ABSTRACT
Objetivos: La enfermedad de Parkinson (EP) genera alta incidencia de caídas, sin embargo, existe poca evidencia de inestabilidades en etapas iniciales. Esta investigación buscó comparar los tiempos de activación muscular en pacientes con EP inicial frente a una alteración postural vs. un grupo control. Materiales y métodos: Se evaluó la actividad electromiográfica (EMG) de 10 pacientes con EP (61,3 ± 3,8 años) en etapas iniciales y grupo control de 10 adultos (62,2 ±3,0 años). Los participantes fueron tratados mediante una alteración de la superficie, la cual generó una respuesta de estabilización. La prueba se realizó en 2condiciones: ojos abiertos (OA) vs. ojos cerrados (OC). Se analizó el tiempo de activación de músculos del tronco (erector espinal) y extremidad inferior (sóleo, tibial anterior, peroneo lateral largo, recto femoral, bíceps femoral, glúteo medio y aductor mayor) usando EMG de superficie. Resultados: El grupo con EP mostró tiempos de respuestas más rápidas en comparación con l grupo control en el músculo sóleo en OC (p=0,04). Este mismo músculo mostró diferencias al comparar OA vs. OC solo en el grupo con EP (p=0,04), mostrando un menor tiempo de respuesta en la condición OC. Al comparar el músculo erector espinal el grupo con EP mostró tiempos de respuesta más lentos en la condición de OA (p=0,02) y OC (p=0,04) con relación al grupo control. Conclusiones: Los tiempos de activación muscular muestran que las personas con EP responden con un retraso en la activación en la musculatura del tronco, mientras que a nivel distal responden más rápido que los sujetos controles. En las etapas tempranas las respuestas más lentas a nivel de tronco podrían explicar el inicio de las alteraciones del equilibrio en estos pacientes.(AU)
Objectives: Parkinson's disease (PD) generates a high incidence of falls, however, there is little evidence of instabilities in the initial stages. This investigation sought to compare the muscle activation times in patients with initial PD against a postural disturbance vs. a control group. Materials and methods: The electromyographic activity (EMG) of 10 patients with PD in early stages (61.3 ±3.8 years) and a control group of 10 adults (62.2 ±3.0 year) was evaluated. The participants were subjected to a surface disturbance, which generated a stabilization response. The test was performed under 2conditions: eyes open (OA) v/s eyes closed (OC). Trunk (spinal erector) and lower extremity (soleus, tibialis anterior, femoral biceps, femoral rectus, adductor magnus, gluteus medius) muscle activation time was analyzed using surface EMG. Results: The PD group showed faster response times compared to the control group in the soleus muscle in OC (P=.04). This same muscle showed differences when comparing OA vs. OC only in the PD group (P=.04), showing a shorter response time in the OC condition. When comparing the spinal erector muscle, the PD group showed slower response times in the OA (P=.02) and OC (P=.04) conditions compared to the control group. Conclusions: Muscle activation times show that people with PD respond slower in the trunk muscles, while activation times decrease at the distal level. In the early stages, the slower responses at the trunk level could explain the onset of instability postural in these patients.(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Parkinson Disease , Accidental Falls , Muscle Contraction , Postural Balance , Health of the Elderly , Electromyography , Data Interpretation, StatisticalABSTRACT
OBJECTIVES: Parkinson's disease (PD) generates a high incidence of falls, however, there is little evidence of instabilities in the initial stages. This investigation sought to compare the muscle activation times in patients with initial PD against a postural disturbance vs. a control group. MATERIALS AND METHODS: The electromyographic activity (EMG) of 10 patients with PD in early stages (61.3 ±3.8 years) and a control group of 10 adults (62.2 ±3.0 year) was evaluated. The participants were subjected to a surface disturbance, which generated a stabilization response. The test was performed under 2conditions: eyes open (OA) v/s eyes closed (OC). Trunk (spinal erector) and lower extremity (soleus, tibialis anterior, femoral biceps, femoral rectus, adductor magnus, gluteus medius) muscle activation time was analyzed using surface EMG. RESULTS: The PD group showed faster response times compared to the control group in the soleus muscle in OC (P=.04). This same muscle showed differences when comparing OA vs. OC only in the PD group (P=.04), showing a shorter response time in the OC condition. When comparing the spinal erector muscle, the PD group showed slower response times in the OA (P=.02) and OC (P=.04) conditions compared to the control group. CONCLUSIONS: Muscle activation times show that people with PD respond slower in the trunk muscles, while activation times decrease at the distal level. In the early stages, the slower responses at the trunk level could explain the onset of instability postural in these patients.
