Desarrollo de una nueva metodología para la valoración de la movilidad cervical basada en técnicas de fotogrametría / Development of a new methodology for the assessment of cervical mobility based on photogrammetry techniques

Introducción. La inexistencia de métodos objetivos, fiables y precisos de valoración funcional de la movilidad de la columna cervical dificulta la elección de un adecuado tratamiento rehabilitador y posterior control de su evolución en pacientes afectados de dolor cervical. Todo esto ha planteado la necesidad de desarrollar una nueva metodología de valoración de la movilidad cervical a partir de técnicas de vídeo-fotogrametría y de definición de los patrones de movilidad en función de las variables edad y género. Material y métodos. Para la realización del estudio se ha seleccionado una muestra de 50 personas de edades comprendidas entre 20 y 79 años, con ausencia de patología cervical. También se ha realizado un estudio piloto con 14 personas afectadas de dolor cervical. El equipo de medida está basado en un sistema de video-fotogrametría. Los movimientos que se registraron fueron el de flexo-extensión, inclinación lateral y el de rotación de la cabeza. Resultados. Cabe destacar la alta influencia de las variables edad y sexo en los rangos de movimiento, además de la disminución de los rangos de movilidad en los pacientes aquejados de latigazo cervical cuya significación también es muy alta. Discusión. Se ha demostrado que la metodología presentada en el siguiente trabajo resulta una herramienta muy útil para la valoración funcional de la movilidad de la columna cervical, mejorando la precisión y la fiabilidad de los resultados obtenidos y permitiendo realizar un tratamiento rehabilitador de un modo más eficaz y controlado

Introduction. The non-existence of objective, reliable and precise methods of functional valuation of the cervical spine mobility makes difficult the election of a suitable rehabilitation treatment and subsequent control of its evolution in affected patients of cervical pain. All this has raised the need of developing a new methodology of cervical mobility valuation based on video-photogrammetry techniques and to define the patterns of mobility based on the parameters age and gender. Material and methods. For the accomplishment of the study a sample of 50 people aged between 20 and 79 years with absence of cervical pathology has been selected. Besides, a pilot study was made with 14 affected people of cervical pain. The measuring equipment is based on a video-photogrammetry system. The movements that were registered were flexo-extension, lateral flexion and rotation of the head. Results. It is possible to emphasize the high influence of the variables age and sex in the movement ranges, in addition to the diminution of the ranges of mobility in patients affected of whiplash injury whose meaning also is very high. Discusion. The methodology presented in the present work has been demonstrated as a useful tool for the functional valuation of the cervical spine mobility, improving the accuracy and the reliability of the obtained results and allowing making a rehabilitation treatment in a more effective and controlled way

Estudio evolutivo en pacientes intervenidos de plastia de ligamento cruzado anterior / An evolution assessment of some patients with anterior cruciate ligament injury who suffered from an autograft surgical operation

El aumento de la actividad física en nuestra sociedad incrementa el número de lesiones de rodilla, y más concretamente, del ligamento cruzado anterior. Todavía existe mucha controversia acerca del tratamiento más adecuado para este tipo de lesiones. El objetivo de este estudio es demostrar la validez de un protocolo de fisioterapia acelerado para el tratamiento de rotura del ligamento cruzado anterior intervenido con plastia autóloga del músculo semitendinoso. Para ello se ha realizado, en 23 pacientes, medidas antropométricas, de funcionalidad y desplazamiento antero-posterior de la rodilla, en tres momentos, antes de la intervención, a los tres y a los seis meses. Con todo lo anterior, se ha podido valorar la progresión del paciente durante el proceso de recuperación y podemos afirmar que el protocolo de fisioterapia acelerada utilizado en este estudio ha resultado válido y eficaz para la recuperación funcional de los pacientes. Este protocolo produce un incremento significativo de la diferencia de potencial del músculo semitendinoso de la pierna lesionada, siendo éste mayor que el de la sana, lo que nos indica que se deberá trabajar también con el músculo sano a fin de evitar desequilibrios

Today's increasing physical activity in our society has lead to an increment in the number of knee injuries, and especially those related with the anterior cruciate ligament. Still exists much controversy in regard to the most adequate treatment of this type of injuries. The main objective of this study is to show the validity of an early physiotherapy protocol for the treatment of a torn anterior cruciate ligament carry out by surgical autograft operation of the semitendinous muscle. Anthropometric and functional measurements and displacements antero-posterior of the knee have been effected over 23 patients, in different moment; before the operation, and three and six months afterwards. With all these information, we have evaluated the progression of the patients during the process of recovery and we can conclude that the early physiotherapy protocol used in this study has resulted valid and effective in the functional recovery of the patients. This protocol produces a significant increase in the potential of the semitendinous muscle in the injured leg, being this increased potential ever better than in the healthy leg. This clearly indicates that in the application of this protocol, we must work on both legs muscles in order to obtain an adequate balance

