Levorphanol in the Perioperative Setting: Decreasing Opioid Requirements While Improving Pain Management.

Levorphanol is a Food and Drug Administration (FDA)-approved long-acting opioid. Most information on perioperative use of levorphanol comes from the early- and mid-1950s when this drug emerged in the field of experimental pharmacology and anesthesia. It was mainly studied during this period with some additional data being generated in the 1960s and 70s. Since this time, perioperative use has declined and research is limited. This review of literature aims to provide pharmacologic and historic description of levorphanol as a tool for perioperative pain management and as an aid to potentially decrease total postoperative opioid use during the current opioid crisis.

Controlled trial of balance training using a video game console in community-dwelling older adults.

BACKGROUND: gamification is a potentially attractive option for improving balance and reducing falls. OBJECTIVES: to assess the effect of balance training using the NintendoTM Wii game console on balance (primary outcome), falls and fear of falling. DESIGN: quasi-randomised, open-label, controlled clinical trial in parallel groups, carried out on community-dwelling patients over 70 years, able to walk independently. Participants were assigned 1:1 to the intervention or control group. Balance training was conducted using the Nintendo WiiFitTM twice a week for 3 months. Balance was assessed using the Tinetti balance test (primary outcome), the unipedal stance and the Wii balance tests at baseline, 3 months and 1 year. Falls were recorded and Fear of falling was assessed by the Falls Efficacy Scale (Short-FES-I). RESULTS: 1,016 subjects were recruited (508 in both the intervention and the control group; of whom 274 and 356 respectively completed the 3-month assessment). There was no between-group difference in the Tinetti balance test score, with a baseline mean of 14.7 (SD 1.8) in both groups, and 15.2 (1.3) at 3 months in the intervention group compared to 15.3 (1.7) in controls; the between-group difference was 0.06 (95% CI 0.30-0.41). No differences were seen in any of the other balance tests, or in incident falls. There was a reduction in the fear of falling at 3 months, but no effect at 1 year. CONCLUSIONS: the study found no effect of balance training using the NintendoTM Wii on balance or falls in older community-dwelling patients.The study protocol is available at clinicaltrials.gov under the code NCT02570178.

Densidad poblacional y estructura de talla del pepino de mar Holothuria (Halodeima) grisea (Aspidochirotida: Holothuriidae) en aguas someras del sur del golfo de Morrosquillo, Caribe Colombiano / Density population and size structure of the sea cucumber Holothuria (Halodeima) grisea (Aspidochirotida: Holothuriidae) in shallow waters south of the gulf of Morrosquillo, Colombian Caribbean

Resumen Holothuria grisea, a pesar de no ser considerado un recurso comercial, ha sido objeto de extracciones ilegales en Colombia, hecho que se vuelve más grave debido al vació de información biológica de estos organismos. Por esta razón, se estimó la densidad poblacional y estructura de talla de H. grisea en tres sectores del sur del golfo de Morrosquillo de abril a noviembre 2015. Para ello, se ubicaron mensualmente tres transectos circulares en cada sector de muestreo abarcando un área de 300 m2, donde se contabilizaron y midieron in situ los individuos encontrados. La densidad media de H. grisea en el área estudiada fue 0.4 ind m-2, presentándose los mayores valores en el sector La Ahumadera (1.09 ± 0.11 ind m-2) y los menores valores en el Banco de Arena (0.02 ± 0.004 ind m-2). El análisis de varianza señalo una diferencia significativa en los valores de densidad y talla de H. grisea en los sectores estudiados. La especie presentó una distribución de tallas unimodal, registrándose una talla promedio de 13.5 ± 0.91 cm con una talla mínima de 2.5 y una máxima de 30 cm, en general las tallas intermedias presentaron una mayor representatividad a lo largo de este estudio (77.2 %). Los aspectos biológicos presentados en este documento son de gran importancia para la conservación de esta especie y corresponde a un avance en el conocimiento de la clase Holothuroidea en el Caribe Colombiano.

Abstract Holothuria grisea, despite not being considered a commercial resource has been the subject of illegal extractions in Colombia, a fact that becomes more serious due to the empty of biological information of these organisms. For this reason the density population and size structure of H. grisea were evaluated in three sectors south of the gulf of Morrosquillo from April to November 2015. To this end, three circular transects were located each month in each sampling site covering an area of 300 m2, where individuals were counted and measured in situ. The average density of H. grisea in the study area was 0.4 ind m-2, with the highest values in the La Ahumadera (1.09 ± 0.11 ind m-2) and the lowest values in Banco de Arena (0.02 ± 0.004 ind m-2). The analysis of variance showed a significance in the values of density and size of H. grisea in the studied sectors. The species presented a unimodal distribution of sizes with an average size of 13.5 ± 0.9 cm with a minimum size of 2.5 and a maximum of 30 cm, intermediate sizes generally showed a higher representativeness throughout this study (77.2 %). The biological aspects presented in this paper are of great importance for the conservation of this species and corresponds to an advance in the knowledge of the Holothuroidea class in the Colombian Caribbean. Rev. Biol. Trop. 66(2): 776-787. Epub 2018 June 01.

