Aspectos epidemiológicos del dolor en pacientes con cefalea tensional

Fundamento. La cefalea tensional es la más prevalente de las cefaleas primarias tanto en atención primaria, como en medicina del trabajo o en las consultas de neurología, con importantes repercusiones en la calidad de vida de los pacientes. Para efectuar un tratamiento de fisioterapia, es necesario conocer las características de la cefalea y su posible etiología, valorar los aspectos que pueden ser modificados, seleccionando así el más eficaz. El objetivo es analizar los aspectos epidemiológicos de la cefalea tensional en una muestra de pacientes, características de su dolor, diferencias sociodemográficas observadas e intensidad de sus crisis de dolor. Métodos. La muestra está formada por 84 pacientes diagnosticados de cefalea tensional, de entre 18-65 años, evaluados mediante entrevista clínica estructurada. No-validada, con selección previa y participación voluntaria. Resultados y Conclusiones. De los 84 pacientes, todos ellos cumplieron los criterios de inclusión y respondieron a la entrevista, el 81% eran mujeres con edad media de 39,76 años (dt 11,38). El 36,9% siente dolor en la zona occipital, el 35,7% en la zona interparietal y el 27,4% en la región frontal. El 97,6% padecían dolor bilateralmente, el 81% refirieron dolor no pulsátil, y de severidad media a moderada el 92,9%. En el 71,4% el dolor no aumentaba con la actividad física. La intensidad media del dolor fue de 6,49 (dt 1,69). La mitad de los pacientes refirieron que el dolor se desencadena por la tos, al sonarse, al esfuerzo, o con la ingesta de alcohol. El mayor factor de agravación es el estrés (70,2%), aliviándoles la relajación en el 50% de los casos. La cefalea tensional es más frecuente en las mujeres, con edades en torno a los 40 años y con antecedentes familiares de cefaleas primarias. El dolor es de características holocraneales por lo general, aunque con predominio de irradiación en la zona occipital e interparietal, afectan con intensidad media, se agravan por el estrés, y se alivian con las técnicas de relajación y con el sueño.Background. Tension-type headache is the most prevalent type of primary headaches, both in primary health care and occupational medicine or in neurology consultations, with important repercussions on patients’ quality of life. To carry out a physiotherapy treatment, it is necessary to know the characteristics of the headache and its probable etiology, and take into account the aspects that can be modified, in order to choose the most effective treatment. The objective is to analyse the epidemiological aspects of tension-type headache in a sample of patients, characteristics of their pain, observed socio-demographic differences and intensity of their pain crises. Methods. The sample is made up of 84 patients diagnosed with tension-type headache, assessed through structured clinical interview. Not validated, with previous selection and voluntary participation. Results and Conclusions. Out of 84 patients, all of them met the inclusion criteria and replied to the interview), 81% were women, with mean age of 39,76 years (sd 11,38); 36,9% feeling pain in the occipital region, 35,7% in the interparietal area and 27.4% in the frontal region. 97,6% suffered from bilateral pain, 81% described non-throbbing pain, and 92,9% related pain of medium to moderate severity. In 71,4% of cases pain did not increase with physical activity. The average intensity of pain was 6,49 (sd 1,69). Half the patients related that the pain was triggered off by cough, during exertion and when blowing their nose, or with alcohol intake. The biggest aggravation factor was stress (70,2%), and patients were relieved by relaxation techniques in 50% of cases. Tension-type headache is more frequent in women, with approximate mean age of 40 years and with history of primary headaches in their family. The generalised characteristics of the pain affect with medium intensity pain to the whole head, with more predominance in interparietal and occipital regions, gets worse with stress and is relieved by relaxation and sleep

Numerical analysis of the vibrational behavior of the moving assembly of a dynamic loudspeaker

En este trabajo se describe el proceso llevado a cabo para analizar numéricamente mediante el método de los elementos finitos (MEF) el comportamiento vibratorio del conjunto móvil de un altavoz dinámico de bobina con doble suspensión inferior y en ausencia de la superior. El estudio se centra en el rango de baja frecuencia. El calibrado del modelo se realiza en base a medidas experimentales de la frecuencia de resonancia y desplazamiento del diafragma. Se hace énfasis en la importancia de los factores de participación asociados a la fuerza de excitación y en los cambios que se producen en estos al introducir fuerzas no equilibradas. Así mismo, el análisis proporciona datos para decidir sobre la distancia entre suspensiones, su número óptimo de pliegues y la ubicación de las trencillas, siendo estos parámetros de gran interés en el diseño de este tipo de altavoces.This paper describes the process undertaken to analyze numerically the vibrational behavior of the moving assembly of a dynamic loudspeaker with double bottom suspension and in the absence of the above one using the finite element method (FEM). The study focuses on the low frequency range. Model calibration was performed based on experimental measurements of the resonance frequency and diaphragm displacement. The importance of the participation factors associated to the excitation force and the changes produced in these when unbalanced forces are introduced are emphasized. The analysis also provides data to decide on the distance between suspensions, their optimal number of folds and the placement of the lead wires, parameters of great interest on the design of this type of loudspeakers.Peer Reviewe