Prevalencia de dermatitis atópica en la población infantil en una consulta de alergología / Comparison of the prevalence of atopic among the children visiting an allergology department

Objetivo: Comparar las características de dos grupos de niños alérgicos que acudieron a una consulta de Alergología en 1997 y 2000.Métodos: 150 pacientes en 1997, 89 niños y 61 niñas (grupo A), y 267 pacientes en 2000, 162 niños y 105 niñas (grupo B). Se dividieron en: 0-5 años, 5-10 y >10 años. Se realizó anamnesis, examen físico, analítica y pruebas alergológicas. Resultados: En el grupo A, la prevalencia de dermatitis atópica fue del 13,1 por ciento y en el B del 19,5 por ciento (p >0,05). Como antecedentes familiares de atopia en niños con dermatitis atópica (DA), el 44 por ciento tenía padre o madre atópicos y el 25 por ciento tenía padre y madre atópicos. En el grupo A el 39 por ciento había recibido lactancia materna exclusiva, y el 38 por ciento en el grupo B. Otras enfermedades alérgicas concomitantes con DA: grupo B, el 51,9 por ciento padecía asma y el 34 por ciento rinitis alérgica. En el grupo A, el 22,8 por ciento padecía rinitis alérgica. Los alergenos más frecuentes para ambos grupos que presentaban DA fueron huevo, leche y ácaros. Los valores de IgE se encontraban en una media de 453,98 KU/L ñ 617,70 en la población general y de 628 KU/L ñ 875 en los pacientes con DA. Conclusiones: Los antecedentes familiares por sí solos no justifican el aumento en la prevalencia de DA, pero sí otros factores ambientales, como la sensibilización precoz a alergenos alimentarios y, posteriormente, a otros alergenos inhalantes. Las medidas de prevención precoces ayudan a evitar o disminuir estas sensibilizaciones, previniendo así el desarrollo de otras enfermedades alérgicas como el asma y la rinitis (AU)

Respiratory infection in asthma.

Ever since the first decades of the 20th century, some authors have given respiratory infection triggered by bacteria an etiologic role in bronchial asthma, focusing on infection and the asthmatic response. In 1995 our group already presented a study in this sense on nasal secretion cultures and the relationship between IgE and sensitization to allergens. There is a significant association between patients with sensitization to Dermatophagoides, high levels of total IgE, and positive culture to Staphylococcus aureus. Following studies by Norn, we performed a study with 40 children, aged 2-14 years, where we observed that children with sensitization to mites and a positive culture had higher levels of histamine release than did children with negative culture and controls, the differences being significant. We also found, like other authors, that the joint presence of Staphylococcus aureus and Derrmatophagoides pteronyssinus potentiates antigen-specific histamine release. In recent years, with the increasing prevalence of bronchial asthma being studied, the role that infection could play in this increase is being considered again among other factors. As participants of the ISAAC project and using the same methods as in this study, we performed a simultaneous questionnaire with questions related with triggering and contributing factors, etc., including respiratory infection. We found an association between having had more than three episodes of "bronchitis" with fever and lasting for longer than seven days in the last year and having ever had asthma (OR 29.09). This association is still greater with having had wheezing in the last 12 months (OR 43.26), a finding that it is also associated with requiring attention in an emergency room (OR 30.65). From these results, we concluded that respiratory infection is an aggravating factor of asthma, something we already knew. In order to have our own experience, we studied serum interleukin 4 (IL-4) and interferon gamma (IFNgamma) in a sample of 41 children aged 3 to 17 years. The most frequent values of IL-4 ranged between 0.25 and 0.40 ng, and very low dispersion was found in the sample, which did not allow correlation with other parameters. Regarding IFNgamma, we found values between < 5 pg/ml and 605 pg/ml. When we studied children under treatment with antigen-specific immunotherapy, we observed mean values of IFNgamma of 115.86 pg/ml, whereas the ones who did not follow this treatment or had followed it for less than one year had a mean of 66.06 pg/ml, these differences being significant (p = 0.035), and proving a Th1 response to immunotherapy. This significance is not found if children who have been under immunotherapy for less than one year are included. When we studied children with bacterial immunotherapy, we found that the mean IFNgamma value in children under immunotherapy for longer than one year was 56.4 pg/ml, whereas in children with no immunotherapy it was 101.75 pg/ml (p = 0.034). We conclude that bacterial immunotherapy modifies the Thl response, inhibiting it in those children with greater susceptibility to infections.

Allergy to pine nut.