Subject(s)
Muscle, Skeletal , Parkinson Disease , Postural Balance , Humans , Parkinson Disease/physiopathology , Muscle, Skeletal/physiopathology , Middle Aged , Electromyography , Reaction TimeABSTRACT
Resumen El concepto de Recuperación Mejorada Después de Cirugía, Enhanced recovery after Surgery (ERAS), engloba una serie de protocolos para el manejo perioperatorio optimizado en diversas patologías quirúrgicas. Los objetivos de estos protocolos son: mejorar los resultados quirúrgicos, disminuir las complicaciones, reducir los días de hospitalización, disminuir los costos asociados a la intervención y, finalmente, favorecer una rehabilitación más rápida. Para una correcta aplicación de estos protocolos, se requiere la interacción y el trabajo de un equipo multidisciplinario. En este artículo, se realizará una puesta al día de las intervenciones más importantes de los procesos perioperatorios de la cirugía torácica.
The concept of ERAS includes a series of optimized perioperative management protocols in various surgical pathologies. The objectives of these protocols are: improve surgical results, reduce complications, reduce length of in-hospital stay, reduce the associated health care costs and finally, favor a more rapid rehabilitation. For the correct application of these protocols, the interaction and work of a multidisciplinary team is required. In this article, an update will be made of the most important interventions in the perioperative processes of thoracic surgery.
Subject(s)
Humans , Clinical Protocols , Perioperative Care/methods , Postoperative Complications/prevention & control , Perioperative Care/standards , Perioperative PeriodABSTRACT
PURPOSE: To analyze the current scientific and/or clinical evidence supporting the use of platelet-rich plasma (PRP) in the treatment of rotator cuff pathology. METHODS: After a systematic review in PubMed, studies assessing PRP efficacy in the treatment of rotator cuff pathology published since 2013 to date were identified. Data were grouped based on type of study (laboratory, clinical or meta-analysis); accordingly study design, pathology treated and clinical outcomes were summarized. RESULTS: Thirty five articles have been analyzed: 10 laboratory studies, 17 clinical assays and 8 meta-analyses. While laboratory studies report positive or partially positive results for the use of PRP, 70.6% of clinical studies and 75% of meta-analysis found no statistically significant differences between the PRP group and the control group. DISCUSSION: The positive results of laboratory studies do not translate well to clinical practice. There is no concordance among the few positive results reported in the clinical studies, and even some contradictory effects have been reported. CONCLUSIONS: There is no solid scientific and/or clinical evidence supporting the use of PRP in the treatment of rotator cuff pathology in routine clinical practice.
Subject(s)
Platelet-Rich Plasma , Rotator Cuff Injuries/therapy , Rotator Cuff Tear Arthropathy/therapy , Humans , Rotator Cuff Injuries/pathology , Rotator Cuff Tear Arthropathy/pathology , Treatment OutcomeABSTRACT
Our study was designed to contribute to an understanding of the timing and conditions under which transmission of Andes hantavirus in Oligoryzomys longicaudatus reservoir populations takes place. Mice were caged in test habitats consisting of steel drums containing holding cages, where seronegative rodents were exposed to wild seropositive individuals by freely sharing the same cage or being separated by a wire mesh. Tests were also performed for potential viral transmission to mice from excrement-tainted bedding in the cages. Andes virus transmitted efficiently; from 130 attempts with direct contact, 12.3% resulted in virus transmission. However, if we consider only those rodents that proved to be infectious, from 93 attempts we obtained 16 infected animals (17.2%). Twelve of them resulted from intraspecies O. longicaudatus encounters where male mice were differentially affected and 4 resulted from O. longicaudatus to Abrothrix olivaceus. Experiments using Abrothrix longipilis as receptors were not successful. Transmission was not observed between wire mesh-separated animals, and mice were not infected from excrement-tainted bedding. Bites seemed not to be a requisite for oral transmission. Genomic viral RNA was amplified in two out of three saliva samples from seropositive rodents, but it was not detected in urine samples obtained by vesicle puncture from two other infected rodents. Immunohistochemistry, using antibodies against Andes (AND) hantavirus proteins, revealed strong reactions in the lung and salivary glands, supporting the possibility of oral transmission. Our study suggests that AND hantavirus may be principally transmitted via saliva or saliva aerosols rather than via feces and urine.
