras de CK, siempre superiores a 5000 UI/l, que se encuentran en el inicio del cuadro la rabdomiólisis se clasifica en ligera y severa. De entre las diversas causas etiológicas que la pueden provocar, desde el punto de vista del deporte, interesa la rabdomiólisis inducida por esfuerzo. Este trabajo revisa la etiología del cuadro, prestando especial atención al ejercicio como desencadenante o coadyuvante del síndrome y a las características del tipo de ejercicio (condición física y experiencia del deportista, intensidad y duración del ejercicio físico, tipo de ejercicio, condiciones ambientales, etc.) que pueden provocarla. Aunque las causas de la rabdomiolisis son muy variadas y diferentes, la vía patogénica final que conduce a la destrucción muscular es común a todas y tiene que ver con la alteración en la regulación de los electrolitos intracelulares y especialmente con los niveles de calcio citoplasmático. Además del diagnóstico analítico, actualmente, la ecografía permite un diagnóstico rápido y la observación de la evolución del cuadro. La rabdomiólisis muestra patrones de afectación muscular que se describen en el trabajo. Se describen las estrategias de prevención basadas en la realización de un ejercicio físico adecuado (tipo, intensidad y duración del ejercicio), medidas relacionadas con la nutrición y alimentación, medidas relacionadas con los factores ambientales y medidas educativas. Por último, se presenta el tratamiento inmediato del cuadro, con hospitalización necesaria en algunos casos, y las recomendaciones sobre re-incorporación al entrenamiento y a la competición deportiva

IRhabdomyolysis is a clinical syndrome characterized by the destruction of striated muscular tissue and the dumping of the intracellular content of the muscle that presents with muscle pain due to myositis, loss of strength and muscular edema. It is characterized by the high elevation of creatine kinase, myoglobin, dehydrogenated lactate and it can cause important complications, especially renal complications. According to the CK figures, always higher than 5000 IU / l, which are at the beginning of the table, rhabdomyolysis is classified as light and severe. From the point of view of sport, among the various etiological causes that can cause it, it is interesting to focus on stress-induced rhabdomyolysis. This work reviews the etiology of the clinical picture, paying special attention to exercise as a trigger of the syndrome and the characteristics of the type of exercise (physical condition and experience of the athlete, intensity and duration of physical exercise, type of exercise, environmental conditions, etc.) that can cause it. Although the causes of rhabdomyolysis are very varied and different, the final pathogenic pathway leading to muscle des-truction is common to all and has to do with the alteration in the regulation of intracellular electrolytes and especially with cytoplasmic calcium levels. Currently, in addition to the analytical diagnosis, ultrasound allows a rapid diagnosis and the observation of the evolution of the picture. Rhabdomyolysis shows muscle involvement patterns that are described in this work. Different prevention strategies are described based on the execution of an adequate physical exercise (type, intensity and duration of the exercise), measures related to nutrition and feeding, as well as measures related to environmental end educational factors. Finally, is presented the immediate treatment of the symptoms, with necessary hospitalization in some cases, and recommendations on re-incorporation to training and sports competition

Suplementos nutricionales para el deportista. Ayudas ergogénicas en el deporte - 2019. Documento de consenso de la Sociedad Española de Medicina del Deporte / Nutritional supplements for athletes. Ergogenic aids in sport - 2019. Consensus document of the Spanish Society of Sports Medicine