Amphiphilic Gemini Pyridinium-mediated incorporation of Zn(II)meso-tetrakis(4-carboxyphenyl)porphyrin into water-soluble gold nanoparticles for photodynamic therapy

Zn-containing porphyrins are intensely investigated for their ability to form reactive oxygen species and thereby being potent photosensitizers for use in photodynamic therapy (PDT). Some of the drawbacks of the PDT approach, such as unspecific distribution, could be addressed by means of photosensitizer drug delivery systems. In this work, we synthesize and characterize new water-soluble gold nanoparticles (GNP) stabilized by a mixture of a polyethyleneglycol-containing thiol (to improve water solubility) and a new amphiphilic gemini-type pyridinium salt, which also acts as promotor of the incorporation of the anionic photosensitizer Na-ZnTCPP into the GNP. The obtained GNP have sizes between 7 and 10 nm, as observed by Transmission Electron Microscopy. The incorporation of the photosensitizer caused an increase in the hydrodynamic size, detected by Dynamic Light Scattering, as well as a shift in the Surface Plasmon Resonance peak on the GNP UV–vis absorption spectra. The presence of the photosensitizer in the GNP was corroborated using Fluorescence Spectroscopy. The amount of Na-ZnTCPP was found to be 327 molecules per GNP. The porphyrin-containing Na-ZnTCPP-1·GNP showed good enhanced ability to produce singlet oxygen, compared to free Na-ZnTCPP. Their cytotoxicity and phototoxicity were investigated in vitro using two different human breast cell lines, one of tumoral origin (SKBR-3) and another of normal epithelium origin (MCF-10A). SKBR-3 cells showed higher sensitivity to Na-ZnTCCP and Na-ZnTCPP-1·GNP in dark conditions. After irradiation, no significant differences were observed between both cell lines except for 1 μM Na-ZnTCCP-1·GNP where SKBR-3 cells were also more sensitive

Estudio de calidad de vida de pacientes con coxartrosis

La artroplastia de cadera secundaria a artrosis es una de las intervenciones más frecuentes dentro de la cirugía ortopédica. La coxartrosis produce una limitación funcional severa, que invalida a los pacientes y los hace dependientes para sus actividades cotidianas. Se calcula la calidad de vida aportada en las intervenciones de reemplazo articular de cadera de 85 pacientes con coxartrosis utilizando el “EQ-5D”. La puntuación media preoperatoria fue 0,222 ± 0,320 y la postoperatoria 0,794 ± 0,251. El incremento de calidad de vida en función de la edad de los pacientes siguió una tendencia descendente (β= −0,010), sin diferencias significativas (p=0,214). El incremento de calidad de vida no se vió condicionado por la presencia de infección (p>0,5), duración de la intervención (p>0,5) ni tiempo de estancia hospitalaria (p>0,5). La sustitución de esta articulación ha transformado la vida de muchos de los pacientes incrementando su calidad de vida, principalmente en pacientes que ingresan por coxartrosis en comparación con otros diagnósticos.Hip replacement secondary to osteoarthritis is one of the most performed surgeries in orthopaedic surgery. Osteoarthritis produces a severe functional limitation that invalidates patients and makes them dependent for their daily activities. It is calculated the quality of life provided by hip replacement procedure in 85 osteoarthritis patients using the “EQ-5D”. The mean preoperative score was 0.222 ± 0.320 and the postoperative score 0.794 ± 0.251. The increase in quality of life according to patients age followed a descendent tendency (β= −0.010), without a statitically relationship (p=0.214). The increase in quality of life was not conditioned by infection (p>0.5), length of stay (p>0.5) or length of the procedure (p>0.5). Joint replacement has changed the lives of many patients, increasing their quality of life, mainly in osteoarthritis patients compared to patients with other diagnosis