Subject(s)
Hantavirus Infections/veterinary , Rodent Diseases/transmission , Sigmodontinae/virology , Animals , Antibodies, Viral/blood , Disease Reservoirs , Disease Transmission, Infectious , Female , Hantavirus Infections/transmission , Immunohistochemistry , Male , Saliva/virology , Seasons , Seroepidemiologic Studies , Time FactorsABSTRACT
Background: There is an alarming increase in the prevalence of child obesity in Chile. Lack of exercise and bad feeding habits strongly contribute to the problem. Aim: To investigate the influence of television publicity on school age children food preferences. Material and methods: A semi structured interview was applied to a representative sample of 786 school age children aged 6 to 11 years old, living in Metropolitan Santiago. Time watching television during week days and the attitude towards food and beverage commercials was analyzed and related to food preferences. Results: Ninety nine percent of school age children watch television during week days and 20 percent watches more the three hours daily. Snack commercials such as those about potato chips, chocolates, cookies and ice cream, are preferred by 35 percent of children. Soda commercials are preferred by 33 percent and yoghurt commercials by 12 percent. Eighty five percent of children had money to buy food. Of these, 66 percent bought snacks, 15 percent bought sodas and 7 percent yoghurt. The same tendency was observed in school collations. Conclusions: The high percentage of children watching television and the influence of commercials in their food preferences, requires an urgent educational strategy to promote healthy feeding habits
Subject(s)
Humans , Male , Female , Advertising/trends , Food Preferences/psychology , School Feeding , Television , Food Preferences , Obesity , Food and Nutrition Education , Feeding BehaviorABSTRACT
Los aneurismas de la porción infrarrenal de la aorta abdominal (AAA) constituyen el tipo más frecuente de aneurisma. Su incidencia ha experimentado un alza real estos últimos años debido a múltiples causas. La reparación quirúrgica protésica es aún el estándar de tratamiento. El objetivo de este trabajo es evaluar los resultados del tratamiento quirúrgico electivo de AAA realizados por el equipo de cirugía vascular del Hospital del Salvador. Para tal efecto se revisaron en forma retrospectiva los antecedentes de 106 pacientes. Para obtener un mejor análisis a través del tiempo se dividió la serie en 2 períodos. Un 1er período entre 1983 y 1989 (84 meses) y un 2º período entre 1990 y 1997 (90 meses). Ambos grupos fueron similares respecto de edad, sexo, patologías asociadas, diámetro promedio de aneurismas y tipo de compromiso aneurismático. En el 1er período hubo un 25 por ciento de morbilidad y en el 2º un 30,6 por ciento. La mortalidad general fue de 4 pacientes que corresponde a un 3,7 por ciento, siendo de 6,82 por ciento en el 1er período y de sólo 1,61 por ciento en el 2º período. Los resultados de morbimortalidad de nuestra serie son comparables con otras series extranjeras
Subject(s)
Humans , Male , Female , Middle Aged , Aortic Aneurysm, Abdominal/surgery , Elective Surgical Procedures/methods , Arterial Occlusive Diseases/complications , Aortic Aneurysm, Abdominal/complications , Blood Vessel Prosthesis , Postoperative Complications/mortality , Smoking/adverse effectsABSTRACT
Infant mortality in Chile decreased from 120 to 12 per thousand between 1960 and 1994. Outstanding events of ths "great descent" are reviewed, based on past research and on updated information. Demographic and socioeconomic changes and improvements in health care that occured during this period of decline are shown. It is estimated that 30 percent of the reduction of infant mortality between 1972 and 1982 was due to the decreasing proportion of biths of high mortality risk, as a consequence of the fertility decline imitiated in the mid 60s. Possible explanations for the continuing decline of infant mortality during the economic crisis of 1975 and 1982 are discussed. Finally, neonatal and postneonatal mortality rates by causes are compared between 1994 and causes of death in extreme groups of infant mortality differentials by age of mother, bith order, gestational age, place of residence and educational level of the mother are shown