En el año 2012 se publicó el consenso "Ayudas ergogénicas nutricionales para las personas que realizan ejercicio físico" que ha servido durante estos años como referente en la materia para muchos profesionales de la materia. La modificación de normativas y la aparición de nuevas evidencias han aconsejado efectuar un nuevo documento, en esta ocasión "Suplementos nutricionales para el deportista. Ayudas ergogénicas en el deporte" que supone una puesta al día rigurosa sobre la evidencia existente, sobre la legislación actual en el contexto europeo y sobre las expectativas de futuro. El documento describe en profundidad los suplementos que se utilizan en la actualidad agrupándolos en hidratos de carbono, bebidas especialmente diseñadas para el deportista, Proteínas como ayuda ergogénica en el deporte, minerales, vitaminas, ácidos grasos y otros componentes (creatina, β-hidroxi-β-metil-butirato, carnitina, mezclas de aminoácidos ramificados, otros aminoácidos y sustancias nitrogenadas, cafeína, guaraná y té verde, antioxidantes, inmunomoduladores, bicarbonatos y citratos, ginseng, glicerol, cannabidiol, melatonina, leptina, sulfato de condroitina, sulfato de glucosamina, ácido hialurónico, bromelina, nitratos y otras ayudas ergogénicas.Se presentan las evidencias de consenso actuales y un novedoso diagrama de decisión en relación con la utilización de suplementos nutricionales en el deporte para terminar efectuando importantes recomendaciones para el deportista que se entrena y compite y se incorporan las recomendaciones sobre el uso de suplementos nutricionales y de ayudas ergogénicas para prevenir el dopaje accidental. Este documento constituye una verdadera puesta al día en los suplementos nutricionales que se utilizan actualmente y sirve como rigurosa guía de utilización para los profesionales que trabajan en el deporte y en la actividad física

In 2012 the consensus "Nutritional ergogenic aids for physical exercise practitioners" was published, which has served during these years as a reference in the field for many professionals of the field. The modification of regulations and the appearance of new evidence have made it advisable to produce a new document, this time "Nutritional supplements for athletes. Ergogenic aids in sport" which means a rigorous update on the existing evidence, on the current legislation in the European context and on the expectations for the future. The document deeply describes the supplements that are currently used by grouping them into carbohydrates, drinks specially designed for athletes, proteins as an ergogenic aid in sport, minerals, vitamins, fatty acids and other components (creatine, β-hydroxy-β-methyl-butyrate, carnitine), mixtures of branched amino acids, other amino acids and nitrogenous substances, caffeine, guarana and green tea, antioxidants, immunomodulators, bicarbonates and citrates, ginseng, glycerol, cannabidiol, melatonin, leptin, chondroitin sulphate, glucosamine sulphate, hyaluronic acid, bromelain, nitrates and other ergogenic aids. It is presented the evidence of current consensus and a novel decision diagram regarding the use of nutritional supplements in sport to end up making important recommendations for the athlete who trains and competes and incorporates recommendations on the use of nutritional supplements and ergogenic aids to prevent accidental doping. This document is an update on the nutritional supplements currently in use and serves as a rigorous user guide for professionals working in sport and physical activity

Multi-stage Differentiation Defines Melanoma Subtypes with Differential Vulnerability to Drug-Induced Iron-Dependent Oxidative Stress.

Malignant transformation can result in melanoma cells that resemble different stages of their embryonic development. Our gene expression analysis of human melanoma cell lines and patient tumors revealed that melanoma follows a two-dimensional differentiation trajectory that can be subclassified into four progressive subtypes. This differentiation model is associated with subtype-specific sensitivity to iron-dependent oxidative stress and cell death known as ferroptosis. Receptor tyrosine kinase-mediated resistance to mitogen-activated protein kinase targeted therapies and activation of the inflammatory signaling associated with immune therapy involves transitions along this differentiation trajectory, which lead to increased sensitivity to ferroptosis. Therefore, ferroptosis-inducing drugs present an orthogonal therapeutic approach to target the differentiation plasticity of melanoma cells to increase the efficacy of targeted and immune therapies.

Lesiones deportivas versus accidentes deportivos. Documento de consenso. Grupo de prevención en el deporte de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) / Sports injuries versus sports accidents. Consensus document. Group of prevention in the sport of the Spanish Society of Sports Medicine (SEMED-FEMEDE)