BACKGROUND: food allergy is highly prevalent in our environment, especially among atopic patients. Pinus pinea is common in our region and its fruit, the pine nut, is allergologically important. Several cases have been reported in the literature that demonstrate the existence of common antigenic bands between pine nut and almond. In this study we try to assess this finding and the possible existence of common allergens by in vitro techniques. METHODS AND RESULTS: we present a 10-year-old boy, previously diagnosed of seasonal rhinoconjunctivitis with sensitisation to grass and olive pollen, who had an anaphylactic reaction after eating pine nut. We performed in vivo (prick test, prick-by-prick) and in vitro tests (total and specific IgE determinations [CAP-FEIA]), histamine release test, and immunoblotting (SDS-PAGE). We also reviewed the literature through the MEDLINE database in PubMed. CONCLUSIONS: because pine nut is commonly consumed in our environment, the prevalence of allergic reactions is probably considerable and these reactions take place at an early age. We demonstrate the existence of common antigenic proteins between pine nut and peanuts.

Schnitzler syndrome: a case study.

Schnitzler syndrome is a clinical entity of unknown etiopathogenesis and is an unusual cause of chronic urticaria. It is characterized by the presentation of a monoclonal band, especially IgM, as well as fever, asthenia and arthralgia. We present the case of a 48-year-old man with 5 years of recurrent urticarial lesions, slight itching, as well as lip, face and occasional pharyngeal edema. The patient had also suffered from fever and right hip and left knee arthralgia. The protein electrophoresis and the immunoelectrophoresis presented an IgG band and a slight lambda band, which is suggestive of a monoclonal gammopathy. The bone marrow examination showed a slight increase in the lymphoplasmatic cells. The marrow biopsy was negative. In order to rule out tumorous, infectious and rheumatic processes as well as collagen diseases, other complementary examinations were performed with negative results. The diagnosis of Schnitzler syndrome as a cause of chronic urticaria requires a thorough study in order to rule out other systemic processes provoking the same symptoms.

Risk factors for latex sensitization among health care workers.

Health care workers, children with spina bifida and rubber industry workers show higher prevalence of latex sensitization compared to the general population, and they are considered at-risk groups. Our aim was to establish the prevalence of latex allergy among health care workers at the Clínica Universitaria of Navarra and to analyze potential risk factors, including personal and family history of atopy, sex, as well as factors leading to enhanced exposure to latex, such as being a nurse, belonging to surgical departments, having undergone previous surgery and the number of gloves employed per week. Health care workers (n = 1,150) (doctors, nurses, assistant nurses, laboratory technicians and practicing medical and nursing students) were evaluated using a questionnaire and skin prick test (SPT). Serum specific IgE was determined by CAP-FEIA (Pharmacia, Sweden) in those with positive SPT. The participation index was 26.17%: 301 volunteers answered the questionnaire and underwent SPT. Fifteen subjects presented positive SPT to latex. It was found that 5% of the health care workers from the Clínica Universitaria were sensitized to latex allergens. Thirteen were females and two males. Mean age was 38.4 (+/- 7.09) years. Nine were nurses, three assistant nurses, one nursing student and two medical doctors. Eight belonged to medical, five to surgical and two to laboratory departments. There were no significant differences among the subjects in the prevalence of latex sensitization. Fourteen reported symptoms related to latex, mostly pruritus, dryness and/or redness of the hands (n = 12) and rhinitis (n = 6). Only one subject reported no symptoms when using latex products. Eight were atopic; personal history of atopy was the only significant (odds ratio = 5.10, p < 0.01) risk factor for latex sensitization. It was concluded that atopic health care workers show a more increased risk of latex sensitization than those who are nonatopic.

Protective effect of R(-)-1-(benzo[b]thiophen-5-yl)- 2-[2-(N,N-diethylamino)ethoxy]ethanol hydrochloride (T-588), a novel cerebral activator, against experimental cerebral anoxia.

Effects of R(-)-1-(benzo[b]thiophen-5-yl)-2-[2- (N,N-diethylamino)ethoxy]ethanol hydrochloride (T-588) on normobaric hypoxia, histotoxic anoxia by KCN and complete ischemia by decapitation were investigated in mice. T-588 (30-100 mg/kg, p.o.) showed a significant and dose-dependent prolongation of the survival time in all of the models studied. Bifemelane (100-300 mg/kg, p.o.) was also protective against all the models. Tacrine was protective against hypoxia but had no effect on anoxia and ischemia. Imipramine was protective against anoxia, but shortened the survival time of hypoxic mice. It had no effect on ischemia. The anti-hypoxic effect of T-588 was completely inhibited by pretreatment with scopolamine (1 mg/kg, i.p.), while the anti-anoxic effect was partially inhibited. Its effect on the ischemia was not affected by scopolamine. Hypoxia decreased the cerebral contents of ATP, phosphocreatine and glucose and increased the contents of lactate in mice. T-588 had no effect on these changes. Bifemelane prolonged pentobarbital-induced sleeping time in mice with the doses inducing anti-anoxic action, but T-588 did not. These results suggest that the activation of the CNS cholinergic system is involved as one of the mechanisms for the anti-anoxic action of T-588.