Study protocol of a randomized clinical trial evaluating the effectiveness of a primary care intervention using the Nintendo™ Wii console to improve balance and decrease falls in the elderly.

BACKGROUND: Balance alteration is a risk factor for falls in elderly individuals that has physical, psychological and economic consequences. The objectives of this study are to evaluate the usefulness of an intervention utilizing the Nintendo™ Wii console in order to improve balance, thereby decreasing both the fear of falling as well as the number of falls, and to evaluate the correlation between balance as determined by the console and the value obtained in the Tinetti tests and the one foot stationary test. METHODS/DESIGN: This is a controlled, randomized clinical trial of individual assignment, carried out on patients over 70 years in age, from five primary care centers in the city of Mataró (Barcelona). 380 patients were necessary for the intervention group that carried out the balance board exercises in 2 sessions per week for a 3 month period, and 380 patients in the control group who carried out their usual habits. Balance was evaluated using the Tinetti test, the one foot stationary test and with the console, at the start of the study, at the end of the intervention (3 months) and one year later. Quarterly telephone follow-up was also conducted to keep track of falls and their consequences. DISCUSSION: The study aimed to connect the community with a technology that may be an easy and fun way to assist the elderly in improving their balance without the need to leave home or join rehabilitation groups, offering greater comfort for this population and decreasing healthcare costs since there is no need for specialized personnel. TRIAL REGISTRATION: Current Control Trial NCT02570178.

Revisión teórica del concepto de victimización secundaria / Theoretical review of the concept of secondary victimization

En el presente artículo se hace una revisión teórica sobre el concepto de victimización secundaria. Esta revisión hace parte de la línea de Investigación en procesos de Victimización Secundaria de la Universidad Cooperativa de Colombia, facultad de psicología, y corresponde a la primera etapa del proyecto “Efectos Psicológicos de la Victimización secundaria durante la etapa de Denuncia”. La Victimización secundaria hace referencia a la mala o inadecuada atención que recibe una víctima por parte del sistema penal, e instituciones de salud, policía, entre otros (Garcia-Pablos, 1993; Campbell, 2005). Este fenómeno, pese a los efectos perjudiciales que ocasiona en las víctimas, no es un tema de debate y atención especial, que podría prevenirse o reducirse con medidas simples a nivel social, político, económico y psicológico.

This article is a review on the theoretical concept of secondary victimization. This review is part of the line research on Secondary Victimization Processes of the Cooperative University of Colombia, Psychology Faculty, and it falls within the first phase of the project "Psychological Effects of Secondary Victimization during the Complaint." The Secondary Victimization refers to poor or inadequate attention received by a victim from the Criminal Justice system, Health Institutions and others (Garcia-Pablos, 1988; 1993). This phenomenon, despite the adverse effects caused on the victims, is not a subject of debate and attention, which could be prevented or reduced with simple measures at social, political, economic and psychological level.

Efectividad de una Intervención Educativa en Pacientes con Artritis Reumatoide. Hospital Universidad del Norte. Barranquilla. Abril-Mayo de 2005 / Effectiveness of an education program in patients with Rheumatoid Arthritis

Objetivos: determinar la efectividad de una intervención en pacientes con Artritis Reumatoide que asisten a la consulta externa del Hospital Universidad del Norte (HUN) de la ciudad de Barranquilla. Materiales y Métodos: estudio cuasi experimental de antes -después, que consistió en el diseño, aplicación y evaluación de una intervención educativa. La población objeto de estudio fue de diecinueve pacientes que asistían a la consulta reumatológica del HUN y cumplieron con los criterios de inclusión y exclusión. La intervención tuvo una duración total de nueve horas y en ella se manejaron aspectos relevantes sobre la enfermedad, haciendo énfasis en el automanejo. La información fue recolectada antes de la intervención y después de esta, mediante la aplicación de test autodiligenciados destinados a evaluar cada una de las variables de estudio, tales como: conocimiento acerca de la enfermedad, calidad de vida, dolor, estado general de salud y categorizó la población por variables sociodemográficas y características de la enfermedad. Resultados: el 89,5 por ciento de los pacientes eran mujeres, con una media de edad de 53,1 1 años más o menos 18,21. La duración de la artritis fue de 4,68 años más o menos 3,36. Se encontró asociación significativa entre la intervención educativa y mejoría en el conocimiento acerca de la enfermedad (p = 0,00), función física (p = 0,05) y rol físico (p = 0,018). No se encontró asociación significativa entre la intervención y la mejoría del dolor, estado general de salud y estado funcional de la persona. Conclusiones: la educación mejora el conocimiento acerca de la enfermedad, la función física...