La práctica deportiva tiene numerosos efectos beneficiosos sobre la salud y el bienestar de las personas, pero también puede tener efectos negativos, entre los que se encuentran los accidentes y las lesiones. Establecer las diferencias entre lesión y accidente deportivo es de vital importancia desde el punto de vista médico-legal y ayudará a clarificar la regulación jurídica del deporte en estos aspectos. Por ello, el objetivo de este documento es establecer un consenso sobre lo que entendemos por lesión deportiva y sobre qué tipos de lesiones pueden calificarse como accidente deportivo. Se vienen utilizando diferentes criterios, muy dispares, para definir las lesiones deportivas, así como para clasificarlas, lo que lleva a que los datos epidemiológicos no puedan extrapolarse de unos a otros. Así, para unos son todas aquellas que requieren asistencia médica; otros consideran que existe una lesión cuando hay daño corporal que obliga al deportista a abandonar o modificar una o más sesiones de entrenamiento o competición; otros autores entienden que una lesión deportiva debe combinar la necesidad de asistencia médica con la pérdida de tiempo de las actividades deportivas; y finalmente algunos estiman que una lesión deportiva es cualquier problema físico sufrido por un deportista durante el entrenamiento o la competición, independientemente de la necesidad de atención médica y de la pérdida de tiempo de actividades deportivas. Bajo el punto de vista de este consenso, una lesión deportiva es un problema físico debido a una alteración de la integridad de los tejidos que se produce como resultado de la práctica de actividad física o deporte, y que altera la capacidad absoluta o relativa de practicar deporte, independientemente de que requiera atención de personal sanitario o que conlleve ausencias o modificaciones en las sesiones de entrenamiento o en las competiciones. Puede aparecer de forma súbita, en el caso de las lesiones agudas, o tener un comienzo lento y progresivo, en el caso de lesiones por sobrecarga o sobreuso. Un accidente deportivo es una lesión corporal, no intencionada por parte del accidentado, de inicio repentino, provocada por un traumatismo o una carga que supere los límites fisiológicos, y que acontece durante una actividad deportiva identificable. Las causas de los accidentes varían en función de la modalidad deportiva, del terreno donde se practica el deporte, del material deportivo, etc. Todas las lesiones agudas (por traumatismos, malos gestos técnicos o cargas que superen los límites fisiológicos y provoquen un daño tisular) deben ser consideradas como accidentes deportivos, y aquellas en las que el daño tisular aparece en un determinado momento y es progresivo, pudiendo manifestarse clínicamente o no (sobrecargas de repetición), quedan excluidas de lo que entendemos por accidente deportivo

Sports practice has many beneficial effects on the health and well-being of people, but it can also have negative effects between those tha are accidents and injuries. Establishing the differences between injury and sports accident is of vital importance from the medical-legal point of view and will help to clarify the legal regulation of sport in these aspects. Therefore, the purpose of this document is to establish a consensus on what we understand as sports injury and what kind of injuries can be classified as sports accidents. Different criteria have been used, very differente, to define sports injuries, and to classify them, so that epidemiological data cannot be extrapolated from some study to other. Thus, for some are all those that require medical assistance; Others consider that there is an injury when there is bodily injury that forces the athlete to leave or modify one or more training session or competition; another group of authors understand that a sports injury must combine the need for medical assistance with the loss of time from sports activities; finally, others estimate that a sports injury is any physical problem suffered by an athlete during training or competition, regardless of the need for medical attention and loss of time from sports activities. From our point of view, a sports injury is a physical problem due to an alteration of the integrity of the tissues that occurs as a result of the practice of physical activity or sport, and that alters the absolute or relative capacity to practice sport, independently of the fact that it requires attention of sanitary personnel or that it involves absences or modifications in training sessions or competitions. It can appear suddenly, in the case of acute injuries or have a slow and progressive onset, in the case of overload or overuse injuries. A sports accident is a bodily injury, unintentional by the injured person, of sudden onset, caused by trauma or a load that exceeds physiological limits and that occurs during an identifiable sports activity. The causes of accidents depend on the sport modality, sports playground, sports equipment, etc. All acute injuries (due to trauma, incorrect sport technique or loads that exceed physiological limits and cause tissue damage) should be considered as sports accidents and those in which the tissue damage appears at a certain time and is progressive, being able to manifest itself clinically or not (repeated overloads), are excluded from what we understand by sports accidents

Contraindicaciones para la práctica deportiva. Documento de consenso de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) / Contraindications of sports practice. Consensus document of the SPANISH Society of Sports Medicine (SEMED-FEMEDE)

