Can we use the questionnaire SNOT-22 as a predictor for the indication of surgical treatment in chronic rhinosinusitis?

Introduction: Chronic rhinosinusitis is a prevalent disease that has a negative impact on the lives of sufferers. SNOT-22 is considered the most appropriate questionnaire for assessing the quality of life of these patients and a very effective method of evaluating therapeutic interventionshowever it is not used as a tool for decision -making. Objective: To test the hypothesis that the SNOT-22 score can predict the outcome of surgical treatment. Methods: A retrospective, longitudinal and analytical study. We evaluated the medical records of patients with chronic rhinosinusitis that completed the SNOT-22 at the time of diagnosis. All the patients were consecutively receiving care at an otolaryngology service in Salvador, Bahia from August 2011 to June 2012. The outcomes of the surgical treatment of these patients were obtained from their medical records. The initial score was compared to a group of patients who were not referred for surgery. All the patients completed and signed a consent form. Results: Of the 88 patients with chronic rhinosinusitis, 26 had evolved to surgery over the last 3 years. The groups were homogeneous regarding gender and respiratory and medication allergies. The patients of the surgical group were 44.8 + 13.8 years old and the patients of the clinical group were 38.2 + 12.5 years old (p = 0.517). The average SNOT-22 score of the case group was 49 + 19 and the average score of the control group was 49 + 27 (p = 0.927). Conclusion: The SNOT-22 was unable to predict the outcome of surgical patients with chronic rhinosinusitis. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Escola Bahiana Med & Saude Publ Bahiana, Programa Posgrad, Salvador, BA, BrazilUniv Fed Bahia UFBA, Salvador, BA, BrazilInst Otorrinolaringol Otorrinos Associados INOOA, Salvador, BA, BrazilSanta Casa Sao Paulo, Otorrinolaringol, Sao Paulo, SP, BrazilUniv Porto, Bioet, Oporto, PortugalUniv Fed Sao Paulo UNIFESP, Programa Posgrad Otorrinolaringol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Programa Posgrad Otorrinolaringol, Sao Paulo, SP, BrazilWeb of Scienc

Vertical Jumping as a Monitoring Tool in Endurance Runners: A Brief Review

Jumping performance (e.g., countermovement jump [CMJ]), as a measure of neuromuscular performance, has been suggested as an easy-to-use tool which simultaneously provides neuromuscular and metabolic information and, thereby, allows coaches to confidently monitor the status of their athletes during a workout. This hypothesis has been satisfactorily tested with sprint athletes. However, the rationale for the use of CMJ height loss as an index to monitor the workload during an endurance running session is not sufficiently evidence-based. First, it is assumed that a CMJ height loss occurs during typical interval training for endurance runners. Second, it is also assumed that a significant relationship between metabolic stress and the neuromuscular strain induced during these endurance workouts exists. These two assumptions will be questioned in this review by critically analyzing the kinetics of CMJ performance during and after running workouts, and the relationship between neuromuscular and physiological stress induced during different protocols in endurance runners. The current evidence shows that fatigue induced by common running workouts for endurance runners does not counterbalance the potentiation effect in the CMJ height. Additionally, the findings reported among different studies are consistent regarding the lack of association between CMJ height loss and physiological stress during interval sessions in endurance runners. In practical terms, the authors suggest that this marker of neuromuscular fatigue may not be used to regulate the external training load during running workouts in endurance runners. Nevertheless, the analysis of CMJ height during running workouts may serve to monitor chronic adaptations to training in endurance runners

La empatía como variable moderadora entre la victimización criminal y las actitudes hacia la población carcelaria en universitarios de Trujillo

La presente investigación tuvo como objetivo general determinar el rol de la empatía como variable moderadora entre la relación de victimización criminal y las actitudes hacia la población carcelaria. La muestra estuvo conformada por 225 estudiantes universitarios de la ciudad de Trujillo. La investigación es de tipo aplicada, de carácter descriptiva, con enfoque cuantitativo, diseño no experimental y de corte transversal. Los instrumentos utilizados fueron el Cuestionario de empatía de Toronto, la Escala de miedo al Delito y la Escala para medir actitudes hacia los presos. El análisis de los datos se obtuvo a través de los programas Jamovi, SPSS 25 y Amos. Finalmente, los resultados obtenidos fueron que la distancia empática trabaja como variable moderadora entre la victimización criminal y las actitudes hacia los presos, así mismo se concluyó que aquellas personas víctimas de algún delito presentan actitudes negativas hacia los presos y que las personas con una adecuada empatía presentan actitudes positivas y mayor comprensión hacia los presos

Effects of Maturation on Physical Fitness Adaptations to Plyometric Drop Jump Training in Male Youth Soccer Players

The objective of this study was to compare the effects of maturation on physical fitness adaptations to a twice weekly, 7-week plyometric drop jump training program. Seventy-six young male soccer players (aged 10–16 years) participated in this randomized controlled trial. Before and after the intervention, a physical fitness test battery was applied (countermovement jump; drop jump from 20 to 40 cm; 5 multiple bounds test; 20-m sprint time; change of direction speed; 2.4-km running time-trial; 5 repetition maximum [RM] squat; and maximal kicking distance). Participants were randomly divided into an active soccer-control group (CG) with Tanner stage maturation of 1–3 (CG-early; n = 16) or Tanner stage 4–5 (CG-late; n = 22), and to plyometric drop jump training groups with Tanner stage 1–3 (plyometric jump training [PJT]-early; n = 16) or 4–5 (PJT-late; n = 22). The analysis of variance and effect size (ES) measures revealed that when compared with their age-matched controls, the PJT-early (ES = 0.39–1.58) and PJT-late (ES = 0.21–0.65) groups showed greater improvements (p < 0.05) in sprint time, 2.4-km running time-trial, change of direction speed, 5RM squat, jumping, and kicking distance. The PJT-early exceeded the PJT-late group with greater (p < 0.05) improvements in drop jump from 20 cm (ES = 1.58 vs. 0.51) and 40 cm (ES = 0.71 vs. 0.4) and kicking distance (ES = 0.95 vs. 0.65). Therefore, a 7-week plyometric drop jump training program was effective in improving physical fitness traits in both younger and older male youth soccer players, with greater jumping and kicking adaptations in the less-mature athletes

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

The development and application of EU food hygiene legislation in slaughterhouses

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Hygiene assessment system (HAS) scores: an analysis of the available data from English slaughterhouses

As control systems have developed and the implications of poor hygienic practices have become better known, the evaluation of the hygienic status of premises has become more critical. The assessment of the overall status of premises hygiene call provide useful management data indicating whether the premises are improving or whether, whilst still meeting legal requirements, they might be failing to maintain previously high standards. Since the creation, for the United Kingdom, of the meat hygiene service (MHS), one of the aims of the service was to monitor hygiene on different premises to provide a means of comparing standards and to identify and encourage improvements. This desire led to the implementation of a scoring system known as the hygiene assessment system (HAS). This paper analyses English slaughterhouses HAS scores between 1998 and 2005 outlining the main incidents throughout this period, Although rising initially, the later results displayed a clear decrease in the general hygiene scores. These revealing results coincide with the start of a new meat inspection system where, after several years of discussion, risk based inspection is finally coming to a reality within Europe. The paper considers the implications of these changes in the way hygiene standards will be monitored in the future