Changes in Indocyanine Green Lymphography Patterns after Physical Treatment in Secondary Upper Limb Lymphedema

Indocyanine green (ICG) lymphography is used to evaluate the lymphatic function before and after pneumatic compression or post-manual lymphatic drainage. The aim of this study was to ascertain the changes in the fluoroscopic pattern produced by the provision of complex physical therapy. This prospective analytic (pretest-posttest) study was conducted in 19 patients with upper lymphedema secondary to breast cancer. Nine patients were excluded due to ICG found after 3 weeks. The ICG patterns were analyzed under basal conditions and after three weeks of treatment. After the treatment, 45% of the patients presented tracer remains in the affected limb, and this finding was significantly related to time of the lymphedema development. In one subject, the patterns remain unchanged or cannot be defined. Three of the ten patients observed present the worsening of at least 1 of the patterns and in the rest of the subjects, six cases, the improvement of the patterns is observed. In 60% of the cases, the most severe pattern reversed towards slight (splash) cases, and moderate cases reversed towards a slight case in 70% of cases. Therefore, after treatment with complex physical therapy, the pathological patterns observed in the pretest, which evolved positively, reverted their severity toward milder disease patterns or towards normalit

Inclusive design in the field of education from the paradigm of early intervention

Inclusive education and early intervention go hand in hand in the early educational stages to reach the maximum potential of the student body. The aim of this study was to analyze the inclusive profile of an educational center and assess the effectiveness of an inclusive task (designed for this study) in a group of students of early childhood education. This analytical, prospective, descriptive and longitudinal study was conducted from both qualitative and quantitative approaches. From the qualitative approach, an interview was carried out with early childhood education teachers. A total of nine participants were interviewed. Their mean age was 42.25 ± 9.30 years, with a mean experience of 14.25 ± 9.25 years. The quantitative part of the study was carried out with 97 students of early childhood education. After delivering a learning workshop about awareness of functional diversity, three variables were analyzed: story memory, demonstrated emotion, and game memory. The qualitative study indicates that it is necessary to develop coping strategies, such as including special education tasks in the classroom, prior to specific staff training and programming in specific aspects of awareness. Moreover, it is shown that the perception of treatment among peers is already present at this educational stage. The quantitative study reveals that the task was exciting and motivating for the students, which promotes learning and awareness

Effects of Training on Cardiorespiratory Fitness in Triathletes: A Systematic Review and Meta-Analysis

Triathlon is an aerobic sport, which is commonly measured by maximal aerobic consumption (VO2max). Objective: to analyze the changes produced in cardiorespiratory and physiological measurements during practice, which determine triathletes’ performance level. A systematic review and a meta-analysis based on PRISMA protocol and registered in PROSPERO (CRD42020189076) was conducted. The research was performed using PubMed, SPORTDiscus, Embase, Dialnet, Web of Science (WOS) and MEDLINE databases during February and March 2020. Studies that measured cardiorespiratory variables in triathletes published in the last 10 years were included. Results: 713 articles were identified, with 25 studies selected for the systematic review and five articles for the meta-analysis. These articles concluded that the main cardiorespiratory variables that determine triathletes’ performance were modified depending on the triathlon segment performed and the athletes’ sex and age. The meta-analysis showed no conclusive results related to the effects of changes in VO2max in triathletes’ performance [SMD = −0.21; 95%CI: (−0.84 to 0.43)]. Conclusions: cardiorespiratory fitness, in terms of VO2max and ventilatory thresholds, is the strongest predictor of performance in triathlon. This response may be affected depending on the triathlon segment performed and the athlete’s age or sex, leading to both physiological and biomechanical alterations that affect competition performance.This research received partial funding by the University of Malaga and the Department of Nursing and Physiotherapy (University of Cadiz). Partial funding for open access charge: Universidad de Málaga

Eficacia terapéutica de la diatermia capacitiva monopolar mediante radiofrecuencia en la disminución de la paniculopatía fibroedematoesclerótica y perímetros corporales

Premio Extraordinario de Doctorado U

The Effects of Mind–Body Exercises on Chronic Spinal Pain Outcomes: A Synthesis Based on 72 Meta-Analyses

An umbrella review of systematic reviews with a meta-analysis was developed to summarize the evidence on the effectiveness of qigong, tai chi, and yoga in chronic spinal pain outcomes. The CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and SPORTDiscus databases were searched. Pain, psychological factors, and quality of life (QOL) were the outcomes of interest. The methodological quality of the reviews was evaluated using the AMSTAR-2 tool. The overlap was calculated using the corrected covered area. A total of 72 meta-analyses drawn from 20 systematic reviews were included and often were rated at a critically low quality. The effects of qigong on chronic low back and neck pain (CLBP and CNP, respectively) were inconsistent, although it improved the physical component of QOL after 12 weeks for CNP. Tai chi was superior to the controls in reducing CLBP; no reviews of interest were found on CNP. Yoga was superior to multiple controls in reducing CLBP, but no relevant effects on depression or QOL were found. QOL, anxiety, depression, and general mood improved with yoga for CNP. Inconsistencies arose related to yoga and CNP. Our findings mainly supported the potential effects of yoga and tai chi on pain-related outcomes, psychological factors, and QOL in populations with CLBP and NP. Clinical and methodological considerations were discussed