La función principal de la medicina del deporte es el cuidado de la salud del deportista, no solo desde el punto de vista del tratamiento, sino también desde el de la prevención. Los reconocimientos médicos para la aptitud deportiva, una de las atribuciones principales de esta especialidad, están destinados a descubrir patologías, enfermedades o alteraciones que pueden afectar a la salud, y abarcan desde las situaciones que pueden desencadenar incidentes mortales hasta las que, sin poner en riesgo la vida, pueden afectar la salud o el rendimiento del deportista. La realización adecuada de reconocimientos para el deporte implica el diagnóstico de problemas médicos que deben analizarse, entre otros puntos de vista, desde la óptica de la aptitud para la práctica deportiva, y el médico encargado debe disponer de una guía que le oriente sobre la decisión de autorizar o no la práctica de deporte, y en caso de no autorización, la temporalidad de esta y el riesgo asumible de participación en algunos deportes. Las contraindicaciones para la práctica deportiva mejor conocidas son las de origen cardiovascular, tratadas extensamente en la literatura, pero también existen contraindicaciones del resto de aparatos y sistemas del organismo, entendiendo que el deportista es un ser completo y que el ejercicio físico afecta a todo su conjunto. Este documento, además de recoger dichas contraindicaciones, analiza los aspectos legales que afectan a los profesionales en los que recae la responsabilidad de realizar los reconocimientos y los aspectos documentales que les son propios

Main purpose of sports medicine is reaching the health care of the athlete, not only from the point of view of treatment, but also from the point of view of prevention. The performance of preparticipation medical sports evaluation, one of the main attributions of this specialty, is aimed at the discovery of pathologies, diseases or alterations that may affect health. They might range from situations that can trigger deadly incidents, to those without putting life at risk, can affect the health or performance of the athlete. Adequate implementation of preparticipation medical sports evaluation implies the diagnosis of medical problems that must be analyzed, from other points of view such as the perspective of fitness for sport practice. In addition, the doctor in charge must have a guide for clearance for sports practice. In case of non-authorization, time for non-sports activities must be recommended in order to decrease injury risks. Cardiovascular pathologies are the best known contraindications in sport practice, treated extensively in the literature. However, there are also contraindications secondary to problems or issues of the rest of apparatus organs and systems of the organism, knowing that the athlete represents an entity in which physical exercise affects all their sets. This document highlights those contraindications already discussed above and analyzes the legal aspects of sports practice contraindications. Medical professionals are responsible for managing the pre-participation medical sports evaluation as well as the documentary aspects that support it

Low Computational-Cost Footprint Deformities Diagnosis Sensor through Angles, Dimensions Analysis and Image Processing Techniques.

Manual measurements of foot anthropometry can lead to errors since this task involves the experience of the specialist who performs them, resulting in different subjective measures from the same footprint. Moreover, some of the diagnoses that are given to classify a footprint deformity are based on a qualitative interpretation by the physician; there is no quantitative interpretation of the footprint. The importance of providing a correct and accurate diagnosis lies in the need to ensure that an appropriate treatment is provided for the improvement of the patient without risking his or her health. Therefore, this article presents a smart sensor that integrates the capture of the footprint, a low computational-cost analysis of the image and the interpretation of the results through a quantitative evaluation. The smart sensor implemented required the use of a camera (Logitech C920) connected to a Raspberry Pi 3, where a graphical interface was made for the capture and processing of the image, and it was adapted to a podoscope conventionally used by specialists such as orthopedist, physiotherapists and podiatrists. The footprint diagnosis smart sensor (FPDSS) has proven to be robust to different types of deformity, precise, sensitive and correlated in 0.99 with the measurements from the digitalized image of the ink mat.

The benefit of a supplement with the antioxidant melatonin on redox status and muscle damage in resistance-trained athletes.