Bases para el ordenamiento territorial y ambiental de La Oroya - Junín - Perú

This study focuses on the production of a geotechnical map and a landslide hazard map in La Oroya district (Junín region in Perú), as a basis for land use planning. The method applied regards the analysis of the physical environment with a Geographic Information System (GIS) with layer (spatially referenced database) algebra. The results obtained show that this kind of maps represent a start point for land use and environmental planning, as they provide a reliable overview of where to carry out further studies (e.g. environment of Curipata) and which are the main advantages and disadvantages of the territory regarding geotechnics and landslides (the major natural hazard observed in the study area). The logical next study to carry out in the area after this survey should focus on obtaining maps of the other natural hazards that have been observed in the region (seismic and flood hazard maps), allowing to start examining other aspects and their relation with the natural environment, which is the basis for land use planning.El presente trabajo centra su estudio en el distrito La Oroya (región de Junín, en Perú), y ha consistido en la elaboración de los mapas de viabilidad geotécnica y de peligrosidad por movimientos de ladera y un análisis del medio físico como una base a considerar en los estudios de ordenamiento territorial y ambiental. La metodología empleada consiste en el análisis del medio físico empleando un Sistema de Información Geográfica (SIG) mediante álgebra de capas (bases de datos espaciales). Los resultados obtenidos ponen de manifiesto que esta cartografía constituye un punto de partida para los estudios de ordenamiento territorial y ambiental del territorio de la Oroya, ya que dan una idea bastante aproximada sobre dónde desarrollar futuros estudios (proximidades de Curipata) y cuáles serán algunas de las principales ventajas e inconvenientes del territorio en lo que se refiere a la viabilidad geotécnica y a uno de los principales peligros naturales observados en la región (los movimientos del terreno). La continuación lógica de este trabajo debería centrarse en la obtención de mapas de otros peligros naturales observados en la zona de estudio (peligrosidad sísmica y peligrosidad por avenidas e inundaciones), lo que daría pie a la realización de estudios de otros aspectos y su relación con el medio, lo que constituye la base del ordenamiento territorial y ambiental

Relationship between time from symptom''s onset to diagnosis and prognosis in patients with symptomatic colorectal cancer

BACKGROUND: Controversy exists regarding the relationship of the outcome of patients with colorectal cancer (CRC) with the time from symptom onset to diagnosis. The aim of this study is to investigate this association, with the assumption that this relationship was nonlinear and with adjustment for multiple confounders, such as tumor grade, symptoms, or admission to an emergency department. METHODS: This multicenter study with prospective follow-up was performed in five regions of Spain from 2010 to 2012. Symptomatic cases of incident CRC from a previous study were examined. At the time of diagnosis, each patient was interviewed, and the associated hospital and clinical records were reviewed. During follow-up, the clinical records were reviewed again to assess survival. Cox survival analysis with a restricted cubic spline was used to model overall and CRC-specific survival, with adjustment for variables related to the patient, health service, and tumor. RESULTS: A total of 795 patients had symptomatic CRC and 769 of them had complete data on diagnostic delay and survival. Univariate analysis indicated a lower HR for death in patients who had diagnostic intervals less than 4.2 months. However, after adjustment for variables related to the patient, tumor, and utilized health service, there was no relationship of the diagnostic delay with survival of patients with colon and rectal cancer, colon cancer alone, or rectal cancer alone. Cubic spline analysis indicated an inverse association of the diagnostic delay with 5-year survival. However, this association was not statistically significant. CONCLUSIONS: Our results indicated that the duration of diagnostic delay had no significant effect on the outcome of patients with CRC. We suggest that the most important determinant of the duration of diagnostic delay is the biological profile of the tumor. However, it remains the responsibility of community health centers and authorities to minimize diagnostic delays in patients with CRC and to implement initiatives that improve early diagnosis and provide better outcomes. © 2022. The Author(s)

El cuento motor como recurso didáctico provocativo para fomentar la cooperación y la empatía.

Este artículo trata sobre el uso de un cuento motor, creado ex profeso de forma colaborativa por profesorado de Educación Física de Primaria y Educación Superior. La experiencia pedagógica tiene como propósito desarrollar la compasión y la empatía del alumnado hacia la inclusión mediante la cooperación en diferentes retos propuestos. El cuento motor se implementó en dos grupos de 3º de Primaria de dos centros públicos diferentes y, de forma complementaria, en dos jornadas destinadas a la formación de profesorado. La recogida de datos se realizó sobre todo mediante diarios de observación, la grabación de las dos sesiones en Primaria y un grupo de discusión posterior al visionado de la experiencia. Los resultados abogan por preparar concienzudamente la actividad, mostrar una buena actitud y dedicar tiempo a la reflexión. Asimismo, durante el cuento afloraron emociones como la empatía y la compasión hacía las personas con diversidad funcional, pero también acabaron produciéndose situaciones de 'superempatía' y de 'cooperación impuesta'. This article deals with the use of a motor story, created ex profeso collaboratively by teachers of Physical Education of Primary and Higher Education. The purpose aims to develop compassion and empathy of students towards inclusion through the cooperation in different challenges proposed. The motor story was implemented in two groups of 3rd Primary from two different public schools and, in a complementary way, in two events aimed at teacher training. The data collection was done especially through observation diaries, recording of the two sessions in primary school, and a discussion group. Results show the need to properly prepare the activity, the attitude of the person who narrates it and add a time dedicated to reflection. Motor story brought out emotions such as empathy and compassion towards people with functional diversity, but also ended up producing situations of 'superempathy' and 'imposed cooperation'