Visualization of Accessory Lymphatic Pathways, before and after Manual Drainage, in Secondary Upper Limb Lymphedema Using Indocyanine Green Lymphography

Manual Lymphatic Drainage (MLD) appears to stimulate lymphatic contraction, aid in the development of secondary derivation pathways, and stimulate the appearance of collateral pathways that could function as the main drainage routes of the limb in case of lymphedema. Through stretching, call up maneuvers are used to stimulate lymphangion reflex contraction and, therefore, lymphatic function. The aim was to describe the presence of areas and pathways of collateral lymphatic drainage under basal conditions and to determine, using Indocyanine Green (ICG) lymphography, whether an increase in these pathways occurs after 30 min of manual lymphatic stimulation with only call up maneuvers according to the Leduc Method®®. In this prospective analytical study (pretest–posttest), the frequency of presentation of areas and collateral lymphatic pathways was analyzed in 19 patients with secondary lymphedema of the upper limb after breast cancer using an infrared camera. Analyses were completed at three time points: after ICG injection, at baseline (pretest), and after the application of MLD (post-test). The Leduc Method maneuvers were applied to the supraclavicular and axillary nodes, chest, back, Mascagni, and Caplan pathways. The areas visualized in the pretest continued to be visible in the posttest. Additional pathways and fluorescent areas were observed after the maneuvers. The McNemar test showed statistical significance (p = 0.008), the odds ratio was infinite, and the Cohen’s g value was equal to 0.5. Manual stimulation by call up maneuvers increased the observation frequency of areas and collateral lymphatic pathways. Therefore, ICG lymphography appears to be a useful tool for bringing out the routes of collateral bypass in secondary lymphoedema after cancer treatment

Diseño e implementación de un sistema de apoyo a la valoración clínica del glaucoma basado en seguimiento de la mirada

Las tecnologías de seguimiento de la mirada o eye tracking (ET) se han consolidado como herramientas de gran potencial en el campo de la ingeniería biomédica. En este trabajo se propone la utilización de la tecnología ET como herramienta de apoyo a la valoración clínica del glaucoma. Así, se presenta un estudio comparativo entre los patrones de mirada de individuos sanos y pacientes con glaucoma al realizar tareas basadas en la observación de imágenes. En el trabajo se han desarrollado dos tareas que deben realizar los participantes del estudio. La primera de ellas consiste en la observación libre de imágenes mientras que la segunda se basa en la búsqueda de elementos. El experimento se ha llevado a cabo en el Servicio de Oftalmología del Hospital Clínico San Carlos de Madrid y ha involucrado a 55 personas. Los resultados sugieren que la tecnología ET tiene un enorme potencial como herramienta para detectar diferencias entre individuos sanos y afectados por la patología. Sin embargo, son necesarios nuevos estudios para validar estadísticamente esta suposición

Desarrollo de un entorno virtual para la valoración clínica del glaucoma

El glaucoma es una enfermedad neurodegenerativa caracterizada por la degeneración lenta y progresiva de las células ganglionares de la retina. Aunque el campo visual central es relativamente resistente a la degeneración que produce esta enfermedad, el campo periférico es muy susceptible a sufrir daño, viéndose significativamente reducido en pacientes con glaucoma desarrollado. Este trabajo de investigación presenta un entorno virtual que permite la evaluación objetiva del campo visual, para lo que se emplean técnicas de seguimiento de mirada. Una prueba de concepto con 57 personas (34 pacientes con glaucoma y 23 de control) ha permitido validar la viabilidad de emplear la tecnología de seguimiento de mirada para dicho objetivo

Diseño e implementación de un sistema de apoyo a la valoración clínica del glaucoma basado en seguimiento de la mirada

Las tecnologías de seguimiento de la mirada o eye tracking (ET) se han consolidado como herramientas de gran potencial en el campo de la ingeniería biomédica. En este trabajo se propone la utilización de la tecnología ET como herramienta de apoyo a la valoración clínica del glaucoma. Así, se presenta un estudio comparativo entre los patrones de mirada de individuos sanos y pacientes con glaucoma al realizar tareas basadas en la observación de imágenes. En el trabajo se han desarrollado dos tareas que deben realizar los participantes del estudio. La primera de ellas consiste en la observación libre de imágenes mientras que la segunda se basa en la búsqueda de elementos. El experimento se ha llevado a cabo en el Servicio de Oftalmología del Hospital Clínico San Carlos de Madrid y ha involucrado a 55 personas. Los resultados sugieren que la tecnología ET tiene un enorme potencial como herramienta para detectar diferencias entre individuos sanos y afectados por la patología. Sin embargo, son necesarios nuevos estudios para validar estadísticamente esta suposición

Desarrollo de un entorno virtual para la valoración clínica del glaucoma

El glaucoma es una enfermedad neurodegenerativa caracterizada por la degeneración lenta y progresiva de las células ganglionares de la retina. Aunque el campo visual central es relativamente resistente a la degeneración que produce esta enfermedad, el campo periférico es muy susceptible a sufrir daño, viéndose significativamente reducido en pacientes con glaucoma desarrollado. Este trabajo de investigación presenta un entorno virtual que permite la evaluación objetiva del campo visual, para lo que se emplean técnicas de seguimiento de mirada. Una prueba de concepto con 57 personas (34 pacientes con glaucoma y 23 de control) ha permitido validar la viabilidad de emplear la tecnología de seguimiento de mirada para dicho objetivo