Previous data showed that the administration of high doses of melatonin improved the circadian system in athletes. Here, we investigated in the same experimental paradigm whether the antioxidant properties of melatonin has also beneficial effects against exercise-induced oxidative stress and muscle damage in athletes. Twenty-four athletes were treated with 100 mg·day-1 of melatonin or placebo 30 min before bedtime during 4 weeks in a randomized double-blind scheme. Exercise intensity was higher during the study that before starting it. Blood samples were collected before and after treatment, and plasma was used for oxygen radical absorption capacity (ORAC), lipid peroxidation (LPO), nitrite plus nitrate (NOx), and advanced oxidation protein products (AOPP) determinations. Glutathione (GSH), glutathione disulphide (GSSG) levels, and glutathione peroxidase (GPx) and reductase (GRd) activities, were measured in erythrocytes. Melatonin intake increased ORAC, reduced LPO and NOx levels, and prevented the increase of AOPP, compared to placebo group. Melatonin was also more efficient than placebo in reducing GSSG·GSH-1 and GPx·GRd-1 ratios. Melatonin, but not placebo, reduced creatine kinase, lactate dehydrogenase, creatinine, and total cholesterol levels. Overall, the data reflect a beneficial effect of melatonin treatment in resistance-training athletes, preventing extra- and intracellular oxidative stress induced by exercise, and yielding further skeletal muscle protection against exercise-induced oxidative damage.

Improvements in health-related quality of life, cardio-metabolic health, and fitness in postmenopausal women after a supervised, multicomponent, adapted exercise program in a suited health promotion intervention: a multigroup study.

OBJECTIVES: This study explored the multidimensional outcomes that resulted from the adherence to regular exercise among previously sedentary postmenopausal women. The exercise was managed through a supervised, multicomponent, adapted approximately 20-week program in a suited health promotion intervention. METHODS: A multigroup, mixed-design study with between-group (intervention, sedentary, and active women) and within-subject measures (baseline, postintervention, and 3- and 12-month follow-ups) was conducted using intention-to-treat methodology. The Cervantes Scale assessed health-related quality of life (HRQoL), and several indicators of cardio-metabolic status and fitness were also assessed. RESULTS: After the intervention, the participants experienced positive changes in short and long-term physical and mental health, with significant enhancements in several HRQoL dimensions, particularly mental well-being and menopause-related health and subdomains. Improvements were maintained or continued (eg, mental well-being) throughout the period, leading up to the 12-month follow-up. These outcomes were accompanied by significant improvements in cardio-metabolic status and fitness, including weight, body mass index, cardio-respiratory fitness, and flexibility. CONCLUSIONS: Our findings parallel previous empirical evidence showing the benefits associated with regular exercise, and add evidence to the association of positive outcomes in HRQoL with improvements in cardio-metabolic health and fitness status after the adoption of an active lifestyle.

Improvements in Health-Related Quality of Life, Cardio-Metabolic Health, and Fitness in Postmenopausal Women After an Exercise Plus Health Promotion Intervention: A Randomized Controlled Trial.

BACKGROUND: This study explored multidimensional outcomes that were derived from the adherence to regular exercise among previously sedentary postmenopausal 45 to 64 years old women who engaged in a ~20-week exercise program. METHODS: A randomized controlled trial with between-group (intervention and control women) and within-subject measures (baseline, postintervention, and 3-month and 12-month follow-ups) was conducted. HRQoL and several indicators of cardio-metabolic status and fitness were assessed. RESULTS: After the intervention, the participants experienced a positive change in their short and long-term physical and mental health, with significant enhancements in several HRQoL dimensions, particularly mental well-being (23.3% of change) and menopause-related health and subdomains (17.0% of change) (P < .01). Improvements were maintained or continued (eg, mental well-being) overtime. These outcomes were accompanied by significant improvements in cardio-metabolic status and fitness, including weight, BMI, cardio-respiratory fitness and flexibility (up to 16.2% of change, P < .05). After the intervention, the intervention group exhibited better HRQoL than the control group at each of the measurement phases. Between-group differences were also observed for some indicators of cardiovascular health and flexibility. CONCLUSIONS: Our findings add evidence on the association of positive outcomes on HRQoL with improvements in cardio-metabolic health and fitness status after the adoption of an active lifestyle.

Pruebas de esfuerzo en medicina del deporte. Documento de consenso de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) / Stress tests in sports medicine. Consensus document of the Spanish Society of Sports Medicine (SEMED-FEMEDE)

No disponible

XVI Congreso Nacional de la Sociedad Española de Medicina del Deporte: Granada, 23 al 26 de noviembre de 2016 / No disponible

No disponible

Recomendaciones para un deporte recreacional saludable. Guía para práctica deportiva recreacional de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) / No disponible

No disponible